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E-Cigarette Use Costs U S. $15B Per Year, Reports UCSF in First Study of Its Kind UC San Francisco

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.

E-cigarettes can be used to smoke or "vape" marijuana products, herbs, waxes and oils. In the US, e-cigarettes are the most commonly used tobacco product among middle- and high-school students. In 2023, 2.1 million students (10% of high-school students and 4.6% of middle-school students) reported current e-cigarette use.

Electronic cigarettes, or e-cigarettes, include e-pens, e-pipes, e-hookah, and e-cigars are known collectively as ENDS— electronic nicotine delivery systems. According to the FDA, e-cigarettes are devices that allow users to inhale an aerosol containing nicotine or other substances. Other studies show that newer e-cigarettes deliver higher doses of nicotine more efficiently, which could be a reason why these findings were observed. The authors acknowledge that more frequent use of e-cigarettes may also reflect greater determination to quit smoking combustible cigarettes and that their study did not evaluate risks of youth e-cigarette use. Over the next few years, the optimism over e-cigarettes waned as their popularity skyrocketed. Juul’s sales increased over 600 percent each year to become the best selling device on the market while I inhaled an atmosphere’s worth of vanilla vapor into my lungs.

However, the FDA then paused its decision in July while it carries out an additional review on the company's products. Many physical retail locations neglect to check identification for customers, allowing children to access the devices. Like cigarettes, an American must be at least 21 years old to purchase a vape. They can come as vape pens — which are shaped like a pen or small tube with a tank to store e-liquid and batteries — or pod systems that are rechargeable and often shaped like USB sticks.

The evidence for e-cigarettes as a tool to help adults quit smoking is limited. To date, no e-cigarettes have been approved by the FDA as smoking-cessation devices. The report also discusses the changing landscape of tobacco products, including smoked products, smokeless products, and e-cigarettes. The liquid solution used in e-cigarettes, sometimes called vape juice or e-liquid, usually contains nicotine and other chemicals.

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 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.

Use of microporous ceramic as a wicking material improves heating efficiency, but how it affects the chemical emissions of these devices is unclear. We assessed the emissions of a pod e-cigarette with innovative ceramic wick-based technology and two flavoured e-liquids containing nicotine lactate and nicotine benzoate (57 and 18 mg mL−1 nicotine, respectively). Among the studied harmful and potentially harmful constituents (HPHCs) listed by the US FDA and/or WHO TobReg, only 5 (acetone, acetaldehyde, formaldehyde, naphthalene and nornicotine) were quantified at levels of 0.14 to 100 ng puff−1. In the combustible cigarette (Kentucky reference 1R6F), levels were from 0.131 to 168 µg puff−1.

Most factory-made cigarettes are equipped with a filter; those who roll their own can buy them separately. Filters can reduce some substances from smoke but do not make cigarettes any safer to smoke. A recipe-specified combination of brightleaf, burley-leaf, and oriental-leaf tobacco is mixed with various additives to improve its flavors. Most commercially available cigarettes today contain tobacco that is treated with sugar to counter the harshness of the smoke. At the start of the 20th century, the per capita annual consumption in the U.S. was 54 cigarettes (with fewer than 0.5% of the population smoking more than 100 cigarettes per year), and consumption there peaked at 4,259 per capita in 1965. The authors wish to thank all adolescents and schools that participated in the SHP study in 2017, and the SHP study coordinators from the Finnish Institute for Health and Welfare who prepared the initial data and provided practical support with it.

Smoking is the leading cause of lung cancer, and people who smoke are 20 times more likely than nonsmokers to be diagnosed with lung cancer. Tobacco products contain unsafe substances, from acetone and tar to nicotine and carbon monoxide. The inhaled substances can affect your lungs and the other organs in your body.

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.

Juul’s C.E.O., Kevin Burns, who is fifty-four, has a friendly dad-who-loves-his-vacation-house demeanor. Burns described Juul to me as a "cigarette-killing company." Before he accepted the job, he said, he convened an informal focus group in his kitchen with his son, who’s in high school, and a few of his son’s friends. He asked them why they had these things, when they got them, how prevalent they were. "We have frustrations about how the product is glorified on social media," he told me. I admitted to Winickoff that I was probably endangering my lungs as a weed smoker. He gamely pointed out that I could look into ingested forms of marijuana, and noted that my brain was in a much more stable place than it had been when I was twenty-one.

