Winter 2019

It’s Time to Address the Vaping Epidemic

The director of the Tufts Medical Center Outpatient Pulmonary Clinic explains.

By Sucharita Kher

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Photo: Shutterstock

Vaping, the practice of inhaling aerosol from electronic cigarettes, is rampant in schools. An estimated 3.6 million American middle and high school students used e-cigarettes in the past thirty days, according to a recent report from the Centers for Disease Control and Prevention. In 2018, one in five high schoolers reported vaping in the past month—up from about one in 100 in 2011—and the numbers are rising. The U.S. Surgeon General and the commissioner of the Food and Drug Administration have called e-cigarette use among youth an “epidemic.”

E-cigarettes are electronic devices that heat pods of liquid containing nicotine, flavorings, and other chemicals to produce an aerosol that can be inhaled. Many look like sleek pens and USB drives, making them easy to conceal at school and at home.

Teenagers view vaping as a safe alternative to cigarette smoking, but that’s a dangerous misconception. A single pod from Juul, the largest maker of these devices, can contain as much highly addictive nicotine as twenty cigarettes. Nicotine can adversely affect adolescent brain development, which continues until young adults are in their midtwenties and can decrease impulse control. It is also associated with mood, attention, and learning problems in adolescents, as well as with heart attack risk.

There are many other harmful substances in e-cigarettes, too. They are marketed in fruit, candy, and dessert flavors to appeal to children and teens. While some flavorings may be safe to eat, they can be harmful when breathed into the lungs. Propylene glycol, another common ingredient, is known to be an irritant when inhaled. The contents of e-cigarettes are not regulated, and some ingredients can be carcinogenic. Metals such as tin, nickel, and lead have been also found.

Adolescents who vape are more likely to smoke traditional cigarettes in the future compared to their non-vaping counterparts. Vaping increases airborne concentration of nicotine and particulate matter in indoor environments. Similarly, malfunctioning equipment has led to burn injuries, and accidental ingestion of the e-liquid has resulted in seizures and even death. As the CDC advises: “If you have never smoked or used other tobacco products or e-cigarettes, don’t start.” The long-term effects of e-cigarettes aren’t known; more research on the health risks is needed. And it is needed now.

For more tips on how to talk to teenagers about vaping, visit

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