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We all know cigarettes are harmful to our health, but what about new and emerging products such as e-cigarettes and other vaping devices? We must educate ourselves about this emerging trend to protect our kids from the influence of the tobacco and vaping industries.

Learn more about these products, why they are harmful and resources to quit or provide support to youth who want to take the first step to becoming substance-free. 

What is vaping? Vaping is the act of inhaling and exhaling the aerosol (often called vapor) produced by an e-cigarette or similar battery-powered device. 

What is an e-cigarette? E-cigarettes are battery-powered vaporizers that simulate the action and sensation of smoking.

What are other names for e-cigarettes? They are also known as e-cigs, vape pens, e-hookahs, e-pipes, tanks, mods, vapes, electronic nicotine delivery systems, or ENDS, and more. Some people refer to vaping devices by their brand name such as JUUL, BO, Blu, and others.

How do e-cigarettes work? E-cigarettes contain pre-filled pods or e-liquids/e-juices the user adds to the device. E-liquids generally consist of propylene glycol, glycerin, water, nicotine, and flavorings. Many of these pods and e-liquids come in fruit and candy flavors that appeal to youth.

E-cigarettes produce an aerosol, commonly called vapor, which users inhale from the device and exhale. 

Rechargeable e-cigarettes often look like small electronic devices such as a USB stick. Common brand names are JUUL, Bo, and myblu. They frequently are sold with pre-filled cartridges or pods.

Disposable e-cigarettes often appear like actual, filter cigarettes in both shape and coloring. Common brand names include Zig Zag, Vapor4Life, V2, and White Cloud.

Many types of e-cigarettes are rechargeable, except for disposable e-cigarettes which are disposed of after the initial charge of the battery is depleted.

E-cigarettes and other vaping devices are considered either open or closed systems.  In open systems, the user adds the e-liquid (commonly referred to as e-juice). In closed systems, the user uses pre-filled cartridges or pods.  The vaping devices convert the e-liquids into an inhalable aerosol.

E-liquids/juices come in thousands of flavors including chocolate, cotton candy, fruit punch, gummy bear, banana, peach, lime, and many others. Flavors are often cited as the main reason youth try these products.

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What does the aerosol (not water vapor) in e-cigarettes contain? The aerosol can contain harmful and potentially harmful substances, including:

• Nicotine

• Ultrafine particles that can be inhaled deep into the lungs

• Flavoring such as diacetyl, a chemical linked to a serious lung disease

• Volatile organic compounds

• Cancer-causing chemicals

• Heavy metals such as nickel, tin, and lead

According to the Centers for Disease Control and Prevention, e-cigarettes are not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products. E-cigarettes have not been approved by the FDA as a smoking cessation device and additional research is needed to help understand long-term health effects of e-cigarette use.

Secondhand vape - According to the Surgeon General, the aerosol from e-cigarettes is not harmless. It can contain harmful and potentially harmful chemicals, including nicotine; ultrafine particles that can be inhaled deep into the lungs; flavoring such diacetyl, a chemical linked to a serious lung disease; volatile organic compounds such as benzene, which is found in car exhaust; and heavy metals, such as nickel, tin, and lead.

Other Harms - Due to nicotine content, e-liquids are dangerous to small children and pets. Defective e-cigarette batteries have caused fires and explosions, some of which have resulted in serious injuries.

Risks specific to Teens: 

According to the Surgeon General, because the brain isn't fully developed until the mid 20s, youth and young adults are uniquely at risk for long-term, long-lasting effects of exposing their developing brains to nicotine.

Risks include nicotine addiction, mood disorders, and permanent lowering of impulse control.  Nicotine also changes the way synapses are formed, which can harm the parts of the brain that control attention and learning.

Nicotine can also prime the adolescent brain for addiction to other substances. E-cigarette use among youth and young adults is strongly linked to the use of other tobacco products such as regular cigarettes, cigars, hookah, and smokeless tobacco.

Due to changes in the brain, quitting is harder for those who start at a young age. Prevention is key.

Many people specifically ask if e-cigarettes can be used to vape marijuana.  The answer is yes. Marijuana can be vaped in open systems that require the user to add the e-juice. Closed systems (those that use pre-filled pods) can also be altered to vape substances other than nicotine.

