What is an e-cigarette?
E-cigarettes are battery-powered noncombustible (not flammable) tobacco products that simulate the action and sensation of smoking. People use e-cigarettes to vape.
What is vaping?
Vaping is the act of inhaling and exhaling the aerosol (often called vapor) produced by an e-cigarette or similar battery-powered device.
They are also known as e-cigs, vape pens, e-hookahs, e-pipes, tanks, mods, vapes, electronic nicotine delivery systems, or ENDS, and more.
Some people refer to vaping devices by their brand name such as Puff Bar, fruyt STIK, JUUL, BO, myblu, Smok, and Suorin.
What are the different types of e-cigarettes?
E-cigarettes come in many different sizes, types and colors.
Some e-cigarettes are made to look like regular cigarettes, cigars, or pipes. Some resemble pens, small electronic devices such as USB sticks, and other everyday items. The products that are designed to resemble small electronic devices are often compact and allow for discreet carrying and use – at home, in school hallways and bathrooms, and even in classrooms.
What is in e-cigarettes?
E-cigarettes contain pre-filled pods or e-liquids/e-juices the user adds to the device. E-liquids generally consist of nicotine, propylene glycol, glycerin, flavorings, and other chemicals. Many of these pods and e-liquids come in fruit and candy flavors that appeal to youth.
E-cigarettes produce an aerosol, which users inhale from the device and exhale. The aerosol can contain harmful and potentially harmful substances, including:
- Ultrafine particles that can be inhaled deep into the lungs
- Flavoring such as diacetyl, a chemical linked to a serious lung disease
- Volatile organic compounds
- Cancer-causing chemicals
- Heavy metals such as nickel, tin, and lead
Are e-cigarettes safe?
According to the Centers for Disease Control and Prevention, e-cigarettes are not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products. E-cigarettes have not been approved by the FDA as a smoking cessation device and additional research is needed to help understand long-term health effects of e-cigarette use.
In the Fall of 2019, vaping was associated with e-cigarette or vaping product use associated lung injury (EVALI). For updated information on the lung injury associated with vaping, visit the CDC’s website on the topic. There can be serious lung issues due to e-cigarette use that are not officially diagnosed as EVALI.
What are the risks of COVID if I vape?
According to the Centers for Disease Control and Prevention, being a current or former cigarette smoker increases your risk of severe illness from COVID-19. Smoking can weaken the immune system, making it harder to fight infections such as COVID. For up-to-date information about COVID-19 and tobacco use, visit the CDC’s website.
We are still learning about the link between e-cigarette use and more severe risk due to COVID-19, but other harms remain.
- Most e-cigarettes contain nicotine, which has several known health effects, including causing inflammation in lung tissue.
- E-cigarettes contain acrolein, a pesticide. Acrolein can cause acute lung injury and Chronic Obstructive Pulmonary Disease (COPD) and may cause asthma and lung cancer – all four health issues are potential risk factors for developing more severe COVID-19 symptoms.
For other known dangers associate with e-cigarette use, see the other sections in FAQ.
Is nicotine addictive?
E-cigarettes contain nicotine. Nicotine is a highly addictive substance.
According to the Surgeon General, because the brain isn’t fully developed until the mid-20s, youth and young adults are uniquely at risk for long-term, long-lasting effects of exposing their developing brains to nicotine.
These risks include nicotine addiction, mood disorders, and permanent lowering of impulse control. Nicotine also changes the way synapses are formed, which can harm the parts of the brain that control attention and learning.
Teens can get addicted more easily than adults. The nicotine in e-cigarettes and other tobacco products can also prime the adolescent brain for addiction to other drugs such as cocaine.
E-cigarette use among youth and young adults is strongly linked to the use of other tobacco products, such as regular cigarettes, cigars, hookah, and smokeless tobacco.
What are the other dangers of vaping?
In addition to nicotine, e-cigarettes contain harmful and potentially harmful chemicals such as ultrafine particles that can be inhaled deep into the lungs; flavoring such as diacetyl, a chemical linked to a serious lung disease; volatile organic compounds such as benzene, which is found in car exhaust; and heavy metals, such as nickel, tin, and lead.
Due to nicotine content, e-liquids are dangerous to small children and pets. The Massachusetts Attorney General requires that nicotine liquid and gel be sold in appropriate child-resistant packaging.
In addition to chemical contents, defective e-cigarette batteries have caused fires and explosions, some of which have resulted in serious injuries.
Is being around secondhand vape safe?
No. According to the Surgeon General, the aerosol from e-cigarettes is not harmless. It can contain harmful and potentially harmful chemicals, including nicotine; ultrafine particles that can be inhaled deep into the lungs; flavoring such as diacetyl, a chemical linked to a serious lung disease; volatile organic compounds such as benzene, which is found in car exhaust; and heavy metals, such as nickel, tin, and lead.
Scientists are still working to more fully understand the health effects and harmful doses of e-cigarette contents when they are heated and turned into an aerosol, both for users who inhale from a device and for those who are exposed to the aerosol secondhand.
Can e-cigarettes be used to vape other substances?
