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Heart: Vaping can increase the risk of heart attack. It also increases heart rate.

Lungs: Vaping produces lots of chemicals including acetaldehyde, acrolein, and formaldehyde. These chemicals can cause deadly lung diseases.

Arteries: Vaping can create plaque in your arteries. It can also increase blood pressure and spikes your adrenaline.

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3.3% of all middle school students report that they are currently using e-cigarettes

https://www.fda.gov/tobacco-products/youth-and-tobacco/results-annual-national-youth-tobacco-survey#:~:text=2022%20Findings%20on%20Youth%20E%2DCigarette%20Use,-In%20October%202022&text=In%202022%2C%20about%201%20in,(past%2030%2Dday).&text=14.1%25%20(2.14%20million)%20of,reported%20current%20e%2Dcigarette%20use.

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2022 Findings on Youth Tobacco Use

In November 2022, FDA and Centers for Disease Control and Prevention (CDC) released federal data from the 2022 National Youth Tobacco Survey (NYTS) on youth tobacco use in the Morbidity and Mortality Weekly Report: " Tobacco Product Use among Middle and High School Students - United States, 2022." Findings show that in 2022, more than 1 in 10 middle and high school students (3.08 million) had used a tobacco product during the past 30 days - including 16.5% of high school and 4.5% of middle school students.
Current Use

11.3% (3.08 million) of middle and high school students reported current use (past 30 days) of any tobacco product

Approximately 3.7% (1.00 million) of all students reported currently smoking any combustible tobacco product

3.5% (960,000) reported current use of multiple (≥2) tobacco products

Most Commonly Used Types of Devices

E-cigarettes (9.4%)

Cigars (1.9%)

Cigarettes (1.6%)

Smokeless (1.3%)

Hookahs (1.1%)

Nicotine Pouches (1.1%)

Heated Tobacco Products (1.0%)

Pipe Tobacco (0.6%)

Demographics and Social Determinants of Health
Current Use (past 30 days) of Any Tobacco Product (middle and high school):

13.5% of non-Hispanic American Indian or Alaska Native (AI/AN) students

16.0% of those identifying as lesbian, gay or bisexual

16.6% of those identifying as transgender

18.3% of those reporting severe symptoms of psychological distress

12.5% of those with low family affluence

27.2% of those with low academic achievements (mostly Fs)

Methodology
The 2022 data was collected between January and May of 2022, using an online survey among U.S. middle school (grades 6-8) and high school (grades 9-12) students. The use of an online survey allows all eligible students to participate in a classroom or at home during a designated class period as part of a class activity, however most students completed the survey in a classroom setting. Prior to 2021, the survey was solely conducted in a classroom setting. Due to changes in methodology, including differences in survey administration and data collection procedures in recent years due to the COVID-19 pandemic, the ability to compare estimates from 2022 with those from prior NYTS waves is limited.
Download Infographic
2022 Findings on Youth E-Cigarette Use

In October 2022, FDA and Centers for Disease Control and Prevention (CDC) released federal data from the 2022 National Youth Tobacco Survey (NYTS) on e-cigarette use among U.S. youth in the Morbidity & Mortality Weekly Report " Notes from the Field: E-cigarette Use Among Middle and High School Students - United States, 2022. " E-cigarette use among youth remains a top concern for the FDA. In 2022, about 1 in 10 or more than 2.5 million U.S. middle and high school students currently used e-cigarettes (past 30-day).

Current Use

14.1% (2.14 million) of high school students and 3.3% (380,000) of middle school students reported current e-cigarette use.
Flavored E-Cigarette Use

Overwhelmingly, current users (nearly 85%) used flavored e-cigarettes, with fruit flavors being the most popular, followed by candy, desserts, or other sweets.

Frequency of Use

More than a quarter (27.6%) of current youth e-cigarette users use an e-cigarette product every day.

More than 4 in 10 youth e-cigarette users report using e-cigarettes at least 20 of the last 30 days.

Type of Device

The most commonly used device among current users was disposables (55.3%), followed by prefilled/refillable pods or cartridges (25.2%).

