Hawaii Youth Vaping is at Epidemic Levels

In Hawaii, vaping is addicting a new generation of youth to nicotine. While often marketed as healthier alternatives to cigarettes, e-cigarettes, also known as vapes and electronic smoking devices, are not healthy options and are considered tobacco products because they contain nicotine.[1] Almost one in three high school students in Hawaii regularly vape.[2] Youth who use e-cigarettes are four times more likely to try regular cigarettes, and three times more likely to become cigarette smokers.[3] Most youth do not think regularly using e-cigarettes is harmful, and many do not know that they contain nicotine.[4] JUUL, an e-cigarette brand popular with youth, contains more nicotine than a pack of cigarettes, and the Suorin Vagon brand contains as much nicotine as 90 cigarettes.

Vaping May Increase COVID-19 Risks

Vaping has been linked to COVID-19 risk in teens and young adults. A recent Stanford University-led study found that among young people who were tested for the virus that causes COVID-19, those who vaped were five to seven times more likely to be infected than those who did not use e-cigarettes.[5] According to the National Institute on Drug Abuse, “because it attacks the lungs, the coronavirus that causes COVID-19 could be an especially serious threat to those who smoke tobacco or marijuana or who vape. Vaping, like smoking, may also harm lung health. Whether it can lead to Chronic Obstructive Pulmonary Disease (COPD) is still unknown, but emerging evidence suggests that exposure to aerosols from e-cigarettes harms the cells of the lung and diminishes the ability to respond to infection.”[6]

In addition to the possible increased risk of severe illness from COVID-19, teens who vape may be more likely to get the disease. The repeated hand-to-mouth action of vaping and common practice of sharing of e-cigarettes among teens may increase transmission risk for COVID-19.

Vaping is Addictive and Dangerous

Nicotine is as addictive as heroin and cocaine. Nicotine can harm brain development and may have long-term consequences including reduced impulse control, difficulty with attention and memory, mood disorders, and vulnerability to addictions. The aerosol from e-cigarettes is not water vapor, and may contain ultrafine particles of heavy metals and cancer-causing chemicals that can lodge in the lungs. Vaping is known to cause seizures and breathing difficulties, and evidence is growing about the health risks, especially for children and youth. Larger e-cigarettes including “tanks” and “mods” create larger plumes and rely on higher heat, which increases risks for fires and explosions.

E-cigarettes and vapes come in candy and fruit flavors that introduce youth to nicotine and keep them returning. Vaping in schools and classrooms is commonplace, even in elementary schools. Companies have aggressively marketed to youth using social media and enticing flavors. While the legal minimum age for purchasing tobacco products in Hawaii is 21, some teens are circumventing age verification by purchasing e-cigarettes online and then both using and reselling the products. Only 5 percent of Hawaii youth who vape reported purchasing e-cigarettes from stores, most obtained them from friends or on the Internet.[7]

Don’t be Fooled

E-cigarettes come in many shapes and sizes that may be difficult to recognize. Smaller pod-based e-cigarettes look like USB sticks or hot spots and can be charged using a laptop. These devices are popular with middle and high school students because they are easy to conceal, feel hi-tech, have appealing flavors, and are affordable. Teachers and parents may detect a sweet odor when a youth takes a puff.

Advice for Talking to Youth Who Vape

This is an important time to talk to youth about the risks of vaping. Here are some tips.

  • Be patient and ready to listen, avoid criticism and lecturing.
  • Encourage an open dialogue with youth by discussing things that are going on in their lives.
  • Don’t be direct or confrontational. Instead of asking, “Are you vaping?” or “Do you use e-cigarettes?”, ask them what they know about vaping, if they see vaping in school or among their friends. Ask them what they are hearing in the news and if they are concerned about health problems from vaping and nicotine.
  • If you find out that they are vaping, stay calm. If you become upset, it is unlikely that they will continue confiding in you.
  • Learn more about vaping by talking with other parents, educators and medical professionals or from the resources listed below.

Know a Teen Who Needs Help Quitting?

My Life My QuitTM provides vaping cessation services for youth.  Visit MyLifeMyQuit.com, call 1-855-891-9989, or text “Start My Quit” to 36072.

My Life, My Quit Promotional Resources

For Schools: Teen Audience – Get the Support You Need to Stop Vaping poster, 8″ x 11″ (PDF)

For Schools: Teen Audience – Get the Support You Need to Stop Vaping poster, 11″ x 17″ (PDF)

For Schools: Educators – Print Material Recommendations for Distributing My Life, My Quit Guide (PDF)

Teen Posters

Ready to Quit Vaping Poster 1 (JPG)

Ready to Quit Vaping Poster 2 (JPG)

Hawaii State Department of Health Resources

Hawaii Vaping Resource Guide for Educators (PDF)

Hawaii Vaping Resource Guide for Parents (PDF)

Escape the Vape: Get the Facts About Vaping Classroom Poster (PDF)

Learn how nicotine affects the brain and how My Life, My Quit can help youth quit vaping.

Additional Resources


Informative Brochures and Posters

E-Cigarette Curricula

[1] U.S. Department of Health and Human Services. E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2016. https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Full_Report_non-508.pdf

[2] Youth Risk Behavior Survey, 2019. https://www.cdc.gov/healthyyouth/data/yrbs/index.htm

[3] Berry KM, Fetterman JL, Benjamin EJ, et al, Association of Electronic Cigarette Use With Subsequent Initiation of Tobacco Cigarettes in US Youths. JAMA Netw Open. 2019;2(2):e187794. doi:10.1001/jamanetworkopen.2018.7794.

[4] Johnston, L. D., Miech, R. A., O’Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2018). Monitoring the Future national survey results on drug use: 1975-2017: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan. http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2017.pdf

[5] Gaiha SM, Cheng J, Halpern-Felsher B.  Association between youth smoking, electronic cigarette use and Coronavirus Disease 2019.  Journal of Adolescent Health 2020; epub ahead of print 11 Aug 2020. https://doi.org/10.1016/j.jadohealth.2020.07.002.

[6] COVID-19: Potential Implications for Individuals with Substance Use Disorders-NIDA, March 24, 2020. https://www.drugabuse.gov/about-nida/noras-blog/2020/04/covid-19-potential-implications-individuals-substance-use-disorders

[7] Youth Risk Behavior Survey, 2019. https://www.cdc.gov/healthyyouth/data/yrbs/index.htm