Current Trend - Vaping, E-cigarettes, and Nicotine

Most e-cigarettes consist of four different components, including:

  • a cartridge, reservoir or pod which holds a liquid solution (e-liquid or e-juice) containing varying amounts of nicotine, flavorings, and other chemicals
  • a heating element (atomizer)
  • a power source (usually a battery)
  • a mouthpiece that the person uses to inhale

In many e-cigarettes, puffing activates the battery-powered heating device, which vaporizes the liquid in the cartridge. The user then inhales the resulting aerosol or vapor (called vaping).

Vaping devices are popular among teens and are now the most commonly used form of nicotine among youth in the United States. Some research shows that many teens do not even realize that vaping cartridges contain nicotine, and assume the pods contain only flavoring. The easy availability of these devices, alluring advertisements, various e-liquid flavors, and the belief that they're safer than cigarettes have helped make them appealing to this age group. In addition, they are easy to hide from teachers and parents because they do not leave behind the stench of tobacco cigarettes, and are often disguised as flash drives.

How does vaping affect the brain?

The nicotine in e-liquids is readily absorbed from the lungs into the bloodstream when a person vapes an e-cigarette. Upon entering the blood, nicotine stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, breathing, and heart rate. As with most addictive substances, nicotine activates the brain’s reward circuits and also increases levels of a chemical messenger in the brain called dopamine, which reinforces rewarding behaviors. Pleasure caused by nicotine’s interaction with the reward circuit motivates some people to use nicotine again and again, despite risks to their health and well-being.

Health Effects for Teens

The teen years are critical for brain development, which continues into young adulthood. Young people who use nicotine products in any form, including e-cigarettes, are uniquely at risk for long-lasting effects. Because nicotine affects the development of the brain's reward system, continued nicotine vaping can not only lead to nicotine addiction, but it also can make other drugs such as cocaine and methamphetamine more pleasurable to a teen's developing brain. 1  

Nicotine also affects the development of brain circuits that control attention and learning. Other risks include mood disorders and permanent problems with impulse control—failure to fight an urge or impulse that may harm oneself or others. 1

E-cigarette, or Vaping Product, Use Associated Lung Injury (EVALI)

In recent years, public health and medical professionals have encountered a novel concern known as E-Cigarette or Vape Associated Lung Injuries, otherwise known as EVALI. EVALI refers to damage to a vape user’s lungs that can result in symptoms such as shortness of breath, cough, chest pain, and rapid and shallow breathing.2 During the period of time between the summer of 2019 and February 2020, the CDC recorded over 2,800 hospitalizations due to EVALI along with 68 deaths caused by the condition. Researchers believe the cause of this outbreak may have been linked to the presence of vitamin E acetate, a synthetic form of vitamin E, in some THC-containing vaping products. However, available evidence cannot rule out the contribution of other chemicals of concern included in both THC and/ or non-THC vape products. Most of these EVALI cases reported obtaining their vape products from “informal sources” such as friends, family, dealers, or online sources, rather than commercial outlets. 

Fortunately, EVALI cases are on the decline - due in part to increased public awareness of the dangers surrounding vapes. The CDC, the FDA, state and local health departments, and other clinical and public health partners continue monitoring cases of EVALI, but stress that people do not use THC-containing e-cigarette, or vaping products, particularly from informal sources like friends, family, or in-person or online dealers. The public health agencies also urge that both nicotine- and THC-containing vaping products should NEVER be used by youth or young adults.3

1 U.S. Department of Health, and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease, Prevention and Health Promotion, Office on Smoking and Health. E-Cigarette Use Among Youth And Young Adults: A Report of the Surgeon General — Executive Summary.; 2016  https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf

2 E-cigarette, or vaping product, use associated lung injury (EVALI) [Internet]. Yale Medicine; 2022. Available from: https://www.yalemedicine.org/conditions/evali 

3 Outbreak of lung injury associated with the use of e-cigarette, or vaping, products [Internet]. Centers for Disease Control and Prevention; 2021. Available from: https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

Resources

Center for Disease Control and Prevention - Tobacco

CDC's website on smoking and tobacco use. See here for data and statistics related to tobacco use, related health effects, and information on how to quit.

Keeping your Kids Tobacco Free

Quitting tobacco is not easy, but it can be done. Whether you smoke cigarettes, use smokeless tobacco, or are trying to help a friend or loved one, you'll find the information you need in this section.

Helping a Teen or Young Adult Quit Vaping

BecomeAnEX (‘EX’) is run by Truth Initiative®, the largest non-profit public health organization dedicated to helping people quit tobacco. Use the following link for resources such as: Community support from other parents and former vapers/smokers, information about addiction and how medication can make quitting more comfortable, guides for conversations with your child, and interactive learning tools on strategies to help manage stress and quit vaping.

Know the Risks

This website is a product of the U.S. Department of Health and Human Services, created through a partnership between the Office of the U.S. Surgeon General and the U.S. Centers for Disease Control and Prevention, Office on Smoking and Health. See here for the facts on e-cigarette use among youth and young adults.