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Some e-cigarette chemicals mimic nicotine, possibly bypassing regulation

In contrast, other studies found acute microvascular endothelial dysfunction, increased oxidative stress and arterial stiffness in smokers after exposure to e-cigarettes with nicotine, but not after e-cigarettes without nicotine (reviewed in [20]). In women smokers, a study found a significant difference in stiffness after smoking just one tobacco cigarette, but not after use of e-cigarettes (reviewed in [20]). However, research updates on, and analysis of, the potential health benefits/risks of e-cigarettes are outside the scope of TobaccoTactics. These devices come in a variety of shapes and sizes, as pictured below, with several different names. Some e-cigarettes look like regular cigarettes, but many resemble pens or USB flash drives, and are not recognized as tobacco products. Larger e-cigarettes such as tank systems, or "mods," do not resemble other tobacco products.

He encourages people committed to quitting to try non-inhaled methods such as the nicotine replacement patch or another FDA-approved smoking cessation product, as well as counseling. E-cigarettes are battery-operated devices that convert liquid into aerosol, which is inhaled into the user’s lungs. Typically, the liquid contains addictive nicotine, as well as flavors. More than 10 million adults in the United States use e-cigarettes, and vaping has become especially popular among teenagers.

Vaping can cause eye, throat, and nose irritation, as well as irritation in the respiratory tract. The nicotine in e-cigarettes can cause dizziness and nausea, especially in new users. E-cigarettes contain many of the same toxins as regular cigarettes, but they may have smaller amounts. Some brands also have much less nicotine than regular cigarettes or no nicotine at all. Their brains are still developing and forming the structure and connections necessary for the mature behavior of adulthood.

Conducted from October 2021 to October 2023, the study involved 1,503 adolescents ages from across the United States who reported past 30-day e-cigarette use and were interested in quitting. Compared to a control group, participants who received the interactive text message program were 35% more likely to report not using nicotine at the 7-month study endpoint. Quit rates were 37.8% in the intervention groups compared to 28% in the control group. In North Macedonia, Italy, Malta, Austria, Luxembourg, and Belgium, the age for legal vending is 16. Since January 1, 2007, all cigarette machines in public places in Germany must attempt to verify a customer's age by requiring the insertion of a debit card.

The liquid solution can contain nicotine, flavorings, harmful chemicals, or other substances. Since the early 2000s TTCs have developed interests in e-cigarettes (also known as electronic cigarettes health delivery systems, or ENDS), heated tobacco products (HTPs), snus and nicotine pouches. Companies have referred to these types of product as ‘next generation products’ (NGPs) although terminology changes over time. Finally, the report discusses steps that e-cigarette companies took in 2021 to deter or prevent underage consumers from visiting their websites, signing up for mailing lists and loyalty programs, or buying e-cigarette products online. These steps include the use of online self-certification to verify users were at least 21 years old and following state laws requiring an adult signature upon delivery of e-cigarette products. The 2021 report also provides details on some characteristics of e-cigarette products, including flavors and nicotine concentration, as well as the bundling of the components in cartridge systems.

Some of the research for Tobacco Tactics was funded by Cancer Research UK Limited and Bloomberg Philanthropies. This work has previously received funding from The New Venture Fund, Smokefree South West, and the Economic and Social Research Council (ESRC) Knowledge Exchange Opportunities scheme. These funders have had no input into the research reported on this website or its conclusions. They are not responsible for its content or publication, nor do they necessarily endorse it.

And nicotine use in young adults still can lead to other illicit substance use. The request from the Federal Trade Commission asks six companies to turn over data by January dealing with the sale and promotion of their products for the years 2015 to 2018. In the United States, states are a primary determinant of the total tax rate on cigarettes. As part of the Family Smoking Prevention and Tobacco Control Act, the federal government collects user fees to fund Food and Drug Administration (FDA) regulatory measures over tobacco.

In e-cigarettes, tobacco combustion is replaced by e-liquid heating, leading some manufacturers to propose that e-cigarettes have less harmful respiratory effects than tobacco consumption. Other innovative features such as the adjustment of nicotine content and the choice of pleasant flavours have won over many users. Nevertheless, the safety of e-cigarette consumption and its potential as a smoking cessation method remain controversial due to limited evidence. Moreover, it has been reported that the heating process itself can lead to the formation of new decomposition compounds of questionable toxicity. Numerous in vivo and in vitro studies have been performed to better understand the impact of these new inhalable compounds on human health.

Using e-cigarettes, or "vaping," are terms used synonymously to refer to the use of a wide variety of electronic, battery-operated devices that aerosolize, but do not burn, liquids to release nicotine and other substances. Nicotine-containing e-cigarettes are regulated as "tobacco products" by the FDA because the nicotine is derived from the tobacco plant. E-cigarettes pose a threat to the health of users and the harms are becoming increasingly apparent. In the past few years, the use of these products has increased at an alarming rate among young people in significant part because the newest, re-engineered generation of e-cigarettes more effectively delivers large amounts of nicotine to the brain.

Electronic cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavorings and other chemicals. Richmond-based Altria previously took a $13 billion stake in Juul in 2018, when the brand controlled most of the U.S. vaping market. But Juul’s value plummeted after it was hit with lawsuits and investigations over its role in sparking a national spike in underage vaping.

They found that the amounts of nicotine in the blood were similar between the two groups after 10 minutes of smoking at a constant rate. The flavoring liquid for electronic cigarettes, or e-cigarettes, may increase the risk of cardiovascular disease when inhaled, according to a study led by researchers at the School of Medicine. My reading of the evidence is that smokers who switch to vaping remove almost all the risks smoking poses to their health. Smokers differ in their needs and I would advise them not to give up on e-cigarettes if they do not like the first one they try. It may take some experimentation with different products and e-liquids to find the right one. An expert independent evidence review published today by Public Health England (PHE) concludes that e-cigarettes are significantly less harmful to health than tobacco and have the potential to help smokers quit smoking.

