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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.

Because there is no safe tobacco product, quitting use of all tobacco products is the best way to protect your health. Most e-cigarettes contain nicotine, which is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s. E-cigarettes can contain other harmful substances, including cancer-causing chemicals; chemicals linked to serious lung disease; and heavy metals, such as nickel, tin, and lead. Young people who use e-cigarettes may be more likely to smoke traditional cigarettes in the future. Vapor products produce aerosol by heating a liquid solution, which is inhaled as an aerosol. The process is referred to as "vaping." Vapor products often contain nicotine.

They are sometimes called e-cigs, e-hookahs, mods, vape pens, vapes, and tank systems. Using an e-cigarette is often called "vaping" or "JUULing." 2Most e-cigarette users do not consider themselves to be smokers. E-cigarettes, vapes, vape or hookah pens, e-pipes, and other vaping products are battery-powered devices that allow users to inhale, or vape, aerosolized liquid (e-juice).

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

Over the years, Evans tried to quit by using the nicotine patch, gum, and even hypnosis. When you stop using it, you can go into withdrawal and feel depressed and crabby. We have lots of detailed vaping guides and blog posts to help new vapers make the transition to vaping. Find everything you need to know about e-liquids, starter kits, and what to expect when switching to vaping. Alternatively, why is electronic cigarettes dangerous not speak to one of our customer service advisors? Great for new vapers, disposable vape kits are the simplest way to vape.

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.

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.

Cigarette smoking is still the No. 1 cause of preventable death in this country, killing nearly five hundred thousand people each year. (According to some studies, more than half of longtime smokers will die from smoking-related complications.) It’s incredibly hard to stop smoking; people spend lifetimes trying. Around seventy per cent of American smokers say that they want to quit, and for many of them e-cigarettes have been a godsend. But, according to a 2017 study by the C.D.C., about fifty per cent more high schoolers and middle schoolers vape than smoke. Young people have taken a technology that was supposed to help grownups stop smoking and invented a new kind of bad habit, one that they have molded in their own image. The potential public-health benefit of the e-cigarette is being eclipsed by the unsettling prospect of a generation of children who may really love to vape.

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.

One of the first studies in humans involved the analysis of 9 volunteers that consumed e-cigarettes, with or without nicotine, in a ventilated room for 2 h [8]. Pollutants in indoor air, exhaled nitric oxide (NO) and urinary metabolite profiles were analysed. The results of this acute experiment revealed that e-cigarettes are not emission-free, and ultrafine particles formed from propylene glycol (PG) could be detected in the lungs. In line with these observations, dysregulation of lung homeostasis has been documented in non-smokers subjected to acute inhalation of e-cigarette aerosols [10]. Globally, there is an ongoing debate about whether e-cigarettes are a threat or an opportunity to public health.

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.

Almost 9 in 10 people (86%) supported prohibiting the sale of e‑cigarettes to people under 18 years of age, a substantial increase from 2019 (79%). Social and economic factors shape people’s behaviours of vaping or smoking. Generally, people living in the most disadvantaged socioeconomic areas were the most likely to currently smoke regular cigarettes but not use e‑cigarettes (13.2%). In contrast, people living in the most advantaged socioeconomic areas were the most likely to use e‑cigarettes but not smoke regular cigarettes (6.6%) (Figure 4). Young people aged 18 to 24 were the most likely to have used e‑cigarettes in 2022–‍2023, with almost 1 in 2 (49%) having used them at least once in their lifetime, and over 1 in 5 (21%) currently using e‑cigarettes in 2022–‍2023. More information on young people’s use of vapes and e-cigarettes can be found online.

Prior to that, it was the Wild West, where a variety of companies started making and selling products with their own personal spin. Per the survey, 10.0% of students (2.80 million) reported current use of any tobacco product; 12.6% (1.97 million) high school students and 6.6% (800,000) middle school students reported current use of any tobacco product. Importantly, the researchers found strong evidence of the program's effectiveness among key subgroups defined by race, ethnicity, gender, higher levels of nicotine dependence, smoking and other substance use, mental health challenges, and household dysfunction. "For many years, healthcare providers, teachers, and parents have been asking how to help teens quit vaping," said Dr. Amanda Graham, Chief Health Officer at Truth Initiative and principal investigator of the study.