This can also increase the levels of other toxicants to the user and also expose bystanders to harmful emissions. Vapes, vaporizers, vape pens, hookah pens, electronic cigarettes (e-cigarettes or e-cigs), e-cigars, and e-pipes are some of the many tobacco product terms used to describe aap electronic cigarettes nicotine delivery systems (ENDS). An electronic cigarette (e-cigarette) is a device that heats up the liquid nicotine and flavoring for you to breathe in. There are many varieties of e-cigarettes that go by different names, including vapes, vape pens or sticks, e-hookahs, hookah sticks, mods and personal vaporizers (PVs). They can also be collectively called electronic nicotine delivery systems (ENDS).

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).

Youth ENDS use raises concerns about nicotine addiction, negative effects of nicotine on adolescent brain development, and other potential health harms, including increased risk of initiating cigarette smoking. Electronic nicotine delivery systems (ENDS), also called electronic cigarettes, e-cigarettes, vaping devices, or vape pens, are battery-powered devices used to smoke or "vape" a flavored or unflavored solution which usually contains nicotine. The American Academy of Family Physicians (AAFP) recognizes the increased use of ENDS, especially among youth and young adults, as well as its use by those attempting to quit smoking tobacco. Although e-cigarettes do not contain tobacco, for regulatory purposes, they are considered "tobacco products" by the US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). E-cigarettes can go by different names, including vapes, vape pens or sticks, e-hookahs, hookah sticks, mods, and personal vaporizers.

A note from Cleveland ClinicNicotine poisoning is on the rise, mostly due to the availability of some of the newer forms of nicotine that are now popular. Children eat cigarettes and can be accidentally poisoned by touching, tasting or swallowing liquid nicotine or liquid nicotine-containing products used in e-cigarettes. To keep you and your family and pets safe from nicotine poisoning, the most effective approach would be to eliminate or ban tobacco-containing or nicotine-containing products in your home. If you're interested in quitting smoking, your healthcare team is here, ready and looking forward to helping you. All tobacco products contain nicotine and are harmful to your health. All are technically capable of causing poisoning if taken in large enough quantities.

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.

Vaping products, "vapes" or "e-cigarettes", comprise a wide range of products that heat a substance to produce an aerosol that is inhaled. We link to further pages giving more detailed information about each company’s products, market share and business strategy, including methods used to promote their products around the world. We also point to examples of lobbying activity conducted by, and on behalf of, tobacco companies, in order to influence regulation around e-cigarettes. Some have rechargeable batteries and changeable prefilled cartridges; others are disposable after running out of charge or e-liquid. Reported sales of cartridge products increased from $2.133 billion in 2020 to $2.496 billion in 2021; sales of disposable, non-refillable e-cigarette products increased from $261.9 million in 2020 to $267.1 million in 2021. Bene-Alhasan also said e-cigarettes are not recommended as a tool to quit smoking, since many people may continue vaping long after they quit smoking.

In addition to the battery component, an e-cigarette comprises an atomizer and a cartridge containing either a nicotine or a non-nicotine liquid solution. When the device is operated, the battery heats the liquid in the cartridge, and the atomizer vaporizes the liquid, emitting it as a mist that the user inhales. Hence, e-cigarette use is commonly described as vaping, a term also used in reference to the use of similar devices, including vape pens and e-hookas. Electronic cigarettes (e-cigarettes) go by many names, including but not limited to electronic nicotine delivery systems, vapes, vape pens, e-cigars, and hookah pens.

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.

The liquid and vapour contain some potentially harmful chemicals also found in cigarette smoke, but at a much lower level. Find out more about e-cigarettes, e-liquids and vaping to quit smoking on the Better Health website. In many e-cigarettes, puffing activates the battery-powered heating device, which vaporizes the liquid in the cartridge. The person then inhales the resulting aerosol or vapor (called vaping).

Vape flavors like mint and mango appeal to young people and mask the harshness of nicotine. The small, discreet size of vapes and e-cigarettes make them easy to conceal at school and home. The bottom line is e-cigarettes and vapes are unsafe for kids, teens and young adults. Nicotine is harmful to the developing brain and the use of e-cigarettes as a teen increases the likelihood of smoking cigarettes as an adult. The chemical additives and flavoring can also cause unwanted health effects.

E-cigarettes (often called vape pens) are battery-operated vaping devices that heat a liquid until it becomes an aerosol (mist), which is inhaled. It usually contains nicotine, other harmful chemicals, and flavorings. Even e-cigarettes that claim to have no nicotine have been found to contain nicotine. A non-smoker who uses ENDS may become addicted to nicotine and find it difficult to stop using ENDS or become addicted to conventional tobacco products. Further, many e-cigarettes are designed to allow the control of nicotine (which can reach dangerously high levels).

