What You Should Know about E-Cigarettes and Vaping

Electronic cigarettes, or e-cigarettes, include vapes, hookah pens, or other disposable vape devices. They are battery-powered devices that heat an e-liquid sometimes called "e-juice" that often contains nicotine. E-cigarettes are inhaled like regular cigarettes and produce an aerosol cloud of nicotine or other substances. They are not proven to be a safer alternative to cigarettes.

• The aerosol produced by e-cigarettes isn’t water vapor and it isn’t harmless.
• The aerosol inhaled from these products is often a mixture of harmful chemicals like nicotine, formaldehyde and acrolein.
• Virtually all e-cigarettes contain nicotine—even the ones labeled "nicotine free." This is because there are no rules about how e-cigarettes or "e-juice" are made. There is no way to know exactly what is in an e-cigarette.
• "E-juice" and e-cigarettes that are flavored like fruit or other treats carry the same health risks as the unflavored products. Also, the flavorings used are typically not safe to be inhaled into the lungs.

• For years, Big Tobacco has used flavoring to lure young smokers into a life of addiction. Now they are using this same strategy to entice today’s youth into trying e-cigarettes.
• Two-thirds of teens who vape are using fruit-flavored e-cigarettes, and 64 percent report using mint or menthol e-cigarette flavors.
• It has also been found that if teens start vaping with sweet flavors like cotton candy or mango, they are more likely to develop a lifetime addiction.
• The American Lung Association strongly supports clearing all flavored products from the market, including menthol.

• E-cigarettes contain chemicals that can cause irreversible lung damage and alter teen brains.
• E-cigarettes contain harmful chemicals such as formaldehyde, which is known to cause cancer, and acrolein which is used as a weed killer and can cause irreversible lung damage.
• Nicotine is highly addictive and exposure during adolescence can harm the developing brain.
• Youth who use e-cigarettes are more likely to go on to use traditional cigarettes.
• In the short term, e-cigarette aerosol can irritate your lungs, throat and eyes. It can also make it more likely that you’ll catch colds or get the flu.

• In the majority of states, the minimum age of sale for e-cigarettes is 18; in three states the minimum age is 19 and in six states and DC the minimum age is 21.
• In many states, it is illegal for retailers to sell youth e-cigarettes, and in some states it is also illegal for youth to possess e-cigarettes.
• Many schools have added e-cigarettes to their tobacco-free school policies and the consequences for using them on school grounds are often the same as smoking traditional cigarettes.

• No e-cigarette has been found to be safe and effective to help people quit smoking.
• If you know someone who wants to quit smoking, they can call 1-800-LUNGUSA (1-800-586-4872) or visit Lung.org/quit-smoking to learn about quitting safely.

• E-cigarettes are battery-powered devices that use a heating element to heat e-liquid, typically containing nicotine, from a cartridge that produces a chemical-filled aerosol.
• Many e-liquids or "e-juice" come in fruit flavors, making them appealing to kids.
• E-cigarettes come in many forms and can look like everyday products like pens, USB flash drives, phones and tubes of lipstick.

• The Surgeon General has concluded that e-cigarette aerosol is not safe.
• E-cigarettes contain harmful and potentially harmful ingredients, including formaldehyde and acrolein, which can cause irreversible lung damage. They also contain nicotine.
• E-cigarettes can be used for delivery of marijuana and other illicit drugs.
• FDA has found no e-cigarette to be safe and effective in helping people quit; in fact, more than half of all adult e-cigarette users continue to use regular cigarettes.

• Use by "friend or family member"
• Availability of "flavors such as mint, candy, fruit, or chocolate"
• Belief that "they are less harmful than other forms of tobacco such as cigarettes"

The bottom line: e-cigarette use is unsafe, especially for young people.

• Schools should work with their students to help educate them about the potential long-term consequences of using e-cigarettes.
  • Kids often don't realize that they are harming their lungs and their brains by using e-cigarettes.
  • Kids may not realize that the products they are using contain nicotine, which is highly addictive and can harm adolescent brain development.
• It's not just harmless water vapor: secondhand emissions from e-cigarettes can contain nicotine; ultrafine particles; flavorings such as diacetyl, a chemical linked to serious lung disease; volatile organic compounds such as benzene, which is found in car exhaust; and heavy metals, such as nickel, tin and lead.
• The e-cigarette industry is currently using many of the same tactics that worked to sell traditional cigarettes for decades.
• These products are designed to appeal to and be used by teens and can go undetected by adults.

• Institute and enforce comprehensive tobacco-free campus policies, including all e-cigarettes. Punitive policies aren’t effective. Many of our youth are already addicted to nicotine through these tobacco products and therefore efforts are needed to help kids quit. Schools should offer programs on-site to help students quit or connect them with resources to support them in breaking free from their addiction.
• Ensure all teachers, administrators and staff know the different kinds of e-cigarettes on the market and the dangers they pose to young people.
• Participate in the "Real Cost Campaign." FDA's tobacco prevention campaign which now features ads to educate teens on the dangers of e-cigarettes. Schools can take advantage of free print materials and web content from the campaign.

• The Vape Talk is a resource for parents to learn more about how to talk to teens about vaping and download a conversation guide.
• Not On Tobacco (N-O-T) is the American Lung Association’s teen smoking cessation program and helps teens who want to quit, and provides the tools, information and support to quit for good. NOT for Me is also available as a self-paced online version at NOTforMe.org.
• Intervention for Nicotine Dependence: Education, Prevention, Tobacco and Health (INDEPTH) is an "out-of-the-box" alternative to suspension or citation that seeks to address the teen vaping problem in a more supportive way. Instead of exclusionary discipline, students participate in a series of interactive educational sessions focused on nicotine addiction, establishing healthy alternatives and making the change to be free of all nicotine and tobacco products. The program is administered by an adult facilitator in either a one-on-one or group format and can be offered in a school or community-based setting or through an online version at INDEPTHOnline.org. Visit Lung.org/INDEPTH, call 1-800-LUNGUSA (1-800-586-4872) or email INDEPTH@Lung.org to learn more.