Risks of E-Cigarettes

E-Cigarette use among youth and young adults creates concerns for the Surgeon General

Soaring use of e-cigarettes among young people “is now a major public health concern,” according to the December 2016 report published from the United States Surgeon General. In the preface to the report, the surgeon general wrote that e-cigarette use among high school students increased “an astounding 900 percent” from 2011 to 2015.” The report finds that e-cigarettes are now the most commonly used tobacco product among youths, surpassing tobacco cigarettes. Most e-cigarettes contain nicotine, “which can cause addiction and can harm the developing adolescent brain.” The Surgeon General urged stronger action to prevent young people from getting access to e-cigarettes. 

As noted by the Surgeon General in Figure 1, the growing use of e-cigarettes among the youth is becoming a major problem.

Figure 1. Growth in E-Cigarette use among the youth from 2011–2015

Chart displaying the grown in e-cigarette use amoung youth

Source: Surgeon General, Know The Risks, E-Cigarettes & Young People, 2017

What are E-Cigarettes?

E-Cigarettes are commonly known as E-Cigs, Mods, E-Hookahs, Vape Pens, or Tank Systems. These devices heat a liquid into an aerosol that the user inhales. The liquid usually has nicotine in it among other flavorings and additives. E-cigarettes are considered to be tobacco products because most of them contain nicotine.

Nicotine is not the only harmful ingredient that e-cigarettes contain, according to the Surgeon General, other harmful and potentially harmful ingridients include:

  • Ultrafine particles that can be inhaled deep into the lungs
  • Flavorants such as diacetyl, a chemical linked to serious lung disease
  • Volatile organic compounds
  • Heavy metals, such as nickel, tin, and lead

Risks Associated with the Use of E-Cigarettes

The Surgeon General report highlights how e-cigarettes affect youth, pregnant women, and fetuses.

Youth: The use of e-cigarettes has a variety of effects on youth and young adults:

  • Causes nicotine addiction
  • Affects brain developmental
  • Prompts the use of conventional cigarettes and dual use of conventional cigarettes and e-cigarettes
  • Influences illicit drug use
  • Impacts psychosocial health
  • Risks battery explosion and accidental overdose of nicotine

Pregnant women: The rate of e-cigarette use among pregnant adolescents is currently unknown, according to the Surgeon General report, but effects of nicotine, secondhand smoke, and the potential harm by other e-cigarette toxicants shows that the use of e-cigarettes is a fetal risk factor. Listed below are specific effects of nicotine on prenatal development and postnatal outcomes specified in the Surgeon General report.

  • Higher risk of SIDS—Sudden Infant Death Syndrome—of an infant younger than 1 year of age
  • Altered development of corpus callosum
  • Deficits in auditory processing
  • Alternations in appetite behavior
  • Attention and cognitive deficits in the children

For further information about specific outcomes read the Surgeon General's full report, E-Cigarette Use Amoung Youth and Young Adults.

Marketing

The Surgeon General’s report shows a significant relationship between tobacco marketing and smoking, specifically among youth. There is a correlation, as shown in Figure 2, between the trend of e-cigarette use, that has been on the rise, and the amount spent on marketing efforts for e-cigarettes. In 2014, “$125 million was spent on marketing e-cigarettes.” In the same year, “47% of U.S. teens (1217 years of ages) and 82% of young adults (1821 years of age)” were exposed to advertisements of e-cigarettes in magazines. The more exposure the youth receives from advertising, the more curious they will become about e-cigarettes.

Figure 2. Quarterly Promotional Spending for E-Cigarettes, 2010–2014

Chart displaying Quarterly Promotional Spending for E-Cigarettes, 2010–2014

Source: Surgeon General, E-Cigarette Use Among Youth and Young Adults, 2016

Prevention

The Surgeon General issued a Call to Action specifically for young adults and the youth on the use of e-cigarettes. The Call to Action presents six goals and related strategies to help to reduce the use of e-cigarettes among the youth:

  1. Do no harm.
  2. Provide information about the dangers of e-cigarettes to the youth.
  3. Continue to regulate e-cigarettes at the federal level.
  4. Create programs and policies to prevent e-cigarette use among the youth.
  5. Curb advertising and marketing that encourages youth and young adults to use e-cigarettes.
  6. Expand surveillance, research, and evaluation related to e-cigarettes.

To learn more about the call to action, what us as individuals can do, view pages 237249 of the Surgeon General’s Report.

Cited Works

U.S. Department of Health and Human Services. 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 for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2016.

U.S. Department of Health and Human Services. Know The Risks, E-Cigarettes and Young People. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2017.