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.

The tobacco industry profits from destroying health and is using these newer products to get a seat at the policy making table with governments to lobby against health policies. WHO is concerned that the tobacco industry funds and promotes false evidence to argue that these products reduce harm, while at the same time heavily promoting these products to children and non-smokers and continuing to sell billions of cigarettes. Nicotine affects the development of the brain’s reward system and brain circuits that control attention and learning. Continued use of nicotine can lead to addiction and raise the risk for addiction to other drugs. In a recent study, about 18% of people who switched to vaping had been able to quit smoking.

In the multivariate model (Table 3), results were similar for both girls and boys. S-EC remained higher for those planning for vocational education, and lower with liking school. Further, S-EC was higher with parental smoking, positive attitudes towards e-cigarette use in one’s age group, current smoking, and current snus use. Between-school differences were larger for girls (MOR 1.23) than boys (MOR 1.16). Educational aspirations were measured with ‘Where do you primarily want to go to study after comprehensive school?

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).

When the human body breaks down a foreign substance, one can typically find chemical by-products in hair or urine that provide clues about how it has interacted with cells. This is true for nicotine, but in the case of propylene glycol, no one has established what the relevant by-product is or how to best detect it. Boston, MA – Diacetyl, a flavoring chemical linked to cases of severe respiratory disease, was found in more than 75% of flavored electronic cigarettes and refill liquids tested by researchers at Harvard T.H. Chan School of Public Health. Two other potentially harmful related compounds were also found in many of the tested flavors, which included varieties with potential appeal to young people such as Cotton Candy, Fruit Squirts, and Cupcake. In conclusion, the prevalence of susceptibility among adolescents differs by product type. Liking school and academically oriented educational aspirations appear as consistent protective factors, while the use of other tobacco or nicotine products and positive attitudes towards product use in one’s age group appear as risk factors.

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.

As a non-profit organization, we accept no government or tobacco industry funding. We rely on contributions from individuals, philanthropic foundations, corporations and other non-profit organizations to continue working toward a tobacco-free future. The U.S. Surgeon General declared vaping an epidemic among our youth in 2018. Additional collection points are being added all the time, you can use your postcode to find your nearest vape recycling locations. You can take vapes for recycling to the shop where you buy your replacements or to your local authority household waste recycling centre. Once you have bought the kit, it's been estimated that vaping costs about a third as much as smoking.

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.

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.

The results showed that people who used e-cigarettes at any point were 19% more likely to develop heart failure compared with people who had never used e-cigarettes. In calculating this difference, researchers accounted for a variety of demographic and socioeconomic factors, other heart disease risk factors and participants’ past and current use of other substances, including alcohol and tobacco products. The researchers also found no evidence that participants’ age, sex or smoking status modified the relationship between e-cigarettes and heart failure. While teen smoking has fallen by 80% over the past 20 years, a new generation is now at risk of becoming addicted to nicotine — and possibly at risk for other serious health problems — through e-cigarettes. More than 2.5 million U.S. middle and high school students are now using e-cigarettes, with nearly 85% of them using flavored products.

One study detected vitamin E acetate in the lung fluid of 48 out of 51 EVALI patients sampled across 16 states. By contrast, lung fluid samples taken from healthy people did not contain the vitamin. EVALI is a serious medical condition in which a person’s lungs become damaged from substances contained in e-cigarettes and vaping products. The smoke-free and tobacco-free policies at schools, businesses, healthcare institutions, and other organizations should also cover e-cigarettes. This will help non-users avoid being exposed to potentially harmful e-cigarette aerosol.

