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This was a large increase from 2019, when only 11.3% of people had ever used e‑cigarettes, and 2.5% were currently using them (Figure 1). The proportion of people who used e‑cigarettes daily in 2022–2023 was 3.5%, rising from 1.1% in 2019. In smokers who smoke tobacco cigarettes, blood flow increased modestly after cigarette inhalation and then decreased with subsequent stress. However, with those who vaped, blood flow decreased after inhalation at rest and also after handgrip stress. Finally, lung health effects are not expected to be seen for 20 to 30 years.
Learn more about e-cigarettes lung health risks and get downloadable resources for parents, schools and teens. Today's rapidly evolving e-cigarette market includes many varieties of disposable e-cigarettes, or single-use e-cigarettes, that do not use pre-filled pods containing e-liquid. The latest e-cigarettes also contain some of the highest nicotine levels ever seen in tobacco products. While some claim to be "tobacco-free" — made with lab-created synthetic nicotine, or with nicotine that does not come from tobacco — synthetic nicotine products still contain nicotine. E-cigarettes are products that heat a solution that typically includes nicotine and flavoring.
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.
Still, many people, including teens and young adults drawn to vaping, may not realize that, Bittoni said. Other popular brands, like Puff Bar, have received warnings from regulators about the sale of flavored devices as well. Following the Golden State, Washington had the second-lowest amount of youth vapers, at eight percent. In the Evergreen state, the legal age to purchase vapes is 21, and there is a ban on all flavored varieties. Last year, Alaska Senate President Gary Stevens, a Republican, introduced Senate Bill 89, aimed at imposing the state's first-ever tax on e-cigarette products. Wyoming had the highest rate of youth vapers, with 30 percent of kids under 18 reporting they had used e-cigarettes in 2023.
Upon entering the blood, nicotine stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, breathing, and heart rate. As with most addictive substances, nicotine activates the brain’s reward circuits and also increases levels of a chemical messenger in the brain called dopamine, which reinforces rewarding behaviors. Pleasure caused by nicotine’s interaction with the reward circuit motivates some people to use nicotine again and again, despite risks to their health and well-being. First PuffsThe current iteration of e-cigarettes was invented and popularized by Chinese pharmacist Hon Lik in 2003 and entered the U.S. market some seven years ago. A federal appeals court ruled in December 2010 that the agency lacked authority over e-cigs because they offer only the recreational benefits of a regular cigarette.
We would argue that further studies with chronic administration of low doses of nicotine are required to clearly evaluate its impact on carcinogenicity. In this line, a study compared the acute impact of CS vs. e-cigarette vaping with equivalent nicotine content in healthy smokers and non-smokers. Both increased markers of oxidative stress and decreased NO bioavailability, flow-mediated dilation, and vitamin E levels showing no significant differences between tobacco and e-cigarette exposure (reviewed in [20]). Inasmuch, short-term e-cigarette use in healthy smokers resulted in marked impairment of endothelial function and an increase in arterial stiffness (reviewed in [20]). Similar effects on endothelial dysfunction and arterial stiffness were found in animals when they were exposed to e-cigarette vapor either for several days or chronically (reviewed in [20]).
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.
Yet there has been hardly any definitive legislation regarding the sale and consumption of e-cigs in the U.S. Meanwhile Canada has made it illegal to sell e-cigarettes preloaded with nicotine in stores, but the regulation is not well enforced, and customers can buy vials of nicotine online. At press time, the European Parliament had approved a ban on e-cigarette advertising starting in mid-2016, and the ban seemed likely to get approval from the E.U.'s member states. Vaping products in the state also have to include health warnings per California state laws regarding the use of nicotine and other chemicals.
We are within out states laws and obtained all the proper licensing ect. At 180 Smoke, we prioritize the customer and guarantee an ideal vaping experience with our expansive product selection and knowledgeable staff. We will be there every step of the way, guaranteeing a satisfying vaping journey for you with excellent customer service. Unfortunately, today’s teens, and even tweens, often know more about vaping than their parents. The newly announced campaign by Ohio Attorney General Dave Yost to combat the flood of illegal e-cigarettes streaming into the state represents an...
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.
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).
We also have leading brands of e-liquid from some of the biggest manufacturers in the UK. So, if you feel like trying more than one, make sure you check out our multi-buy deals. Unlike cigarette butts, e-cigarette waste won’t biodegrade even under severe conditions. E-cigarettes left on the street eventually break down into microplastics and chemicals that flow into the storm drains to pollute our waterways and wildlife.
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.
