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"From a public health perspective, we have always been concerned about dual-use of both traditional and e-cig products," said study lead author Marisa Bittoni, an oncology researcher at Ohio State University in Columbus. A second brand of e-cigarettes — marketed as Nixotine, Nixodine, Nixamide and Nic-Safe – contained a nicotine analog called nicotinamide, also at levels lower than the labels indicated, and combined with undisclosed amounts of 6-methyl nicotine. He emphasised that e-cigarettes are not an effective tobacco cessation tool, as they are not approved by food regulatory bodies. Additionally, they often lead to dual usage with people continuing to use traditional cigarettes along e-cigarettes.
JUULs very closely resemble a USB drive, can be charged in a USB port, and emit little to no detectable vapor or odor. Due to their easily concealable design, they are of particular concern with regard to youth use. DOH urges all people to be very careful when it comes to your health. Even if a substance has not yet been proven to be dangerous, there is no guarantee it is safe. You don’t actually light up an e-cig; they’re powered by a rechargeable lithium battery. Instead of burning tobacco, the "e-liquid" is vaporized in a heating chamber when the user inhales.
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.
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.
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].
Fortunately, there has been a substantial drop in cases since they peaked in August and September of 2020. What’s more, researchers have also identified vitamin E acetate, a chemical added to some THC-containing vaping products, as the main—but possibly not the only—cause of the illness. The outbreak of EVALI cases emerged against a backdrop of an ongoing vaping epidemic among youth.
Most modern cigarettes are filtered, although this does not make the smoke inhaled from them contain fewer carcinogens and harmful chemicals. Nicotine, the psychoactive drug in tobacco, makes cigarettes highly addictive. About half of cigarette smokers die of tobacco-related disease and lose on average 14 years of life.
For a summary of Iowa youth vaping/e-cigarette use statistics from the 2018 IYS, check out our infographic and factsheet. Adolescents are more likely to use e-cigarettes than any other tobacco product, and rates of e-cigarette use have risen sharply in recent years. Population-level interventions to reduce tobacco use include price increases, mass media campaigns, and smoke-free policies that include e-cigarettes. E-cigarettes, also known as electronic smoking devices (ESD) and vaporizer cigarettes, are battery-operated devices that emit doses of nicotine and non-nicotine vaporized solutions that are inhaled.
Restrictions on importation, packaging and flavourings will come into effect in early 2024 (TGA 2023). Between 2012 and 2022, most Australian jurisdictions have amended their laws to further restrict the advertising and sale of e‑cigarettes (Department of Health and Aged Care 2023b). Recent reports have linked serious lung injury – and even deaths – to vaping. According to the CDC, cigarette smoking causes nearly 1 out of every five deaths in the United States. It’s possible that we don’t yet know all the physical effects of vaping. Numerous studies have been performed to evaluate the safety/toxicity of e-cigarette use both in vivo and in in vitro cell culture.
In fact, they are widely used as alimentary and pharmaceutical products [2]. In an analysis of 54 commercially available e-liquids, PG and glycerol were detected in almost all samples at concentrations ranging from 0.4% to 98% (average 57%) and from 0.3% to 95% (average 37%), respectively [35]. According to a 2018 study examining infrequent cannabis smoking in adults, vaping THC produced stronger mind-altering effects than smoking a similar amount of weed. However, nicotine alone is relatively harmless, and switching from daily tobacco smoking to daily e-cigarette use can be an important step for people to stop smoking completely. However, researchers found that only daily e-cigarette use had a statistically significant effect on smoking cessation rates. Research generally accepts that while vaping can harm the lungs and other bodily systems, its impact is much less than tobacco smoking.
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.
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.
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.
Electronic nicotine delivery systems (ENDS), or e-cigarettes, are battery-powered devices used to vape a flavoured solution containing varying concentrations of nicotine, an addictive chemical found in tobacco products. Some people take up vaping – or inhaling vapor from electronic cigarettes – to avoid the health hazards of smoking cigarettes made with tobacco. But when it comes to your heart health, a pair of recent studies show e-cigarettes are just as dangerous – and possibly are even more dangerous – than traditional cigarettes. The long-term effects of smoking cigarettes are well-documented and include an increased risk of stroke, heart disease, and lung cancer.
In 2022–2023, 2.3% of people in Australia both smoked regular cigarettes and used e‑cigarettes, an increase from 0.7% in 2016. In the second study, researchers analyzed heart blood flow, a measure of coronary vascular function, of 19 young adult smokers immediately before and after smoking either e-cigarettes or tobacco cigarettes. They examined coronary vascular function by a myocardial contrast echocardiography while participants were at rest and after performing a handgrip exercise to simulate physiologic stress. In the first study, researchers looked at the impact of e-cigarettes on lipids and glucose in the blood. They recruited 476 healthy human participants without cardiovascular disease who were either nonsmokers, e-cigarette-only smokers, smokers of e-cigarettes and tobacco cigarettes and those who smoked tobacco cigarettes only.
