For millions of teens, using e-cigarettes is a matter of taste. According to a 2017 National Institute on Drug Abuse report, one-third of 12th graders tried vaping in the past year, and over half report using just flavoring liquid, or e-cigarette “juice” that’s supposedly free of nicotine.
Teen vaping — inhaling the vapor from an electronic cigarette — is exploding, with the number of middle schoolers and high schoolers using vaping products nearly doubling since last year.
Colorful, sweet and heavily marketed, e-cigarette juice flavors include cotton candy, cherry cola and mango. Because flavors are so popular with youth, the U.S. Food and Drug Administration (FDA) last month proposed tightening restrictions around where such flavors can be sold.
In a statement released in November, FDA Commissioner Scott Gottlieb says the agency’s proposals “firmly and directly address the core of the epidemic: flavors.”
Under the proposal, e-cigarette flavors (except mint and menthol, which research shows are preferred by adults and used less often by youth) would only be sold in locations that aren’t accessible to people younger than 18.
A cloud of misinformation
Teens who vape “just flavoring” might get more than they bargain for. Nicotine-free e-cig juices contain chemicals, colorants and cancer-causing compounds; in a new study published in Pediatrics, researchers found five carcinogens in the urine of teens who used e-cigarettes.
The “nicotine-free” flavors may actually contain nicotine, too.
The “nicotine-free” flavors may actually contain nicotine, too. “The flavorings are definitely a draw for youth, and there’s misinformation and misunderstanding about what they are,” says Liz Wilhelm, M.S., of Seattle Children’s Division of Adolescent Medicine and drug-free communities coordinator with Seattle’s Prevention W.I.N.S. coalition.
“Testing shows that some flavors marketed as ‘just flavoring’ do contain nicotine. Vaping products are under-regulated, so there’s no guarantee that the claims are true of vaping liquids being nicotine-free.”
But health advocates say restricting access to e-cigarette flavors is only one part of preventing youth use. For one thing, teenagers often get e-cigarettes and vape liquid from friends and relatives over 18 who can buy them legally, or online.
Because it’s hard to know what kind of impact these retail restrictions might have, education and information for parents, school staff and youth are essential, says Wilhelm.
“We find that parents and school staff don’t know what these devices are or how they work. They don’t know what to look for or how to have a conversation about it. And teens often don’t see e-cigarettes as harmful or addictive.”
Talking to your teen
It’s vital to look for teachable moments to begin an ongoing dialogue around vaping, Wilhelm says.
“When you’re out with your child and you see someone using a vape, ask your child what they think about it. What’s the appeal?”
If you discover your teen has been using e-cigarettes, keep the conversation flowing, she recommends.
“Ask questions about why your child wants to do this; is it a social thing? Does it look cool, or is it more for curiosity?”
And if you sense something is off about your child’s behavior, ask about e-cigarettes, says Wilhelm. “Trust, but verify.”