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The Flip Side

Crisis in Teen Vaping Has Consequences for Health and Education

At least it’s not smoking. This idea brought vaping to the marketplace with the goal of offering nicotine-addicted adults a path to quit tobacco cigarettes. Unfortunately, this idea has also prompted confusion. Underestimating the effects of vaping, many teens are surprised to find themselves intensely addicted to nicotine. Thus, what was promoted as a public health breakthrough for adults has also spurred a new public health crisis among teens.

The rapid rise of teen vaping has taken parents, educators, and health professionals by surprise. Teen smoking peaked in 1997—at 36.4 percent of high school students—before plummeting sharply in the wake of high-profile lawsuits that highlighted tobacco’s health toll and introduced strong restrictions on marketing tobacco to minors. E-cigarettes, which were not originally regulated like tobacco, heat a liquid containing nicotine into a vapor that users inhale. Their use has skyrocketed in recent years as the delivery device has been refined. Correspondingly, e-cigarette use among high school students jumped from 11.7 percent in 2017 to 20.8 percent in 2018, according to the Center for Disease Control. That same year was also the first time in decades that the CDC recorded growth (to 8.1 percent), rather than decline, in the rate of teens smoking tobacco cigarettes.

Nicotine is highly addictive because it stimulates dopamine, a brain chemical that is released when we perceive ourselves to be getting rewards—ranging from a friend’s congratulations to the pleasure of listening to music or eating an ice cream sundae. The good feelings dopamine stimulates encourage us to repeat experiences. Consequently, smoking and vaping habituate nicotine into the brain’s cycle of reinforcement. Young users are hit the hardest because adolescence is one of the brain’s busiest phases for building neurocircuitry, and research has shown that our brains are not fully mature until age 25.

In my profession, I regularly encounter young people for whom nicotine is disrupting sleep, creating uncontrollable mood swings, and provoking increasingly risky behavior to satisfy addiction cravings. Vaping can also be used to mask other drug issues—a recent study recently showed that nearly one-third of high school e-cigarette users have also vaped marijuana. Hazards lurk whenever someone relies on substances to manage emotions and eventually can derail students’ education and everyday life. I feel so fortunate to be able to connect struggling families to programs that help adolescents build a healthier approach to the social-emotional demands of growing up.

Prevention is the best way to address what the U.S. Surgeon General has now declared to be an epidemic of teen vaping. The U.S. Food and Drug Administration has recently launched initiatives to reduce marketing vaping to minors. Meanwhile, we must become more knowledgeable about the consequences of vaping for young people. One study has shown that only 37 percent of 15- to 24-year-olds knew that the vapor they breathed contained nicotine. Yet nicotine is in all pods sold by Juul, the company with more than 75 percent of the market share and whose name has become a de facto verb for vaping. In addition, vaping can deliver a bigger nicotine hit than traditional tobacco cigarettes, so addiction can ramp up faster. Many also don’t realize that one Juul pod contains 20 cigarettes worth of nicotine. Parents must learn to recognize vaping devices, plastic cartridges which are often described as looking like flash drives. The low profile of this activity, which may not generate smoke, allows it to creep into every arena of life, inside and outside of school. With a concerted effort, we can regain the ground we have lost in helping teens make healthy life choices.

Jeremy McGeorge specializes in serving families whose children need nontraditional​ services as part of their educational plan. He can be reached at