A 2018 report from the National Academies Press (NAP) found significant evidence that taking a puff from a nicotine e-cigarette triggers an increase in heart rate. In summary, it seems that either smoking or nicotine vaping may adversely impact on COVID-19 outcome. However, additional follow up studies are required in COVID-19 pandemic to clarify the effect of e-cigarette use on lung and cardiovascular complications derived from SARS-CoV-2 infection. It is also noteworthy that among the 3 most cytotoxic vapours for HUVEC evaluated in the Putzhammer et al. study, 2 were nicotine-free, which suggests that nicotine is not the only hazardous component in e-cigarettes [24]. However, while vape products can reduce the amount of tar and other chemicals a person inhales, they can increase a person’s nicotine dependency. The National Institute on Drug Abuse (NIDA) states that around half of all smokers try to quit every year, while only 6% manage to do so.
Read this paper by NCI’s Dr. Ned Sharpless and CRUK’s Dr. Iain Foulkes. Drug forums and e-liquid vendors were monitored by the researchers for e-liquids that "purportedly contained alternative pharmaceuticals." A clue in searching for e-liquids that contain illicit drugs is cost, the scientists said. Most nicotine e-liquids range from $5 to $10, while alternative drug e-liquids go for five to twenty times as much. In comparison to the general population, support for these measures varied greatly among people who currently used e‑cigarettes. The most supported measure was prohibiting the sale of e‑cigarettes to people under 18 years of age (67%), while the least supported measure was banning all additives in e‑cigarettes, to make them less attractive to young people (33%) (Figure 7).
Further, synthetic nicotine may pose challenges in countries that regulate products with tobacco-derived nicotine. "We are beginning to see the robust supply chains and lack of enforcement that supports the illicit e-vapor market (is) enabling increased illicit activity across multiple tobacco categories," Gifford said. Three years after puffing my first e-cig had led to me vaping all the goddamn time. All night when I’m out with friends and now all day while I’m at work.
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.
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.
According to the National Institute for Occupational Safety and Health, the lethal dose of inhaled nicotine is 50 to 60 mg/kg in a 70-kg adult (154 pounds). The UK government is working on the ongoing launch of a new and unprecedented incentive, encouraging smokers to switch to vap... The public consultation is now open to the public, and it's time to have your say. They can be seen in corner shops, supermarkets, and vape shops across the UK, peering out from behind the... Vaping has come a long way over the last few years, and the market is more diverse than ever.
Please be advised that many of these stories contain graphic and upsetting photos of injuries. Exposure to nicotine can also rewire a young brain to become more easily addicted to other substances, including cocaine and alcohol. Even if a cartridge doesn’t contain nicotine, other harmful chemicals may be present.
Meanwhile, some influential conservatives are calling for the Trump administration to hold back on its plans to ban flavored tobacco. They argue such a move would hurt small vape business owners and people trying to quit smoking. Many governments impose restrictions on smoking tobacco, especially in public areas. The primary justification has been the negative health effects of second-hand smoke.[124] Laws vary by country and locality. Nearly all countries have laws restricting places where people can smoke in public, and over 40 countries have comprehensive smoke-free laws that prohibit smoking in virtually all public venues. During World War I and World War II, cigarettes were rationed to soldiers.
WASHINGTON (AP) — The Supreme Court took up an e-cigarette case Tuesday, weighing Food and Drug Administration decisions blocking the marketing of sweet flavored products amid a surge in vaping by young people. Despite not authorizing a single synthetic nicotine product, it has allowed these products – including e-cigarettes in kid-friendly flavors – to stay on the market well past the July 13 deadline. There is little research on the safety of vaping in pregnancy, but it's likely to be substantially less harmful for you and your baby than smoking. Unlike cigarettes, vapes do not produce carbon monoxide, which is very harmful to a developing baby in the womb. They also cause other serious illnesses, including lung disease, heart disease and stroke.
New York State law restricts the sale of flavored vapor products intended or reasonably expected to be used with or for the consumption of nicotine, regardless of whether the nicotine is derived from tobacco or synthetic. E-Cigarettes, Vapes, and other Electronic Nicotine Delivery Systems (ENDS). /tobacco-products/products-ingredients-components/e-cigarettes-vapes-and-other-electronic-nicotine-delivery-systems-ends. They are sometimes called e-cigs, e-hookahs, mods, vape pens, vapes, tank systems, and electronic nicotine delivery systems (ENDS).
"More research about the health effects of alternative tobacco products is critically needed to put science behind the regulation of the tobacco industry." As the debate blazes, deep-pocketed big tobacco investors are buying up e-cig companies, injecting millions of dollars into the market and banking on a bright future for the devices. More than 100 e-cigarette companies are now jockeying for the business of smokers and nonsmokers alike.
