Teen vaping crisis: Q&A with a substance use expert

Teen vaping has surged to alarming levels, making e-cigarettes the most popular nicotine product among U.S. adolescents. According to the Center for Disease Control and Prevention, 4.6% of middle school and 10% of high school students, or 2.1 million students, used e-cigarettes in 2023.

In Florida, the situation is even more concerning, with a staggering 410% increase in adolescent e-cigarette use since 2011.

Elisa Trucco, an associate professor of psychology and a leading researcher on teen substance use at the Center for Children and Families shares her insights into why teen vaping continues to rise and what can be done to address this pressing problem.

Why are teens choosing to vape these days - what's the attraction - and is their use on the rise?

Vaping products are marketed specifically for a teen demographic through their variety of flavors and sleek designs. Take the Elf Bar, for example. It comes in flavors like Blue Razz Ice and Miami Mint and has a trendy ombré design that looks a lot like AirPod cases.

A lot of online marketing also highlights the fun and social aspects of vaping and not the potential harms. This makes it easier for teens to focus on the social benefits of vaping while overlooking the potential associated health costs.  

Which is worse for teens: vaping or cigarette use?

We know that cigarette smoke has serious negative health effects, like causing lung cancer. Since vaping devices produce vapor rather than smoke, vaping may be less harmful. Still, less harmful does not mean harmless! Most vaping devices still contain nicotine, which is super addictive and can mess with your mood and give you more anxiety. In addition, early research shows that there are heavy metals and chemicals, such as formaldehyde in vaping liquids, which increases the risk for respiratory disease. Since vaping is relatively new, we don’t really know what the long-term effects are yet.

Is vaping more serious a problem for teens than for adults, and why?

Absolutely, vaping at a young age can lead to some serious issues. First off, the earlier someone tries a substance, the more likely they are to end up using it heavily later on, developing a substance use disorder. Take alcohol, for example—research shows that about 40% of people who start drinking before 15 end up with an alcohol use disorder, compared to just 10% who wait until they’re 21. Vaping seems to follow a similar trend.

Also, keep in mind that the brain doesn’t fully mature until around age 25. So, when teens vape, it can really affect the parts of their brain responsible for attention, learning, and memory. Since young brains are wired to learn, they can also get hooked on vaping much more easily than adults.

What role do social media and influencers play in the popularity of vaping among teens?

Social media and influencers play a huge role in why vaping is so popular among teens. Just look at how companies like Juul marketed their products in the beginning. They handed out free Juuls to young influencers to help them promote vaping to their followers. Their “Vaporized” campaign showed vaping in a really glamorized way, using social media to target young adults.

What are your plans for reducing teen vaping use? 

When it comes to cutting down on teen vaping, we know that most treatment approaches are just adapted from adult programs. But research shows that teens have different reasons for using substances and face different challenges, which is why they often don’t engage with these treatments—only about 6% actually participate.

Right now, there aren’t many effective vaping cessation programs aimed at teens, and we want to change that. With support from the Florida Department of Health, we’re focusing on high school students in South Florida, especially those who identify as Hispanic, since they have some of the highest vaping rates. Our goal is to create and test a new program that really fits their needs and strengths.

Is there a key to reaching this population? And what kind of messaging would be most appropriate to dissuade them from vaping?

To really connect with teens about vaping, we need to change our approach. Instead of just focusing on what makes them vulnerable, we should highlight their strengths. Teens have a lot of resilience and social skills, and we can use that in our interventions.

It’s super important that teens feel empowered and respected. When we work with them to identify their values and show how vaping might get in the way of their goals, we’re likely to have a bigger impact. Rather than just telling them what to do or focusing on rules, let’s have conversations that resonate with them and empower them make their own choices.

So, what advice do you give parents on how to talk to their teens about vaping?

Given the rapidly evolving landscape of teen vaping, it’s important for parents stay informed. Engaging with social media platforms that are popular among teens can help them see the types of content they are exposed to.

It’s also really important for parents to understand the risks of vaping so they can have informed conversations. Approaching conversations with teens with an open mind to understand what motivates their teens to use these products without blame or punishment is important. Talking about ways they can achieve those same goals—like reducing stress or fitting in—without turning to vaping can lead to a more productive and supportive conversation.