It can often lead to debilitating symptoms and frequent hospitalizations as people age. Electronic nicotine products, which include e-cigarettes, vape pens, hookah pens, personal vaporizers and mods, e-cigars, e-pipes and e-hookahs, deliver nicotine in aerosol form without combustion. Since they were first introduced in the U.S. in the late 2000s, electronic nicotine products have often been portrayed as a safer alternative to smoking, but a growing body of research has led to increased concern about potential negative health effects. Some individuals who smoke choose to try e-cigarettes to help them stop smoking. Since smoking kills fully half of all long-time users, successfully stopping smoking leads to well-documented health benefits.
A cigarette is a narrow cylinder containing a combustible material, typically tobacco, that is rolled into thin paper for smoking. The cigarette is ignited at one end, causing it to smolder; the resulting smoke is orally inhaled via the opposite end. The term cigarette, as commonly used, refers to a tobacco cigarette, but the word is sometimes used to refer to other substances, such as a cannabis cigarette or a herbal cigarette. A cigarette is distinguished from a cigar by its usually smaller size, use of processed leaf, different smoking method, and paper wrapping, which is typically white. Not everyone is aware that there is nicotine in most e-cigarettes in varying amounts. Some pods of e-cigarettes contain as much nicotine as one pack of cigarettes (Truth Initiative, 2019).
The vape juice in this device is tightly sealed inside its own compartment, with heat-resistant food-grade fibers to wick it up to the heating coil. This reduces the chances of liquid sloshing around inside and causing issues with the battery. There's also a smart chip designed to prevent overheating, making it much less likely that you'll burn yourself or start a fire. I stuck it in the wrist of my sweater, inhaled, and blew out a little cloud of vapor. As recently as May 2019, Juul held a 74.6% share in the U.S. e-cigarette market. That’s when a series of regulatory actions contributed to product-reduction concessions and lower consumer demand.
Whilst long-term health effects are not fully known, we do know that they generate toxic substances, some of which are known to cause cancer and some that increase the risk of heart and lung disorders. Electronic delivery systems have also been linked to a number of physical injuries, including burns from explosions or malfunctions, when the products are not of the expected standard or are tampered with by users. The Preventing Online Sales of E-Cigarettes to Children Act was created in 2019 to reduce children and teens access to online sales of smokeless tobacco products. According to a 2020 study by the Centers for Disease Control and Prevention (CDC), 85% of high school students and 74% of middle school students who used tobacco products in the past 30 days reported using a flavored tobacco product during that time. The electronic cigarette (e-cigarette), for many considered as a safe alternative to conventional cigarettes, has revolutionised the tobacco industry in the last decades.
To date, FDA has authorized 34 tobacco- and menthol-flavored e-cigarette products and devices. These products have undergone rigorous scientific review, including toxicologic assessments, and have been found by FDA to meet the statutory public health standard. Vaping is often thought of as safer than cigarette smoking, but vaping causes health problems, too.
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.
And nicotine use in young adults still can lead to other illicit substance use. The request from the Federal Trade Commission asks six companies to turn over data by January dealing with the sale and promotion of their products for the years 2015 to 2018. In the United States, states are a primary determinant of the total tax rate on cigarettes. As part of the Family Smoking Prevention and Tobacco Control Act, the federal government collects user fees to fund Food and Drug Administration (FDA) regulatory measures over tobacco.
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.
With so many adults kicking the cigarette smoking habit, Altria was looking for ways to sustain its financial stability. Outside of addiction, nicotine can also have other long-term and permanent effects on developing brains. Because vaping has only recently gained popularity, we don’t yet have the data to tell us all its health effects. E-cigarettes are also called e-cigs, vape pens, vapes, mods, and other terms.
That’s about twice as many people as those who used other methods to quit smoking. Of people who used other methods, 91% kicked nicotine products altogether. People usually think vaping isn’t as bad as cigarette smoking, but the mist you breathe in still has nicotine and other harmful chemicals in it. Vaping isn’t safe and can cause health problems, including life-threatening lung injuries.
The Centers for Disease Control and Prevention (CDC) report that vaping nicotine can permanently affect brain development in people under the age of 25. The researchers concluded that vaping with and without nicotine disrupts typical lung function in otherwise healthy people. The researchers reported a number of adverse effects on both types of cells, including toxicity, oxidation, and inflammation. However, these results aren’t necessarily generalizable to vaping in real life. A 2019 study assessed data from a nationwide survey of nearly 450,000 participants and found no significant association between e-cigarette use and heart disease. The authors also described moderate evidence suggesting that taking a puff from an e-cigarette increases blood pressure.
Vaping may also have specific adverse effects on certain groups, particularly young people. The full magnitude of effects of toxic e-cigarette ingredients may not be known for another three decades. Yale’s Tobacco Center of Regulatory Science received funding support for the study from the National Institute on Drug Abuse, which is part of the National Institutes of Health (U54DA036151), and the Center for Tobacco Products of the FDA. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the FDA. For information on products eligible to be sold in San Francisco, please visit the FDA website of Tobacco Product Marketing Orders. If you have the appropriate software installed, you can download article citation data to the citation manager of your choice.