Ebay recently has allowed pre approved sellers to sell products on ebay that were not allowed in the past. Yet ebay has been allowing the same accounts with ebay stores to continue selling without issue. This website hosts promotional and sales material for adults only (18/19+), not intended for minors. Our customer service team is available 7-days a week to provide courteous and prompt support on anything vaping-related. We understand that you may have questions or concerns about vaping, order details, product warranties, and more, so we've compiled a list of frequently asked questions to help you make informed decisions about your experience. Remember, it’s important to have conversations rather than suspicion and accusations.
The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. The products available in Australia are often made up of many parts, from all over the world, which makes it difficult to assess the safety of the overall product. Most e-cigarettes available in retail stores have not been tested or approved by the TGA, which means their safety cannot be guaranteed. Children are exposed to e-cigarette advertising online and on TV, in magazines and billboards. Although it is illegal for e-cigarettes to be sold to youth under age 21, they can be ordered online. While flavors were nationally banned in 2019, this ban excludes mint and menthol flavors.
Levels below the LOD or LOQ, or even below the threshold levels proposed by the AFNOR standard guidelines, provide evidence of the optimal operation conditions (e.g., adequate wick saturation without extreme coil heating) of the ceramic wick-based device. E-cigarettes are battery-powered devices designed to deliver nicotine and/or other substances including, in some cases, flavourings. Although e-cigarettes were first proposed in 1927 by Joseph Robinson1, it was only in the early 2000s that the 1st generation of e-cigarettes or ‘cig-a-likes’ became commercially available2,3,4. Subsequent generations of devices have evolved since then, ranging from e-cigarettes with prefilled or refillable cartridges (2nd generation) to rechargeable tank-style devices (3rd generation) with modifiable or ‘‘Mods’’ components3,4,5,6. The 4th generation of devices, known as ‘Pods’, has been driven by advances in electronic atomization technology3,7,8,9.
In January, the Cumberland County Board of Commissioners passed a new ordinance that prevents new vape shops from opening within 1,000 feet of a school to address youth nicotine consumption. On the rare occasions I partake, instead of filling my nostrils with the taste of a warm crème brûlée, my mouth tastes like a street gutter for an hour. I like the nicotine, but everything else about the experience is viscerally revolting. About 43% of the study participants were LGBTQ+ adolescents, for instance, and research suggests that LGBTQ+ young people smoke and vape at a higher prevalence than their non-LGBTQ+ peers. The new study included a diverse group of adolescents, indicating how the text message program could be helpful for marginalized communities, said Dr. Suchitra Krishnan-Sarin, a professor of psychiatry at the Yale School of Medicine. "Text messaging is a scalable and cost-efficient approach to delivering vaping cessation treatment on a population basis," the researchers wrote in the study.
Parents and anti-tobacco groups immediately criticized the decision, which follows years of advocacy efforts to keep menthol and other flavors that can appeal to teens off the market. The FDA said it authorized four menthol e-cigarettes from Njoy, the vaping brand recently acquired by tobacco giant Altria, which also sells Marlboro cigarettes. This is in contrast to passive smoking (secondhand smoke), which is known to be very harmful to health.
For those who currently use, My Life My Quit offers resources tailored to support youth ages on their journey to quitting. Youth and teens can text Start My Quit to or visit the website for free, confidential quit help. Other appeals courts have sided with the FDA, which regulates new tobacco products under a 2009 law aimed at curbing youth tobacco use.
Do we really know the composition of the inhaled vapour during the heating process and its impact on health? In the present review, we have attempted to clarify these questions based on the existing scientific literature, and we have compiled new insights related with the toxicity derived from the use of these devices. With the rise in electronic cigarettes (e-cigarette, e-cigs or vapes) and vaping use among youth, teens and young adults, the Health Department and our team are working to prevent initiation and reduce vaping of all substances in Vermont. As of 2021, 16% of Vermont high school students said they used e-cigarettes at least once in the past 30 days. Students who smoke cigarettes, tried flavored tobacco before age 13, binge drink or use cannabis vape at the highest rates.
These refills are cheaper than disposables, but they're almost as foolproof. Switching from cigarettes to e-cigarettes could also save you a lot of money. Some people spend more than others but in general smoking costs more than vaping. Now there is an option available to me that is far less harmful or offensive as cigarettes and, for now, I am allowed to enjoy the company of my friends and family indoors with the rest of society. No longer do I have to huddle under the awning of a building, trying to avoid the rain, nor do I have to freeze my fingers off trying to rush through a cigarette just so everyone else can be satisfied.
"Parents should base their information on accurate facts and also encourage their children to read about and understand the science on this issue instead of relying on what their friends and peers tell them." Oregon Health & Science University is dedicated to improving the health and quality of life for all Oregonians through excellence, innovation and leadership in health care, education and research. Food and Drug Administration (FDA) has regulatory authority over synthetic nicotine as it does over tobacco-derived nicotine.
