Vaping and E-Cigarettes

Key takeaways

• Nicotine: most e-cigarettes contain nicotine, which is highly addictive
• Brain development: continues until about age 25, and nicotine can harm it
• Most useful single change: Talk openly with teens about vaping and listen to their reasons.
• Commonest mistake: Buying vaping products from informal or online sellers, or THC vapes from unlicensed sources.
• See a doctor if any of the signs under "When to get help" below apply to you.

Why it matters

E-cigarettes are the most commonly used tobacco product among US middle and high school students, and nicotine harms the developing brain.

The numbers, in one place

Published figures for Vaping and E-Cigarettes

Measure	Figure
Nicotine	most e-cigarettes contain nicotine, which is highly addictive
Brain development	continues until about age 25, and nicotine can harm it
Legal age	the federal minimum age to buy tobacco products, including e-cigarettes, is 21
Aerosol	can contain harmful substances, including heavy metals and cancer-causing chemicals
Quitline	1-800-QUIT-NOW (1-800-784-8669)

What helps

• Talk openly with teens about vaping and listen to their reasons
• Use free help to quit, such as 1-800-QUIT-NOW or smokefree.gov
• Ask your doctor about FDA-approved quit-smoking medicines if you are an adult who smokes
• Store e-liquids locked away from children; swallowing them can be poisonous

What to avoid

• Buying vaping products from informal or online sellers, or THC vapes from unlicensed sources
• Using e-cigarettes and cigarettes together
• Assuming vaping is harmless for young people

In depth

E-cigarettes work by heating a liquid, usually containing nicotine, flavorings and other chemicals, into an aerosol that is breathed into the lungs. Devices range from disposable vapes to refillable tanks and pods, and some look like USB drives, pens or other everyday items. Some are used to vape THC or other substances rather than nicotine.

Nicotine is the main reason vaping is hard to stop. It reaches the brain within seconds and triggers the release of dopamine, which reinforces the habit. Many vapes contain high levels of nicotine, sometimes as much as or more than a pack of cigarettes, and young people can become dependent quickly. Nicotine also affects attention, learning and impulse control in the developing brain.

For adults who smoke, completely switching to e-cigarettes may reduce exposure to some harmful chemicals compared with smoking cigarettes, but e-cigarettes are not risk-free, and the long-term effects are still being studied. They are not approved by the FDA as quit-smoking aids. For young people and people who have never smoked, there is no health benefit to vaping, and guidelines advise against it.

Signs and symptoms

• Strong urges to vape, or vaping soon after waking
• Irritability, restlessness or trouble concentrating when not vaping
• Unfamiliar devices, pods or chargers among a teen's belongings
• Sweet or fruity smells without an obvious source
• Coughing, wheezing or chest discomfort
• Increased thirst, nosebleeds or mouth irritation

Causes and risk factors

• Appealing flavors and marketing aimed at young people
• Friends, siblings or parents who vape or smoke
• Easy access through stores, online sellers or social contacts
• Using vaping to cope with stress, anxiety or depression
• Believing vaping is harmless
• High-nicotine products, which make dependence more likely

How it is checked

There is no single test for vaping. Your doctor will ask about vaping, smoking and other tobacco use, and how often and how soon after waking you vape. These questions help gauge nicotine dependence. They may listen to your lungs, check your breathing and ask about symptoms such as cough, chest pain or shortness of breath.

In 2019, a serious lung illness called EVALI was linked mainly to THC-containing vaping products with vitamin E acetate. If you vape and develop shortness of breath, chest pain, cough, fever or stomach symptoms, tell your doctor about all products you use, including THC. They may order a chest X-ray or other tests.

Related topics

• Vaping and Teens: What the Evidence Actually Says (Teen Health)
• Smoking and the Heart: What Published Guidance Supports (Heart Health)
• The Evidence on Stopping Smoking, Without the Hype (Preventive Care)
• Smoking and the Lungs: Sorting the Evidence From the Noise (Respiratory Health)

Where to go next

• Vaping and E-Cigarettes in Five Minutes
• What the Guidance Really Says About Vaping and E-Cigarettes
• Substance Use: The Complete Guide
• What the Guidance Really Says About Stimulant Use
• Medications for Opioid Use Disorder: What Published Guidance Supports

When to get help

See your doctor for a cough, chest pain or shortness of breath that does not go away. Call Poison Control at 1-800-222-1222 if a child swallows e-liquid, and 911 if they have a seizure, trouble breathing or are hard to wake.

Where this comes from

• CDC — E-Cigarette Use Among Youth
• FDA — E-Cigarettes, Vapes, and other Electronic Nicotine Delivery Systems (ENDS)
• National Cancer Institute — Smokefree.gov

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.