Participants took one vape from an e-cigarette, with at least 12 mg/mL of nicotine, or inhaled a conventional cigarette, every 20 s for 10 min. Blood samples were collected 1, 2, 4, 6, 8, 10, 12 and 15 min after the first puff, and nicotine serum levels were measured by liquid chromatography-mass spectrometry (LC–MS). The results revealed higher serum levels of nicotine in the conventional CS group than in the e-cigarette group (25.9 ± 16.7 ng/mL vs. 11.5 ± 9.8 ng/mL). However, e-cigarettes containing 20 mg/mL of nicotine are more equivalent to normal cigarettes, based on the delivery of approximately 1 mg of nicotine every 5 min [40].

The cells are also less able to form new vascular tubes and to migrate and participate in wound healing. With a 399.73% increase in retail e-cigarette sales (excluding internet sales and tobacco-specialty stores) from 2015 through 2020, the environmental consequences of e-cigarette waste are enormous. The fourth-generation vaporizers can also be customized and come with different types of heating coils — some intended for vaporizing solids, not liquids. In general, people using e‑cigarettes did not report doing so in order to quit smoking regular tobacco cigarettes. In 2022–‍2023, only 1 in 5 (21%) people who had ever used e‑cigarettes reported that they first used e‑cigarettes to help them quit smoking (Figure 5). The most common reason people gave for using e‑cigarettes was out of curiosity (58%).

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.

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.

Some people believe that e-cigarettes can help them quit smoking tobacco. However, nicotine patches and many other FDA-approved quit aids are available now to help people quit smoking. E-cigarettes are not currently approved by the FDA as aids to help stop smoking.

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.

The FDA does not currently require testing of all the substances in e-cigarettes to ensure they are safe. It's also hard to know exactly what chemicals are in an e-cigarette because most products do not list all of the harmful or potentially harmful substances contained in them. E-cigarettes do not contain tobacco, but many of them contain nicotine, which comes from tobacco. Because of this, the Food and Drug Administration (FDA) classifies them as "tobacco products." For adults who smoke, switching completely from cigarettes to e-cigarettes may reduce exposure to many harmful chemicals present in cigarettes. However, it is important that they switch completely from cigarettes to e-cigarettes to get the full health benefit.

Vape products are taxed at the sales tax rate rather than the tobacco or cigarette tax rate. While vape products are not covered by the Smoke-free Air Act, each business can prohibit the use of vape devices indoors, but this is not required by state law. Iowa law places several restrictions on youth access to e-cigarettes, including but not limited to, prohibiting the sale, distribution, possession, purchase and use of vapor products to anyone under the age of 21. There are health and safety concerns related to the use of vapor products.

To truly help tobacco users quit and to strengthen global tobacco control, governments need to scale up policies and interventions that we know work. Tried and tested interventions, such as brief advice from health professionals, national toll-free quit lines and mobile and digital cessation services are recommended. Where economically feasible, governments should also consider promoting nicotine replacement therapies and non-nicotine pharmacotherapies for cessation. E-cigarette emissions typically contain nicotine and other toxic substances that are harmful to both users and non-users who are exposed to the aerosols second-hand.

Given their relatively recent introduction, there has been little time for a scientific body of evidence to develop on the health effects of e-cigarettes. Notably, the reverse was not true—students who said they smoked cigarettes were no more likely to report use of e-cigarettes when asked approximately 6 months later. Electronic cigarettes, or e-cigarettes, are tobacco products that have been sold in the U.S. for about a decade. They include e-pens, e-pipes, e-hookah, and e-cigars, known collectively as ENDS—electronic nicotine delivery systems. They're also sometimes called JUULs, "vapes" and "vape pens." E-cigarettes are the most commonly used tobacco products among kids—and it's become an epidemic. While much remains to be determined about the lasting health consequences of e-cigarettes, there’s evolving evidence about the health risks of e-cigarettes on the lungs—including irreversible lung damage and lung disease.

These devices are permitted on planes, but the FAA recently notified airlines that the lithium batteries used in these devices are fire hazards and should not be packed in checked baggage. This page may contain information that is outdated and may not reflect current policy or programs. But, CDC stats on teen smoking show that while use of e-cigs went up to 24% in 2015, cigarette smoking dropped to an historic low -- to just under 11%.

Silica was commonly the first material to be used as a wick, followed by cotton and ceramic3,13,14,15. Cotton has good wicking properties but is less thermally stable than silica14,16,17, while ceramic is chemically stable and heat-resistant18. The use of microporous ceramic as a wicking material has increased in the past few years14,16,18,19,20. Its application has been reported to improve heating efficiency and reduce charring14,16,18,19,20. Additional research is ongoing to clarify the dangers from vaping, and how vaping damages the lungs and other organs. Long-term human studies, in particular, could bring the risks from e-cigarettes into better focus, Crotty Alexander says.

