Snap, Crackle, and Puff: The E-Cigarette Epidemic

What is an e-cigarette?

E-cigarettes, also known as “vapes” come in a variety of shapes and sizes. They are primarily used by people who are either attempting to quit smoking cigarettes or are looking for other options that don’t smell as bad as a cigarette. These products are being advertised as a “safer” alternative to cigarettes. E-cigarettes are battery-operated and use liquid, which is placed in the device and heated. The heat creates a vapor with nicotine (although nicotine-free options are also available) instead of smoking cigarettes. 

Who is using E-cigarettes?

According to, E-cigarettes are the most popular tobacco products among teens. While teens may be using it for a nicotine fix, they’re also using it to create those large clouds that can often be seen in videos on the internet. A study by Stanford found  Juul, one of the industry’s largest manufacturers of E-cigarettes, targeted teens in their marketing campaigns. Teens attended advertised social events and were given free Juul devices and “pods” which are their refillable cartridges. The cartridges come in numerous flavors, which was also marketed toward teens. Combining ease of access, flavor diversity, social media campaigns, and influencer-type advertising, e-cigarettes have grown to become the most used tobacco product among the teen population in the United States.

What are the health risks associated with E-cigarettes?

Currently, the long-term effects of E-cigarette usage are a little hazy, pun intended. Upon examination of some liquids in various cartridges, large amounts of nickel and chromium were seen. This can lead to toxicity if large enough amounts are able to accumulate. Another notable area of impact may be breathing. As with smoking cigarettes, which has been shown to reduce lung function, using e-cigarettes may also decrease lung function. The component responsible for this may be cadmium, which is also found in cigarette smoke. Speaking specifically about teen health impacts, the concept of addiction comes into play. The teen years are when the brain is still continuing to develop, and nicotine can impair development. The nicotine can wire the brain and lead to the teen craving the release of dopamine, which is the “reward” hormone the brain releases that makes you feel good. By driving the brain to want to experience this reward daily, an addiction to nicotine is formed. In an interview with “CBS This Morning” the CEO of Juul, Kevin Burns, stated teens who are not currently using nicotine-containing products should not use this product by stating “don’t use the product, you’re not our target customer”. Burns went on later to state the long-term effects of vaping are not currently known. 

With the lack of information currently known about the long-term effects of vaping, health risks are still unclear. However, when paired with the teen nicotine epidemic and knowledge of some of the ingredients found in the product and its accessories, it should be said vaping may not be the “safe alternative” to cigarettes it’s being marketed as. If you or someone you know currently smokes or vapes and would like to quit, please reach out to our team of pharmacists to discuss which method is right for you. For more information on what you can do to quit smoking and improve your heart health, click *here*.


Ronald Knighton, PharmD Candidate 2020

For more information

Stanford Study:

Juul CEO Interview:

E-cigarette Information:

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