Vaping and Teen Health

Over the past decade, vaping has surged among teenagers in the United States and around the world.1 Originally marketed as a safer alternative to traditional smoking and as a potential smoking cessation aid for adults, e-cigarettes have instead found a large and growing user base among adolescents.11 According to the 2023 National Youth Tobacco Survey, more than 2.1 million U.S. middle and high school students reported current e-cigarette use, with over 25% of those students using them on a near-daily basis.1

The increasing popularity of teen vaping has raised urgent concerns among public health experts, pediatricians, educators, and parents. Adolescents are especially vulnerable to the harmful effects of vaping, including substance use disorder (addiction), respiratory illness, and neurocognitive impairment.12 But what’s driving teens to try vaping in the first place? And what signs of vaping can parents or guardians watch for?

To answer those questions and more, our guide to teen vaping breaks down fundamental information, outlines known and emerging health risks, and provides evidence-based resources and guidance for teens (and families) seeking support.

Vaping devices, or vaporizers, are electronic products that heat a liquid or oil into an aerosol, which is then inhaled into the lungs and absorbed into the bloodstream. The most common types include e-cigarettes, which typically contain nicotine, flavorings, and solvents like propylene glycol or vegetable glycerin. However, many vape devices — including those used by teens — are also designed to deliver cannabis-derived substances, such as THC or CBD. These devices can resemble e-cigarettes in appearance but often operate at higher temperatures or use different cartridge systems.

Vapes and e-cigarettes were originally marketed as a way to help people quit smoking, but no such device is currently approved for that use by the FDA. Despite this, there's been a sharp rise in use, particularly among teens. According to CDC data, vaping among U.S. high school students increased from just 1.5% in 2011 to nearly 21% by 2018, amounting to nearly three million new teen users in under a decade. In response to growing concerns, both the FDA and CDC issued warnings in 2019 about the dangers of vaping.2

Teen vaping is driven by a combination of psychological, social, and structural factors. These include curiosity, peer influence, flavored products, mental health challenges, perceived safety, and targeted marketing — all reinforced by the addictive properties of nicotine.

Curiosity, taste, and peer pressure

According to a nationally representative U.S. survey of 8th, 10th, and 12th graders, the most common self-reported reason for vaping was experimentation, cited by 53% of adolescents. Other top reasons included liking the taste (42%), alleviating boredom (29%), and wanting to have a good time (28%).16

Social factors were also critical: over 30% of teens reported that their friends used e-cigarettes, and many cited peer influence as a reason for initiating use. A 2024 study found that among South African high schoolers, vaping was often introduced in group settings, with participants describing it as a shared social experience. Students also referenced feeling pressure to conform or be included.18

Flavor and marketing appeal

With flavors and devices engineered for youth appeal, vaping has become deeply embedded in teen culture — making prevention and cessation all the more critical. Flavored e-cigarettes — ranging from fruit to candy to mint — play a significant role in attracting and retaining teen users. According to the CDC, nearly 90% of middle and high school vapers reported using flavored products in 2021. Many teens start with flavored varieties because they mask nicotine’s harsh taste, making vaping more palatable and habit-forming from the outset. Youth are also widely exposed to vape marketing through retail stores, social media, and online ads, with roughly seven out of ten teens reporting exposure to e-cigarette advertising.17

Perception of safety and discretion

Teens often perceive vaping as safer and more socially acceptable than cigarette smoking. Devices are sleek, easy to hide, and produce little odor, making them ideal for discreet use in schools. As the CDC notes, teens cite accessibility, affordability, and the ease of concealment as important factors in their decision to vape.17

Lower cost

Many popular e-cigarette brands such as JUUL, Puff Bar, and Elf Bar produce devices that are relatively inexpensive and easy to use. A disposable vape may cost as little as $10 to $15 and contain the equivalent of one or more packs of cigarettes in nicotine. Rechargeable systems often sell for $20 to $50, with refill cartridges or pods sold separately.

Between 2017 and 2023, disposable e-cigarettes rapidly became the most commonly used device type among youth who vape in Canada, England, and the United States, overtaking pods across all demographics. By 2023, Elf Bar was the leading brand among youth in both England and the U.S., while STLTH dominated in Canada, reflecting a shift toward nicotine salt-based disposable products.14 The affordability and convenience of these products have made them particularly attractive to teens, who may not recognize the severity of the risks.

Mental health

Mental health also plays a significant role in teen vaping. A study from 2019 found that adolescents with elevated depressive symptoms were significantly more likely to start using e-cigarettes within a year — even after accounting for externalizing behaviors like impulsivity or risk-taking. This suggests that vaping may be used as a coping mechanism for emotional distress.19

However, vaping may also exacerbate mental health issues. A 2023 study found that regular e-cigarette use predicted worsening symptoms of depression, anxiety, and social dysfunction over time.20 This aligns with findings from a 2020 systematic review, which concluded that the relationship between vaping and mental health is bidirectional: adolescents with pre-existing anxiety or depression are more likely to vape, but vaping itself can increase the risk of mental health deterioration.21

A growing body of research shows that e-cigarette aerosols contain carcinogenic and toxic substances, including formaldehyde — a chemical traditionally used to preserve biological specimens — as well as acrolein (a “highly toxic and corrosive substance”) and heavy metals like lead, nickel, and tin.3 29 30 Scientists have detected these compounds in vape emissions, raising serious concerns about long-term exposure.