And studies show that brands claiming to be "nicotine-free" may still have trace amounts. Developing teenage brains are especially sensitive to nicotine's addictive properties. Urgent action is needed to control e-cigarettes to protect children, as well as non-smokers and minimize health harms to the population. E-cigarettes as consumer products are not shown to be effective for quitting tobacco use at the population level. Instead, alarming evidence has emerged on adverse population health effects. Without urgent and effective public health action, e-cigarettes will lead to a new generation of nicotine-addicted individuals.

Results of toxicological analyses suggest that e-cigarettes can be safer than conventional cigarettes, although harmful effects from short-term e-cigarette use have been described. Worryingly, the potential long-term effects of e-cigarette consumption have been scarcely investigated. In this review, we take stock of the main findings in this field and their consequences for human health including coronavirus disease 2019 (COVID-19). Heart failure is a condition affecting more than 6 million U.S. adults in which the heart becomes too stiff or too weak to pump blood as effectively as it should.

Nicotine pouches, led by top-selling Zyn by Swedish Match, have become increasingly popular among adult tobacco consumers, particularly those trying to lower or end their traditional or electronic cigarette consumption. Chalmers said some students are realizing the dangers of vaping after seeing their peers struggle with nicotine addictions. She believes that adding the CATCH My Breath education only solidifies it for them.

While their manufacturers say they are an alternative for tobacco smokers who want to avoid inhaling smoke, critics say too little is known about the safety of ESDs because they are not regulated. All tobacco products, including e-cigarettes, pose a risk to the health of the user. Beginning smoking, switching to smoking, or reverting to smoking exposes the user to potentially devastating health effects.

Another potential risk posed by vaping indoors is allergic reactions, especially among children. According to research, roughly 8% of kids in the United States have food allergies. Nuts (a common food allergy) are sometimes used to make added flavors in vaping fluids.

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.

The availability of "vape wear," such as backpacks and hoodies, also allow the user to vape while concealing the product. The study showed that the e-liquids of certain cig-a-like brands contain high levels of nickel and chromium, which may come from the nichrome heating coils of the vaporizing device. Cig-a-likes may also contain low levels of cadmium, a toxic metal also found in cigarette smoke that can cause breathing problems and disease.11 More research is needed on the health consequences of repeated exposure to these chemicals.

A 2016 study found that people who use or have used e-cigarettes are less likely to stop smoking altogether. Flavors vary widely, from "traditional" and menthol to watermelon and "lava flow." Some e-cigarettes taste like traditional cigarettes and even mimic the tastes of specific brands. When the user sucks on the mouthpiece, the heating element vaporizes the solution, which the person then "vapes," or inhales. The nicotine content of the liquid can range from "very high" to zero. Refills come in flavors such as cool cucumber, mango, and mint, which may seem natural and harmless, but a single JUUL refill contains as much nicotine as a pack of 20 cigarettes. To inform this work and evaluate the effectiveness of policy, the CDC Foundation is collecting and analyzing information about e-cigarette sales, teen e-cigarette use, and teens’ attitudes about the epidemic.

Overall, comparisons of the particle-size distribution in aerosols from e-cigarettes found that the substances tested had particle distributions similar to the traditional e-liquids containing nicotine. "Our finding indicates that health care expenditures for a person who uses e-cigarettes are $2,024 more per year than for a person who doesn’t use any tobacco products," said lead author Yingning Wang, PhD, of the UCSF Institute for Health & Aging. Use of electronic cigarettes costs the United States $15 billion annually in health care expenditures – more than $2,000 per person a year – according to a study by researchers at the UC San Francisco School of Nursing. Between 2016 and 2022–2023, the proportion of people who both smoked regular (combustible) tobacco cigarettes and used e‑cigarettes increased, as did the proportion who currently used e‑cigarettes but did not use regular cigarettes.

Not only is there evidence of mislabelling of nicotine content among refills labelled as nicotine-free, but there also seems to be a history of poor labelling accuracy in nicotine-containing e-liquids [37, 38]. "Since there is no safe tobacco product, eventual abstinence from all tobacco products is the end goal," concluded senior study author Andrew Hyland, PhD, Chair of Health Behavior at the Roswell Park Comprehensive Cancer Center. Meanwhile, people who were smoking e-cigarettes non-daily had a 3.1% rate of quitting smoking and a 10.2% rate of cutting down to non-daily tobacco smoking. However, the CDC states that there is insufficient evidence to suggest vaping can help people quit smoking. 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. The nicotine analogs were included in flavored e-cigarettes, which prior research has indicated are preferred by youths and those who vape for the first time.

