E-cigarettes have been on sale for over 10 years but in recent years there has been a rapid increase in adolescents vaping in the USA.
A few quick statistics and facts
- In 2019 9% of US 13-14 year olds had vaped nicotine in 2017 it was only 3.5%4
- In 2020 20% of US high school students (15-18 year olds) and 5% of middle school students (11-14 year olds) reported current e-cigarette use7
- In 2019 15% of UK teens had vaped in 2013 it was 4.5%10
- Around 66% of JUUL users aged 15-24 do not know that JUUL contains nicotine5
- Only 40% of parents were aware that their children vaped against 70% for smoking9
- The nicotine content of one JUUL pod is equivalent to one pack of cigarettes6
- Vaping poses a risk to lungs – In 2016 nearly 200 e-cigarette users developed severe lung disease in 22 states across USA
- Vaping often contains nicotine which is highly addictive and affects brain development7
Teenagers are vaping in growing numbers. Part of the reason for this is that vaping liquid, known as vaping juice comes in many flavours and unsurprisingly in 2020 the most popular juices for adolescents (ages 12 to 17) and young adults (18 to 24) are fruit (73%), mint (56%) and menthol (37%)1. Previous research from early 2019 showed that the preference was for candy and fruit-flavoured products2. Part of the change was due to the banning of certain flavours but this has not quit the rise in vaping nor the fact that most vaping juices include nicotine / tobacco and many include marijuana.
% of US students who said they vaped during the last 30 days, 2018
Source: University of Michigan Monitoring the Future survey4
The vaping devices are electronic products that heat a liquid to produce a vapour/smoke. They come in many shapes and sizes from looking like cigarettes, to USB flash drives (JUUL), to large tank system devices.
In 2013-14 a study showed that the reason many adolescents start vaping is because of the flavours3. Many US teens also report that due to the widespread advertising they are curious about the products and want to try them7.
Most e-cigarettes liquid contains nicotine which is highly addictive.
E-cigarettes are illegal to be sold to under 18s but they can be ordered online so they are readily available as are the vaping liquids or juices.
E-cigarettes very often contain nicotine in the juice and those that do not are often a gateway to the nicotine variety. In fact 99% of the e-cigarettes sold in the USA contained Nicotine5 and according to JUUL’s website the nicotine content of one JUULpod is equivalent to one packet of cigarettes.
Nicotine exposure in adolescents can harm brain development such as those parts that control attention, learning, mood and impulse control and may affect mental health7.
Nicotine is a highly addictive substance and in fact it has been reported to be harder to quit than cocaine. Adolescents are more susceptible to addiction than adults because their brains are still developing. It may also increase the risk for future addiction to other drugs6. It is therefore important to help them to quit vaping cartridges with flavouring only so that they do not move on to nicotine flavours and the challenges of becoming free from nicotine addiction.
In January 2018, the National Academies of Science, Engineering and Medicine released a consensus study report that reviewed over 800 different studies and concluded that e-cigarettes [vaping] cause health risks5.
The single biggest factor appears to be to raise children in a smoke and vape free home. If the parents smoke or vape it normalises the behaviour in children who particularly when they are young look up to parents as their role models. This increases the likelihood that the child will go on to vape and smoke9 Read more about Vaping around kids and is it safe?
When children are young, if a smoke/vape free home is coupled with positive discussions about the issues and downsides of vaping (smoking, drugs etc.) it has been shown to reduce the likelihood that they will start smoking or vaping9 (read about how to help your teen quit vaping). Given that they are exposed at younger and younger ages now the earlier you can speak with them the better as the marketing often makes it appear safe and the flavours appealing.
A 2020 study found that only 40% of parents or guardians were aware that their child was vaping compared with 70% for smoking9.
6 signs that you teen is vaping
- Unusual items in their things – Vaping devices have many parts including detachable tanks, batteries, chargers and some are like USB devices (JUUL). If you see something unusual or unfamiliar search on the internet for vaping parts or talk to other parents to check what they might be. These are the most obvious signs of vaping.
- Sweet smells – 73% of teens prefer fruit flavour vaping so smelling sickly sweet fruit aromas is likely to be a strong sign. Read more about what teens are vaping
- Changes in taste or more thirsty – vaping dries the mouth and so an increase in drinking is a potential sign. Also dry mouths changes the taste of food making them have less flavour so if they are adding salt, spices, sauces more than usual it could be a sign.
- Shortness of breath – As with smoking it is thought that vaping affects the lungs and will lead to shortness of breath. If they are sporty this will become clear during training and matches.
- Nosebleeds – Vaping also dries out the nostrils as the vaping gas is exhaled. This can lead to an increase in nosebleeds.
- Changes in their behaviour – During the teen years they will inevitably change , maybe getting angry, frustrated and tearful. However, most vaping juices contain nicotine and many contain cannabis – taking nicotine, getting addicted to nicotine as a child affects emotional control, decision making and impulses and so will change the pattern of behaviour of your child over a sustained period.
Stay calm, don’t shame
– The teenage years are often a difficult and confusing time for young people due to the expectations and changes in their bodies. So stay calm and don’t shame them if you find them vaping.
