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Vaping is the term for smoking an electronic cigarette. The device heats liquid, containing nicotine and other chemicals, into a vapor that can be inhaled. They can resemble cigarettes, flash drives, pens, and other objects.
Nicotine is extremely addictive and e-cigarettes deliver a lot of it: One pod of liquid contains the nicotine equivalent of an entire pack of cigarettes. The popularity of vaping has left many individuals, especially young adults, newly addicted to nicotine.
Vaping is not currently approved by the FDA as an aid to quit smoking. However, clinical trials have found evidence that e-cigarettes can be an important tool to achieve that goal—and in some cases, they may be as effective as nicotine replacement therapy.
Vaping began to surge in popularity only recently, so the habit may not be familiar to everyone. Scientists and federal agencies have begun to study e-cigarettes as a smoking cessation tool, as well as their influence on development and health, but there’s still a lot to be learned about the consequences of continual e-cigarette use.
Most electronic cigarettes contain nicotine, but the devices can also deliver other drugs such as the cannabis-derived compounds THC and CBD. The components of the device include a cartridge of liquid containing nicotine (or another substance), a chamber where the liquid is vaporized, and a rechargeable battery.
Yes. E-cigarettes are just as addictive as conventional cigarettes. They contain the chemical nicotine, which is a highly addictive substance that’s hard to stop consuming. Since vaping has risen dramatically among teens, many adolescents may have an addiction to nicotine as they enter adulthood.
Smoking is the leading cause of preventable disease and death in the United States, according to the CDC. Vaping may offer tobacco smokers a less dangerous alternative and a path to quitting altogether—electronic cigarettes deliver nicotine, the addictive element of regular cigarettes, but without tobacco, a cancer-causing agent.
However, the devices are not currently approved by the FDA as an aid to quit smoking. An agency task force concluded that there was not enough evidence to officially recommend that smokers switch to e-cigarettes.
While the cumulative data has not risen to that threshold, a few randomized controlled trials have found evidence that e-cigarettes were a more successful quitting aid than nicotine replacement therapy, although people continued to use e-cigarettes longer after quitting. Other surveys indicate that many people who begin vaping use both regular and electronic cigarettes, rather than quitting altogether.
Numerous states have banned or limited the sale of e-cigarettes, including California, Massachusetts, Michigan, Montana, New York, Oregon, Rhode Island, and Washington, although many have faced legal challenges. In December 2019, the legal age to purchase any tobacco product, including e-cigarettes, was raised from 18 to 21 across the U.S.
The aerosol in e-cigarettes contains far fewer dangerous chemicals than the 7,000 found in regular cigarettes. But the vapor isn’t completely safe. In addition to nicotine, it contains flavoring that is often made from the chemical diacetyl, which has been linked to lung disease. The aerosol also includes particles of harmful organic compounds and metals like nickel, tin, and lead.
Vaping is dangerous for adolescents, as nicotine can disrupt healthy brain development, which continues until around age 25. Vaping is also not safe for pregnant women, because nicotine can harm both the expectant mother and the developing fetus.
Connections between neurons are still forming in the brain during adolescence. Nicotine can render the brain vulnerable to changes in the regions that govern impulse control, attention, and learning. It may also elevate the risk for mood disorders and addiction to other substances.
Nicotine acts on acetylcholine receptors, a neurotransmitter that plays a role in attention and memory. Nicotine’s activity in the brain also releases dopamine, which acts on regions like the nucleus accumbens, part of the brain’s reward network, which contributes to its addictive nature. This is why nicotine can boost mood and sharpen attention. The effects arrive quickly but they also fade quickly, which can generate symptoms of withdrawal and fuel the cycle of addiction.
In the spring of 2019, mysterious cases of respiratory illness began to emerge in adolescents and adults who used e-cigarettes. It was an enigma to the medical community, who came to refer to it as E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI.) As of February 2020, the CDC reported 2,807 hospitalizations for EVALI. Sixty-eight of those individuals died. Although this disease should be taken extremely seriously, it’s also important to note that it’s very rare, as more than 40 million people worldwide use e-cigarettes.
The CDC recommends that no one begin using e-cigarettes who doesn’t currently use tobacco products. But those who used e-cigarettes to quit smoking may want to continue in consultation with a doctor.