The survey also found that Minnesota youth are ill-informed about the health risks of e-cigarettes with 76.1% of 11th graders saying there is either no, slight, or a moderate risk to using e-cigarettes. 11th grade students responding to the student survey said that the top ways they got e-cigarettes included getting products from friends (72.3%), getting products at a vape shop (14.0%), and on the Internet (9.6%). Among 8th grade students, e-cigarette use nearly doubled from 2016 to 2019, and one in four 11th graders now use e-cigarettes. Students in all grades surveyed now use e-cigarettes and vapes at five times the rate of conventional cigarettes. In Australia, during the survey period, it was not legal to obtain e‑cigarettes containing nicotine without a prescription (TGA 2020).

Many grants on this topic are funded through the Tobacco Regulatory Science Program, an NIH partnership with FDA’s Center for Tobacco Products to fund research to inform FDA’s tobacco regulatory activities. Interestingly, most of these reports linking COVID-19 harmful effects with smoking or vaping, are based on their capability of increasing the expression of angiotensin-converting enzyme 2 (ACE2) in the lung. It is well known that ACE2 is the gate for SARS-CoV-2 entrance to the airways [106] and it is mainly expressed in type 2 alveolar epithelial cells and alveolar macrophages [107]. To date, most of the studies in this field indicate that current smokers have higher expression of ACE2 in the airways (reviewed by [108]) than healthy non-smokers [109, 110]. While tobacco products have been a long-standing public health issue, e-cigarette (aka e-cigs, vape pens, vapes) use has continued to gain popularity throughout the last decade. Poison centers began receiving calls about e-cigarettes and liquid nicotine products in 2010, which overlaps with the initial period where these products reached the U.S. market.

Helping a teen understand what sources to trust can give them a powerful tool to educate themselves. Don’t just tell them that there’s no good reason to start, help them learn why there’s no good reason. Talk about peer pressure, the tricks advertisers use and the importance of health.

Vapes are often viewed and marketed as a safe alternative to smoking. Secondhand smoke can cause heart disease, stroke, and lung cancer in people who don’t smoke. They compared this information against vape and cigarette sales data over four-week intervals from January 2018 through March 2023, a period during which flavor restrictions went from affecting 1.3% of the U.S. population to affecting 38%.

Some public health experts believe that e-cigarettes are an essential alternative to smoking tobacco that can help smokers quit. Others argue that e-cigarettes could be a route into nicotine addiction and point out that their long-term safety has not yet been proven. There are also those that believe that e-cigarettes may offer public health benefits but that e-cigarettes should be regulated, particularly when it comes to the marketing of such products.

Upon entering the blood, nicotine stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, breathing, and heart rate. As with most addictive substances, nicotine activates the brain’s reward circuits and also increases levels of a chemical messenger in the brain called dopamine, which reinforces rewarding behaviors. Pleasure caused by nicotine’s interaction with the reward circuit motivates some people to use nicotine again and again, despite risks to their health and well-being. First PuffsThe current iteration of e-cigarettes was invented and popularized by Chinese pharmacist Hon Lik in 2003 and entered the U.S. market some seven years ago. A federal appeals court ruled in December 2010 that the agency lacked authority over e-cigs because they offer only the recreational benefits of a regular cigarette.

Friday’s action is part of a sweeping FDA review intended to bring scientific scrutiny to the multibillion-dollar vaping market after years of regulatory delays. Currently the U.S. market includes thousands of fruit- and candy-flavored vapes that are technically illegal but are widely available in convenience stores, gas stations and vape shops. Most teens who vape use disposable e-cigarettes, including brands like Elf Bar, which come in flavors such as watermelon and blueberry ice.

When I exhale, the vapor is gone within 10 seconds, along with the smell. Funny how just about 10 years ago people were still allowed to smoke actual cigarettes in some restaurants and I didn’t see anyone walking out on their meal due to the smell coming from the smoking section. I’m not saying it was a wonderful arrangement, but people dealt with it.

Fetal exposure to e-cigarettes can adversely affect the development of the fetus in pregnant women. Exposure to emissions from e-cigarettes also poses risks to bystanders. E-cigarettes may help nonpregnant adults quit smoking cigarettes if they are used as a complete substitute for all smoked tobacco products. However, e-cigarettes are not currently approved by the FDA to help people quit smoking. If you are using e-cigarettes for smoking cessation, it is important to make a plan to quit vaping.

Surgeon General’s recommendation urging those who influence youth, young adults and people who are pregnant to discourage nicotine use in any form, including e-cigarettes. To protect kids now, states and cities must also continue their growing efforts to end the sale of flavored e-cigarettes, as well as other flavored tobacco products. Electronic cigarettes, or e-cigarettes, are part of a category of products called Electronic Smoking Devices (ESDs), which are designed to mimic combustible tobacco cigarettes and, in most cases, contain varying levels of nicotine. Our compassionate providers can help both you and your child understand the dangers of vaping and provide resources that help people quit using tobacco products like e-cigarettes. During this time, the brain is constantly rewiring itself, which makes it far more vulnerable to nicotine addiction. This is part of why teens who vape are nearly three times more likely to begin smoking cigarettes.

Upon the selection of the educational track, students may already have normative perceptions of smoking in vocational schools, such as understanding of smoking as an integral and expected practice in these schools and professions [8]. These perceptions may increase S-SM and other nicotine product use, also among students with better academic performance. Student network characteristics and their associations with smoking vary between schools [28].

In fact, the overall evidence points to e-cigarettes actually helping people to give up smoking tobacco. There is no evidence that e-cigarettes are undermining England’s falling smoking rates. Instead the evidence consistently finds that e-cigarettes are another tool for stopping smoking and in my view smokers should try vaping and vapers should stop smoking entirely. E-cigarettes not only pose substantial health risks to youth and young adults, they pose a significant environmental threat (see the Truth Initiative fact sheet on Tobacco and the Environment). Almost half (49.1%) of young people don’t know what to do with used e-cigarette pods and disposable devices. A second brand of e-cigarettes—marketed as Nixotine, Nixodine, Nixamide and Nic-Safe—contained a nicotine analog called nicotinamide, also at levels lower than the labels indicated, and combined with undisclosed amounts of 6-methyl nicotine.

