2 What Are the Health Risks?

3 What Leads to E-Cigarette Use?

4 What Can You Do About It?

1 What Are E-Cigarettes?
WHAT ARE E -CIGARETTES?

E-cigarettes are devices 

that heat a liquid into an 

aerosol that the user inhales.

E-cigarettes sometimes called “e-cigs,” “vapes,” and “electronic nicotine delivery systems (ENDS),” are

battery operated devices that heat a liquid to produce an inhaled aerosol. The liquid in e-cigarettes

usually contains nicotine as well as flavorings and other chemicals. Some e-cigarettes can also be used to

deliver THC (a psychoactive chemical found in cannabis) or other drugs.

E-cigarettes come in a variety of shapes and sizes. Some e-cigarettes look like USB flash drives or regular

cigarettes.

In 2022, the most common type of device used by middle and high school students was disposable ecigarettes. Notes from the Field: E-cigarette Use Among Middle and High School Students — United 

States, 2022 | MMWR (cdc.gov)

Tobacco use is NOT safe for young people.

NOTE: The definition of aerosol is a suspension of fine solid or liquid particles in gas. Aerosol Definition 

& Meaning - Merriam-Webster It is not water vapor. Examples of aerosols include cleaning products 

and cooking sprays.
2 What Are the Health Risks?

3 What Leads to E-Cigarette Use?

4 What Can You Do About It?

1 What Are R-Cigarettes?
E-Cigarettes Are the Most Commonly

Used Tobacco Product Among U.S. Youth

E-cigarettes are the most common tobacco product

currently used (use on 1 or more days in the past 30

days) by 2.55 million students, or almost 1 in 10

of America’s middle school and high school students.

 Slightly more than 4 in 10 reported frequent use 

(use on 20 or more days in the past 30 days) 

 Slightly more than 1 in 4 reported daily use. 

Source:Cooper M,Park-Lee E, Ren C, et alNotes . from the FieldE:-Cigarette Use Among Middle and High School 

Students—National Youth Tobacco Survey, United States, 2022. MMWMRorbMortal WklyRep 2022;71:1283–1285.

CDC and the Food and Drug Administration (FDA) analyzed data from the 2022 National Youth Tobacco 

Survey (NYTS) to estimate current (past 30-day) use of eight tobacco products among U.S. middle 

(grades 6–8) and high school (grades 9–12) students.

• Since 2014, e-cigarettes have been the most commonly used tobacco product among U.S. youth.

• In 2022, e-cigarettes continue to be the most common tobacco product.

o Over 2.5 million students currently used (past 30-day) e-cigarettes in 2022, including

2.14 million high school students.

o Among both middle and high school students who currently used e-cigarettes, the most

commonly used device type was disposables, followed by prefilled or refillable pods or

cartridges and tanks or mod systems.

o The most commonly reported “usual brand” was Puff Bar, followed by Vuse, JUUL,

SMOK, NJOY, Hyde, and blu. Approximately one fifth of current e-cigarette users

reported “some other brand” as their usual brand.
Nicotine Poses Unique Dangers to Young People

Nicotine is a highly

addictive drug.

Nicotine can harm brain 

development, which continues 

until about age 25. 

Nicotine can harm the parts of 

the brain that control attention, 

learning, mood, and impulse 

control.

Nicotine can prime the 

brain for addiction to other 

drugs. 

Source: USDHHS. E -cigarette - Use Among Youth and Young Adult–sA Report of the Surgeon General. 2016.

• Nicotine exposure during adolescence can harm the developing brain—which continues to

develop until about age 25.

• Using nicotine in adolescence can harm the parts of the brain that control attention, learning,

mood, and impulse control.

• Using nicotine in adolescence may also increase risk for future addiction to other drugs.
Nicotine Addiction Is a 

Source of Stress

• When a person is dependent on nicotine and 

stops using it, their body and brain must readjust

to not having nicotine.

• Youth may turn to vaping to try to deal with stress

or anxiety,creating a cycle of nicotine dependence.

• Nicotine withdrawal symptoms includerritability,

restlessness, feeling anxious or depressed, trouble 

sleeping, problems concentrating, and craving

nicotine.

• People, especially youth, maykeep using tobacco

productsto help relieve these symptoms.

• When a person is dependent on nicotine and stops using it, their body and brain must readjust

to not having nicotine.

• Youth may turn to vaping to try to deal with stress or anxiety, creating a cycle of nicotine

dependence.

• Nicotine withdrawal symptoms include irritability, restlessness, feeling anxious or depressed,

trouble sleeping, problems concentrating, and craving nicotine.