While smoking can increase your risk of certain health conditions over years, like glaucoma, cancer, and issues with blood clotting, some of the bodily effects happen immediately. There's a lot that's still unknown about the harms of secondhand vaping, but research suggests that bystanders who breathe in the aerosol might be exposed to toxins. It's unclear how exposure to these toxins might impact health, but it's possible that repeated exposure could impact lung function in the long term.

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 FDA must act without further delay to remove all flavored e-cigarettes from the market. CDC recommends you not use e-cigarettes or vapor products, especially those with THC. Fewer Pierce County youth are smoking cigarettes in recent years, but more are vaping. The main ingredient in vapes is propylene glycol, vegetable glycerine or glycerol, and almost all vapes contain nicotine, flavours and other chemicals.

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.

But they may also contain other compounds including artificial flavors, nicotine, THC, and cannabinoid (CBD) oil. E-cigarettes are known by many different names, including e-cigs, electronic nicotine delivery systems (ENDS), alternative nicotine delivery systems (ANDS), e-hookahs, mods, vape pens, vaporizers, vapes, and tank systems. We know nicotine and other ingredients in e-liquids can hurt your body and we still don’t know what long-term health problems vaping could cause. There are online resources, texting and phone services and apps that connect you with real people to help you on your journey to kick the habit. E-cigarettes, aka JUULs and vape pens, use a battery to heat up a special liquid into an aerosol that users inhale.

The composition of e-liquids requires stricter regulation, as they can be easily bought online and many incidences of mislabelling have been detected, which can seriously affect consumers’ health. Beyond their unknown long-term effects on human health, the extended list of appealing flavours available seems to attract new "never-smokers", which is especially worrying among young users. Additionally, there is still a lack of evidence of e-cigarette consumption as a smoking cessation method. Indeed, e-cigarettes containing nicotine may relieve the craving for smoking, but not the conventional cigarette smoking habit.

In the case of the enzymatic reaction, the two substrates (reactants) are again acetic ester and H2O, the two products of the reaction are alcohol and acetate. Once the acetate group is removed from the cellulose chain, the polymer can be readily degraded by cellulase, which is another enzyme found in fungi, bacteria, and protozoans. Cellulases break down the cellulose molecule into monosaccharides ("simple sugars") such as beta-glucose, or shorter polysaccharides and oligosaccharides. Discarded cigarette filters usually end up in the water system through drainage ditches and are transported by rivers and other waterways to the ocean.

Altria Group chief executive William Gifford told analysts during a second-quarter conference call that makers of unregulated e-cigarettes are responding to consumers’ switching to nicotine pouches. According to the latest Nielsen convenience store report released Wednesday, Zyn sales have jumped 74.6% year-over-year with total annual sales now in the $2 billion range. Tobacco industry executives and analysts are sounding alarms about a surge of unregulated nicotine pouches entering the U.S. that is chipping away at regulated products.

The FDA lists 93 harmful or potentially harmful chemicals found in regular cigarettes, and the National Cancer Institute (NCI) describes cigarettes as having more than 7,000 chemicals in them. Because e-cigarettes contain fewer chemicals the industry has presented them as a healthier alternative to regular cigarettes. But vape liquids can still contain nicotine, a highly addictive drug.

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.

FDA published a rule clarifying when products made or derived from tobacco are regulated as tobacco products, drugs, and/ or devices. Vaping is when you use a handheld electronic device to breathe a mist ("vapor") into your lungs. An e-cigarette, vape pen or other electronic nicotine delivery system (ENDS) heats a liquid of nicotine, flavoring, propylene glycol and other additives into an aerosol that you inhale through a mouthpiece.

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.

In smoking and school disengagement (e.g. truancy), students often choose to affiliate with similar peers [28, 29]. Smoking prevalence has been lower in schools where educational attainment and attendance are better than predicted based on student socio-demographic factors, indicating the importance of positive school ethos [30]. Yet, other school-level factors than school connectedness [22] have rarely been studied in connection with susceptibility. Youth use of e-cigarettes has surpassed youth use of regular combustible cigarettes in Delaware. Approximately 38 percent of Delaware high school students reported ever trying an electronic vapor product. Finally, the researchers compared the levels of nicotine in the blood serum of people after they had vaped e-cigarettes with the levels in people who smoked traditional cigarettes.

Median odds ratio (MOR), which shows the difference between two respondents with identical student-level characteristics from two randomly chosen different schools, was calculated to express between-school variance on the odds ratio scale [36]. The analysis was not pre-registered, and the results should be considered exploratory. Scholastic Real Cost of VapingThe FDA collaborated with the Scholastic Corporation to develop lessons, activities and resources for teachers to increase awareness about the health consequences of youth e-cigarette use. Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. This study was the first to use endothelial cells derived from iPS cells to directly investigate the effect of e-liquids with and without nicotine on their viability and function.