They found that kids who used e-cigs were more likely than non-users to smoke cigarettes or other tobacco products over the next year. To study the short-term impacts of vaping, the researchers performed MRI exams on 31 healthy, non-smoking adults before and after vaping a nicotine-free e-cigarette. Comparing the pre- and post-MRI data, the single episode of vaping resulted in reduced blood flow and impaired endothelial function in the large (femoral) artery that supplies blood to the thigh and leg. The endothelium, which lines the inside surface of blood vessels, is essential to proper blood circulation. Once the endothelium is damaged, arteries thicken, and blood flow to the heart and the brain can be cut off, resulting in heart attack or stroke.

Experts have long suspected it, but a new study confirms that folks who vape and smoke tobacco face higher risks for lung cancer than if they'd done either alone. Propylene glycol, for example, is usually eaten (in cupcakes, soft drinks and salad dressings) or slathered onto the body (in soaps, shampoos and antiperspirants)—not breathed into the lungs. Many things that can be safely eaten—such as flour—can damage the lungs when inhaled. "We have little information about what happens to propylene glycol in the air," the federal Agency for Toxic Substances and Disease Registry says on its Web site.

This is why it took as long as it did for the negative health effects of cigarettes to be widely recognized. There is abundant evidence that e-cigarettes can help some individuals to quit smoking, so they should be more widely recommended as smoking cessation aids. Vaping and smoking share similar negative effects on the body, such as damage to the lungs and increased cancer risk.

Nicotine yields for different e-cigarette brands have been reported from 2 to 313 µg puff−1 while for conventional cigarettes smoke the values ranged from 170 to 232 µg puff−16,31,36,48,64. Nicotine poisoning refers to the toxic effects of consuming nicotine, a chemical in all tobacco products. A recent increase in poisonings is due to liquid nicotine, a product in the popular e-cigarette. Symptoms include vomiting, rapid heart rate, unsteadiness and increased salivation. The comprehensive review of the evidence finds that almost all of the 2.6 million adults using e-cigarettes in Great Britain are current or ex-smokers, most of whom are using the devices to help them quit smoking or to prevent them going back to cigarettes. It also provides reassurance that very few adults and young people who have never smoked are becoming regular e-cigarette users (less than 1% in each group).

Although e-liquids do not contain tobacco, they contain chemicals, usually including flavorings, and often contain nicotine, which is addictive. Aerosol from e-cigarettes can also include cancer-causing chemicals, and diacetyl, a chemical used in some e-cigarette flavorings, has been linked with serious lung disease. Some people (most commonly youths or young adults) have experienced seizures while using e-cigarettes.

A 2018 report from the National Academies Press (NAP) found significant evidence that taking a puff from a nicotine e-cigarette triggers an increase in heart rate. In summary, it seems that either smoking or nicotine vaping may adversely impact on COVID-19 outcome. However, additional follow up studies are required in COVID-19 pandemic to clarify the effect of e-cigarette use on lung and cardiovascular complications derived from SARS-CoV-2 infection. It is also noteworthy that among the 3 most cytotoxic vapours for HUVEC evaluated in the Putzhammer et al. study, 2 were nicotine-free, which suggests that nicotine is not the only hazardous component in e-cigarettes [24]. However, while vape products can reduce the amount of tar and other chemicals a person inhales, they can increase a person’s nicotine dependency. The National Institute on Drug Abuse (NIDA) states that around half of all smokers try to quit every year, while only 6% manage to do so.

Of the 544 young people who owned e-cigarette devices, 75.7% said that they considered recycling e-cigarettes. Respondents also reported keeping or selling the devices, or returning them to a vape shop. "We do not know what these chemicals do when they are heated and inhaled. These are questions that should be answered before we allow products on the market." One chemical, known as 6-methyl nicotine, has been shown in rodent experiments to be far more potent than nicotine in targeting the brain's nicotine receptors and more toxic than nicotine. Another, called nicotinamide, is marketed as targeting the same brain receptors as nicotine, despite evidence it does not bind to these receptors.

Yet another analysis linked e-cig use with greater odds of trying tobacco. They come in kid-friendly flavors, including chocolate, bubble gum and gummy bear. Sold online and in the mall, e-cigarettes are also easy for minors to acquire.

FDA approved tobacco treatment medications can help people trying to quit smoking. These include over-the-counter and prescription options, which are known to be effective. These medications can make you nearly two times as likely to successfully quit smoking. E-cigarettes are the most commonly used tobacco product among middle- and high-school students. Since e-cigarettes are still new, detailed knowledge about the short-term health effects is limited, and the long-term health effects of e-cigarettes are unknown. Deepa Camenga, MD, a pediatrician who is board-certified in addiction medicine, says it’s never too early to begin talking about e-cigarettes in age-appropriate language.

Children and adults can develop nicotine poisoning from swallowing, breathing, or absorbing e-liquid through their skin or eyes. E-cigarette use can also result in serious injury due to defective batteries that have caused fires and explosions. Vaping and smoking both involve inhaling nicotine and other substances into the lungs. While cigarettes burn tobacco that produces smoke, e-cigarettes heat liquid to make an aerosol that often contains nicotine, various chemicals, heavy metals (nickel, tin, and lead) and small particles that can be inhaled deeply into the lungs.

A recent study compared the acute effects of e-cigarette vapor (with PG/vegetable glycerine plus tobacco flavouring but without nicotine) generated from stainless‐steel atomizer (SS) heating element or from a nickel‐chromium alloy (NC) [92]. Neither the air‐exposed rats nor those exposed to e-cigarette vapor using SS heating elements developed respiratory distress. In contrast, 80% of the rats exposed to e-cigarette vapor using NC heating units developed clinical acute respiratory distress when a 70‐W power setting was employed. Thus, suggesting that operating units at higher than recommended settings can cause adverse effects. Nevertheless, there is no doubt that the deleterious effects of battery output voltage are not comparable to those exerted by CS extracts [30] (Figs. 1 and 2). "Our findings are consistent with earlier evidence that sufficient nicotine replacement can be helpful for quitting smoking.

