May 20, 2016

Vaping isn’t harmless, and selling e-cigarettes to those under 18 soon will be illegal.


Smoking electronic cigarettes (“vaping”) is increasingly popular, especially among teenagers. If you aren’t yet familiar with e-cigarettes: They are designed to look like cigarettes, and most contain a cartridge filled with a nicotine-laced liquid that is vaporized by a battery-powered heating element. The user inhales the nicotine vapor, as with a regular cigarette. E-cigarettes come in a variety of flavors and nicotine levels.

Because they don’t produce smoke, they are touted as a less dangerous alternative to tobacco cigarettes. That should be a good thing — the U.S. Centers for Disease Control and Prevention lists cigarette smoking as the leading cause of disease, disability and death in the United States. However, the U.S. Food and Drug Administration notes that e-cigarettes have not been fully studied, so potential risks are not known. Most recently, two leading cancer organizations, the American Society of Clinical Oncology and the American Association for Cancer Research, have called for more oversight and research into the long-term health effects of e-cigarettes.

In May 2016, the FDA issued new regulations that make it illegal to sell e-cigarettes (and cigars and hookah tobacco) to people under the age of 18. That rule will go into effect Aug. 8, 2016.

Just as teenagers have managed to use traditional cigarettes despite a longtime ban on sales to minors, they’ll likely continue to find ways to buy vapes. So parents should still watch for signs of vaping.

Also, the liquid nicotine used in e-cigarettes poses a hazard to younger children. Poison control centers report a sharp increase in calls about exposure to the liquid nicotine for vapes. Poisonings related to e-cigarettes in children age 5 and under have increased nearly 15 times during the three-year period ending in 2015. A study published May 9, 2016, in the journal Pediatrics reports that most poisonings in young children were from swallowing the liquid nicotine used in e-cigarettes.

Parents, teachers and teenagers should be aware of the risks of nicotine poisoning. Liquid nicotine can be very toxic to children, teens and adults. Just a few drops of nicotine liquid swallowed or absorbed through the skin can send a child to the emergency room.

Nicotine poisoning can happen with e-cigarettes in three ways:

  1. Ingestion (consuming a substance through the mouth, as in eating or drinking)
  2. Inhalation (breathing in any form of gas or vapor)
  3. Absorption through skin or eyes (entering the body through skin contact)

Side effects of nicotine exposure can include anxiety, breathing problems and upset stomach. At lower doses, nicotine may cause a fast or irregular heartbeat, while an overdose of the drug can cause a dangerously slow heart rate. Some symptoms of nicotine overdose to be aware of include confusion, cold sweat, seizures, tremors and pale skin.

Important electronic cigarette information that parents need to know

Besides the risk of poisoning, keep in mind these other facts about vapes:

  • E-cigarettes may be very appealing to children and teens because of their high-tech design, availability online and celebrity endorsement.
  • Because many come in flavors like cotton candy or gummy bear, health officials say that the brightly colored liquid could appeal to young children.
  • Infants and children exposed to nicotine may have problems with feeding, and may experience delays in mental and physical development. Other side effects for children may include impairments in brain development, learning, attention and memory.
  • There is no safe level of nicotine for those who are pregnant or breastfeeding; women who are pregnant or breastfeeding should not smoke tobacco or e-cigarettes. However, in some cases, the nicotine patch, gum or lozenge is a safer alternative for both the mother and child than a mother’s use of tobacco cigarettes or e-cigarettes, says Hilary Tindle, M.D., an associate professor in medicine, physician and founding director of the Vanderbilt Center for Tobacco, Addictions and Lifestyle. Pregnant or breastfeeding smokers should talk to their doctor about using nicotine-replacement products such as the patch, gum or lozenge rather than vaping.

Vaping has become increasingly popular among teenagers in recent years. In 2014, the CDC reported that teens’ use of e-cigs had tripled in just three years. Some parents may believe that their teenager’s vaping is not cause for worry,  because the e-cigs seem less harmful than traditional tobacco cigarettes. But recent studies suggest that e-cigarettes can be a gateway — a first step — toward using tobacco cigarettes, probably because the vapes contain nicotine, the same addictive substance found in tobacco cigarettes. Eventually a teen who’s become hooked on e-cigs may turn to regular cigarettes for a nicotine fix.

It can be difficult to know if your child or teen is using e-cigarettes because vapes do not smell like tobacco or smoke. However, e-cigarettes have been associated with dry cough, as well as mouth and throat irritation. So if these symptoms are persistent in your child or teen with no other known cause, you should find out if they’ve been using e-cigarettes and try to help them quit smoking.

E-cigarettes have been touted as a lesser evil to conventional cigarettes, but questions remain about their use and safety, and the FDA has recognized those concerns with the ban against selling e-cigarettes to minors. I encourage you to be informed about e-cigarettes in order to make the best decisions for your health and your family’s.


Emily Riley is an injury prevention program coordinator at Monroe Carell Jr. Children’s Hospital with a background in adolescent health and development. When she is not working, Emily enjoys running, cooking/baking, being outdoors, exploring local coffee shops and spending time with the people she loves. She also has a hard time putting down a good book.

If you’re quitting smoking, The Tennessee Tobacco Quitline, available online or by toll-free call at 1-800-QUIT-NOW, is a great resource. For more tips and inspiration, see My Southern Health’s posts about quitting smoking.