From the Guidelines
Vaping nicotine is extremely harmful for children and should be strictly avoided due to its detrimental effects on brain development, cardiovascular health, and overall well-being. Children and adolescents should not use any nicotine products, including e-cigarettes or vaping devices, as their developing brains are particularly vulnerable to nicotine's effects 1. Nicotine exposure during adolescence can harm brain development, which continues until about age 25, affecting attention, learning, mood, and impulse control. Vaping products often contain high concentrations of nicotine; for example, one JUUL pod can contain as much nicotine as 20 regular cigarettes. Beyond nicotine, vaping aerosols contain harmful chemicals including volatile organic compounds, ultrafine particles, and heavy metals like nickel, tin, and lead.
Some key points to consider:
- Nicotine poses risks to the cardiovascular system, including causing an increase in blood pressure, heart rate, flow of blood to the heart, and a narrowing of the arteries 1.
- Adolescent care providers are uniquely well positioned to assist in detecting ECPO use: open communication with adolescents and consistent, routine screening with validated tools could help identify use of these evasive substances in adolescents 1.
- Brief prevention and intervention efforts, including addressing the nature and risk related to ECPOs, along with use of motivational interviewing, are non-resource-intensive prevention and intervention approaches available to providers 1.
For parents concerned about their child's nicotine use, speaking with their pediatrician about cessation strategies appropriate for young people is crucial. Prevention is also key through open communication about the dangers of vaping, setting clear expectations against tobacco use, and modeling tobacco-free behavior. If a child is already vaping, professional help may be needed, as nicotine is highly addictive and withdrawal symptoms can include irritability, difficulty concentrating, and increased appetite. According to the most recent study, pediatricians should provide brief counseling to all children to prevent tobacco use initiation and screen all teenagers for tobacco and nicotine use 1.
From the FDA Drug Label
Doses of nicotine that are tolerated by adult smokers during treatment may produce severe signs and symptoms of poisoning in children and may prove fatal Suspected nicotine poisoning in a child should be considered a medical emergency and treated immediately Safety and effectiveness in pediatric and adolescent patients below the age of 18 years have not been established for any nicotine replacement product.
Vaping nicotine in children is potentially fatal. The effects of nicotine in children can be severe and may prove fatal. Nicotine poisoning in children should be treated as a medical emergency. Additionally, the safety and effectiveness of nicotine replacement products, including vaping, have not been established in pediatric and adolescent patients below the age of 18 years 2 2.
From the Research
Vaping Nicotine in Children: Health Risks and Concerns
- The use of e-cigarettes, or "vaping," is increasingly popular among adolescents and young adults, with over 40% of high school seniors reporting use within the past year 3.
- Vaping has been shown to reverse a decades-long trend of declining nicotine use among youth, with 27% of high school students having used a tobacco product within the last month, the majority being e-cigarettes 4.
- The health implications of vaping include short-term consequences such as seizures, acute nicotine toxicity, burns, and lung injury, as well as long-term concerns like addiction and social maladjustment 4, 5.
Mechanisms of Harm
- E-cigarettes induce oxidative stress, a critical underlying molecular factor that drives the harmful effects of traditional cigarettes, and the developing brain is particularly vulnerable to these effects 5.
- Many e-cigarette components, including flavoring, vapor, e-liquids, and metallic coil, trigger oxidative stress, indicating that both nicotine and non-nicotine e-cigarette use may be harmful 5.
- Vaping has been linked to extrapulmonary effects, including cardiovascular, immunologic, and neuro-developmental effects, many of which are likely dose-dependent 3.
Public Health Response
- Public health efforts are urgently needed to decrease or eliminate new e-cigarette initiation, and support should be established to assist current e-cigarette users with cessation 3.
- Legislation must include regulations that strictly avoid marketing and sales to youth, as well as reducing access to these products 4.
- Clinicians should be aware of the potentially harmful effects of vaping and advise patients, parents, and school authorities accordingly 5, 6.