Teen Guidance

What’s the Bottom Line on the Risks of E-cigarettes for Kids, Teens, and Young Adults?

  • The use of e-cigarettes is unsafe for kids, teens, and young adults.
  • Most e-cigarettes contain nicotine. Nicotine is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s.
  • E-cigarettes can contain other harmful substances besides nicotine.
  • Young people who use e-cigarettes may be more likely to smoke cigarettes in the future.

What Are E-cigarettes?

  • E-cigarettes are electronic devices that heat a liquid and produce an aerosol, or mix of small particles in the air.
  • E-cigarettes come in many shapes and sizes. Most have a battery, a heating element, and a place to hold a liquid.
  • Some e-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items. Larger devices such as tank systems, or “mods,” do not look like other tobacco products.
  • E-cigarettes are known by many different names. They are sometimes called “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” “tank systems,” and “electronic nicotine delivery systems (ENDS).”
  • Using an e-cigarette is sometimes called “vaping.”

How Do E-cigarettes Work?

  • E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavorings, and other chemicals that help to make the aerosol.
  • The liquid used in e-cigarettes often contains nicotine and flavorings. This liquid is sometimes called “e-juice,” “e-liquid,” “vape juice,” or “vape liquid.”
  • Users inhale e-cigarette aerosol into their lungs. Bystanders can also breathe in this aerosol when the user exhales it into the air.
  • E-cigarette devices can be used to deliver marijuana and other drugs.

Why Is Nicotine Unsafe for Kids, Teens, and Young Adults?

  • Most e-cigarettes (vapes) contain nicotine—the addictive drug in regular cigarettes, cigars, and other tobacco products.
  • A CDC study found that 99% of the e-cigarettes sold in assessed venues in the United States contained nicotine.
  • Some vape product labels do not disclose that they contain nicotine, and some vape liquids marketed as containing 0% nicotine have been found to contain nicotine.
  • Nicotine can harm the developing adolescent brain. The brain keeps developing until about age 25.
  • 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. Young people’s brains build synapses faster than adult brains. Nicotine changes the way these synapses are formed.
  • Using nicotine in adolescence may also increase risk for future addiction to other drugs.
  • Most e-cigarettes (vapes) contain nicotine—the addictive drug in regular cigarettes, cigars, and other tobacco products.
  • A CDC study found that 99% of the e-cigarettes sold in assessed venues in the United States contained nicotine.
  • Some vape product labels do not disclose that they contain nicotine, and some vape liquids marketed as containing 0% nicotine have been found to contain nicotine.
  • Nicotine can harm the developing adolescent brain. The brain keeps developing until about age 25.
  • 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. Young people’s brains build synapses faster than adult brains. Nicotine changes the way these synapses are formed.
  • Using nicotine in adolescence may also increase risk for future addiction to other drugs.

How Does Nicotine Addiction Affect Youth Mental Health?

  • When a person is dependent on (or addicted to) nicotine and stops using it, their body and brain have to get used to not having nicotine. This can result in temporary symptoms of nicotine withdrawal.
  • Nicotine withdrawal symptoms include irritability, restlessness, feeling anxious or depressed, trouble sleeping, problems concentrating, and craving nicotine. People may keep using tobacco products to help relieve these symptoms.
  • Youth may turn to vaping to try to deal with stress or anxiety, creating a cycle of nicotine dependence. But nicotine addiction can be a source of stress.
  • What may start as social experimentation can become an addiction.
    • The most common reason U.S. middle and high school students give for trying an e-cigarette is “a friend used them.”
    • The most common reason youth give for continuing to use e-cigarettes is “I am feeling anxious, stressed, or depressed.”
  • Youth e-cigarette and cigarette use have been associated with mental health symptoms such as depression.

Do symptoms of nicotine withdrawal improve after quitting?

Yes. As long as a person stays quit, withdrawal symptoms will fade over time as the brain gets used to not having nicotine.

Does quitting vaping improve mental health?

Scientists are still learning about the effects of quitting vaping on mental health. Quitting smoking cigarettes is associated with lower levels of anxiety, depression, and stress, as well as improved positive mood and quality of life.

