Electronic Vapor Product Use - Youth

Electronic Vapor Product Use - Youth in United States

United States

In recent years, there has been an increase in the popularity of electronic vapor products (also known as e-cigarettes, vapes or vape pens) among youth. Electronic vapor products are electronic devices that use heat to make an aerosol that is inhaled by the user. They are typically used to deliver the addictive compounds nicotine or tetrahydrocannabinol (THC), the active component of cannabis. The aerosol made by e-cigarettes contains toxic substances, such as nicotine, that can cause cancer and lung disease. Nicotine has also been found to negatively affect brain development in children and adolescents. A 2017 study showed e-cigarette use in adolescence as a strong predictor of subsequent cigarette use. 

E-cigarettes pose other risks to children, teens and young adults. Both children and adults have been poisoned by coming into contact with e-cigarette liquid. Further, defective e-cigarette batteries have caused fires and explosions.

The prevalence of electronic vapor product use is higher among:

• Female high school students compared with male high school students.
• Hispanic and white students compared with Black students. 
• Gay, lesbian or bisexual students compared with heterosexual and questioning/unsure students.
• Transgender high school students.

The role of parents is important in preventing and reducing e-cigarette use in youth. Strategies include:

• Being an example for youth by being tobacco-free. 
• Visiting tobacco-free restaurants and other public locations.
• Ensuring children’s schools, colleges or universities are tobacco-free.
• Prohibiting the use of tobacco products at home and in vehicles. 
• Visiting health care providers for answers to questions about the health risks of e-cigarette use. 

Various resources are available to help parents, teachers and health care providers prevent e-cigarette use in youth. 

On the policy level, effective actions for addressing e-cigarette use in youth include:

• Restricting e-cigarette advertisements online and on social media such as YouTube, Twitter and Instagram, particularly ads targeting youth.
• Expanding current tobacco policies to include e-cigarettes. For example, current tobacco-free campus policies should include e-cigarette use.
• Developing educational initiatives about the health consequences of e-cigarette use. 
• Restricting sales to minors by placing a clear indication of the minimum age where sales of e-cigarettes take place, prohibiting sales from vending machines and eliminating self-service displays of e-cigarettes. 
• Enforcing existing laws that focus on e-cigarette retailers.

Healthy People 2030 has a goal to reduce current e-cigarette use in adolescents.

England, Lucinda J., Rebecca E. Bunnell, Terry F. Pechacek, Van T. Tong, and Tim A. McAfee. “Nicotine and the Developing Human.” American Journal of Preventive Medicine 49, no. 2 (August 16, 2015): 286–93. https://doi.org/10.1016/j.amepre.2015.01.015.

Gentzke, Andrea S., Teresa W. Wang, Monica Cornelius, Eunice Park-Lee, Chunfeng Ren, Michael D. Sawdey, Karen A. Cullen, Caitlin Loretan, Ahmed Jamal, and David M. Homa. “Tobacco Product Use and Associated Factors Among Middle and High School Students — National Youth Tobacco Survey, United States, 2021.” MMWR. Surveillance Summaries 71, no. 5 (March 11, 2022): 1–29. https://doi.org/10.15585/mmwr.ss7105a1.

McKenna, Lawrence A., Jr. “Electronic Cigarette Fires and Explosions in the United States 2009 - 2016.” USFA Topical Fire Report Series. United States Fire Administration, FEMA, July 2017. https://www.usfa.fema.gov/downloads/pdf/publications/electronic_cigarettes.pdf.

Soneji, Samir, Jessica L. Barrington-Trimis, Thomas A. Wills, Adam M. Leventhal, Jennifer B. Unger, Laura A. Gibson, JaeWon Yang, et al. “Association Between Initial Use of E-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults: A Systematic Review and Meta-Analysis.” JAMA Pediatrics 171, no. 8 (August 1, 2017): 788–97. https://doi.org/10.1001/jamapediatrics.2017.1488.

U.S. Department of Health and Human Services. “E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General.” Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2016. https://www.cdc.gov/tobacco/data_statistics/sgr/e-cigarettes/pdfs/2016_sgr_entire_report_508.pdf.