In Hawaii, vaping is addicting a new generation to nicotine. While often marketed as healthier alternatives to cigarettes, vapes and e-cigarettes are not healthy. They’re considered tobacco products because they contain nicotine. Most youth don’t think regularly using vapes or e-cigarettes is harmful, and many don’t know that they contain nicotine. More than one in four high school students in Hawaii regularly vape, and Neighbor Island rates are higher. Kids who use e-cigarettes are four times more likely to try regular cigarettes, and three times more likely to become cigarette smokers. E-cigarettes and vapes can contain the amount of nicotine in anywhere from 20 to 90 cigarettes.
Nicotine is as addictive as heroin and cocaine. It can harm brain development and may have long-term consequences including reduced impulse control, difficulty with attention and memory, mood disorders, and vulnerability to addictions. The aerosol from e-cigarettes is not water vapor but may also contain ultrafine particles that can lodge in the lungs, including heavy metals and cancer-causing chemicals. Vaping is known to cause seizures and breathing difficulties and evidence is growing about the health risks, especially for children. Larger e-cigarettes including “tanks” and “mods” create larger plumes and rely on higher heat, which increases risks of fires and explosions.
E-cigarettes and vapes come in many shapes and sizes that may be difficult to recognize. Smaller pod-based devices look like USB sticks or hot spots and can be charged using a laptop. These devices are popular with middle and high school students because they’re easy to conceal, feel high-tech, have appealing flavors, and are affordable. Teachers and parents may detect a sweet odor when one is in use.
E-cigarettes and vapes come in candy and fruit flavors that introduce youth to nicotine and keep them returning. Vaping in schools and classrooms is commonplace, even in elementary schools. Companies have aggressively marketed to youth using social media. While the legal minimum age for purchasing tobacco products is 21, some teens are purchasing them online and then reselling them. Sixty percent reported purchasing e-cigarettes from friends.
Need help quitting? The Hawaii Tobacco Quitline has been expanded to include services for quitting vaping and services for youth. Visit www.htql.org or call 1-800-QUIT-NOW.
 Hawai`i Youth Risk Behavior Survey, 2017.
 Kaitlyn M. Berry, MPH1; Jessica L. Fetterman, PhD2; Emelia J. Benjamin, MD, ScM2,3; et al, Association of Electronic Cigarette Use With Subsequent Initiation of Tobacco Cigarettes in US Youths. JAMA Netw Open. 2019;2(2):e187794. doi:10.1001/jamanetworkopen.2018.7794.
 Hawai`i Youth Tobacco Survey, 2017.