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 nicotine delivery systems (ENDS). Get the facts about e-cigarettes, their health effects, and the risks of vaping.
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.
CATCH My Breath’s curriculum attempts to empower students with this information for them to decide whether to pick up an e-cigarette, Marcella Bianco, the program’s director of government partnerships, explained. Once the school year starts, the 34 middle and high schools in the district join 56 others across the state that have already implemented the prevention program since its launch in 2017. The participants were encouraged to set a quit date and were asked about their vaping behavior via follow-up text message assessments. The trial participants were recruited via ads on social media, including Instagram, Facebook and Snapchat. From October 2021 to October 2023, about half of the participants were randomly assigned to the This is Quitting text message program.
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).
Vaping is the term often used to describe the act of using an electronic cigarette. E-cigarettes are battery-operated devices that heat a liquid solution — usually, but not always, containing nicotine — turning it into a vapor that can be inhaled. If the base nicotine mixture is not palatable, many flavors, such as mint, apple and others, can make vaping attractive, especially to adolescents. "We also did not see evidence that teens who quit vaping transitioned to smoking," added Graham. The text message intervention tested in this study is called This is Quitting, now part of the EX Program from Truth Initiative.
Although there’s no definitive answer at this point, experts do have a theory about how vaping harms lungs. Young people who vape may be more likely to become addicted than adults. Nicotine exposure during this vital time can affect brain development in subtle and important ways. Research published in 2017 found that the high temperatures needed to form the mist for vaping can create dozens of toxic chemicals, such as formaldehyde, which is thought to cause cancer.
In fact, the overall evidence points to e-cigarettes actually helping people to give up smoking tobacco. There is no evidence that e-cigarettes are undermining England’s falling smoking rates. Instead the evidence consistently finds that e-cigarettes are another tool for stopping smoking and in my view smokers should try vaping and vapers should stop smoking entirely. E-cigarettes not only pose substantial health risks to youth and young adults, they pose a significant environmental threat (see the Truth Initiative fact sheet on Tobacco and the Environment). Almost half (49.1%) of young people don’t know what to do with used e-cigarette pods and disposable devices. A second brand of e-cigarettes—marketed as Nixotine, Nixodine, Nixamide and Nic-Safe—contained a nicotine analog called nicotinamide, also at levels lower than the labels indicated, and combined with undisclosed amounts of 6-methyl nicotine.
Overall, comparisons of the particle-size distribution in aerosols from e-cigarettes found that the substances tested had particle distributions similar to the traditional e-liquids containing nicotine. "Our finding indicates that health care expenditures for a person who uses e-cigarettes are $2,024 more per year than for a person who doesn’t use any tobacco products," said lead author Yingning Wang, PhD, of the UCSF Institute for Health & Aging. Use of electronic cigarettes costs the United States $15 billion annually in health care expenditures – more than $2,000 per person a year – according to a study by researchers at the UC San Francisco School of Nursing. Between 2016 and 2022–2023, the proportion of people who both smoked regular (combustible) tobacco cigarettes and used e‑cigarettes increased, as did the proportion who currently used e‑cigarettes but did not use regular cigarettes.
These findings can reflect general openness to nicotine use, indicated by a previous study showing considerable overlap between susceptibility types [24]. Several school-level factors have a role in both youth tobacco use and educational pathways. These include school rules and policies, physical environment, curriculum, discipline, school health services, school social and learning environment, student commitment to learning and school community as well as parents and the broader community [26]. Further, school influence partly occurs through the perceptions of smoking behaviour in the social network (descriptive norms) and perceptions of social network beliefs (injunctive norms), which both predict smoking initiation among youth [27].
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.
Learn more about the symptoms and overall effects of smoking on the body below. For example, in New York and Vermont, vaping is prohibited in all smoke-free venues (like workplaces, bars, restaurants, and gambling facilities) except e-cigarette stores. The makeup of these devices—combined with individual or group vaping patterns—can significantly impact what pollutants get into the air and how many. The program provides participants with tailored advice, cognitive and behavioral coping strategies, and social support to help them quit. Now that ebay is starting to allow sellers like myself to utilize the site again why cant they allow a process to become a pre approved seller for vape products.
Nicotine pouches, led by top-selling Zyn by Swedish Match, have become increasingly popular among adult tobacco consumers, particularly those trying to lower or end their traditional or electronic cigarette consumption. Chalmers said some students are realizing the dangers of vaping after seeing their peers struggle with nicotine addictions. She believes that adding the CATCH My Breath education only solidifies it for them.
You should use the vape as much as you need to manage your cravings and withdrawal symptoms. Here are some of the most common myths, and the facts based on scientific evidence and data. Nicotine itself is not very harmful and has been used safely for many years in medicines to help people stop smoking. E-liquids come in different nicotine strengths, so you control how much nicotine you need to help with cravings and other withdrawal symptoms, such as feeling irritable and having low mood. Electronic cigarettes and ESDs also pose a risk of fire and explosions, which result in serious injuries and property damage.
