The Facts About Teen Vaping

Vaping has become an epidemic among teens. While the rate of teen cigarette smoking is going down, the number of teenagers who are vaping is soaring, and we’re now learning the truth about vaping health risks.

According to a 2017 study by the Centers for Disease Control (CDC), about 50 per cent more high schoolers and middle schoolers vape than smoke. When cigarette smoking and nicotine vaping are added together, nicotine use may actually have increased.

Furthermore, the 2017 Monitoring the Future survey on adolescent drug use found that 11 percent of 12th graders, 8.5 percent of 10th graders, and 3.5 percent of 8th graders had vaped nicotine in the previous 30 days. Moreover, among the high school seniors, 24 percent reported vaping daily.

This trend is bad news for teen health. Research continues to uncover many negative side effects of vaping. A new study has found that some common chemicals used to flavor vape juice could harm people’s blood vessels.

In addition, vaping increases the likelihood that a teen will abuse other substances.

What Is Vaping?

Vaping refers to the act of inhaling and exhaling the aerosol, or vapor, created by a vaping device. A vaping device includes a mouthpiece, a battery, a heating component, and a cartridge that contains the e-liquid or e-juice. The e-liquid is a combination of nicotine, flavorings, and other chemicals.

The battery powers the heating component, which heats up the e-liquid, also known as vape juice. As a result, the device produces water vapor. Users inhale this vapor into their lungs.

Types of vaping devices include the following:

  • E-cigarettes, which resemble traditional cigarettes—also called e-cigarettes, e-cigs, hookah pens, vape pens, or ENDS (electronic nicotine delivery systems)
  • Advanced personal vaporizers (also known as “mods”), customized by the user
  • Vape pens, which look like large fountain pens.

What Is Juul?

Juul is the brand name of an e-cigarette that has become increasingly popular among teenagers. A Juul device provides approximately the same amount of nicotine as a pack of cigarettes. At this time, Juul makes up about half of the e-cigarette industry’s retail dollar share.

Juul’s online store requires customers to be 21. And the company requires a match between public records, credit card information, and government ID. However, teens find ways to buy Juul products in bulk on eBay and other sites using prepaid debit cards.

Juul uses bright colors and youthful images in its marketing campaigns. But the company insists it never deliberately targeted teens.

The Appeal of Vaping for Teens

In fact, vaping appeals to teens in particular, according to experts. Here are some of the reasons why teens choose vaping vs. smoking.

Packaging and flavoring: Vape cartridges are available in candy, fruit, and dessert flavors, like doughnut, cotton candy, apple pie, chocolate, cherry, “Belgian waffle,” “strawberry milk,” watermelon, bubble gum, etc. And labels of “vape sauce” resemble candy wrapper designs, like Jolly Ranchers and Blow Pops.

Related promotion and merchandising: In addition, companies promote vaping with campaigns that appeal to teens, such as vaping cloud contests. Moreover, a line of hoodies and backpacks called Vaprwear is designed to conceal vaping devices.

Easier to hide: Moreover, vaping devices, such as electronic cigarettes, are harder for parents and teachers to detect. That’s because they don’t give off as much smoke as traditional cigarettes. Also, unlike traditional cigarettes, e-cigarettes are odorless or have a sweet smell. Plus, vaping devices often resemble pens or thumb drives. Thus, it’s easier for teens to use them without getting caught.

Peer pressure: On social media, teens post photos and videos of themselves “Juuling,” with hashtags like #doitforjuul. As a result, these social media images give teens the idea that vaping is cool. And the frequency of vaping-related posts leads teens to believe that everyone is vaping. Hence, they’re more likely to try vaping themselves.

Accessibility: Furthermore, although vaping is illegal in most states for those under 18, teens can easily find ways to buy products online. Also, e-cigarettes cost less than traditional cigarettes.

Reduced health concerns: Many teens believe that vaping is less harmful than smoking.

Newport Academy Substance Abuse Resources: Vaping Health Risks

Vaping Health Risks

Nicotine is the primary substance in both traditional and electronic cigarettes. And it is harmful to human health. Nicotine raises blood pressure and spikes adrenaline levels. As a result, it increases the user’s heart rate and their likelihood of having a heart attack.

