US Adults' Perceptions About the Harms of Nicotine in Electronic Vapor Products on the Adolescent Brain, United States, 2016–2017

Henraya McGruder, PhD, MS; Kimp Walton, MS; Saida Sharapova, MD, MPH; Brian A. King, PhD, MPH


Prev Chronic Dis. 2020;17(3):e27 

In This Article


We found that approximately two-thirds of adults in the United States agree that nicotine in EVP is harmful to the developing adolescent brain. However, variations in agreement exist across subpopulations, with lower prevalence among current and former smokers and e-cigarette users.

In 2016, the Surgeon General concluded that the use of products containing nicotine in any form among youth, including in e-cigarettes, is unsafe.[2] At that time, the Surgeon General released a Public Service Announcement warning about these risks.[5] Subsequently, several states and communities developed educational and media materials to reflect the growing body of scientific evidence on this issue.[6] Such information is important given that current e-cigarette use increased 78% among US high school students during 2017–2018 alone;[7] this increase was likely because of the recent popularity of newer e-cigarettes such as JUUL, which can be used discreetly, have a high nicotine content, and come in youth appealing flavors.[4]

Prevalence of agreement varied between 2016 and 2017, both overall and across subpopulations. This difference could be due to multiple factors, including differences in exposure to media campaigns and education about the risks of nicotine among youth, or differences in respondent characteristics or sample size between the 2 surveys.

This study has limitations. First, the survey was internet-based and may not be fully representative of the US adult population; however, data were weighted to US Current Population survey proportions. Second, data were self-reported, which could lead to recall bias.

In conclusion, about one-third of adults do not agree that nicotine harms the developing brain, which continues to develop through adolescence and into young adulthood.[4] Continued efforts are warranted at the national, state, and local levels to educate the public about the risks of EVP use among youth, specifically related to the risks of nicotine exposure.[2–4]