According to the 2023 National Youth Tobacco Survey, more than 2 million teens reported vaping nicotine, and there was an increase in current overall tobacco product use among middle school students (4.5% to 6.6%) and multiple tobacco product use (1.5% to 2.5%). They are not technically categorized as smokeless tobacco, so the Food and Drug Administration (FDA) does not regulate them as strictly as smoked tobacco products or combustible tobacco. Without long-term data, we cannot be certain if or how reduced exposure will prevent harm to one’s health. In Canada, most of the provinces require smokers to be 19 years of age to purchase cigarettes (except for Quebec and the prairie provinces, where the age is 18). However, the minimum age only concerns the purchase of tobacco, not use. Alberta, however, does have a law which prohibits the possession or use of tobacco products by all persons under 18, punishable by a $100 fine.
Without immediate measures to stop epidemic use of these products, the long-term adverse health effects will increase. Despite their popularity, little is known about their health effects. Some suggest that e-cigarettes likely confer lower risk compared to combustible tobacco cigarettes, because they do not expose users to toxicants produced through combustion. Proponents of e-cigarette use also tout the potential benefits of e-cigarettes as devices that could help combustible tobacco cigarette smokers to quit and thereby reduce tobacco-related health risks. Others are concerned about the exposure to potentially toxic substances contained in e-cigarette emissions, especially in individuals who have never used tobacco products such as youth and young adults.
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.
To vape is to inhale vapor created from a liquid heated up inside a device. The devices have many names—vape pens, pod mods, tanks, electronic nicotine delivery devices (ENDS), e-hookahs and e-cigarettes. Most e-cigarettes contain nicotine and their repeated use can lead to nicotine addiction or increase the user's risk of addiction. Some e-cigarette brands contain nicotine salts to mask the harshness of nicotine and make it more palatable. As of 2018, all tobacco products must bear the required nicotine addictiveness warning statement on product packages and advertisements in order to warn consumers about the presence of and addictive nature of nicotine.
Youth and young adults who want to quit vaping are invited to text DITCHVAPE to to sign up for a totally free, anonymous texting service that provides 24/7 support, daily tips and motivation to keep you focused on your end goal. This service incorporates messages from young people who have attempted to quit, or successfully quit, e-cigarettes. Visit Truth Initiative to learn more about the This is Quitting campaign. According to a 2017 study, teens who use e-cigarettes are more likely to smoke regular tobacco products later on, compared with their peers. An electronic cigarette is a battery-operated device that emits a vaporized solution to inhale. These devices have various names, including e-cigarettes, e-hookahs, vaporizer cigarettes, vapes, and vape pens.They come in a range of shapes.
The cytotoxic and pro-inflammatory effects of different e-cigarette flavouring chemicals were also tested on two human monocytic cell lines—mono mac 6 (MM6) and U937 [86]. Also, all the tested flavours produced significant levels of ROS in a cell-free ROS production assay. Finally, diacetyl, pentanedione, O-vanillin, maltol, coumarin, and CAD induced significant IL-8 secretion from MM6 and U937 monocytes [86]. It should be borne in mind, however, that the concentrations assayed were in the supra-physiological range and it is likely that, once inhaled, these concentrations are not reached in the airway space.
Silica was commonly the first material to be used as a wick, followed by cotton and ceramic3,13,14,15. Cotton has good wicking properties but is less thermally stable than silica14,16,17, while ceramic is chemically stable and heat-resistant18. The use of microporous ceramic as a wicking material has increased in the past few years14,16,18,19,20. Its application has been reported to improve heating efficiency and reduce charring14,16,18,19,20. Additional research is ongoing to clarify the dangers from vaping, and how vaping damages the lungs and other organs. Long-term human studies, in particular, could bring the risks from e-cigarettes into better focus, Crotty Alexander says.
It acknowledges the wisdom of Elders past and present, and pays respect to all Aboriginal communities of today. Always be considerate when vaping around anyone else, especially people with health conditions like asthma or other respiratory conditions, or people who do not like vaping. But as a precaution, it is best not to vape around babies and children if you can avoid it. Remember, if you have stopped smoking completely you have already achieved a huge step in protecting your health, so don't worry if it takes you a while to stop vaping. You can buy them from specialist vape shops, some pharmacies, supermarkets and other retailers, or from an online vape store.
We also left out propylene glycol, a petroleum byproduct often used as a flavor enhancer. This stuff isn't considered toxic, but it adds a harsh edge to your inhale, and we wanted to stick to strictly plant-based components. I understand that for a few moments during your meal you may have a sniff of my vape that you don’t care for, but I’m sure that it isn’t as horrible as you make it sound in your rant. Life is full of mild unpleasantries that we all must deal with on a daily basis, but we can choose to deal with them or let them torment us.
