Cigarettes are becoming a relic of the past, rejected by a new generation as dirty and deadly.

• 20 years ago, 25% of Tennessee high school students smoked cigarettes
• Today, only 11.5% report having smoked recently, and
• Only 2% are daily smokers.

Unfortunately, a new habit is moving in. Today’s teens “vape” or “Juul,” using electronic devices that deliver a hit of nicotine in water vapor. As of 2016, 54% of high school seniors had tried e-cigarettes and 28% were regular users.

“Kids don’t think of these devices as cigarettes and believe they are harmless,” says Dr. Michelle Fiscus, deputy medical director at the Tennessee Department of Health’s Division of Family Health and Wellness. “Kids who have never been smokers of conventional tobacco because they have grown up knowing about the problems with cigarettes have become huge consumers of these nicotine devices, not understanding that they cause the same addiction.”

Right now, sales of the devices are restricted to adults over 21, but that doesn’t stop millions of underage purchases.

More than half of high school seniors have tried e-cigarettes

A quick history of e-cigarettes

An e-cigarette works by heating up a liquid, usually containing nicotine, into a vapor that the user inhales. It allows smoking without tobacco.

The first patent for a non-tobacco cigarette was awarded in 1965, but e-cigarettes didn’t become popular until the early 2000s, with sales of the devices soaring around 2015. At first, smokers adopted e-cigarettes so that they could get their hit of nicotine in places that didn’t allow smoking. Some companies began marketing the devices as a path to quit cigarettes, adding new flavors as demand grew.

In 2017, a number of companies introduced new sleekly designed devices that didn’t produce a cloud of vapor. Users could choose from dozens of sweet and fruity vape flavors, taking quick hits from their device without being detected – making these products attractive to teens.

“It’s not the 40-year-old accountant trying to cut back on cigarettes who buys Unicorn Puke vape juice,” says Dr. Fiscus. “And packaging that looks like Sourpatch Kids is not the way you market to adults.”

What’s the harm?

The health issues associated with cigarette smoking develop from the burning tobacco and chemicals used in making cigarettes. The addictive substance in cigarettes is nicotine, and it is powerful. With continued use, users can become addicts and crave nicotine in stronger doses over time.

E-cigarettes eliminate tobacco from the equation, so users inhale vapor instead of smoke. Some research shows that the devices are a healthy alternative for heavy smokers. Others indicate that smokers who turn to vaping usually continue to smoke cigarettes too. It’s true that nicotine-free options are widely available, but a good percentage of teens who vape use products that have nicotine.

89% of adults who smoke started before the age of 18

“What we are concerned about for public health is this high level of nicotine addiction now happening in very young children — as young as 11 — and they can’t get themselves off of it. That makes them extremely likely to become users of cigarettes. So, we’ll be right back where we were before. All of the strides we have made to reduce tobacco use in our state and across the country are being undone by this industry promoting nicotine consumption.”

How to stop the trend

The FDA responded to the news of overwhelming underage vaping by announcing a crackdown on the sales of the devices to minors. Parents, schools and communities can best get the issue under control by following the path of the anti-smoking effort. That involves education, restricting access and changing perceptions about vaping as an acceptable action in public.

Dr. Fiscus recently worked with more than 400 Tennessee teens at the TNSTRONG (Tennessee Stop Tobacco & Revolutionize Our New Generation) summit who are working to stop smoking and e-cigarette use among their classmates. These teen ambassadors are taking what they learned about nicotine addiction and e-cigarettes and working to raise awareness among their peers.

“About 89% of adults who smoke started before the age of 18. This is the age when they get hooked and become lifelong smokers,” says Dr. Fiscus. “The teen ambassadors who are in TNSTRONG are the force behind a grassroots movement to change policies in their communities and their schools, so that their generation will be smoke-free.”

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.