Targeting Teens to Vape

Teens Think Vaping is Glamorous

Source: iStock/Aleksandryu

One of the scariest aspects of vaping is that many teenagers and young adults think it’s so much healthier than smoking cigarettes. General Barrye Price, CEO of Community Anti-Drug Coalitions (CADCA), told me this is absolutely not true.

“Vaping nicotine and/or marijuana is incredibly dangerous as the pods contain very large concentrations of these substances, which make using them in this manner much more addictive than alternative methods of administration,” he said.

Price says vaping is causing an epidemic of nicotine use and addiction among adolescents and young adults.

General Barrye L Price , Ph.D.

Source: CADCA

Electronic cigarettes (e-cigarettes), also known as e-cigs, vapes, vape pens, and electronic nicotine delivery systems (ENDS), are very popular among adolescents. Experts report that e-cigarettes are the most popular product among teenage tobacco users, and in 2023, 2.1 million youths in the United States were vapers. In November 2023, the CDC reported e-cigarettes were the most reported currently used tobacco product among middle school (4.6 percent) and high school students (10 percent). Of students currently using e-cigarettes, about 25 percent use e-cigarettes daily, and 89 percent use flavored e-cigarettes.

Vaping devices heat a liquid into an aerosol inhaled into the lungs. These devices are called vapes, mods, e-hookahs, and vape pens. They have different appearances but work similarly.

E-Cigarette Makers Target Adolescents

Adolescents are driving the demand for easy-to-disguise, school supply look-alike vapes with flavored liquids. Youth e-cigarette use is a critical public health concern because approximately half of students who ever used e-cigarettes continue to use them.

According to the American Lung Association, the most frequent reason youth use e-cigarettes is vaping by a "friend or family member" (39 percent), and nearly a third (31 percent) liked the availability of flavors like mint, candy, fruit, or chocolate.

Vaping Health Risks

Researchers report Price is right that many young adults and teenagers who vape believe they have made a healthier choice compared to their peers smoking cigarettes. There’s a problem with this belief. Most nicotine vapers start very early, about age 14. Vaping devices are also easily concealed, allowing for their sneaky use in classrooms or bathrooms, and thus more frequent inhalations, higher doses, and more addictions.

Other Health Risks

The liquid used in e-cigarettes can be dangerous, apart from its intended use. Both children and adults have been poisoned by swallowing, breathing, or absorbing the liquid through skin or eyes. E-cigarettes have been linked to thousands of cases of serious lung injury, some resulting in death.

Jessica Hulsey

Source: Addiction Policy Forum

According to Jessica Hulsey, researcher and CEO of the Addiction Policy Forum, "Contrary to early claims vaping had health benefits, we have found harmful ingredients in vapes, including ultrafine particles that can be inhaled deep into the lungs; flavorings that are linked to serious lung disease; volatile compounds like benzene, which is found in car exhaust, and even toxic metals, like nickel, tin, and lead. And we are still learning about the chemical reactions that occur in vapes. As the ingredients, nicotine or cannabis, are heated, it can create new molecules and acetals that are not included in the ingredients listed or regulations testing. We have no longitudinal tests about the long-term effects of these unknown components."

Vaping can worsen asthma and other existing lung diseases. Breathing in the harmful chemicals from vaping products can cause irreversible lung damage, lung disease and, in some cases, death. Some chemicals in vaping products can cause cardiovascular disease and biological changes associated with cancer development. Of course, vapers are also at risk for addiction from nicotine in vaping products.

One of e-cigarettes’ biggest threats to public health may be this: The increasing popularity of vaping may “re-normalize” smoking. Reversing hard-won gains of the past in the global effort to curb smoking would be catastrophic. Smoking is still the leading preventable cause of death, responsible for over 480,000 deaths in the U.S. each year.

What’s in E-Cigarettes?

People who vape ingest many chemicals, some very dangerous and even carcinogenic. Nicotine is the addicting substance, and just the beginning of problematic chemicals kids (and adults) ingest when they vape. There are also nicotine analogues, or drugs that are not actually nicotine, which means they are harder for the government to control, yet can be just as dangerous as nicotine.