Last year, 9.4% of individuals ages 12 years and above reported vaping nicotine within the previous month, up from 8.3% in 2022. "This research has provided greater understanding in the court systems nationwide as to the nature of drug usage, abuse, and overdose cases in which electronic cigarettes were used to deliver an illicit drug," the researchers concluded. THC, synthetic cannabinoids, and dextromethorphan, a drug found in some cough medicines, "were identified in e-liquids purportedly containing only CBD to be consumed for ‘health benefits,’" the researchers said. Results from the National Drug Strategy Household Survey do not provide evidence for or against the use of e-cigarettes as a smoking cessation tool, or as a gateway to tobacco smoking. The age groups most likely to smoke tobacco in 2019 and 2022–2023 were the least likely to use e-cigarettes, and the age groups most likely to use e-cigarettes had low tobacco smoking rates in 2019 and 2022–2023. In 2022–2023, 1 in 5 (19.8%) people aged 14 and over in Australia reported having used e‑cigarettes at least once in their lifetime, with 7% currently using e‑cigarettes at least daily, weekly, monthly, or less often than monthly.
The last wave analyzed took place during the COVID-19 pandemic in March to November 2021 and was administered via audio computer-assisted self-interviews and telephone interviews. The study featured 1,985 participants; 49.4% were male and the average age was 40. The patient population was 80.7% white, 11.4% Black, 9.2% Hispanic, and 8% of another race. You can get health news and information from The Science of Health blog delivered right to your inbox every month.
Jabba and colleagues, including co-senior author Sven Eric Jordt, Ph.D., analyzed an e-cigarette product sold under the brand name Spree Bar, which comes in at least nine flavors and is listed as containing 5 percent 6-methyl nicotine. Study results showed the actual amount of the chemical was about 88% less than labeled. The e-cigarettes also included an artificial sweetener that is up to 13,000 times sweeter than table sugar, and an artificial coolant that mimics menthol’s effects. Talk to your patients, including youth and young adults, about the dangers of tobacco use.
E-cigarettes may be disposable, be refillable with e-liquid, or have a prefilled cartridge or pod for reuse. Some e-cigarettes can also be used to deliver cannabis and other drugs. Additionally, high quality epidemiology studies consistently demonstrate that e-cigarettes use increases conventional cigarette uptake, particularly among non-smoking youth, by nearly 3 times. Evidence reveals that these products are harmful to health and are not safe. However, it is too early to provide a clear answer on the long-term impact of using them or being exposed to them.
If you are not sure whether disposables are for you, these kits would be a great place to start. The leading disposable vape kits are Elf Bars, Lost Mary and Crystal Bar. Both come in a wide range of tastes to suit anyone looking to switch from smoking but also work well as a cheap back up kit for existing vapers. The Perelman School of Medicine is consistently among the nation's top recipients of funding from the National Institutes of Health, with $550 million awarded in the 2022 fiscal year. Data from the 2019 Minnesota Student Survey shows a steep rise in e-cigarette use among students. This study was supported by funding from the National Institute on Drug Abuse of the NIH and the FDA Center for Tobacco Products.
Manufacturers claim e-cigarettes are a safe alternative to smoking regular cigarettes. Cancer is definitely a concern, given that vaping introduces a host of chemicals into the lungs. But vaping products haven’t been around long enough for us to learn whether or not they cause cancer. In 2018, 3.6 million U.S. high school and middle school students smoked an e-cigarette within 30 days of polling, making it the most common tobacco product used among this group.
Beginning August 1, 2019, Minnesota law prohibits the use of these products indoors where cigarette use is prohibited, including bars and restaurants. A 2021 study found that daily e-cigarette usage among tobacco smokers can increase the likelihood of quitting smoking eightfold. Researchers assessed data from the 2014–2019 Population Assessment of Tobacco and Health (PATH) study, focusing on smokers who were not planning to quit smoking at the start of the period. However, a 2019 study into the long-term health effects of vaping found that people using e-cigarettes had a higher risk of respiratory disease than people who never smoked. The authors first created a comprehensive database of tobacco product flavor prohibition and restriction laws across the United States, including both state and local statutes. To date, there is no state excise or special tax placed on e-cigarettes.
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.
A 2018 study assessed the lung function of 10 people who had never smoked cigarettes immediately after vaping fluids, either with or without nicotine. However, the researchers concluded that, overall, vaping is thought to be less harmful to the heart than smoking cigarettes. However, they found that people who smoked conventional cigarettes and e-cigarettes were more likely to have heart disease. In a recently published randomised trial of 886 subjects who were willing to quit smoking [100], the abstinence rate was found to be twice as high in the e-cigarette group than in the nicotine-replacement group (18.0% vs. 9.9%) after 1 year.