Yes. E-cigarettes and other vaping devices can be used to vape other substances, such as marijuana. Open systems require the user to add the e-juice, which can be a substance other than nicotine. Closed systems are generally not refillable because they use pre-filled pods. However, they can also be altered to vape substances other than nicotine.
Where are e-cigarettes sold and how are youth getting them?
Until recently, e-cigarettes of all flavors and nicotine content levels could be sold in many places including convenience stores, corner stores, gas stations, vape shops, and online. As of November 27, 2019, Massachusetts implemented a law that restricts where flavored tobacco products, including e-cigarettes can be sold. The sale of all flavored tobacco products, including e-cigarettes, in Massachusetts is restricted to adult-only (age 21+) smoking bars. This also includes menthol. The sale of unflavored e-cigarettes with a nicotine content over 35 mg/mL is restricted to adult-only tobacco retail stores or smoking bars. Only unflavored e-cigarettes with a nicotine content of 35 mg/mL or less can still be sold in convenience stores, gas stations, liquor stores and other similar businesses, as well as online.
Just like other tobacco and nicotine products, youth may get e-cigarettes from friends who vape or from local or online stores that do not abide by Massachusetts’ restrictions on sales. If you wish to report one of these sales violations, call 1-800-992-1895 or contact your local Board of Health.
How old do you have to be to purchase e-cigarettes?
The legal age to buy e-cigarettes and other tobacco products in Massachusetts is 21.
Where can you use e-cigarettes?
As of December 31, 2018, the use of e-cigarettes is prohibited throughout the state in places where smoking is prohibited by the Smoke Free Workplace Law.
According to the Federal Aviation Administration (FAA), e-cigarettes may not be used or charged on airplanes. In addition, the FAA prohibits the devices in checked bags. E-cigarettes and similar battery powered devices may only be carried in the aircraft cabin (in carry-on baggage or on your person).
How many people use e-cigarettes in Massachusetts?
In 2019, 32% of Massachusetts high school students reported vaping in the past 30 days compared to 5.6% of adults (2018).
51.2% of Massachusetts high school students have tried vaping. The reported use of e-cigarettes among high school students was higher than for all other tobacco products combined.
What can I do to prevent my child from vaping?
Simply talking with your child about these products can help protect them. Let them know that you care about them and that vaping is not safe.
Youth of parents who talk to their kids about the dangers of substances early and often are 50 percent less likely to use drugs than those who do not receive these critical messages at home (NCADD, 2015).
How can I tell if my child is vaping?
Many types of e-cigarettes are manufactured to resemble everyday items that can easily fit in a pocket or the palm of a hand. In addition, they come in fruit and candy flavors (although these flavors are now restricted in MA). For these reasons, it may be hard to tell if your child is vaping—you may not recognize a vaping device or an e-liquid scent.
Here are subtle signs your child might be vaping:
Unexplained sweet scent—If you notice a sweet scent that is unexplainable, it might be a flavored e-juice for a vaping device.
Unfamiliar products—If you come across unusual looking items such as unusual pens or USB drives or an unfamiliar battery or battery charging device, they could be associated with vaping.
Nicotine is an addictive substance that impacts the brain and body. Some young people may not realize they are addicted to nicotine. If they experience one or more of the following, they likely are hooked:
- Having strong cravings to vape or use tobacco
- Feeling nervous or anxious when they can’t vape or use tobacco
- Vaping in places they aren’t supposed to (going out of their way to vape or use tobacco)
- Having trouble concentrating
- Feeling like they need to vape or use tobacco to feel better
- Feeling angry, irritable or restless when they haven’t vaped or used tobacco in a while.
What if my child is vaping? How can I help them quit?
Quitting vapes or other tobacco products can be hard. Here are some ways to help young people get the support they need:
- My Life, My Quit TM has youth coach specialists trained to help young people by phone or text. Call 855-891-9989 or text Start My Quit to 36072 for free and confidential help. For more information or to sign up online, visit mylifemyquit.com.
- This is Quitting powered by truth® is a free and confidential texting program for young people who vape. Young people can text VapeFreeMass to 88709 to get started.
- Smokefree Teen (teen.smokefree.gov) is part of the National Cancer Institute’s (NCI) Smokefree.gov Initiative. Services offered include text messaging and a quitSTART app that provides strategies for tackling cravings, bad moods, and other situations.
- Young people can ask for help from their school nurse or counselor, athletic coach, doctor, parent, or other trusted adult.
- For more information, young people can visit mass.gov/vaping.
What if I use tobacco or have in the past?
Be honest and talk with your child about your choices and how hard it is/was to quit.
If you need help quitting tobacco, it is never too late to take the first step.
Call 1-800-QUIT-NOW or visit mass.gov/quitting for information and support.
Information is taken from E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General, 2016, and the Centers for Disease Control and Prevention (website on Electronic Cigarettes Accessed 5/22/18)
Other sources include:
McRobbie, Hayden; Bullen, Chris; Hartmann-Boyce, Jamie; Hajek, Peter (2014). “Electronic cigarettes for smoking cessation and reduction”. The Cochrane Library. 12: CD010216. doi:10.1002/14651858.CD010216.pub2. PMID 25515689.