Electronic cigarettes, or e-cigarettes, have gained immense popularity in recent years, particularly among youth. Despite being marketed as a safer alternative to traditional cigarettes, e-cigarettes pose significant health risks that cannot be ignored. In this article, we will explore five essential facts about e-cigarettes that everyone should be aware of.
1. The E-Cigarette Industry Targets Youth
The e-cigarette industry has a history of targeting young people through various marketing strategies. Since the invention of the JUUL in 2015, the disposable e-cigarette market has experienced rapid growth, with a 46% increase in the total number of brands between January 2020 and December 2022. Companies appeal to youth by offering candy and food-flavored products, sometimes resembling toys, food, or cartoon characters.
Experts believe that the e-cigarette industry targets youth because they are more easily manipulated, have developing brains, and can become long-term customers due to nicotine addiction. As a result, approximately 1.63 million middle school and high school students currently use e-cigarettes.
2. E-Cigarettes Contain Harmful Substances
Not all e-cigarette devices are created equal, and they often differ in the harmful substances they contain. The most common types of vapes include disposable e-cigarettes, refillable e-cigarettes, and e-cigarettes with prefilled cartridges or pods. E-cigarette aerosol can contain nicotine, cancer-causing chemicals, heavy metals, volatile organic compounds, and flavorings like diacetyl, which is linked to serious lung disease.
It is important to note that some flavorings found in e-cigarettes may be safe for consumption but dangerous when inhaled, as the gut and lungs process substances differently. Additionally, companies often lack transparency in their marketing, claiming that products are nicotine-free even when they contain nicotine. Many e-cigarettes also contain nicotine salts, which allow individuals to consume high amounts of nicotine without experiencing the harshness of freebase nicotine.
3. E-Cigarette Use Poses Serious Health Risks
Despite the efforts of Big Tobacco to advertise e-cigarettes as "safer" alternatives to cigarettes, they are still linked to various health concerns. Nicotine, a key ingredient in e-cigarettes, can harm brain development and increase the risk of addiction. E-cigarette use is associated with increased risks of breathing problems, frequent cases of bronchitis, and lung infections.
Nicotine levels in e-cigarettes can raise heart rates, increase blood pressure, and irritate blood vessels, similar to the effects seen in people who smoke regular cigarettes. E-cigarette use, especially among youth, can harm brain development and lead to long-term health consequences. While long-term studies are limited, the potential risks are significant and require further investigation.
4. Regulations Aim to Curb Youth E-Cigarette Use
Governments and regulatory bodies have taken steps to address the growing concern of youth e-cigarette use. In January 2020, the FDA banned unauthorized flavored e-cigarettes appealing to youth, such as fruit and mint flavors. Companies that failed to comply faced enforcement actions within 30 days. The FDA also prioritized enforcement against manufacturers that did not prevent youth access and required companies to submit applications demonstrating product safety and appropriateness.
As of June 2024, all US states and territories have banned the sale of e-cigarettes to minors. Many states also require a retail license for over-the-counter sales and have included e-cigarettes in smokefree indoor air laws. Several states have implemented taxes on e-cigarettes, either based on volume or a percentage of cost. The US Supreme Court recently reviewed the FDA's ban on flavored e-cigarettes, which are often marketed to youth. Concerns have been raised about potential deregulation under the Trump administration after President-elect Donald Trump vowed to "save vaping" in a Truth Social post.
5. The COVID-19 Pandemic Worsened Youth Vaping and Mental Health
The youth vaping and mental health crises are intertwined, and both have worsened during the COVID-19 pandemic. Before the pandemic, 70% of youth perceived anxiety and depression as major issues, a trend that was amplified by the pandemic. E-cigarette use may further increase mental health risks, with current users twice as likely to be diagnosed with depression.
Surveys have found that many young people vape to cope with anxiety, stress, and depression, but vaping can actually worsen these symptoms. Nicotine withdrawal can exacerbate mental health issues, creating a cycle of addiction and worsened mental health. The COVID-19 pandemic has contributed to increased levels of e-cigarette use and mental health challenges, with about 78% of individuals who vaped during the pandemic reporting that they vape the same or more now. Despite returning to in-person learning, many students anticipate continued or increased vaping rates among their peers.
Quitting vaping can significantly improve mental health by reducing anxiety, depression, and stress. Despite high e-cigarette usage, many young vapers express interest in quitting, with a significant portion making recent quit attempts or planning to quit soon. Given the urgent need to reduce youth e-cigarette use, especially in the post-pandemic era, current efforts like flavor bans, nicotine restrictions, taxation, and premarket review are positive steps. However, further measures such as limiting adult access, regulating internet sales, and ensuring age-appropriate marketing are crucial for future public health initiatives.
