The Food and Drug Administration conducted a surprise inspection of Juul Labs Inc.’s headquarters in San Francisco last week. U.S. health officials are trying to combat what they call a harmful and surging health epidemic as e-cigarette use rises amongst teens.

According to the Wall Street Journal, FDA inspectors collected more than a thousand pages of documents at the e-cigarette startup offices to investigate their sales and marketing practices. The FDA claims the company is targeting youth, with their bright colors, flavored liquids and inconspicuous packaging design.

Juul Chief Executive Kevin Burns said, “We want to be part of the solution in preventing underage use.” Burns says the company is cooperating with the FDA.

The use of Juul and other e-cigarettes is “especially dangerous among youth because these products contain extremely high levels of nicotine, which can harm the developing brain,” said Corrine Graffunder, director of CDC’s Office on Smoking and Health.

Wall Street Journal reported that Juul sold 16.2 million devices last year, up from 2.2 million in 2016. The number of high school students using e-cigarettes has is now at about 3 million, or about 20% of high school students. That number rose 30% in just the past month.

Cyber Safety Cop, a member of the WebSafety team, published an incredible resource for families to understand and help their teens steer clear of this growing problem of underage usage and e-cigarette sales.

He’s laid out several ways to start a conversation with your child about vaping, how to monitor your child’s social media and internet purchases to protect them and more information about the e-cigarette industry.

How to talk to your child about vaping

The following are talking points to include in a discussion you should have with your child about smoking vaping devices and other tobacco products.

1. Nicotine is addictive and harmful. JUUL, Soren, Phix, and other similar contain nicotine.

“The effects include the release of epinephrine, which is like adrenaline, and activates the sympathetic nervous system, the so-called flight-or-fight system,” said Dr. Robert Millman, an addiction expert at New York-Presbyterian Hospital/Weill Cornell Medical Center. “It raises the heart rate, increases blood pressure, increases cardiac output and constricts blood vessels. All those things lead to long-term hypertension and heart diseases like congestive heart failure and arrhythmias.”

“The dangers of nicotine may not relate so much to cancer of the lung,” which is tied to tars and other cigarette residues, explained Dr. Millman, the Saul P. Steinberg Distinguished Professor of Psychiatry and Public Health, “but it does relate to heart attacks and cardiovascular accidents, or strokes.”

It is hard to separate the highly addictive drug nicotine from the very efficient delivery system embodied in the JUUL.

“Rapidly acting drugs are generally more addictive than those that act more slowly,” Dr. Millman said. “The effects are felt almost instantaneously and wear off quickly, powerfully reinforcing the tendency to want to do it again and again and again.”

A tolerance also develops, so that more and more of the drug is needed to get the same effect, he said, and then there is the withdrawal syndrome, which with nicotine is associated with psychological problems like depression.

The teen years are critical for brain development, which continues into young adulthood. Young people who use nicotine products in any form, including e-cigarettes, are uniquely at risk for long-lasting effects. Because nicotine affects the development of the brain’s reward system, continued e-cigarette use can not only lead to nicotine addiction, but it also can make other drugs such as cocaine and methamphetamine more pleasurable to a teen’s developing brain.

Nicotine also affects the development of brain circuits that control attention and learning. Other risks include mood disorders and permanent problems with impulse control—failure to fight an urge or impulse that may harm oneself or others.

2. Smoking vaping devices increases the likelihood of smoking cigarettes in the future.

A major national study on electronic cigarettes reportedly finds evidence that vaping can lead to nicotine addiction and may prompt teenagers to switch to cigarette smoking.

A CDC study found in 2016 that among e-cigarette users ages 18 to 24, 40 percent had never smoked a cigarette before taking up vaping. The study found that the majority of e-cigarette users overall also smoked cigarettes.

3. It is not harmless water vapor.

Dr. Ana Navas-Acien, a professor of environmental health sciences at the Mailman School of Public Health at Columbia University, recently released a study measuring metal levels in this aerosol.

The research found chromium, nickel, zinc and lead, Navas-Acien said. “Comparing what was initially in the liquid, that was very, very tiny amount (of lead) practically undetectable. But after the e-liquid was heated through the e-cigarette device, lead levels were then 25 times higher,” she said. “There is no safe level of lead.” Without standard regulations requiring uniform warning labels, people aren’t always fully aware of what they’re consuming.

What parents can do to protect their children

1. Monitor your child’s social media.

Every part of your child’s life intersects in their social media. It is imperative that parents engage in their child’s digital world. Here are some suggestions on how to do that:

  • Attend a Cyber Safety Cop parent seminar near you to learn about what is going on in your child’s digital world and practical steps to make them safe.
  • Follow the parenting plan outlined in Parenting in the Digital World: A Step-by-Step Guide to Internet Safety.
  • Use to filter inappropriate website from being accessed on your home internet connection.
  • Know all of your child’s usernames and passwords to their phone and all of their online accounts.
  • Log in to your child’s email account and search for online purchases
  • Using your child’s username and password, log in to their social media accounts, like Instagram, as them on your phone.
  • Install a parental control and notification app on your child’s device like WebSafety.
  • Charge your child’s mobile devices in your room at night.

2. Prevent your child from purchasing vaping devices from online stores

  • Protect your computer’s password.
  • Protect your credit card number. Check your statement for online purchases.
  • Do not give VISA gift cards to your child.
  • Get notifications of package deliveries by signing up for UPS My Choice, FedEx Delivery Manager, and USPS Informed Delivery.

More about the e-cigarette industry

What is a JUUL, Soren, or Phix?

In just two years on the market, JUUL, a new type of e-cigarette, has become so popular among young people that it has already amassed nearly half of the e-cigarette market share. The product’s quick rise in popularity prompted The Boston Globe to call it “the most widespread phenomenon you’ve likely never heard of.” In addition to the JUUL, other popular vaping devices are constantly appearing on the market, including the Soren and  Phix devices.

How do the JUUL and similar devices work?

JUUL devices heat up a cartridge containing oils to create vapor, which quickly dissolves into the air. The device is small enough to fit in a closed fist and has a sleek, tech-inspired design that resembles a USB flash drive. While its manufacturer says that JUUL is only for adults, it comes in flavors — including mint, mango and crème brulee — which are proven to appeal to young people and facilitate initiation of tobacco product use. A single JUUL cartridge is roughly equal to a pack of cigarettes, or 200 cigarette puffs.