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Children's Health

Vaping and E-Cigarettes

Close up image of three vape/e-cigarettes on a white background.

E-cigarettes have become very popular with teens, and with people who are trying to quit smoking. People who use these devices also call it vaping or Juuling. But major health concerns have been raised about e-cigarettes. And experts are advising people not to use them. This Q&A explains what’s known about e-cigarettes.

What are e-cigarettes?

E-cigarettes are also known as electronic nicotine delivery systems. These devices are often made to look like regular cigarettes, cigars, or pipes. Some even look like flashlights or pens. The leading e-cigarette brand, Juul, makes a device that looks like a USB flash drive. This is easy for teens to hide from their parents or teachers. It’s so popular that teens now call using this device "Juuling."

E-cigarettes may be harmful. They may have substances that can cause cancer. They have also been linked to severe lung conditions. Some people have died from these lung conditions. Experts are not sure exactly what has caused these life-threatening illnesses. They don’t seem to be caused by lung infections. But all of the people who developed these lung conditions had used e-cigarettes. The CDC calls this EVALI (e-cigarette or vaping product use-associated lung injury). Experts don't know if people who have had EVALI are at higher risk for severe complications of the flu (influenza) or other viral lung infections. Healthcare providers recommend a yearly flu shot for everyone over 6 months of age, including people who have had EVALI.

Because of these and other health risks, experts advise people not to use e-cigarettes.

How do e-cigarettes work?

E-cigarettes have 3 parts: a battery, a heating device, and a cartridge or tank. The part that heats up is called a vaporizer. To use an e-cigarette, a person inserts a cartridge or fills the tank with a liquid solution. This liquid may contain different substances such as:

  • Nicotine

  • THC and CBD oils, both active ingredients in marijuana

  • Other substances and additives

The type of substances in the liquid, and the amounts, may vary with each product. One of the dangers of e-cigarettes is that users often don’t know what is actually in the liquid.

When the e-cigarette is puffed, the vaporizer heats up. It turns the nicotine-containing liquid in the tank or cartridge into a vapor (aerosol). Users then breathe in this vapor. Doing this is called vaping. It mimics real cigarette smoking. Other people nearby can also breathe in this vapor. Experts don’t yet know what the effects are of secondhand vaping smoke. But there is concern that this may also be harmful.

What are the health risks of e-cigarettes?

E-cigarettes are dangerous for kids, teens, young adults, or pregnant women. They are not considered safe for adults who don't smoke.

Lung disease concerns

E-cigarettes have been linked to severe lung disease. The exact cause is not clear yet. But all of the people who developed these lung conditions had vaping in common. Some people have died from these illnesses. Most people who became sick used e-cigarettes that contained the chemical THC. This is the main active ingredient in marijuana. Some people became ill after using e-cigarettes with both THC and nicotine. Others got sick after using only nicotine e-cigarettes.

Some of the people who became sick after vaping had symptoms of severe lung disease. These symptoms can occur slowly over a few days or weeks. They may become so serious that you need to be hospitalized. Call your healthcare provider right away if you use e-cigarettes and have these symptoms:

  • Cough, shortness of breath, or chest pain

  • Nausea, vomiting, or diarrhea

  • Extreme tiredness (fatigue)

  • Fever of 100.4ºF (38°C) or higher

  • Belly (abdominal) pain

People who use e-cigarettes should not buy e-cigarette products off the street. They may not be safe. They are more likely to contain unknown amounts of THC, CBD, and other harmful substances. Users should also not modify these devices or add substances to them that are not made by the e-cigarette manufacturer and not purchased from a store.

Nicotine and other harmful chemicals

E-cigarette users are inhaling nicotine. This is a very addictive substance. And that’s a special concern for young users. Teens who vape may become addicted to nicotine, which can harm their developing brain. They may also start smoking regular cigarettes.

At high doses, nicotine can cause dizziness and vomiting. Juul products, which are popular among teens, deliver much more nicotine than other brands. One of their "pods" has about the same amount of nicotine as one pack of cigarettes. And e-cigarette users who refill their own cartridges are especially at risk for unsafe levels of nicotine.

Nicotine poisoning is also a big concern in children. Children younger than age 5 have been harmed after accidentally coming into contact with the nicotine liquid.

E-cigarettes may contain other harmful substances that cause cancer. The inhaled vapor may contain chemicals such as formaldehyde, acrolein, and acetaldehyde. The chemical acrolein is used in weed killers and has been linked to severe, acute lung problems and asthma, COPD, and lung cancer. E-cigarette flavorings may also hide possible toxins. It’s also unclear if the vapor puffed into the air puts nonsmokers at risk for health problems.

It's hard to know exactly what chemicals are in an e-cigarette. That’s because most e-cigarette products don’t list all of the ingredients. Sometimes these products are changed or modified. These modified products are often more likely to have harmful or illegal substances. Users should only buy e-cigarette products from a store, not from the street. It’s not safe to add substances to e-cigarettes that are not made by the manufacturer.

It's also possible for e-cigarettes to overheat and explode in a person’s pocket or face. This is mainly caused by overheating of the lithium batteries. These explosions have been described as “flaming rockets.” They have caused serious skin burns.

Can e-cigarettes help smokers quit?

Some people use e-cigarettes to help quit smoking. But they are not approved by the FDA as an aid to quit smoking. So far, research shows limited evidence that e-cigarettes can actually help with quitting smoking. They may also contain substances that cause cancer or life-threatening lung conditions.

A number of quit-smoking tools are available that have been approved by the FDA and CDC. If you are trying to quit smoking, see your healthcare provider for help, and call 800-QUIT NOW (800-784-8669).

Online Medical Reviewer: Eric Perez MD
Online Medical Reviewer: Marianne Fraser MSN RN
Online Medical Reviewer: Raymond Kent Turley BSN MSN RN
Date Last Reviewed: 2/1/2019
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