Researchers in a 2018 study found that cinnamaldehyde (found in cinnamon), o-vanillin (found in vanilla), and pentanedione (found in honey) all had toxic effects on cells. Studies suggest that nicotine-free vaping can irritate the respiratory system, cause cell death, trigger inflammation, and harm blood vessels. The e-liquid comes in a Juul pod or J-pod cartridge, which usually contains nicotine.
In December 2019, Congress raised the minimum age to buy tobacco products, including e-cigarettes, from 18 to 21. Because of the popularity of certain flavored e-cigarette products among children, FDA stated in January 2020 that it would prioritize enforcement actions against the manufacture and sale of most flavors in cartridge-based e-cigarettes. In April 2020, FDA extended from May to September 2020 the deadline for manufacturers to apply for premarket authorization, a process that includes the scientific evaluation of risks and benefits of e-cigarettes for the U.S. population. NCI supports research to understand the potential impact of ENDS use on both individual and population health, as it relates to cancer control and prevention.
As such, it is imperative that e-cigarette cessation programs focused on adolescents are developed, evaluated, and implemented," Halpern-Felsher wrote. "This may point to the changing norms around e-cigarette use and the fact that quitting vaping among young people is becoming more normative and accepted," she said. Most of the study participants, about 87%, reported that they had tried to quit in the previous year, and about 94% reported feeling somewhat or very addicted to vaping. E-cigarettes usage by adolescents has become an epidemic according to the American Lung Association–20% (5 million) of all youth use e-cigarettes, a 135% increase in just two years.
The success of all these enterprises hinges on the claim that e-cigarettes are healthier than traditional cigarettes. Companies like to paint a black-and-white picture of a new era of safe smoking. "Cigarettes, you've met your match," NJOY proudly proclaims in its Super Bowl ads. E-cigarettes and vaping are part of a trend going back at least nine years in the U.S. First publicized as a safer alternative to smoking tobacco, vaping caught on because it didn’t contain the carcinogens or tars found in most smoking tobacco products. Also, vaping was supposed to eliminate the dangers of secondhand smoke to those nearby.
However, the long-term effects of all flavour chemicals used by this industry (which are more than 15,000) remain unknown and they are not usually included in the product label [78]. Furthermore, there is no safety guarantee since they may harbour potential toxic or irritating properties [5]. In addition to its toxicological effects on foetus development, nicotine can disrupt brain development in adolescents and young adults [44,45,46]. Several studies have also suggested that nicotine is potentially carcinogenic (reviewed in [41]), but more work is needed to prove its carcinogenicity independently of the combustion products of tobacco [47].
Sustained e-cigarette use among young people can in part be credited to products remaining on the market illegally for years without U.S. Standards, which prohibit the use of diacetyl in electronic cigarettes, Vapemate juice prioritizes safety. The ingredients are tested for contaminants before the manufacturing process begins, and production takes place in sanitized clean rooms. You can rest assured that you're getting high-quality vape juice with this brand. Smoking causes at least 16 different types of cancer so stopping smoking completely is the best thing you can do for your health.
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.
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.
The association between student- and school-level factors and susceptibility to smoking. Nationally, e-cigarette use among high school students doubled from 11.7% in 2017 to 27.5% in 2019. The researchers studied human endothelial cells generated in the laboratory from what are called induced pluripotent stem cells, or iPS cells. IPS cells can become many different cell types, and they provide an ideal way for researchers to closely study cells that would be difficult to isolate directly from a patient. A.C.—managed the analytical testing programme and co-authored the manuscript.
However, we do allow certain pre-approved sellers to list e-cigarettes, Electronic Nicotine Delivery Systems (ENDS), and e-liquids on the US eBay website (eBay.com) provided they follow federal, state, local, and other applicable laws and regulations. This policy is applicable to those approved sellers, and buyers who transact with them. Our team of vaping experts regularly updates our blog to bring you the latest trends, product reviews, and tips for optimizing your vaping experience. Sit back, relax, and start exploring our insightful articles and informative guides to take your vaping journey to the next level. We also offer heat-not-burn tobacco devices, and an extensive selection of cannabis vaporizers for dry herb and concentrates.
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).
The vapor produced by e-cigarettes usually contains nicotine, heavy metals, volatile organic compounds, carcinogens (cancer causing chemicals), and in some cases, flavoring linked to serious lung disease. These and other harmful substances present in e-cigarette vapor can negatively affect the respiratory health of users. The monitoring of other tobacco product sales in conjunction with the monitoring of e-cigarette sales is necessary to provide a comprehensive picture of the overall U.S. tobacco product market. These cigarette data briefs provide estimates of cigarette sales in the U.S. market overall and select U.S. states. In January 2020, the US Food and Drug Administration (FDA) ordered the removal of flavored cartridge-based e-cigarettes from the market. This rule does not prohibit the sale of tobacco and menthol flavored cartridge-based e-cigarettes, flavored disposable e-cigarettes, or refillable flavored e-cigarette products.
