The E-Cigarette Epidemic - The Facts And How To Help

With the recent explosion of vaping, adolescents are among those most vulnerable to its siren call. Most e-cigarettes contain nicotine, which is especially harmful to a young person's developing mind because it can harm the part of the brain responsible for memory, attention, and learning. This part of the brain continues to develop until the age of 25, so nicotine use before that age can have consequences beyond those traditionally associated with smoking. Advertising for e-cigarettes piggybacks on many of the themes used to market regular cigarettes to kids in the 1960s and 1970s. In 2016, nearly 7 out of 10 US middle and high school students saw ads for e-cigarettes [PDF–3.69 MB] in stores, on the Internet, on TV, or in magazines and newspapers. They also come in flavors, which can make them more appealing to young people. E-cigarettes can look like other everyday items, such as highlighters, credit cards, remote controls, and pens, so they are easy to conceal.

If you have children, it's worth learning the facts about e-cigarettes. Know what to say when the topic comes up. The earlier and more often you speak with young people about e-cigarettes, the more likely they are to listen.

The Facts 1. Approximately 8 million people experience tobacco-related deaths each year. This includes 1.2 million nonsmokers who experience secondhand tobacco exposure. Globally, 21 % of adults, >1 billion people, are current smokers, with the majority residing in low- and middle-income countries. The life expectancy for smokers is approximately 1O years less than for nonsmokers.

2. The World Health Organization (WHO) aims to support 100 million smokers to quit as part of the "Commit to Quit" campaign. The WHO MPOWER framework can reduce tobacco consumption through increased price of products, counter-marketing campaigns, and availability of programs to promote cessation.

3. The rate of electronic cigarette (e-cigarette) use among adolescents has grown worldwide. Rates are highest of e-cigarette use for 13-15-year-olds in 23.4% in Poland, 18.4% in Ukraine, 18% in Latvia, and 17.5% in Italy. In the United States, as of 2020, over 3.6 million adolescents reported using e-cigarettes.

4. Nicotine is the main addictive substance in tobacco products. Nicotine poses risks to the cardiovascular system, including causing an increase in blood pressure, heart rate, the flow of blood to the heart, and a narrowing of the arteries. Nicotine may also contribute to the hardening of the arterial walls, which in turn can lead to a heart attack. Nicotine also impacts brain development and poses dangers to youth, pregnant women, and the developing fetus. During pregnancy, nicotine can cross the placenta and result in multiple adverse consequences, including sudden infant death syndrome.

5. Smoking is associated with increased disease severity for coronavirus disease 2019 (COVID-19), and with increased risk for death during a COVID-19-related hospitalization.

6. As with cigarettes, e-cigarette products include toxic substances beyond just nicotine. Compared with the use of combustible tobacco cigarettes, a very high-risk comparator, e-cigarette use likely poses less risk. However, there is growing evidence that e-cigarettes and their aerosol constituents, nicotine, vaporizing solvents, particulate matter, metals, and flavorings, can have deleterious effects on the cardiovascular system, respiratory system, and brain.

7. Many e-cigarette users also continue to smoke cigarettes, and dual-use of e-cigarettes while continuing to smoke traditional cigarettes is not associated with higher rates of quitting. More research is needed to understand the efficacy of e-cigarettes in promoting quitting relative to approved pharmacotherapies.

8. Heated tobacco, nicotine pouch products, and other novel tobacco products loosely represent an emerging class of tobacco products being marketed by the industry as reduced exposure or modified-risk products. There is currently limited evidence regarding either the long-term individual health risks posed by these products or their potential public health impact.

9. Among adolescents and young adults, flavored tobacco products, including menthol cigarettes and flavored e-cigarettes, are consumed at higher rates than in older adults. The difference in favored products also exists by race/ethnicity.

Resources For Parents

Fact Sheet—E-Cigarettes Shaped Like Flash Drives: Information for Parents, Educators, and Health Care Providers

Fact Sheets—E-Cigarettes and Youth

E-Cigarettes and Youth: What Parents Need to Know [PDF – 1 MB]

E-Cigarettes and Youth: What Health Care Providers Need to Know [PDF – 975 KB]

E-Cigarettes and Youth: What Educators and Coaches Need to Know [PDF – 614 KB]

Infographic—Teachers and Parents: That USB Stick Might Be an E-Cigarette

Talk with Your Teen About E-Cigarettes: A Tip Sheet for Parents [PDF–5.20 MB]

Print Ad—“One Brain” [PDF–2.56 MB]

Evidence Brief: Tobacco Industry Sponsored Youth Prevention Programs in Schools [Print Only PDF – 786 KB]

Resources For Young People

Presentation—Know the Risks: A Youth Guide to E-Cigarettes

Teen.Smokefree.gov—information for teens who use tobacco products

This is Quitting mobile program

Author

Dr. Mark L. Meyer Dr. Meyer graduated from Haverford College with a Bachelor of Science, High Honors, in cellular and molecular biology, Phi Beta Kappa, Magna Cum Laude. He attended the Yale University School of Medicine, where he also completed a categorical residency in Internal Medicine, served for one year as an Emergency Department attending physician, and held the title of Clinical Instructor in the Department of Surgery. During this time, Dr. Meyer obtained a J.D. from the Yale Law School, concentrating on medical ethics, scientific research law, and FDA law. He then completed a fellowship in Cardiovascular Diseases at the Hospital of the University of Pennsylvania, where he obtained Level 3 Nuclear Cardiology training.