Key messages:
- Nicotine vaping is prevalent among adolescents.
- Discreet, easily concealed vaping devices, with concentrated nicotine and youth-friendly flavours and features, present new clinical challenges.
- Nicotine vaping is associated with nicotine addiction, adverse effects on mental, lung, and oral health, co-use with cannabis, and increased cigarette smoking uptake.
- Screening for vaping use and providing effective treatments are essential to reduce the harm of vaping among adolescents and young adults.
Introduction
Vaping among adolescents and young adults poses a significant clinical challenge. The average age at which individuals begin vaping nicotine is approximately 14 years. Currently, 10% of secondary school students vape nicotine, which is higher than the combined use of all other tobacco products. Among students who have ever used an e-cigarette, nearly half report being current users, with the majority using flavoured products and 25% using e-cigarettes daily.
Nicotine vaping devices consist of a cartridge or tank that contains a liquid, which is heated by a battery to create an aerosol that can be inhaled. These devices are designed to deliver higher and more addictive doses of nicotine, with fruit, candy, and mint flavours that appeal to youth and lessen the perception of health risks.
Most vape liquids contain 5% nicotine, propylene glycol, glycerin, flavourings, carcinogens, such as aldehydes, heavy metals (e.g., nickel, tin, lead), and other chemicals such as diacetyl, which are linked to serious lung disease. Newer disposable devices with a 10 mL reservoir of 5% nicotine deliver the nicotine equivalent of over ten packs of cigarettes.
Many vaping devices are easily concealed, allowing youth to use them discreetly in classrooms and other settings, allowing more frequent use than tobacco smoking, increasing the risk of nicotine addiction.
This article discusses the following topics:
- Nicotine addiction
- Cognitive and mental health effects
- Pulmonary and other health effects
- Dual nicotine and cannabis vaping
- Current recommendations for screening and treatment
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