As such, it is imperative that e-cigarette cessation programs focused on adolescents are developed, evaluated, and implemented," Halpern-Felsher wrote. "This may point to the changing norms around e-cigarette use and the fact that quitting vaping among young people is becoming more normative and accepted," she said. Most of the study participants, about 87%, reported that they had tried to quit in the previous year, and about 94% reported feeling somewhat or very addicted to vaping. E-cigarettes usage by adolescents has become an epidemic according to the American Lung Association–20% (5 million) of all youth use e-cigarettes, a 135% increase in just two years.

The inhaled vapor may contain nicotine (the addictive drug in tobacco), flavorings, and toxins—including ones that cause cancer. People who have already switched completely from smoking to e-cigarettes should not switch back to smoking (either solely or along with e-cigarettes), which could expose them to potentially devastating health effects. It's important to know the US Centers for Disease Control and Prevention (CDC) has stated that sometimes e-cigarette products are changed or modified and can have possibly harmful or illegal substances from unknown sources. Get regular updates on the health effects of tobacco, public health educational resources, and highlights on current tobacco issues and regulations.

Little research has been conducted into the safety of e-cigarettes and e-liquids in pregnancy. It is not known whether the vapour is harmful to a baby in pregnancy. E-cigarettes do not produce tar or carbon monoxide, two of the most harmful elements in tobacco smoke.

A Yale study in 2019 found that, among students at three Connecticut public schools, those who used e-cigarettes were more likely to smoke regular cigarettes in the future. Most e-cigarettes have a battery, a heating element, and place to hold a liquid (such as a cartridge or pod). The e-liquid usually contains nicotine, flavorings, and other chemicals. As the user draws on the device, the battery heats the e-liquid to produce aerosol (not water vapor).

With millions of teens and young adults using e-cigarettes, a new generation could become addicted to nicotine and face other health risks. For some adult smokers, e-cigarettes may offer a less harmful substitute for traditional cigarettes. However, long-term effects on users, second-hand exposure, and environmental effects are not yet fully known. The e-liquid typically contains humectants and flavourings, with or without nicotine; once vapourised by the atomiser, the aerosol (vapour) provides a sensation similar to tobacco smoking, but purportedly without harmful effects [3].

"More research about the health effects of alternative tobacco products is critically needed to put science behind the regulation of the tobacco industry." As the debate blazes, deep-pocketed big tobacco investors are buying up e-cig companies, injecting millions of dollars into the market and banking on a bright future for the devices. More than 100 e-cigarette companies are now jockeying for the business of smokers and nonsmokers alike.

We want to make a difference in the lives of our users, and create products that can fit all levels and styles of vapers, to help as many as possible. Stanford Medicine Tobacco Prevention ToolkitTheory-based and evidence-informed resources created by educators, parents, and researchers aimed at preventing middle and high school students' use of tobacco and nicotine. There are several resources available to assist with learning more about e-cigarettes and educating youth about the risks. Resources are available for parents, educators, and health care providers. According to the 2017 Behavior Risk Factor Survey (BRFS) conducted by DHSS, 4.8 percent of Delaware adults currently use e-cigarettes, roughly the same percentage reported in the 2016 survey.

According to the study, 40.1% of 1,018 adolescents between the ages of 14 and 29 surveyed said they refilled devices not intended to be refilled and 35.8% recharged the battery of vaping pods meant to be thrown out after one use. Others reported mixing nicotine and cannabis liquids in devices designed only for nicotine. The decision lends new credibility to vaping companies’ longstanding claim that their products can help blunt the toll of smoking, which is blamed for 480,000 U.S. deaths annually due to cancer, lung disease and heart disease. Some of the harmful substances emitted in secondhand e-cigarette aerosols are similar to those in secondhand tobacco smoke.

Tetrahydrocannabinol (THC)-containing e-cigarette or vaping products was linked to most EVALI cases. Emergency department visits related to e-cigarette, or vaping, products have sharply declined in recent years, but the CDC continues to monitor reports. In 2022, e-cigarettes remained the most common tobacco product used by high school (16.5%) and middle school (4.5%) students in the last 30 days. And more than a quarter (27.6%) of current youth e-cigarette users say they use an e-cigarette product every day.

They also contain toxins that can damage your lungs and overall health. One of the reasons why the e-cigarette epidemic among young people is so troubling is that e-cigarette use seems to lead to the use of traditional cigarettes. This makes them a better choice for people who already smoke or use other tobacco products. Vaping may have some benefits for smokers who switch to it as a complete substitute for using other tobacco products. E-cigarette manufacturers are using marketing tactics used by the tobacco industry to lure kids to conventional cigarettes.

It can also reduce fertility, increase the chance of developing type 2 diabetes, and contribute to bone loss. Even people who "smoke but don’t inhale" face an increased risk of mouth cancer. By Robyn Correll, MPHCorrell holds a master of public health degree and has over a decade of experience working in the prevention of infectious diseases. Researchers spent decades studying the health consequences of secondhand smoke. It might be a while before we have a clear picture of how secondhand vaping can impact a person’s long-term health, especially for young children.

All this evidence would suggest that e-cigarettes are potentially less harmful than conventional cigarettes (Fig. 2) [11, 14, 22, 24, 27,28,29]. Importantly, however, most of these studies have investigated only short-term effects [10, 14, 15, 22, 27,28,29, 31, 32], and the long-term effects of e-cigarette consumption on human health are still unclear and require further study. Vapes come in colorful, fun, and unique product designs, along with many flavors, all of which come together as part of the attraction for youth who believe that these products are not addictive and are safe to use. Many users believe vaping will reduce stress, anxiety, and depression.

Although PG and glycerol are the major components of e-liquids other components have been detected. Of note, the analysis identified formaldehyde, acetaldehyde and acrolein [4], 3 carbonyl compounds with known high toxicity [63,64,65,66,67]. While no information was given regarding formaldehyde and acetaldehyde concentrations, the authors calculated that one puff could result in an acrolein exposure of 0.003–0.015 μg/mL [4]. However, given that e-cigarette units of vaping are not well established, users may puff intermittently throughout the whole day. Thus, assuming 400 to 500 puffs per cartridge, users could be exposed to up to 300 μg of acrolein.

