More youth turn to vaping

When companies first sold electronic cigarettes in 2007, they marketed the product as a way to quit smoking. But in recent years there’s been a spike in underage use of e-cigarettes, and it’s not because youth are trying to kick a smoking habit.

Approximately 14 percent of high schoolers and 3 percent of middle schoolers—more than 2.5 million U.S. students overall—used e-cigarettes in 2022, according to an October 2022 study from the Centers for Disease Control and Prevention and the Food and Drug Administration. The highest number of children with vaping-related nicotine poisoning was reported in 2022 as well, with the majority of cases involving children under 5. Earlier this year, advocates and legislators raised concerns that some e-cigarette companies use packaging that may appeal to children and is not child-resistant.

While doctors don’t fully know how smoking e-cigarettes, or vaping, affects health, recent research raises serious concerns about underage vaping. Most e-cigarettes, also called vape pens, contain nicotine, which can impair adolescent brain development. Some also contain cancer-causing chemicals and tiny particles that can penetrate the lungs. A 2022 study found that long-term use of e-cigarettes damages blood vessels and increases the risk for cardiovascular disease. The latest research, published in Thorax earlier this month, indicates that young people can develop serious respiratory problems, including shortness of breath and bronchitis, after only 30 days of e-cigarette use.

In 2019, President Donald Trump signed a bill into law that prohibited selling any tobacco product, including e-cigarettes, to people under age 21. Some states have introduced further restrictions on e-cigarettes: California, Massachusetts, New Jersey, New York, and Rhode Island ban all flavored e-cigarettes, while Utah and Maryland ban some flavors. A 2022 study showed that e-cigarette sales dropped by up to 31 percent in states with flavor bans, in comparison to states without bans.

Naomi Hamburg, a cardiologist and professor of medicine at Boston University School of Medicine, researches the effects of vaping on children’s health. She said that when children vape, their blood vessel health changes: blood pressure and heart rate increase, while the ability of blood vessels to relax decreases. “The change relates to toxins released in the vape called volatile organic compounds,” Hamburg said in an email.

Hamburg said vaping also activates the nervous system’s fight-or-flight response, which means that children who respond to stress by vaping are actually increasing their stress levels.

U.S. teenagers aren’t the only ones experimenting with vaping. In the United Arab Emirates, counselor Vidya Venkat has worked with two teen clients who came to her while struggling with life issues after turning to vaping to cope. One, a 15-year-old boy, was placed in counseling after being caught twice vaping in school. The second client, a 13-year-old boy, was brought to her because of anger issues. Venkat said both boys were vaping as a coping mechanism. “There is this underlying need to suppress their emotions,” she said. “So the easiest thing that they have access to is vaping.” Once she helped the teens identify root causes like anger and feelings of helplessness, both boys were able to eventually quit vaping.

Stephanie Siete is a member of Parents Against Vaping E-cigarettes and the public information officer at Community Bridges Inc., an addiction treatment center in Mesa, Ariz. She pulled no punches in describing the harm vaping products can do. “It’s poison, period,” she said. Siete explained that the liquid in an e-cigarette is vaporized by heating to over 400 degrees Fahrenheit. “Now you can inhale this vapor into your lungs. Well, at some point that 400 degrees plus vapor has to re-cool and re-solidify, and that’s what does damage to the lungs,” she said.

Siete said parents, youth, and even law enforcement officers tend to be under-informed about the health risks of vaping. During training sessions, she shows graphic images of burn marks, vape device explosions, and children on ventilators. “When you show real stories, the kids and the adults are usually shocked,” she said.

Siete explained children can hide their vaping habits, tucking an e-cigarette, which can be as small as a USB drive, into their sleeve and discreetly exhaling puffs back into their sleeve during class without anyone noticing. And flavored e-cigarettes like blueberry ice and cool mint flavors give off pleasant fragrances, unlike the distinctly unpleasant tobacco smell that cigarettes carry.

Vaping researcher Hamburg said most teens and young adults who vape are interested in quitting. Her group developed a research program using virtual reality to help youth stop using e-cigarettes. “The teens who are trying the program are enthusiastic,” she said about the VapeChat program. “There is an urgent need for more well-tested approaches to help kids who vape stop using.”