Research has also shown flavor chemicals to be toxic in both e-liquid and aerosol form. While many flavor chemicals used in vaping products have been approved for ingestion, they have not yet been tested for safety when aerosolized. Flavor chemicals are typically not listed on e-cigarette packaging, and most e-liquids contain more than one flavor chemical. Benzaldehyde (used in cherry-flavored products) and 2, 5-dimethyprazine (used in chocolate-flavored products), specifically, may harm human health.

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.

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

Their tactics include slick magazine ads, sponsorship of concerts and auto races, celebrity endorsements and sweet, colorful flavors.21 In addition, e-cigarettes are often aggressively placed in convenience stores near candy. Flavors, including mint and menthol, are one of the top reasons young people use e-cigarettes. Candy and fruit-flavored e-liquids can make e-cigarettes appealing and seem harmless. As of July 2020, the sale of flavored e-cigarettes is prohibited in NYC. Further, in 2018, one in 15 (6.7%) middle school students reported using e-cigarettes. E-cigarette use was higher among older students, with one in 11 (9%) seventh grade students reporting use, compared to one in 38 (2.6%) in sixth grade.

As with high school students, e-cigarette use was much more common than cigarette use. E-cigarettes come in many shapes and sizes and can also be called e-cigs, e-hookahs, vapes, vape pens, personal diffusers or diffuser sticks. But one vape can contain the equivalent of 50 cigarettes of nicotine in the one product. They also contain a complex combination of chemicals including nicotine, nickel, tin, arsenic, chlorine and lead. These substances can be harmful to the body, with different flavourings helping to mask these poisons when they are taken into the body. An electronic cigarette (e-cigarette) is a battery-operated device that heats liquid nicotine, flavoring, and other additives to create an aerosol.

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 cigarette battery types 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.

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.

This guidance is intended to support healthcare providers in their understanding and tracking of -cigarette and vaping product use. 20% (5 million) of all youth use e-cigarettes, a 135% increase in just two years. Additional data, rates and trends can be found in the American Lung Association’s Tobacco Trends Brief.

Current evidence indicates that using e-cigarettes is dangerous, especially for young people and people who have never smoked. In young people, the use of nicotine can impact the reward system in the brain. In time, this can make the use of other drugs, such as cocaine, more pleasurable, according to the National Institute on Drug Abuse (NIDA).

Any smoking is harmful and you will only get the full benefits of vaping if you stop smoking completely. Some people manage to make a full switch very quickly, while for others it can take a bit longer. The NFHS Learning Center offers a 3-level national coaching credential that helps you gain knowledge you can use to provide a fun, educational, and a safer environment for your students.

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.

E-cigarettes are known by many different names, including "vapes," "e-cigs," "puff bars," and "electronic nicotine delivery systems (ENDS)." E-cigarettes are devices which produce an aerosol by heating a liquid that usually contains nicotine—the addictive drug in regular cigarettes, cigars, and other tobacco products—flavorings, and other chemicals that help to make the aerosol. Bystanders can also breathe in this aerosol when the user exhales into the air. The nicotine in e-cigarettes and regular cigarettes is highly addictive. While these devices may help some people quit smoking, there is growing evidence that e-cigarettes can pose serious health risks, especially to people who do not smoke traditional cigarettes.

Again assuming a worst-case exposure of 300 puffs day–1 spread over 8 h, the levels of glyoxal exposure to a consumer would still be more than 40 times lower than the occupational exposure limit of 0.10 mg m–377,94,95. The high standard deviation for glyoxal and methylglyoxal observed in BB18 e-cigarette emissions is probably related to an analytical sample matrix effect and/or batch variability83,96,97. Despite the high standard deviation, the percentage reduction of glyoxal and methylglyoxal in both e-cigarette emissions relative to cigarette smoke was ≥ 97.0% and ≥ 94.5%, respectively (Table 3).

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.

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.

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.

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.

Steer clear of unregulated mods unless you have lots of experience vaping and a decent knowledge of electronics. Like disposable vapes, these devices don't allow modification to the battery and heating element. The difference is that they're rechargeable and refillable, letting you swap in a fresh pod or cartridge of vape juice when the old one runs out.