Parent groups and anti-tobacco advocates immediately criticized the decision, which comes after years of pushing regulators to keep menthol and other flavors that can appeal to teens off the market. In 2023, 309.4 million units of e-cigarette products were sold in U.S. retail stores nationwide. An e-cigarette’s appearance is determined by the shape and size of its components.

The number of unique e-cigarette products more than quadrupled from 453 in June 2021 to 2,023 in June 2022. But it is not responsible for the harmful effects of smoking, and nicotine does not cause cancer. People have safely used nicotine replacement therapy (NRT) to stop smoking for many years. Nicotine replacement therapy is prescribed by doctors or is available from pharmacies. I’m doing my part by not smoking cigarettes and releasing their known carcinogens to the atmosphere, while still dealing with my addiction. I am trying to improve my health, trying to not smell like cigarette smoke all the time, and get to spend time with my loved ones as well.

E-cigarettes are available in flavors like cherry, bubble gum, and cotton candy, and are allowed to be advertised on TV, which may increase their appeal for children and teens. As of July 31, 2024, Poison Centers have managed 4,955 e-cigarette and liquid nicotine related exposure cases. For more information about the health effects of e-cigarettes, visit CardioSmart.org/StopSmoking. People who use e-cigarettes are significantly more likely to develop heart failure compared with those who have never used them, according to one of the largest prospective studies to date investigating possible links between vaping and heart failure. The findings are being presented at the American College of Cardiology’s Annual Scientific Session.

The "e-juice" that fills the cartridges usually contains nicotine (which is extracted from tobacco), propylene glycol, flavorings and other chemicals. Studies have found that even e-cigarettes claiming to be nicotine-free contain trace amounts of nicotine. Additionally, when the e-liquid heats up, more toxic chemicals are formed. Among youth, e-cigarettes, especially the disposable kind, are more popular than any traditional tobacco product.

Television advertisements for cigarettes have been banned in the U.S. since 1971, but in the past few years supposedly healthier, battery-powered alternatives have landed numerous prime-time appearances. Electronic cigarettes, or e-cigs, as they are known, soaked up the spotlight in recent Super Bowl commercials, on late-night talk shows and in a comedy sketch during the 2014 Golden Globe Awards. Indeed, a recent survey shows that nearly 60 percent of Americans are now familiar with the sleek, smokeless devices.

Still, many people, including teens and young adults drawn to vaping, may not realize that, Bittoni said. Other popular brands, like Puff Bar, have received warnings from regulators about the sale of flavored devices as well. Following the Golden State, Washington had the second-lowest amount of youth vapers, at eight percent. In the Evergreen state, the legal age to purchase vapes is 21, and there is a ban on all flavored varieties. Last year, Alaska Senate President Gary Stevens, a Republican, introduced Senate Bill 89, aimed at imposing the state's first-ever tax on e-cigarette products. Wyoming had the highest rate of youth vapers, with 30 percent of kids under 18 reporting they had used e-cigarettes in 2023.

Several states have imposed restrictions on the sale of e-cigarettes. There are also restrictions on liquids with flavors that may be more attractive to younger people. The researchers also noted a lack of evidence that vaping is an effective means of quitting smoking. The marketing of e-cigarettes and their range of flavors can give the impression that vaping is not harmful.

"This is the first study to demonstrate the effectiveness of any quit vaping program for adolescents. It’s also a program that has been used by more than 780,000 young people nationwide since Truth Initiative launched it in 2019," Dr. Amanda Graham, chief health officer at Truth Initiative and principal investigator of the study, said in an email. Her team tracked rates of both vaping and smoking among nearly 5,000 Columbus-area people diagnosed with lung cancer, and compared them to a group of almost 27,300 people without cancer. It found that there was not enough evidence to confirm its products did not harm public health. The FDA has banned the sale of flavored nicotine products in the US unless a company has received their expressed approval.

JUULs very closely resemble a USB drive, can be charged in a USB port, and emit little to no detectable vapor or odor. Due to their easily concealable design, they are of particular concern with regard to youth use. DOH urges all people to be very careful when it comes to your health. Even if a substance has not yet been proven to be dangerous, there is no guarantee it is safe. You don’t actually light up an e-cig; they’re powered by a rechargeable lithium battery. Instead of burning tobacco, the "e-liquid" is vaporized in a heating chamber when the user inhales.

Moreover, we just don’t know the long-term effects of vaping," said Dr. Bhavna Barmi, a senior clinical psychologist. Vaping, still at epidemic levels among youth with about one in five high school students using e-cigarettes in 2020, generates a significant amount of toxic and plastic waste. Many popular e-cigarettes, like JUUL, are pod-based with single-use plastic cartridges containing nicotine. Generating even more waste are disposable e-cigarettes like Puff Bar, which are designed entirely for one-time use and have skyrocketed in popularity with a 1,000% increase in use among high school students between 2019 and 2020. Nicotine exposure during adolescence can affect learning, memory, and attention. It can also increase risk for future addiction to nicotine and other drugs.

The review authors conclude that further research could help untangle how vapers’ bodies develop disease. These types of studies, they say, promise to identify early indicators of—and ultimately treatments for—vaping-related disease. While some tout e-cigarettes as a solution to quitting conventional smoking, the truth about relative risks is complicated, says Crotty Alexander, who is a researcher in addition to providing patient care and teaching.

Nicotine-free e-juice contains a number of potentially toxic chemicals, such as base liquids and flavoring agents. However, based on the experience with cigarettes, similar adverse health effects, including COPD, heart disease, and cancer, can be expected. Finally, a 2017 review of the cardiovascular effects of vaping indicates that e-cigarettes may pose certain risks to the heart and circulatory system, notably for people who already have some form of heart disease.

When studying tobacco cigarettes, researchers rely on smoking machines that simulate how frequently a typical smoker takes a puff and how much smoke is inhaled with each breath. No one has yet determined how much e-cig vapor the typical user breathes in, so different studies assume different amounts of vapor as their standard, making it difficult to compare their results. Tracing what happens to that vapor once it is inhaled is equally problematic.

