Let’s make sure teens don’t start vaping again

The school year has ended for most teens and many states have reopened businesses fully with few restrictions. More than 5.6 million 12-18 year olds are fully vaccinated against COVID-19 as of mid-June. For many teens, this summer will be more “normal” and they can socialize freely with friends again. As teens get together this summer, and when they go back to school this fall, this may mean greater peer pressure around certain unhealthy behaviors, especially with regard to e-cigarette use or vaping. We need to be vigilant to prevent a resurgence of the youth vaping epidemic. 

During the pandemic, the number of underage youths who used e-cigarettes or vaped declined in the United States. In one national study in May 2020, 37 percent of underage youths said they quit e-cigarettes and 31 percent reduced the amount they vaped since the pandemic began. In another national study, the rate of youths ages 15-17 who reported vaping in the preceding 30 days declined from 21 percent in January 2020 to 14 percent in June 2020. The decline was partly explained by stay-at-home restrictions, which meant that youths had less access to retail stores that sell vaping products. 

Vaping is a highly social behavior; the most common reason that teens say they vape is that a friend or family member vapes. Youths who primarily vaped at schools or at social events may have had fewer opportunities to do so during the pandemic. This was a welcomed trend, reversing years of rapidly rising rates of youth vaping that led the U.S. Surgeon General to declare an epidemic.   

As researchers who have studied vaping and other tobacco product use among young people for nearly a decade, we believe we must double down on efforts to further reduce youth vaping rates. Vaping, while considered less dangerous than smoking combusted cigarettes, is not harmless for children and teens. Vape products that contain nicotine, a highly addictive substance, can harm the developing brain and have been linked to mental health disorders in young people. Besides nicotine, youths who vape also can inhale other dangerous chemicals present in the aerosols such as formaldehyde, a known carcinogen.

Youths who vaped in the past month are over four times more likely to subsequently become cigarette smokers, compared with those who did not vape, leading to long-term health harms. In 2019, vaping was linked to an outbreak of severe lung injuries because of vitamin E acetate, a chemical found in vaping products. One study reported that vaping in teens was linked to higher rates of being diagnosed with COVID-19 and having its related symptoms. 

As pandemic restrictions are lifted and the push continues to fully reopen schools by the fall, we must take steps to prevent a potential resurgence of vaping among young people. Resources are available for parents who are concerned that their child may be vaping. Parents should learn about the different kinds of vaping devices, the health risks of vaping, and telltale signs that their child may be vaping. If their child is addicted to vaping, they should seek treatment and counseling from a health provider.

Public health agencies can amplify social media campaigns targeted at youths to talk about the harms of vaping. Local, state and national policymakers should take steps to further reduce youth access to vape products, including increasing taxes, limiting internet sales and expanding sales restrictions of flavored cartridge-based e-cigarettes to all categories of vape products.

In preparing to reopen safely for students to reduce risks of COVID-19 transmission, schools also will need to incorporate measures to prevent and detect vaping among students on campus. They can provide health education messages to youth about the health harms of vaping and include information about risks of vaping for COVID-19 infection.

We want young people to socialize with their friends and attend school again. In doing so, we must not give up the gains in addressing the youth vaping epidemic. With concerted efforts by schools, parents and public health agencies, we can further drive down the rates of vaping among youths.

Andy Tan, PhD, MBBS, MPH, MBA, is senior fellow at the Leonard Davis Institute of Health Economics and an associate professor at the Annenberg School for Communication at the University of Pennsylvania. He served on the Massachusetts Task Force to Study and Provide Recommendations Regarding the Vaping Industry in 2020, and is lead researcher on a National Institutes of Health-funded study on the impact of the 2019 Massachusetts law restricting the sale of flavored tobacco products, including e-cigarettes.

Ramzi G. Salloum (PhD, MA, MBA) is an assistant professor at the University of Florida College of Medicine. He serves as an expert panel member of the American Academy of Pediatrics Tobacco Consortium and as a member of the Florida Cancer Control & Research Advisory Council.