If you’re scratching your head and wondering what @AskTSA is, it’s a small team of TSA professionals from various agency offices who answer TSA related questions from the traveling public that are sent via Twitter. You can read more about the program in this recent USA Today article. "It has become clear to me that e-cigarettes cause their own set of diseases that seem to impact just about every organ in the body—from the brain to the bladder." Critics of e-cigarettes fear that vaping will get kids hooked on nicotine and that they'll "graduate" to cigarettes when they want a bigger kick, Warner says. Vaping worked in a month, and she's been off cigarettes for more than two years. "I'm breathing, sleeping, and eating much better since I started vaping. My 'smoker's laugh' went away, and I no longer smell like an ashtray."

Turkey, which has one of the highest percentage of smokers in its population,[126] has a legal age of 18. Japan is one of the highest tobacco-consuming nations, and requires purchasers to be 20 years of age. Since July 2008, Japan has enforced this age limit at cigarette vending machines through use of the taspo smart card. In other countries, such as Egypt, it is legal to use and purchase tobacco products regardless of age.[citation needed] Germany raised the purchase age from 16 to 18 on September 1, 2007. In the unadjusted analyses (Table 3), those planning for vocational education or extra year/discontinuation had higher S-EC compared with those planning for GUSS. Among girls, those without educational aspirations also had higher S-EC.

Their actions should come as no surprise as e-cigarette manufacturers fail to provide consumers with guidance or take responsibility for appropriate disposal methods. In a separate study conducted by Truth Initiative in 2019, almost half (46.9%) of e-cigarette device owners said that the e-cigarette device they used currently did not provide any disposal information, such as where to send used batteries or empty pods. Additionally, when e-cigarette device owners were asked about e-cigarette waste disposal, the majority (73.7%) believed that it was difficult to find e-cigarette drop off sites. Principal investigator Wendy Max, PhD, director of the Institute for Health & Aging, noted that from 2013 to 2018, e-cigarette use among high school students soared  from 4.5% to 20.8%. The Australian Government’s new Public Health (Tobacco and Other Products) legislation commences from April 2024 and incorporates new controls governing the advertising and promotion of e‑cigarettes (Department of Health and Aged Care 2024). According to the National Tobacco Strategy 2023–‍2030 (Department of Health and Aged Care 2023b), strengthening regulations on e‑cigarettes has been listed as a priority area, and actions such as prohibiting the sale of flavoured e‑cigarettes have been proposed.

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.

These retail sales data briefs are intended to provide information about population trends in sales for participating retailers; they do not include online sales or vape store sales and cannot be used to make conclusions about subgroup purchasing or behaviors. These estimates are based on the information available at the time of publication and may be subject to updates as more information becomes available. The nicotine in e-liquids is readily absorbed from the lungs into the bloodstream when a person vapes an e-cigarette.

Perhaps contrary to what many would expect, vaping marijuana may have as many negative health effects as nicotine-based vaping. This may have more to do with how vape liquids are processed than the THC itself. The tobacco industry profits from destroying health and is using these newer products to get a seat at the policy-making table with governments to lobby against health policies. The tobacco industry funds and promotes false evidence to argue that these products reduce harm, while at the same time heavily promoting these products to children and non-smokers and continuing to sell billions of cigarettes.

The review authors conclude that further research could help untangle how vapers’ bodies develop disease. These types of studies, they say, promise to identify early indicators of—and ultimately treatments for—vaping-related disease. While some tout e-cigarettes as a solution to quitting conventional smoking, the truth about relative risks is complicated, says Crotty Alexander, who is a researcher in addition to providing patient care and teaching.

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 replaceable liquid cartridge contains nicotine mixed with a base (usually propylene glycol), along with flavorings and chemicals. The tip often contains LED lights that simulate the glow of a burning cigarette. Nicotine poisoning can occur when someone ingests, inhales, or absorbs nicotine through the skin or eyes. It can be particularly dangerous for children and young adults, as they are more susceptible to the effects of nicotine. The tax must be broken out as a separate amount from the products sold in any transaction.

