Doctors’ Notes



We receive many questions from parents, ranging from what is vaping to how to talk to teens about it to how to get help for the addiction to nicotine. We hope this Note can address these concerns and provide some helpful answers.

What is Vaping?

Vaping involves the use an electronic cigarette (e-cigarette, or Vape) to inhale vapor infused with flavor, nicotine, both, or neither. Some vapes include THC, the active ingredient in marijuana. Ingredients in the vapes are not regulated by the FDA, and companies are not required to verify their listed ingredients.

Why Has Vaping Become So Popular Among Teens?

E-cigarettes come in sleek packaging that appeals to the tech-savy side of teens. Popular flavors such as mint, mango, and crème brulee make them attractive as well. Commercials are flashy. Many vape companies have denied this, but it’s clear that some of the marketing directly targets teens and young adults.

Vape sales can legally be sold to minors in Pennsylvania. They’re illegal on the federal level, but this has been difficult to enforce locally, and even more so on the internet, where they’re readily available.

Vapes are small, compact, and easy to hide. Vapes are so discrete, in fact, that many teens are able to vape at school or even in class. Teens like the social aspect of vaping as well.

What are the Dangers and Risks?

A common misconception about vapes is that they’re safer than cigarettes. But there are no regulations on the substances that compose the vapor, and many devices dispense high levels of nicotine within the vapor. Marijuana and other drugs can be formulated for use in an e-cigarette, so some teens may not even know this is in their vape if they don’t ask.

Studies show that minors wheo begin vaping are more likely to eventually begin smoking cigarettes. There have also been reported cases of significant malfunctions with vapes, including the product exploding. Dental injuries, burns, and lacerations are just some of the injuries that may result from this type of accident.

Due to high levels of nicotine, some teens are becoming addicted and have withdrawal symptoms if they stop vaping. (See more below on symptoms and when to call the doctor.) High levels of nicotine can also affect teen brains and their ability to make good decisions.

There have even been serious illnesses from Vaping, called E-cigarette or Vaping Product-Use Associated Lung Injury (EVALI). Over 2,000 patients have been hospitalized with severe lung illness, with some needing to be admitted to an intensive care unit. So far, the CDC has found that most patients used vapes containing THC and Vitamin E suspension, but studies are still ongoing, and there may be more ingredients that will later be identified as harmful.

Bottom line: if you’re inhaling anything other than air into your lungs, it can be damaging. We won’t know the full harmful effects of these devices until they’ve been more thoroughly studied.

How Do I Know if My Child is Vaping?

One of the most attractive things about vaping for teens is the easy ability to hide them.Here are some things to look for that may indicate your child is vaping:

Unfamiliar Objects
E-cigarettes vary in appearance. Some appear thin and pen like, while others may be square, or even similar in appearance to a USB drive.

Discarded Atomizers
The atomizer is an important part of any e-cigarette; it’s the component that turns the liquid into vapor. The atomizers don’t last forever and eventually need to be discarded. If you happen to come across a discarded atomizer in your child’s room or garbage can, it can be a sign that your child has been vaping. Atomizers typically look like a small piece of metal with an area on the end that looks like a screw.

Unfamiliar Batteries and Chargers
Some vape pens can be charged with a USB cable, but most require batteries or specific chargers designed for the device. If you find an unfamiliar battery or battery charging device, this could be a sign that your child may be vaping.

What are JUULs?

JUUL is one of the most popular brands of vapes. It’s a compact vaporizer that resembles a flash drive and allows teenagers to easily conceal their e-cigarettes and take quick, discreet hits at home, school, or even in class. The device is small enough to fit in a closed fist.

They’re also very potent sources of nicotine. The company reports that a single JUUL cartridge is roughly equal to an entire pack of cigarettes.

My Teen is Vaping. What Do I Do?

It’s important to talk to your teens and pre-teens about tobacco, alcohol, and substance use, and vaping should be part of that discussion. Start by finding out what your child already knows and thinks about vaping. By asking this question, it can help shape your conversation and lead to a better approach. It’s always important to remember to listen to the perspective of your child, as well, and to have a conversation instead of a lecture.

There are many resources from trusted organizations including the CDC, Tobacco Free Allegheny, and Teen Smoke Free to name a few. See below for more, including some text-based quit programs that appeal to teens.

If your teen vapes and you notice he/she is having increased heart rate, anxiety, irritability, trouble sleeping, cravings, trouble concentrating, or change in appetite, they may be having nicotine withdrawal. We should see them in the office to discuss treatment, including nicotine replacement therapy.

Vaping Quit Programs & Tips

My Life My Quit
Teen-based texting program through the National Jewish Health Foundation. Text “Start My Quit” to 855-891-9989

Teen Smoke Free
US Department of Health program. Text QUIT to 47848

Central Quit Hotline – 1-800-QUIT-NOW

Tobacco Free Allegheny  Tips to Talk to Teens

• Discuss tobacco use in a way that doesn’t make kids fear punishment or judgment

• Make tobacco use an ongoing conversation; talk and listen patiently

• Encourage teens to get involved in activities that prohibit smoking, such as sports

• Discuss ways to respond to peer pressure (hint: self-confidence is a child’s best protection!)

• Establish firm rules for your household that exclude tobacco use

• Explain to your child the consequences of your smoking.

• If you smoke, quit. Talk to your kids about how difficult it is to quit smoking and how much easier it would have been if you’d never started smoking in the first place.

Dr. Lisa Stefano became a Kids Plus Provider in 2019.