E-cigarettes and Adolescents

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March 30, 2020

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It is now known that over 25% of high-school students and over 10% of middle schoolers are using e-cigarettes. Their sleek design, ease of use, and appealing flavors have largely driven this dramatic rise in popularity. Although e-cigarettes have been marketed as a quit-smoking option, these devices have proven more effective at leading to adolescent nicotine addiction.

Harms of E-cigarettes

Nicotine is the chemical in e-cigarettes that leads to addiction, similar to the traditional cigarette. Unfortunately, the teenage brain is undergoing rapid development (through the age of 25) and is especially susceptible to both the addictive and toxic effects of nicotine. Addiction in teens can occur at lower levels of nicotine exposure and less frequent use compared to adults. In fact, we know nearly all adult smokers started young with 95% beginning smoking before the age of 21. Nicotine is also harmful to the teenage brain and increases risk for mood disorders, reduced impulse control, difficulties with attention and cognition, and priming for use of other addictive substances.
In addition to nicotine, e-cigarettes also emit many toxins and fine particles. Several of these toxins are carcinogens (known to cause cancer). Heavy metals like cadmium, nickel, and lead have also been identified in e-cigarettes. These chemicals can deposit in the lungs and be absorbed into the body. Because e-cigarettes are a newer entity, we do not have long-term data on the harms that accompany their use but growing evidence is showing links between e-cigarettes and cancer.

Future Directions

An entire generation of adolescents is currently at risk of life-long nicotine addiction and the health harms that accompany use. We have an urgent need to protect teenagers from these devices. Increasing public education campaigns, expanding smoke-free air laws to include e-cigarettes, increased taxation, and flavor bans are all tools that need to be employed to fight this epidemic. Please talk to your teen about the harms of these devices and support interventions to reduce their use.

Brian Williams
Brian Williams is an Assistant Professor of Internal Medicine and Pediatrics at the University of Wisconsin School of Medicine and Public Health. He works as an adult and pediatric hospitalist. His academic interests include helping protect children from second and thirdhand smoke exposure as well as reducing adolescent vaping.

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