With the rise of vaping among teens and the increase of lung-related illnesses, even death linked to e-cigarettes, understanding the facts about vaping has never been more crucial.

In late October, the U.S. Centers for Disease Control and Prevention (CDC) reported 1,888 vaping-related injuries across the nation with more than half of those cases involving people under the age of 24. Though the official cause of this outbreak has yet to be determined, the CDC has stated, “the only commonality among all cases is that patients report the use of e-cigarette, or vaping, products.”

Here’s what you need to know about teens and vaping:

What are e-cigarettes and how does vaping work?

E-cigarettes are small devices that heat a liquid and then produce an aerosol into the air. They come in many shapes and sizes and can be made to look like traditional cigarettes, cigars or pipes. Some look like USB flash drives, pens or larger non-traditional tobacco devices with a “tank” system.

E-cigarettes produce an aerosol when heating a liquid that usually contains nicotine, different flavorings and other chemicals. These devices can also be used to deliver marijuana and other drugs.

E-cigarettes go by many names, sometimes called “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” “tank systems” and “electronic nicotine delivery systems (ENDS).” Using e-cigarettes can be called “vaping” or “JUULing.”

What is JUUL? Is it any different?

JUUL is a specific brand of e-cigarette that is typically shaped like a USB flash drive. Like most e-cigarettes, it is battery operated and produces an aerosol from heating a liquid containing nicotine. It is the top-selling e-cigarette brand in the United States.

JUUL uses nicotine salts, which allow for particularly high levels of nicotine to be inhaled more easily and with less irritation than has traditionally been used in tobacco products. JUUL “pods”, the liquid-containing component of JUUL devices, come in a variety of fruit, candy and other teen-friendly flavors.

Is vaping and e-cigarette use on the rise in the U.S.?

Yes. Since 2017, there has been a rise among 12th graders (11 percent to 25 percent), 10th graders (8 percent to 20 percent) and 8th graders (4 percent to 9 percent) who’ve shared they’ve vaped in the past month, according to data collected from the University of Michigan’s Monitoring the Future (MTF) survey.

Vaping has also increased among college students, growing from 6 percent in 2017 to 16 percent in 2018.

Is Nicotine dangerous? What other health risks are there?

Nearly all e-cigarettes, including JUUL, contain the highly addictive drug nicotine. Nicotine can be harmful to the development of young people’s brains, including the parts of the brain that control attention, learning, mood and impulse control. Nicotine also increases the risk of addiction to other drugs in adolescents.

When new memories are formed or a new skill is developed, connections – or synapses – are built within our brain cells. Young people’s brains build synapses faster than adult brains, however, nicotine can change the way these synapses are formed.

The long-term effects of e-cigarettes are still being studied, but there has been evidence to suggest that e-cigarette aerosol is harmful to the health of the lungs. Additionally, defective batteries have caused some serious injuries when they’ve caught on fire or exploded.

Can bystanders be harmed by e-cigarette aerosol?

Yes. The aerosol produced by e-cigarettes, including JUULs, can expose bystanders to harmful substances.

E-cigarette aerosol contains the following harmful substances:

• Nicotine

• Ultrafine particles that can be inhaled into the lungs

• Diacetyl, a chemical linked to lung disease

• Carcinogenic chemicals

• Metals like nickel, tin and lead

Is vaping safer than smoking real cigarettes?

Maybe. E-cigarettes expose users to fewer harmful chemicals than burned cigarettes. Burned cigarettes are extremely dangerous, killing half of all people who smoke long-term.

There is evidence to support that using e-cigarettes can help individuals to break their addiction to regular cigarettes. However, the use of any tobacco product, including e-cigarettes, is unsafe for young people.

What can I do if I suspect my preteen or teen is vaping?

First, ensure that you’re setting a good example to be followed by not using e-cigarettes or JUUL devices. If you smoke regular cigarettes yourself, seriously consider quitting smoking.

Go over the facts with your preteen or teen and help them to understand the harmful effects of vaping. Be open to their experience and approach the conversation with patience and understanding.

For more information on how to speak to your preteen or teen and what to say to them, visit e-cigarettes.surgeongeneral.gov