The number of teens who vape has risen significantly over the past decade. In 2023, approximately 1 in every 22 middle school students and 1 in every 10 high school students reported e-cigarette use in the past month.
This dramatic increase in e-cigarette use, especially among teenagers, is causing concern – and for good reason, says Devika Rao, M.D., a pediatric pulmonologist at Children's Health℠ and Associate Professor at UT Southwestern.
"It's very worrisome. Vaping devices are not FDA-regulated and have been found to contain substances that are not meant to be inhaled, like benzene, which leads to cellular damage of the lung. We don't yet know the long-term effects of vaping," Dr. Rao says.
What are the health risks of vaping?
There is a misconception that e-cigarettes are a healthier alternative to traditional combustible cigarettes. Health effects of vaping include the risk of chronic nicotine addiction, lung disease and damage, cardiovascular damage and increased risk for additional substance use.
Still, the popularity of vaping shows a lack of understanding of the potential side effects. Dr. Rao says a big part of the problem is confusion about what e-cigarettes contain.
"Many people think that there's just simple water vapor and flavorings that taste good, but there is so much more," she says. "Things like nickel, tin and lead – these are heavy metals that can cause direct damage to the lungs."
While research is still underway about the health effects of vaping, Dr. Rao explains what we know and why teens are at risk.
1. Vaping puts teens at risk for nicotine addiction.
Many teens do not know that the majority of e-cigarettes contain nicotine, nor do they understand how addictive nicotine can be. Many e-cigarettes are extremely addictive due to the high concentration of nicotine in each hit. Combined with a vulnerable, developing brain, adolescents and teens are more susceptible to long-term nicotine addiction.
"The nicotine that is contained in vaping products is very potent, and the potential for chronic nicotine addiction is so much more in teens and adolescents than in adults because their brains are still developing," says Dr. Rao. "Children are leaving class, asking to use the bathroom to use e-cigarettes because they're so addicted."
Nicotine can harm brain development in adolescents, affecting their attention span, learning, mood and impulse control.
"People with nicotine addiction are frequently anxious and depressed, have less of an ability to concentrate without the drug, have less patience and feel worse than their peers," explains David Atkinson, M.D., Medical Director of the Teen Recovery Program at Children's Health and Associate Professor at UT Southwestern.
2. Vaping is bad for your lungs.
The aerosol from e-cigarettes is not just water vapor. Flavor cartridges include a number of chemicals and toxins, such as diacetyl, formaldehyde, benzene and other carcinogens. When heated and inhaled, these toxins pose many health dangers including "popcorn lung," a condition which scars the lungs and blocks tiny airways, leading to respiratory problems.
"We know vaping can cause inflammation and cellular impairment in the airways of the lungs, but we still don't know the full long-term repercussions," warns Dr. Rao.
One study published in June 2019 showed that the lung's ability to clear itself of mucus was impaired when lung cells were exposed to e-cigarette nicotine containing vapor. Another study from 2017 showed that adolescents using e-cigarettes were more likely to have chronic bronchitis compared to those who never used e-cigarettes.
"The lung has a natural ability to clear itself of pollutants and even bacteria and viruses. When you can't clear out mucus, you're more susceptible to respiratory illnesses and even chronic bronchitis," explains Dr. Rao.
In 2019, a multistate outbreak of severe lung illnesses that may be linked to e-cigarette use was reported, including multiple fatalities.
"What we're seeing are cases of acute lung injury that may be linked to vaping," says Dr. Rao. "The symptoms are similar to pneumonia, but seem to be harder to treat, and even may require treatment in an intensive care unit."
The Centers for Disease Control and Prevention says that symptoms include breathing difficulty, shortness of breath, chest pain, gastrointestinal distress and fatigue, all in patients who report e-cigarette use. Experts are currently investigating the exact cause of this condition.
3. Vaping, even once, affects cardiovascular health.
In addition to affecting the lungs, the nicotine and chemicals in e-cigarettes have also been tied to cardiovascular (heart) disease. A 2019 study found that people who vape were 56% more likely to have a heart attack and 30% more likely to suffer a stroke than those who do not vape.
New research shows that these cardiovascular risks are not limited to regular e-cigarette users. Another 2019 study found that after just one use of an e-cigarette, the body's blood vessels and circulation were affected – even when no nicotine was present.
4. Use of e-cigarettes increases risk of other substance use.
Teens who use e-cigarettes are much more likely to smoke tobacco, traditional cigarettes and use other substances such as drugs and alcohol. The NIH reports that 30.7% of e-cigarette users started smoking within 6 months while 8.1% of non-users started smoking. Another study found that teens who vape were more than 3-times more likely to use marijuana than their peers.
The main message parents and teens should know about e-cigarette use is they are simply not safe. Having open conversations with your child, early and often, can help prevent e-cigarette use now and in the future.
See more tips about talking to teens about the dangers of vaping.
Some dangers of vaping include nicotine addiction and lung damage. In 2023, 1 in every 10 high school students reported vaping within the past month. Talk to teens about the risks and learn more via @Childrens.
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