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This guide supports health care providers, systems, and communities seeking to prevent vaping. These resources and others are on the AAFP’s Tobacco and Nicotine Prevention and Control webpage. Familydoctor.org, the Academy’s patient-facing web resource, has additional materials on tobacco addiction, the harms of vaping and several related topics. Young adults with family incomes of less than 200% of the federal poverty level also were more likely to use e-cigarettes than those with greater family income.
Commercial tobacco use is the leading cause of preventable disease, disability, and death in the United States.
Cigarette smoking is still the No. 1 cause of preventable death in this country, killing nearly five hundred thousand people each year. (According to some studies, more than half of longtime smokers will die from smoking-related complications.) It’s incredibly hard to stop smoking; people spend lifetimes trying. Around seventy per cent of American smokers say that they want to quit, and for many of them e-cigarettes have been a godsend. But, according to a 2017 study by the C.D.C., about fifty per cent more high schoolers and middle schoolers vape than smoke. Young people have taken a technology that was supposed to help grownups stop smoking and invented a new kind of bad habit, one that they have molded in their own image. The potential public-health benefit of the e-cigarette is being eclipsed by the unsettling prospect of a generation of children who may really love to vape.
If a child ingests or touches fluids with an allergen in it, they could have a reaction. This, however, is only a theoretical risk for now, as little research has been done on the topic. One study, for example, found that under most conditions, someone vaping at home all day didn’t change the air quality a terrible amount unless they vaped intensely at a high voltage.
However, 87% of people who reported using e‑cigarettes with nicotine had obtained them without prescriptions. "This relatively small study showed that e-cigarettes have the potential to decrease heart muscle blood supply, not just under the stress of exercise like traditional cigarettes but even at rest," he says. The authors of a 2019 review point out that e-liquid aerosols contain particulates, oxidizing agents, aldehydes, and nicotine. When inhaled, these aerosols most likely affect the heart and circulatory system. Of note, another study indicated that although RANTES/CCL5 and CCR1 mRNA were upregulated in flavour/nicotine-containing e-cigarette users, vaping flavour and nicotine-less e-cigarettes did not significantly dysregulate cytokine and inflammasome activation [43].
Parental smoking, positive attitude towards e-cigarette use in one’s age group, current smoking, and snus use increased S-EC, whereas liking school lowered it. At school level, both among girls and boys, a higher proportion of students liking school and being never-users lowered S-EC, whereas a higher proportion of students with positive attitudes towards e-cigarette use increased it. Among girls, a higher proportion of girls in the school, students with a high parental education and planning for GUSS lowered S-EC, but a higher proportion of students with parental smoking increased it.
Their tactics include slick magazine ads, sponsorship of concerts and auto races, celebrity endorsements and sweet, colorful flavors.21 In addition, e-cigarettes are often aggressively placed in convenience stores near candy. Flavors, including mint and menthol, are one of the top reasons young people use e-cigarettes. Candy and fruit-flavored e-liquids can make e-cigarettes appealing and seem harmless. As of July 2020, the sale of flavored e-cigarettes is prohibited in NYC. Further, in 2018, one in 15 (6.7%) middle school students reported using e-cigarettes. E-cigarette use was higher among older students, with one in 11 (9%) seventh grade students reporting use, compared to one in 38 (2.6%) in sixth grade.
E-liquid physical properties are also important in carbonyl formation15,47,84,86. The viscosity and density of the e-liquid determine its mobility, capillary action, and delivery to the wick and coil, influencing the likelihood of a dry puff15. Sub-ohm vapes (sometimes called cloud kits) are more advanced vaping devices that are capable of outputting huge amounts of power; if you’ve ever noticed someone exhaling gigantic clouds from their kit, they were probably using one of these! Using a sub-ohm device requires a working knowledge of battery safety and Ohm’s Law, so it’s best to do some reading before investing in one. "India should be taking lessons from the West where vaping has become an epidemic. Claims that e-cigarettes aid cessation is a big lie, rather they are gateway devices.
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.
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.
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.
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.
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.
Taken together, the studies provide strong evidence that an interactive, tailored text message program can help teens and their older peers break free from nicotine addiction. These findings are especially important given the recent youth mental health crisis documented by the U.S. Adolescents in this study were characterized by high severity of past-year problems with depression, sleep, anxiety, trauma, and substance use. In addition, moderate to high levels of nicotine dependence were observed across multiple measures, with more than three-quarters (76.2%) of teens vaping within 30 minutes of waking — a common way to measure addiction. Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses.
