Sound the Alarm: Youth Vaping can Harm

The Office of the Surgeon General, in partnership with the Smoking and Tobacco Use Advisory Committee and the Food and Drug Administration (FDA) have created this resource for parents and caregivers, educators, and healthcare professionals to understand the threat vaping poses to America’s youth.

Sound the Alarm: Youth Vaping can Harm Resource Guide.

Download the Resource Guide.

How We Got Here

2010s

E-cigarette use, commonly known as vaping, gained widespread popularity among youth.

2011-2018

E-cigarette use rose dramatically, from just 220,000 high school students in 2011 to over 3 million by 2018.

2016

The Surgeon General’s report on E-cigarettes.

2018

The 20th U.S. Surgeon General to declare youth vaping an epidemic.

2019

Vaping usage among high school students was nearly 1 in 3.

2024

More than 1.6 million U.S. youth reported currently vaping.

Federal Response

Over half of e-cigarettes on the market are illegal products, majority deriving from China, despite annual seizure of millions of illegal units by the U.S. Food and Drug Administration and U.S. Customs and Border Protection. These unauthorized vapes, often flavored and marketed to appeal to youth, are flooding the U.S. market from China through deceptive shipping practices such as mislabeling packages as toys or electronics bypassing regulatory oversight and posing serious public health risks. In response, federal agencies have ramped up seizures and issued warning letters to combat the illicit trade. These illegal imports from China constitute an unusual and extraordinary threat to the public of the United States.

Learn the Basics

Vaping is the use of battery-operated devices to inhale nicotine, flavoring, or other drugs in the form of an aerosol. These devices go by many names and have various types including vapes, vape pens, e-cigarettes (e-cigs), cig-a-likes, mods, tanks, disposables, or electronic nicotine delivery systems (ENDS).

Vaping devices share similar basic components, i.e., a battery, heating element (usually a coil or wick), and a tank or pod that contains the e-liquid (fluid that is turned into aerosol in an e-cigarette). 

The e-liquid within a vape usually contains nicotine, propylene glycol, vegetable glycerin or glycerol, flavorings, and may contain metal particles or other chemicals. Other e-liquids may contain cannabis concentrates like THC or CBD.

Know the Facts

  • In 2024, more than 1.6 million U.S. youth vaped.
  • When vaping, nicotine absorbs rapidly and reaches the brain quickly, delivering a dopamine surge resulting in feelings of pleasure and reward.
  • Vapes have been the most commonly used tobacco product among middle and high school students in the U.S. for a decade.
  • In 2024, 87.6% of current e-cigarette users vaped flavored e-cigarettes.
  • Disposable e-cigarettes were the most common type of vape used, at 55.6%, by current vape users in 2024.
  • As of September 2025, there are only 39 FDA authorized e-cigarette products for sale to persons over the age of 21. The sale of e-cigarettes to persons under the age of 21 is prohibited.
  • Use of multiple tobacco products is also a concern among middle and high school students, with 38.9% and 36.6% of current users, respectively, using more than one type of tobacco product in 2024.
  • More than half of middle and high school students who currently use e-cigarettes want to quit and have tried to quit; in 2020 63.9% of current e-cigarette users reported wanting to quit and 67.4% reported trying to quit in the last year.
  • Youth who vape are 3 to 4 times more likely to go on to smoke tobacco compared to teens who do not vape.

Recognize the Risks

Nicotine exposure can negatively affect normal brain development by impacting concentration and reducing impulse controls. Additionally, nicotine can worsen mental health issues (e.g., anxiety or depression) and may enhance the risk of developing chronic diseases (e.g., cancer and heart disease).

Self-reported hypertension, of similar magnitude to that of cigarette smoking and hypertension, was found to be associated with vaping.

Vaping aerosol can cause lung damage from harmful chemicals, e.g. formaldehyde, acrolein and acetaldehyde. Secondhand nicotine vape exposure can result in the risk of asthma exacerbation.
Inorganic arsenic and toxic metals, like antimony, are classified as carcinogenic and can lead to an increased risk of cancer and disruption of hormones.

Vaping leads to changes in the oral microbiome and inflammation, which may elicit oral disease. Oral effects from vaping include increased risks of gum disease, tooth decay, oral mucosal lesions, impaired wound healing, dry mouth, and bad breath.

Teens should also not use vapes – especially from informal or illicit sources – containing THC, a psychoactive component of the marijuana plant. In 2019, an outbreak of lung injuries was strongly linked to the vaping of THC products containing thickening agents, like vitamin E acetate.

  • Increased risk of seizures, especially in youth
  • Severe burns or other injuries due to vape explosions
  • Altered oral microbiome leading to gum disease, tooth decay, oral mucosal lesions, impaired wound healing, dry mouth, and bad breath
  • Short- and long-term effects on attention, learning, and memory
  • Irritability and mood swings
  • Insomnia, restlessness, and sleeplessness
  • Coughing and wheezing
  • Nausea, vomiting, headaches, and dizziness
  • Nicotine addiction
  • New onset of seizures
  • Cavities and gum disease

Understand the Popularity among Youth

A group of different colored vaping devices

The popularity of vaping among youth is due to any combination of factors which include:

  • Some vapes costing less than regular cigarettes, price incentives, or free samples
  • Social influences and use of online or social media strategies
  • Sleek and modern design of devices, featuring bright colors to give a less harmful appearance
  • Positioning products at festivals and within digital games
  • Predatory marketing tactics like those used by tobacco companies
  • Gamification through engaging features, competition, reward system, and flavors attractive to youth

Many vaping products accessible to youth are not authorized by the FDA and are illegally marketed.

Get Informed

For parents and youth

The Real Cost (FDA)

E-cigarettes (Vapes) (CDC)

Talk to Kids About the Risks of Vaping (FDA)

For educators

Empower Vape-Free Youth Campaign (CDC)

Vaping Prevention and Education Resource Center (FDA)

Vaping and E-cigarettes: A Toolkit for Working with Youth (FDA)

Infographics

The Risks of Vaping (FDA)

Vaping Misperceptions (FDA)

2024 NYTS MMWR on E-cigs and Nicotine Pouches (CDC)

For health professionals

USPHS Tobacco Cessation and Counseling Billing Toolkit (IHS)

USPHS-Rx for Change: Tobacco Cessation Intervention Program (Purdue University)

Multiple Cessation Facilitator and Quit Programs (American Lung Association)

Get Help Quitting

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