FFFE-Cigarettes and Vaping

No. 133; October 2020

A large number of Middle School and High School students are using electronic cigarettes (vaping) or using Heat Non Burn (HNB) devices to inhale nicotine and marijuana. However, the use of these devices poses significant risks, and recreational nicotine and marijuana use below the age of 21 is illegal throughout the United States.

E-Cigarettes / Vaping

Electronic Cigarettes (e-cigarettes) are battery-operated devices that heat up a liquid (the e-liquid). This e-liquid usually contains nicotine but can also contain marijuana or other drugs, and other potentially harmful chemicals. Additionally, the e-liquid can include flavorings (such as fruit, candy, or dessert-like flavors), which can be well-liked and marketed towards youth. When heated, the e-liquid becomes an aerosol, which is then inhaled into the users’ lungs. Using e cigarettes is called vaping.

2. Heat-Not-Burn (HNB) or Heated Tobacco Products (HTPs)

A Heat-Not-Burn (HNB) product has an electronic heating device that heats up actual tobacco leaves. When the tobacco leaves are heated up, they create an aerosol. The user than inhales this aerosol, which contains nicotine and tobacco.

Parents and Prevention

Parents can help their children learn about the harmful effects of nicotine and marijuana use. Talking to your children at an early age can have an impact, especially as many children have already used e-cigarettes in middle school. Youth are less likely to use nicotine and marijuana if they can ask parents for help and know how their parents feel about these drugs. When talking to your child, it may be helpful to consider the following recommendations:

  • Ask what your child has heard about nicotine and marijuana. Listen and try not to interrupt or make angry comments.
  • If you choose to talk to your child about your own experience with nicotine or marijuana, be honest about why you used. Be aware that the nicotine products and marijuana available today may be stronger and produce a very different effect than what you experienced.
  • Explain that research tells us the brain continues to mature into the 20s. While it is developing there is a greater risk that substances will be harmful.

Sometimes parents may suspect their child is already vaping. The following are some signs of nicotine use by vaping or HNB devices:

  • Carrying vaping or HNB devices
  • Starting to use combustible cigarettes
  • Stealing money to pay for their vaping
  • Showing signs of nicotine toxicity, overdose, or withdrawal
  • Strong artificial candy-like or fruity scents
  • Skipping school to vape, or decrease in grades due to time spent vaping

Effects of Nicotine: Know the Facts

Pease see FFF Marijuana and Teens for effects of marijuana.

Many teenagers believe vaping nicotine or using HNB devices to be safer than smoking combustible cigarettes. When talking to your child it is helpful to explain the myths and the facts. They may say “it is less addicting than smoking” or “it’s less dangerous than smoking.” However, research shows vaping can cause serious short- and long-term health problems.

  • 1 e-liquid cartridge is equivalent to 20 combustible cigarettes, and vaping delivers nicotine into a persons’ system faster than combustible cigarettes. This increases risk of nicotine overdose when nicotine is used by vaping.
  • Nicotine is addictive.
  • Nicotine affects brain development including attention, learning, mood regulation and impulse control.
  • Use of HNB Devices and Vaping often progresses to combustible cigarette use and all the associated medical risks of lung cancer and COPD.
  • Vaping can cause lung disease which has led to teenagers needing lung transplants. 
  • EVALL is the name given to E-cigarette, Vaping, Associated, Lung, Illnesses.

E cigarettes, Vaping and HNB devices can lead to long term consequences. Preteens and teens rarely think they will end up with long term problems, so it is important to talk to them about the risks of nicotine and marijuana early and often. Talking to them can help delay their first use and helps protect their brain.

If they are using, talk to them openly. Be curious, allow them to talk, and listen, so they will talk more. If you have concerns about your child's drug use, talk with your child's pediatrician or a qualified mental health professional.

Related Resources

For more information about marijuana, drugs, and teenagers, you can check out:

National Institute on Drug Abuse (NIDA)

If you find Facts for Families© helpful and would like to make good mental health a reality, consider donating to the Campaign for America’s Kids. Your support will help us continue to produce and distribute Facts for Families, as well as other vital mental health information, free of charge.

You may also mail in your contribution. Please make checks payable to the AACAP and send to Campaign for America’s Kids, P.O. Box 96106, Washington, DC 20090.

The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 10,000 child and adolescent psychiatrists who are physicians with at least five years of additional training beyond medical school in general (adult) and child and adolescent psychiatry.

Facts for Families© information sheets are developed, owned and distributed by AACAP. Hard copies of Facts sheets may be reproduced for personal or educational use without written permission, but cannot be included in material presented for sale or profit. All Facts can be viewed and printed from the AACAP website (www.aacap.org). Facts sheets may not be reproduced, duplicated or posted on any other website without written consent from AACAP. Organizations are permitted to create links to AACAP's website and specific Facts sheets. For all questions please contact the AACAP Communications Manager, ext. 154.

If you need immediate assistance, please dial 911.

Copyright © 2023 by the American Academy of Child and Adolescent Psychiatry.