Vaping Sends More Costa Rican Teens to the Doctor as New Rules Wait Until 2027

Four out of every 10 medical consultations for vaping-related disorders recorded in Costa Rica last year involved patients between the ages of 10 and 19, according to data from the Costa Rican Social Security Fund (CCSS). Outpatient services logged 5,901 visits for vaping-related disorders in 2025. Of those, 2,438 involved patients in that age group. The figures arrive at a moment when the rules meant to curb the appeal of these products are still more than a year away. A technical regulation limiting nicotine concentrations, flavors, and other characteristics of vaping products will not take effect until August 2027. The Ministry of Health had originally planned for the regulation, published in February, to begin applying this year. In July it postponed implementation by 12 months to “strengthen the technical capabilities needed to enforce it.” The delay was formalized through an executive decree signed by President Laura Fernández and Health Minister Alexander Sánchez. Health authorities said the postponement changes only the effective date and leaves every restriction intact. Once in force, the regulation caps nicotine concentration at 20 milligrams per milliliter, restricts fruit and other flavors and aromas considered attractive to minors, and adds controls on labeling, advertising, promotion, sponsorship, laboratory analysis, and sanitary surveillance. The ministry has said it is acquiring specialized laboratory equipment to analyze the chemical composition of vaping liquids before enforcement begins. Jeancarlo Córdoba, a researcher at the Public Health Observatory of the University of Costa Rica (UCR), said the country maintains robust tobacco regulations but has struggled to keep pace with how fast the market has changed. “Regulations have fallen behind in recent years. This gap is widening as vaping gains ground among adolescents,” Córdoba said. The National Survey on Psychoactive Substance Use Among Secondary School Students found that 12.6% of high school students surveyed had used electronic cigarettes in the previous month. The medical data show a steep climb. In 2024, the CCSS recorded 4,435 outpatient visits for vaping-related disorders. A year later that figure had risen to 5,901, an increase of 33%. The rise was sharper among adolescents. Visits by patients aged 10 to 19 went from 1,702 in 2024 to 2,438 in 2025, a 43% increase. The most recent records continue to show the same pattern. Between January 1 and April 30, 2026, 2,268 people of all ages were treated for vaping-related disorders. Of those, 822 were between 10 and 19 years old. Hospital discharges listing a vaping-related disorder as a primary or secondary diagnosis rose from 11 in 2024 to 17 in 2025. Four such cases were recorded in the first four months of 2026. Among the conditions treated were respiratory symptoms, anxiety, and behavioral disturbances. In severe cases, the CCSS has identified lung injuries associated with the use of electronic cigarettes or vaping devices, a condition known as EVALI. Córdoba said the trend cannot be read simply as young people choosing electronic devices over conventional cigarettes. He linked the increase to how easily the products can be obtained. “What the market offers is availability. The restrictions applied to the traditional cigarette since 2012 reduced the chances of access for minors,” he said. Part of that generation, he added, does not consider the conventional cigarette an option at all. That leaves a gap of roughly 17 months between the current data and the date when the flavor limits, nicotine caps, and packaging rules become enforceable. During that period, the products remain on sale under the existing framework, and the consultations continue to accumulate in a health system that only began recording them in meaningful numbers a few years ago.