Regular use of marijuana during adolescence may result in: 

• Learning problems

• Memory issues

• Future use of alcohol, tobacco and other drugs

• Lower math and reading scores

• Mental health issues, such as impaired emotional development, depression, anxiety and psychotic symptoms (not knowing what is real, hallucinations and paranoia)

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THC, or tetrahydrocannabinol, is the chemical responsible for most of marijuana's psychological effects and acts much like the cannabinoid chemicals made naturally by the body, according to the National Institute on Drug Abuse (NIDA).

Youth Smoking, Vaping, and COVID-19 Research:

While much remains to be learned, an early study examining the relationship between smoking, vaping, and COVID-19 in youth was published in August 2020. The full study can be found in the Journal of Adolescent Health here and a media release can be found here.

What was studied? A diverse group of youth and young adults ages 13-24 were surveyed. Questions included ever smoking or vaping as well as past 30-day use. Regarding COVID-19, youth indicated if they had experienced symptoms, received a COVID-19 test, and/or were positively diagnosed as having COVID-19. Participants also provided demographic information and information on compliance with shelter-in-place orders.

What were key findings?

• As compared to youth who reported never vaping or smoking, youth who reported vaping, smoking, or both, were at increased risk of experiencing COVID-19 symptoms (e.g., coughing, fever, tiredness, or difficulty breathing) and were more likely to have been tested for COVID-19.

• Within youth tested for COVID-19, those who had ever vaped were five times more likely than non-users to be positively diagnosed. This increased to 6.8 times more likely to get a positive diagnosis if youth both vaped and smoked within the past 30-days.

• While smoking alone was not associated with positive COVID-19 diagnosis, this was likely due to most youth reporting either only vaping or both smoking and vaping.

What can I do if I suspect my child is at risk for vaping or is already vaping nicotine and/or marijuana (THC)?

Given the growth of marijuana use and vaping among American youth, it’s a good idea to explore your teen's views on vaping and perceptions of the risks.

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• Have conversations often. Before any talk, it helps to be able to share facts, but don’t assume that an information download to your child will translate into healthy behaviors.

• Look for good opportunities to have a discussion. You can do this when passing a vape shop, smelling marijuana on the street, seeing someone vaping on TV or in person or seeing one of the ads for vapes.

• Try to listen, rather than give a lecture. Open-ended questions can be a great way to get your child’s perspective, i.e. “I understand that some kids are vaping marijuana. What are your thoughts about it?” If you know they are already vaping marijuana, you might ask “What does vaping marijuana or THC oil do for you?” Perhaps it’s a way to fit in, handle social anxiety or address boredom. Get to the root of “why.”

• Set clear expectations. Express your understanding of the risks, but also why a person may want to vape. Share why you don’t want him/her vaping, and remember, it’s important to avoid scare tactics. Be honest.

• Teach refusal skills. It’s likely that your teen or young adult will be introduced to vaping marijuana by a friend or older sibling. It helps to rehearse what he/she will say if that happens.

• Have your loved one talk to other trusted adults who can reinforce your message. Sometimes, messages coming from your pediatrician, school counselor, favorite aunt or uncle, etc. can be more impactful.

• Model healthy behaviors. If you come home from work and discuss what a tough day it’s been while popping open a beer, pouring a glass of wine or smoking a joint, you are conveying this is how you handle stress. It’s healthier for your child — and you — if you take a walk with the dog or a bath or go for a run rather than turn to substances as stress busters.

Sources & Resources: 

Truth Initiative: https://truthinitiative.org/news/flavored-tobacco-use-among-youth-and-young-adults  

United States Surgeon General: 

https://e-cigarettes.surgeongeneral.gov/ 

National Institutes of Health: 

https://www.drugabuse.gov/publications/family-checkup/introduction 

Centers for Disease Control and Prevention:

https://www.cdc.gov/tobacco/infographics/youth

“Electronic Cigarettes and Vaping”, UCLA School of Medicine: https://www.youtube.com/watch?v=9dZS_Rniak0

For Quitting Support: 1-866-QUIT-YES

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Free helpline for parent support through Partnership for Drug-Free Kids: 1-855-DRUGFREE 

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