E-cigarettes & Youth Risk

E-cigarette use among teens is SKYROCKETING. The U.S. Surgeon General has declared a nationwide vape epidemic. And South Dakota teens are at serious risk for nicotine addiction:

  • Middle schoolers are using e-cigarettes at a rate 8x higher from 2011.1
  • In 2019, 1 in 4 high schoolers and 1 in 16 middle schoolers in South Dakota regularly used e-cigarettes.2
  • Half of all South Dakota high school kids have tried an e-cigarette at least once.2

It’s likely these numbers will continue to rise as more national and state data is released and e-cigarette manufacturers develop sneakier tactics for targeting youth.

E-cigarettes are now the most commonly used tobacco product among youth in the United States. Many of the kids who are using e-cigarettes now will become tomorrow’s cigarette smokers because most tobacco use starts during adolescence.

Fact: Adolescents who vape are permanently damaging their brains.

Nicotine changes the way young brains learn skills and build habits. Because developing brains form connections quickly, adolescents can get addicted to nicotine alarmingly fast. This habit can also make the brain more susceptible to other addictions, like alcohol or drugs.

But there’s good news.

Sixty percent of young e-cigarette users want to quit within a year.3 And, the South Dakota QuitLine can help anyone 13+ kick their nicotine habit for good. Get the facts, talk with the teens in your life, and help end this epidemic.

What are e-cigarettes?

E-cigarettes are battery-operated devices that heat a solution (or e-liquid) and convert it into an aerosol (not a vapor), which is then inhaled and delivers nicotine and other chemicals to the user. This process is often called “vaping” or “juuling.”

Companies often market their devices and flavors to look like candy or other kid-friendly food items. These e-liquids contain highly concentrated nicotine.

E-cigarette and vape devices go by many names:

  • electronic nicotine delivery systems (ENDS)
  • e-cigs
  • e-hookahs
  • mods
  • vape pens
  • vapes
  • JUULs

Various e-cigarette devices from left to right: Puff Bar, Air Bar Max, POD, Vuse, JUUL, Suorin Air Open Pod, Joyetech e-Vic-VT Vape MOD, Glas Pod System, NJOY.

E-cigarette industry tactics

JUUL is currently the top-selling e-cigarette brand in the United States. Their product is shaped like a USB or flash drive. Other brands, such as Vuse or Puff Bars, resemble common objects like pens or lighters. There are hundreds of different brands and thousands of flavors of e-liquid.

E-cigarette manufacturers have purposely made their devices small and discrete, making it easy for teens to hide them in a sleeve, pocket, purse, or book bag at school.

And their sneakiness doesn’t stop at disguising the devices. Vape companies disguise the truth, too:

  • They target kids with ads that make vaping look cool and fun.
  • They downplay the high levels of nicotine in their products and potential for addiction.
  • They emphasize freedom, community and suggest vaping is a casual social activity.
  • Unlike nicotine replacement therapy (NRT) products that are designed to help people step-down and quit, e-cigarette companies want customers — not quitters.

At first glance, it’s hard to tell which is candy and which isn’t. Well, that’s no accident. Confusion works in the tobacco and vape companies’ best interest. They WANT kids to think products like chew tobacco, vape, mods, JUUL pods, and flavored cigars are as fun and harmless as candy bars. It’s a trick, not a treat. Nicotine in any form is poison and ADDICTIVE!

Why is vaping so dangerous?

Vaping is especially harmful to kids. Here are just some of the reasons why:

  1. The brain keeps developing until age 25. Using nicotine in any form hurts the part of the brain controlling impulse control, attention, learning, and memory. THIS DAMAGE IS IRREVERSIBLE.
  2. Teens who use e-cigarettes are 4 TIMES more likely to start smoking, which causes even more lifelong health problems.4
  3. It’s a common myth that the cloud produced by vaping is just harmless water vapor. It isn’t. E-cigarette aerosols can contain nicotine, toxins, metals, and cancer-causing chemicals. One study discovered that vaping aerosols can have equal to OR HIGHER concentrations of these dangerous particles than cigarette smoke.
  4. The liquid in vapes is DEADLY. Small children and pets have died from accidentally consuming e-cigarette liquid.
  5. The chemicals in e-liquids can be absorbed through the skin too. Kids or pets don’t have to ingest it. Just touching it can be very dangerous. Scary stuff.
  6. Vape companies play down how much nicotine is actually in their devices. It’s a lot. One JUUL Pod = 20 cigarettes worth of nicotine. That’s an entire pack of cigarettes. Yikes! And some manufacturers have even included nicotine salts in their e-liquids, which increases the rate and amount of nicotine delivered. Yikes again.
  7. Nicotine use can damage adolescents’ abilities to cope with stress. Researchers have found that nicotine dependence is associated with anxiety, depression, and even suicidal tendencies.