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 data highlights a small part of a larger issue, despite the ban on e-cigarettes and vapes in India under the Prohibition of Electronic Cigarettes (Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage, and Advertisement) Act, 2019. The Annual Review of Physiology article summarizes what is known—and highlights where gaps in knowledge exist—about e-cigarettes and harm to the lungs. The review discusses the range of effects found in rigorous studies, including shorter-term acute effects and longer-lasting chronic impacts. As substantiated in the review, a convincing body of evidence exists that confirms e-cigarettes cause lung inflammation and injury, as well as negative health effects in multiple organs. Crotty Alexander says e-cigarettes come with far more dangers than even she expected.
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.
"These products appear to be designed to circumvent the laws and regulations in place to protect people—especially children—from the harmful effects of smoking and tobacco use," Jordt said. The CDC advises people who have asthma to avoid tobacco smoke, yet Minnesota teens who have asthma are more likely to breathe someone else’s tobacco smoke or e-cigarette aerosol than teens who do not have asthma. Minnesota’s teens who have asthma are less likely to be protected by rules against smoking in the family’s homes or vehicles. Individuals included from the PATH study were 21 years and older daily cigarette smokers and reported any use of e-cigarettes within the previous 30 days. The new study findings follow on the heels of a report from the Substance Abuse and Mental Health Services Administration (SAMHSA) showing growing numbers of e-cigarette users.
The replaceable liquid cartridge contains nicotine mixed with a base (usually propylene glycol), along with flavorings and chemicals. The tip often contains LED lights that simulate the glow of a burning cigarette. Nicotine poisoning can occur when someone ingests, inhales, or absorbs nicotine through the skin or eyes. It can be particularly dangerous for children and young adults, as they are more susceptible to the effects of nicotine. The tax must be broken out as a separate amount from the products sold in any transaction.
In December 2019, the federal government raised the legal minimum age of sale of tobacco products from 18 to 21 years, and in January 2020, the FDA issued a policy on the sale of flavored vaping cartridges. The e-liquid in most e-cigarettes contains nicotine, the same addictive drug that is in regular cigarettes, cigars, hookah, and other tobacco products. However, nicotine levels are not the same in all types of e-cigarettes, and sometimes product labels do not list the true nicotine content. Products marketed for therapeutic purposes (for example, marketed as a product to help people quit smoking) are regulated by FDA’s Center for Drug Evaluation and Research (CDER).
This includes quit coaching, up to 2 weeks of nicotine replacement therapy, and a youth digital program for those ages 13-17. Vuse, owned by Reynolds American, and Juul control about 60% of the market, while hundreds of disposable brands account for the rest. While nicotine is the addictive substance in cigarettes, most of the harm from smoking comes from the thousands of other chemicals in tobacco smoke, many of which are toxic.
E-cigarettes contain many of the same cancer-causing chemicals that regular cigarettes do. Nicotine is highly addictive, and most e-cigarettes include it as a main ingredient. The AMA promotes the art and science of medicine and the betterment of public health. The rise of e-cigarettes and vaping has raised concerns that another generation may become dependent on nicotine. The AMA has been a leading force to eliminate public smoking and warn people about the dangers of smoking, including secondhand smoke, since the 1960s.
"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.
Because there is no safe tobacco product, quitting use of all tobacco products is the best way to protect your health. Most e-cigarettes contain nicotine, which is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s. E-cigarettes can contain other harmful substances, including cancer-causing chemicals; chemicals linked to serious lung disease; and heavy metals, such as nickel, tin, and lead. Young people who use e-cigarettes may be more likely to smoke traditional cigarettes in the future. Vapor products produce aerosol by heating a liquid solution, which is inhaled as an aerosol. The process is referred to as "vaping." Vapor products often contain nicotine.
Meanwhile, California had the lowest rate of vaping - six percent - due to strict regulations from Governor Gavin Newsom, who recently outlawed the sale of flavored vapes to people of all ages. Since smoking affects every body system, finding a way to quit can help you live a longer and healthier life. If you quit smoking, the risk of developing most of these types of cancers decreases in about 10 to 20 years, depending on the type of cancer. However, your risk will still be higher than that of people who have never smoked.
As a non-profit organization, we accept no government or tobacco industry funding. We rely on contributions from individuals, philanthropic foundations, corporations and other non-profit organizations to continue working toward a tobacco-free future. The U.S. Surgeon General declared vaping an epidemic among our youth in 2018. Additional collection points are being added all the time, you can use your postcode to find your nearest vape recycling locations. You can take vapes for recycling to the shop where you buy your replacements or to your local authority household waste recycling centre. Once you have bought the kit, it's been estimated that vaping costs about a third as much as smoking.
