Vaping is inhaling and exhaling the vapor produced by an electronic cigarette (e-cigarette, e-cig). The vaporizer heats up a chemical liquid into an aerosol which is then breathed in. It’s also commonly referred to as JUULing (pronounced jeweling), after a common brand name of e-cigarette. Almost all e-cigarettes contain nicotine—though they can also deliver marijuana or other drugs.
Teen vaping is extremely common. One in five high school students vape. The popularity is driven by attractive marketing, fun flavors, and a misconception that vaping is harmless. Many adolescents and young adults don’t realize there are significant health effects of vaping on teens—risks that are more serious for people under age 25.
What does vaping do to the teenage body?
There are two main reasons why vaping is bad for teens: lung damage or irritation, and health effects of nicotine consumption.
“Vaping is terrible in general, and even worse for a teenager,” says Osita Onugha, MD, thoracic surgeon, and assistant professor of thoracic surgery at Saint John’s Cancer Institute at Providence Saint John’s Health Center in Santa Monica, California. “As the body is growing and maturing, vaping introduces irritants in the lungs that can stay in the lung for decades.” In the short term vaping can cause coughing and wheezing. There’s also potential for long-term lung issues.
There is also a serious form of respiratory illness emerging called e-cigarette or vaping product associated lung injury (EVALI), affecting people who vape, including teenagers. “EVALI causes lung injury producing pneumonia, respiratory failure, and chronic lung disease,” says Joi Lucas, MD, author and pediatric pulmonology specialist in Lakeland, Florida. “Diacetyl, a chemical found in flavorings popular in electronic cigarettes, is a known cause of bronchiolitis obliterans, irreversible scarring and restriction of the lung.”
Vaping liquids and flavorings that are not regulated can have unknown toxins or chemicals such as benzene, formaldehyde, vitamin E acetate, and heavy metals (like nickel, tin, and lead). These compounds put teenagers at risk of lung damage when they are heated to make a vapor.
Health effects of nicotine
Most e-cigarettes contain nicotine—even ones that are labelled nicotine-free have been found to contain it. On top of that, the amount of nicotine is often quite high. One JUUL pod contains as much nicotine as an entire pack of 20 regular cigarettes. Two-thirds of JUUL users aged 15 to 21 reportedly don’t know that the product always contains nicotine, according to teen vaping statistics.
Those high doses of nicotine can cause headaches and behavioral changes. “Nicotine in e-cigarettes impacts areas of the brain that control mood, impulse control, learning, and attention,” says Dr. Lucas. This can cause problems in school, sports, and social situations. When consumed in excess, it can also cause nicotine toxicity, which in severe cases can cause seizures, respiratory failure, and other serious complications.
The brain continues to develop until about age 25 to 30. The maturing connections between brain cells make teenagers more likely than adults to become addicted to substances such as nicotine. There is also evidence that addiction to nicotine can prime the adolescent brain for addiction to other drugs such as cocaine.
“JUUL, a popular e-cigarette brand, uses nicotine salts which allow a higher level of nicotine to be inhaled with less irritation,” says Dr. Lucas. “This means kids may become addicted quickly without realizing how much nicotine they are consuming.”
E-cigarettes are also used to inhale marijuana, which has been linked to problems such as psychosis when used by people under the age of 25.
Is it better to vape or smoke?
“That’s like choosing the best of the worst,” says Dr. Onugha. “Due to the way vaping liquid is preserved, it can kill very quickly by causing respiratory distress syndrome. Smoking can result in lung cancer which is the number one cause of cancer-related deaths. So, what’s the better option? Easy…neither!”
There is a myth that vaping can help teens quit smoking or prevent them from smoking. Instead, kids who vape are about four times more likely to start smoking cigarettes or using other tobacco products than kids who don’t vape. Many teenagers also end up both smoking and vaping. This can lead to more nicotine intake, not less.
Positing vaping as less harmful than smoking is aimed at deterring cigarette smoking, but instead tends to minimize how harmful teenagers view vaping. Many consider it just a pleasant vapor, underestimating the dangers of vaping for teens and adults. Instead of comparing smoking to vaping, it may be more effective to focus on how vaping is harmful in its own right.
How do you know if your teenager is vaping?
“Parents must be proactive and ask their children if they are vaping, ‘juuling’, or using e-cigarettes,” says Dr. Lucas. “Do not ask if they are smoking, because they do not consider vaping the same as smoking.”
Some signs to look for that may mean a teenager is vaping include:
- Vaping equipment: “Parents should also be aware that some of the vape devices do not resemble cigarettes and may look like USB devices or pens,” says Dr. Lucas. Look out for other items, like pods or cartridges, e-liquid, or marijuana products.
- Unexplained purchases: Look for packages coming in the mail, online charges to your credit card, items bought at big box stores or gas stations, or purchases from friends and family.
- Scents and odor: If you notice a faint whiff of something like cotton candy, chocolate, or similar scents, without there being a source for it, it may be e-cigarette flavoring. A skunky smell can be from a marijuana vape.
- Physical symptoms: Look for physical signs such as increased thirst, nosebleeds, trouble breathing, headaches, cough, dizziness, sore throat, or chest pain.
- Less caffeine intake: It could be a sign of vaping if your teen previously drank coffee or energy drinks and suddenly cuts back.
- Use of vaping slang: Common vaping slang terms include atty, e-juice, VG, sauce, getting nicked, or nic sick.
- Behavior online and on social media: Check your teen’s Instagram, TikTok, Snapchat, YouTube, Twitter, and other social media accounts for photos and references to vaping. Teenagers often posture and brag about their vape use. See if there are popular vaping terms in their online searches.
- Behavioral changes: “If you notice your child is losing focus, doing poorly in school, withdrawing from normal activity, or has behavioral changes, sit and talk with them,” says Dr. Lucas.
How can I help my teen to stop vaping?
Once you’ve determined your child is vaping, the next step is to help them stop. Try these steps.
- Educate yourself on vaping: Learning what vaping is, how it works, and why it is dangerous will help you answer questions that your child may have. If your teen asks a question you don’t know the answer to, look it up together.
- Have an open, non-judgmental dialogue with your teen: Ask open-ended questions about vaping. “The best way to stop a teenager from vaping is to find out why they are vaping,” says Dr. Lucas. “Teenagers admit to vaping because they are bored, anxious, want to fit in, or because of peer pressure.”
- Explain the risks of vaping: Use accurate, science-based information and be honest. The goal is to educate them on why vaping is harmful, not scare them.
- Create a vaping cessation program: “Once a child is heavily vaping and possibly addicted to nicotine, they may need nicotine replacement therapy with a nicotine patch or gum to avoid withdrawal,” says Dr. Lucas. “Talk to your pediatrician about smoking cessation programs for teens.” Smokefree.gov offers a great guide to teenagers who want to learn how to quit vaping.
- Plan for how to resist the temptation to vape: Role play scenarios in which your child can practice saying no with confidence.
- Discuss the cons of vaping: Include everything from health risks to money. Ask your teenager to help with the list.
“Every teenager is different and parents know what their teenager will respond to,” says Dr. Onugha. “The major vaping companies try to make vaping cool as a method to target teenagers.” Once teens realize vaping can prevent them from doing things they enjoy—like playing sports or doing well in school—they may think twice.