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Keeping teens safe: E-cigarettes and vaping risks

Hitting the U.S. market in 2006, e-cigarettes are one of the most popular smoking trends today.

Sometimes referred to as “vaping” or “juuling,” these devices work by using an electronic device to heat a liquid typically made up of nicotine, flavoring, and other chemicals which the user inhales as a vapor.

As of 2016, there were 10.8 million adult users of e-cigarettes. While the use of these products among adults is growing, its increasing popularity among teenagers is alarming. In 2018, the rate of vaping nearly doubled among U.S. high school students.

While they have been marketed as healthier than cigarettes, vaping products contain toxins.  The amount of nicotine in e-cigarettes is not regulated and may vary, sometimes to levels higher than traditional cigarettes.

E-cigarette brands appeal to a younger crowd that otherwise may not be legally allowed to purchase tobacco products. By developing cartridge flavors like mango and donuts, brands distract teens from the fact that each cartridge can have as much nicotine as an entire pack of cigarettes.

One of the most popular e-cigarettes among teens is a device known as a Juul, a particularly small e-cig, much like a USB, that can discretely fit inside one’s pocket.

This has caused concern among parents and teachers about students’ ability to bring these devices to school. Many parents are concerned about the long-term effects of this trend, but the health concerns don’t stop there.

What is the health impact of e-cigarettes?

While any benefit of “vaping” is inconclusive, the hazards of vaping are rapidly becoming apparent.

In August 2019, there was an outbreak of lung disease linked to e-cigarettes that affected over 450 cases in 33 states, with 5 reported deaths to date.  The Centers for Disease Control is investigating the exact cause of lung disease outbreak.

In adolescents, the use of e-cigarettes can cause lifelong harm in many ways.

Nicotine affects the development of the brain’s reward system and continued e-cigarette use not only fuels nicotine addiction, but it also can make other drugs such as cocaine and marijuana more pleasurable to a teenager’s developing brain.  For teens and young adults, vaping has been shown to increase the use of tobacco cigarettes and other addicting substances later in life.

Myth: E-Cigarettes help you quit smoking

One argument made in support of e-cigarettes that they may help established smokers quit tobacco smoking.  However, the harm caused by e-cigarettes can be severe, offsetting any health benefits from quitting tobacco.  There are plenty of quality nicotine substitutes and medications to aid in quit smoking other than vaping, and the use of e-cigarettes is not generally recommended to aid in smoking cessation.

The US Centers for Disease Control recommends these 6 tips:

  1. Adults who do not currently use tobacco products should not start using e-cigarette products.
  2. If you do use e-cigarette products, you should not buy these products off the street (for example, e-cigarette products with THC or other cannabinoids).
  3. Youth and young adults shouldn't use e-cigarette products.
  4. Pregnant women shouldn't use e-cigarette products.
  5. You should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer.
  6. Adult smokers who are attempting to quit should use evidence-based treatments, including counseling and FDA-approved medications. If you need help quitting tobacco products, including e-cigarettes, contact your doctor or other medical providers.

Important resources to help you quit

This is Quitting

This is Quitting from Truth a free mobile program from the Truth Initiative to help teens and young adults quit juuling. Simply text “DITCHJUUL” to 887-09 to get started..


A 24/7 resource is available. Whether it is for you or someone you love, QuitlineNC has confidential counseling and Quit Coaches ready to support you as you strive for a tobacco-free life. There is also a special five-call program for teens who are addicted to tobacco products, including e-cigarettes. Teens who call receive coaching from a dedicated Quit Coach, specially trained to work with adolescents. This is available state-wide regardless of health insurance status. Call 844-8NCQUIT or 844-862-7848.

Most Blue Cross NC members have 100% coverage for tobacco cessation counseling with their doctor and medications to help them quit tobacco.

Larry Wu, MD
Larry Wu, MD

Regional Medical Director

Larry is a regional medical director for Blue Cross NC providing consultative services for employee health solutions, prevention, chronic disease, care management, medical expense and utilization management. He's a family physician with over 20 years in clinical practice, has served as clinic director in the Indian Health Service, Kaiser Permanente and Duke Family Medicine and currently maintains a part-time clinical practice.

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