On December 8, the U.S. Surgeon General Vivek Murthy released a report on e-cigarette use by youth and young adults. This first-ever Surgeon General's report on e-cigarettes shatters the myth that e-cigarettes are harmless. Instead, it lays out in clear, indisputable terms that e-cigarette use is a risk to the health of young users that includes nicotine addiction, harm to brain development and likely increased odds of future use of other tobacco products. The report's overarching message is stark and definitive: "All Americans need to know that e-cigarettes are dangerous to youth and young adults."

According to the report, e-cigarettes are now the most popular tobacco product among American teens, and use by high school students grew by 900 percent between 2011 to 2015. They surpassed traditional cigarettes as teens' preferred tobacco product in 2014. The Surgeon General's groundbreaking report, "E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General," sounds the alarm on the harmful effects of e-cigarettes to youth and young adults on many levels.


The report concludes that flavors, such as candy and fruit, appeal to kids and that these flavors are one of the primary reasons youth and young adults try an e-cigarette for the first time. This is a page taken directly from Big Tobacco's playbook, which has used sweet flavorings to attract kids to tobacco products like cigars. This underscores why it is so important that the U.S. Food and Drug Administration (FDA) be allowed to use its authority to protect our nation's youth from these tobacco products. The American Lung Association strongly urges Congress not to weaken FDA's authority.


Nicotine is contained in many e-cigarettes, and is not only highly addictive, but also places youth health at risk. Because the brain is still developing until about age 25, exposure to nicotine, while young, can cause lasting cognitive and behavioral impairments, such as disrupted development of attention, learning and increase susceptibility to addiction (including addiction to other substances). Nicotine is harmful to pregnant women and fetuses, including the risk of sudden infant death syndrome (SIDS).

Secondhand Exposure

The Surgeon General also found that exposure to the aerosol from e-cigarettes is not "harmless water vapor" but can contain harmful and potentially harmful chemicals, including carcinogens and, of course, nicotine. Because of this, the Lung Association is calling on all states to include e-cigarettes in their comprehensive smokefree workplace laws – as nine states and the District of Columbia have already done. 

 E-cigarettes, Cigars and Cigarettes

According to the report, over half of younger users of cigarettes and cigars also use e-cigarettes. Those younger e-cigarette users may transition to become regular cigar and cigarette users. The Lung Association urges states to act to reduce the number of youth who start using any tobacco product by funding youth tobacco prevention programs. States and communities must also pass Tobacco 21 laws to raise the minimum age of sale to 21 for all tobacco products.

A Cautionary Note

This Surgeon General's report ends with something unusual for such a report – an urgent word of caution to all those who influence kids. It asks parents, teachers, healthcare providers and others who influence youth and young adults to take an active role, to advise and inform them of the dangers of nicotine and discourage youth tobacco use in any form, including e-cigarettes. It also asks adults to set a positive example by being tobacco-free.

A message to parents from Dr. Vivek H. Murthy about the value of our kids' health and well-being.

At the American Lung Association, we echo this advice, and also urge America to act as a nation, to reduce e-cigarette use by youth. Much can be done at the federal, state and local level to reduce e-cigarette use among youth and young adults. E-cigarettes should be included in smokefree policies; flavorings in tobacco products should be prohibited; access to e-cigarettes by youth should be reduced through actions like Tobacco 21 measures, price and tax increases; and efforts to educate young people about the dangers of e-cigarettes and all tobacco products should be undertaken.

Learn more about e-cigarettes, and how you can get involved to help protect our kids from becoming the next generation of addicted tobacco users.

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