What is vaping?
Vaping uses electronic cigarettes (or e-cigarettes) to simulate traditional cigarette smoking. E-cigarettes are battery-powered or chargeable smoking devices. Some look like traditional cigarettes or pipes. Others are designed to look like pens or USB memory sticks. They use a cartridge (or pod) filled with liquid. The liquid typically contains nicotine, flavorings, and other chemicals. When you puff on the mouthpiece of the device, it activates a heating element. This heats up the liquid in the pod and turns it into vapor. You then inhale the vapor. This is why it’s called “vaping.”
E-cigarettes are often marketed as a safer alternative to smoking. But they’re not safe. They still put an addictive drug and chemicals into your body and into the air around you.
How is vaping different from JUULing?
Vaping and JUULing are the same thing. JUUL (a brand of e-cigarettes that look like USB memory sticks) is a very popular vaping device among teenagers. So popular, in fact, that its brand name has become a verb to describe vaping. Teens may also use the term “ripping” to describe smoking an e-cigarette or JUUL. For more on JUULing and how it relates to teens, see “Teens and JUULing” below.
Disputing common myths about e-cigarettes
The makers of e-cigarettes market them for a variety of uses. Researchers are still in the early stages of studying e-cigarettes. But studies have shown that e-cigarettes still contain harmful chemicals, including nicotine. Below are common myths—and the real facts.
- Myth: E-Cigs are a safer alternative to smoking cigarettes.
Fact: Makers claim that e-cigarettes don’t contain the harmful chemicals that cigarettes do. Of course, this is not true. Most devices contain nicotine. A JUUL pod contains either 3% or 5% nicotine. A JUUL pod that contains 5% nicotine is equivalent to the amount of nicotine in one pack of cigarettes.
- Myth: E-cigs aren’t addictive.
Fact: While there are some cartridges that don’t contain nicotine, most do. Any time a smoker inhales nicotine, they are inhaling an addicting and harmful chemical.
- Myth: You can use e-cigs indoors.
Fact: At first, makers of e-cigarettes said that e-cigarettes were appealing because they could be smoked in places that didn’t allow traditional cigarette smoking. This is no longer true. Many states have created laws that prohibit vaping in the same areas where traditional smoking is not allowed.
- Myth: E-cigs are a way to quit smoking.
Fact: Marketers claim it is easier to quit smoking if you switch to vaping first. But e-cigarettes contain nicotine and may even lead to a user becoming a traditional cigarette smoker.
What are the dangers of vaping?
Experts have a number of concerns about the safety of e-cigarettes and vaping.
E-cigarettes contain nicotine. In large doses, nicotine can be toxic.
- Nicotine stimulates your central nervous system. This increases your blood pressure, breathing, and heart rate. Higher doses of nicotine can cause blood pressure and heart rate to go higher. This can lead to an abnormal heart rate (arrhythmia). In rare cases, this can cause heart failure or death. Over time, nicotine can lead to medical problems. These include heart disease, blood clots, and stomach ulcers.
- Nicotine increases the level of dopamine in your brain. This chemical messenger affects the part of the brain that controls feelings of pleasure. It can motivate you to use nicotine again and again to get that feeling of pleasure. You do this even though you know it is a risk to your health and well-being. That is what makes nicotine addictive.
- The ingredients in the liquid are not labeled. This means that we don’t know for sure what’s in the liquid or in what amounts.
- There are often chemicals in the liquid. Some of these are known to cause cancer. One study found a toxic chemical that is found in antifreeze.
- Tiny particles are released by the heating element and may be harmful. These particles can cause inflammation in the lungs, which can cause bacterial infections or pneumonia.
- The liquid in the cartridge can be poisonous if someone touches, sniffs, or drinks it. There has been an increase in poisoning cases of children under 5 who have had access to the liquid.
- “Secondhand smoke” is still a problem for e-cigarettes. Secondhand e-cigarette vapor contains chemicals that harm the lungs and hearts of people who aren’t vaping.
- They serve as an introductory product for preteens and teens. Many kids start with vaping and then move on to other tobacco products.
- Right now, there is little regulation when it comes to e-cigarettes. Even if it isn’t a JUUL product, there are many other kinds of e-cigarettes available. Doctors do not know what may be in them.
Teens and JUULing
E-cigarettes are popular among teens and are now the most commonly used form of tobacco among youth in the United States, according to the Centers for Disease Control and Prevention. In 2020, the U.S. Food and Drug Administration stated that 3.6 million middle and high school students were current users of e-cigarettes. This is a disturbing trend for many reasons:
- Teenagers face increased risks from JUULs/e-cigarettes. The teen years are a critical time in brain development. This puts young people uniquely at risk for long-lasting effects. Nicotine affects the development of brain circuits that control attention and learning. It puts kids at higher risk of having mood disorders and permanent problems with impulse control. It also affects the development of the brain’s reward system. This can make other, more dangerous, drugs more pleasurable to a teen’s developing brain.
- Kids who use e-cigs like JUULs are more likely to become smokers than kids who do not, according to a three-year study. The study followed high school students as they transitioned from e-cigarettes to traditional ones.
The federal government is trying to discourage teens from buying these products. Before December 2019, people who were at least 18 years old could buy tobacco products. In December 2019, the government changed the rule and said a person had to be at least 21 years old to buy tobacco products. In January 2020, the FDA issued a policy limiting the flavors available in e-cigarettes.
There is much still to be learned about e-cigarettes and vaping. Since it’s relatively new, there aren’t long-term studies on the effects it may have. Until these long-term effects are known, doctors are encouraging patients to avoid e-cigarettes.
How do I talk to my child about JUULing?
If you suspect your child is JUULing (and even if you don’t), ask them about it. Start a conversation. Ask if they’ve seen friends doing it or seen JUULing at school. Use this opportunity to tell them the dangers of JUULing. JUULing is addictive. JUULing has been shown to lead to smoking. Smoking causes cancer, heart disease, and emphysema. Smoking is responsible for 1 in 5 deaths in the United States.
What if my child is already JUULing?
Talk to your child about quitting. Make an appointment for you and your child to talk to your family doctor about the best ways to quit JUULing. Your doctor may suggest a plan that includes some of the FDA-approved elements for smoking cessation listed below.
Things to consider
The FDA has approved 7 medications for smoking cessation in adults. These include nicotine gum, nicotine patches, and medicines. (Vaping is not one of the 7 approved methods.) There is little evidence that these same tactics will work for vaping. If you are trying to stop vaping, here are some tips to consider:
- Talk to your doctor. They may be able to suggest nicotine replacement therapy. They also may be able to prescribe medicines to help you quit.
- Make a plan. Set a date to begin the quitting process. Set goals as part of your process. These can be as small as having one less e-cigarette a day for a week. Then you can continue to cut back on a schedule until you no longer smoke or vape.
- Stay busy. Keep your mind off smoking by keeping busy. Do activities with your hands to keep them occupied. Plan ahead for times when you know you’ll want to smoke, such as after a meal or when you go out.
- Put off cravings. Cravings can be hard to resist, but they usually pass. Tell yourself to wait until a certain time, and the urge to smoke will often be gone by then.
- Get support. Surround yourself with people who support you. Tell your friends and family that you are quitting so they can be supportive. If you don’t want anyone to know you smoke or vape, join an online or in-person support group.
Questions to ask your doctor
- Can I quit JUULing cold turkey?
- Is there any sort of nicotine replacement I could try while quitting JUUL? Do you recommend this?
- How long should it take me to quit JUULing?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.