Vapor products produce aerosol by heating a liquid solution, which is inhaled as an aerosol. The process is referred to as “vaping.” Vapor products often contain nicotine. They also may include flavors or other substances. Vapor products have many names, including electronic nicotine delivery systems (ENDS), electronic cigarettes (e-cigarettes), JUULs or vape pens.
There are health and safety concerns related to the use of vapor products. Nicotine used in vapor products is highly addictive. It can damage your heart, arteries, and lungs, increasing the risk for heart attack, stroke, and chronic lung disease. Learn more about vapor product health and safety concerns.
A September 2019 Health Impact Review by the Washington State Board of Health points to recent scientific research finding that solvents and flavor chemicals used in vapor products are hazardous to human health. While other substances used in these products may also be determined unsafe in the future, we currently know:
Propylene glycol and glycerin are the most common solvents used in vapor products. While generally recognized as safe for ingestion by the FDA, research has found both substances to be toxic when aerosolized through the vaping process.
Research has also shown flavor chemicals to be toxic in both e-liquid and aerosol form. While many flavor chemicals used in vaping products have been approved for ingestion, they have not yet been tested for safety when aerosolized. Flavor chemicals are typically not listed on e-cigarette packaging, and most e-liquids contain more than one flavor chemical. Benzaldehyde (used in cherry-flavored products) and 2, 5-dimethyprazine (used in chocolate-flavored products), specifically, may harm human health. Though not all flavors have yet been scientifically studied, there is a strong chance others may also be harmful.
DOH urges all people to be very careful when it comes to your health. Even if a substance has not yet been proven to be dangerous, there is no guarantee it is safe. Consider the risk. It may not be worth it.
What is a JUUL?
JUUL is a type of e-cigarette/vapor product that has become increasingly popular, especially among youth. JUULs very closely resemble a USB drive, can be charged in a USB port, and emit little to no detectable vapor or odor. Due to their easily concealable design, they are of particular concern with regard to youth use.
As of 2019, JUUL holds more than 75 percent of the e-cigarette/vapor product market share. The e-liquid contains .7 ml nicotine by volume, and 5 percent nicotine by weight. This is roughly equivalent to the amount of nicotine in a pack of cigarettes. Every flavored JUUL pod contains nicotine. They come in flavors that appeal to youth. The U.S. Surgeon General has determined that vapor products are still the most common tobacco product among youth, and e-cigarette/vapor product use is strongly associated with the use of other tobacco products among youth and young adults, particularly the use of combustible tobacco products. The National Youth Tobacco Survey showed that e-cigarette use increased 78 percent among high school youth and 48 percent among middle school youth from 2017 to 2018. In Washington, we saw similar increases. For example, eighth-grade use of vapor products increased from 6 percent in 2016 to 10 percent in 2018, 10th-grade use of vapor products increased from 13 percent in 2016 to 21 percent in 2018, and 12th-grade use of vapor products increased from 20 percent in 2016 to nearly 30 percent in 2018.
Vapor Product Laws
In 2016, the Washington State Legislature passed a law (RCW 70.345) to regulate vapor products. Among other things, the law prohibits the sale of vapor products to people under 18 years of age, requires sellers to obtain a license, and requires that vapor products in stores are inaccessible to minors. Effective January 1, 2020, the legal sales age of tobacco and vapor products will change to 21. Learn more about the vapor product regulations at the Washington State Liquor and Cannabis Board.
E-cigarette/vapor product use is now considered an epidemic by the U.S. Surgeon General and the U.S. Food and Drug Administration (FDA). As cigarette use declines, new tobacco products, and electronic cigarette/vapor products, are being introduced and marketed, and thus contributing to the overall youth nicotine use rate. More than four times as many youth (10th-graders) report using vapor products than cigarettes. The Surgeon General states that e-cigarette use is strongly associated with the use of other tobacco products among youth and young adults, particularly the use of combustible tobacco products. Among youth who vape, 16 percent also report smoking cigarettes. Learn more about e-cigarette and vapor product use rates in Washington State.
Visit our tobacco cessation page for information and resources on how to quit tobacco, including the Washington State Tobacco Quitline (1-800-QUIT-NOW) and the 2MorrowHealthTM app.
For young people trying to quit vaping, try This is Quitting, a new text-to-quit vaping program for people ages 13-24. Text VAPEFREEWA to 88709 to sign up.
For adults looking to talk to teens about vaping, Live Vape Free is an online program that provides tips, tools, and one-on-one support.
Below are some helpful resources for more information about vapor products and JUUL:
- Evidence on the Health Impacts of E-Cigarettes and Vaping (PDF) | Español (PDF)
- Know the Risks: E-Cigarettes and Young People, based on the United States 2016 Surgeon General's report on E-cigarettes and Young People. This site has resources, including a Parent Tip Sheet, Health Care Provider Conversation Card, Videos, and Fact Sheets.
- Learn about e-cigarettes shaped like USB flash drives, including JUUL, and actions that parents, educators, and health care providers can take to protect kids.
- Find information for teens who use tobacco products, including quit tips.
- Basic information about e-cigarettes (CDC).
- Campaign for Tobacco-Free Kids, “JUUL E-Cigarettes: A New Threat to Kids”, 2018.
- Recently developed prevention module on JUULs from Stanford University
- 2018 National Youth Tobacco Survey, data showing a dramatic increase in e-cigarette use among youth over the past year.
- Morbidity and Mortality Weekly Report (MMWR): Use of Electronic Cigarettes and Any Tobacco Product among Middle and High School Students-United States, 2011-2018.
- FDA's Comprehensive Plan for Tobacco and Nicotine Regulation
- To make sure educators have the tools and information they need to combat the youth e-cigarette epidemic, FDA partnered with Scholastic to deliver educational vapor product prevention resources.
- Infographic from the Office of the Superintendent of Public Instruction (OSPI), “Red Flag for Supports: Students Who Smoke or Vape”
- Youth Now, Resources to help school administrators, counselors, educators, and parents connect with youth and teens about vaping.
- The 101 on E-cigarettes Infographic (American Heart Association)
- Vapor Products on Campus: Seeing through the Smoke, infographic on nicotine, vapor products, and JUUL in schools (PDF)