Nicotine itself is also harmful; it’s a highly addictive,31 potential carcinogen that adversely affects multiple body systems, including the cardiovascular system.32 33 While cessation products like nicotine patches or gums are designed to taper off use, e-cigarettes deliver high doses of nicotine to the brain “in seconds,” according to the FDA. Although using any tobacco product can cause nicotine dependence, the rapid delivery of the substance to the brain through smoking or vaping increases the risk and makes quitting more difficult.31

Additionally, nicotine poisoning — which can occur rapidly in inexperienced users or when high-concentration products are used — may be to blame for seizures following vape use in some adolescents. Between 2010 and 2019, the FDA received 35 reports of young people experiencing seizures shortly after vaping.6

The flavoring agents in vapes are also a cause for concern. Chemicals like diacetyl, used to create buttery or creamy flavors, have been linked to bronchiolitis obliterans, a rare but serious condition often referred to as “popcorn lung.” Inhalation of heated propylene glycol or vegetable glycerin may produce toxic byproducts such as formaldehyde and acetaldehyde, both of which are respiratory irritants and potential carcinogens. Additionally, heavy metals such as lead, nickel, and chromium can leach into the aerosol from the device’s heating coil and be inhaled directly into the lungs.5

Other types of vapes are designed to deliver cannabis-derived substances, most commonly tetrahydrocannabinol (THC) or cannabidiol (CBD). These products often use oil-based liquids and may contain cutting agents, diluents, or thickeners that pose unique risks. One of the most significant examples is vitamin E acetate, a substance used to dilute cannabis oil.

Vitamin E acetate was found in many of the illicit THC vape cartridges examined after the 2019 outbreak of EVALI (e-cigarette, or vaping, product use-associated lung injury), a vaping-related illness responsible for hundreds of hospitalizations and at least 68 deaths.5 According to the CDC, vitamin E acetate was also identified in the lung fluid of most patients diagnosed with EVALI, suggesting it played a central role in the injuries reported.4

The lipid-based carriers that cannabis vapes often rely on can also cause fat or lipid pneumonia when aerosolized and deposited in lung tissue. And some cannabis vapes may contain synthetic cannabinoids or unlabeled additives, especially when sourced from informal or unregulated markets. These products are not only inconsistent in potency but can also contain toxic residues from pesticides, solvents, or manufacturing processes.

Vaping poses a range of serious health risks, both immediate and long-term. E-cigarettes, which are the most common type of vaping device among teens, typically contain a liquid solution of nicotine, flavorings, and solvents such as propylene glycol or vegetable glycerin.

Nicotine is the primary addictive agent in these products, and adolescents are especially vulnerable to its effects. Once inhaled, nicotine binds to receptors in the developing brain, altering pathways involved in attention, learning, and emotional regulation. These changes can be long-lasting. Even intermittent use can lead to addiction, with withdrawal symptoms such as irritability, anxiety, and intense cravings, making cessation particularly difficult for teens.3

Nicotine poisoning is another concern, especially for teens using high-concentration products. Excessive exposure can lead to nausea, vomiting, dizziness, and seizures. Between 2010 and 2019, the FDA reviewed 35 reports of seizures in young users shortly after using e-cigarettes.7

One of the most acute dangers of vaping is EVALI (e-cigarette, or vaping, product use-associated lung injury), a severe respiratory condition. Symptoms include chest pain, shortness of breath, persistent cough, fever, and nausea. In serious cases, hospitalization and mechanical ventilation may be required. As of February 2020, the CDC confirmed more than 2,800 cases of EVALI and 68 deaths, with most linked to illicit THC vape products contaminated with vitamin E acetate.6

Emerging research suggests that vaping contributes to chronic respiratory problems, including asthma exacerbation, wheezing, and reduced lung function. It also appears to impair vascular health, elevating blood pressure and causing endothelial dysfunction, a risk factor for heart disease. Even brief exposure to flavored e-cigarettes has been shown to reduce blood vessel dilation in young, healthy users.8

A 2021 study found that exposure to propylene glycol and vegetable glycerin — the main solvents in vape liquids — impairs glucose uptake and metabolism in airway cells, compromises the lung’s protective barrier, and increases epithelial permeability. These effects, even after short-term exposure, may make the lungs more vulnerable to infection and long-term damage, raising serious concerns for teens whose lungs and immune systems are still developing.13

THC vaping — especially from unregulated sources — presents its own set of dangers. It has been associated with cognitive impairment, memory loss, and an increased risk of psychosis and depression in adolescents.27 Contaminants like vitamin E acetate or pesticides in illicit THC vapes further increase health risks.4