E-cigarettes are not safe for youth, young adults, and pregnant women, and can be dangerous for adults who use tobacco products. The novel results for school-level factors indicate that prevention of nicotine use may be supported by facilitating nicotine-free schools through policies and programmes. This may address especially the peer selection processes, which have been observed both in school disengagement and smoking initiation [28, 29]. Further, it may influence the students’ descriptive and injunctive norms, which both predict smoking initiation among youth [27].

Perhaps contrary to what many would expect, vaping marijuana may have as many negative health effects as nicotine-based vaping. This may have more to do with how vape liquids are processed than the THC itself. The tobacco industry profits from destroying health and is using these newer products to get a seat at the policy-making table with governments to lobby against health policies. The tobacco industry funds and promotes false evidence to argue that these products reduce harm, while at the same time heavily promoting these products to children and non-smokers and continuing to sell billions of cigarettes.

In King County, youth e-cigarette use is now higher than the use prices of electronic cigarettes conventional cigarettes. The ACS does not recommend the use of e-cigarettes as a cessation method. No e-cigarette has been approved by the Food and Drug Administration (FDA) as a safe and effective cessation product. Some people use vaping to curb their appetite, but there’s no proof that vaping helps with weight loss.

Electronic cigarettes (e-cigarettes) are devices made to resemble cigarettes. Despite making great strides to reduce smoking, tobacco is still our biggest killer. Our region has always kept an open mind towards using electronic cigarettes as we can see the massive potential health benefits from switching.

He also highlighted the ban on e-cigarettes in India under the Prohibition of Electronic Cigarettes Act, 2019, aimed at preventing health risks and curbing their use among youth. These ingredients pose significant health risks, particularly to pregnant women, children, and adolescents, and leads to issues like impaired brain development and respiratory diseases, said Dr Goel. Cumberland County Schools is implementing a national vaping and nicotine prevention program in each of its middle and high schools to try and curb rates of youth vaping. Cigarettes pushed me back to shivering outside the bar where a nicotine habit belongs.

WASHINGTON (AP) — The Supreme Court took up an e-cigarette case Tuesday, weighing Food and Drug Administration decisions blocking the marketing of sweet flavored products amid a surge in vaping by young people. Despite not authorizing a single synthetic nicotine product, it has allowed these products – including e-cigarettes in kid-friendly flavors – to stay on the market well past the July 13 deadline. There is little research on the safety of vaping in pregnancy, but it's likely to be substantially less harmful for you and your baby than smoking. Unlike cigarettes, vapes do not produce carbon monoxide, which is very harmful to a developing baby in the womb. They also cause other serious illnesses, including lung disease, heart disease and stroke.

There is no single test for EVALI; it’s what is known as a "diagnosis of exclusion," which means that a doctor will conduct tests to rule out other potential diseases and conditions. The primary risk factor for EVALI is current or previous use of a vaping device. They can look like cigarettes, cigars, pipes, pens, USB flash drives, or may be in other forms. We fund research that explores how risk factors such as smoking, poor nutrition, and lack of physical activity can affect the development of cancer. For instance, 68 people died in an outbreak of vaping-related illness (EVALI) in 2019 and 2020. Links to E-Cigarette Resources Links other websites, reports educational materials, toolkits and more information on e-cigarettes.

The main danger with a closed-system vape comes from the lithium-ion battery. If you try to charge it using an incompatible device, there's a small but real chance of a fire or explosion. If you're new to vaping, we'd suggest starting out with a disposable vape pen. Because these devices are pre-assembled and standardized, there's no need to worry about making a dangerous mistake with the power supply that causes overheating. There's no e-liquid at all in this device, just natural, food-grade flavor extracts. And third-party testing has confirmed that the E-Z contains no allergens, carcinogens, or toxins of any kind.

Other compounds that have been detected in aerosols include acetamide, a potential human carcinogen [5], and some aldehydes [69], although their levels were minimal. Interestingly, the existence of harmful concentrations of diethylene glycol, a known cytotoxic agent, in e-liquid aerosols is contentious with some studies detecting its presence [4, 68, 70,71,72], and others finding low subtoxic concentrations [73, 74]. In this regard, either it was detected at concentrations that did not exceed the authorised limit [73], or it was absent from the aerosols produced [4, 71, 72]. Only one study revealed its presence at high concentration in a very low number of samples [5]. Nevertheless, its presence above 1 mg/g is not allowed by the FDA [73]. Figure 1 lists the main compounds detected in aerosols derived from humectant heating and their potential damaging effects.

Beginning July 1, 2019, Illinois law prohibits the sale of tobacco products, including these products, to people younger than age 21. The smoke also caused damage to the lungs and bladders of mice, indicating that it may increase the risks of developing lung and bladder cancer. Since e-cigarettes arrived in the U.S. in 2007, they have been investigated by addiction researchers as possible cessation devices for adults trying to quit combustible, or regular, cigarettes.

The decision to pursue a smoking cessation objective, even in such a controlled form, should be made only after considering national circumstances, along with the risk of uptake and after exhausting other proven cessation strategies. Both smoking and vaping involve heating a substance and inhaling the resulting fumes. With vaping, a device (typically a vape pen or a mod — an enhanced vape pen — that may look like a flash drive) heats up a liquid (called vape juice or e-liquid) until it turns into a vapor that you inhale. Electronic smoking devices or e-cigarettes are battery operated devices used to inhale a vaporized liquid solution that frequently contain nicotine, flavorings and other chemicals. Because the liquid solution is converted into an aerosol vapor, e-cigarette use is often referred to as "vaping," rather than smoking. E-cigarettes are devices that heat a liquid, called e-liquid, into an aerosol that the user can inhale.

"Recent studies should make us all more concerned about the impact of traditional and e-cigarettes on the heart as well," Dr. Cireddu says. According to the 2018 NAP report, secondhand vapor contains nicotine, particulate matter, and volatile organic compounds (VOCs) at concentrations that are above recommended levels. The 2018 NAP report found that there’s some evidence that e-cigarette exposure has adverse effects on the respiratory system. Some studies suggest that vaping may have negative effects on the lungs, but more research is needed.