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.
Vaping has exploded into a national crisis, and tobacco companies are helping to fuel it by targeting kids with flavors such as gummy bear and cotton candy. E-cigarette companies have promoted unsubstantiated health claims about their products as healthier than traditional cigarettes, when, in fact, e-cigarettes are uniquely dangerous for kids due to nicotine’s impact on their developing brains. Since being introduced to the U.S. market in 2007, e-cigarette use among youth has increased to epidemic levels (Surgeon General's Advisory on E-cigarette Use Among Youth, 2018). The availability of flavored e-cigarettes is one of the most commonly cited reasons for e-cigarette use among youth (Tsai et al., 2018). Given the importance of flavors contributing to use of e-cigarettes among youth, these data briefs build on this previously published article, providing an update on trends in unit sales of e-cigarettes in the U.S. by product and flavor type.
That means you don't have to worry at all about the effects of hot vapor in your lungs. Part of the appeal of vaping is that it can help you quit smoking little by little instead of going cold turkey. These small disposables from Elf Bar make that easier by reducing the amount of nicotine per inhale. While many inhalers use e-liquid containing 5% nicotine salt, the ELFBAR 600 lets you choose between 2%, 1%, and 0%. It's a great way to gradually wean yourself off this addictive chemical. More and more people are vaping cannabidiol, or CBD, to feel the relaxing effects of cannabis without the intoxication.
Originally, it was thought that vaping might be helpful for people trying to quit smoking. Some e-cigarette labels have claimed that the product had no nicotine when, in fact, it was in the vapor. For this reason, it’s important to use only trusted brands if you vape. E-cigarettes are still relatively new, so their long-term effects are unknown.
Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America’s oldest professional training program in public health. This study explored the prevalence of S-SM, S-EC, and S-SN among adolescents in a country with advanced tobacco control regulations. We found that the susceptibility was highest for e-cigarette use, followed by smoking and snus use. S-SM was more common among girls, whereas S-EC and S-SN were more common among boys. In our analysis, levels of carbonyls were considerably reduced relative both to other studies of e-cigarettes and to Ky1R6F cigarette smoke.
FDA regulates the manufacture, import, packaging, labeling, advertising, promotion, sale, and distribution of ENDS, including components and parts of ENDS but excluding accessories. An outbreak of EVALI in late 2019 and early 2020 put thousands of people in the hospital. Since then, EVALI cases have been declining, but people who vape can still get EVALI. Research from the CDC shows that vaping among youth has declined somewhat since 2020.
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. E-cigarettes have been sold in the U.S. since 2007 but in recent years their potential benefits for smokers have been overshadowed by their use by adolescents and teens. Vaping nicotine has not been thoroughly evaluated in scientific studies. For now, not enough data exists on the safety of e-cigarettes, how the health effects compare to traditional cigarettes, and if they are helpful for people trying to quit smoking.
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.
This mixture is typically made up of propylene glycol and/or glycerol (vegetable glycerin) and other chemicals. Flavouring ingredients include chemicals and blends of chemicals used to make different flavours. Disposable e-cigarettes are not covered by the flavor restrictions imposed by the Food and Drug Administration.
Consequently, stricter regulation and a higher quality control in the e-liquid industry are required. The mislabelling of nicotine content in e-liquids has been previously addressed [8, 34]. Of note, several studies have detected nicotine in those e-liquids labelled as nicotine-free [5, 35, 36]. Among the 17 samples tested in this latter study 14 were identified to be counterfeit or suspected counterfeit. A third study detected nicotine in 7 of 10 nicotine-free refills, although the concentrations were lower than those identified in the previous analyses (0.1–15 µg/mL) [5].
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].
Among people who were currently using e‑cigarettes, the proportion of people who used them daily remained stable from 2016 (42%) to 2019 (42%), then increased in 2022–2023 (49%). While more males than females used e‑cigarettes daily, the change among females was much greater than among males, rising from 36% in 2019 to 51% in 2022–2023. This corresponds to a fourfold increase in the number of females using e‑cigarettes daily, from approximately 70,000 to 300,000 (Figure 2).
As with high school students, e-cigarette use was much more common than cigarette use. E-cigarettes come in many shapes and sizes and can also be called e-cigs, e-hookahs, vapes, vape pens, personal diffusers or diffuser sticks. But one vape can contain the equivalent of 50 cigarettes of nicotine in the one product. They also contain a complex combination of chemicals including nicotine, nickel, tin, arsenic, chlorine and lead. These substances can be harmful to the body, with different flavourings helping to mask these poisons when they are taken into the body. An electronic cigarette (e-cigarette) is a battery-operated device that heats liquid nicotine, flavoring, and other additives to create an aerosol.