The program’s curriculum includes a four-part series of lessons, with one set for fifth through eighth graders and another for high schoolers. The lessons teach students about the dangers of vaping, vaping marketing and resources for quitting vaping. Students that go through the program are 45% less likely to vape, according to Bianco. This is Quitting was developed by Truth Initiative, a nonprofit focused on ending tobacco use, as a free and anonymous text messaging program to help young people quit vaping.

This solution typically contains propylene glycol or glycerol, nicotine, and flavouring agents. Indeed, the "vapor" may have a lot more than those five ingredients listed above. Some studies have found it to contain lead, nickel, tin, and silver from the machinery inside the devices along with formaldehyde, manganese, tolulene, and other ingredients linked to cancer, central nervous system problems, and other possible health issues. A 2018 study of e-cig smokers’ urine found at least five of the same carcinogens found in cigarettes.

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.

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.

Many people diagnosed with EVALI need to be treated in a hospital where medications can be closely monitored, and respiratory support is readily available. "I screen all of my patients, any child over age 12, since [vaping] can exacerbate underlying conditions like asthma," says Yale Medicine pediatric pulmonologist Pnina Weiss, MD. To learn more about e-cigarettes, here are resources from the American Cancer Society and the FDA. There are some e-cigarette brands that claim to be nicotine-free but have been found to contain nicotine. For medical questions, we encourage you to review our information with your doctor.

In the United States, the mortality rate for smokers is three times that of people who never smoked. In fact, the Centers for Disease Control and Prevention (CDC) note that smoking is the most common preventable cause of death in the United States. Join our rewards program today to start earning rewards with your in-store and online purchases. With 180 Rewards, you can earn back what you spend and shop smarter to get the most out of your purchases. Nicotine also can affect concentration and brain development, according to information and data from a new report from the surgeon general.

A 2016 report indicated that many vape fluids contain flavoring agents at concentrations that may pose risks to users. It carries the same health risks as vaping with any other e-cigarette brand. There’s limited evidence to date of the long-term effects of vaping because we know the lung effects of vaping will take decades to develop.

Studies have found that nearly two-thirds of adult e-cigarette users plan to quit, and almost a quarter of adolescents want to quit and have made a quit attempt. We hope this article helps you feel a little more secure about your choice of vaping products. Remember that the safest way to use any vape is in moderation, so try not to overdo it, no matter which one you choose. Flavored vapes without nicotine (and other types of vapes) come in hundreds of different sizes and styles, and some are less risky than others. How can you decide which ones are safest and what's considered a healthy vape brand. Our only gripe with CAPNOS is that they're a little vague about where exactly their flavors come from.

However, a major concern about vaping is its attraction for young people. And, while it’s safe when taken orally as a supplement or used on the skin, it’s likely an irritant when inhaled. It’s been found in the lungs of people with severe, vaping-related damage. Some of these additives have health risks, such as diacetyl, which has a buttery taste. Diacetyl has been found to cause a severe lung disease similar to bronchiolitis. Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers.

I can go for six months at a time without catching a nasty, lingering cough. My clothing doesn’t reek of smoke all of the time and my car actually smells nice. So, though they are far from perfect, I am enjoying the changes that not smoking cigarettes has brought to my life. "Since there is no safe tobacco product, eventual abstinence from all tobacco products is the end goal," says Dr. Hyland, who is senior author on the new work. Adults in the U.S. who used e-cigarettes daily and also smoked combustible cigarettes were more likely to quit smoking than those who smoked but used e-cigarettes less frequently. Justice announced the task force that they say will address the illegal domestic distribution and sale of electronic cigarettes.

Similarly, a 2014 review reported that vaping may trigger gum, mouth, and throat irritation. In particular, a 2015 study examined the effects of flavored e-juices on both human lung cells and lung cells in mice. Here’s what we currently know about the effects of vaping fluids with and without nicotine and vaping cannabis or CBD. In cultured human airway epithelial cells, both e-cigarette aerosol and CS extract induced IL-8/CXCL8 (neutrophil chemoattractant) release [28]. Researchers noted that study participants using both types of cigarettes had a higher nicotine dependence in relation to e-cigarettes. Find more resources on tobacco, e-cigarettes, and vaping on the SAMHSA Store.

