Vaping and Teens: What You Need to Know

By EW Emanuel, MD

The ads are alluring for any teen: Attractive young men and woman, e-cigarettes in hand, cheerfully announcing the "freedom to have a cigarette without the guilt." E-cigarette makers are pouring millions into those campaigns and they are hitting their mark. In fact, 3 million middle and high school students were "vaping" in 2015, according to the Centers for Disease Control and Prevention (CDC).

While e-cigarette industry officials tout the benefits of vaping versus traditional tobacco products such as cigarettes, make no mistake: Vaping is harmful to adolescents' health. E-cigarettes contain nicotine and other potentially toxic chemicals, and teens who use them may be more likely to start smoking tobacco.

The message from the medical establishment is clear: Kids should not do it.

E-Cigarette Exposure

E-cigarettes emerged roughly a decade ago. They are an example of what is referred to as an Electronic Nicotine Delivery System (ENDS). Other ENDS include e-pipes, vaporizers, vape pens, and hookah pens. Most e-cigarettes feature a battery-powered pipe with space for replaceable liquid cartridges. Users typically press a button to boil the liquid and produce an inhalable vapor.

Many of the same companies that manufacture traditional tobacco products created these nicotine-infused vapors to offer a less toxic alternative to smokers - especially those who wanted to quit smoking tobacco, but still enjoyed smoking.

But these companies are also targeting another demographic. Much like Joe Camel and the Marlboro Man were used to sell cigarettes to an earlier generation, today's e-cigarette makers are making vaping seem attractive to your kids. Ads often air where minors can see them, including on social media, elsewhere online, and on television. Vendors also sell them in booths at malls.

To make matters worse, the liquid cartridges come in kid-friendly flavors like cotton candy, bubble gum, and "Katy Perry cherry," and feature colors including hot pink, yellow, and lime green (In 2013-2014, the PATH Study found that 81 percent of current youth e-cigarette users cited the availability of appealing flavors as the primary reason for use).

It is estimated that seven in 10 middle- and high schoolers (more than 18 million kids) in the U.S. were exposed to e-cigarette ads in 2014. The president of the Campaign for Tobacco-Free Kids called this media blitz "as strong as anything we've ever seen," with the ads incorporating the same themes (rebellion and independence, for example) as conventional tobacco products.

The marketing and gimmicks are working. Middle- and high-school students exposed to the ads in any medium are more likely to try e-cigarettes, according to a national study published recently in the journal Pediatrics.

Long-Term Impact

E-cigarettes are too new for the longitudinal studies needed to evaluate their long-term impact. But government officials have seen enough evidence to act when it comes to e-cigarettes - as well as other ENDS - and kids. The U.S. Food and Drug Administration (FDA) banned the distribution of e-cigarettes to minors beginning in August. As of 2018, all product packages and advertisements of these newly regulated products must include: "WARNING: This product contains nicotine. Nicotine is an addictive chemical." The FDAs involvement follows earlier bans in Virginia, Maryland, and the District of Columbia, and warnings from the CDC and the American Medical Association.

These groups recognize the potential dangers of ENDS like e-cigarettes. Nicotine has been shown to be addictive and interfere with an adolescent's long-term brain development. Many e-cigarettes contain formaldehyde - found in fungicide and industrial-strength cleaners - and chemicals that may lead to severe respiratory illness if inhaled as vapor. Even kids who don't inhale the vapor are exposed to these chemicals when breathing contaminated air.

In addition, new research shows that teens who use e-cigarettes are more likely to try traditional cigarettes.

What You Can Do

Regulations alone won't stop kids from vaping. Informed and vigilant parents are needed, too. To prevent your children from falling into this unhealthy habit, treat vaping like any harmful drug:

  • Set a positive example by avoiding vaping in front of your kids.
  • Talk to your kids about vaping. For example, take advantage of an e-cigarette advertisement by discussing vaping when it airs.
  • If your child is already vaping, talk to her about it and raise the issue with her pediatrician, who may refer her to an addiction specialist.
  • If you use e-cigarettes, keep the cartridges out of the reach of small children, as many have been poisoned by the e-liquids.

These conversations may not be comfortable, but - like any conversations about unhealthy habits - they beat ignoring the problem. Don't think just because your son's bedroom smells like bubble gum - and not tobacco or some illicit drugs - that vaping is no big deal.

For more about talking to teens about smoking, vaping and nicotine addiction, our A-Z Health Topics on smoking in teens can help.