How Vaping Is Different Among Young Adults and Teens |
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Nicotine exposure before age 25 disrupts brain development, causing permanent cognitive impairments.
Despite the risks and new regulations, vape products continue to be marketed aggressively to young people.
Many teens are unaware that vape products contain nicotine.
By Brian Coon, MA, LCAS, CCS, MAC, with Becky Shipkosky
In December of 2025, Janica Mendenhall took her daughter to a local urgent care. The 16-year-old had a respiratory infection with excessive coughing that worried her mother. Providers at the clinic sent the teen to a nearby hospital and, as of the latest update in mid-January, she remained there on life support.
Media reports characterize her condition as “severe complications of the flu, exacerbated by vaping,” which the daughter had taken up just one year prior. This is only the latest; a Google news search returns dozens of such stories within the past year alone.
As part of our ongoing examination of e-cigarettes and their use, dangers, and cultural context, we’re taking a look at how vaping is different among adolescents and young adults (AYAs). We’ll explore what it is about vaping that makes it more harmful than other tobacco products, plus why users under 25 are uniquely and especially vulnerable.
What’s Different About Vaping?
For those of us with children between the ages of 14 and 25 years, cigarettes were likely prevalent when we were in high school or college. And while conventional cigarettes are harmful to young bodies in some of the same ways that e-cigarettes are, the latter come with some of their own particular, or multiplied, dangers. The following are qualities unique to e-cigarettes that may cause AYAs greater vulnerability or harm.
Social Media Marketing
Brand accounts offer coupons and discounts, often with extra incentives for users who tag friends. Influencer accounts show off tricks like rings and shapes, demonstrate device-hacking for (sometimes dangerous) unintended uses, and sneak product placement into youth-popular content like video game livestreams.
Vape makers also have the advantage of designing the delivery system itself. While a cigarette pack in the '90s may have featured a cartoon camel, the cigarettes inside always looked the same. While the most egregiously youth-appealing designs have been outlawed in most places, fun colors and shapes, candy-inspired designs, and cute names still effectively draw young people’s attention.
Candy-, soda-, dessert-, and fruit-flavored vape juice are legal in most states. These flavors not only appeal to young people; they also mask unpleasant flavor or harshness from harmful nicotine, encourage more frequent use, and reduce risk perception.
Due to an effect called false consensus, teens often overestimate how many of their peers are engaging in substance use (Noland et al., 2016). In any case, vape products are genuinely ubiquitous in some environments; a teenager whose friends vape is seven times more likely to do so themselves and three times more likely if a family member does (Khoury et al., 2016). Many of the teens featured in stories about vaping-related health emergencies, such as EVALI (e-cigarette or vaping use-associated lung injury) or lung collapse, report having started vaping to fit in or impress peers.
Many of us Gen Xers and Millennials might have smoked, or we might have smoked more habitually than we did, if not for the too-evident odor. Nonsmoking parents and teachers would surely know by the smell, even if we were never caught in the act. Vape smell, on the other hand, doesn’t cling to hair and clothing or linger in spaces for very long. Furthermore, any smell from flavored products can be easily attributed to gum, lip gloss, or other fragrances.
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Stealthy appearances also prevent detection. Vape devices may be disguised as highlighters, markers, and pens, USB devices, jewelry, keychains, phone cases, and more. Undetected, vape pods and devices especially lend themselves to all-day use, which can lead to far more nicotine consumption than even users themselves realize.
All of this appeal and normalization creates pressure to buy, as product design and marketing are meant to do. Youth-targeted, user-friendly, and novel designs harken back to big tobacco’s diabolical Joe Camel era, obscuring the fact that an addictive alkaloid is at the heart of such popular and innocuous-looking devices. Many teens (63 percent in 2019) are unaware that vape products contain nicotine (Willet et al., 2019).
Why Are Young Users at Higher Risk?
Young users, naturally, are subject to the same risks as all e-cigarette users, plus they face some additional special risks. We’ve explored why vaping in particular is more harmful or insidious than smoking. What is it about adolescent and young adults’ physiology and psychology that exposes them more to these and other vaping-related harms?
Cognitive Development
A deeply concerning fact of AYA nicotine use is that it disrupts development in and around the amygdala, hippocampus, and prefrontal cortex, which are not fully matured until about age 25. Tobacco use of any kind before that time permanently inhibits neural connection in, to, and from these areas, which are responsible for important functions like mood stability, impulse control, and rational thinking (U.S. Department of Health and Human Services, 2016).
Pronounced Addiction Imprinting
Adolescent and young adult brains are about as neuroplastic as a human brain can be. A hyper-sensitive reward system and faster-forming synapses, combined with the underdeveloped prefrontal cortex, turn the brain’s addiction pathways into superhighways. This leads to stronger and more persistent addiction, echoing well into adulthood even after successfully quitting (National Institute on Drug Abuse, 2008).
This process also creates a stronger proclivity to other addictions. An adolescent who vapes is three to four times more likely to smoke cigarettes and four times more likely to try cannabis. They’re also more likely to drink alcohol and use illicit drugs (Singh et al., 2020).
E-cigarette use is associated with increased mental health problems among adolescents (Becker et al., 2021; Abdulhay et al., 2025), and while causality is not established here, the relationship between mental health and tobacco use in general is considered bidirectional (Esmaeelzadeh et al., 2018). That is to say, people are more likely to use tobacco if they have mental illness, and tobacco appears to contribute to worsening mental health symptoms.
Incidentally, the parts of adolescent and young adult brains developmentally disrupted by tobacco use are also ones strongly implicated in depression, anxiety, bipolar disorder, schizophrenia, and attention-deficit/hyperactivity disorder—all of which occur more in tobacco users than nonusers (Hu et al., 2025; Lee and Lee, 2023).
So what can concerned parents do? In an upcoming post, we’ll walk through what quitting looks like, including withdrawal patterns and evidence-based supports. For now, here are three starting points to encourage prevention or cessation:
Lead with curiosity. Initiate open conversations about what your child’s peers are doing. If they are vaping, ask what they like about it and what they know about it.
Name the tactics. Help them see how they’re being marketed to with flavors and colors that obscure risk, and encourage them to consider why the products are discreet or secretive by design.
Keep the door open. Prevention and quitting may not be straightforward, one-time events. Offer ongoing, nonjudgmental conversations and support.
If your child is vaping, it’s not a character flaw or a failure of parenting. It is the predictable outcome of products engineered to attract and normalize, and ultimately to hook developing brains.
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