The Fight Against Teen Vaping 

Alexa Addison remembers what vapes—also known as e-cigarettes—looked like when she was in high school. Many of them were slim black rectangles with sharp corners, resembling flash drives.

By the time Addison, now 19, started college in North Carolina in 2022, however, vapes had had a makeover. Many of her classmates were using Elf Bars. These brightly colored e-cigarettes look like AirPods cases. But the playful packaging masks what is hidden inside: nicotine, a dangerous and highly addictive substance that can damage the brain and lungs. 

Addison bought sweet and fruity flavors like strawberry-kiwi. She took selfies when the vapes matched her outfits. Before long, she was going through an Elf Bar a week. During a period of intense use, her gums turned gray, she says. Still, the devices—which young people often say look like candy, lip gloss, or fun soap—kept her vaping.

“They looked really pretty, honestly,” Addison says. “I just never had an interest in vaping until the pretty ones started being sold.”

Alexa Addison, 19, remembers what vapes looked like when she was in high school. Vapes are also known as e-cigarettes. Many of them were slim black rectangles with sharp corners. They resembled flash drives.

In 2022, Addison started college in North Carolina. By then, vapes had had a makeover. Many of her classmates were using Elf Bars. These brightly colored e-cigarettes look like AirPods cases. But the playful packaging masks what is hidden inside: nicotine. That is a dangerous and highly addictive substance. It can damage the brain and lungs. 

Addison bought sweet and fruity flavors like strawberry-kiwi. She took selfies when the vapes matched her outfits. Soon she was going through an Elf Bar a week. She says her gums turned gray during a period of intense use. Yet the devices kept her vaping.

Young people often say vapes look like candy, lip gloss, or fun soap. “They looked really pretty, honestly,” Addison says. “I just never had an interest in vaping until the pretty ones started being sold.”

Addison isn’t the only one being drawn in. While e-cigarette use among teens has declined overall since 2019, use of the newer, flavored devices is on the rise. About 1 in 10 high school students and 1 in 20 middle school students used an e-cigarette in the previous month, according to the 2023 National Youth Tobacco Survey. 

Doctors say that’s troubling. Research shows that teens—whose brains are still developing—become addicted to nicotine more easily than adults do. And one Elf Bar has as much nicotine as 590 traditional cigarettes, according to a study by Stanford University in California. 

It’s illegal for people under 21 to buy cigarette products in the first place. And to top it off, the vast majority of the estimated 11,500 vaping products for sale are not authorized by the U.S. Food and Drug Administration (FDA). The FDA is a federal agency whose job it is to ensure that products for sale—such as food and cosmetics—are safe to use. Several e-cigarette brands, including Elf Bars, have been banned from being imported to the United States at all. 

So why are these tempting products still on store shelves—and getting into the hands of young people? 

Addison is not the only one being drawn in. Since 2019, e-cigarette use among teens has gone down overall. But use of the newer, flavored devices is on the rise. About 1 in 10 high school students and 1 in 20 middle school students used an e-cigarette in the previous month. That is according to the 2023 National Youth Tobacco Survey. 

Doctors say that is troubling. Teens’ brains are still developing. Research shows that teens become addicted to nicotine more easily than adults do. And one Elf Bar has as much nicotine as 590 traditional cigarettes. That is according to a study by Stanford University in California. 

It is illegal for people under 21 to buy cigarette products in the first place. And most of the estimated 11,500 vaping products for sale are not authorized by the U.S. Food and Drug Administration (FDA). The FDA is a federal agency whose job it is to ensure that products for sale are safe to use. That includes food and cosmetics. Several e-cigarette brands, including Elf Bars, have been banned from being imported to the United States at all.

So why are these tempting products still on store shelves? And why are they getting into the hands of young people? 

Most U.S. states began restricting how cigarette companies market their products to kids and teens in 1998. Decades of research had shown that the tobacco in cigarettes carries significant health risks. Tobacco is made up of thousands of toxic chemicals, some of which can cause cancer.

E-cigarettes, which were invented about 20 years ago, do not contain tobacco. Some companies have marketed them as a safe alternative to cigarettes as a result. But, like cigarettes, they do contain nicotine. And though the research is ongoing, what experts do know so far is alarming. Studies have found that vaping may be linked to lung disease.

That hasn’t stopped cigarette companies from trying to appeal to kids and teens, though (see “The Government vs. Big Tobacco,” below). The companies want lifelong customers, so they try to attract new users when they are young, experts say. Today’s colorful and trendy e-cigarettes are yet another attempt to win over teens, according to everyone from lawmakers to anti-smoking groups.

In 1998, most U.S. states began to restrict how cigarette companies market their products to kids and teens. Decades of research had shown that the tobacco in cigarettes carries serious health risks. Tobacco is made up of thousands of toxic chemicals. Some of them can cause cancer.

E-cigarettes were invented about 20 years ago. They do not contain tobacco. So some companies have marketed them as a safe alternative to cigarettes. But, like cigarettes, they do contain nicotine. Research is ongoing. But what experts do know so far is alarming. Studies have found that vaping may be linked to lung disease.

That has not stopped cigarette companies from trying to appeal to kids and teens (see “The Government vs. Big Tobacco,” below). The companies want lifelong customers. So they try to attract new users when they are young, experts say. Today’s colorful and trendy e-cigarettes are yet another attempt to win over teens. That is according to everyone from lawmakers to anti-smoking groups.

