New Decade: “New” Devices for “Old” Drugs

One of the biggest changes in the past few years concerning adolescent substance use is not a new substance but a new way to deliver existing ones. This article reviews e-cigarettes and how they are changing the use and abuse of nicotine and THC and discusses the latest knowledge of the effects of these substances upon adolescents. Concurrent trends in the increased potency and legality of marijuana in the USA are discussed as well as suggestions for how to proactively work with adolescents around the issue of substance use. “Vaping” is changing the usage patterns of nicotine and marijuana, exposing youth to new dosages and potential effects. Increased nicotine and THC exposure is erasing public health gains, leading to new drug-related syndromes (hyperemesis syndrome, acute exogenous lipoid pneumonia) and mental health effects. More research is needed with respect to long-term effects.