©2016 American Heart Association. Text and design by The Education Center, LLC

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Being around cigarette smoke can lead to early death. In fact, about 41,000 people 35 and older died from the effects of secondhand smoke each year from 2005 to 2009.

©2016 American Heart Association. Text and design by The Education Center, LLC

3Direct students to find the total number of people who died during this range of time (205,000). Then have students use the same statistics to determine in what year a half million people will have died from these effects (2017).

For younger students, explain that about 112 people died each day from the effects of secondhand smoke. Guide each child to make or draw a model of the number 112.

E-Cigarettes and Adolescents: What It’s All About

E-cigarettes are electronic devices that are designed to deliver nicotine, flavorings, and other additives. They are the most commonly used tobacco product among US middle and high school students.

How do e-cigarettes work? The user fills an e-cigarette with a liquid, which is heated by the device to produce an aerosol. The user inhales the aerosol into the lungs.

E-cigarettes may not look like cigarettes at all. E-cigarettes come in different shapes and sizes. Some look like regular cigarettes. Others look like USB flash drives, pens, cigars, pipes, and other everyday items.

One brand is a favorite of middle and high school kids. The brand is called JUUL (pronounced like jewel). A JUUL e-cigarette looks like a USB flash drive. All JUUL e-cigarettes deliver a high level of nicotine. JUUL refill pods come in a variety of flavors like mango and mint.

Kids use different names for e-cigarettes. You may hear students use the terms “e-cigs,” “e-hookahs,” “vapes,” “vape pens,” “mods,” “tank systems,” or “JUULs.” Kids may refer to smoking e-cigarettes as “JUULing” or “vaping.”

Kids use e-cigarettes for various reasons. • They believe they aren’t as harmful as other tobacco products. • They have a friend or family member who is a user.• They like the appealing flavors. • E-cigarettes are easy to get and seem cool. • Sometimes e-cigarettes can be used in places where smoking regular

cigarettes isn’t allowed.

Kids see e-cigarette ads. Middle and high school students see e-cigarette ads in retail stores, on television, in movies, on the Internet, and in magazines and newspapers.

american.heart.org/americanheartchallenge©2019 American Heart Association. Text and design by The Education Center

Know the Facts

Kids Think They’re Safe. They’re Not.

E-cigarettes are harmful. They are not nicotine-free. Most e-cigarettes deliver nicotine, a highly addictive drug that can harm brain development. They are not “just water vapor.” The aerosol from e-cigarettes may be harmful to the lungs and the cardiovascular system. They are a dangerous stepping stone. Using them in middle or high school makes a student more likely to smoke other tobacco products.Students think, “I’ll just try one.” Nearly 20% of kids who simply try an e-cigarette go on to become regular users.

E-Cigarette usage among kids is going up—and fast.Research shows a significant increase in e-cigarette use between 2017 and 2018. The numbers are alarming.

78% increase in e-cigarette use among high schoolers

48% increase in e-cigarette use among middle schoolers

1.5 million more students used e-cigarettes in 2018 vs 2017.Over 60% of teenagers believe that using an occasional e-cigarette is relatively safe. (Statistics from the 2018 National Youth Tobacco Survey)

What can you do? Know the facts. Learn about e-cigarettes and their risks to young people.

Pay attention. Students are likely using them at your school in hallways, bathrooms, and even in your classroom.

Develop, implement, and enforce smoke-free school policies. Using any tobacco product—including e-cigarettes—is unsafe. Make sure students know that e-cigarettes are no exception.

american.heart.org/americanheartchallenge©2019 American Heart Association. Text and design by The Education Center

e-Cigarettesthe 101 on

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Vaping is becoming an increasing epidemic among teens. In 2018, e-cigarette use nearly doubled in high school students.

What is an e-cigarette?Electronic cigarettes (e-cigarettes) are battery-powered devices that can deliver nicotine and flavorings to the user in the form of an aerosol. Most have a battery, a heating element, and a place to hold a liquid or nicotine salts. Flavors that make e-cigarettes so appealing can have toxic effects themselves, although they are GRAS (generally regarded as safe) when ingested in food or drinks.

Drip Tip1

Where you place your mouth to breathe in the vapor

Atomizer2

The heating component which results in a vapor

Power Button

The power button attaches to the battery and is used to send power to the Atomizer

Battery

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What is vaping?Vaping is the act of inhaling and exhaling the aerosol, often referred to as vapor, which is produced by an e-cigarette or similar device. The term is used because e-cigarettes do not produce tobacco smoke, but rather an aerosol, often mistaken for water vapor, that actually consists of fine particles. Many of these particles contain varying amounts of toxic chemicals, which have been linked to heart and respiratory diseases and cancer.

Why are e-cigarettes unsafe for kids, teens and young adults? • Nicotine can harm the developing

adolescent brain

• e-cigarettes contain nicotine

• Nicotine addiction that occurs with e-cigarette use may lead to transition to use of combustible tobacco products

• Addiction itself, whether to nicotine or other drugs, can drive undesirable behaviors

What do e-cigarettes look like?E-cigarettes come in a wide variety of shapes and sizes; mini (often called cig-a-like), mid-size, vape pens, vape pod systems like JUUL, e-hookahs, e-cigars, advanced personal vaporizers or mods; even ones shaped to look like pens and usb drives.

What Is JUUL? JUUL is a rapidly growing type of e-cigarette that became available in the US in 2015. It now accounts for about 72 percent of the market share of vaping products in the United States.

• JUUL is particularly appealing to adolescents and young adults because it has a slim design shaped like a USB flash drive (which makes it easier to hide).

• It comes in different colors, and a wide variety of flavors, including many that appeal to kids.

• JUUL does not emit large smoke clouds, making it optimal for discreet use.

• Not only is nicotine high in JUUL pods, it is present in a benzoic acid salt rather than a free base which increases the rate of nicotine delivery and decreases the harsh sensation in the mouth and throat.

What can parents do?• Do not use any tobacco products• Talk with your kids about the dangers of smoking and

the importance of avoiding any tobacco use (conventional cigarettes or e-cigarettes)

• Educate your kids that e-cigarettes contain nicotine, a HIGHLY addictive substance

• Advocate for comprehensive tobacco prevention policies (that include e-cigarettes)

vape pen mid-size mod box “usb” JUUL

The JUUL nicotine refill (“pods”) contain as much nicotine as a pack of 20 regular cigarettes. Average pod length varies but can last up to 200 puffs.

Noting this unprecedented spike in e-cigarette use in

youth, in December 2018, the US Surgeon General issued an advisory for parents, teachers

and health professionals about the negative health

consequences of e-cigarettes in kids.

e-cig device