Electronic Cigarettes and Vaping

Electronic cigarettes (e-cigarettes) go by many names, including but not limited to electronic nicotine delivery systems, vapes, vape pens, e-cigars, and hookah pens. They may also go by the product brand name (e.g., JUUL, Puff Bar). On this webpage, these products are collectively referred to as e-cigarettes.

About E-Cigarettes

E-cigarettes are tobacco products that come in many shapes and sizes. Some look like regular cigarettes, cigars, or pipes. Others have a modern, sleek design and look like writing pens, highlighters, USB sticks, or other everyday items. Larger devices such as tank systems, or “mods”, do not look like other tobacco products.

E-cigarette use among youth (ages 17 and younger) and young adults (ages 18-24) is a significant public health concern. Since 2014, e-cigarettes have been the most commonly used tobacco product among youth and young adults.[1][2] Flavoring and taste, curiosity, and low perceptions of harm are common reasons youth and young adults start or use e-cigarettes.[3][4]

How E-Cigarettes Work

Most e-cigarettes have a battery, a heating element, and place to hold a liquid (such as a cartridge or pod). The e-liquid usually contains nicotine, flavorings, and other chemicals. As the user draws on the device, the battery heats the e-liquid to produce aerosol (not water vapor). The aerosol is then inhaled into the lungs. E-cigarettes are also used to deliver marijuana and other drugs.

This is the process known as “vaping”.  

Health Effects

Tobacco companies have marketed e-cigarettes as a safer alternative to regular cigarettes. They have also marketed e-cigarettes as a tool to help people quit smoking. However, to date, the U.S. Food and Drug Administration (FDA) has not approved any e-cigarette for smoking cessation. The FDA has also not authorized any companies to make a modified risk claim.[5]

Research on the long-term health effects of e-cigarette use is still unclear. However, most e-cigarettes contain nicotine, heavy metals, and cancer-causing chemicals. These substances have known and negative health effects.[6]

There is also evidence that youth and young adults who use e-cigarettes may be more likely to smoke regular cigarettes in the future.[7][8][9]

Nicotine Addiction:[10]

  • Most e-cigarettes contain nicotine. Nicotine is the highly addictive chemical found in regular cigarettes, cigars, snuff, and other tobacco products.
  • Nicotine is as addictive as heroin and cocaine.
  • Symptoms of nicotine addiction include cravings, withdrawal, and continued use despite health problems.

Youth and Young Adult Exposure to Nicotine:[11][12]

  • The adolescent brain is not fully developed until about age 25.
  • The brains of youth and young adults are more vulnerable to the negative effects of nicotine.
  • Youth and young adult exposure to nicotine can harm the developing brain and cause addiction.
  • Youth and young adult nicotine use can harm areas of the brain that control attention, learning, memory, mood, and impulse control. It can also be a gateway to using other substances.
  • The use of e-cigarettes or any product with nicotine in any form among youth and young adults is dangerous.

E-Cigarette Aerosol:[13][14]

  • E-cigarette aerosol is not water vapor. It is also not harmless.
  • E-cigarette aerosol can contain:
    • Nicotine.
    • Cancer-causing chemicals.
    • Heavy metals like nickel, tin, and lead.
    • Ultrafine particles that can be inhaled deep into the lungs.
    • Flavoring such as diacetyl, a chemical linked to a serious lung disease known as "popcorn lung".
  • Secondhand aerosol exposes bystanders to harmful substances.

Unintended Injuries:[15][16]

  • Defective e-cigarette batteries have caused fires and explosions. Some explosions have resulted in serious injuries and death.
  • Children and adults have been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their skin or eyes.

Quitting

Quitting is hard but finding resources does not have to be. The Texas Tobacco Quitline offers free, confidential, and convenient cessation services to Texas residents ages 13 and older. This includes quit coaching, up to 2 weeks of nicotine replacement therapy, and a youth digital program for those ages 13-17.

If you are ready to quit, we can help. Call 877-937-7848 (877-YES-QUIT) or visit YesQuit.org to get started on your quit journey today.

References

[1] U.S. Department of Health and Human Services. (2016). E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General.

[2] Centers for Disease Control and Prevention. (2023). About Electronic Cigarettes (E-Cigarettes). www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html.

[3] U.S. Department of Health and Human Services. (2016). E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General.

[4] Gentzke, A.S., Wang, T.W., Cornelius, M., et al. (2022). Tobacco Product Use and Associated Factors Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021. MMWR. DOI: http://dx.doi.org/10.15585/mmwr.ss7105a1.

[5] U.S. Food and Drug Administration. (2023). E-Cigarettes, Vapes, and other Electronic Nicotine Delivery Systems (ENDS). www.fda.gov/tobacco-products/products-ingredients-components/e-cigarettes-vapes-and-other-electronic-nicotine-delivery-systems-ends.

[6] U.S. Department of Health and Human Services. (2016). E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General.

[7] Ibid.

[8] National Academies of Sciences, Engineering, and Medicine. (2018). Public Health Consequences of E-Cigarettes.

[9] Centers for Disease Control and Prevention. (2022). Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults. www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html.

[10] U.S. Department of Health and Human Services. (1988). The Health Consequences of Smoking—Nicotine Addiction. A Report of the Surgeon General.

[11] U.S. Department of Health and Human Services. (2016). E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General.

[12] Centers for Disease Control and Prevention. (2022). Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults. www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html.

[13] U.S. Department of Health and Human Services. (2016). E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General.

[14] Centers for Disease Control and Prevention. (2022). Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults. www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html.

[15] U.S. Department of Health and Human Services. (2016). E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General.

[16] Centers for Disease Control and Prevention. (2022). Quick Facts on the Risks of E-cigarettes for Kids, Teens, and Young Adults. www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html.