E-cigarettes have become the most commonly used tobacco product among U.S. and Iowa youth, and their popularity has risen dramatically over the past several years. According to the Iowa Youth Survey (IYS), Iowa 11th-graders were far more likely to use e-cigarettes compared to traditional cigarettes. They also reported increased likelihood in trying e-cigarettes and decreased quit success when compared to cigarettes.
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.
You need to start at a nicotine level that matches your cigarette use – how frequently and how much you smoke. A specialist vape shop or your local Stop Smoking Service can advise you. Vaping has not been around for long enough to know the risks of long-term use. While vaping is substantially less harmful than smoking, it is unlikely to be totally harmless. These examples are programmatically compiled from various online sources to illustrate current usage of the word 'electronic cigarette.' Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors.
In the vaping liquids that contain nicotine, the level of nicotine can vary widely. Prior to July 2021 in Canada, vaping substance nicotine strengths ranged from 0 to over 60 mg/ml of nicotine. Since July 2021, the Nicotine Concentration in Vaping Products Regulations establish a maximum concentration of 20 mg/mL for vaping products manufactured in or imported into Canada. Market size is clearly affected by national laws governing the sale of e-cigarette products. In 2016, the Washington State Legislature passed a law (RCW 70.345) to regulate vapor products.
In many high and middle income countries lower socioeconomic status is a strong predictor of smoking. In North America, the common name for the remains of a cigarette after smoking is a cigarette butt. In Britain, it is also called a fag-end or a dog-end.[44] The butt is typically about 30% of the cigarette's original length. It consists of a tissue tube which holds a filter and some remains of tobacco mixed with ash. According to data from the World Health Organization,[39] the amount of tobacco per 1000 cigarettes fell from 1.03 kg (2.28 pounds) in 1960 to 0.41 kg (0.91 pounds) in 1999, largely as a result of reconstituting tobacco, fluffing, and additives. The epidemic use of e-cigarettes is a complicated problem which requires a cooperative effort between partners, organizations, and communities.
Instead of bathing lung tissue with a therapeutic mist, just as a nebulizer does, vaping coats lungs with potentially harmful chemicals. E-liquid concoctions usually include some mix of flavorings, aromatic additives and nicotine or THC (the chemical in marijuana that causes psychological effects), dissolved in an oily liquid base. "We think that some of the vaporized elements of the oil are getting deep down into the lungs and causing an inflammatory response," explains Broderick.
In response to this issue, the PACT Act Amendment prohibits sellers from using the U.S. Post Office to ship e-cigarettes, vapes, flavored and smokeless tobacco products. The PACT Act applies to all shipments in interstate commerce (15 U.S.C. § 376) as well as to all delivery sales. Some people who smoke choose to use both cigarettes and e-cigarettes at the same time on an ongoing basis, whether they are trying to quit or not.
When smoking an e-cigarette, the user inhales and exhales the vapour, which can look similar to cigarette smoke. The best way to protect your children is to never smoke or vape near them. Never smoke indoors, in your car, or in places where children spend time. Most teens who vape use disposable e-cigarettes, including brands like Elf Bar, which come in flavors such as watermelon and blueberry ice. New York State youth, ages 13-17, and young adults, ages 18-24, can text DropTheVape to to sign up to receive age-appropriate supportive and motivating text messages to support quit efforts.
The 2019 outbreak of EVALI cases emerged against a backdrop of an ongoing vaping epidemic among youth. The amount, quantity and toxicity of substances that e-cigarettes release depend on several factors, such as the type of device, how the device operates and is used, and the e-liquid used. Drop the Vape also directs users to the New York State Quitline for free and confidential quit-coaching via telephone, internet, and text, and free starter kits of nicotine replacement therapy (NRT) for eligible New Yorkers. In absence of federal law, states are acting to remove flavored nicotine products from the shelves. All the e-cigarettes previously authorized by the FDA have been tobacco, which isn’t widely used by young people who vape.
Young adults also were more likely to use both e-cigarettes and combustible cigarettes compared with adults 45 and older. Liquid nicotine in e-cigarettes can be easily absorbed by the skin, potentially causing nicotine poisoning with symptoms that include difficulty breathing, fainting, or seizures. For a comprehensive list of all TCRG publications, including TCRG research that evaluates the impact of public health policy, go to the Bath TCRG’s list of publications. BAT went on to acquire more independent e-cigarette companies, and developed a range of products under the Vype and Vuse brands. In 2020, BAT began consolidating the two brands as Vuse.8910 In 2022 it launched a "disposable" product Vuse Go (see below).
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].