The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. The products available in Australia are often made up of many parts, from all over the world, which makes it difficult to assess the safety of the overall product. Most e-cigarettes available in retail stores have not been tested or approved by the TGA, which means their safety cannot be guaranteed. Children are exposed to e-cigarette advertising online and on TV, in magazines and billboards. Although it is illegal for e-cigarettes to be sold to youth under age 21, they can be ordered online. While flavors were nationally banned in 2019, this ban excludes mint and menthol flavors.

You should use the vape as much as you need to manage your cravings and withdrawal symptoms. Here are some of the most common myths, and the facts based on scientific evidence and data. Nicotine itself is not very harmful and has been used safely for many years in medicines to help people stop smoking. E-liquids come in different nicotine strengths, so you control how much nicotine you need to help with cravings and other withdrawal symptoms, such as feeling irritable and having low mood. Electronic cigarettes and ESDs also pose a risk of fire and explosions, which result in serious injuries and property damage.

There's no evidence so far that vaping causes harm to other people around you. If you're pregnant, licensed NRT products such as patches and gum are the recommended option to help you stop smoking. Nicotine replacement therapy (NRT) has been widely used for many years to help people stop smoking and is a safe treatment. In the UK, e-cigarettes are tightly regulated for safety and quality.

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.

Others can be refilled with liquid, recharged, and used over and over. Our Board of Health is a leader in protecting people from the dangers of e-cigarettes and vapor products. Vapes contain nicotine and other substances like THC that negatively affect brain development in youth. Nicotine is also highly addictive and can lead to smoking later in life. Vapes are electronic devices designed to deliver vapourised liquids into your lungs when you breathe in.

Much like free-base nicotine products, these liquids contain propylene glycol and/or vegetable glycerin, as well as other chemicals such as flavouring ingredients. Most vaping devices use electrical power from a battery to heat a liquid solution. The term "vaping" is also used to refer to the inhalation of cannabis aerosols, which are produced by products that differ from nicotine products described on this page. Propylene glycol and glycerin are the most common solvents used in vapor products. While generally recognized as safe for ingestion by the FDA, research has found both substances to be toxic when aerosolized through the vaping process.

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.

Truth Initiative forcefully rejects, however, the notion that this requires the further development of a huge commercial market in addictive nicotine products focused on growth and the acquisition of new users, most of whom are youth and young adults. Because the youth e-cigarette crisis in the United States and the youth appeal of flavored e-cigarettes go hand in hand, Truth Initiative strongly supports removing all flavored e-cigarettes from the market, regardless of device type. Based on the evidence already collected, the question shouldn’t be whether e-cigarettes are less dangerous than cigarettes, Christiani says, but whether vaping can be very harmful to health too. "To protect public health, I discourage the use of vaping—even to quit smoking," he stresses.

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.

"If there was good evidence that people were using e-cigarettes just to quit smoking, there would be wide support," Benowitz says. "The problem is most of the e-cigarette use in the U.S. is dual use with cigarettes." People use e-cigs in places or situations where they can't smoke, like in a restaurant, but continue lighting up when they can, he explains. "My reading of the evidence is that it is quite convincing that e-cigarettes are helping some people quit smoking." Many young e-cigarette users reported throwing away, improperly recycling, or littering the devices. Only 15% of young e-cigarette users reported disposing of empty pods or disposable vapes by dropping them off or sending them for electronic recycling.

Freebase nicotine products can be used in refill liquids or in cartridges for closed systems. Because the brain experiences significant development during adolescence, nicotine use during this critical time can rewire the brain which can make it easier for youth to get addicted to other substances due to issues with impulse control. Together, these three categories accounted for almost two thirds of expenditures in 2021. If you or someone you know has had a safety issue with an denver electronic cigarette cigarette (e-cigarette or vape), please report the problem to the Food and Drug Administration (FDA) at the FDA Safety Reporting Portal (hhs.gov). For adults looking to talk to teens about vaping, Live Vape Free is an online program that provides tips, tools, and one-on-one support.

In regard to COVID-19 pandemic, the actual literature suggests that nicotine vaping may display adverse outcomes. Therefore, follow up studies are necessary to clarify the impact of e-cigarette consumption on human health in SARS-CoV-2 infection. Recently, a commonly commercialized crème brûlée-flavoured aerosol was found to contain high concentrations of benzoic acid (86.9 μg/puff), a well-established respiratory irritant [88]. When human lung epithelial cells (BEAS-2B and H292) were exposed to this aerosol for 1 h, a marked cytotoxicity was observed in BEAS-2B but not in H292 cells, 24 h later.

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.