Commonly Used Brands

Current users reported their usual brands as: Puff Bar (14.5%), Vuse (12.5%), Hyde (5.5%) and SMOK (4%).

Methodology

The 2022 data was collected between January and May of 2022, using an online survey among U.S. middle school (grades 6-8) and high school (grades 9-12) students. The use of an online survey allows all eligible students to participate in a classroom or at home during a designated class period as part of a class activity, however most students completed the survey in a classroom setting. Prior to 2021, the survey was solely conducted in a classroom setting. Due to changes in methodology, including differences in survey administration and data collection procedures in recent years due to the COVID-19 pandemic, the ability to compare estimates from 2022 with those from prior NYTS waves is limited.

Public Education Campaigns

FDA conducts several public education campaigns aimed at young audiences to prevent youth from tobacco initiation and use. FDA's longest-running campaign, " The Real Cost," educates teens on the health consequences of smoking cigarettes and in recent years has prioritized e-cigarette prevention messaging.

In the 2021 NYTS, 75.2% of middle and high school students reported having seen or heard any antitobacco public education campaign ad within the past year. An estimated 15.8 million (60.9%) students reported recognizing the FDA's "The Real Cost" campaign ad: by school level, almost two-thirds (65.8%) of high school students and more than half (54.8%) of middle school students reported recognizing "The Real Cost" campaign ad.

However, public health education campaigns are not the only messaging about tobacco products that youth receive and notice.

They might see advertisements for tobacco products while engaging in common activities - such as going to a convenience store, supermarket, or gas station; using the Internet; watching television or streaming services or going to the movies; or reading newspapers or magazines. In the 2021 NYTS, among youth who reported engaging in those common activities, 75.7% reported exposure to marketing or advertising for any tobacco product.

Among students who reported using social media, 73.5% had ever seen e-cigarette-related content.

Goals of NYTS

FDA is committed to a science-based approach that addresses public health issues associated with tobacco use. We collaborate with CDC on this nationally representative survey of middle and high school students that focuses exclusively on tobacco use behaviors and associated factors.

NYTS was designed to provide national data on long-term, intermediate, and short-term indicators key to the design, implementation, and evaluation of comprehensive tobacco prevention and control programs.

For a deeper look at the agencies' collaboration on the study over the years, see CDC's " Historical NYTS Data and Documentation. "

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Results from the annual National Youth Tobacco Survey (NYTS)

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In November 2022, FDA and Centers for Disease Control and Prevention (CDC) released federal data from the 2022 National Youth Tobacco Survey (NYTS) on youth tobacco use in the Morbidity and Mortality Weekly Report: " Tobacco Product Use among Middle and High School Students - United States, 2022."

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Any minor who purchases or uses an e-cigarette in public, or misrepresents their age to do so should pay a $50 fine for the first offense, and $100 for subsequent offenses.
It is a violation of a federal law to sell a vape to a minor, consequences for this can include fines between $200-$500.
Retailers who sold e-cigarettes to minors may be subject to fines from $279-$11,182.

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Percentage of flavored e-cigarettes smoked

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Percentage of flavored e-cigarettes smoked

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more than 80% of middle and high school student vaping report using flavored vapes

https://www.cdc.gov/mmwr/volumes/70/wr/mm7039a4.htm

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Centers for Disease Control and Prevention

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Notes from the Field: E-Cigarette Use...

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This report describes e-cigarette use among middle and high school students as a serious public health concern.

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9.4% of middle school that vaped users reported daily use

https://www.cdc.gov/mmwr/volumes/69/wr/mm6937e1.htm

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Centers for Disease Control and Prevention

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E-cigarette Use Among Middle and High School Students ...

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The use of any tobacco product by youths is unsafe, including electronic cigarettes (e-cigarettes).

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Main points of the article are e-cigarettes were around for a decade but when vapes were invented the nicotine levels sky rocketed and now a lot of teens are in danger from the vapes.  The article also talks about how only people over 21 are allowed to be vaping but young people get their hands on vapes and are being endangered.