Vaping Essential Reads

The Hidden Dangers of Vaping: Causes, Impacts, and Solutions

Why Vaping Is So Dangerous for the Adolescent Brain

Nicotine

Most products vaped by e-cigarette users contain nicotine, which can harm brain development up to age 25. Using nicotine during adolescence can harm crucial parts of the brain controlling attention, learning, mood, and impulse control. In addition, study after study has shown the younger the person using problematic substances (nicotine, marijuana, alcohol, and many others), the higher the probability the individual will continue using it. This is why so many experts urge youths to delay using alcohol, vapes, and marijuana as long as possible. Some experts suggest nicotine dependence is among the hardest addictions to treat.

Most vape liquids or e-juice contain 5% nicotine (39-48 mg/pod).

Nicotine and Other Substances

In addiction to nicotine, vape liquids contain propylene glycol, glycerin, and flavorings. They also include carcinogens, like aldehydes, heavy metals such as nickel, tin, and lead, and other chemicals like diacetyl, all linked to serious lung disease.

Newer disposable devices with a 10-mL well of 5% nicotine (500-600 mg/device) e-juice deliver the nicotine equivalent of more than 10 packs of cigarettes.

An Insidious Problem: Chemical Analogues

Although the Food and Drug Administration (FDA) regulates tobacco products and nicotine content, this authority does not extend to chemical analogues of nicotine. For example, Spree, a recently introduced e-cigarette, contains 5% 6-methylnicotine (6MN). 6MN is a nicotine analogue loophole the manufacturer claims is exempt from FDA tobacco-product regulations, thereby allowing marketing with youth-appealing flavors and avoiding tobacco product taxes. Other sellers have introduced e-cigarette liquids containing nicotinamide, marketed as Nixotine, Nixodine, Nixamide, and Nic-Safe. Producers boast this substance is “carefully designed to target the same nicotinic acetylcholine receptors that traditional nicotine stimulates”. Government agencies need to catch-up to managing these addictive chemical analogues. I believe nicotine analogues should be urgently addressed by lawmakers and regulators, and the FDA should be granted authority to regulate these items the same as tobacco products.

Teens Wishing to Quit Vaping

In a creative use of two of adolescents’ favorite things, their phone and social media, researchers used an automated and interactive text message program to help vapers in the intervention group who wanted to end vaping. The researchers found 38% of the adolescents in the intervention successfully quit vaping, compared to 28% of the teens in the control group.

Vaping Marijuana

Cigarette smokers or nicotine vapers often smoke or vape cannabis as well. Many marijuana concentrate users prefer the e-cigarette/vaporizer because it is smokeless, sometimes odorless, and easy to conceal. The user (“dabber”) takes a small amount of marijuana concentrate, the “dab,” heating the substance using the e-cigarette/vaporizer, and producing vapors conferring an instant “high.”

Just like e-cigarettes, cannabis vaping is increasing as the most popular method of cannabis delivery among adolescents in the U.S. According to Hulsey, "Vaping cannabis carries significantly increased risks. It produces significantly greater physiological and psychological effects than smoking cannabis by delivering more THC per dose, which raises the potential for negative health effects and adverse reactions, from cannabis use disorder (CUD), mood disorders, psychosis, and cannabis-associated schizophrenia, especially among men.”

Conclusion

Adolescents and young adults are increasingly turning to vaping nicotine and marijuana, blissfully unaware of dangers these substances introduce to their brains, lungs, and overall health. Like heroin, cocaine, or other addictive drugs, nicotine induces drug-related feelings of pleasure and well-being by causing a release of dopamine. In addition, it induces releases of serotonin, important in appetite suppression, as well as glutamate, involved in learning and memory. But over time, the pleasure is gone, and the drug is needed to feel normal. Sometimes craving can trigger using alcohol, marijuana, or other drugs of abuse. Nicotine addiction has been recognized by researchers as easy to acquire as a teen and hard to quit. It’s important for everyone to realize threats caused by teenage vaping so we may better educate and protect them.