A woman holds an e-cigarette.
The federal government is now regulating e-cigarettes, with the aim of curbing youth use of these devices. (For Spectrum Health Beat)

With the exception of those who do it, does anyone understand what “vaping” really is?

Sure, you’ve seen the e-cigarette. It resembles some sort of steaming pen, right?

Beyond that, most of us have nothing but a blank stare. So what is it, and is it safe? And what’s up with the new Food and Drug Administration crackdown on e-cigarettes?

Certainly many teens think it’s cool. In fact, more than a quarter of a million youth who had never smoked a cigarette tried vaping in 2013, according to a Centers for Disease Control and Prevention study published in the journal Nicotine and Tobacco Research.

Given those numbers, and reports that they are growing, what should kids (and everyone, for that matter) know about e-cigarettes? And what will the new FDA regulations mean for them?

What is vaping?

Vaping delivers nicotine through a flavored liquid atomized by an e- (for electronic) cigarette.

The liquid base is usually a vegetable glycerin or propylene glycol. Interestingly, propylene glycol, while present in many food products such as salad dressings, is also used to de-ice planes.

Whichever form is its base, the liquid (which comes in variations of 0 to 24 milligrams of nicotine) is vaporized through a battery-powered atomizer. The resulting vapor is then inhaled to simulate the experience of smoking.

“Some people think this might be a way to quit smoking,” said Lisa Lowery, MD, division chief of Spectrum Health Helen DeVos Children’s Hospital Adolescent Medicine. “Because of the flavors, the gadgets and lack of regulations, the idea soon became attractive to kids. When you vape, you are exposing yourself to chemicals—inhalants and contaminants—and in many cases, nicotine.”

Dr. Lowery added deeper concerns about the popularity of e-cigarettes.

“Some kids are even using the vaping tool and putting marijuana oil in it,” she said.

She noted that some retail vaping shops have become teen hangouts.

“Manufacturers are selling them just like they did cigarettes, promoting their use as a sexy, bold and rebellious move,” said Libby Stern, LMSW, TTS, a tobacco treatment specialist at Spectrum Health Healthier Communities. “You can see the appeal of these flavored electronic gadgets to youth.”

FDA targets youth vaping

In early May, the FDA took action. In new regulations that went into effect in August, the FDA banned the sale of e-cigarettes to anyone under 18 and required an ID to buy them if you look like you’re younger than 26.

This is huge, by all accounts.

The New York Times wrote that these sweeping reforms “shifted the terms of the public debate” and health experts have expressed fears that a new generation has become hooked on nicotine.

While it’s a good first step, Dr. Lowery said, parents still need to be on guard.

“Teens can be very savvy and, like they have done with cigarettes and alcohol in the past, they may try to get around rules and bans regarding purchasing e-cigarettes,” she said.

Stern agreed that the ruling by the FDA to begin regulating emerging and previously unregulated tobacco products is a good first step. But, she said, it “really misses the mark in protecting our youth by the failure to regulate the 7,700-plus flavorings and the careless marketing of these products.”

She said the flavorings—such as gummy bear, cotton candy, cocoa puffs—are major factors in youth use.

Health effects and quitting

Few studies have examined health effects of vaping, but a 2013 study indicates at least a reduced toxicity level compared to smoking a cigarette.

Yet, since it’s relatively new, no long-term data exists.

From a parent and doctor perspective, Dr. Lowery urged, “We also need to be aware of what vaping can represent: a behavior that may indicate an emotional or social struggle. It can be a signal of bucking against authority or act as a gateway to riskier actions.”

Stern said drug addiction is the same, it’s the route of administration that’s different. Vaping can be just as addictive as smoking cigarettes, and has similar health consequences. Quitting can be difficult, but doable with the right support.

“Like with other addictions to nicotine products, having a well-developed quit plan is essential,” she said. “For adults it should address things like coping with triggers and urges, getting support, developing coping and problem-solving skills and stress management. For youth, avoiding peers that use and developing refusal skills are also a crucial part of the plan.”