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Although e-cigarettes have been around for more than a decade, vaping rates have skyrocketed in recent years, especially among teens. E-cigarettes are now the most frequently used tobacco product among adolescents - some 2.1 million middle and high school students were e-cigarette users in 2017 - far surpassing traditional combustible cigarettes.

JUUL, a popular vape device that comes in fun flavors, looks like a flash drive and can be charged in a USB port, is especially concerning. JUUL delivers high levels of nicotine, making the product extremely addictive. The company that makes and markets JUUL recently exceeded a $10 billion valuation faster than any company, including Facebook. JUUL sales now make up more than half of the e-cigarette market.

The FDA announced that it will be cracking down not only on illegal sales of e-cigarettes to minors, but also the "kid-friendly marketing and appeal of these products" because "we see clear signs that youth use of electronic cigarettes has reached an epidemic proportion." And after recent unexplained illnesses and deaths that have been attributed to vaping, the CDC and the American Medical Association are expressing serious concern, recommending that people should avoid vaping entirely.

Teachers, health professionals and parents are alarmed by the growing popularity of vaping among young people and trying to educate not only teens but also themselves, as it's all still so new.

Vaping is the act of inhaling and exhaling the vapor produced by the heated nicotine liquid (often called "juice") of an electronic cigarette (e-cigarette or e-cig), vape pen, or personal vaporizer. It's also commonly called JUULing (pronounced jewel-ing).

What originated as a smoking cessation aid has quickly became a popular - and addictive - product in its own right. Sarper Taskiran, MD, a child and adolescent psychiatrist at the Child Mind Institute, attributes the recent rise in popularity to packaging and advertising. "The teens are after innovation and they're attracted by sleek design and ease of use," he says. "They look like an Apple product."

Although vaping companies emphatically deny that they are marketing to young people, critics note such features in their advertising as youthful images and colors, animation, actors who appear to be under 21, and suggestions that vaping makes you happier and improves your social status.

Although some of the health risks associated with vaping appear to be less severe than traditional combustible cigarettes (there's no tar, for example), there are still risks.

Some known risks of vaping are:

E-cigarettes contain high levels of nicotine. According to the company's website, the nicotine content of one JUULpod is equivalent to one pack of cigarettes.

Because of these high nicotine levels, vaping is extremely addictive - and teens are already more susceptible to addiction than adults because their brains are still developing, which makes them more likely to habituate to using drugs and alcohol.

Addiction can impact the ability to focus. Dr. Taskiran has observed this with the adolescents he works with, who report that vaping initially increases their alertness and attention, but then experience a decrease in attention span. One student, for example, was able to sit through practice ACT exams but after JUULing for six months "can't sit still because she starts craving, can't think of questions, and just starts fidgeting."

E-cigarettes and similar devices contain carcinogenic compounds, and a recent study found significantly increased levels of carcinogens in the urine of teens who vape.

One study found that vaping does, in fact, cause lung irritation akin to that seen in smokers and people with lung disease and causes damage to vital immune system cells.

There have been several deaths and hundreds of cases of lung illness attributed to vaping. Right now it is unclear if the cause is bootleg cartridges containing THC or CBD oil or legal nicotine cartridges. The CDC and the American Medical Association are recommending that people avoid vaping entirely while this is being investigated.

Taskiran notes that vaping increases heart rate and blood pressure, so can increase circulatory problems. One teen he works with started vaping and found that his swim times dropped because he can no longer sustain the heart rate required for swimming.

Since they leave little odor, e-cigarettes are particularly easy to hide and even use discreetly in public places, including school. Kids are also vaping marijuana at increasing rates, which brings its own health risks.

Why parents should be concerned

One problem with vaping is that teens hear that it's not as bad for your health as smoking cigarettes and many think there is no harm. "They really think that they are mostly flavors and that they are inhaling a pleasant gas," says Dr. Taskiran.

One study of 12th graders found that kids who vaped (but were not previously smokers) were more than four times as likely to "move away from the perception of cigarettes as posing a great risk of harm." The study and others like it have showed that teens who vape are much more likely to start smoking cigarettes.