Bianco recalled an instance where her son was even subject to content in which a fishing YouTuber he watched was sponsored by a spitless tobacco brand. He notes that the most effective methods involve some sort of pharmaceutical, either nicotine replacement patches or pills, combined with a program that helps you deal with the problems of quitting smoking. (The American Lung Association recommends Freedom From Smoking.) Even then the average quit rate is just 25 percent, so even the best methods only have a one in four chance of succeeding. While saturated fat and alcohol still have their supporters, nobody is rushing to cigarettes’ defense. The new study included more than 1,500 adolescents in the United States, ages 13 to 17, who reported vaping in the previous 30 days, with many of them — about 76% — reporting that they vape within 30 minutes of waking up, a signal of nicotine dependence. Moreover, people who both vaped and smoked were four times more likely to go on to develop lung cancer compared to people who had only smoked, Bittoni's group found.

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.

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.

Starting to use e-cigarettes or switching from tobacco products to e-cigarettes increases your risk of adverse health effects. Interestingly, there is a strong difference of opinion on e-cigarettes between countries. Whereas countries such as Brazil, Uruguay and India have banned the sale of e-cigarettes, others such as the United Kingdom support this device to quit smoking.

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

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.

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.

Researchers noted that they were unable to assess any association between e-cigarette nicotine formulation and cigarette cessation outcomes. Another potential limitation was that the study only included adult participants who reported smoking within the previous 30 days, limiting information about younger smokers and former smokers. In that same vein, 5.9 million people began vaping, bringing the total use of tobacco products among those 12 and older to 64.4 million.

Even liquid nicotine spilled on the skin can be poisonous within minutes. A standard vape kit is usually an electronic cigarette - this usually consists of a battery and tank that allows you to fill it with e-liquid. But you can get many types of vapes, such as pod mods, sub-ohm kits, cigalikes, and many more. We have a wide range of vape kits available, whether you’re looking for a refillable pod vape, a heated tobacco product or a prefilled pod kit.

Enter e-cigarettes, which were new, high-tech, and came with no proven health risks. There were no long-term studies yet, but common sense dictated that if you wanted to quit inhaling tobacco through smoking, the least you could do was switch to e-cigarettes. She added that there is also an "absence of studies" on the effects and dosage of nicotine replacement therapy, or NRT, for adolescents as a way to help them quit vaping. Nicotine replacement therapy is the family of medications used to help adults quit using nicotine, including over-the-counter patches, gums or lozenges or prescription inhalers or nasal sprays. California has some of the strictest regulations in the US, including a ban on the sale of flavored tobacco products to residents of any age.

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.

The survey also found that Minnesota youth are ill-informed about the health risks of e-cigarettes with 76.1% of 11th graders saying there is either no, slight, or a moderate risk to using e-cigarettes. 11th grade students responding to the student survey said that the top ways they got e-cigarettes included getting products from friends (72.3%), getting products at a vape shop (14.0%), and on the Internet (9.6%). Among 8th grade students, e-cigarette use nearly doubled from 2016 to 2019, and one in four 11th graders now use e-cigarettes. Students in all grades surveyed now use e-cigarettes and vapes at five times the rate of conventional cigarettes. In Australia, during the survey period, it was not legal to obtain e‑cigarettes containing nicotine without a prescription (TGA 2020).

Nicotine use can have an impact on learning, memory and attention and increase the likelihood of addiction to other drugs in the future. While some people have reported that using e-cigarettes has helped them quit smoking, there are other proven, safe and effective options that should be explored first. It's important to help protect children and teens from using or being exposed to the harmful vapor from e-cigarettes. Talk with your pediatrician for more information about these products and keeping your child safe and healthy. Your regional Pediatric Environmental Health Specialty Unit (PEHSU) also have staff who can also talk with you about environmental toxins.