Lung injury appears to be associated with vaping THC, the compound in marijuana that produces the feeling of being high, rather than nicotine. EVALI was also linked to devices that were homemade or acquired from off-brand, underground sources.
The likely culprit is the chemical vitamin E acetate, which is used as a thickening agent for THC products. Vitamin E acetate doesn’t pose a risk in its natural forms, such as in foods like vegetables, meats, and oils, but it may impair the lungs when inhaled.
Vaping has spread through teen social circles with remarkable speed. One reason is that e-cigarette companies, most notably Juul Labs, directed marketing efforts toward teens, many of whom had never picked up a cigarette.
Between 2018 and 2019, the percentage of high-schoolers who reported vaping in the past 30 days jumped from 20 percent to 28 percent. For middle schoolers, the percentage rose from 5 percent to 11 percent. More than 3 million youth use e-cigarettes as of 2020, according to the CDC.
E-cigarettes are not considered safe for children or teens, according to the CDC, as they pose a risk to the developing brain. Nicotine may make it more difficult for young people to concentrate, learn, and control their impulses. Additionally, vaping products that contain THC has been linked to a deadly lung disease, EVALI, that has hit patients as young as 15 years old.
The vaping trend skyrocketed at the beginning of the decade. E-cigarette use among high school students increased by 900 percent between 2011 and 2016, according to a US Surgeon General's Report. Yet as of 2020, the trend may have begun to reverse. About 1.8 million fewer U.S. youth regularly smoke e-cigarettes in 2020 compared to 2019, according to the CDC.
Still, 3.6 million youth continue to use e-cigarettes. That represents nearly 20 percent of high school students (3.02 million) and about 5 percent of middle school students (550,000).
E-cigarette companies’ marketing practices may have targeted youth through their flavors and messaging on social media. Advertisements from the company JUUL, for example, often featured young people, and they established prominent channels on Instagram, Twitter, and YouTube. About 70 percent of middle and high school aged kids have viewed an advertisement for e-cigarettes. And once teens begin vaping, of course, the trend easily spreads through their social circles.
Vaping can impair brain development and lead to nicotine addiction, yet research suggests that adolescents often have a misconception that vaping is harmless. Most teens are unclear about the health risks, and many believe e-cigarettes are actually beneficial. As the study author stated, "Kids were really good at describing the harmful things that happen with cigarette smoking, but when we asked about other products, there was a lot of confusion.”
Although some teens may use e-cigarettes openly, others may hide the habit. The devices are relatively easy to conceal, because they resemble household items like pens or USBs and don’t involve an ashtray or a lighter. Some flavors are scented, but others can be odorless. People can vape without releasing a cloud of smoke. Vapes are relatively inexpensive, although regularly purchasing cartridges makes the habit increasingly pricey.
If you ask your child about vaping, broach the topic from a place of curiosity rather than attack. Read up on vaping and share information, because many teens don’t know that vaping poses risks to their health and brain development. Set an example by sharing the strategies you use to cope with stress. Then be clear on your stance. When they’re ready to quit, help them find resources that others have found helpful and effective.
Nicotine is a powerful substance, so quitting is no small feat. It often requires multiple attempts, but with appropriate therapy—and persistence—it’s always possible to permanently stop vaping.
Nicotine replacement therapy is one of the most effective treatments to help people stop vaping. It slowly delivers smaller quantities of nicotine through a patch or gum to alleviate symptoms of withdrawal. Therapy can also help change behavior to overcome addiction, such as acceptance and commitment therapy, dialectical behavior therapy, and cognitive behavioral therapy.
One woman’s story of quitting vaping revealed what made her final attempt different than previous ones: letting go of specific quit dates, using oral substitutes such as gum, mentos, or sunflower seeds, journaling to release and organize thoughts during withdrawal, praying, intention-setting, or otherwise acknowledging and asking for help, and changing the narrative of being a “vaper.”
Some individuals have found success quitting nicotine with holistic approaches such as meditation, acupuncture, and hypnosis. Clinical trials have found that mindfulness in particular can be an effective tool to quit smoking, by providing skills to uproot cravings for nicotine. This may provide a foundation for future insights about the role mindfulness can play in quitting e-cigarettes.
