Original Articles By Dr. Lavin Featuring Expert Advice & Information about Pediatric Health Issues that you Care the Most About

The Curious Case of the Vape: How Nicotine Tricked and Hurt Our Children

By Dr. Arthur Lavin

Every parent shares the fear that it will be their child who will end up hurt by drugs.  And it’s a good fear to have.  Dangerous and tragic events happen far more often as the result of use of drugs, including alcohol and tobacco, than from more familiar dangers such as disease and infection.

The threat from drugs is also quite insidious, and makes everyone feel helpless in the face of real dangers.  It’s insidious because young adolescents and adults typically use drugs in settings unknown to parents.  We feel helpless because so many millions of young people are using drugs and so many millions get hooked, causing deep harm to themselves and all who love them, all without much ability on our part to keep the tragedies from happening.

So it was very good news in 2018 to find that trends are pointing to our kids using drugs less often, quite a bit less often.

This makes the one serious exception to this good news actually excruciating to see happen, the sudden bolt of use of nicotine, perhaps the most addictive of all drugs used.

First, the Good News

There are two items to share here.

The first is that overall drug use has consistently dropped from 1974 to 2014.  The AAP published an article in Pediatrics in August 2018 that presented the following observations:  https://tinyurl.com/ybq5fsd9

  • Over the last 40 years the numbers of high school seniors not using drugs, any drugs, ever, increased five-fold
  • Alcohol use by adolescents has dropped dramatically over the last 38 years
  • Tobacco use (see below for more on this) has dropped dramatically over the last 20 years
  • Illegal drugs including marijuana use has not seen a big drop, even a very slight increase, over time.
  • Girls use drugs more frequently than boys, about 25% more likely over this time period.
  • If we divide by color, those classified in the US as white use drugs more frequently than those classified in the US as black, about 50% more likely over this time period.
  • Being religious makes you 40% less likely to use drugs
  • Higher education has no impact on the chance of using drugs, and therefore, neither does not having an education
  • Of the suburban, urban, and rural areas of the US, the suburban area is the scene of the highest chance of drug use, with urban areas 9% less likely, and rural areas 18% less likely to use drugs over this time period.

Secondly, and related to the above data, this generation of high schoolers once was the first to see a really substantial drop in the use of nicotine and tobacco.  For many decades about 25% of high schoolers graduated smoking, that is, essentially addicted to nicotine for the rest of their lives.

After decades of effort, and billions of PR spent, that number finally began to budge, with the latest figures showing that only 17% of graduates smoke, and that number dropping rapidly.

Now the Catastrophe

Just when the nation could look forward to a day when our children would no longer be addicted to nicotine, when so many years of national and local effort were paying off, I think we were all amazed to see high school students suddenly embrace the use of nicotine in droves.

A word on nicotine.  For most drugs, like alcohol, heroin, cocaine, if about 100 people use them regularly, about 10 in those 100 will develop very deep and potentially lifelong addictions to those drugs.  For nicotine, that number is 33.  That’s right, the drug nicotine leads to addiction about 3 times more than any other, and it is a very, very tight addiction, most people get hooked for life.

Using nicotine is bad, it can and often does, kill you over time.  How so- in two big ways:

  1. Nicotine raises your blood pressure, which makes it more likely you will die of a heart attack or stroke.
  2. Once you are hooked on nicotine, you are far, far, far,  more likely to use tobacco which adds the deadly risk of cancer.

You might ask, knowing that nicotine is highly addictive, that regular use of nicotine can kill you, and that it took 50 years to start to get kids off use of nicotine, why would a company make a device to hook kids on nicotine?

There is no good answer, the only one I can imagine is to get rich at the cost of our children’s lives.

The product that is addicting our kids to nicotine is the nicotine vape.  Vape of course refers to the fact that all these devices work by dissolving nicotine in a little pod of oil, then heating the oil to make a vapor (hence vape), that is then inhaled.  There are many brands including names like V2, Aspire, Halo, and Juul.

The companies making nicotine vapes are very clever.  The pods with nicotine they heat contain no tobacco plant material and so cannot cause cancer.