Kasza's group also pointed to dual use of cigarettes and e-cigarettes, which has increased over time and usually involves smoking cigarettes more frequently than using e-cigarettes. "Individuals who dual use remain exposed to cigarette smoking toxicants, making complete rather than partial substitution of cigarettes with e-cigarettes important for risk reduction," they wrote. "Indeed, healthcare clinicians are now encouraged to discuss e-cigarettes as a cessation tool with patients who smoke cigarettes and have already tried FDA-approved cessation medications." A comparison of the serum levels of nicotine from e-cigarette or conventional cigarette consumption has been recently reported [39].
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.
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.
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.
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.
In this latter regard, no differences were encountered in the frequency of tumour appearance in rats subjected to long-term (2 years) inhalation of nicotine when compared with control rats [48]. Despite the lack of carcinogenicity evidence, it has been reported that nicotine promotes tumour cell survival by decreasing apoptosis and increasing proliferation [49], indicating that it may work as a "tumour enhancer". In a very recent study, chronic administration of nicotine to mice (1 mg/kg every 3 days for a 60-day period) enhanced brain metastasis by skewing the polarity of M2 microglia, which increases metastatic tumour growth [50]. Assuming that a conventional cigarette contains 0.172–1.702 mg of nicotine [51], the daily nicotine dose administered to these animals corresponds to 40–400 cigarettes for a 70 kg-adult, which is a dose of an extremely heavy smoker.
Smoking may also contribute to fertility issues and lower sex hormone levels in males and females, leading to decreased sexual desire. Smoking is an environmental risk factor for conditions such as rheumatoid arthritis, though researchers do not yet understand the mechanism behind the connection. The actual policy is below, and it looks like a lot of hoop jumping is involved - age verification upon delivery? Not sure how you would even do this unless sent some sort of signed restricted delivery.
The sleek shapes and appealing flavors such as cotton candy, mango, and strawberry have made e-cigarettes especially enticing to youth. If you're a smoker trying to quit, you might prefer a cigalike model as the experience is as close to smoking as possible. If you like to perform tricks, you might find that a cloud kit or sub-ohm device is better suited to your needs. If you simply want to experiment with different e-liquid flavours, a standard vape pen should cater to your needs. Here at The Electric Tobacconist, we have a large selection of devices on offer that you can browse through. Electronic cigarettes (e-cigarettes) have had a lot of interest recently as a replacement for smoking traditional cigarettes.
The Therapeutic Goods Administration (TGA) has not approved any e-cigarette products as a medicine to help people quit smoking. This is because the quality and safety of e-cigarettes has not yet been thoroughly tested, and it is not clear whether they are actually helpful for people trying to quit. Electronic cigarettes (e-cigarettes or vapes) simulate the act of smoking, but you don’t burn tobacco when you use them. Instead, the e-cigarette is a battery-powered device that works by heating liquid into an aerosol, which you then inhale into your lungs. These electronic devices, also known as e-cigarettes, vapes, vape pens, personal vaporizers, e-cigars, pod systems, mods and e-hookah, are not a safe alternative to cigarette smoking. Talk with your teens about the health effects of nicotine and e-cigarettes.
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].
Many people believe electronic cigarettes (also called e-cigarettes or vapes) are a safe alternative to traditional cigarettes. But with a recent report from the U.S. surgeon general calling e-cigarette use "a major public health concern," this may not be the case. The FDA reports an alarming 900% rise in e-cigarette use among high school students from 2011 to 2015 and the number of high school students using them increased 78% in 2018 alone. Vaping doesn’t create second-hand smoke.Breathing in second-hand smoke is a health risk for people who are around cigarette smokers, including vapers. In addition, third-hand smoke on clothes and furniture is smelly and can be dangerous for people with respiratory conditions. Vaping doesn’t produce the same smelly fumes as cigarettes, but the secondhand vapor contains chemicals and compounds that pollute the indoor air.
Helping a teen understand what sources to trust can give them a powerful tool to educate themselves. Don’t just tell them that there’s no good reason to start, help them learn why there’s no good reason. Talk about peer pressure, the tricks advertisers use and the importance of health.
Tobacco urges are likely to be strongest in the places where you smoked or chewed tobacco most often, such as at parties or bars, or at times when you were feeling stressed or sipping coffee. Find out your triggers and have a plan in place to avoid them or get through them without using tobacco. Queries sent to the health ministry’s tobacco cell remained unanswered till press time. From October this year it will be an offence to sell e-cigarettes to anyone under the age of 18 or to buy e-cigarettes for them. The government is consulting on a comprehensive array of regulations under the European Tobacco Products Directive.