However, to date, no e-cigarette product has been approved by the FDA for quitting smoking. Although e-cigarettes have been sold in the U.S. for nearly 20 years, use patterns have shifted dramatically. As newer iterations brought higher levels of nicotine in an increasing array of flavors and product designs, youth use skyrocketed.
E-cigarettes aren't thought of as 100% safe, but most experts think they're less dangerous than cigarettes, says Neal Benowitz, MD, a nicotine researcher at the University of California at San Francisco. Cigarette smoking kills almost half a million people a year in the United States. Most of the harm comes from the thousands of chemicals that are burned and inhaled in the smoke, he explains. E-cigarettes are battery-operated devices that can look like a real cigarette or pen.
The harmful effects of CS and their deleterious consequences are both well recognised and widely investigated. However, and based on the studies carried out so far, it seems that e-cigarette consumption is less toxic than tobacco smoking. This does not necessarily mean, however, that e-cigarettes are free from hazardous effects. Indeed, studies investigating their long-term effects on human health are urgently required. In this regard, the main additional studies needed in this field are summarized in Table 3.
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.
But they may also contain other compounds including artificial flavors, nicotine, THC, and cannabinoid (CBD) oil. E-cigarettes are known by many different names, including e-cigs, electronic nicotine delivery systems (ENDS), alternative nicotine delivery systems (ANDS), e-hookahs, mods, vape pens, vaporizers, vapes, and tank systems. We know nicotine and other ingredients in e-liquids can hurt your body and we still don’t know what long-term health problems vaping could cause. There are online resources, texting and phone services and apps that connect you with real people to help you on your journey to kick the habit. E-cigarettes, aka JUULs and vape pens, use a battery to heat up a special liquid into an aerosol that users inhale.
He encourages people committed to quitting to try non-inhaled methods such as the nicotine replacement patch or another FDA-approved smoking cessation product, as well as counseling. E-cigarettes are battery-operated devices that convert liquid into aerosol, which is inhaled into the user’s lungs. Typically, the liquid contains addictive nicotine, as well as flavors. More than 10 million adults in the United States use e-cigarettes, and vaping has become especially popular among teenagers.
Once discarded into the environment, the filters create a large waste problem. Synthetic particulate filters may remove some of the tar before it reaches the smoker. The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study.
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.
Not only is there evidence of mislabelling of nicotine content among refills labelled as nicotine-free, but there also seems to be a history of poor labelling accuracy in nicotine-containing e-liquids [37, 38]. "Since there is no safe tobacco product, eventual abstinence from all tobacco products is the end goal," concluded senior study author Andrew Hyland, PhD, Chair of Health Behavior at the Roswell Park Comprehensive Cancer Center. Meanwhile, people who were smoking e-cigarettes non-daily had a 3.1% rate of quitting smoking and a 10.2% rate of cutting down to non-daily tobacco smoking. However, the CDC states that there is insufficient evidence to suggest vaping can help people quit smoking. A second brand of e-cigarettes -- marketed as Nixotine, Nixodine, Nixamide and Nic-Safe – contained a nicotine analog called nicotinamide, also at levels lower than the labels indicated, and combined with undisclosed amounts of 6-methyl nicotine. The nicotine analogs were included in flavored e-cigarettes, which prior research has indicated are preferred by youths and those who vape for the first time.
Just like people around smokers can breathe in cigarette smoke, it’s possible to breathe in e-cigarette aerosol if you’re around someone vaping. This is called secondhand vaping, and there isn't a lot of published research yet on how inhaling this aerosol affects the body, especially among adolescents. If you spend time around someone who vapes, you might be wondering if you can get secondhand smoke from a vape. While there's still a lot we don’t know about the harms of secondhand vaping, research suggests that bystanders who breathe in the aerosol might be exposed to many of the same toxins found in e-cigarettes and even some found in traditional tobacco. E-cigarettes and vapes are electronic devices that vaporize an e-liquid to produce vapor without combustion. With a wide range of flavours and nicotine strengths available in disposable, closed pod, and refillable systems you are sure to enjoy a more discreet and customizable experience that caters to your personal preferences with greater convenience.
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.
While e-cigarette use prevalence has declined significantly since the heyday of JUUL — 10% of high school students reported using e-cigarettes in 2023 — e-cigarette use among young people remains a concern. Thousands of flavored, high-nicotine, and relatively cheap e-cigarette products remain on the market — many of them illegally — driving youth use and nicotine addiction. Equally concerning, nearly half of young people who have ever tried e-cigarettes continue to use them, and many do so daily. As encouraging as the data was a few years ago, it’s starting to look like that’s not the case. The FDA is yet to approve them as a smoking cessation aid and a recent CDC study found that most adult e-cigarette users — 58.8 percent of them — don't stop smoking cigarettes and instead wind up using both products. The few scientists actively trying to fill the gap in the research literature are running into obstacles.
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.
