FDA clears fruit-flavored vapes as 1.63 million kids use e-cigarettes, and doctors warn of a rebound

The Food and Drug Administration's decision to authorize some fruit-flavored e-cigarettes for adults comes at a particularly tense moment. 

While youth vaping has fallen from earlier highs, 1.63 million U.S. middle and high school students still reported using e-cigarettes in 2024.

That has some doctors warning that the move could make it harder to keep that progress from slipping.

What's happening?

In the latest federal survey, e-cigarette use was reported by a little under 6% of U.S. middle and high school students in 2024. Flavors still dominate among teens, with The Associated Press reporting that nearly 9 out of 10 young users choose them.

The FDA's action has drawn concern because it marks the agency's first authorization of fruit-flavored vapes for adults seeking to quit or cut back on traditional cigarettes. 

In a memo released this week, the agency said those fruit-flavored products do not appear meaningfully more effective at helping smokers quit than tobacco-flavored e-cigarettes.

"I understand the goal of giving adult smokers a less harmful off-ramp, but fruit and sweet flavors are precisely what draw young people in," said Dr. Scott Hadland at Mass General Brigham for Children and Harvard Medical School. "I worry this could erode the hard-won progress that brought teen vaping to its lowest level in roughly a decade."

For teens like Ricky Resendez, that appeal was easy to see firsthand.

"It was just kind of normal," said Ricky, a 17-year-old recent graduate in Superior, Wisconsin. "Kids were vaping in class, in the bathrooms, wherever."

Why does it matter?

Clinicians say nicotine can be especially harmful during adolescence because the brain is still developing, affecting attention, learning, and mood.

Dr. Devika Rao, who treats young patients with vaping-related breathing problems, said, "The addiction factor cannot be overstated enough. Adolescent brains are primed for addiction."

Former teen users have also described the physical toll.

Gaby Cuadra, who started vaping at 15, said it hurt her athletic performance.

"As the years kept going on and I would keep vaping, the distances that I used to be able to run, I, like, couldn't do them anymore," she recounted. "I would run out of breath."

There is also a broader public health cost beyond nicotine exposure. Disposable vapes add to the growing stream of single-use plastics, toxic e-waste, and improperly discarded lithium batteries, creating additional hazards in homes, schools, and communities.

What can I do?

Parents are encouraged to respond with steady, open conversations instead of punishment or panic.

Rao's advice is simple: "Start open-ended conversations." She suggests asking what a child has heard about vaping, whether they've encountered it at school, and whether their friends are using it.

If a teen is already vaping, doctors recommend keeping the approach nonjudgmental and centered on support.

Ricky said what helped him was understanding his triggers and breaking the cycle. "What I didn't realize is that because I was addicted to nicotine, when I didn't have it, I'd be anxious and really couldn't focus," he said. "Instead of being something that helped me, it just made things worse."

Parents can also involve a doctor, who may connect teens with counseling or free text-based quit programs. For heavier users, supervised options can include nicotine replacement therapy or medications such as Chantix.

Programs like the American Lung Association's Not On Tobacco and the Truth Initiative and Mayo Clinic's EX program were also cited as tools that can help young people quit.

"The best thing I ever did for myself was quit vaping," Cuadra said.

Ricky now tells peers, "I'm not here to judge you," and adds, "I'm here to help you."

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