"It’s young people doing something terrible for them that’s supposed to be healthy," he said. There’s a whole genre of throwing-away-my-Juul videos on social media, with people tossing their vape into a river or a snowbank as dramatic music plays. New research led by Roswell Park experts in health behavior and published today in the journal JAMA Network Open suggests that daily e-cigarette use may help some people to quit using combustible cigarettes.
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.
To learn more about tobacco and its health effects, see Tobacco and Cancer. There have been reports of e-cigarettes exploding and causing serious injuries. Usually the explosions are caused by faulty batteries or because the batteries were not handled as they should be. Visit the Food and Drug Administration website for safety tips to help avoid an e-cigarette battery explosion. Among people who were hospitalized with severe EVALI, most were younger than 35 and used THC-containing vapes from informal sources (online, family or friends). However, EVALI can happen in anyone using either nicotine or THC-containing vapes.
Protect the environment and ensure safe disposal of e-cigarette products by discarding them properly. Vapes, e-cigarettes, refills and cartridges should be treated like hazardous waste and taken to your local hazardous waste facility or hazardous waste collection event for disposal. Always remove the device's battery before dropping off to prevent unintentional burns, fires, and explosions. Store these products safely to protect yourself and any children in and around the home from accidental exposure.
That figure is controversial and might be a little high, says Kenneth Warner, a tobacco policy researcher at the University of Michigan. But, he adds, "The worst critics of e-cigarettes would probably argue they're a half to two-thirds less dangerous. But from a practical view, they're probably on the order of 80% to 85% less dangerous, at least." A 2015 expert review from Public Health England estimated e-cigs are 95% less harmful than the real thing.
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.
Vaping is when you use a small, handheld device (like e-cigarettes, vape pens or mods) to inhale a mist of nicotine and flavoring (e-liquid). It’s similar to smoking a cigarette, but vaping heats tiny particles out of a liquid rather than burning tobacco. On May 15, 2019 a federal judge sided with the American Lung Association and our partners in this lawsuit. The judge concluded that FDA acted unlawfully by delaying requiring e-cigarettes and other newly deemed tobacco products to go through a pre-market review process. The judge subsequently ruled that the filing deadline for all premarket review applications is May 12, 2020.
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.
More research is needed to address the potential long-term adverse effects of vaping on vascular health, but he predicts that e-cigarettes are potentially much more hazardous than previously assumed. Earlier this year, for instance, his research group found that acute exposure to e-cigarettes causes vascular inflammation. One in four middle school and high school students in Minnesota had tried e-cigarettes (teens call it vaping or juuling). Half of high school seniors reported having tried e-cigarettes at least once. The growing popularity of e-cigarettes among Minnesota’s youth caused the first rise in overall tobacco use in over two decades.
Middle and high school students are the largest users of these smoking replacements. Recent youth tobacco surveys found e-cigarette use had surpassed conventional cigarettes as the most commonly used tobacco product among youth. These surveys also revealed that many young people consider vaping to be safe and are not aware that e-cigarettes contain nicotine. It is easy for middle school and high school students to conceal their use of vaping devices because of their appearance as everyday objects.
In 2021 "other" flavored devices made up 71 percent of all disposable devices sold or given away, with the most-popular subcategories being fruit-flavored and fruit & menthol/mint flavored products. These two subcategories alone made up more than half of all disposable e-cigarette devices sold or given away in 2021. Researchers said that the study’s prospective observational design allows them to infer, but not conclusively determine, a causal relationship between e-cigarette use and heart failure. However, with its large sample size and detailed data on substance use and health information, Bene-Alhasan said the study is one of the most comprehensive studies to assess this relationship to date. This guide is intended to provide general information about the California Electronic Cigarette Excise Tax and registration, collection, filing, and payment responsibilities of retailers of electronic cigarettes containing or sold with nicotine. When the liquid is used up or the battery dies, the user throws the device away.
WHO regularly monitors and reviews the evidence on ENDS and health and offers guidance to governments. "Yale physicians have been at the forefront in identifying EVALI cases," Dr. Weiss says. She explains that even before CDC guidelines on treating the illness were released, Yale doctors were successfully treating patients with a combination of antibiotics and steroids. Doctors at Yale Medicine also collaborate with researchers in the fields of tobacco and addiction medicine to provide care for patients with EVALI.
He also highlighted the ban on e-cigarettes in India under the Prohibition of Electronic Cigarettes Act, 2019, aimed at preventing health risks and curbing their use among youth. These ingredients pose significant health risks, particularly to pregnant women, children, and adolescents, and leads to issues like impaired brain development and respiratory diseases, said Dr Goel. Cumberland County Schools is implementing a national vaping and nicotine prevention program in each of its middle and high schools to try and curb rates of youth vaping. Cigarettes pushed me back to shivering outside the bar where a nicotine habit belongs.
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.
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.
