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E-cigarettes, "Vapes" and JUULs: What Schools Should Know

E-cigarette in a row of gray pencils against a black chalkboard.

What are these products?

  • 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.
  • Currently, the most popular e-cigarette among teens is the JUUL, which looks like a USB flash drive and produces little visible aerosol when being used. Many JUUL pods contain high levels of nicotine—one JUUL pod claims to contain roughly the same amount of nicotine as one pack of cigarettes.

Are e-cigarettes less harmful than cigarettes?

  • 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.

Is youth e-cigarette use really an epidemic?

  • The FDA has called e-cigarette use among teens an epidemic with no signs of abating.
  • E-cigarettes are the most commonly used tobacco products among kids, with nearly 12 percent of high school students nationwide using e-cigarettes and about 20 percent using at least one tobacco product.1

Most common reasons youth use e-cigarettes2

  • 39% Use by "friend or family member"
  • 31% Availability of "flavors such as mint, candy, fruit, or chocolate"
  • 17% Belief that "they are less harmful than other forms of tobacco such as cigarettes"

Impact of e-cigarette use on teens

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.

What should schools do to protect their students from these products?

  • 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.

What resources does American Lung Association offer to address this issue?

  • 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.
  • 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. Visit Lung.org/INDEPTH, call 1-800-LUNGUSA (1-800-586-4872) or email [email protected] to learn more.

Contact

Lung HelpLine and Tobacco Quitline is a telephone support line available in over 200 languages and is a free service allowing callers access to expert staff, including registered nurses, respiratory therapists, pharmacists and certified tobacco cessation specialists.

1-800-LUNG-USA (1-800-586-4872) or Lung.org/helpline.

Contact your local American Lung Association office for information on youth leadership groups and other youth tobacco initiatives at 1-800-LUNGUSA.

  • Sources
    1. Wang TW, Gentzke A, Sharapova S, Cullen KA, Ambrose BK, Jamal A. Tobacco Product Use Among Middle and High School Students — United States, 2011–2017. MMWR Morb Mortal Wkly Rep 2018;67:629–633. DOI: http://dx.doi.org/10.15585/mmwr.mm6722a3
    2. Tsai J, Walton K, Coleman BN, et al. Reasons for Electronic Cigarette Use Among Middle and High School Students — National Youth Tobacco Survey, United States, 2016. MMWR Morb Mortal Wkly Rep 2018;67:196–200. DOI: http://dx.doi.org/10.15585/mmwr.mm6706a5
    Resources
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    The Impact of E-Cigarettes on the Lung [PDF]

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    E-cigarettes, "Vapes" and JUULs: What Parents Should Know [PDF]

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    E-Cigarettes, "Vapes" and JUULs: What Schools Should Know [PDF]

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    E-Cigarettes, "Vapes" and JUULs: What Teens Should Know [PDF]

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    E-Cigarette Resources [PDF]

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    Page Last Updated: August 12, 2019

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