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.
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.
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.
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.
A lack of data has led to classification of methylgloxal as a Group 3 carcinogen (carcinogenicity to humans not classifiable) by IARC. Both compounds have been previously detected in e-cigarette emissions at concentrations of 0.07–0.94 and 0.09–33 µg puff–1, respectively86,88. In our study, glyoxal was present at lower levels (BB57 and BB18, 0.02 and 0.05 µg puff–1, respectively), while methylglyoxal was at concentrations of 0.13 and 0.19 µg puff–1 in BB57 and BB18, respectively (Table 3). Glyoxal was detected in the method air blank and therefore the actual levels in the e-cigarette emissions are potentially lower than reported in Table 3.
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.
There have also been cases of e-cigarettes exploding or catching fire. Some chronic users have developed obstructions in their lung pathways that cause them to suffer 'asthma-like' symptoms. Similar to Wyoming, the state's vast rural areas might contribute to difficulty enforcing regulations surrounding youth vaping. West Virginia came in second place, with 28 percent of teens vaping last year. The large rural area may make it more difficult to enforce the state's vaping laws. Rural areas also tend to have less access to clinics and resources about the health harms surrounding vaping.
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.
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.
If you experience side effects from vaping, get advice from a stop smoking adviser or specialist vape retailer before you decide to stop using a vape as your quit smoking tool. Almost two-thirds of people who use a vape along with support from a local Stop Smoking Service successfully quit smoking. Vaping is not completely harmless and we only recommend it for adult smokers, to support quitting smoking and staying quit. It made sense – Altria, the bad actor formerly known as Philip Morris, maker of Marlboro cigarettes, owned a 35% stake in JUUL.
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.
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].
Since This is Quitting launched as a text message program in 2019, more than 750,000 young people have enrolled from across the U.S. Grounded in clinical guidelines for treating tobacco dependence, This is Quitting incorporates powerful messages from other young e-cigarette users who have offered their advice about how to quit. Teens and young adults can text DITCHVAPE to to receive free quit vaping support from the program. This study is the first published randomized clinical trial of a quit vaping program among teens, filling an important gap in the scientific literature and providing much needed evidence for pediatricians, school administrators, and public health agencies. Although stopping smoking can cause short-term side effects such as reversible weight gain, smoking cessation services and activities are cost-effective because of the positive health benefits. Further, educational aspirations and school engagement are tied to student composition and school-based networks and norms, which have had different associations with smoking between schools [28].
Electronic nicotine dispensing systems (ENDS), commonly known as electronic cigarettes or e-cigarettes, have been popularly considered a less harmful alternative to conventional cigarette smoking since they first appeared on the market more than a decade ago. Both the electronic devices and the different e-liquids are easily available in shops or online stores. The long-term health effects of electronic cigarettes (e-cigarettes) are not fully understood, but the science indicates they are not a safe alternative to smoking. Most are noncombustible which includes a battery, a heating element, and a liquid compartment, usually containing addictive nicotine, that is added to the e-liquid or included in the device. The heating element aerosolizes the liquid for the inhalation of the liquid nicotine or other contents.
I never kidded myself into thinking that this habit was harmless, but my conviction that they were less harmful than cigarettes made the endeavor seem worthwhile, even praiseworthy. A May analysis found that vaping increases the risk of asthma by 200 percent and previous studies have linked the products to lung cancer, respiratory conditions, lung disease and organ damage. It’s still not clear how the toxins found in vaping can affect the health of non-vapers, especially long-term. The limited research available so far has largely focused on immediate health effects.
"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.
And Puerto Rico have passed comprehensive smoke-free indoor air laws that include e-cigarettes, as of March 31, 2023. These laws prohibit smoking and the use of e-cigarettes in indoor areas of private worksites, restaurants, and bars. In our fight to end youth and young adult nicotine addiction, we focus on the issues that matter most.
In general, e-cigarettes are not safe for young people or people who are pregnant. Vaping is no safer for developing fetuses than smoking traditional cigarettes. They may also resemble sleek electronic devices, making them appealing to younger users.
Sales data did not include e-cigarette sales made online, in vape shops, or via illicit markets. While the study was not a randomized experiment, the analytical methods used were robust enough to identify causal relationships. ESD aerosol is a new source of pollution and toxins being emitted into the environment. We do not know the long-term health effects of ESD use and although the industry marketing of the product implies that these products are harmless, the aerosol that ESD emit is not purely water vapor. These figures coincide with additional research that indicates an overall increase in e-cigarette use. Vaping is the act of inhaling and exhaling an aerosol produced by a vaping product, such as an electronic cigarette.
