In 2022, 2.55 million U.S. middle and high school students 
currently use e-cigarettes. About 14% of high school students and 3.3 % of middle school students reported current e-cigarette use. According to the survey, middle and high school e-cigarette users increased significantly between 2019 and 2020. Approximately 23.6 million people in the United States have a dependence on nicotine. Nicotine dependence stems from the use of tobacco products, which most often occurs during youth and young adulthood.
According to a survey conducted by the Centers for Disease Control and Prevention, e-cigarettes are the most commonly used tobacco product among high school and middle school students, which subsequently increases the risk for these kids to go on to use other tobacco products or to have addictions to other substances.
About 14 percent of those high school students and 3.3 percent of middle school students reported current e-cigarette use. Daily use was reported among 27.6 percent of current e-cigarette users. According to the survey, middle and high school e-cigarette users increased significantly between 2019 and 2020. In 2020 and 2021, approximately 80 percent of middle and high school students who used e-cigarettes opted for the flavored varieties.
While JUUL suspended the online sale of its flavored e-cigarettes, Puff Bar still has more than 20 different flavors that are available for purchase online.
Another potential reason for the rise in vaping among young people is that the type of nicotine used in e-cigarettes is different from those in regular cigarettes. E-cigarettes use nicotine salts, which are complex compounds that contain salt-base nicotine. The effects of the nicotine salts are typically less harsh and allow for a better tolerance when vaping, as opposed to smoking traditional cigarettes.
“Nicotine salts act more quickly,” said Megan Roberts, PhD, an assistant professor in the College of Public Health at The Ohio State University and a member of the Cancer Control Program. “Nicotine salts are less acidic, so they are less averse to young users. With cigarettes, the first experience is usually unpleasant. But these nicotine salts are a lot less aversive and so that initial barrier for first use goes away.”
But selling palatable flavored cartridges is not the only reason for the rise in interest among teenagers. The marketing strategies of common e-cigarette brands, like Puff Bar and JUUL have been controversial for a number of years now. In its early days, JUUL bought ad space on youth-focused websites, like Nickelodeon, and Cartoon Network, as well as Seventeen magazine, reports The New York Times.
“From my experience, various groups of teens use vape products – some who struggle in school and social situations, as well as those who appear to be high achievers,” said Patricia Folan, RN, CTTS, Director of the Northwell Health Center for Tobacco Control in Lake Success, New York. “The attractive packaging, the enticing flavors, the belief that they are safe or safer than cigarettes, and the fact that many of their friends are using them have all contributed to this trend of e-cigarette use among our youth.”
It is true that e-cigarettes are less harmful than regular cigarettes, says the CDC. E-cigarettes have far fewer chemicals than the 7,000 chemicals in regular cigarettes. But that does not mean that e-cigarettes are “better” for you.
“We’re still learning about the concerns of e-cigarettes,” said Roberts. “There is current evidence that shows short-term acute effects that are indicative of long-term concern. Inhaling chemicals in the paper is a concern, as is the concern of nicotine, which is the addictive component of cigarettes.”
Nicotine has many harmful effects, including:
- Dizziness
- Lightheadedness
- Abnormal sleep disturbances
- Blood-flow risk
- Headache
- Coronary artery disease
- Shortness of breath
- Cancer
“Nicotine also affects the brain of developing young people. Earlier use is even more of a concern, and then the concern also becomes the transition to other types of tobacco products, like regular cigarettes,” said Roberts. “This creates potential for a lifetime of nicotine addiction. Education is the first avenue for change, but government policy should also play a role in slowing down this harmful trend.
“We need to institute policies and regulations, similar to those for cigarette smoking, to change the social norm forming around these products and discourage their use among teens,” said Folan. “Pediatricians, other healthcare providers, and parents need to be educated about these products and talk to teens in an effort to prevent use or help with cessation.”