Along with nicotine, vaping liquids contain additives such as propylene glycol and glycerol. These are toxic chemicals that have been linked to cancer, respiratory disease, and heart disease. Scientists have found that diacetyl, a chemical used to flavor some vape juice, may cause a condition called “popcorn lung,” the scarring and obstruction of the lungs’ smallest airways.

Furthermore, a study published in the journal Pediatrics in March found substantially increased levels of five carcinogenic compounds in the urine of teenagers who vape. Hence, cancer is one of the clear vaping health risks for teens. And researchers are only beginning to discover how vaping affects physical health over the long term.

“People need to understand that e-cigarettes are potentially dangerous to your health. You’re exposing yourself to all kinds of chemicals that we don’t yet understand and that are probably not safe.”

—Michael Blaha, MD, MPH, director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease

New Study Shows Vaping Harms Blood Vessels

A paper published this week in the American Heart Association journal Arteriosclerosis, Thrombosis, and Vascular Biology showed evidence that the chemicals in nine common vape juice flavorings pose dangers to endothelial cells. These are the cells that line blood vessels and lymph vessels.

Researchers exposed endothelial cells to nine different vape flavorings: menthol (mint), acetylpyridine (burnt flavor), vanillin (vanilla), cinnamaldehyde (cinnamon), eugenol (clove), diacetyl (butter), dimethylpyrazine (strawberry), isoamyl acetate (banana), and eucalyptol (eucalyptus).

Subsequently, the researchers inspected the cells. Hence, they found that high concentrations of all the flavor chemicals caused cell death and reactive oxygen species production, a sign of bodily stress.

Furthermore, they found that low concentrations of the molecules used for menthol, clove, vanillin, cinnamon, and burnt flavors caused inflammation in the endothelial cells. In addition, these flavorings reduced the production of nitric oxide. Nitric oxide is a molecule that helps blood vessels to function in a healthy way. Therefore, the chemicals inhibited cell function.

As a result, researchers concluded that the flavoring compounds used in vaping products have adverse effects on cardiovascular health.

Vaping and Nicotine Addiction

Furthermore, the nicotine in e-liquids is highly addictive. Like other drugs, nicotine releases dopamine in the brain. In fact, research suggests that nicotine may be as addictive as heroin and cocaine. Hence, vaping carries a high risk of addiction.

In addition, e-cigarette users can buy extra-strength cartridges that have a higher concentration of nicotine. Or they can increase the e-cigarette’s voltage so they inhale larger amounts of vapor. Hence, teens who vape are taking in even more nicotine than they would get from traditional cigarettes.

In fact, some e-liquid products contain nearly 50 milligrams of nicotine per milliliter of liquid. This is more than four times the milligrams of nicotine in a cigarette.

Moreover, addiction to nicotine typically starts at a young age. In fact, about 90 percent of people who smoke cigarettes start before age 19. And about three-quarters of teen smokers continue smoking into adulthood. Therefore, teen vaping is likely to lead to lifelong nicotine dependence.

Research on Teen Vaping and Cigarette Use

Multiple studies show that teen vaping leads to cigarette smoking. Moreover, research has found that even teens at low risk for cigarette smoking will try vaping. Here are some of those findings.

  • Among teens, e-cigarettes are more popular than any traditional tobacco products.
  • A study from the Center for Tobacco Control Research and Education at the University of California–San Francisco found that students in grades six through 12 who had never smoked and were considered at low risk for smoking had used e-cigarettes.
  • In 2015, the US surgeon general reported that e-cigarette use among high school students had increased by 900 percent. And 40 percent of these teen e-cigarette users had never smoked regular tobacco.
  • Another study followed 2,500 ninth-grade students from 10 Los Angeles high schools. Those who had used e-cigarettes at least once were more likely to start smoking cigarettes within the next year.
  • Moreover, an anonymous survey of more than 7,000 Connecticut high school students found that 1,080 of them had used e-cigarettes.
  • The 2016 Monitoring the Future study followed students who, in 12th grade, had never smoked a cigarette. Subsequently, a year later, those who used e-cigarettes were about four times as likely to have smoked a cigarette.
  • A study released by the National Academies of Sciences, Engineering and Medicine also concluded that vaping leads teens to smoke cigarettes.

“What I find most concerning about the rise of vaping is that people who would’ve never smoked otherwise, especially youth, are taking up the habit. And, it often leads to using traditional tobacco products down the road.”