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.
Nicotine levels ranged 0.10–0.32 mg puff−1 across the 3 study products. From the 19 proposed HPHCs specifically of concern in e-cigarettes, only 3 (glycerol, isoamyl acetate and propylene glycol) were quantified. As crucial as it is to health to quit smoking conventional cigarettes, it is unwise, as a rule, to take up vaping as a substitute, Christiani emphasizes.
In this data brief we use the 2017 MYTS to report e-cigarette initiation prevalence, which teens are trying e-cigarettes, and why initiation is a problem. The tobacco use landscape in the United States and Minnesota is evolving. E-cigarettes are rapidly increasing in popularity, especially among youth. However, products like cigarettes and smokeless tobacco continue to have a stronger hold in rural areas due to decades of targeted marketing by the tobacco industry, which integrated tobacco use into rural culture.
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.
Although e-cigarettes do not give off smoke like tobacco cigarettes, they do expose people to secondhand aerosol or "vapor" that may contain harmful substances. Scientists are still learning about the health effects of being exposed to secondhand e-cigarette aerosol. The FDA monitors the national usage rates for all tobacco products, including an annual youth survey, and has seen a drastic increase in youth use of e-cigarette products in recent years.
For information about ENDS products that are authorized for marketing in the U.S., view FDA’s "Searchable Tobacco Products Database." These problems can seriously hurt the person using the ENDS product and others around them. There may be added dangers, for example if a vape battery catches fire near an oxygen tank, a propane tank (such as used in backyard grills), or a gas pump, or if a person has a vape-related seizure while driving. Enlist in our movement, explore youth activism programs, share quitting resources, and learn about more ways you can get involved. By using our website or products, you agree that you have read and agree to our terms of service, disclaimer, age policy, refund policy, and privacy policy.
If you’re having trouble quitting e-cigarettes on your own, get help from your doctor or from other support services, such as your state quitline (1-800-QUIT-NOW) or the American Cancer Society (1-800-ACS-2345). Electronic cigarettes (e-cigarettes) are sometimes called e-cigs, vapes, vape pens, and electronic cigarettes and cancer nicotine delivery systems (ENDS). Get the facts about e-cigarettes, their health effects, and the risks of vaping.
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.
Most of the harmful chemicals in tobacco smoke, including tar and carbon monoxide, are not contained in vape aerosol. Switching to vaping significantly reduces your exposure to toxins that can cause cancer, lung disease, and diseases of the heart and circulation like heart attack and stroke. These diseases are not caused by nicotine, which is relatively harmless to health.
However, your local Stop Smoking Service may offer a free vaping starter pack. Make sure you buy your vaping products from a reputable retailer so you can be confident they are covered by UK safety and quality regulations. Get advice from a specialist vape shop or a local Stop Smoking Service. Finding the right device and strength of nicotine in your e-liquid may take time – so stick with it.
Experimenting with different ways of using vaping materials may be additionally risky. In addition, nicotine use can affect areas of a young person’s brain that are responsible for attention and learning. Primary spontaneous pneumothorax, or collapsed lung, occurs when there’s a hole in the lung through which oxygen escapes.
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.
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.
This includes data on youth use of these products, which has led to development of several educational programs designed to prevent adolescents and teens from using these products. Through tobacco product problem reports and tobacco product violation reports, the FDA also knows much more about many safety and health hazards they may pose. The Surgeon General reports e-cigarette use among youth is a significant public health concern and steps must be taken by parents, educators and especially policymakers to discourage use of e-cigarettes.
Strong decisive action is needed to prevent the uptake of e-cigarettes based on the growing body of evidence of its use by children and adolescents and health harms. Public Health Consequences of E-Cigarettes reviews and critically assesses the state of the emerging evidence about e-cigarettes and health. This report makes recommendations for the improvement of this research and highlights gaps that are a priority for future research. Vape explosions have been linked to faulty batteries in vaping devices.
Watch the UK Health Security Agency's video demonstration on the impact of smoking versus vaping. As of July 1, 2024, 1,061 municipalities, plus 26 states, commonwealths, and territories restrict e-cigarette use in 100% smokefree venues. The Royal Children’s Hospital (RCH) acknowledges the traditional owners of the land on which the RCH is situated, the Wurundjeri people of the Kulin Nation, and we pay our respects to their Elders past and present. Dr. Tan provides care to adults alongside an entire team of lung specialists at Loma Linda University Health.
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].