There is “no question” that the latest vapes are designed to catch the eyes of young people, who are drawn toward bright colors and rounded shapes, says Susan Linn. She is a professor at Harvard Medical School in Massachusetts.

“Tobacco companies use cartoons or brightly colored packaging in order to hook kids, to make kids think that this is fun and harmless,” she says.

The appealing flavors are another pull for teens. With names like Banana Cake and Watermelon Bubblegum, Elf Bar was the leading e-cigarette brand this past summer among middle- and high-school students who vape, according to the 2023 National Youth Tobacco Survey.

“If it looks glamorous and it looks appealing, that’s going to be the first driver that will bring a horse to water,” says Brian King, head of the FDA’s tobacco center. “The flavors then get them to drink. And the nicotine keeps them coming back for more.”

The company that manufactures Elf Bar—iMiracle Shenzhen Technology—says it markets to adults. Representatives for the company point out that their products carry the required warning label that nicotine is addictive. 

There is “no question” that the latest vapes are designed to catch the eyes of young people. They are drawn toward bright colors and rounded shapes, says Susan Linn. She is a professor at Harvard Medical School in Massachusetts.

“Tobacco companies use cartoons or brightly colored packaging in order to hook kids, to make kids think that this is fun and harmless,” she says.

The appealing flavors are another pull for teens. Elf Bar flavors have names like Banana Cake and Watermelon Bubblegum. Elf Bar was the leading e-cigarette brand this past summer among middle and high school students who vape. That is according to the 2023 National Youth Tobacco Survey.

“If it looks glamorous and it looks appealing, that’s going to be the first driver that will bring a horse to water,” says Brian King. He is head of the FDA’s tobacco center. “The flavors then get them to drink. And the nicotine keeps them coming back for more.”

The company that makes Elf Bar is iMiracle Shenzhen Technology. It says it markets to adults. And representatives for the company point out that its products carry the required warning label that nicotine is addictive. 

The FDA banned Elf Bar and a few other brands this past summer because of their appeal to teens and kids. Still, finding the products isn’t hard. Shelves in convenience stores, gas stations, and other businesses across the nation are lined with thousands of vapes in bright colors and fun flavors. What’s going on?

Many e-cigarettes that wind up in the U.S. are imported illegally from China. There is high demand—vapes generated $8.3 billion of revenue in the U.S. last year alone. So companies find creative ways to get their products into the country.

When the FDA bans imports of something, it directs U.S. Customs and Border Protection officials to seize incoming shipments. But tens of thousands of shipping containers full of various products arrive daily at U.S. ports. It is impossible for inspectors to check them all. What’s more, some vape shipments are labeled as shoes, toys, or other items.

Another tactic is to quickly rename banned products. Elf Bar now also goes by at least two other names. One of those products is still allowed entry into the U.S.

Meanwhile, new vaping products continue to pour into the country.

This past summer, the FDA banned Elf Bar and a few other brands because of their appeal to teens and kids. Still, it is not hard to find the products. Shelves in convenience stores, gas stations, and other businesses across the nation are lined with thousands of vapes in bright colors and fun flavors. What is going on?

Many e-cigarettes that wind up in the U.S. are imported illegally from China. There is high demand for them: Vapes generated $8.3 billion of revenue in the U.S. last year alone. So companies find creative ways to get their products into the country.

When the FDA bans imports of something, it directs U.S. Customs and Border Protection officials to seize incoming shipments. But tens of thousands of shipping containers arrive daily at U.S. ports. They are full of various products. It is impossible for inspectors to check them all. And some vape shipments are labeled as shoes, toys, or other items.

Another tactic is to quickly rename banned products. Elf Bar now also goes by at least two other names. One of those products is still allowed entry into the U.S.

Meanwhile, new vaping products continue to pour into the country.

Because the FDA’s authority to target foreign companies is limited, it has focused on businesses in the U.S. Last year, the agency sent hundreds of warning letters to gas stations and convenience stores. It ordered them to stop selling unauthorized vapes. (There are only about two dozen FDA-authorized brands of e-cigarettes on the market today. None of them are flavored.) The FDA has also issued dozens of fines totaling about $20,000 each to stores that did not comply with the order.

Parents, anti-smoking groups, and lawmakers are calling for even stronger action to address underage vaping. Some states are taking matters into their own hands. California and Massachusetts have barred the sale of all flavored tobacco products, and other states are considering similar bans.

Young people are stepping up too. Many are spreading the word about kicking the habit, and a number of groups are helping them do it. One national organization, Truth Initiative, offers a free text-messaging program to coach teens through the process of quitting.

The FDA has limited authority to target foreign companies. So it has focused on businesses in the U.S. Last year, the agency sent hundreds of warning letters to gas stations and convenience stores. It ordered them to stop selling unauthorized vapes. (Only about two dozen FDA-authorized brands of e-cigarettes are on the market today. None of them are flavored.) The FDA has also issued dozens of fines totaling about $20,000 each to stores that did not obey the order.

Parents, anti-smoking groups, and lawmakers are calling for even stronger action to deal with underage vaping. Some states are taking matters into their own hands. California and Massachusetts have barred the sale of all flavored tobacco products. Other states are considering similar bans.

Young people are stepping up too. Many are spreading the word about kicking the habit. And a number of groups are helping them. One national organization is called Truth Initiative. It offers a free text-messaging program to coach teens through the process of quitting.