Many young people don't see the harm in vaping—and that's a big problem.

The recent vaping-related lung injury outbreak in the US demonstrates that there is a lot more to learn about the short- and long-term impact of e-cigarette use.

E-cigarettes are never safe for youth and young adults. Strongly advise anyone who is vaping, dabbing or using e-cigarette products to discontinue use of these products and help prevent young patients from switching to cigarettes. Unfortunately, shifts in social acceptability and access to marijuana create opportunities for youth to experiment with vaping products containing THC, despite being illegal in Vermont. Direct young patients who want to stop using marijuana and need help to call 802-565-LINK or to go to to find treatment options.

By understanding the allure of vaping to teens and young adults, you can advise young patients about their risks and treatment options. We can help you have those youth cessation conversations.

What do you know about vaping?

Vaping devices have many names: vape pens, pod mods, tanks, e-hookahs, JUUL and e-cigarettes. The liquids they contain can be called e-juice, e-liquid, vape juice, cartridges or pods. Most vape liquids contain a combination of glycerin and nicotine or flavoring chemicals to produce common or outlandish flavors, from mint to “unicorn puke.” Batteries power a heating element that aerosolizes the liquid. The aerosol is inhaled by the user.

Since 2014 e-cigarettes have been the most common type of tobacco product used by Vermont youth. Unfortunately, e-cigarettes can be used to deliver marijuana and other drugs. In 2015, one-third of US middle and high school students reported using e-cigarettes with non-nicotine substances. See Prevalence of Cannabis Use in Electronic Cigarettes Among US Youth .

Shifts in social acceptability and access to marijuana create opportunities for youth to experiment despite being illegal in Vermont.

Download “Electronic Cigarettes: What’s the Bottom Line?” infographic from the CDC (PDF)

Update on national outbreak of vaping product use-associated lung injury (EVALI):

EVALI cases that peaked in August and September 2019 have been in gradual decline since. The Vermont Department of Health discontinued surveillance on February 14, 2020. The CDC, FDA and state health authorities have made progress in identifying the cause of EVALI. The CDC continues to update findings, key facts on pulmonary effects from vaping and provider recommendations.

Get the most recent case counts and information from the CDC

Find other EVALI resources for health care providers from the CDC CDC


Your young patients get erroneous information from all kinds of dubious sources, including friends and e-cigarette manufacturer advertising. You can help set them straight with facts about vaping.

The reality: Most e-cigarettes contain nicotine

  • E-cigarette ingredients aren’t always labeled correctly. They aren’t tested for safety either.
  • Nicotine is common in most e-cigarettes. Popular brands of e-cigarettes, like JUUL, contain doses of nicotine that can exceed a pack of cigarettes.
  • Nicotine can permanently change the developing brain and impact youth wellbeing, study habits, anxiety levels and learning.
  • Nicotine is very addictive and may also increase risk for future addiction to other drugs.
  • Becoming addicted to nicotine is like losing freedom of choice.

The reality: Aerosol from vaping is more than water vapor

  • Liquids used in vapes are filled with a variety of chemicals like nicotine and flavoring agents; we often don’t know what else is in there. There isn’t required testing by the FDA.
  • Besides delivering nicotine, which is addictive and toxic, heavy metals from the heating coil and fine chemical particles have been found in the aerosol. They can cause respiratory disease.
  • Nickel, tin and aluminum can be in e-cigarettes and end up in the lungs.
  • Chemicals that are known to cause cancer can also be present in e-cigarette aerosol.

The reality: Flavors contain chemicals

  • E-cigarette manufacturers add chemical flavoring to appeal to first-time users — especially teenagers.
  • Nicotine-free e-cigarettes are not regulated. The chemicals that create flavors, like candy, cake and cinnamon roll, can be toxic to the body’s cells.
  • If you vape, you’re 4 times more likely to start smoking cigarettes.

For more information and talking points (PDF): Download E-Cigarettes and Youth: What Health Providers Need to Know (PDF)

Consider using a practice tool to assess level of nicotine addiction: Download the Hooked on Nicotine Checklist (HONC) for cigarettes (PDF) or vaping (PDF)

Studies show that youth, like my son, have no clue what's in these products most of the time.Jerome AdamsUS Surgeon General


UNHYPED is Vermont’s health education campaign intended for teens. It is designed to share knowledge about health consequences of vaping and to correct common misconceptions. UNHYPED separates the truth from the hype so young people can understand the facts.

Click here to see the spring 2020 media campaign for Vermont parents to help their teens stop vaping, developed by the Vermont Department of Health.

Youth Cessation – Referring Youth and Young Adults

Learn how to help young patients ages 13+ quit cigarettes, e-cigarettes, chewing tobacco, dip or hookah.