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.

The Policy Scan Project, by the Institute for Global Tobacco Control (at Johns Hopkins University) tracks and reports regulatory approaches to e-cigarettes around the world. In 2012 and 2013 there was a flurry of tobacco company investment in e-cigarettes, both in the United Kingdom (UK) and in the United States (US), a trend which continued in subsequent years. In 2018, 8% of Pierce County 12th graders said they had smoked a cigarette in the past 30 days. NSW Health acknowledges the people of the many traditional countries and language groups of New South Wales.

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.

The inhaled vapor may contain nicotine (the addictive drug in tobacco), flavorings, and toxins—including ones that cause cancer. People who have already switched completely from smoking to e-cigarettes should not switch back to smoking (either solely or along with e-cigarettes), which could expose them to potentially devastating health effects. It's important to know the US Centers for Disease Control and Prevention (CDC) has stated that sometimes e-cigarette products are changed or modified and can have possibly harmful or illegal substances from unknown sources. Get regular updates on the health effects of tobacco, public health educational resources, and highlights on current tobacco issues and regulations.

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.

"Vaping products containing nicotine are subject to federal laws that prohibit sales to people under the age of 21," said study co-author Sairam V. Jabba, D.V.M., Ph.D., a senior research scientist at Duke University School of Medicine. "Even with the current relatively low use of e-cigarettes among adults – 3.7 percent – health care costs are already substantial, and likely to increase in the future if youth continue to use this product," said Max. "Vaping products containing nicotine are subject to federal laws that prohibit sales to people  under the age of 21," said study co-author Sairam V. Jabba, D.V.M., Ph.D., a senior research scientist at Duke University School of Medicine. The 2022–2023 NDSHS had a series of questions regarding policy measures designed to address e‑cigarette use. Support increased for all e‑cigarette policy options among the Australian population (Figure 6).

In contrast, other studies found acute microvascular endothelial dysfunction, increased oxidative stress and arterial stiffness in smokers after exposure to e-cigarettes with nicotine, but not after e-cigarettes without nicotine (reviewed in [20]). In women smokers, a study found a significant difference in stiffness after smoking just one tobacco cigarette, but not after use of e-cigarettes (reviewed in [20]). However, research updates on, and analysis of, the potential health benefits/risks of e-cigarettes are outside the scope of TobaccoTactics. These devices come in a variety of shapes and sizes, as pictured below, with several different names. Some e-cigarettes look like regular cigarettes, but many resemble pens or USB flash drives, and are not recognized as tobacco products. Larger e-cigarettes such as tank systems, or "mods," do not resemble other tobacco products.

However, no rigorous scientific studies have shown that they are safe for use. Some people who smoke choose to try e-cigarettes to help them stop smoking. But switching to e-cigarettes still exposes users to potentially serious ongoing health risks. It’s important to stop using all tobacco products, including e-cigarettes, as soon as possible both to reduce health risks and to avoid staying addicted to nicotine.

The agency says companies were blocked because they couldn’t show the possible benefits for adult smokers outweighed the risk of underage use. The companies say they had prepared detailed plans to avoid appealing to young people. Vaping is the inhaling of an aerosol (mist) created by an electronic cigarette (e-cigarette) or other vaping device. As a result of the FDA’s missed deadlines and inadequate enforcement, flavored e-cigarettes remain widely available online and in stores across the country. Every day flavored e-cigarettes remain on the market, our kids remain at risk.

With regards to toxicity, little is known about the effects of humectants when they are heated and chronically inhaled. Indeed, the latter study established that one e-cigarette puff results in a PG exposure of 430–603 mg/m3, which is higher than the levels reported to cause airway irritation (average 309 mg/m3) based on a human study [55]. The same study established that one e-cigarette puff results in a glycerol exposure of 348–495 mg/m3 [57], which is close to the levels reported to cause airway irritation in rats (662 mg/m3) [58]. Results from in vitro studies are in general agreement with the limited number of in vivo studies.

