The use of e-cigarettes is unsafe for kids, teens, and young adults.Most e-cigarettes contain nicotine. Nicotine is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s.E-cigarettes can contain other harmful substances besides nicotine.Young people who use e-cigarettes may be more likely to smoke cigarettes in the future.What Are E-cigarettes?E-cigarettes are electronic devices that heat a liquid and produce an aerosol, or mix of small particles in the air.E-cigarettes come in many shapes and sizes. Most have a battery, a heating element, and a place to hold a liquid.Some e-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items. Larger devices such as tank systems, or "mods," do not look like other tobacco products.E-cigarettes are known by many different names. They are sometimes called "e-cigs," "e-hookahs," "mods," "vape pens," "vapes," "tank systems," and "electronic nicotine delivery systems (ENDS)."Using an e-cigarette is sometimes called "vaping."How Do E-cigarettes Work?E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavorings, and other chemicals that help to make the aerosol.The liquid used in e-cigarettes often contains nicotine and flavorings. This liquid is sometimes called "e-juice," "e-liquid," "vape juice," or "vape liquid."Users inhale e-cigarette aerosol into their lungs. Bystanders can also breathe in this aerosol when the user exhales it into the air.E-cigarette devices can be used to deliver marijuana and other drugs.What Is JUUL?
News outlets and social media sites report widespread use of JUUL by students in schools, including classrooms and bathrooms.
JUUL is a brand of e-cigarette that is shaped like a USB flash drive. Like other e-cigarettes, JUUL is a battery-powered device that heats a nicotine-containing liquid to produce an aerosol that is inhaled.All JUUL e-cigarettes have a high level of nicotine. According to the manufacturer, a single JUUL pod contains as much nicotine as a pack of 20 regular cigarettes.JUUL is one of a few e-cigarettes that use nicotine salts, which allow particularly high levels of nicotine to be inhaled more easily and with less irritation than the free-base nicotine that has traditionally been used in tobacco products, including e-cigarettes.News outlets and social media sites report widespread use of JUUL by students in schools, including classrooms and bathrooms.Approximately two-thirds of JUUL users aged 15 – 24 do not know that JUUL always contains nicotine.Although JUUL is currently the top-selling e-cigarette brand in the United States, other companies sell e-cigarettes that look like USB flash drives. Examples include the MarkTen Elite, a nicotine delivery device, and the PAX Era, a marijuana delivery device that looks like JUUL.Why Is Nicotine Unsafe for Kids, Teens, and Young Adults?Most e-cigarettes (vapes) contain nicotine—the addictive drug in regular cigarettes, cigars, and other tobacco products.A CDC study found that 99% of the e-cigarettes sold in assessed venues in the United States contained nicotine.Some vape product labels do not disclose that they contain nicotine, and some vape liquids marketed as containing 0% nicotine have been found to contain nicotine.Nicotine can harm the developing adolescent brain. The brain keeps developing until about age 25.Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control.Each time a new memory is created or a new skill is learned, stronger connections – or synapses – are built between brain cells. Young people's brains build synapses faster than adult brains. Nicotine changes the way these synapses are formed.Using nicotine in adolescence may also increase risk for future addiction to other drugs.How Does Nicotine Addiction Affect Youth Mental Health?When a person is dependent on (or addicted to) nicotine and stops using it, their body and brain have to get used to not having nicotine. This can result in temporary symptoms of nicotine withdrawal. include irritability, restlessness, feeling anxious or depressed, trouble sleeping, problems concentrating, and craving nicotine. People may keep using tobacco products to help relieve these symptoms.Youth may turn to vaping to try to deal with stress or anxiety, creating a cycle of nicotine dependence. But nicotine addiction can be a source of stress.What may start as social experimentation can become an addiction.The most common reason U.S. middle and high school students give for trying an e-cigarette is "a friend used them." The most common reason youth give for continuing to use e-cigarettes is "I am feeling anxious, stressed, or depressed." Youth e-cigarette and cigarette use have been associated with mental health symptoms such as depressionWhat Are the Other Risks of E-cigarettes for Kids, Teens, and Young Adults?Scientists are still learning about the long-term health effects of e-cigarettes.Some of the ingredients in e-cigarette aerosol could also be harmful to the lungs in the long-term. For example, some e-cigarette flavorings may be safe to eat but not to inhale because the gut can process more substances than the lungs.Defective e-cigarette batteries have caused some fires and explosions, a few of which have resulted in serious injuries.Children and adults have been poisoned by swallowing, breathing, or absorbing e-cigarette liquid through their skin or eyes. Nationally, approximately 50% of calls to poison control centers for e-cigarettes are for kids 5 years of age or younger.Flavors and Marketing Make E-cigarettes Appealing to YouthE-cigarettes come in various flavors, including fruit, candy, mint, and menthol.A study from 2013-2014 showed that most youth who use e-cigarettes first start with a flavored variety, and flavors are the primary reason youth report using e-cigarettes.6In 2022, most youth who reported using e-cigarettes used flavored varieties (84.9%). Among middle and high school students who currently used any type of flavored e-cigarette in 2022, the most commonly used flavors were fruit (69.1%), candy, desserts, or other sweets (38.3%), mint (29.4%), and menthol (26.6%).12On January 2, 2020, the U.S. Food and Drug Administration (FDA) finalized an enforcement policy that prohibits the sale of prefilled cartridge e-cigarettes in any flavor other than tobacco or menthol, unless authorized by FDA. FDA has since taken additional steps to prohibit certain companies from selling youth-appealing, flavored disposable e-cigarettes and flavored e-liquids without authorization.7Several states and communities have restricted the sale of flavored tobacco products, including menthol-flavored products.8E-cigarettes are also advertised using the same themes and tactics that have been shown to increase youth initiation of other tobacco products, including cigarettes. In 2021, approximately 76% of students reported exposure to tobacco product marketing through traditional sources and approximately 74% of students who used social media had seen e-cigarette–related posts or content.12Widespread advertising for e-cigarettes, including via media for which advertising for conventional tobacco products is prohibited (e.g., TV), and the lower costs of some e-cigarettes relative to regular cigarettes has contributed to use among youth.1Many youth also report using e-cigarettes because they are curious about these products.1Can Using E-cigarettes Lead to Future Cigarette Smoking Among Kids, Teens, and Young Adults?Many young people who use e-cigarettes also smoke cigarettes. There is some evidence that young people who use e-cigarettes may be more likely to smoke cigarettes in the future.Specifically, a 2018 National Academy of Medicine report found that there was some evidence that e-cigarette use increases the frequency and amount of cigarette smoking in the future.E-cigarettes also can be used to deliver other drugs, including marijuana; in 2016, approximately one-third of U.S. middle and high school students who have ever used an e-cigarette reported using marijuana in the device.But e-cigarette use among young people is still unsafe, even if they do not progress to future cigarette smoking.
