UNC Health Care
e-cigarette in a backpack emitting smoke

What You Need to Know About Your Teens and Vaping

Smoking cigarettes has long been symbolic of teenage rebellion. But today, kids are more likely to be caught in a fog of vapor than a cloud of smoke.

That’s right—today’s teenagers are using e-cigarettes more than regular ones, according to the National Institute on Drug Abuse. While decreased cigarette use by teens is a great development, says Adam Goldstein, MD, MPH, director of Tobacco Intervention Programs at the UNC School of Medicine, there is reason to worry about e-cigarette use among teens.

First things first: What is vaping, and how do e-cigarettes work?

E-cigarettes, or vape pens, use a battery to heat a liquid tobacco product into a vapor. Vaping is the inhalation of this product. The liquid tobacco product, called “vape juice,” consists of nicotine, glycerin, propylene glycol and flavoring.

Is vaping these ingredients safe, for adults or teens?

First, it’s important to note that there is no safe tobacco use. Because of how recently e-cigarettes came on the market, and given how they have only recently begun to have any regulations associated with them, we have very little data about long-term safety.

For youth in particular, we know that nicotine adversely changes many aspects of brain development. That’s why preventing youths from being exposed to nicotine is in and of itself a public health goal.

Why is e-cigarette use among teens of special concern?

Tobacco use is particularly worrisome for youth and young adults because of the addictiveness of all tobacco products. Those who start consuming tobacco products at a young age are more likely to become addicted and to continue using tobacco for long periods of time. In fact, we know e-cigarette use has increased among youth and young adults at alarming rates. E-cigarettes are now the most commonly used tobacco product among youth in the United States.

For parents who suspect their kids are vaping and want to know more about the health effects, tell us: What does vaping do to your lungs?

Vaping, because it involves the inhalation of tobacco products at elevated temperatures—although at temperatures less than combustible tobacco, can have adverse pulmonary effects. There are many reports of inflammation in the lungs, due in particular to the flavoring.

What is popcorn lung? Can vaping cause it?

Popcorn lung, or bronchiolitis obliterans, is a disease that results in the obstruction of the smallest airways of the lungs due to inflammation. Symptoms include a dry cough, shortness of breath, wheezing and feeling tired. These symptoms generally get worse over weeks to months.

Yes, vaping can cause popcorn lung. The first thing to understand is that vape juice flavorings are not designed to be inhaled; they’re designed to be eaten. So these flavorings, when inhaled at higher temperatures, can be toxic to the lungs and cause damage, including the possibility of popcorn lung.

Do e-cigarettes carry any other risks people should know about?

Because vaping frequently involves a repeated behavior, this can create a problem with vape pen batteries and long-term heavy-metal exposure. If you use e-cigarettes, you may be exposed to heavy metals that build up through the battery you are inhaling. There’s a concern that this heavy-metal exposure over long periods of time could be exceedingly dangerous to users.

What about burns? Do vape pens really explode and cause injuries?

We actually did some work on this and put a commentary in the British Medical Journal a few months ago. We shared case reports at the North Carolina Jaycee Burn Center in addition to the estimated hundreds to thousands of burns—mostly unreported—that are happening from e-cigarettes.

A large portion of these burn cases came from batteries that were spontaneously exploding, oftentimes in people’s pockets, causing some serious burns. Since that report has come out, there has been a lot more attention to this issue, including the FDA now taking notice.

If you recall, Samsung had to remove a whole class of smartphones off the market. E-cigarettes have caused many more injuries to date, but they are still on the market virtually unregulated.

Can vaping help you quit smoking?

If people who are using combustible tobacco say they have quit, then we are thrilled. We are thrilled any time people quit using tobacco products. The problem occurs when people cut their tobacco consumption but are also vaping at the same time. Dual use is a major problem. Using one of the seven FDA-approved products to quit smoking that have been proven safe and effective would be a safer choice, compared to a product that is virtually untested.


For more information on UNC’s work to decrease tobacco use and to learn about resources that can help you quit, visit the UNC Department of Family Medicine’s Tobacco Intervention Programs page.