That legal decision allowed sales of e-cigarettes to proceed but left many questions about their safety unaddressed. To lower the potential risks posed by secondhand aerosol exposure from vaping, some U.S. states, territories, and cities have started restricting where people can vape. There are currently more than 7,000 varieties of flavored e-cigarettes and e-juice (liquid containing nicotine that is used in refillable devices) on the market. Although the popularity and use of e-cigarettes continues to increase, there is a lack of data on their potential health effects. Food and Drug Administration (FDA) has issued a proposed rule to include e-cigarettes under its authority to regulate certain tobacco and nicotine-containing products. Fourth-generation ‘pod’ e-cigarette devices have been driven by technological advances in electronic atomization of the e-liquid.

While vaping might help you quit smoking, it probably won’t help you quit nicotine altogether. The CDC has identified vitamin E acetate as a chemical of concern among people with EVALI. Vitamin E acetate is a thickening agent often used in THC vaping products, and it was found in all lung fluid samples of EVALI patients examined by the CDC. Unlike traditional cigarettes, e-cigarettes are generally battery-operated and use a heating element to heat e-liquid from a cartridge (usually refillable), releasing a chemical-filled aerosol. Below are answers to common questions about e-cigarettes, including health consequences, risks of secondhand emissions, kids and e-cigarettes and FDA oversight. This is Quitting is tailored based on age (13-24 years old) and product usage to give teens and young adults appropriate recommendations about quitting.

On this webpage, these products are collectively referred to as e-cigarettes. E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavorings, and other chemicals that make the aerosols. The liquid is sometimes called e-juice, e-liquid, vape juice, or vape liquid. Bystanders can also breathe in this aerosol when the user exhales it into the air. E-cigarette devices can be used to deliver marijuana and other drugs. Additionally, a study of adult smokers in Europe found those who vaped nicotine were less like to have stopped smoking than those who did not.

The Finnish Social and Health Data Permit Authority Findata grants permits to the secondary use of the SHP data. Conceptualized and designed the study, managed data, and conducted analyses. All authors contributed to manuscript revisions and have approved the final version of the article. The association between student- and school-level factors and susceptibility to e-cigarette use.

Refillable pod mods use replaceable pods that contain either a built-in or removable coil. They are designed to be easier to use than vape pens as they adopt a secure magnetic connection between the pod and battery instead of a tank with a screw mechanism. They have few features and are compact, appealing to those new to the world of vaping and those wanting to upgrade to something simple. The term " vape pen" normally refers to a vape kit consisting of a refillable tank and a rechargeable battery; they are often slim and shaped like a pen, but not always!

Health services in the United Kingdom say that vaping can be an effective tool for quitting smoking. Additionally, in 2021, the Food and Drug Administration (FDA) permitted the marketing of three e-cigarette products, specifically citing their potential benefit in helping people quit smoking. Quitting is your best option to reduce your risk from smoking and tobacco use-related diseases.

Next, we examined the e-cigarette emissions of flavouring compounds, together with acetic acid and propionic acid, as listed by the U.S. These compounds were not analysed in cigarette smoke because the Ky1R6F cigarette used in the study is an unflavoured US-blended cigarette and validated analytical methods for these compounds were not available. From the studied carbonyls, only acetaldehyde, acrolein and formaldehyde are included in the nine WHO TobReg priority smoke toxicants55. Relative to cigarette smoke, their percentage of reduction in the e-cigarette emissions was ≥ 98.8%. Liquid refills are sold in quantities of 10 mL to more than 30 mL (about two to six teaspoons) in a variety of nicotine strengths. The products come in flavors with attractive scents and inviting packaging.

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.

However, a single e-cigarette can be harmful to the body’s blood vessels — even when the vapor is entirely nicotine-free — according to a new study by researchers in the Perelman School of Medicine at the University of Pennsylvania. Tobacco products contain nicotine, which is highly addictive and can harm brain development as teens grow. Rural youth are at higher risk for harm, because they tend to begin using tobacco products at a younger age and use tobacco products more frequently. Products like e-cigarettes, vapes, and e-hookahs typically contain nicotine, which is highly addictive and can harm brain development as teens grow.

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.

We've curated a selection of authentic premium quality vape products from the best vaporiser manufacturers worldwide. We have high-quality products and knowledge to ensure an exceptional vaping experience customised to your needs. Electronic cigarettes—or e-cigarettes—are battery-powered devices that convert a liquid, usually with nicotine, into an inhalable aerosol. They are designed as an alternative to smoking traditional cigarettes. First introduced in the United States about 15 years ago, e-cigarettes have evolved from disposable, single-use products to more sophisticated devices that can be refilled and customized (fig. 1). PHILADELPHIA – Smoking e-cigarettes, also called vaping, has been marketed as a safe alternative to tobacco cigarettes and is rising in popularity among non-smoking adolescents.

If used during preg