However, the FDA then paused its decision in July while it carries out an additional review on the company's products. Many physical retail locations neglect to check identification for customers, allowing children to access the devices. Like cigarettes, an American must be at least 21 years old to purchase a vape. They can come as vape pens — which are shaped like a pen or small tube with a tank to store e-liquid and batteries — or pod systems that are rechargeable and often shaped like USB sticks.
"From a public health perspective, we have always been concerned about dual-use of both traditional and e-cig products," said study lead author Marisa Bittoni, an oncology researcher at Ohio State University in Columbus. The U.S. Food and Drug Administration and the European Union are grappling with these issues as they decide how to regulate the products. Unfettered access could leave people vulnerable to unknown health hazards, but there is also the chance that greater restrictions might hurt folks who are trying to forgo conventional—and more dangerous—tobacco products.
The study was supported by the National Institutes of Health, the American Heart Association, the Stanford Diabetes Research Center, the University of California Tobacco Related Disease Research Program and the FDA. We acknowledge the assistance of Belinda Zonnestein in sourcing and testing of the products. We further acknowledge My-Linh Tran and Joseph Sutton for their contribution to product development and provision of product details and to Sandra Costigan and Elaine Brown for the toxicological inputs. Death typically happens due to paralysis of the muscles that control your breathing, fluid buildup in your airways and heart and blood vessel failure (cardiovascular collapse).
At last I can feel like I am a part of society again, and not some evildoer who deserves to be sent out to the village gates to hide my atrocious acts. Siegel is concerned that the use of nicotine salts could make the Juul more addictive. "With Juul, the pattern of use isn’t kids having a cherry vape every now and then," he said. "It’s kids sneaking off to the bathroom, kids vaping consistently throughout the day." Siegel said that he was keeping an eye on this behavior.
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.
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.
You can turn to our smoking cessation resource center, which has tips for how to stop smoking, information on smoking cessation therapies, and more. Doctors may also recommend prescription and nonprescription medications to help you quit. For people with vaginas, it can result in sexual dissatisfaction by decreasing lubrication and the ability to reach orgasm. Babies may be born with underdeveloped lungs if the pregnant person smokes during pregnancy. Smoking damages the airways, air sacs (alveoli) in the lungs, and cilia, which are tiny hair-like structures that prevent dirt and mucus from entering your lungs.
E-cigarette use has remained relatively low and stable among adult users since around 2012, although use has gone up slightly among adults recently, from 4.5% in 2021 to 6% in 2022. In 2022, the greatest e-cigarette use among adults was among 23- to 24-year-olds, 22.8% of whom were current users, according to Monitoring the Future. Get the latest facts and analyses on the most important issues related to smoking, vaping, nicotine and substance use. Also, we've published an article on where to buy nicotine free vapes, to help you make a more informed decision. We have yet to encounter an e-liquid company as committed to transparency as VaporFi. Their products are made in the U.S.A., in FDA-registered labs, and all of their various test results and certifications are available for customers to view.
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.
In addition to nicotine, e-cigarettes can also be used to inhale other drugs, such as cannabis. Retailers are not permitted to sell e-cigarettes in retail outlets to anyone. Instances of non-compliance should be reported to the local council where the premises is located. More than 5 million middle and high school students used e-cigarettes, according to the 2019 National Youth Tobacco Study (NYTS), up from more than 3.6 million the previous year. Surgeon General’s office began the work of awareness when the nation’s doctor, Jerome Adams, MD, issued a warning that vaping among youth has reached epidemic levels. This module provides an understanding of the inner workings of e-cigarettes, the content of the aerosols they produce, and thirdhand smoke.
E-cigarettes produce an aerosolized liquid (vapor) that usually contains nicotine and other chemicals inhaled by the user. Months after the release of that advisory, Yale researchers found that byproducts, called acetals, form when flavoring agents mix with solvents in the liquid. It is not yet known if this has negative effects on the body, but Sven-Eric Jordt, PhD, one of the study’s authors, says he hopes that the FDA will begin to study the short- and long-term effects of inhaled acetals. Under the PACT Act, delivery sales of electronic nicotine delivery systems must also comply with state, local or tribal laws involving excise taxes on these devices.
To inform schools of intervention needs, the susceptibility measure could be utilized in school surveys and relevant student services as a screening tool. Simultaneously, it would support the evaluation of existing policies and programmes and monitoring of potential counter-effects. For example, an earlier study observed that school-based programmes and policies had resulted in higher susceptibility risk at some intervention schools [37]. Effective and non-counter-productive interventions are especially important for products where susceptibility is at a high level, like e-cigarettes. Interventions to reduce susceptibility therefore need to address product regulation and marketing as well as social influence, norms, and perceptions.
Much like free-base nicotine products, these liquids contain propylene glycol and/or vegetable glycerin, as well as other chemicals such as flavouring ingredients. Most vaping devices use electrical power from a battery to heat a liquid solution. The term "vaping" is also used to refer to the inhalation of cannabis aerosols, which are produced by products that differ from nicotine products described on this page. Propylene glycol and glycerin are the most common solvents used in vapor products. While generally recognized as safe for ingestion by the FDA, research has found both substances to be toxic when aerosolized through the vaping process.