So, for a group of 55 year old guys who smoke cigarettes, switching to an e-cigarette, or nicotine vape device, does in fact drop the chances of coming down with cancer, and since the person is already hooked on nicotine, does nothing to increase the chance of getting addicted or dying of heart disease or stroke.

I have heard these companies celebrate their product as a great advance in health, so much safer than tobacco.

That may be true if you are a 55 year old person long addicted to cigarettes, but it is not true for our kids.

Our kids were about to embrace a life without being addicted to nicotine, and now these companies have rolled out their multi-million dollar campaigns to push their drug, nicotine, in high schools across the country, and our kids have been allured into buying them.

Nicotine vaping is now all the rage, mainly in suburban high schools, much less so in urban high schools.  One very well off private high school in suburban Cleveland has seen an epidemic of freshmen using nicotine vape devices, not so much in upperclasspeople.  The point here is that the companies pushing nicotine have hit fertile ground and fooled millions of young high school students very recently.  The catastrophe is happening right now.

Why a catastrophe?

  1. Because nicotine hooks people for life, up to about a third of our children goofing around with use of Juuls and other nicotine vaping devices, will confront a lifetime of nicotine addiction.
  2. The amount of nicotine in a vaping device is shockingly large.  The Juul brand boasts the same amount of nicotine in one of their vaping pods equal to the amount of nicotine in a whole pack of cigarettes.
  3. Taking in about a pack’s worth of nicotine a day is a truly excellent way to addict someone to nicotine.
  4. Once addicted, a person often struggles their entire life to stop using nicotine.  And once that happens, even if that child, over the next 40 years never moves on to cigarettes to get their nicotine, will face a greater chance of dying of a heart attack or of a stroke.
  5. Once addicted, some of the millions in the process right now of being hooked on nicotine for many decades, will move to using cigarettes, and then will face a sharply increased chance of dying of cancer.
  6. The oil in some brands’ nicotine pods contains an oil called diacetyl.  Diacetyl, when heated into a mist, and inhaled, dissolves tissues of the lung causing emphysema.  When you dissolve the walls between the tiny air sacs of the lungs, the lung turns into a sponge of big air sacs, too big to get oxygen into the blood, giving the child a lifetime of crippling emphysema, a special type called popcorn emphysema.  A study from Harvard found that 75% of nicotine vaping device brands have diacetyl in them.  https://news.harvard.edu/gazette/story/2015/12/chemical-flavorings-found-in-e-cigarettes-linked-to-lung-disease/

So we have companies, knowing each of these 6 points above, and, knowing that a generation was emerging that was for the first time escape the addiction of nicotine, knowingly crafting a clever device to hook a new generation.  The catastrophe is that they have succeeded on a very, very large scale.



  1. Nicotine is a highly addictive drug, millions of adults spend their lives trying to stop using it.
  2. This generation of our high school students were showing signs of really dropping the numbers of kids using nicotine, reducing the number of our children who would face a lifetime of struggle against nicotine addiction.
  3. Purely as a result of a decision of nicotine vape device companies, many millions of our high school children are right now getting hooked on nicotine, about 1/3 of them for life.  They face greater risk of death from heart disease or stroke.  
  4. Some number of them using devices containing diacetyl may develop popcorn emphysema, and experience crippling lung disease for life.
  5. The companies that sell nicotine vaping devices pitch their brand as saving lives by getting older smokers off cigarettes, a nice action not available to our kids.  For them the vaping device does not help.  It does not reduce disease risk, it creates a lifelong nicotine addiction, giving their customers heart attacks and strokes, and greatly increasing the chance they will use cigarettes, and thereby, cancer.
  6.  This eruption of nicotine addiction comes at an incredibly tragic time, right when we see the use of all drugs, including nicotine, dropping over the last 40 years.   
  7.  Lastly, it is notable that after 50 years of the War on Drugs, most drugs turn out to be used by suburban white youth, not where the war has been waged.


Families and our children have done an excellent job moving away from drug use.  Now come the nicotine vaping industry, with large resources to deny us the safety of our children, and dare to hook a generation on nicotine right when we were about to win this battle for the lives of our children.

We need all we can to keep our children from playing with nicotine.

To your health,
Dr. Arthur Lavin



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