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How an E-cigarette Works

E-cigarettes create an aerosol by using a battery to heat up liquid that usually contains nicotine, flavorings, and other additives. Users inhale this aerosol into their lungs. E-cigarettes can also be used to deliver cannabinoids such as marijuana, and other drugs.

Black and white illustration of the different parts of an e-cigarette sketch of an ecigarette Battery
Powers the device.
Mouthpiece
Allows user to inhale the aerosol.
Atomizer
Heats the e-liquid into an aerosol.
Cartridge
Stores the e-liquid.
Black and white illustration of different types of e-cigarettes E-cigarettes come in a variety of shapes and sizes
 
2011
1% symbol for female Girls 2% symbol for male Boys
2018
19% symbol for female Girls 23% symbol for male Boys
Source: MMWR, Vital Signs: Tobacco Product Use Among Middle and High School Students, United States, 2011-2018.
More High School Students Are Current E-cigarette Users

Did You Know?

Since e-cigarettes arrived on the market, there's been a lot of buzz about them. In the past several years, many myths, safety concerns, and questions have come up. Let's review some key facts.

Business Trends

E-cigarettes are a 2.5 billion dollar business in the United States. As of 2014, the e-cigarette industry spent $125 million a year to advertise their products and used many of the techniques that made traditional cigarettes such a popular consumer product.

Marketing and advertising of conventional tobacco products like cigarettes are proven to cause youth to use tobacco products. Scientists are also finding that youth who are exposed to e-cigarette advertisements are more likely to use the product than youth who are not exposed.

Usage Trends

Between 2011 and 2018, past-30-day e-cigarette use grew dramatically among middle school (grades 6-8) and high school (grades 9-12) students. E-cigarettes have been the most commonly used tobacco product by youth in the United States since 2014. Dual use, or use of e-cigarettes and conventional cigarettes by the same person, is common among youth and young adults (ages 18-24).

  • Among middle and high school students, Non-Hispanic White, Hispanic, and older students are more likely to use e-cigarettes than Non-Hispanic Black and younger students.

Appeal to Young People

Youth and young adults cite a variety of reasons for using e-cigarettes. These include:

  • Use by a friend or family member
  • Taste, including the flavors available in e-cigarettes
  • The belief that e-cigarettes are less harmful than other tobacco products
  • Curiosity

Flavored e-cigarettes are very popular among youth and young adults. In 2014, more than 9 of 10 young adult e-cigarette users said they use e-cigarettes flavored to taste like menthol, alcohol, candy, fruit, chocolate, or other sweets. In 2018, more than 6 of 10 high school students who use e-cigarettes said they use flavored e-cigarettes.

Source: MMWR, Reasons for Electronic Cigarette Use Among Middle and High School Students

Source: MMWR, Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students – United States, 2011-2018.

Marketing to Youth and Young Adults

E-cigarette marketing, including product design and packaging, appeals to a young audience. For example, many e-cigarettes feature bright colors and fruit, candy, alcohol or other flavors that youth find attractive and interesting.

Many themes in e-cigarette marketing, including sexual content and customer satisfaction, are parallel to themes and techniques that the tobacco industry aimed at youth and young adults in their advertising and promotion of conventional cigarettes.

In 2018, more than 5 in 10 middle school and high school students – more than 14 million youth – said they had seen e-cigarette advertising. Retail stores were the most frequent source of this advertising, followed by the internet, TV and movies, and magazines and newspapers.

Teen Beliefs

Youth tobacco use in any form, including e-cigarettes, is unsafe. A recent national survey showed that about 10% of U.S. youth believe e-cigarettes cause no harm, 62% believe they cause little or some harm, and 28% believe they cause a lot of harm when they are used some days but not every day. In 2014, nearly 20% of young adults believe e-cigarettes cause no harm, more than half believe that they are moderately harmful, and 26.8% believe they are very harmful.

Young people who believe e-cigarettes cause no harm are more likely to use e-cigarettes than those who believe e-cigarettes cause a lot of harm.

