E-Cigarettes, also called personal vaporizers, vape pens, e-cigars, e-hookah, vaping devices, mod systems or pod systems, are products that produce an aerosolized mixture containing flavored liquids and nicotine that is inhaled by the user. E-Cigarettes can resemble traditional tobacco products like cigarettes, cigars, pipes or common gadgets like flashlights, flash drives or pens.
These products have grown rapidly, particularly among youth and young adults. Youth use of e-cigarettes is a significant public health concern.
- E-Cigarettes are the most commonly-used tobacco products among youth, and use is rising at an alarming rate. In 2020, 19.6% of high school students and 4.7% of middle school students reported having used e-cigarettes in the last 30 days, according to CDC data. Youth use of e-cigarettes has increased dramatically in recent years.
- Youth who use e-cigarettes are more likely to use cigarettes or other tobacco products, research and a Surgeon General's report has shown.
- E-Cigarettes contain a liquid solution that is usually flavored. Flavors, which are appealing to children, can include fruit flavors, candy, coffee, piña colada, peppermint, bubble gum or chocolate. You can read more about the ways the Tobacco Industry uses flavors to lure kids into using tobacco products in “The Flavor Trap,” a report issued by AAP and four partner organizations.
- E-Cigarette solution contains nicotine, chemicals, and other toxicants (ie, anti-freeze, diethylene glycol and carcinogens like nitrosamines).
- E-Cigarette devices mimic conventional cigarette use and help re-normalize smoking behaviors.
- Youth who use e-cigarettes are at higher risk of transitioning to traditional cigarettes, according to an AAP Policy Statement.
- Youth are uniquely vulnerable to the nicotine in e-cigarettes because their brains are still developing, CDC data has shown.
- E-Cigarettes are not approved for smoking cessation, and the long-term health effects to users and bystanders are still unknown. The chemical compounds in an e-cigarette device can vary between brands.
- E-liquid from e-cigarettes and refill packs can contaminate skin, leading to nicotine poisoning. Symptoms of nicotine poisoning include vomiting, sweating, dizziness, increased heart rate, lethargy, seizures, and difficulty breathing.
- In 2016, US Surgeon General Vivek Murthy, MD MBA released a report, "E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General." The report concluded that youth should not use e-cigarettes due to the health effects on users and on others exposed to secondhand e-cigarette aerosol.
Clinical Training Videos for Youth E-Cigarette Use
These brief training videos showcase a clinical interaction between pediatricians and adolescents about 4 key elements of e-cigarette screening and counseling (English and Spanish captions available).
- Promoting Confidentiality During an Adolescent Clinical Visit
- Counseling About E-cigarettes When a Patient is Ready to Quit
- Counseling About E-cigarettes When a Patient is Reluctant to Quit
- Screening and Prevention of E-cigarette Use – English Captions
AAP and FDA Educational Videos
These brief educational videos feature advice from pediatricians about recognizing e-cigarettes, understanding health effects, and intervening with youth who are using these products.
- Video 1 – Pediatricians’ Overview of Vaping
- Video 2 – How to Identify Signs of Youth Vaping and Nicotine Addiction
- Video 3 – Resources Available to Address E-cigarette Use in Youth
- AAP E-cigarette Curriculum: This curriculum describes clinical and community strategies to address youth e-cigarette prevention and cessation, based on current evidence and best practices.
- Vaping, JUUL and E-Cigarettes Presentation Toolkit: This toolkit contains a powerpoint presentation and related resources about vaping, JUUL, and e-cigarettes. These resources can be used by AAP members and tobacco control advocates for grand rounds or other educational presentations. To obtain an editable version of the powerpoint, please contact the Richmond Center.
- State-of-the-Art Review Article: A Public Health Crisis: Electronic Cigarettes, Vape, and JUUL: This review article presents a state-of-the-art review of the current data around electronic cigarettes and vaping. The article describes the variety of e-cigarettes currently on the market, provides an overview of health effects, and includes recommendations for protecting youth and families from these products. The article was authored by pediatricians from the AAP Richmond Center and AAP Section on Nicotine and Tobacco Prevention and Treatment.
- Supporting Youth who are Addicted to Nicotine: Advice for Pediatricians: This factsheet provides information for pediatricians about how to support adolescents who are addicted to nicotine from cigarettes, vaping, or other tobacco products. The content includes tips for screening, counseling, and helping youth with a cessation attempt. This factsheet is also available in Spanish
- Nicotine Replacement Therapy and Adolescent Patients: Information for Pediatricians: This document provides information for pediatricians about how to use nicotine replacement therapy (NRT) to support adolescents who are addicted to nicotine from cigarettes, vaping , or other tobacco products.
- JUULing: What Pediatricians and Families Need to Know
- AAP Policy Statement: E-Cigarettes and Similar Devices
- E-Cigarette fact sheet for parents
- More AAP e-cigarette content for parents
- E-Cigarette fact sheet for physicians: This resource was created via a collaboration by 5 major medical organizations: the American Academy of pediatrics, American Academy of Family Physicians, American College of Physicians, American Congress of Obstetricians and Gynecologists, and American Medical Association.
- E-Cigarette reference guide for clinicians (This factsheet is also available in Spanish )
- Video Presentation: “JUUL, Vaping and Electronic Cigarettes: A Public Health Crises” – Plenary Presented by Deepa Camenga MD, FAAP at the 2018 AAP National Conference & Exhibition on November 5, 2018 in Orlando, Florida. Posted on YouTube.