Muir Wood therapist, David Laing

The Vaping Epidemic Among America’s Teens

The use of e-cigarettes, or vapes, among teens has become so widespread and so troubling that the Food and Drug Administration has started to take drastic action to counter the trend. Last September, the FDA ordered five brands—Juul, Vuse, MarkTen, blu e-cigs, and Logic—to submit plans to address teen use of their products within 60 days or they may be pulled from the market. In a statement, FDA Commissioner Scott Gottlieb warned that vaping among teens has reached “nothing short of an epidemic proportion of growth.”

“I use the word epidemic with great care. E-cigs have become an almost ubiquitous—and dangerous—trend among teens,” Gottlieb said in the statement. “The disturbing and accelerating trajectory of use we’re seeing in youth, and the resulting path to addiction, must end. It’s simply not tolerable. I’ll be clear. The FDA won’t tolerate a whole generation of young people becoming addicted to nicotine as a tradeoff for enabling adults to have unfettered access to these same products.”

A 2016 report from the US Surgeon General cited a 900 percent increase in e-cigarette use by high school students from 2011 to 2015, and the 2016 National Youth Tobacco Survey noted that 1.7 million high school students said they had used e-cigarettes in the previous 30 days.

“Despite opposition from researchers and other critics, the vaping industry is now worth billions of dollars,” reported public radio station WBUR in May. Stanton Glantz, director of the Center for Tobacco Control Research and Education at the University of California San Francisco, told Here & Now‘s Jeremy Hobson:

“JUUL is wildly popular with kids, and unlike conventional cigarettes where youth use them as a way to emulate adults, the e-cigarette epidemic has really grown from the young kids up into the adults. So e-cigarette market penetration in the youth market is way higher, and the JUUL, it’s cool. It looks like a flash drive; it’s very high-tech. You get a huge nicotine hit from it, and it comes in fun flavors.”

And nicotine is addictive and toxic. “One of the incorrect things that a lot of people think about e-cigarettes is they’re just harmless water vapor,” says Professor Glantz. “Water vapor is clear, and you’re breathing out a huge plume of propylene glycol.” The inhaled nicotine is dangerous and so are “the coils in the cigarettes, the fact that they’re soldered, people get a lot of lead, cadmium and other heavy metals,” says Glantz.

Vaping also prepares the ground for more traditional tobacco products. There is evidence that teens who try-e-cigarettes are far more likely to then go on to smoking old-fashioned combustible cigarettes.

Additionally, there is a much higher risk that they move on to marijuana products. Teens who use e-cigarettes may be twice as likely to smoke cannabis as their peers who never try vaping, a study suggests.

The results, from surveys of more than 10,000 youth ages 12 to 17, add to earlier evidence suggesting that e-cigarettes may be a gateway to smoking tobacco and experimenting with drugs. In the current study, younger teens aged 12 to 14 were 2.7 times more likely to smoke pot once they tried vaping, while the odds of marijuana use were 1.6 times higher for older adolescents who used e-cigarettes.

“Experimenting with e-cigarettes might also increase youth’s curiosity about marijuana, reduce perceived harm of marijuana use, and increase the social access to marijuana from peers and friends,” lead study author Hongying Dai told Reuters.

Indeed, that seems to be the case. More than two million US middle and high school students—nearly 1 in 11—have vaped marijuana, another new study suggests. Teen marijuana users like vaping because it easily hides what they are doing from parents and teachers.

And vape pens can be loaded with marijuana concentrates, or “hash oil”—a yellow resin chemically extracted from the plant. These concentrates can be really strong. Marijuana flowers may contain up to about 20 percent THC, the psychoactive chemical that gives users the high. 50 years ago, the THC levels of a joint were around 1 percent, but concentrates can now contain up to 90 percent THC.

Adolescents are uniquely susceptible to lasting damage from marijuana use. The teenage brain is still under construction and particularly sensitive to damage from drug exposure. “Reward-sensitive areas are heavily active, even overactive in the teen years, while the prefrontal cortex that controls reason and judgment, the area that puts the brakes on is slower to develop,” according to neuroscientist Daphna Shohamy of Columbia University’s Zuckerman Institute. And the higher the THC concentration, the higher the risk.   

Although marijuana products can be extremely potent today, legalization in California and other states has been driven by a low-risk perception for cannabis use which has not gone unnoticed by teenagers. The adolescent substance misuse treatment specialists at Muir Wood frequently encounter young Americans who developed problems believing cannabis was neither harmful nor addictive. Many of the teens treated for substance misuse and co-occurring mental health conditions at Muir Wood developed a marijuana use disorder and many of them were vaping marijuana at school.