Illustration of e cigarette tools

From CDC Smoking & Tobacco Use: About Electronic Cigarettes (E-Cigarettes)

Did you know that vapes are now the most commonly used tobacco product for teens? According to the 2019 National Youth Tobacco Survey conducted by the CDC, about 27.5% of high schoolers and 10.5% of middle schoolers are current vape users. You’ve probably seen at least one kind of vape, but they can vary widely by design and look.  

In fact, the sheer number of different names for these devices has been a critical challenge for researchers’ surveillance of vape products and investigating patterns of use. For example, some names include e-cigarettes, e-cigs, vapes, vape pens, pods, tanks, and tank systems.1 In an interview with NPR, Mil Schooley, a college student, demonstrated how different perceptions may also cause confusion, claiming that there is a difference between people who “JUUL” and those who “vape.” Certain that “JUULing” is less intense and less addictive - Schooley says, “people who JUUL can be normal people, but people who vape are like a certain crowd… you can JUUL and not be addicted to nicotine.”8 This is factually untrue and an example of how misinformation abounds about vapes.

Some vapes in the market are made to look like regular cigarettes, cigars, or pipes. However, some other devices look more like pens, USB drives, and other ordinary objects.3 Variety in name, shape, and size can make vapes hard to spot in a classroom setting, and easier to hide than traditional cigarettes, with some teens reporting that as a reason for using vapes.2

Vape pen illustration

Regardless of form, vapes generally have the same components and operate similarly. Most vapes have a battery, a heating element like a metal coil, and a chamber that holds the e-liquid, or e-juice. When the liquid inside the vape is heated, it creates an aerosol that users inhale. The aerosol is comprised of microdroplets of water that can contain nicotine, metals like nickel, tin, and lead, cancer-causing chemicals, and often flavorings. 4,5,6 People around those vaping can also breathe in this aerosol when the user exhales into the air.3 

Some vapes, including Juul, the most popular vape on the market, often contain high concentrations of nicotine. JUUL has more than twice the amount of nicotine concentrate as many other brands of vapes. One JUUL cartridge, or pod, contains roughly the same amount of nicotine as one pack of cigarettes.7 Different vapes can create larger or smaller clouds of aerosol, which facilitates easier, subtler use in an indoor setting. 

There are dangers associated with vapes beyond vaping. Vapes can cause fires because of defective batteries. Poisonings have resulted from accidental swallowing or touching the vapes’ e-liquid. Acute nicotine exposure can be toxic, and many e-liquids contain high concentrations of nicotine.1 

Danger of vaping All of this information should be concerning for teachers. There are many reports that highlight the issue of teens vaping in the classroom. An article from The Wall Street Journal, “Vaping Moves From the Bathroom to the Classroom,” highlights how easy vapes are to hide, leaving behind only a faint fruity scent and a cloud that quickly dissipates. Kids can hide vapes in highlighters, pencil cases, sleeves, and more. There is even a line of clothing designed specifically to conceal vapes in hoodies, jackets, and more. There are special phone cases, backpacks, pens, and smart watches, all designed to be subtle vapes or vape containers.10

An article from Stanford’s School of Medicine blog reports the existence of tens of thousands of YouTube videos, many posted by teens, on how to “stealth vape.” This refers to the practice of using discrete or hidden vapes and low-odor e-juice to hide the use of vapes. These videos have received hundreds of thousands of views.11

Some researchers assert that the easy concealment of these devices is the clearest example of marketing to youth. Why would adults need to conceal the use of vapes? A spokesperson for JUUL Labs, the manufacturer for JUUL, said in a statement to NPR that both the design and the flavors offered were intended to make the device more inviting to adult cigarette smokers, not children. 

So how are students getting their hands on these devices? While some states are tightening restrictions, these products are often being sold directly from the brands’ website. This means that kids can still go online, click a button that says they are at least 21 years old, and purchase through the website. “The majority of adolescents I see are purchasing JUUL from the Internet,” says Sarper Taskiran, MD, a child and adolescent psychiatrist at the Child Mind Institute.9 Kids can also get vapes from older students, family, or friends. 

As manufacturers get more creative, parents and teachers are challenged to keep up with the vape market features to be able to identify these devices. Regardless of the form of these vapes, education and open conversation can go a long way to helping students understand the long-term risks of vapes and make productive choices. Online resources are available to equip communities with the tools they need to support teens and fight youth vaping.

 References:

  1. U.S. Department of Health and Human Services (USDHHS). E-cigarette use among youth and young adults. A report of the Surgeon General. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center of Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2016. https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Full_Report_non-508.pdf
  2. Peters R.J., Jr., Meshack A., Lin M.T., Hill M., Abughosh S. The social norms and beliefs of teenage male electronic cigarette use. J. Ethn. Subst. Abuse. 2013;12:300–307. doi: 10.1080/15332640.2013.819310
  3. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html#what-are-e-cigarettes
  4. Ebbert, J., Agunwamba, A., & Rutten, L. (2015). Counseling patients on the use of electronic cigarettes. Mayo Clinic Proceedings, 90(1), 138-134.
  5. Willett, J. G., Bennett, M., Hair, E. C., Xiao, H., Greenberg, M. S., Harvey, E., . . . Vallone, D. (2018). Recognition, use and perceptions of JUUL among youth and young adults. Tobacco Control. doi:doi: 10.1136/tobaccocontrol-2018-054273
  6. Centers for Disease Control and Prevention. (2018, May 16, 2018). Electronic Cigarettes. Retrieved from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm 
  7.  Public Health Law Center at Mitchell Hamline School of Law. Public health concerns about youth & young adult use of JUUL. www.publichealthlawcenter.org/blogs/2018-02-19/public-health-concerns-about-youth-young-adult-use-juul
  8. https://www.npr.org/sections/health-shots/2017/12/04/568273801/teenagers-embrace-juul-saying-its-discreet-enough-to-vape-in-class
  9. https://childmind.org/article/teen-vaping-what-you-need-to-know/
  10. https://www.healthline.com/health-news/teens-and-disguised-vaping-devices#Knowing-the-risks
  11. https://scopeblog.stanford.edu/2018/09/19/stealth-vaping-fad-hidden-from-parents-teachers/