by Dr. Carly Wilbur
University Hospitals Rainbow Babies and Children’s Hospital

Vaping refers to the inhalation of aerosolized particles of a drug (usually nicotine or marijuana) mixed with flavoring. Most vaping  devices  contain a battery for power, a heating  element, a place to insert the drug-containing liquid that will be heated  until it vaporizes, and a mouthpiece.

Vaping  was initially  developed to help adults quit smoking but has quickly become popular among  teenagers. From 2011 to 2019, the CDC reported a 900% increase in vaping for teens in high school. And while current reports estimate about 27% of high schoolers have vaped  or currently vape, 5% of middle schoolers admit  to the same. Vaping  is a $22.6 billion  industry worldwide.

On a chemical  level, the nicotine salt delivered from  a vape pen is far more powerful than the nicotine free base that cigarette smokers inhale. This makes vaping  nicotine extremely addicting. Current reports estimate about 30% of high schoolers have vaped or currently vape, and 5% of middle schoolers admit to the same. On a chemical level, the nicotine salt delivered from a vape pen is far more powerful than the nicotine free-base that cigarette smokers inhale. This makes vaping nicotine extremely addicting. Studies show that teens who vape are seven times more likely to later smoke as adults. And over half the high schoolers polled admitted to having had their first vaping experience at age 11 or younger.

The immature frontal cortex of a teenager’s developing brain is uniquely susceptible to the harmful effects of nicotine. Regular use can cause long-term irreversible deficits in memory, attention, and concentration, and also mood  disorders and permanent lowering of impulse control. Tobacco use in adolescence can also prime the brain for addiction to other stimulants of abuse, like cocaine  and methamphetamines. Inhaling marijuana through the heating element of a vape carries an added risk of EVALI (E-cig or Vaping-Associated Lung Injury), a permanent and irreversible insult to the lungs that can cause respiratory collapse.

Vaping is a $22 billion industry worldwide, with Juul being the predominant brand of electronic cigarette. Advertisements that falsely claim vaping is safer than smoking, along with child-friendly flavorings like birthday cake and mango, drive a powerful marketing campaign aimed at hooking younger consumers. The Surgeon General accurately labeled teen vaping an epidemic, and it’s a gravely dangerous one: nicotine-related deaths kill more adult Americans every year than alcohol, AIDS, car accidents, illegal drug abuse, murder, and suicide COMBINED.

Government initiatives to help curb vaping in youth include making tobacco products illegal for purchase to consumers under 21 years of age and restricting marketing of tobacco products to children. There is still room for more protections, like expanding smoke-free and vape-free spaces around parks and schools, and banning flavoring in vapes (just as the Family Smoking Prevention and Tobacco Control Act did with cigarettes in 2009).

The appeal of tobacco use will always be a draw for teenagers. If we are vigilant in limiting advertisers’ legal access to this population and work together to create consistent messaging about its dangers, we might be able to change the trajectory of the vaping trend, and save lives along the way.

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