Needing no extra coils or e-liquid to use they are an all-in-one package. They have become one of the best alternatives to smoking because of the easy setup and delicious flavours. Did you know you can buy 10ml vape juice that tastes just like your favourite disposables? Bar salt liquids are made with extra strong flavours to give you the same great taste for a fraction of the cost.
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.
Research from The Johns Hopkins University on vape ingredients published in October 2021 reveals thousands of chemical ingredients in vape products, most of which are not yet identified. Among those the team could identify were several potentially harmful substances, including caffeine, three chemicals never previously found in e-cigarettes, a pesticide and two flavorings linked with possible toxic effects and respiratory irritation. "These cases appear to predominantly affect people who modify their vaping devices or use black market modified e-liquids. This is especially true for vaping products containing THC," explains Blaha. The American Lung Association will continue to urge FDA and Congress to remove all flavored tobacco products from the marketplace.
Many grants on this topic are funded through the Tobacco Regulatory Science Program, an NIH partnership with FDA’s Center for Tobacco Products to fund research to inform FDA’s tobacco regulatory activities. Interestingly, most of these reports linking COVID-19 harmful effects with smoking or vaping, are based on their capability of increasing the expression of angiotensin-converting enzyme 2 (ACE2) in the lung. It is well known that ACE2 is the gate for SARS-CoV-2 entrance to the airways [106] and it is mainly expressed in type 2 alveolar epithelial cells and alveolar macrophages [107]. To date, most of the studies in this field indicate that current smokers have higher expression of ACE2 in the airways (reviewed by [108]) than healthy non-smokers [109, 110]. While tobacco products have been a long-standing public health issue, e-cigarette (aka e-cigs, vape pens, vapes) use has continued to gain popularity throughout the last decade. Poison centers began receiving calls about e-cigarettes and liquid nicotine products in 2010, which overlaps with the initial period where these products reached the U.S. market.
The SKE Crystal Bar has an auto-shutoff that powers it down after 15 minutes, preventing it from overheating while idle. It also shuts down in response to a short circuit so that wiring or battery issues won't cause it to ignite. And its reverse polarity protection keeps the device from being damaged if the battery is improperly installed (though this shouldn't be an issue since it's a pre-assembled vape). We appreciate the elegant design of the SKE Crystal Bar, and it's got a reputation for delivering rich, long-lasting flavor.
E-cigarettes are available in flavors like cherry, bubble gum, and cotton candy, and are allowed to be advertised on TV, which may increase their appeal for children and teens. As of July 31, 2024, Poison Centers have managed 4,955 e-cigarette and liquid nicotine related exposure cases. For more information about the health effects of e-cigarettes, visit CardioSmart.org/StopSmoking. People who use e-cigarettes are significantly more likely to develop heart failure compared with those who have never used them, according to one of the largest prospective studies to date investigating possible links between vaping and heart failure. The findings are being presented at the American College of Cardiology’s Annual Scientific Session.
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.
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.
This was especially the case for people aged 14 to 17 (74%) and 18 to 24 (68%). The 2022–2023 NDSHS was conducted before these restrictions were put into place. At the time, in most jurisdictions, it was legal for adults to purchase e‑cigarettes that did not contain nicotine from a broad range of retail settings, including those used to purchase tobacco products. Prior to 2024, adults could also import nicotine e‑cigarettes with a prescription via the personal importation scheme. The first study found that vaping can worsen several heart disease risk factors at levels equal to tobacco cigarettes, while the second found that e-cigarettes decrease blood flow in the heart even more than tobacco cigarettes. However, e-cigarettes still pose health risks, even without nicotine.
In addition to these laws, e-cigarettes are prohibited from being used in child care facilities, and people purchasing tobacco products have to pay a 15 percent tax. While not all the effects of smoking are immediate, the complications and damage can last for years. The good news is that quitting smoking can reduce many risk factors for the conditions and diseases below. For a long time, e-cigarettes and other electronic aerosolizers weren’t regulated by the Food and Drug Administration (FDA). They only came under the purview of the FDA in 2016, after they had been on the market for nearly a decade.
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.
Based on the current literature, it seems that several factors have led to the success of e-cigarette use as a smoking cessation tool. First, some e-cigarette flavours positively affect smoking cessation outcomes among smokers [102]. Second, e-cigarettes have been described to improve smoking cessation rate only among highly-dependent smokers and not among conventional smokers, suggesting that the individual degree of nicotine dependence plays an important role in this process [97]. Third, the general belief of their relative harmfulness to consumers' health compared with conventional combustible tobacco [103]. And finally, the exposure to point-of-sale marketing of e-cigarette has also been identified to affect the smoking cessation success [96].