• People, especially youth, may keep using tobacco products to help relieve these symptoms.
E-Cigarette Aerosol is Not Harmless

Besides nicotine, e-cigarette aerosol can contain cancer-causing chemicals, heavy metals, and ultrafine 

particles that can be inhaled deeply into the lungs and harm your body. Again, it is not harmless, and it is 

not water vapor.

And even though e-cigarette aerosol generally contains fewer harmful chemicals than regular cigarettes, 

safer doesn’t mean safe. This applies to both people using e-cigarettes, as well as people who may be 

exposed to secondhand aerosol from other people using e-cigarettes. 

By the way, those flavorings in e-cigarettes aren’t necessarily safe either. The gut can handle a lot more 

than the lungs and flavorings in e-liquids or pods may not be safe when inhaled. 

Scientists are still working to understand more fully the health effects and harmful doses of e-cigarette 

content when they are heated and turned into an aerosol. 
2 What Are the Health Risks?

3 What Leads to E-Cigarette Use?

4 What Can You Do About It?

1 What Are E-Cigarettes?
Youth Reasons for Ever Tryingan 

E-Cigarette, NYTS, 2021

57.8

47.6

25.1

23.3

A friend used/uses them

I was/am curious about them

I was/am feeling anxious,

stressed, or depressed

To get a high or buzz from

nicotine

Percentage (%)

* Restricted to the top 4 reasons listed for combined middle and high school students, NYTS 2021

,Source:Gentzke AS, Wang TW, Cornelius M, et al. Tobacco Product Use and Associated Factors Among Middle and High School 

Students — National Youth Tobacco SurveyUnited States, 2021. MMWSRurveillSumm 2022;71(No.- 5SS):1–29. 

• Youth trying an e-cigarette means the first use of the product.
Youth Reasonsfor Current E-Cigarette

Use, NYTS, 2021

43.4

42.8

28.3

20.0

I am feeling anxious, stressed, or

depressed

To get a high or buzz from nicotine

A friend uses them

I can use them to do tricks

Percentage (%)

* Restricted to the top 4 reasons listed for combined middle and high school students, NYTS 2021

Source:Gentzke AS, Wang TW, Cornelius M, et al. Tobacco Product Use and Associated Factors Among Middle and 

High School Students— Nanal Youth Tobacco Survey, United States, 2021. MMWSuRrveillSumm 2022;71(No.- 5SS):1–29. 

• Current use of e-cigarettes was defined as use on ≥1 day during the past 30 days.
E-CIGARETTE ADVERTISING:

70.3%OF MIDDLE AND HIGH SCHOOL STUDENTS

RETAIL STORES

58.7%

14.37 MILLION

TELEVISION, STREAMING 

SERVICES, OR MOVIES 

21.7%

5.24 MILLION

INTERNET

36.0%

8.97 MILLION

NEWSPAPER OR MAGAZINES

28.7%

3.50 MILLION

ALL TOBACCO 

PRODUCT 

ADVERTISING 

US MIDDLE AND HIGH 

SCHOOL STUDENTS 

(75.7%, 19.21 MILLION)

3 in 4

Source:Gentzke AS, Wang TW, Cornelius M, et al. Tobacco Product Use and Associated Factors Among Middle and High School S—tud nt National e Youth Tobacco Survey, United States, 2021. MMWSuRrveillSumm 

2022;71(No. SS-5):1–29. 

Youth exposure to e-cigarettes is increasing. 

One of the main reasons is advertising.

Overall, 3 in 4 US middle and high school students see tobacco product advertising. 

And these messages come in many different forms, whether it’s store signs, television ads, movies, the 

Internet, social media ads, magazines with cool images, or newspapers.... it’s all around you.

And big tobacco is one of the main contributors. They spent $8.2 billion in the year 2019 on marketing 

their products. 

E-cigarette ads reach nearly 4 in 5 middle and high school students, and tobacco product advertising

reach 3 in 4 middle and high school students.

Here are a few examples of how they are doing it. 