Source: Adolescent health brief - Harm Perceptions of Intermittent Tobacco Product Use Among U.S. Youth, 2016

Public Health Impact

E-cigarettes pose potential risks to the population as a whole. E-cigarettes could cause public health harm if they:

  • Increase the number of youth and young adults who are exposed to nicotine.
  • Lead non-smokers to start smoking conventional cigarettes and other burned tobacco products such as cigars and hookah.
  • Sustain nicotine addiction so smokers continue using the most dangerous tobacco products – those that are burned – as well as e-cigarettes, instead of quitting completely.
  • Increase the likelihood that former smokers will again become addicted to nicotine by using e-cigarettes, and will start using burned tobacco products again.
Black and white illustration of various candies
68% of e-cigarette users in high school use flavors
  • menthol
  • alcohol
  • candy
  • fruit
  • chocolate
  • sweets
Source: MMWR, Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students – United States, 2011-2018.

Test Your Knowledge

Take this quiz to get the facts on e-cigarette use among youth and young adults.

True or False?

Question 1 of 5

More than 6 of 10 youth believe that occasional use of e-cigarettes causes only little or some harm.

True!

More than 60 percent of teens believe that occasional use of e-cigarettes causes only little or some harm.

Not quite

The correct response is True. More than 60 percent of teens do believe that occasional use of e-cigarettes causes only little or some harm.

Next

Select One

Question 2 of 5

Correct!

Nicotine can harm brains as they develop—which continues until age 25 or older! When youth and young adults expose their brains to nicotine, they are vulnerable to nicotine addiction, may have trouble paying attention and concentrating, and experience mood disorders and reduced impulse control. Nicotine may alter the way their brains function for the rest of their lives.

Not quite

The correct response is E. All of the above. For teens and young adults, nicotine may alter the way their brains function for the rest of their lives.

Next

Select One

Question 3 of 5

Your brain continues to develop until about which age?

  1. 12
  2. 18
  3. 21
  4. 25
  5. 30

Correct!

Brain development begins during the growth of the fetus in the womb and continues through childhood and to about age 25.

Not quite

The correct response is D. Brain development begins during the growth of the fetus in the womb and continues through childhood and to about age 25.

Next

Select One

Question 4 of 5

Which of these tobacco products is most commonly used by U.S. high school students?

  1. Cigarettes
  2. E-cigarettes
  3. Little cigars
  4. Hookah

Correct!

U.S. middle and high school students use e-cigarettes more than any other tobacco product.

Not quite

The correct response is B. Both middle and high school students use e-cigarettes more than any other tobacco product.

Next

Select One

Question 5 of 5

Correct!

Young people use e-cigarettes because they are curious about them, like the flavors e-cigarettes contain, and believe e-cigarettes are safer than regular cigarettes.

Not quite

The correct response is D. Young people use e-cigarettes because they are curious about them, like the flavors e-cigarettes contain, and believe e-cigarettes are safer than regular cigarettes.

See Results

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Read up on the following sections of this site to learn more about e-cigarettes:

  • Get the Facts right chevron icon Did You Know right chevron icon Teen Beliefs
  • Get the Facts right chevron icon Did You Know right chevron icon
  • Get the Facts right chevron icon Did You Know right chevron icon Appeal to Young People
  • Know the Risks right chevron icon Brain Risks
  • Know the Risks right chevron icon Addiction

Then, re-take the quiz to test your knowledge again. Share this quiz on social media and challenge your friends to see how well they know the facts.

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Great job! You know the key facts about e-cigarettes. Share this quiz on social media and challenge your friends to see how well they know the facts.

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The Bottom Line

Scientists are still learning more about how e-cigarettes affect health. However, there is already enough evidence to justify efforts to prevent e-cigarette use by young people.

Because most tobacco use starts during adolescence, actions to protect our nation's young people from a lifetime of nicotine addiction are critical.

Working together, we can keep America's youth and young adults safe from the dangers associated with tobacco use and nicotine addiction.

Black and white photo of a young man with earphones around his neck