What Are the Other Risks of E-cigarettes for Kids, Teens, and Young Adults?

  • Scientists are still learning about the long-term health effects of e-cigarettes.
  • Some of the ingredients in e-cigarette aerosol could also be harmful to the lungs in the long-term. For example, some e-cigarette flavorings may be safe to eat but not to inhale because the gut can process more substances than the lungs.
  • Defective e-cigarette batteries have caused some fires and explosions, a few of which have resulted in serious injuries.
  • Children and adults have been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their skin or eyes. Nationally, approximately 50% of calls to poison control centers for e-cigarettes are for kids 5 years of age or younger.

What Is in E-cigarette Aerosol?

  • E-cigarette aerosol is NOT harmless “water vapor.”
  • The e-cigarette aerosol that users breathe from the device and exhale can contain harmful and potentially harmful substances, including:
    • Nicotine
    • Ultrafine particles that can be inhaled deep into the lungs
    • Flavorings such as diacetyl, a chemical linked to a serious lung disease
    • Volatile organic compounds
    • Cancer-causing chemicals
    • Heavy metals such as nickel, tin, and lead
  • The aerosol that users inhale and exhale from e-cigarettes can expose both themselves and bystanders to harmful substances.
  • It is difficult for consumers to know what e-cigarette products contain. For example, some e-cigarettes marketed as containing zero percent nicotine have been found to contain nicotine.

Flavors and Marketing Make E-cigarettes Appealing to Youth

  • E-cigarettes come in various flavors, including fruit, candy, mint, and menthol.
  • A study from 2013-2014 showed that most youth who use e-cigarettes first start with a flavored variety, and flavors are the primary reason youth report using e-cigarettes.
  • In 2023, most youth who reported using e-cigarettes used flavored varieties (89.4%). Among middle and high school students who currently used any type of flavored e-cigarette in 2023, the most commonly used flavors were fruit (63.4%), candy, desserts, or other sweets (35%), mint (27.8%), and menthol (20.1%).
  • On January 2, 2020, the U.S. Food and Drug Administration (FDA) finalized an enforcement policy that prohibits the sale of prefilled cartridge e-cigarettes in any flavor other than tobacco or menthol, unless authorized by FDA. FDA has since taken additional steps to prohibit certain companies from selling youth-appealing, flavored disposable e-cigarettes and flavored e-liquids without authorization.
  • Several states and communities have restricted the sale of flavored tobacco products, including menthol-flavored products.
  • E-cigarettes are also advertised using the same themes and tactics that have been shown to increase youth initiation of other tobacco products, including cigarettes. In 2021, approximately 76% of students reported exposure to tobacco product marketing through traditional sources and approximately 74% of students who used social media had seen e-cigarette–related posts or content.
  • Widespread advertising for e-cigarettes, including via media for which advertising for conventional tobacco products is prohibited (e.g., TV), and the lower costs of some e-cigarettes relative to regular cigarettes has contributed to use among youth.
  • Many youth also report using e-cigarettes because they are curious about these products.

All information is taken from the CDC.gov website. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html

Substance Abuse and Mental Health Services Administration (SAMHSA)

It’s Not Your Fault (NACoA) (PDF | 12 KB)
Assures teens with parents who abuse alcohol or drugs that, “It’s not your fault!” and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.

Treatment programs for teen drug use should be person-centered and evidence-based. Drug rehab facility professionals can assess and design an individualized plan that will best meet teenage needs, including inpatient and outpatient care. Many effective treatments are available to teens diagnosed with substance use disorders, including behavioral family therapy, motivational enhancement therapy, and cognitive-behavioral therapy (CBT). Drug rehab facility prescribers may also utilize medication management to treat teen drug use.

Teen drug abuse: Help your teen avoid drugs

Teen drug abuse can have a major impact on your child’s life. Find out how to help your teen make healthy choices and avoid using drugs.

Mayo Clinic

The Role of the Parent in Adolescent Substance Use

Suicide Prevention: The 988 Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week in the United States. We’re committed to improving crisis services and advancing suicide prevention by empowering individuals, advancing professional best practices, and building awareness. About The Lifeline.