Keeping Teens Safe: E-Cigarette and Vaping Risks

Keeping Teens Safe: E-Cigarette and Vaping Risks

Hitting the U.S. market in 2006, e-cigarettes are one of the most popular smoking trends today.

Sometimes referred to as “vaping” or “juuling,” these devices work by using an electronic device to heat a liquid typically made up of nicotine, flavoring, and other chemicals which the user inhales as a vapor.

As of 2016, there were 10.8 million adult users of e-cigarettes. While the use of these products among adults is growing, its increasing popularity among teenagers is alarming. In 2018, the rate of vaping nearly doubled among U.S. high school students.

Pictured: electronic cigarette device and flavored cartridge.

While they have been marketed as healthier than cigarettes, vaping products contain toxins.  The amount of nicotine in e-cigarettes is not regulated and may vary, sometimes to levels higher than traditional cigarettes.

E-cigarette brands appeal to a younger crowd that otherwise may not be legally allowed to purchase tobacco products. By developing cartridge flavors like mango and donuts, brands distract teens from the fact that each cartridge can have as much nicotine as an entire pack of cigarettes.

Teens who use e-cigarettes are four times more likely to progress to cigarette addiction as adults.

One of the most popular e-cigarettes among teens is a device known as a Juul, a particularly small e-cig, much like a USB, that can discretely fit inside one’s pocket.

Juul cartridges fit in pencil bags and often go unnoticed.

Editorial credit: Steve Heap /

This has caused concern among parents and teachers about students’ ability to bring these devices to school. Many parents are concerned about the long-term effects of this trend, but the health concerns don’t stop there.

What is the Health Impact of E-Cigarettes?

While any benefit of “vaping” is inconclusive, the hazards are rapidly becoming apparent. This has led to health recommendations against vaping.

Most recently, August 2019, there was an outbreak of lung disease linked to e-cigarettes that affected over 450 cases in 33 states, with 5 reported deaths to date.  The Centers for Disease Control is investigating the exact cause of this outbreak.

Learn more about the hazards of e-cigarettes and vaping.

In adolescents, the use of e-cigarettes can cause lifelong harm in many ways.

Nicotine affects the development of the brain’s reward system and continued e-cigarette use not only fuels nicotine addiction, but it also can make other drugs such as cocaine and marijuana more pleasurable to a teenager’s developing brain.  For teens and young adults, vaping has been shown to increase the use of tobacco cigarettes and other addicting substances later in life.

Myth: E-Cigarettes help you quit smoking

One argument made in support of e-cigarettes that they may help established smokers quit tobacco smoking.  However, the harm caused by e-cigarettes can be severe, offsetting any health benefits from quitting tobacco.  There are plenty of quality nicotine substitutes and medications to aid in quit smoking other than vaping, and the use of e-cigarettes is not generally recommended to aid in smoking cessation.

The US Centers for Disease Control recommends these 6 tips:

1. Adults who do not currently use tobacco products should not start using e-cigarette products.

2. If you do use e-cigarette products, you should not buy these products off the street (for example, e-cigarette products with THC or other cannabinoids).

3. Youth and young adults should not use e-cigarette products.

4. Women who are pregnant should not use e-cigarette products.

5. You should not modify e-cigarette products or add any substances to these products that are not intended by the manufacturer.

6. Adult smokers who are attempting to quit should use evidence-based treatments, including counseling and FDA-approved medications. If you need help quitting tobacco products, including e-cigarettes, contact your doctor or other medical providers.

Important resources to help you quit

This is Quitting

It’s a free mobile program from the Truth Initiative to help teens and young adults quit juuling. Simply text “DITCHJUUL” to 887-09 to get started.  Learn more.


A 24/7 resource is available. Whether it is for you or someone you love, we have confidential counseling and Quit Coaches ready to support you as you strive for a tobacco-free life. Learn more.

Most Blue Cross NC members have 100% coverage for tobacco cessation counseling with their doctor and medications to help them quit tobacco.


University of Michigan Monitoring the Future study (December 2018); JAMA (Feb 2019); Truth Initiative

Centers for Disease Control 

Drug Abuse. Gov

Dr. Larry Wu

About Dr. Larry Wu

Larry Wu, MD is a regional medical director for Blue Cross and Blue Shield of North Carolina and provides consultative services for employee health solutions, prevention, chronic disease, care management, medical expense and utilization management. He is a family physician with over 20 years in clinical practice, has served as clinic director in the Indian Health Service, Kaiser Permanente and Duke Family Medicine and currently maintains a part-time clinical practice.