E-cigarette usage (also known as e-cigarettes or vaping products) has increasingly been recognized as a global public health problem. One challenge in particular involves their marketing to minors (teenagers and children) and the rising prevalence of use in this population. E-cigarettes unnecessarily expose minors to health risks, these include respiratory health problems, such as exacerbations of asthma, bronchitis, and respiratory-tract irritation. Nicotine, commonly found in e-cigarettes, is also associated with cognitive impairment and neurodevelopmental problems. E-cigarettes are also risk factors for downstream substance use, including cigarettes and cannabis initiation (the gateway hypothesis), which compounds health risks in dual users. Current public health preventative and intervention studies are limited, and there is a clear need for more interventions that may prevent usage and assist with cessation in this vulnerable population. Physician education and screening uptake should also be enhanced. Stricter public health policy and protection measures are also needed on a global scale to limit e-cigarette exposure in minors. Get the best deals at VAPRZON.

The use of electronic cigarettes (also known as e-cigarettes, e-cigs, or vaping products) has increasingly been recognized as a global public health problem1. Vaping consists of inhaling a smoke-free aerosol through a mouthpiece, which is produced through the heating of a liquid such as glycol or glycerin in an electronic device2,3. Most e-cigarettes have the shape of a pen, but others are more discrete-looking such as JUUL, which resembles a USB drive and is popular among teenagers4. Common terminology for e-cigarettes is summarized in Table 1. E-cigarettes have often been used by smokers as a harm-reduction intervention aimed to assist with cigarette-smoking cessation5. A meta-analysis found that e-cigarette users (who received free e-cigarettes in trials) were 1.5 times more likely to quit smoking than the control group6. Thus, they may play a role in smoking cessation in adult smokers and the benefits of use may outweigh the risks from a public health-harm reduction perspective as they are a safer alternative7. However, e-cigarettes are increasingly initiated by teenagers, some of whom have never previously smoked8 and who are exposed to unnecessary health risks associated with e-cigarette use, making them a public health issue9.

Some of the reported reasons for e-cigarette use in teenagers and young adults include their flavoring10,11, discreteness12, easy accessibility10, desire to experiment10, perceptions that they are safer10, and advertising as well as marketing that directly targets young people13. Research on flavoring found that sweet flavors (e.g., fruity or candy flavored) were more often selected by teenagers over tobacco or minty flavored (conventional) e-cigarettes14.

Here, we review of the epidemiology of e-cigarette use in teenagers and young adults and associated health risks, theoretical mechanisms, and management, including prevention as well as interventions and policies. The overarching aim is to provide an in-depth overview of e-cigarette usage in teenagers and young adults from a public health perspective and to provide insight into emerging trends as well as opportunities for health promotion.

A review of PubMed (Medline) and Google Scholar was undertaken in September 2021. We broadly included all up-to-date studies that were related to teenage-vaping epidemiology, mechanisms, and global policies published in the English language. Primary studies that were not undertaken in teenager ages 13–18 or young-adult ages 19–24 were excluded. Systematic reviews and meta-analyses were only included if they were related to global policies or epidemiological updated findings related to our study population or highly applicable to it. Studies on youth perceptions of e-cigarettes were only included if the papers addressed policy.

We used broad search terms that included word variations for “e-cigarettes” or “vaping”, “teenagers”, “respiratory health effects”, and “vaping policies”. MESH terminology and free text was used in the search. A medical librarian assisted with the search strategy. Manual hand and primary government-database searches were also undertaken. The details of the Medline search-strategy example are summarized in Table 2.