Because of this and other studies, vitamin E acetate is considered the main cause of EVALI. Other chemicals found in nicotine- and THC-containing vaping products may also play a role in the condition. It is important to know that most e-cigarettes contain addictive nicotine. There is evidence that nicotine harms the brain development of teenagers. Again, it is important to know that most e-cigarettes contain nicotine.
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.
A priority of the New York State Tobacco Control Program is to prevent the initiation of tobacco use, including combustible tobacco and electronic cigarettes, by youth and young adults. The Program funds Reality Check, the youth engagement component for New York State teens, ages 13-18, to increase support for New York State's tobacco-free and vape-free norms through youth action and community engagement. Evidence-based, policy-driven, and cost-effective approaches are implemented to decrease youth tobacco use, protect youth from exposure to tobacco marketing and imagery, and eliminate exposure to secondhand smoke. Visit Reality Check for more information and to find your local Reality Check group. According to a 2019 CDC industry update, one out of every 10 high school students reported using tobacco products, due in part to easy access through mail deliveries and online sellers.
That said, there are some concerns about how repeatedly inhaling e-cigarette aerosol over an extended period of time could affect bystanders’ long-term lung function and risk of allergic reactions. "I applaud Governor Cuomo for taking action to prevent exposure to secondhand e-cigarette emissions in public places for all New Yorkers." ALBANY, NY (November 22, 2017) - The New York State Department of Health is reminding all New Yorkers that beginning today the use of electronic cigarettes is banned indoors everywhere that smoking tobacco products are prohibited in New York. Despite these uncertainties, the use of e-cigarettes has skyrocketed since their introduction about a decade ago, particularly among young people. The Food and Drug Administration estimates that more than 3.5 million middle and high school students used e-cigarettes in 2018, though sales to minors are prohibited. In 2018, the FDA restricted the sale of flavored e-cigarettes to adult-only venues, with the exception of tobacco, menthol and mint flavors, which can be sold wherever traditional cigarettes are sold.
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.
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.
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.
Enrollees in the program receive interactive daily text messages tailored to their sign-up date or their target quit date if they set one. Program users who set a quit date (which they can change) receive messages for at least one week prior to the quit date and for at least two months following the quit date. Those brands have been sold in the U.S. for years, awaiting FDA action on their scientific applications. To stay on the market, companies must show that their e-cigarettes provide an overall health benefit for smokers, without significantly appealing to kids.
Guidance exists on best practices on this concept of accountability — known as end-producer responsibility — but isn’t enforced across the industry by any governing body. Substances from inhaled aerosol particles reaching the e-cigarette user’s lungs, blood, and brain. Minnesota’s middle school and high school students who have asthma who vaped or smoked in the past 30 days reported experiencing more frequent symptoms of asthma than students who did not have asthma who had not vaped or smoked.
There’s been one case report where two brothers smoked 17 and 18 pipes of tobacco in a row and were fatally poisoned. However, the greatest risk of nicotine poisoning is in children because of their lower body weight and smaller size. The Xlim range of OXVA vape devices joined the ranks as one of our favourite product lines released in 2023. "Vuse Pro devise is slimline and quick to charge .The best vape for an authentic tobacco flavour. I’ve tried many other vapes but this is overall the best on the market in my opinion." At the Electric Tobacconist UK, we offer vapes kits and disposables suitable for every budget and every level of vaper, shipped directly from our warehouse in Hemel Hempstead! We also sell vape kits in our US store if you are looking for a kit and you're not based in the UK or Europe.
These products use an "e-liquid" that usually contains nicotine derived from tobacco, as well as flavorings, propylene glycol, vegetable glycerin, and other ingredients. The dangers of vaping include lung and other organ damage, breathing problems, addiction and more. People tend to think of vaping as "safer" than smoking, but it’s not safe. When the coronavirus pandemic first began, Blaha says, data show that e-cigarette sales went down, possibly because people were spending more time at home and avoiding stores and public areas. In light of the EVALI outbreak, the CDC advises people who use e-cigarettes for smoking cessation to weigh the risks and benefits and first consider use of other FDA-approved smoking cessation options. If you have thought about trying to kick a smoking habit, you’re not alone.
The most important points to know are that the long-term health effects of e-cigarettes are still unknown, and all tobacco products, including e-cigarettes, can pose health risks to the user. The tobacco industry has co-opted the term harm reduction to further its own interests of reduced tobacco product regulation and expand its user base. E-cigarette use among adults has been more stable, with adult use remaining relatively low since around 2012. Recent data, however, showed a slight uptick in adult e-cigarette use from 4.5% in 2021 to 6% in 2022. While switching completely from cigarettes to e-cigarettes can be less harmful than smoking, many adult smokers use e-cigarettes and cigarettes concurrently — increasing overall exposure to nicotine. Randomized control trials provide growing evidence that e-cigarettes with nicotine can increase quitting rates when compared to nicotine replacement therapies.