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 tetrahydrocannabinol (THC), the active component of cannabis, or the addictive compound nicotine. The aerosol made by e-cigarettes contains toxic substances that can cause cancer and lung disease. Nicotine has also been found to affect brain development in children and adolescents. A 2017 study found e-cigarette use in adolescence to be 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.

According to data from the Youth Risk Behavior Survey, the prevalence of current electronic vapor product use is
higher among:

• Female high school students compared with male students.
• Hawaiian/Pacific Islander, American Indian/Alaska Native, white, Hispanic and multiracial high school students compared with Asian students. 
• Bisexual high school students compared with heterosexual, gay or lesbian, and questioning/unsure students.

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

• Setting an example for youth by being tobacco-free. 
• Prohibiting the use of tobacco products at home and in vehicles.
• Ensuring children’s schools, colleges or universities are tobacco-free.
• Visiting tobacco-free restaurants and other public locations.
• Talking to health care providers about the health risks of e-cigarette use. 
• Starting conversations with youth about e-cigarettes that include facts and avoid criticism.

At 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 that target youth.
• Expanding existing tobacco policies to include e-cigarettes. For example, tobacco-free campus policies should cover e-cigarette use.
• Developing educational initiatives about the health consequences of e-cigarette use. 
• Enforcing minimum age laws on e-cigarette sales by increasing clear signage, 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.

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.

Oliver, Briana E., Sherry Everett Jones, Emily Devora Hops, Carmen L. Ashley, Richard Miech, and Jonetta J. Mpofu. “Electronic Vapor Product Use Among High School Students — Youth Risk Behavior Survey, United States, 2021.” MMWR Supplements 72, no. 1 (April 28, 2023): 93–99. https://doi.org/10.15585/mmwr.su7201a11.

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.