Vaping, Nicotine, and Tobacco

What is vaping?

Vaping is the act of inhaling and exhaling the aerosol (often called vapor) produced by an e-cigarette or similar battery-powered device. They are also known as e-cigs, vape pens, e-hookahs, e-pipes, tanks, mods, vapes, electronic nicotine delivery systems, or ENDS, and more. Some people refer to vaping devices by their brand name such as Puff Bar, fruyt STIK, JUUL, BO, myblu, Smok, and Suorin.

What are the different types of e-cigarettes?

E-cigarettes come in many different sizes, types and colors. Some e-cigarettes are made to look like regular cigarettes, cigars, or pipes. Some resemble pens, small electronic devices such as USB sticks, and other everyday items. The products that are designed to resemble small electronic devices are often compact and allow for discreet carrying and use – at home, in school hallways and bathrooms, and even in classrooms.

What is in e-cigarettes?

E-cigarettes contain pre-filled pods or e-liquids/e-juices the user adds to the device. E-liquids generally consist of nicotine, propylene glycol, glycerin, flavorings, and other chemicals. Many of these pods and e-liquids come in fruit and candy flavors that appeal to youth.

E-cigarettes produce an aerosol, which users inhale from the device and exhale. The aerosol can contain harmful and potentially harmful substances, including:

Nicotine
Ultrafine particles that can be inhaled deep into the lungs
Flavoring such as diacetyl, a chemical linked to a serious lung disease
Volatile organic compounds
Cancer-causing chemicals
Heavy metals such as nickel, tin, and lead

Are e-cigarettes safe?

According to the Centers for Disease Control and Prevention, e-cigarettes are not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products. E-cigarettes have not been approved by the FDA as a smoking cessation device and additional research is needed to help understand long-term health effects of e-cigarette use.

What are the other dangers of vaping?

In addition to nicotine, e-cigarettes contain harmful and potentially harmful chemicals such as ultrafine particles that can be inhaled deep into the lungs; flavoring such as diacetyl, a chemical linked to a serious lung disease; volatile organic compounds such as benzene, which is found in car exhaust; and heavy metals, such as nickel, tin, and lead.

Due to nicotine content, e-liquids are dangerous to small children and pets. The Massachusetts Attorney General requires that nicotine liquid and gel be sold in appropriate child-resistant packaging.

In addition to chemical contents, defective e-cigarette batteries have caused fires and explosions, some of which have resulted in serious injuries.

Is being around secondhand vape safe?

No. According to the Surgeon General, the aerosol from e-cigarettes is not harmless. It can contain harmful and potentially harmful chemicals, including nicotine; ultrafine particles that can be inhaled deep into the lungs; flavoring such as diacetyl, a chemical linked to a serious lung disease; volatile organic compounds such as benzene, which is found in car exhaust; and heavy metals, such as nickel, tin, and lead.

Scientists are still working to more fully understand the health effects and harmful doses of e-cigarette contents when they are heated and turned into an aerosol, both for users who inhale from a device and for those who are exposed to the aerosol secondhand.

Can e-cigarettes be used to vape other substances?

Yes. E-cigarettes and other vaping devices can be used to vape other substances, such as marijuana. Open systems require the user to add the e-juice, which can be a substance other than nicotine. Closed systems are generally not refillable because they use pre-filled pods. However, they can also be altered to vape substances other than nicotine.

Where are e-cigarettes sold and how are youth getting them?

Until recently, e-cigarettes of all flavors and nicotine content levels could be sold in many places including convenience stores, corner stores, gas stations, vape shops, and online. As of November 27, 2019, Massachusetts implemented a law that restricts where flavored tobacco products, including e-cigarettes can be sold. The sale of all flavored tobacco products, including e-cigarettes, in Massachusetts is restricted to adult-only (age 21+) smoking bars. This also includes menthol. The sale of unflavored e-cigarettes with a nicotine content over 35 mg/mL is restricted to adult-only tobacco retail stores or smoking bars. Only unflavored e-cigarettes with a nicotine content of 35 mg/mL or less can still be sold in convenience stores, gas stations, liquor stores and other similar businesses, as well as online.

Just like other tobacco and nicotine products, youth may get e-cigarettes from friends who vape or from local or online stores that do not abide by Massachusetts’ restrictions on sales. If you wish to report one of these sales violations, call 1-800-992-1895 or contact your local Board of Health.

Detailed information about the ban and a list of frequently asked questions are available on the Commonwealth of Massachusetts website.

Additional Resources

Health Department vaping ban press release (September 25, 2019)
Health Department letter to retailers (September 25, 2019)

NICOTINE POUCHES

What Are Nicotine Pouches?

Nicotine pouches have become a popular delivery method for teens and tweens. The most common brand is Zyn, which can be purchased at most tobacco retailers. Like other tobacco products in MA, you must be 21 to purchase Zyn products, but teens are getting their hands on these pouches in what appears to be high numbers. Useful data on young people using nicotine pouches has yet to be collected. But, overall sales of these products are high while adults are reporting low use. This indicates someone else is using them, and it's likely kids.

How Are They Used?

Nicotine pouches are tucked into the upper lip, delivering a dose of nicotine directly to the bloodstream. They can be used for an extended amount of time. Some researches have estimated that one hour of use can deliver 5 cigarettes' worth of nicotine.

What Are The Health Risks?

Researchers have noted that these pouches may be a safer nicotine delivery method than those containing tobacco and could be useful for people trying to quit smoking, but testing has only been done on adults and the health risks for teens are likely higher. Not only can these pouches cause health issues like gastrointestinal symptoms, nausea, gum soreness, ulcers, and cardiovascular risks like elevated heart rate, when young people use nicotine, it changes the way their brains work. When kids use nicotine delivery products like vapes and pouches, it can set them on a path to lifelong nicotine addiction.

How Are They Marketed To Kids?

While the makers of these pouches claim they are selling to users over age 21, the marketing seems heavily targeted to youth. The nicotine pouches are cheap, strong and easy to hide, making them especially appealing to children. And unlike a vape pen or cigarette, impossible to identify by an adult, since they can look like gum or mints. Nicotine pouches can come in many flavors, which is one of the ways manufacturers market them to kids. But flavored tobacco or nicotine products are banned in MA. Retailers get around this law by selling flavored pouches that don't contain any banned substances that are meant to be used with the nicotine pouches. These often look like the example below:

What Can I Do If My Child Is Using Zyn?

There are many resources available to families to help kids quit. The list below offers a variety of approaches and organizations with programs specifically for youth.