The Rapid Spread of E-cigarettes among Teenagers: Faster, Stronger Addiction

The sweet scent of e-cigarettes hides a growing risk of addiction among teenagers. To understand its causes, dangers, and possible solutions, ST spoke with Dr.Won Jong-ha of Inje University.…….Ed

     As the number of e-cigarette users worldwide surpasses 100 million, concerns are mounting over the declining age at which nicotine addiction begins. According to the 2024 Youth Health Behavior Survey conducted by the Korea Disease Control and Prevention Agency (KDCA), the overall youth smoking rate in Korea fell from 4.4% in 2020 to 3.6% in 2024. However, the use of liquid-type e-cigarettes increased from 1.9% to 3.0% during the same period. Notably, 69.5% of teenage smokers started with flavored tobacco products, and many had used liquid-type e-cigarettes

      Tobacco products can be categorized into three main types: traditional cigarettes, heat-not-burn tobacco, and liquid-type e-cigarettes. Traditional cigarettes are made by processing and burning tobacco leaves, while heat-not-burn products vaporize nicotine by heating rather than burning tobacco. Liquid-type e-cigarettes, on the other hand, use vaporized nicotine solutions, often containing synthetic nicotine. Since synthetic nicotine is not legally defined as tobacco under the current Tobacco Business Act (as of October 13, 2025), it has been exempt from taxes and regulations. Consequently, these products have been sold near schools and even through vending machines, becoming a primary gateway to smoking for many teenagers.

     A bill to amend the Tobacco Business Act has been introduced in the National Assembly to regulate synthetic nicotine in the same way as traditional tobacco. If passed, the legal definition of tobacco will expand to include “tobacco or nicotine,” thereby subjecting synthetic nicotine products to existing regulations. However, some e-cigarette industry groups continue to oppose the bill, citing the unique challenges of regulating unmanned 24-hour e-cigarette stores. Even with age verification systems, forged IDs make it easy for minors to gain access, and there are currently no measures to restrict entry to such stores.

     Even if the legislation passes, the issue of teenage e-cigarette use remains a pressing social concern. ST spoke with Dr. Won Jong-ha, Director of the Smoking Cessation Education Research Institute at Inje University, to discuss the causes, risks, and solutions surrounding this problem.

1. ST: What are the main social or psychological factors that lead teenagers to start using e-cigarettes? Dr. Won: Based on our interviews with teenage smokers, the most common factor is stress—stemming from academics, peer relationships, or family conflicts. Many adolescents begin smoking as a coping mechanism. Particularly concerning cases involve teens who run away from home due to family issues and engage in smoking as part of rebellious peer culture. 

2. ST: Some claim that e-cigarettes are less harmful than traditional tobacco. What is your expert opinion? Dr. Won: That belief is a misconception fueled by marketing. While e-cigarettes do not contain tobacco leaves, they often have higher nicotine concentrations and appealing flavors, making them potentially more addictive than traditional cigarettes. In fact, many adolescents who start with e-cigarettes eventually use heat-not-burn or regular cigarettes as well.

3. ST: How does e-cigarette use affect adolescent brain development and learning ability? Dr. Won: E-cigarettes and adolescence form a particularly dangerous combination. Because e-cigarettes deliver higher doses of nicotine and come in various flavors, they can lead to addiction more quickly than conventional tobacco. For adolescents, nicotine exposure can severely damage the prefrontal cortex—responsible for decision-making and impulse control—causing lasting cognitive impairment. Moreover, many young users underestimate the risks because they do not perceive e-cigarettes as real cigarettes, making quitting even harder.

4. ST: What policies or legal measures currently exist to regulate or prevent teenage e-cigarette use in Korea? Dr. Won: In Gimhae, where our research institute is based, local authorities recently revised the city’s anti-smoking ordinance. The new provisions extend smoke-free zones to large public facilities with a total floor area of over 5,000㎡ if requested by owners or tenants. Street smoking restrictions have also been introduced to reduce passive smoking exposure. Additionally, citizens who successfully quit smoking can now receive gift certificates as an incentive. According to Huh Mok, Director of the Gimhae City Health Center, “These measures establish a meaningful and practical framework to protect public health.”

5. ST: What are the most effective approaches to preventing teenage e-cigarette use? Dr. Won: When we work with teenage smokers, we do not simply lecture them about health risks. Instead, we begin by listening to their stories—their family situations, friendships, and emotional challenges. Only after building trust do we begin education about smoking. This psychosocial approach has proven far more effective than traditional health-centered programs in helping teenagers maintain long-term abstinence.

6. ST: What message would you like to convey to parents and educators? Dr. Won: We emphasize parental education alongside youth programs. During the COVID-19 pandemic, families spent more time indoors, and parental smoking at home exposed children to secondhand smoke, sometimes leading them to experiment with smoking themselves. Parents must set an example by quitting smoking and maintaining a smoke-free home environment to instill awareness and responsibility in their children.

7. ST: Finally, what would you like to say directly to teenagers who currently use e-cigarettes? Dr. Won: I want to remind them: “E-cigarettes are still cigarettes.” They contain nicotine, often in higher concentrations than regular tobacco, and can easily become the starting point of addiction. Please be cautious and aware of the risks.

Dr. Won also expressed both pride and responsibility in conducting research on youth smoking in Korea. He emphasized the urgent need for stronger government regulations on unmanned 24-hour e-cigarette stores, which have become a major source of illegal sales to minors.

Kim Min-ju (Planning Editor)

Minjukim900@soongsil.ac.k