A young individual is seated on a green sofa, exhaling a large cloud of vapor from an electronic vaping device. The setting appears to be a modern living room with soft natural light and comfortable furniture. The person is wearing a red t-shirt and casual attire, contributing to a relaxed and informal atmosphere. No visible text or numbers are present in the image.

Vape devices, originally marketed as a tool to help adults quit smoking, have found a different audience: adolescents.

According to the FDA, 5.9% of middle and high school students — an estimated 1.63 million teens and preteens — reported using e-cigarettes in 2024. With fruity flavors and flashy packaging, vaping has become a trend not just among smokers, but also among first-time users.

As vaping becomes more common among teens, understanding the risks and how to talk about them is more important than ever. UT Medicine pediatrician Alefiyah Malbari, M.D., who serves as the Chief of Dell Children’s Medical Group Pediatrics, a clinical partnership between Dell Children’s Medical Center and UT Medicine, breaks down the dangers of vaping and shares guidance for parents and caregivers working to protect their kids.

The real risks for adolescents

Vaping is a risk to individuals of all ages, especially children and adolescents.

“Those who start vaping during childhood are at higher risk due to their heightened sensitivity to nicotine exposure and the potential for addiction,” said Malbari. “Research strongly shows that children and adolescents who start vaping are more likely to experiment with smoking cigarettes and using other drugs.”

The biggest concern is exposure to harmful and addictive chemicals in vaping liquids.

“These chemicals include nicotine, which causes addiction and harms brain development,” said Malbari. “Since the brain develops most rapidly in the first 21 years, exposure to nicotine and chemicals during adolescence can impact the developing brain, including addiction control, decision-making and other cognitive functions.”

Nicotine also increases heart rate, which can contribute to high blood pressure and heart problems over time.

Start with a conversation

Talking to your child about vaping might feel difficult, but it’s one of the most important things you can do to protect their health.

“Parents, caregivers, teachers and others involved in children’s lives should consider addressing the issue directly,” said Malbari. She encourages parents to help their children feel confident in saying no to peer pressure. “Explain that even trying vaping once can quickly lead to addiction, making it very difficult to quit.”

It also helps to relate to your child’s experience. “Consider the social pressures they face. Share your own stories if you’re comfortable. Make it clear that you’re on their side.”

Know the facts

Before starting the conversation, it’s helpful to understand common misconceptions and the science behind the risks.

Myth 1: Vaping is less harmful than smoking cigarettes.

Vaping isn’t a safe alternative to smoking. “A main concern of vaping is the cause of acute lung injury,” said Malbari. “While traditional cigarettes burn tobacco, vaping involves heating and inhaling chemicals found in vape juice, which also have the potential to be carcinogenic. Smoking causes cancer, and there is a belief that vaping may also have the potential to, as well.”

Myth 2: Vapes and electronic cigarettes are less addictive than traditional methods of nicotine consumption.

Nicotine levels are often comparable between vaping and traditional tobacco use. “You can control the nicotine intake on the vape device,” said Malbari, “but depending on how often and deeply you inhale, you might consume more nicotine than through traditional smoking. This makes both vaping and smoking cigarettes equally addictive.”

Myth 3: Longtime smokers are more likely to develop nicotine dependence than children and young adults.

Adolescents are just as likely — if not more — to develop a nicotine dependence. “Several studies suggest that adolescents and young adults are more susceptible to nicotine addiction due to their heightened sensitivity to substances,” said Malbari. “Early exposure to nicotine can impact the ongoing development of the brain and enhance the addictive effects.”

Look for warning signs

You may notice subtle behavior changes if your child has started vaping. “They may be less open to you going through their backpack,” said Malbari, “or they are less likely to share what happens during their day.”

Watch for:

  • Increasing feelings of sadness or depression
  • Decreasing interest in previously enjoyed activities
  • Declining academic performance

“Children who have experienced adverse childhood events, such as abuse or food insecurity, are at higher risk for starting behaviors like vaping,” she said.

Keep the conversation going

“You might not cover everything in one conversation,” said Malbari. “Look for opportunities to bring up the topic regularly. Make sure to create a calm, distraction-free environment — that’s when real conversations happen.”

With empathy, consistency and support, you can help your child make informed, healthy choices.

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Dell Children’s Medical Group Pediatrics