Over the past several years, the landscape of electronic cigarette use has continued to evolve. E-cigarettes — battery-powered devices that heat liquid into an inhalable aerosol — come in many forms, including vape pens, mods and devices that resemble USB drives. Some contain nicotine, while others are used to aerosolize tetrahydrocannabinol (THC), the psychoactive component of cannabis. Despite their modern appearance, these products pose real health risks.
Health effects of vaping
E-cigarette aerosol commonly contains nicotine, flavorings and other chemicals that may affect both users and bystanders. Nicotine is highly addictive and can interfere with brain development in adolescents and young adults. Research continues to link vaping with airway irritation, inflammation and respiratory symptoms. Although many people view vaping as less dangerous than smoking, it is not harmless, and serious lung injury has been associated with vaping products, especially those containing THC from informal or illicit sources. In the 2019-2020 EVALI outbreak, 82% of hospitalized patients reported using THC-containing vaping products.
Youth vaping trends
Among U.S. adults, e-cigarette use rose to 6.5% in 2023, with the highest prevalence among adults ages 21 to 24. Among youth, current e-cigarette use declined in 2024, but more than 1.6 million middle and high school students still reported vaping, and flavored products remained dominant. Of current youth e-cigarette users, 26.3% reported daily use, underscoring the growing concern about dependence among those who continue to vape.
Cancer‑related concerns
Exposure to chemicals found in e-cigarette aerosol may damage cells in the throat and alter gene expression — changes associated with cancer development. While more research is needed to determine the full extent of the connection, early findings indicate that vaping is not a risk-free alternative to smoking.
Quitting vaping
Health experts strongly recommend quitting e-cigarettes. Although some people turn to vaping to reduce cigarette use, more effective cessation methods exist, including nicotine replacement therapy, counseling and behavioral support programs. These structured approaches help users quit without introducing the additional risks associated with vaping.
Why returning to cigarettes is not the answer
Switching back to traditional cigarettes is not a safe alternative. Both vaping and smoking carry significant health risks. For those who struggle to quit, health care providers can help create individualized cessation plans. Many people require multiple attempts before successfully stopping nicotine use, and professional guidance can improve long-term outcomes.
Protecting youth from nicotine addiction
Youth vaping continues to be a top public health priority. In 2024, 87.6% of teen e-cigarette users chose flavored varieties, which remain especially appealing to young people. Schools, families and community organizations play critical roles in prevention, especially as vaping devices become easier to hide and are heavily marketed to younger audiences.
THC in vape pens
Another emerging concern is the increasing use of THC in vape pens. National data suggest adolescent THC vaping rose from 5.5% in 2021 to 7.4% in 2023, peaking at 8.4% in 2022, with an estimated 2.55 million U.S. adolescents reporting current THC vaping in 2023. Among adults, cannabis vaping also reached record levels in 2024. This trend is especially concerning because THC vape products can be highly concentrated, are sometimes obtained from informal sources and have been strongly linked to prior outbreaks of vaping-related lung injury.
Understanding these evolving trends helps parents, educators and policymakers make informed decisions about prevention and support. As research advances, one message remains clear: While e-cigarettes differ from traditional tobacco products, they are far from harmless — and quitting remains the safest choice.
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References:
- Centers for Disease Control and Prevention. Electronic Cigarette Use Among Adults in the United States, 2019-2023. National Center for Health Statistics Data Brief No. 524, January 2025.
- Food and Drug Administration and Centers for Disease Control and Prevention. National Youth Tobacco Survey, 2024.
- U.S. Department of Health and Human Services. Sound the Alarm: Youth Vaping Can Harm. September 2025.
- Chung J, Lim CCW, Stjepanović D, Hall W, Connor JP, Chan GCK. Adolescent Cannabis Vaping Trends (2021-2023): Delta-9-Tetrahydrocannabinol, Cannabidiol, and Synthetic Cannabinoids. Am J Prev Med. 2025 Dec;69(6):107655. doi: 10.1016/j.amepre.2025.107655. Epub 2025 Jul 1. PMID: 40590811.
