Vaping: What you need to know

Last Modified: 3/20/2020


As popularity around vaping continues to grow, so does our responsibility to bring awareness and light to such a rapidly growing issue. Lisa Hatcher, MD, PPG – Family Medicine, helps explain the health risks that vaping and tobacco products have on children and teens.

Have you seen an increase in vaping among patients, specifically teenagers?

I have seen an increase in vape use among adults and teens over the past 2-3 years. Many adults began vaping to quit smoking or because they believed it was safer than traditional cigarettes. When vape products first became available, some healthcare providers thought it was safer, too.

How does vaping affect developing brains and bodies?

Unfortunately, vaping has not been shown to help people quit smoking. In fact, many people now do both and are using more nicotine than ever. It’s certainly not safer, as we learned last summer when the vape-related lung injuries emerged, and we saw subsequent deaths associated with that illness.

It’s been reported that 24% of high school youth and, even more frighteningly, 6% of middle school youth in Indiana self-reported e-cigarette use on the 2018 Indiana Youth Tobacco Survey. The worrisome issue with young people using nicotine in either smoked or vaped form is that the developing brain becomes much more rapidly addicted than the "mature" brain. Your brain is still developing into your early twenties. So, the earlier someone starts smoking, the harder it is to quit. More than 90% of today's adult smokers who can't quit, started when they were teenagers.

Why are the flavored vapes so concerning to you as a physician?

Youth surveys show that kids often try e-cigarettes because of the flavors. Nicotine really doesn't taste good. When you mask the flavor of nicotine with things like tutti-fruity or mango, vaping is a more pleasant sensation and you are more likely to repeat the use. The flavor makes it seem innocent and easier to forget that there’s a drug (nicotine) that affects your brain and is hiding behind the flavor. The tobacco industry knows that menthol made it easier for many people to begin smoking. The marketing leap to other flavors was really a "no brainer" for attracting new and younger users.

What concerns you about the smaller Juul or Stig cartridges?

Products like Juul and Stig are small. They can easily be tucked into a pocket, a purse or a backpack out of sight. Neither product looks like a cigarette. They look like cute little tech gadgets. The Stig website cites their device as "ultra-portable," small and states that it can be "used discreetly". Both Juul and Stig are available in an array of flavors. Vape producers also market vape wear like sweatshirts that hide the vape device and allow you to vape through a thin tube hidden in the string of a hoodie.

Where does Indiana fall in relation to other states’ smoking and tobacco rates?

Indiana's current tobacco use rate is 21%. This is one of the highest rates by state in the United States. Also, depending on which survey you are looking at, Indiana ranks somewhere between 47th and 49th for worst tobacco use.

Do you feel the vaping industry influences Hoosiers’ tobacco rates?

Tobacco use contributes $7.6 billion in cost to our state health care system every year. This means Indiana employers pay higher premiums for health care and Indiana consumers pay more for the detrimental effects of tobacco use. The cost of state sponsored Medicaid programs cost more too, due to nicotine use. This makes Indiana less attractive to employers who might be looking to locate new businesses in our state. One of the more worrisome effects of tobacco use is on our infant mortality rate. Indiana ranks 49th in the nation for infant mortality. Tobacco use by pregnant women and young mothers increases the risk of preterm birth, low birth weight and Sudden Unexpected Infant Death.

What effect would legislation, a higher tax on vaping liquids and raising the age for tobacco products to 21, have on teen vaping and tobacco use in Indiana?

This year, the Indiana state legislature raised the tobacco and vaping age to 21. This was an effort by a number of organizations including the Indiana State Medical Association over the last several years. This year, Governor Holcomb made the "T-21" part of his health care package. So, our efforts had the weight of the governor's office as backup.

This bill also increased the penalties on retailers who sell to kids, thus decreasing access for teens. Studies have shown that raising the age at which people can legally begin smoking leads to reductions in smoking-related illnesses and deaths and improves infant mortality rates.

What advice would you give parents regarding tobacco and vaping products?

My advice to parents would be to become familiar with these vape devices. Look them up on the internet. Know what they look like. Visit a vape shop and see what e-cigarette devices and flavors are available. Learn how much nicotine is in a Juul pod (about the equivalent of a pack of cigarettes). Talk to your kids about the dangers of nicotine use at an early age. Smoking and vaping are harmful to the lungs. Nicotine use at an early age can predispose to life-long addiction. Remind them that nothing about tobacco or nicotine use, in cigarette or vape form, is good for your health.

Helpful Resources

Here are some additional resources and links regarding lobbying efforts against tobacco and vaping in Indiana:

AP News

Kokomo Tribune


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