E-cigarettes are the most commonly used tobacco product among middle- and high-school students.
These electronic devices, also known as e-cigarettes, vapes, vape pens, personal vaporizers, e-cigars, pod systems, mods and e-hookah, are not a safe alternative to cigarette smoking.
E-cigarettes can be hard to recognize. Not all e-cigarettes look alike, and vaping is easy to hide. Here's what parents need to know.
What are e-cigarettes?
E-cigarettes produce an aerosolized liquid (vapor) that usually contains nicotine and other chemicals inhaled by the user. This is called vaping.
The liquid solution used in e-cigarettes, sometimes called vape juice or e-liquid, usually contains nicotine and other chemicals. E-cigarettes can be used to smoke or "vape"
marijuana products, herbs, waxes and oils.
Vape "juice" or e-liquid is often flavored. This makes it appealing to children and adolescents.
Parents, share this video with your teen:
What do e-cigarettes look like?
E-cigarettes can be hard to recognize. They may resemble traditional tobacco products like cigarettes, cigars, pipes, or other common gadgets like pens, flashlights, USB flash drives, fidget spinners, gaming controls, car key fobs,
smart watches and even asthma inhalers. In fact, the U.S. Food and Drug Administration issued warnings to several companies in 2022 for marketing 15 different e-cigarette products packaged to look like toys, food or cartoon characters that were likely to promote use among adolescents.
How popular are e-cigarettes?
According to a 2024 federal survey, about 1.63 million middle school and high school students use e-cigarettes. About 1 in 4 teen e‑cigarette users report daily use. Nearly 88% use flavored e-cigarettes, and fruit flavors are the most popular.
Children are exposed to e-cigarette advertising
online and on TV, in magazines and billboards. Although it is illegal for e-cigarettes to be sold to youth under age 21, they can be ordered online.
Why e-cigarettes and vaping are harmful & addictive
Nicotine side effects & future substance use
The nicotine found in most e-cigarettes is addictive and can harm brain development. The more kids vape, the harder it is for them to stop. Using nicotine in adolescence can
harm the parts of the brain that control attention, learning, mood and impulse control. Some e-cigarettes marketed as containing 0% nicotine have been found to contain nicotine.
Youth who use e-cigarettes are more likely to smoke traditional cigarettes in the future. Using nicotine in adolescence may also increase the risk for future substance use disorders.
E-liquid from e-cigarettes and refill packs
can contaminate skin, leading to nicotine poisoning. Symptoms of nicotine poisoning include vomiting, sweating, dizziness, increased heart rate, lethargy, seizures and difficulty breathing.
The most popular e-cigarettes contain highly concentrated nicotine salts that deliver much more nicotine that traditional cigarettes.
Other health harms from vaping
Beyond nicotine, the solution in e-cigarette devices and vapor contains harmful chemicals like
antifreeze (made from one of two chemicals: propylene glycol or ethylene glycol), diethylene glycol and aldehydes (like formaldehyde). Formaldehyde is ranked as one of the top cardiovascular toxins also found in cigarette smoke.
"E-juice" may also contain cancer-causing chemicals, heavy metals and ultrafine particles that can get deep into the lungs.
Secondhand smoke/vapor from e-cigarettes is harmful to growing lungs. In fact, studies show long-term effects on lung health, function and development.
In some cases, e-cigarette devices have
exploded, causing burns or fires.
Vaping & lung injury: what is EVALI?
In 2019, the U.S. Centers for Disease Control & Prevention began looking into an
outbreak of e-cigarette, or vaping, product use-associated lung injury (EVALI) or vaping-associated pulmonary injury (VAPI). By February 2020, there had been more than 2,800 hospitalizations and 68 deaths from EVALI across the United States.
Tetrahydrocannabinol (THC)-containing e-cigarette or vaping products was linked to most EVALI cases. So was Vitamin E acetate, an additive in vape cartridges e-liquids. Emergency department visits related to e-cigarette, or vaping, products have sharply declined in recent years, but the CDC continues to monitor reports.
Are e-cigarettes a good way to help quit smoking?
No e‑cigarette is FDA‑approved as a smoking‑cessation treatment. There are safer, proven treatments to quit smoking.
The best way to protect your children is to never smoke or vape near them. Talk with your doctor about quitting all tobacco. Never smoke indoors, in your car, or in places where children spend time.
Remember
It's important to help protect children and teens from using or being exposed to the harmful vapor from e-cigarettes. Talk with your pediatrician for more information about these products and keeping your child safe and healthy. Your regional Pediatric Environmental Health Specialty Unit (PEHSU) also have staff who can also talk with you about environmental toxins.
More information
Image source: S. Tanski, courtesy Dartmouth-Hitchcock. Used with permission.