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E-Cigarettes: Trick or Treat?


"HALLOWEEN MERRY HALLOWEEN Jack-O-Lantern" (CC BY-NC-ND 2.0) by UpNorth Memories - Donald (Don) Harrison

This Halloween, it’s not just the boogeyman for whom you must be on high alert. Beware of e-cigarettes luring your young patients with their sweet aromas down a path of addiction!

How many teens in the United States use e-cigarettes?

E-cigarettes have become the most highly-used tobacco product among high-school students in the United States. This amounts to over 2 million e-cigarette users within this age group. Given the scary epidemic and the widespread use of e-cigarettes within school facilities, doctors should counsel their young patients about lowering e-cigarette use.

E-cigarette use has risen at an alarming rate among U.S. youth, growing from just above one percent in 2011 to nearly 12 percent in 2017. In fact, there are now more high school students than adults who use e-cigarettes in the United States. Why is this an eerie issue?

Let’s take a look at the ingredients in e-cigarettes:

E-cigarettes are made of harmful and addictive substances, including tobacco-derived nicotine, about which young users often do not know. A single container of e-cigarette fluid from brand name JUUL holds the same frightening amount of nicotine as a pack of twenty traditional cigarettes. However, sixty-three percent of bewitched teenage users do not know that e-cigarettes contain nicotine.

This can be dreadful for young e-cigarette users since the human brain does not fully develop until age 25. High nicotine levels can impair attention span and learning abilities. Additionally, it can disrupt mood and lead to impulsive behaviors. More importantly, early e-cigarette use increases the risk of nicotine addiction. As a result, this can contribute to trying traditional cigarettes.

There are other abominable ingredients, such as cancer-causing chemicals, volatile organic compounds and heavy metals. Moreover, flavoring substances, like diacetyl, can cause severe lung disease. Despite the morbid health effects, over eighty percent of youth users reported the accessibility of different flavors as their main reason to use e-cigarettes.

Aren’t e-cigarettes safer than cigarettes?

While some argue that e-cigarettes should be encouraged over traditional cigarette use because of reduced exposure to toxins, this does not mean that e-cigarettes are safe for use. Additionally, the mysterious effects of second-hand exposure to e-cigarette vapor are not well understood. There is wide variation in the types and amounts of toxic ingredients released in the ghostly vapor. Thus, it is important to protect young patients from the fumes of e-cigarettes in addition to traditional cigarettes.

What can you do?

Health care providers can prevent the ominous health effects of e-cigarettes by asking young patients directly about use and exposure. Here are some general guidelines:

  1. Ask open-ended questions
  2. Lead the conversation in a non-judgmental manner
  3. Disperse information on the harmful nature of e-cigarette users and non-users alike
  4. Discuss the current recommendations
  5. Direct patients to online resources

In this manner, young patients will become more aware and possibly garner a better understanding of the grave consequences to using e-cigarettes.

During and after this spooky holiday, let us, as current and future health care providers, make a joint effort to prevent our youth from becoming nicotine-addicted zombies by warning them of the tobacco industry’s marketing tricks and encouraging them to stay in e-cigarette-free environments.

Image credit: “Jack-O-Lantern” (CC BY-NC-ND 2.0) by Donald (Don) Harrison

Frances Tao (3 Posts)

Contributing Writer

University of California, Riverside School of Medicine


Frances Tao is a graduate student at Harvard T.H. Chan School of Public Health. Previously she finished her third year of medical school at UC Riverside and will return in fall 2019 to finish her medical degree. She graduated with a B.S. in Psychology and a B.S. in Biochemistry & Cell Biology from UC San Diego in 2014. Her professional interests include lifestyle medicine and global health. In her free time, she enjoys hiking, sketching, and traveling.