E-cigarette marketing ads are using themes including sexual content, independence, rebellion, and

celebrity figures to appeal to youth and young adults.
Tobacco Use Impacts People and Communities Differently

• Certain comminities are targeted by tobacco industry

marketing

• This includes the geographic distribution of tobacco retail

outlets and price promotions

• The tobacco industry develops novel tobacco productsthat 

appeal to youth, including flavored tobacco products and 

“stealth” products

• There is unequal implementation of policies we know work 

to reduce youth use: tobacco price increases,smokefree 

indoor air laws, and flavor restrictions

Source: American Academy of Pediatrics. Youth Tobacco Cessation: Considerations for Clinicians (page 4). Accessed August 8, 

2021. https://downloads.aap.org/AAP/PDF/AAP_Youth_Tobacco_Cessation_Considerations_for_Clinicians.pdf

• Targeted marketing by the tobacco industry – In 2019, the tobacco companies spent about

$22.5 a day marketing their products. The tobacco companies specifically advertise and market

their products to specific populations. (Tobacco Industry Marketing | CDC)

o Youth and young adults

 Tobacco ads make smoking appear to be appealing, which can increase

adolescents’ desire to smoke.

o Women

 Marketing toward women is dominated by themes of social desirability,

empowerment, and independence, which are conveyed by advertisements

featuring slim, attractive, and athletic models.

o Racial and minority populations

 Hispanic and American Indians/Alaska Natives, African American communities

 African American communities is targeted with advertisements and promotion

for menthol cigarettes.

 Asian Americans

 LGBTQ+ communities (Unfair and Unjust Practices Harm LGBTQ+ People and

Drive Health Disparities | CDC)

• Geographic distribution of tobacco retail outlets and promotions – The number of retailers

selling tobacco products varies widely depending on community characteristics with more

retailers in areas with lower incomes and greater proportions of African-American residents.

(Inequalities in tobacco outlet density by race, ethnicity and socioeconomic status, 2012, USA:

results from the ASPiRE Study | Journal of Epidemiology & Community Health (bmj.com)).

• Industry development of novel tobacco products that appeal to youth, including flavored

tobacco products and “stealth” products – E-cigarettes in youth–appealing flavors are being sold

in retailers. Several of the e-cigarettes most popular with youth resemble USB flash drives and
can be relatively odorless. E-cigarettes can be “stealth” products and disguised as backpacks, 

smartwatches, sweatshirts, fidget spinners, or hand-held gaming devices to avoid detection or 

be seen by others. How to Spot Stealth and Disposable E-Cigarettes | Parents | Vaping 

Prevention Resources | HHS.gov 

• There are policies that we know work and have known that they work for decades, but they 

have not been implemented in all communities. This includes increasing the price of tobacco 

products, smokefree indoor air laws, and prohibiting the sale of flavored products.
2 What Are the Health Risks?

3 What Leads to E-Cigarette Use?

4 What Can You Do About It?

1 What Are E-Cigarettes?
Talk with Your Teen

Talk with Your Teen About E-cigarettes: A Tip Sheet for

Parents (surgeongeneral.gov)

It is never too late to talk with your teen about e-cigarettes. 

• Educate yourself about e-cigarettes before discussing them with your teen and learn helpful 

ways to approach the conversation.

• Recognize the warning signs of nicotine addiction in youth and find e-cigarette quit resources 

tailored to teens.

• Keep the conversation going. 

The Surgeon General’s website contains additional tools and resources for parents regarding youth use 

of e-cigarettes. These resources can be found at https://ecigarettes.surgeongeneral.gov/resources.html. 
Resources to Help Youth Quit

Resources to help 

youth Quit: Quitline 

trained counselors Texting Programs Web-Based Resources Smartphone Apps

• 1-800-QUIT-NOW

• 1-800 Dejélo-Ya

(Spanish) 

• 1-800-838-8917

(Mandarin + 

Cantonese) 

• 1-800-566-5564

(Korean) 

• 1-800-778-8440

(Vietnamese) 

• 1-855-5AI-QUIT

• SmokefreeTXT for

Teens

• SmokefreeTXT

• DipfreeTXT

• SmokefreeTXT en

Español

• This is Quitting (Truth)

• My Life, My Quit

• Smokefree Teen

• Smokefree en

Espanol

• Smokefree.gov

• My Life, My Quit

• American Indian 

Commercial

Tobacco Program

• NOT for Me

• QuitSTART

Source: Behavioral Cessation Supports for Youth and Young Adults , AAP. Accessed August 18, 2021. https://teen.smokefree.gov/. Image Source: Become A Smokefree Teen website.

Most youth want to quit using e-cigarettes. There are resources to help them quit. 
Be Tobacco Free!

1) Ensure your child’s school has a tobacco-free grounds policy. 

2) Set a positive example. If you smoke or vape, consider quitting. 

3) Establish a tobacco-free home. Don’t allow anyone to smoke or vape in your house or car. 
Know the Risks

For additional information, 

please visit: Quick Facts on

the Risks of E-cigarettes for

Kids, Teens, and Young

Adults | CDC