Cigalike brands such as OK Vape give you a very similar experience to smoking a cigarette. Free Stop Smoking Services remain the most effective way for people to quit but we recognise the potential benefits for e-cigarettes in helping large numbers of people move away from tobacco. Much of the research to date has been on cell cultures in the laboratory and in mice. Among the important findings from the review, Christiani stress that "evidence is clear that vaping can cause inflammation of the lung cells and susceptibility to infection." Experts agree that the lungs seem to get the heaviest deposits of aerosols. There were 134 reports of e-cigarette batteries overheating, catching fire, or exploding between 2009 and January 2016, according to Michael Felberbaum, an FDA spokesperson.

The increasing number of adolescent users and reported deaths in the United States prompted the government to ban the sale of flavoured e-cigarettes in 2020. The difference in opinion worldwide may be due to different restrictions imposed. For example, while no more than 20 ng/mL of nicotine is allowed in the EU, e-liquids with 59 mg/dL are currently available in the United States. Nevertheless, despite the national restrictions, users can easily access foreign or even counterfeit products online. Is there sufficient toxicological data on all the components employed in e-liquids?

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

"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.

Teens and young adults can join for free by texting DITCHVAPE to 88709. See " Local restrictions on flavored tobacco and e-cigarette products " for a full report on local flavored tobacco policies. For those who prefer a more "natural" vape experience, Kind Juice provides a range of liquids derived entirely from organically grown plants. The flavors are extracted using relatively gentle solvents, while the vegetable glycerine carrier fluid is made from plant oils using hydrolysis. Kind Juice products contain no additives, nicotine, or psychoactive ingredients, though some have CBD. Many people stick to regulated mods, which include circuit boards that can help prevent problems like power surges.

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.

They do contain propylene glycol, but the concentrations are far below levels usually considered harmful. Though this might make the VITAs hit slightly harsher than vapes without this ingredient, it shouldn't pose much risk to your health. But levels are usually low and generally far lower than in tobacco cigarettes. I don’t sit around inhaling lungful after lungful of vape for seven minutes at a time, like I would a real cigarette, so the lingering aura from my habit certainly isn’t hovering for extended periods of time.

"Recent studies should make us all more concerned about the impact of traditional and e-cigarettes on the heart as well," Dr. Cireddu says. According to the 2018 NAP report, secondhand vapor contains nicotine, particulate matter, and volatile organic compounds (VOCs) at concentrations that are above recommended levels. The 2018 NAP report found that there’s some evidence that e-cigarette exposure has adverse effects on the respiratory system. Some studies suggest that vaping may have negative effects on the lungs, but more research is needed.

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.

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).

Where e-cigarette flavor restrictions had been in effect for at least a year, sales of cigarette brands favored by adults went up by 10%, while sales of cigarette brands that disproportionately attract underage smokers saw a 20% bump. During the study period, hundreds of localities and seven states restricted or prohibited flavored e-cigarette sales. While these policies did reduce per-capita vape sales, they also substantially boosted cigarette sales. To date, there is no state excise or special tax placed on e-cigarettes. In vaping liquids, nicotine and/or flavouring ingredients are dissolved in a liquid mixture.

This is why it took as long as it did for the negative health effects of cigarettes to be widely recognized. There is abundant evidence that e-cigarettes can help some individuals to quit smoking, so they should be more widely recommended as smoking cessation aids. Vaping and smoking share similar negative effects on the body, such as damage to the lungs and increased cancer risk.

"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.

Not to mention the smell that lingers on a person’s body after finishing a cigarette, even if it was outside, far outlasts a vape any day. At Cornell, Jason told me, people Juuled in bathrooms and classrooms, in "every nook and cranny of this campus." In the fall, he’d started a group text, with a few friends, to coördinate pod runs. He called the group Juuluminati, and it has since grown to three hundred and twenty-four members. Jason was Juuling while he talked to me, on the third floor of an academic building. "I know for a fact that there are two or three of my good friends sitting on the first floor of this building eating ham sandwiches and just Juuling away," he said.