Talk to them
– The best approach is always to be calm, engage them and listen to them. Use non-judgemental questions like “I keep hearing about vaping. Do you see many people doing that at school?”, “What do you think about it?”. Also show them that you understand and empathise e.g. say “Wow, that does sound difficult”
Give them the facts
– During the conversation try to give them the facts even if they say you are wrong! Giving them facts from a reliable source will sink in but be prepared for them to say something like “We know that smoking is bad for you but vaping is fine and no risk”. Many kids don’t realise that vaping juice or JUUL pods contain nicotine and that it is as much as a pack of cigarettes6
Help them see they are being manipulated
– They rebel against being told what to do so play that back to them by telling them how the vaping companies are manipulating them. It is why they add nicotine to the juice to get them addicted and buy more juice or JUULpods. The advertising makes it look sexy and attractive and safe but it isn’t really. Tell them that that they did the same thing in my day for cigarettes until it was banned.
Find the right moment to talk
– This is probably the most difficult part because as you know a conversation can quickly escalate with tempers flaring. Clearly that will not help the situation so find a moment when they are more engaged with you. Maybe before you watch that sports match or after lunch (not before lunch when they are likely to be hangry!).
– You can’t dictate to them or they will rebel and resent you! Instead they need to feel that you are taking them seriously and they are not being treated as a child. Be firm regarding vaping but don’t lecture because they will not respond or listen. Often with teens they need to hear something and then fully take it in later that day. You may be tempted to test them with urine nicotine tests but this will not work. It will lead them to resent you and fight harder to do the thing that you are trying to help them to quit doing. Instead you have to trust them, keep talking and show you are there for them.
– They then need to quit. Quitting vaping can be as difficult as quitting smoking but with the right method it is easy. How to quit vaping with Allen Carr’s Easyway
Vaping amongst teens is a growing issue with marketing aimed to encourage them to start and with flavours that will appeal to them. Many of their friends may already vape and they will believe it is safe but it isn’t. The best action you can take is to talk openly with them and not smoke or vape yourself. Once they start vaping they will get addicted to nicotine and because it is so addictive it can appear very hard to be free but there is an easy way with Allen Carr’s Easyway to Stop Vaping. You may be interested in these articles:
- Wang TW, Neff LJ, Park-Lee E, et al. E-cigarette Use Among Middle and High School Students — United States, 2020. Morbidity and Mortality Weekly Report, 2020;69.
- Samir S. Soneji, Kristin E. Knutzen, Andrea C. Villanti. Use of Flavored E-Cigarettes Among Adolescents, Young Adults, and Older Adults: Findings From the Population Assessment for Tobacco and Health Study. Public Health Reports, 2019; 003335491983096 DOI: 1177/0033354919830967
- Goniewicz ML, Gupta R, Lee YH, et al. Nicotine levels in electronic cigarette refill solutions: a comparative analysis of products from the United States, Korea, and Poland. Int J Drug Policy. 2015;26(6):583–588.
- The New England Journal of Medicine : Trends in Adolescent Vaping, 2017–2019 October 10, 2019 N Engl J Med 2019; 381:1490-1491 DOI: 10.1056/NEJMc1910739 https://www.nejm.org/doi/full/10.1056/NEJMc1910739 and University of Michigan Monitoring the Future vaping survey 2021 Richard Miech; Adam Leventhal; Lloyd Johnston Pediatrics October 2020, JAMA Pediatr. 2021;175(2):185-190; DOI: 10.1001/jamapediatrics.2020.5667
- Centres for Disease control and Prevention https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html
- Willett JG, Bennett M, Hair EC, et al Recognition, use and perceptions of JUUL among youth and young adults. Tobacco Control Published Online First: 18 April 2018. doi: 10.1136/tobaccocontrol-2018-054273
- US Department of Health and Human Services. E-cigarette Use Among Youth and Young Adults: A Report of the Surgeon Generalpdf icon[PDF – 8.47MB]. Atlanta, GA: US Department of Health and Human Services, CDC; 2016. Accessed July 27, 2018. https://www.cdc.gov/tobacco/data_statistics/sgr/e-cigarettes/pdfs/2016_sgr_entire_report_508.pdf and US Department of Health and Human Services. E-cigarette Use Among Middle and High School Students 2020pdf icon[PDF – 8.47MB]. US Department of Health and Human Services, CDC; 2020. Weekly / September 18, 2020 / 69(37);1310–1312. https://www.cdc.gov/mmwr/volumes/69/wr/mm6937e1.htm?s_cid=mm6937e1_w
- July 2018 Gallup poll https://news.gallup.com/poll/237818/young-people-adopt-vaping-smoking-rate-plummets.aspx
- Parental Awareness of Youth Tobacco Use and the Role of Household Tobacco Rules in Use Prevention Tsu-Shuan Wu and Benjamin W. Chaffee Pediatrics October 2020, e20194034; DOI: https://doi.org/10.1542/peds.2019-4034 https://pediatrics.aappublications.org/content/early/2020/10/01/peds.2019-4034
- ASH Use of e-cigarettes among young people in Great Britain https://ash.org.uk/wp-content/uploads/2019/06/ASH-Factsheet-Youth-E-cigarette-Use-2019.pdf and https://ash.org.uk/wp-content/uploads/2021/02/YouthEcig2020.pdf
- National Academies of Science, Engineering and Medicine Public Health Consequences of E-Cigarettes Report – https://www.nap.edu/resource/24952/012318ecigaretteConclusionsbyEvidence.pdf