Nicotine and THC also interfere with adolescent brain development, particularly the dopamine system, which regulates reward, motivation, and emotional control. Exposure during this critical developmental period can lead to mood disorders, attention deficits, and a higher risk of future substance use disorders.9

It’s important to note that vaping isn’t limited to nicotine and THC. Some unregulated cannabis vapes have also been found to contain synthetic cannabinoids (commonly known as Spice or K2), which can mimic THC’s effects but are far more potent and unpredictable.28 These substances have been linked to severe psychiatric symptoms, including hallucinations, aggression, and paranoia, as well as cardiac and neurological complications. These products may be adulterated with cutting agents or other toxic additives not listed on any label. Their presence is difficult to detect without lab testing and remains a serious concern in areas where cannabis is illegal or poorly regulated.

Together, these findings demonstrate that vaping — whether involving nicotine or cannabis — carries serious risks for teens. While marketed as safer alternatives to smoking, these products introduce unique harms that are especially dangerous during adolescence.

Is vaping safer than smoking?

One of the most pervasive myths about vaping is that it’s a safer alternative to smoking cigarettes. While vaping does eliminate some of the harmful byproducts of combustion, such as tar, this does not mean that vapes are safe.

As teen use of both e-cigarettes and cannabis vapes increases, so does their exposure to a wide array of inhaled toxicants — many of which have not been thoroughly studied in this form. Whether the device is designed for nicotine, cannabis, or another substance altogether, the chemical exposure and potential for long-term harm remain serious and insufficiently understood.

In both nicotine and THC vapes, the device itself can introduce additional risks. The heating elements may operate at unpredictably high temperatures, degrading ingredients into more harmful compounds. Battery malfunctions can lead to overheating or explosion, particularly in poorly made or counterfeit devices.

Ultimately, vaping is not a safer alternative to smoking. While it may lack the combustion byproducts of cigarettes, it introduces a new set of dangers, particularly for adolescents. From lung inflammation and chemical pneumonia to cardiovascular strain and neurological disruption, the risks are wide-ranging and increasingly well-documented.

Despite the millions of teens addicted to vaping, there are currently no FDA-approved pharmacotherapies specifically designed for e-cigarette cessation in adolescents. Still, several tools and programs have emerged to support young people who want to quit.

Resources for teens

One of the most prominent programs is This is Quitting, a free, anonymous text-based program from the Truth Initiative.22 It offers daily tips, motivational messages, and peer support from former users, tailored specifically for teens and young adults. Another option is the CDC’s quitSTART app, which helps users track cravings, set goals, and develop personalized quit plans.

School-based interventions have also gained traction. The American Lung Association’s Not-On-Tobacco (N-O-T) program provides group counseling in educational settings and has shown promising outcomes in increasing quit attempts among teens. In clinical settings, pediatricians and adolescent medicine specialists can play a key role.23 The American Academy of Pediatrics recommends that providers routinely screen for e-cigarette use and counsel teens and their families on the associated risks.10

More research is needed to develop and evaluate cessation interventions specifically tailored to adolescent vaping. Many existing programs are adaptations of traditional tobacco cessation models, which may not fully address the behavioral, social, and psychological drivers behind youth e-cigarette use.

At the policy level, population-wide measures like increasing tobacco taxes have been shown to reduce both cigarette and e-cigarette sales. However, because teens often shift between products — such as disposables, pods, and traditional cigarettes — policymakers should consider these substitution patterns when designing regulations. Effective cessation support must be complemented by thoughtful policy that reduces overall access and appeal without unintentionally driving youth toward alternative nicotine products.15

Parental guidance and support

Parents play a crucial role in prevention and intervention. In 2024, e-cigarettes were the most commonly used tobacco product among teens, with 5.9% of U.S. middle and high school students reporting using e-cigarettes in the past 30 days.24

Recognizing the signs of vaping can help parents identify potential use early. Common indicators include unfamiliar devices that resemble USB drives, frequent nosebleeds or dry mouth, changes in appetite or taste, increased thirst, irritability, and a lingering cough. A sweet or fruity scent — such as mint, candy, or fruit — on clothing or in bedrooms, especially when there's no obvious source, may also point to e-cigarette use.

When talking to teens about vaping, it helps to take a calm, non-confrontational approach. Look for natural openings — like watching a show that features vaping or walking past a vape shop — to start the conversation. Ask open-ended questions to understand what your teen knows and how they feel about it. Rather than using scare tactics or shame, focus on sharing clear, age-appropriate facts that invite honest dialogue.

The CDC and American Academy of Pediatrics offer downloadable fact sheets that parents can share with their children. These resources outline the known and potential risks of vaping in clear, accessible language. Involving your teen’s doctor in the conversation can also reinforce the message and provide an additional source of support.25 26

Parents, educators, and healthcare professionals all have roles to play in reversing this trend. Early conversations, access to evidence-based resources, and sustained support are essential tools in helping teens make informed choices about their health.