The packaging does little to convey the risks. "They are very enticing the way they look. It's not transparent at all. It says 5% nicotine, which sounds like nothing, so teens think 95% is water weight or vapor," laments Dr. Taskiran.

Plus, he points out, smoking never stopped being cool. It's still positively portrayed in movies, and JUUL in particular has re-branded it to make vaping an even cooler alternative. But vaping isn't only for the cool kids - many teens are curious (with flavors like mango, cucumber and crème, who wouldn't be?) and presented with the opportunity will give it a try.

Sarah, a mom of two in Ann Arbor, MI, was shocked to get a phone call the other day from her son's middle school principal, requiring her to come get him immediately for "emergency removal and suspension." He and two friends had been caught vaping on school grounds after school, and a passing parent took photos and sent them to the administration.

Though they didn't find any devices on her son - a straight A student with no prior offenses - the school, like many others, is taking a hard stance. "The principal knows that vaping is common and shared that the businesses in downtown Ann Arbor are selling to teens without asking for IDs," relayed Sarah. "However, she feels the need to let my son and his friends know that it's a really, really big deal."

At this school, students caught vaping have to sign behavior contracts, must attend a Teens Using Drugs Class, and cannot participate in any sports, clubs or special events for the rest of the year. If the kids had been across the street, not on school grounds, it would have been a different scenario. But the principal said that had they been in high school rather than middle school, she would have called the police.

Sarah remembers what it was like to be a teenager so doesn't think trying it is that big of a deal, but is concerned about addiction. "Addiction runs in my family and I worry about my son. Of course, I worry about the damage that the chemicals can do to his lungs and body as well," she says.

Although some places are tightening restrictions locally, kids can still go to a website, click a button that says they are at least 21 years old, and purchase online. "The majority of adolescents I see are purchasing JUUL from the Internet," says Dr. Taskiran.

How to talk to kids about vaping

Dr. Taskiran advises parents to start by educating themselves, so they know what they're talking about going in, and to take an inquisitive and curious approach to what their teen's experience is. "The most important thing is keeping it as a dialogue," he says. "Declarative statements like 'It's bad for you' just end the conversation."

Dr. Taskiran recommends starting the conversation more generally by asking if a lot of kids at school vape. Once the conversation is initiated, you can slowly work up to asking things like, "What is your experience with that? What are the flavors like?" He also suggests getting a sense of what they know (or think they know) about the product, which gives you an opening to start educating them.

The silver lining of Sarah's experience with her son is that he actually told his dad about the experience even before he knew he'd been caught. "They had a full one hour conversation about it after I was already asleep. He told my husband that he tried it for the first time and that it burned his throat and he didn't like it." She got the call from the principal the next morning before her son had a chance to tell her himself. "He's a great kid and doesn't really get in trouble except for talking in class because he's bored. My goal has always been open communication and to keep him talking to us. He did!"

Of course, while parents need to educate themselves, the onus isn't entirely on them. "Schools need to own this as well and provide educational strategies for both teachers and students," says Dr. Taskiran. Prevention is a lot easier than treatment later on, he says, and notes that peer education can play a particularly important role.

If you are concerned that your child has become addicted there are plenty of treatment options. Dr. Taskiran recommends consulting with a clinician who is well-versed in addiction treatments. "This is a true nicotine addiction," he says. "People usually think this is different from cigarette use - but it can be more severe than cigarette use."

For tips on how to talk to teenagers about vaping, check out this guide from the Partnership for Drug-Free Kids.

Frequently Asked Questions

What should I do if my teenager is vaping?

Why do teens vape?

Why is vaping bad for teens?

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Teen Vaping: What You Need to Know - Child Mind Institute

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Why do teens vape? What are the effects of vaping? Learn what are the dangers of e-cigarettes, why parents should be concerned, and get guidance on how to talk to kids about it.

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Depending on where you go, for a first offense you could get an in-school-suspension.  For a second time being caught you could get a full suspension.

https://will.illinois.edu/news/story/discipline-or-addiction-treatment-how-schools-tackle-vaping

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Krystian-Graba/Pixabay (CC0)

Across the U.S., more than 2,000 people have reported vaping-related lung illnesses, and 47 have died. Some vaping happens in schools, so they share the burden of bringing this crisis under control. Which raises the question: what should the consequences be for a student caught vaping?

