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E-cigarette Use and Implications on Health

November is National Smoking Cessation Month and the Miller Wellness Center wants to help spread awareness on the health implications of smoking and e-cigarette use as well as the resources available to help you quit.

“Vaping” or “JUULing,” are terms commonly used to reference the use of electronic cigarettes, which given their rise in popularity, you have probably heard of. From 2017 to 2018, e-cigarette use increased 78% amongst high schoolers.1 With this rise however, many individuals have confusion regarding what an e-cigarette is and their safety. E-cigarettes, vape pens, and vaporizers are a few of the terms used to describe electronic nicotine delivery systems (ENDS). Amongst the most popular is the JUUL, which the CDC has linked to the dramatic increase in e-cigarette popularity.1 The JUUL particularly appeals to the youth population, as it comes in a variety of flavors and is easily hidden, given its similar shape of a USB flash drive. While e-cigarettes are advertised as being safer alternative to cigarettes, it is important to remember that safer does not mean safe.2

ENDS work by heating e-liquid, which contains nicotine, flavorings, and other chemicals. When the e-liquid is heated, it creates a ‘vapor,’ which is then inhaled by the user.3 While the use of these devices is sometimes referred to as vaping, it is not actually ‘water vapor’ as some assume, but rather aerosol. The aerosol contains unknown amounts of nicotine and other chemicals that vary among brands. There are at least sixty chemical compounds found in the aerosol, including heavy metals and potential carcinogens such as formaldehyde and acetaldehyde, which are linked to liver, cardiovascular and brain damage, just to name a few.4, 5, 6 This wide array of chemical exposure also poses increased risks for lung disease and long-term harm to respiratory health.7, 8

While e-cigarette use is dangerous to all ages, youth and young adults are more vulnerable to the dangers of e-cigarette use. This is highly concerning because the brain is still developing and exposure to potential addiction is very early.8 Additionally, the increased exposure to ENDS products in place of standard cigarettes may be more harmful because they contain liquefied nicotine salts, which are absorbed rapidly and at a much higher level than a standard cigarette.3 In fact, one JUUL pod contains as much nicotine as 20 cigarettes.9 Though JUUL and many other e-cigarette companies market themselves as a way to quit cigarette smoking, studies have found that youth who participate in vaping are up to 4 times more likely to start smoking cigarettes compared to their peers who do not vape.9 Given that many of the long-term health consequences of e-cigarette use remain unclear, it is still safe to say that this is one human experiment you do not want to participate in. If you or someone you know is trying to quit tobacco, the Wellness Center has two certified tobacco treatment specialists on staff to support you during your journey to becoming tobacco free. In addition, you may visit or call 1-866-SDQUITS for free tools and services to help you quit.


  1. Simon S. FDA Proposes Regulations as Teen E-Cigarette Use Skyrockets 78% in 1 Year. American Cancer Society Website. . November 21, 2018. Accessed August 28, 2019.
  2. Unger M, Unger DW. E-cigarettes/electronic nicotine delivery systems: a word of caution on health and new product development. J Thorac Dis. 2018;10(Suppl 22):S2588. doi:10.21037/JTD.2018.07.99
  3. The American Cancer Society. What Do We Know About E-cigarettes?. The American Cancer Society Website. Updated June 19, 2019. Accessed August 28, 2019.
  4. Truth Initiative. E-cigarettes: Facts, stats and regulation. Truth Initiative Website. Updated July 19, 2018. Accessed August 28, 2019.
  5. Johns Hopkins Bloomberg School of Public Health. Study: Lead and Other Toxic Metals Found in E-Cigarette ‘Vapors.’ Johns Hopkins Bloomberg School of Public Health Website. Updated February 21, 2018. Accessed August 28, 2019.
  6. Kosmider L, Sobczak A, Fik M, et al. Carbonyl compounds in electronic cigarette vapors: effects of nicotine solvent and battery output voltage. Nicotine Tob Res. 2014;16(10):1319-1326. doi:10.1093/ntr/ntu078
  7. American Lung Association. The Impact of E-Cigarettes on the Lung. American Lung Association Website. Updated May 21, 2019. Accessed August 28, 2019.          
  8. Surgeon General. Know the Risks E-Cigarettes & Young People. Surgeon General Website. Updated 2019. Accessed August 28, 2019.
  9. Truth Initiative. How Much Nicotine is in JUUL?. Truth Initiative Website. Updated February 26, 2019. Accessed August 28, 2019.