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.

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.

] have been offset by the increasing consumption in low income countries, especially China. The Chinese market now consumes more cigarettes than all other low- and middle-income countries combined. Levels of naphthalene were slightly higher than those of pyrene in e-cigarette emissions, while the respective air blank was lower. Nevertheless, it seems likely that these compounds were detected in e-cigarette emissions due to their presence as low-level contaminants in the background air, rather than originating from the vaping product. E-cigarettes are devices that use an electric battery to heat up a liquid (commonly called an "e-liquid") into an aerosol, which the user inhales. Vitamin E acetate, diacetyl, formaldehyde, and acrolein are just a few among hundreds of potentially hazardous substances commonly found in e-liquids and their aerosols.

The prognosis depends on how much nicotine was taken and how quickly treatment was started. If a person is able to survive during the first four hours after poisoning, they’re usually likely to recover. If a person has been severely affected, they may have ongoing seizures or respiratory failure or other problems because of the damage done from low oxygen levels during the nicotine overdose event. Increased levels of nicotine or cotinine (nicotine metabolite) can be detected in urine or blood. Nicotine poisoning or overdose can also result from taking more than the recommended amount of nicotine replacement products (for example, chewing too much gum or dissolving lozenges) or taking too high of a dose of patches, inhalers or nasal sprays.

These products may have reusable parts, or they may be disposable and only used once before they are thrown away. Some damage to your lungs from vaping can heal or get better with medications. Over time, constant irritation to your lungs can lead to health problems (like asthma and COPD) that won’t go away. It actually creates an aerosol (or mist) that contains small particles of nicotine, metal and other harmful substances. Your tax-deductible donation funds lung disease and lung cancer research, new treatments, lung health education, and more. Youth and young adult e-cigarette users, many of whom never previously used tobacco, also need support to quit.

NSW Health has launched a new mass media behaviour change campaign aiming to address the issue of vaping by young people. The campaign, ‘Every vape is a hit to your health’ utilises powerful creative to encourage young people to consider the proven health harms of vaping, such as nicotine addiction, lung damage, breathlessness, nicotine poisoning and burns from exploding vapes. If you're pregnant and need support to quit smoking, licensed nicotine replacement therapy products like patches and gum are the recommended option. Making small changes to your vape products or how you vape should help. Side effects are usually easily managed and should not stop you from vaping as a way to quit smoking. You're roughly twice as likely to quit smoking if you use a nicotine vape compared with other nicotine replacement products, like patches or gum.

They found that the amounts of nicotine in the blood were similar between the two groups after 10 minutes of smoking at a constant rate. The flavoring liquid for electronic cigarettes, or e-cigarettes, may increase the risk of cardiovascular disease when inhaled, according to a study led by researchers at the School of Medicine. My reading of the evidence is that smokers who switch to vaping remove almost all the risks smoking poses to their health. Smokers differ in their needs and I would advise them not to give up on e-cigarettes if they do not like the first one they try. It may take some experimentation with different products and e-liquids to find the right one. An expert independent evidence review published today by Public Health England (PHE) concludes that e-cigarettes are significantly less harmful to health than tobacco and have the potential to help smokers quit smoking.

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.

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.

But e-cigarettes haven't proved to be safer or more effective than nicotine-replacement medications in helping people stop smoking. He was a founding member of the Society for Nicotine and Tobacco Research. As a public health researcher, he has studied numerous issues related to nicotine use and policy, with some recent work focused on cigarette and e-cigarette use among adolescents and young adults. Lynn T. Kozlowski is an internationally recognized expert on tobacco use, e-cigarettes and nicotine policy. He can speak to the media about these issues, including trends in both smoking and vaping (including Juuling). Fears that e-cigarettes have made smoking seem normal again or even led to people taking up tobacco smoking are not so far being realised based on the evidence assessed by this important independent review.