Recent guidance from the Center for Tobacco Products indicates the importance of switching completely away from combustible cigarettes for those who are also using e-cigarettes," she added. The investigators revealed that daily vs nondaily use of e-cigarettes was linked to higher overall rates of quitting combustible cigarettes (12.8% vs 6.1%). The adults who used e-cigarettes in 2019 were more likely to stop smoking traditional cigarettes compared with those who used the e-cigarettes between 2014 and 2015 (12.0% vs 5.3%). There was limited evidence that flavor or device type impacted cigarette cessation. The findings suggest that daily e-cigarette use may help some patients to quit smoking combustible cigarettes.

A 2021 review found people who used e-cigarettes to quit smoking, as well as having expert face-to-face support, can be up to twice as likely to succeed as people who used other nicotine replacement products, such as patches or gum. Vaping involves using a device known as an e-cigarette—also called a vape pen, mod, or tank—to heat up a small amount of liquid, turning it into a vapor that can be inhaled. Most vape liquids contain substances such as propylene glycol and glycerol as base ingredients that create the vapor.

When the human body breaks down a foreign substance, one can typically find chemical by-products in hair or urine that provide clues about how it has interacted with cells. This is true for nicotine, but in the case of propylene glycol, no one has established what the relevant by-product is or how to best detect it. Boston, MA – Diacetyl, a flavoring chemical linked to cases of severe respiratory disease, was found in more than 75% of flavored electronic cigarettes and refill liquids tested by researchers at Harvard T.H. Chan School of Public Health. Two other potentially harmful related compounds were also found in many of the tested flavors, which included varieties with potential appeal to young people such as Cotton Candy, Fruit Squirts, and Cupcake. In conclusion, the prevalence of susceptibility among adolescents differs by product type. Liking school and academically oriented educational aspirations appear as consistent protective factors, while the use of other tobacco or nicotine products and positive attitudes towards product use in one’s age group appear as risk factors.

Differences between schools exist, but having more students with no nicotine use showed protective associations, while having more students with positive attitudes towards product use in one’s age group increased the susceptibility. The results of the present study suggest that both interventions tailored by educational aspirations and universal school policies are needed to reach youth at high-risk of initiation. The concentration of nicotine in the BB57 emissions relative to BB18 was three times greater and followed the three-fold increase in nicotine strength of the e-liquid. In the cigarette smoke, the measured nicotine concentration of 0.23 ± 0.01 mg puff–1 (Table 1), equivalent to 2.07 ± 0.09 mg cig−1, is in accordance with the Ky1R6F certificate value of 1.9 ± 0.1 mg cig−1 (ISO Intense smoking regime)56.

So I must ask that you not make them about you and respectfully let me and my vape alone. I can be conscious not to blow my vapor in your direction, if you will be conscious not to send your judgment and complaints in mine. Dr Sonu Goel, a distinguished public health expert and chairperson of the Tobacco Control Section explained that e-cigarettes, also known as Electronic Nicotine Delivery Systems (ENDS), vaporise a nicotine solution instead of burning tobacco leaves.

To date, no e-cigarette product has been approved by the FDA for smoking cessation. In contrast, nicotine replacement therapies (e.g., patch, gum, lozenge) and some prescription medications (i.e., varenicline, bupropion) have been evaluated by the FDA and found to be safe and effective at helping people quit smoking. Manufacturers and sellers of e-cigarettes aggressively target young people.

Currently, e-cigarettes are not mentioned in the Illinois Smoke-free Illinois Act, which prohibits smoking in virtually all public places and workplaces, but some local ordinances do include e-cigarettes. E-cigarette aerosol is not harmless; it can contain harmful and potentially harmful substances, including nicotine and cancer-causing chemicals. While e-cigarettes typically have fewer chemicals than regular cigarettes, researchers found e-cigarettes present their own unique health risks and can increase the odds of chronic cough, phlegm, bronchitis, and asthma. Some cigarette smokers have replaced traditional smoking with electronic cigarettes (e-cigarettes) or vaping, thinking it is not as dangerous. There are significant negative health effects from smoking cigarettes such as cancer, chronic obstructive pulmonary disease (COPD), heart disease, birth defects, and other health problems relating to nearly every organ of the body.

The most important points to know are that the long-term health effects of e-cigarettes are still unknown, and all tobacco products, including e-cigarettes, can pose health risks to the user. The tobacco industry has co-opted the term harm reduction to further its own interests of reduced tobacco product regulation and expand its user base. E-cigarette use among adults has been more stable, with adult use remaining relatively low since around 2012. Recent data, however, showed a slight uptick in adult e-cigarette use from 4.5% in 2021 to 6% in 2022. While switching completely from cigarettes to e-cigarettes can be less harmful than smoking, many adult smokers use e-cigarettes and cigarettes concurrently — increasing overall exposure to nicotine. Randomized control trials provide growing evidence that e-cigarettes with nicotine can increase quitting rates when compared to nicotine replacement therapies.

There's always a chance that the fail-safe could fail, though, which is why we don't consider these as safe as other vaping devices. The biggest risks in vaping devices come when you get into highly customizable "mods." These devices allow for lots of fine-tuning in terms of the internal electrical setup. But this added flexibility means more possibilities for health hazards. You'll have to be careful not to buy knock-off vape liquids with unhealthy contaminants, for one thing.

What may be the most important message of all is that e-cigarettes and vaping come with many health unknowns, Dr. O’Connor adds. "You see plumes of what looks like steam coming out of people’s mouths on the street when they are vaping, and I think they assume it’s mostly safe, mostly water. But these liquids used in vaping are filled with all kinds of stuff [like nicotine, marijuana, flavoring agents, chemicals], and we don’t always know what else is in there," he says. When potentially risky behaviors experience an uptick in popularity, health researchers are never far behind—gathering data.

And using overly high temperatures could increase the stress on your lungs. Long-term users may not want to keep buying new vapes every time, though, as we touch on in our article on the best 0 nicotine rechargeable vapes. If you're not using disposables, the next safest option is a closed-system vape.