—Michael Blaha, MD, MPH, director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease

Priming the Brain for Addiction

Vaping makes it more likely that teens will begin using other drugs besides nicotine. A study showed that 25 percent of teenagers who use e-cigarettes progressed to smoking marijuana, compared to 12.5 percent of teenagers who did not use e-cigarettes.

Some teens also use vaping devices to inhale THC, the psychoactive chemical in marijuana. Moreover, the THC content in e-liquid concentrates can range between 50 and 90 percent, as compared to 20 percent in marijuana.

In addition, high dosages of nicotine and marijuana act on the brain in ways similar to other substances of abuse. Therefore, they prime the brain for addiction to even more potent drugs in the future. This is particularly dangerous for teens because the adolescent brain is not fully mature. Hence, substance use can have long-lasting negative effects on brain development.

Newport Academy Substance Abuse Resources: Vaping Health Risks

A Gateway to Substance Abuse and Teen Risky Behavior

Besides nicotine and THC, some users vape synthetic drugs, such as flakka, a stimulant that is chemically similar to amphetamines. Heroin users technically create a vapor by heating the drug. However, heroin and cocaine in their most common crystal form cannot be used in vaping devices.

But, if the demand grows, drug suppliers may find ways to make these drugs vapable. Hence, the danger for teens will increase.

Moreover, vaping leads to teen risky behavior, according to the 2015 national Youth Risk Behavior Survey. In the survey, e-cigarette use was associated with health-risk behaviors among high school students. Researchers found that injury, violence, substance use, and sexual activity were more likely among vapers.

What Parents Can Do About Teen Vaping 

Parents can take steps to help prevent their kids from vaping. In particular, communication between parents and teens is key in supporting good choices and positive coping mechanisms. Here are some ways to protect teens from the dangers of vaping.

Watch for warning signs.

Because e-cigarettes do not have an odor, it’s harder to tell when teens are using them. However, there are other signs to watch for, including

  • Bloodshot eyes
  • Irritability caused by nicotine withdrawal
  • Increased thirst—dehydration is a common side effect of vaping as a result of the propylene glycol in e-liquid
  • Nosebleeds—propylene glycol also dries out the inside of the nose
  • Smoker’s cough
  • Avoiding caffeine—some e-cigarette users develop a sensitivity to caffeine
  • Unfamiliar batteries and chargers
  • Discarded Juul pods or atomizers—the component of the e-cigarette that turns the e-liquid into vapor
  • A sweet smell produced by scented flavorings
  • Pens that are unusual looking or larger than usual
  • Other vaping devices and products in a teen’s room.

Ask open-ended questions.

Avoid yes-no questions when talking with teens about vaping. Approach the conversation with caring and curiosity, not judgment. Ask teens what they’ve heard about vaping and what their peers think about it. Hence, you’ll get a sense of how much your teen knows about the topic.

If a teen admits to vaping, getting upset or angry won’t help. Teens need to know that their parents will be there for them even when they make unwise choices. Compassion is key.

Let them know about the dangers.

Make sure that teens understand the potential long-term consequences of vaping. For example, nicotine use can lead to high blood pressure, fatigue, and other health issues.

Moreover, teens need to know that vaping may create a lifelong addiction that impacts physical and mental health.

Set a good example.

Be a role model for teens, and walk the talk. If parents don’t want their teens to vape or smoke, they shouldn’t do so either. Teens will have a hard time believing that vaping is dangerous if they see adults doing it.

Get them the help they need.

If a teen wants to stop vaping, make sure they receive access to professional help for breaking the habit and dealing with the physical and emotional symptoms of withdrawal. A trained counselor can help teens learn how to quit vaping.

To summarize, teen vaping is common. And it threatens teens’ mental and physical health. Furthermore, it can lead to addiction and substance abuse.

Therefore, parents, healthcare providers, and policymakers need to take action now to reverse this harmful trend.


Images courtesy of unsplash


2017 and 2016 Monitoring the Future Surveys 

National Academies of Science, Engineering, and Medicine: Public Health Consequences of E-Cigarettes

Centers for Disease Control and Prevention

Art Thromb Vasc Bio. 2018 June;38(6).

JAMA. 2015;314(7):700-707.  

Pediatrics. 2018 Apr;141(4). 

Pediatrics. 2017 Mar;139(3). 

 Pediatrics. 2017 Feb;139(2).