Social media influencers are at work too, whether intentional or not. When kids repeatedly see TikTok or Instagram personalities vaping, e-cigarette use is normalized. Combine these parasocial relationships with a peer group that, statistically, is no stranger to e-cigarettes, and you’ve got a youth population with an inaccurate and desensitized understanding of vaping’s real risks.

How does nicotine affect developing brains?

Studies on the long-term health consequences of e-cigarettes are still underway, so teens often underestimate or are unaware of the risks associated with e-cigarettes.

But we do know that most e-cigarettes contain nicotine, and nicotine in any form is extremely hazardous for teensʼ developing brains.

FACT: In people under 25, nicotine in any form… smoke, vape, chew, will shrink young brains. So using nicotine is like self-inflicting brain damage!

Increased risk of addiction

The brain keeps developing until about age 25. Teens are uniquely at risk for long-term, irreversible effects of exposing their developing brains to nicotine.

  • Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control.
  • Each time a new memory is created or a new skill is learned, stronger connections – or synapses – are built between brain cells.
  • Because addiction is a form of learning, adolescents can get addicted more easily than adults. 5
Increased risk of substance use

Most tobacco use starts during adolescence.

  • Teens who use e-cigarettes are 4 times more likely to start smoking, which can lead to a lifetime of nicotine addiction.
  • Some evidence suggests nicotine may prime teens for alcohol use and other substance use, such a marijuana.
  • Certain e-cigarette products can be used to deliver other drugs like marijuana.

What can we do?

Talk with your kids

Be open and honest with your kids about the dangers of nicotine and e-cigarette use. Make it clear that vaping is dangerous, and be frank about why.

Be patient. These conversations might take time to sink in.

The U.S. Surgeon General offers a tip sheet for starting the conversation.

Provide resources to quit

Help stop nicotine addiction in its tracks.

The SD QuitLine helps users age 13 and older quit e-cigarettes.

Encourage teens to enroll in our coaching program or request a Kickstart Kit. No matter which option they choose, they’ll be provided with confidential, consistent, and nonjudgmental support to kick the habit. The QuitLine’s Quit Coaches are supportive advocates trained to help people plan and stick to a quit path.

Work together with your community

Schools, educators, community leaders, and healthcare professionals play important roles in providing the facts and guiding teens away from e-cigarette use.

National websites like Smokefree Teen, the Truth Initiative, and the U.S. Surgeon General’s Know the Risks: E-cigarettes and Young People offer information and tools for combatting the e-cigarette epidemic.

What does the Surgeon General say?

E-cigarettes were initially developed and marketed as a substitute for combustible cigarettes. However, they are not an FDA-approved quit aid and most contain nicotine—a highly addictive drug. In fact, according to the Surgeon Generalʼs 2020 Smoking Cessation report, there is “inadequate evidence to conclude that e-cigarettes increase smoking cessation.”

Also alarming is the fact that e-cigarette companies are using the same advertising tactics the tobacco industry has used for decades to persuade a new generation of young people to use their products. Companies use celebrities, sexual content, and claims of independence to glamorize these addictive products and make them appealing to young people.

The Surgeon General Report highlights the rapidly changing patterns of e-cigarette use among youth and young adults, assesses what we know about the health effects of using these products, and describes strategies that tobacco companies use to recruit our nation’s youth and young adults to try and continue using e-cigarettes. The report also outlines interventions that can be adopted to minimize the harm these products cause to our nation’s youth.

If you want to quit, or help someone quit – the QuitLine can help you kick your nicotine habit for good. Enroll now.

What’s the FDA regulation?

In 2016, the FDA created a rule for e-cigarettes and e-liquids. This means that e-cigarettes fall under government regulation as tobacco products because they contain nicotine that comes from tobacco. Under this rule:

  • It is illegal to sell e-cigarettes, hookah tobacco, or cigars in person or online to anyone under age 18.
  • Buyers have to show their photo ID to purchase these products.
  • These products cannot be sold in vending machines (unless in an adult-only facility).
  • It is illegal to hand out free samples.
  • The FDA regulates the manufacture, import, packaging, labeling, advertising, promotion, sale, and distribution of e-cigarettes. This includes components and parts of e-cigarettes but excludes accessories.

The FDA Commissioner released a statement about enforcement and has outlined a plan to prevent e-cigarette use among youth and specifically called out JUUL, in August, 2018. An additional statement was released in November 2018 with plans to limit access to flavored tobacco products.

In January 2020, the FDA implemented a more strict enforcement of regulating flavored e-cigarette products. While not a ban, this regulation makes distributing popular e-cigarette flavors riskier for vape companies. In response, JUUL pulled all flavors besides mint and menthol—but hundreds of other vape companies are still producing sickly sweet flavors.