Some of these devices look like a flash drive, no bigger than a couple of inches. The smoke or vapor they release has little to no smell. Basically, they're really easy to hide and are a nightmare for educators.

In Spencer-Owen Community Schools, about an hour south of Indianapolis, a high school student got sick this fall after vaping a marijuana-laced e-cigarette. He went to the school nurse, and was reported to other school officials.

The student's mother, Shannon Houck told RTV6, "How are we supposed to tell our children if you have a medical problem -- even if it is smoking a vape in school, and I understand he did wrong by doing that -- we're teaching them don't go to the school officials, don't go to the nurse because you can get in trouble."

And that's an important question, because more kids are vaping than ever before. The Centers for Disease Control and Prevention says 1 in 4 high school students have used an e-cigarette in the last 30 days.

So now schools are left to decide how to handle these students.

Spencer-Owen Community Schools says it followed policy. And in most Indiana school districts, a student who vapes in school would be suspended or expelled after one or more instances.

Teenagers are frustrating and impulsive, and what they respond best to is what's hardest."Dr. Sarah Bosslet

"As adults, we think that ought to work, right?" says Dr. Sarah Bosslet, past president of Indiana's Chapter of the American Academy of Pediatrics says. "Because If you just tell them, 'Look, if you do this, you're going to get kicked out,' they won't do it.

"But anyone who's raised a teenager knows that that's not an effective strategy. Teenagers are frustrating and impulsive. And what they respond best to is what's hardest: individual attention and extra effort when they are at risk."

Bosslet says the academy opposes no-tolerance policies in schools.

As a pediatrician, Bosslet sees students vaping by sixth grade. And she says suspending these students can lead to more dangerous behavior, like vaping at home or using drugs.

"The worst thing you can do is isolate them and exclude them from activities that keep them busy and engaged and connected to their peers and to adults that they trust," Bosslet says.

She says there should be some kind of consequence for vaping: community service, additional education. But she and others say suspension isn't the answer.

"I think school nurses see themselves as the leader on the forefront of this as a health problem," says Deb Robarge, executive director of the Indiana Association of School Nurses.

She's also worried about how this sort of discipline can affect students. "I think we're concerned that we want them to get their education, we don't want them to lose out on opportunities they have only as a child because they've gotten caught up in this craze."

So for schools, is this a discipline issue, or a public health issue?

"I think it's somewhere in between," Robarge says. "And I've tried to kind of poll nurses across Indiana. But also, across the country ... I think what a lot of school nurses are feeling like it's a mixture."

On a recent day at Beech Grove Senior High School in Indianapolis, Students are dashing between classes. Principal Lizz Walters says about once a week or so, students are caught with e-cigarettes like those made by Juul.

Students caught the first time face an in-school suspension, she says. That means they have to complete educational materials on vaping and their parents are included too. They also can be connected to counseling. For a second offense, they'll be suspended out of school.

"I think you'd be hard-pressed to find a school that was not sort of supplementing those resources with some type of school punishment," Walters says.

Still, Walters says striking this balance between discipline and help for students is a tough, daily conversation. Principals and teacher realize schools are structured and at home students may have much more freedom.

"But then eventually, we have to make sure that students recognize they cannot continue to do things in a school environment that is detrimental to the school environment," Walters says. "And that's hard. That is very hard."

Some help for schools might be on the way. Raising the age to buy e-cigarettes and tobacco products from 18 to 21 will be at the forefront of the 2020 Indiana legislative session. A similar federal law also has been proposed.
This story was produced by Side Effects Public Media, a news collaborative covering public health.

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Discipline Or Addiction Treatment-How Schools Tackle Vaping | Illinois Public Media

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Across the U.S., more than 2,000 people have reported vaping-related lung illnesses, and 47 have died. Some vaping happens in schools, so they share the burden of bringing this crisis under control. Which raises the question: what should the consequences be for a student caught vaping?