By Dr Khutso N. Sebetseba — Paediatrician | Pocket Paediatrics with Dr K
Most parents know what cigarettes smell like.
Many would not recognise a vape in their teenager’s school bag.
That is part of the problem.
Over the past few years, vaping has become increasingly normalised among adolescents. Sleek devices, sweet flavours, discreet packaging, and social media influence have all contributed to the perception that vaping is “cleaner,” safer, or somehow less harmful than smoking.
For many teenagers, it no longer even feels like smoking.
Yet clinicians, parents, and schools are beginning to see the consequences more clearly.
A growing adolescent health concern
While long-term data on vaping is still emerging, what we do know is concerning.
Most vape products contain nicotine, often in high concentrations. Nicotine exposure during adolescence affects the developing brain, particularly areas involved in:
- attention
- impulse control
- mood regulation
- reward processing
Adolescents are also more vulnerable to developing nicotine dependence than adults.
This is important because many teenagers who vape do not actually realise they are consuming significant amounts of nicotine. Disposable devices and flavoured products are frequently marketed in ways that minimise perceived risk.
In practice, many teenagers view vaping as:
- “just flavour”
- stress relief
- socially acceptable
- safer than cigarettes
The reality is more complicated.
What clinicians and parents are noticing
In clinical settings, vaping is increasingly entering conversations around:
- chronic cough
- throat irritation
- headaches
- poor sleep
- anxiety
- decreased exercise tolerance
difficulty concentrating
Not every symptom is directly caused by vaping, but patterns are becoming harder to ignore.
There is also growing concern about the relationship between vaping and adolescent mental health. Teenagers often describe vaping as a way to cope with stress or anxiety, while nicotine itself may worsen irritability, sleep disturbance, and dependency cycles over time.
For parents, one of the biggest challenges is that vaping is easy to miss.
Devices resemble USBs, cosmetics, or pens. Vapour dissipates quickly, and many products have fruity or sweet scents rather than the smell traditionally associated with cigarettes.
The South African reality
South Africa is not immune to global vaping trends.
Schools, parents, and healthcare professionals are increasingly reporting vape use in younger adolescents, sometimes even in early high school years. Accessibility, peer influence, social media exposure, and misconceptions around safety all contribute to the rise.
At the same time, awareness often lags behind behaviour.
Many adults still view vaping as relatively harmless compared to smoking, while teenagers are frequently exposed to online messaging that presents vaping as fashionable, harmless, or even healthy.
So how should we respond?
Conversations around vaping should avoid panic and shame.
Teenagers generally respond poorly to fear-based messaging alone. What they need is honest, informed discussion about:
- addiction
- marketing manipulation
- mental health
- long-term health uncertainty
- social pressure
Parents should aim for curiosity before confrontation.
Questions such as:
- “What are kids saying about vaping at school?”
- “Do people realise these contain nicotine?”
- “What do you think the risks are?”
often open more productive conversations than accusations or punishment.
For clinicians, Youth Month offers an opportunity to routinely ask adolescents about vaping in the same way we ask about sleep, mood, alcohol, or sexual health.
Because increasingly, vaping is part of the adolescent health conversation.
A quieter public health problem
Youth health is no longer shaped only by alcohol and cigarettes. It is also being shaped by newer, quieter habits that often arrive disguised as harmless trends. And while vaping may appear cleaner, more modern, or less dangerous on the surface, the developing adolescent brain and body still pay attention to nicotine; even when the packaging tells a different story.
Sometimes the biggest risks are the ones that no longer look dangerous at all.