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Vaping is causing serious lung disease in many teens. Yet, youth vaping continues to rise at an alarming rate.

State policies can help curb youth vaping. Michigan has set an example by becoming the first state to ban the sale of many flavors of e-cigarettes in an effort to reduce teen vaping. As part of our 2019 State Honor Roll™ of Asthma and Allergy Policies for Schools (SHR), we look at the rise of vaping among our youth and what states can do to reduce rates.

SHR Spotlight 2019: Youth Vaping

Vaping, the use of electronic cigarettes, is a growing epidemic among kids and teens. These electronic devices heat a liquid to produce an aerosol for users to inhale. The liquid contains high levels of flavoring, numerous harmful chemicals and often nicotine.

Some of most common names for these devices are:

  • Vape
  • Vaporizers
  • Vape pens
  • Hookah pens
  • Electronic cigarettes (e-cigarettes or e-cigs)
  • E-pipes

The 2018 National Youth Tobacco Survey found 3.62 million middle and high school students used e-cigarettes in 2018. This is a 78% increase among high school students and a 48% increase among middle school students in a single year.1

Teachers and school staff have trouble preventing e-cigarette use on school property. The devices come in many shapes and sizes. One of the most popular brands, JUUL, looks like a small USB drive. Other brands look like smart phone cases, pens and lipstick tubes.

One alarming vaping device is shaped like an inhaler. This puts people with asthma at risk if school officials mistakenly confiscate a student’s asthma medicine. The Centers for Disease Control and Prevention (CDC) recommends that teachers learn about the shapes and types of e-cigs and their health risks.

E-cigarettes are not safe for any young people. Evidence suggests that e-cigarettes cause increased cough and wheeze in teenagers, as well as more asthma episodes. There is also evidence e-cigarettes worsen indoor air quality.2 So vaping not only compromises the health of youths, but also impacts the health of students with asthma due to poor indoor air quality.

The U.S. Food and Drug Administration (FDA) has been leading the effort to reduce youth e-cigarette usage through its Youth Tobacco Prevention Plan. This program is at a federal level, but states have also started to address the increased use among kids and teens.

The Public Health Law Center at the Mitchell Hamline School of Law conducted a 50-state review of e-cigarette laws and regulations and found that all states define e-cigarettes in at least one state law.3 Some states have also plainly added vaping to rules barring smoking in schools. But more needs to be done. For instance,16 states define e-cigarettes as tobacco products. So existing school tobacco policies could possibly apply to e-cigarettes. But the states have not yet clearly applied school tobacco policies to e-cigarette use.

AAFA recommends all states adopt policies explicitly prohibiting vaping in all school buildings, on school grounds, on all school buses and at school-related functions. We also encourage schools to teach students about the dangers of e-cigarette use.

1. Notes from the Field: Use of Electronic Cigarettes and Any Tobacco Product Among Middle and High School Students - United States, 2011–2018 | MMWR. (n.d.). Retrieved from
2. Public Health Consequences of E-Cigarettes. (2018, October 19). Retrieved from
3. Public Health Law Center. (n.d.). Retrieved from https://www.publichealthlawcen...ions-50-state-review

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CDC, U.S. Food and Drug Administration (FDA), state and local health departments, and other clinical and public health partners are investigating a multistate outbreak of severe pulmonary disease associated with e-cigarette product (devices, liquids, refill pods, and/or cartridges) use. This investigation is ongoing and has not identified a cause, but all reported cases have a history of using e-cigarette products.

Read more: Outbreak of Lung Illness Associated with Using E-cigarette Products

Map of reported cases

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