The term "vaping" comes from the act of inhaling and exhaling e-cigarette vapor (which is actually an aerosol). E-cigarettes heat up liquid from replaceable cartridges, producing the vapor. Just like a smoker does, an e-cigarette user inhales the vapor through the device, then exhales. People who switch from traditional cigarettes to e-products may put off getting medical help or trying proven tools that can help with quitting. United States federal law does not allow the sale of tobacco products to people under the age of 21.

E-cigarettes consist of a mouthpiece, an e-liquid chamber, an atomiser and a battery. The atomiser has a wicking material that draws the e-liquid onto a battery-powered heating coil. Optimal vapour production depends on an efficient supply of e-liquid to the heating coil, which is limited by the wicking and rate of e-liquid evaporation10,11,12. Power levels that produce aerosol beyond the ability of the wick to resupply the liquid to the coil may result in overheating of the atomizer coil and consequently overheating of the e-liquid10,11. Different types of wicking material, varying in size and shape, have been used in e-cigarettes3,13.

E-cigarettes, also known as e-cigs, vapes, vape pens, and electronic nicotine delivery systems (ENDS), are experiencing rapid growth in popularity, especially among teens and young adults. They come in a variety of forms, sometimes looking like USB flash drives, pens, and other items that make them hard for parents and teachers to spot. Other electronic devices that heat tobacco instead of liquid nicotine, such as IQOS, are not considered e-cigarettes. Teens cannot participate in such studies, but "we all agree that e-cigs are not a good thing for youth and nonsmokers," Dr. Baldassarri says. The Food and Drug Administration on Friday authorized the first menthol-flavored electronic cigarettes for adult smokers, acknowledging that vaping flavors can reduce the harms of traditional tobacco smoking.

The e-liquid is quickly heated and converted to an aerosol that can be inhaled into the lungs. As smoking has declined dramatically in the U.S., vaping has gained tremendous popularity very quickly. A 2018 study reported 20% of high schoolers vaped at least once in the past 30 days. Since e-cigarettes often contain the same chemicals as traditional cigarettes, smoke produced by vaping may be toxic to people nearby. Manufacturers claim that e-cigarettes bypass many of the health risks of tobacco smoking, providing a healthful alternative.

With regards to toxicity, little is known about the effects of humectants when they are heated and chronically inhaled. Indeed, the latter study established that one e-cigarette puff results in a PG exposure of 430–603 mg/m3, which is higher than the levels reported to cause airway irritation (average 309 mg/m3) based on a human study [55]. The same study established that one e-cigarette puff results in a glycerol exposure of 348–495 mg/m3 [57], which is close to the levels reported to cause airway irritation in rats (662 mg/m3) [58]. Results from in vitro studies are in general agreement with the limited number of in vivo studies.

In some instances, because of its appearance and the vapours it emits, an e-cigarette may be confused with a regular cigarette. Other types of e-cigarettes, however, are similar to a cigar, a smoking pipe, or a ballpoint pen in appearance. This story has been updated to correct that two of the four menthol e-cigarettes from Njoy are disposable products.

On the other hand, there is a large body of evidence clearly showing that FDA-approved medications are safe and effective ways to help people quit smoking, especially when combined with counseling. Scientists are still learning about how e-cigarettes affect health when they are used for long periods of time. It’s important to know that the aerosol ("vapor") from an e-cigarette contains some cancer-causing chemicals, although in significantly lower amounts than in cigarette smoke. The FDA has the authority to regulate all tobacco products, including e-cigarettes. The FDA is working on several options to prevent youth access to e-cigarettes.

If used during pregnancy, nicotine may also cause premature births and low birthweight babies. The use of e-cigarettes is often referred to as "vaping" because many people believe e-cigarettes create a vapor, which is then inhaled. But in fact, e-cigarettes produce an aerosol made up of tiny particles, which is different from a vapor. Some vape shops may have legal responsibilities as both manufacturers and retailers of tobacco products.

In addition, the VITA only heats its vape liquid to about 240 degrees Fahrenheit. That's much lower than many other kinds of vapes, so it won't be as rough on your lungs. LUVV also says their products are tested to "safeguard against" harmful byproducts of heating metal and vape fluid. They don't provide much detail to support this claim, though, so take it with a grain of salt. Like HELO, LUVV vapes are free of diacetyl, vitamin E acetate, and nicotine.

Starting to use e-cigarettes or switching from tobacco products to e-cigarettes increases your risk of adverse health effects. Interestingly, there is a strong difference of opinion on e-cigarettes between countries. Whereas countries such as Brazil, Uruguay and India have banned the sale of e-cigarettes, others such as the United Kingdom support this device to quit smoking.

That figure is controversial and might be a little high, says Kenneth Warner, a tobacco policy researcher at the University of Michigan. But, he adds, "The worst critics of e-cigarettes would probably argue they're a half to two-thirds less dangerous. But from a practical view, they're probably on the order of 80% to 85% less dangerous, at least." A 2015 expert review from Public Health England estimated e-cigs are 95% less harmful than the real thing.

Carbonyls in cigarette smoke are formed mainly by pyrolysis of tobacco sugars83, whereas those in e-cigarettes are formed mainly by thermal degradation of PG and/or VG83,84,85. Flavourings may also contribute to the formation of carbonyls, as well as the characteristics of the e-cigarette devices, especially the applied voltage, coil resistance and wicking material47,48,49,86,87. Poor wicking efficiency may lead to a dry wick and overheated e-liquid (dry puff), which promotes the formation of carbonyls and other toxic compounds2,10,13,15. Coil location, orientation, resistance and wick material, as well as power output, have been shown to affect carbonyl generation significantly13,15,86.

This guidance is intended to support healthcare providers in their understanding and tracking of -cigarette and vaping product use. 20% (5 million) of all youth use e-cigarettes, a 135% increase in just two years. Additional data, rates and trends can be found in the American Lung Association’s Tobacco Trends Brief.

E-cigarettes first entered the market in 2007 and have evolved many times since t