[ Fact Sheets >Yale Medicine A recent study compared the acute effects of e-cigarette vapor (with PG/vegetable glycerine plus tobacco flavouring but without nicotine) generated from stainless‐steel atomizer (SS) heating element or from a nickel‐chromium alloy (NC) [92]. Neither the air‐exposed rats nor those exposed to e-cigarette vapor using SS heating elements developed respiratory distress. In contrast, 80% of the rats exposed to e-cigarette vapor using NC heating units developed clinical acute respiratory distress when a 70‐W power setting was employed. Thus, suggesting that operating units at higher than recommended settings can cause adverse effects. Nevertheless, there is no doubt that the deleterious effects of battery output voltage are not comparable to those exerted by CS extracts [30] (Figs. 1 and 2). "Our findings are consistent with earlier evidence that sufficient nicotine replacement can be helpful for quitting smoking. Altria Group chief executive William Gifford told analysts during a second-quarter conference call that makers of unregulated e-cigarettes are responding to consumers’ switching to nicotine pouches. According to the latest Nielsen convenience store report released Wednesday, Zyn sales have jumped 74.6% year-over-year with total annual sales now in the $2 billion range. Tobacco industry executives and analysts are sounding alarms about a surge of unregulated nicotine pouches entering the U.S. that is chipping away at regulated products. They also contain toxins that can damage your lungs and overall health. One of the reasons why the e-cigarette epidemic among young people is so troubling is that e-cigarette use seems to lead to the use of traditional cigarettes. This makes them a better choice for people who already smoke or use other tobacco products. Vaping may have some benefits for smokers who switch to it as a complete substitute for using other tobacco products. E-cigarette manufacturers are using marketing tactics used by the tobacco industry to lure kids to conventional cigarettes. 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. Some public health experts believe that e-cigarettes are an essential alternative to smoking tobacco that can help smokers quit. Others argue that e-cigarettes could be a route into nicotine addiction and point out that their long-term safety has not yet been proven. There are also those that believe that e-cigarettes may offer public health benefits but that e-cigarettes should be regulated, particularly when it comes to the marketing of such products. The device heats a liquid into an aerosol (sometimes known as "vapour" and mistakenly called "water vapour"). Nicotine is a highly addictive substance found in tobacco products, including cigarettes, cigars, chewing tobacco, e-cigarettes, and pouches. Over 50% of middle school and high school students reported seeing e-cigarette advertising. Only 28% of young people in the U.S. believe e-cigarettes have the potential to cause a lot of harm. Up to 40% of teens who vape are unaware their e-cigarette cartridges contain nicotine. E-cigarettes can also be used to vape marijuana’s psychoactive ingredient, THC. According to the 2021 National Youth Tobacco Survey, more than 2 million U.S. middle and high school students reported using e-cigarettes in 2021, with more than 8 in 10 of those youth using flavored e-cigarettes. The mid-to-long-term consequences of e-cigarettes are not yet known, as it's a new product and has been sold for less than a decade in the U.S. While much remains to be determined about these lasting health consequences of these products, we are very troubled by what we see so far. The inhalation of harmful chemicals can cause irreversible lung damage and lung diseases. Adjusted analyses revealed that the type of e-cigarette device used played no role in the rates of cigarette discontinuation. Data were taken from the nationally representative Population Assessment of Tobacco and Health Study (PATH), which assessed participants through audio-based, computer-assisted self-interviews in English or Spanish. Interviews were conducted in "waves" -- October 2014 to October 2015, October 2015 to October 2016, December 2016 to January 2018, and December 2018 to November 2019. Resources are available to help teens quit through the American Lung Association and SmokeFreeTeen. Several outlets also take a look at the history behind regulation of cigarettes and vaping products and also how the growing anxiety about the outbreak of respiratory problems might be dangerous. Other regions are increasingly playing larger roles in the growing global smoking epidemic. The WHO Eastern Mediterranean Region (EMRO) now has the highest growth rate in the cigarette market, with more than a one-third increase in cigarette consumption since 2000. Short-acting nicotine replacement therapies — such as nicotine gum, lozenges, nasal sprays or inhalers — can help you overcome intense cravings. These short-acting therapies are usually safe to use along with long-acting nicotine patches or one of the non-nicotine stop-smoking drugs. Mothers Against Vaping told Mint that they fear for their teenage children. Many people diagnosed with EVALI need to be treated in a hospital where medications can be closely monitored, and respiratory support is readily available. "I screen all of my patients, any child over age 12, since [vaping] can exacerbate underlying conditions like asthma," says Yale Medicine pediatric pulmonologist Pnina Weiss, MD. To learn more about e-cigarettes, here are resources from the American Cancer Society and the FDA. There are some e-cigarette brands that claim to be nicotine-free but have been found to contain nicotine. For medical questions, we encourage you to review our information with your doctor. A 2019 randomized control study also found that daily e-cigarette use leads to an almost doubled rate of smoking abstinence than other nicotine-replacement products after one year. Vaping involves breathing in an aerosol that contains several chemicals, including nicotine and flavoring, through an e-cigarette or vape. SAMHSA's mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes. Nearly five times as many high school students use e-cigarettes than smoke cigarettes. The particle matter (PM) that is emitted by e-cigarettes is also potentially dangerous to those who inhale it, just as passive smoking is harmful to those who share a contained space with regular smokers. Nicotine is a poison which is particularly dangerous if ingested (swallowed or inhaled) by young children which has led to poisoning and even death when swallowed by infants. It is also highly addictive and use by teenagers can have a long-term effect on the development of the brain, which continues until the age of 25 years. If you purchase e-cigarettes and nicotine refill products, store them out of reach of your children and pets. With these products, it’s the liquid nicotine that can be dangerous, especially to children. According to the American Academy of Pediatrics, as little as one teaspoon of liquid nicotine can be fatal to a 26-pound child. In our study, there were between-school differences, which appeared larger for girls than boys. In the univariate analyses, most school-level factors either increased or lowered susceptibility. This was especially the case among girls in S-EC and S-SN, and among boys in S-SM. In the multivariate models, most of the school-level associations were weakened. E-cigarettes are not risk-free but are believed to cause less harm than smoking. They do not burn tobacco or produce tar or carbon monoxide — two of the most harmful parts of tobacco smoke. Smoking can raise your risk for periodontal disease or disease affecting the gums. 