Electronic Vapor Product Use - Youth in Missouri

Missouri

Electronic vapor products (also known as e-cigarettes, vapes or vape pens) have remained the most commonly used tobacco product among youth over the last 10 years. Electronic vapor products are electronic devices that use heat to make an aerosol that the user inhales. They are typically used to deliver either tetrahydrocannabinol (THC), the active component of marijuana, or nicotine, the addictive compound found in tobacco. The aerosol made by e-cigarettes contains toxic substances that can cause cancer and lung disease. Nicotine affects brain development in children and adolescents. Multiple studies have found that using e-cigarettes in adolescence is a strong predictor of subsequent cigarette use. 

E-cigarettes pose other risks to children, teens and young adults. Both children and adults have been poisoned by coming into contact with e-cigarette liquid. Further, defective e-cigarette batteries have caused fires and explosions.

According to data from the Youth Risk Behavior Survey, the prevalence of current electronic vapor product use is higher among:

• Female high school students compared with male students.
• Hawaiian/Pacific Islander, American Indian/Alaska Native, white, Hispanic and multiracial high school students compared with Asian students. 
• Bisexual high school students compared with heterosexual, gay or lesbian and questioning/unsure students.

The role of parents is important in preventing and reducing e-cigarette use in youth. Strategies include:

• Setting an example for youth by being tobacco-free. 
• Prohibiting the use of tobacco products at home and in vehicles.
• Ensuring children’s schools, colleges and universities are tobacco-free.
• Talking to health care providers about the health risks of e-cigarette use. 
• Holding conversations with young people about the health risks of e-cigarette use that avoid criticism and include facts.
• Identifying signs of stress or anxiety in children and encouraging healthy coping mechanisms such as physical activity and mindfulness techniques. 

At the policy level, effective actions for addressing e-cigarette use in youth include:

• Increasing the price of e-cigarettes and other tobacco products.
• Implementing smoke-free policies for public spaces.
• Requiring tobacco retailers to have a license to sell.
• Prohibiting the sale of flavored tobacco products.

Schools should provide resources to help students quit smoking, including counseling and access to support services. The American Lung Association also designed an evidence-based cessation program called Not On Tobacco (N-O-T) for teenagers. Trained facilitators deliver the N-O-T curriculum to small groups in schools or community-based settings. Any individual or organization can register for N-O-T facilitator training. 

Healthy People 2030 has a goal to reduce current e-cigarette use in adolescents.

Castro, Emily M., Shahrdad Lotfipour, and Frances M. Leslie. “Nicotine on the Developing Brain.” Pharmacological Research 190 (April 2023): 106716. https://doi.org/10.1016/j.phrs.2023.106716.

McKenna, Lawrence A., Jr. “Electronic Cigarette Fires and Explosions in the United States 2009 - 2016.” USFA Topical Fire Report Series. United States Fire Administration, FEMA, July 2017. https://www.usfa.fema.gov/downloads/pdf/publications/electronic_cigarettes.pdf.

O’Brien, Doireann, Jean Long, Joan Quigley, Caitriona Lee, Anne McCarthy, and Paul Kavanagh. “Association between Electronic Cigarette Use and Tobacco Cigarette Smoking Initiation in Adolescents: A Systematic Review and Meta-Analysis.” BMC Public Health 21, no. 1 (December 2021): 954. https://doi.org/10.1186/s12889-021-10935-1.

Oliver, Briana E., Sherry Everett Jones, Emily Devora Hops, Carmen L. Ashley, Richard Miech, and Jonetta J. Mpofu. “Electronic Vapor Product Use Among High School Students — Youth Risk Behavior Survey, United States, 2021.” MMWR Supplements 72, no. 1 (April 28, 2023): 93–99. https://doi.org/10.15585/mmwr.su7201a11.