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. 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. E-cigarettes hit the market in the early 2000s and have since soared in popularity, especially among teens and young adults. Once believed to be a "safer" way to smoke, vaping is now considered a public health crisis by many health groups. Stay up to date on the adverse health effects of smoking and vaping tobacco while gaining important guidance on how to counsel patients on the risks and quitting. Even if you’re a tobacco user, having an open, honest discussion with your teen can help. The most important thing to understand is that the liquid in e-cigarette cartridges is not regulated by the FDA. Keep reading to learn more about vaping and how it’s affecting young people. The harms of e-cigarette use in young people include not only the deleterious effects of nicotine, but also exposure of the lungs and airways to potentially toxic solvents and flavoring chemicals. The rapidly rising rates of use in young people and the high rates of daily use strongly suggest that many are addicted to nicotine and will have difficulty in stopping use of all tobacco products. One study found that people who use only e-cigarettes increase their risk of developing lung disease by about 30% compared with nonusers. Electronic cigarettes (e-cigarettes) and other vapor products are devices used to heat and aerosolize (turn into particles) highly addictive nicotine or other substances that a person can inhale into their lungs. Given that nicotine easily diffuses from the dermis to the bloodstream, acute nicotine exposure by e-liquid spilling (5 mL of a 20 mg/mL nicotine-containing refill is equivalent to 100 mg of nicotine) can easily be toxic or even deadly [8]. Thus, devices with rechargeable refills are another issue of concern with e-cigarettes, especially when e-liquids are not sold in child-safe containers, increasing the risk of spilling, swallowing or breathing. An E-cigarette is any device or delivery system sold in combination with nicotine for a single price which can be used to deliver to a person nicotine in aerosolized or vaporized form. An E-cigarettes may also be known as e-cigar, e-pipe, vape pen, or e-hookah or other names. The definition of E-cigarettes includes any liquid or substance containing nicotine, whether sold separately or sold in combination with any device that could be used to deliver to a person nicotine in aerosolized or vaporized form. For each 0.7 milliliters of e-cigarette e-liquid not sold due to these policies, the authors calculated that 15 additional cigarettes were purchased. Other compounds that have been detected in aerosols include acetamide, a potential human carcinogen [5], and some aldehydes [69], although their levels were minimal. Interestingly, the existence of harmful concentrations of diethylene glycol, a known cytotoxic agent, in e-liquid aerosols is contentious with some studies detecting its presence [4, 68, 70,71,72], and others finding low subtoxic concentrations [73, 74]. In this regard, either it was detected at concentrations that did not exceed the authorised limit [73], or it was absent from the aerosols produced [4, 71, 72]. Only one study revealed its presence at high concentration in a very low number of samples [5]. Nevertheless, its presence above 1 mg/g is not allowed by the FDA [73]. Figure 1 lists the main compounds detected in aerosols derived from humectant heating and their potential damaging effects. We are aware of this issue and are diligently working on restoration. Check with your airline on any limitations on the number of devices that can be carried for personal use by a passenger. WHO strives to build a safer, healthier world for everyone, everywhere. Susceptibility to smoking or non-combustible nicotine use is also influenced by national tobacco control policies. In Europe, Finland has been among the countries with most advanced tobacco control regulations [31]. Still, there is a large difference in smoking and snus use between students in academically and non-academically oriented education [7]. For snus, Finland follows the EU-wide sales ban but cross-border traveller imports from Sweden are permitted and an illicit market exists [32]. For e-cigarettes, comprehensive regulations were introduced in 2016 including retail sale licensing and ban for distance sales, display and advertising at point-of-sale, other flavours than tobacco and use of e-cigarettes in smoke-free places [33]. To truly help tobacco users quit and to strengthen global tobacco control, governments need to scale up policies and interventions that we know work. Tried and tested interventions, such as brief advice from health professionals, national toll-free quit lines and mobile and digital cessation services are recommended. Where economically feasible, governments should also consider promoting nicotine replacement therapies and non-nicotine pharmacotherapies for cessation. E-cigarette emissions typically contain nicotine and other toxic substances that are harmful to both users and non-users who are exposed to the aerosols second-hand. To vape is to inhale vapor created from a liquid heated up inside a device. 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A recent study compared the acute effects of e-cigarette vapor (with PG/vegetable glycerine plus tobacco flavouring but without nicotine) generated from stainless‐steel atomizer (SS) heating element or from a nickel‐chromium alloy (NC) [92]. Neither the air‐exposed rats nor those exposed to e-cigarette vapor using SS heating elements developed respiratory distress. In contrast, 80% of the rats exposed to e-cigarette vapor using NC heating units developed clinical acute respiratory distress when a 70‐W power setting was employed. Thus, suggesting that operating units at higher than recommended settings can cause adverse effects. Nevertheless, there is no doubt that the deleterious effects of battery output voltage are not comparable to those exerted by CS extracts [30] (Figs.