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An electronic cigarette, also known as e-cigarette among other names,[notes 1][2] is a handheld battery-powered vaporizer that simulates tobacco smoking without burning tobacco.[3] Using an e-cigarette is called "vaping" and the user is called a "vaper."[4] Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor.[5] E-cigarettes typically have a heating element that atomizes a liquid solution called e-liquid.[6] Some e-cigarettes look like traditional cigarettes,[7] but they come in many variations.[4] E-liquids usually contain propylene glycol, glycerin, nicotine, flavorings, additives, and differing amounts of contaminants.[8]
The benefits and the health risks of e-cigarettes are uncertain;[9][10][11] including the long-term effects.[12][13][14] There is tentative evidence they may help people quit smoking,[15] but smoking cessation medicine is at least as effective.[16] Because of the risk of nicotine addiction, there is concern that young people may start smoking cigarettes.[17][18][19] Their part in tobacco harm reduction is unclear.[20] Regulated US Food and Drug Administration (US FDA) nicotine replacement products are safer than e-cigarettes,[20] but e-cigarettes are likely safer than tobacco products.[notes 2][22][23] The risk of early death is like that of smokeless tobacco.[13] The risk from serious adverse events is low.[24] In 2019 and 2020, an outbreak of severe vaping lung illness in the US was strongly linked to vitamin E acetate by CDC.[notes 3][27]
E-cigarettes create vapor made of fine and ultrafine particles of particulate matter,[28] which contain propylene glycol, glycerin, nicotine, flavors, small amounts of toxicants,[28] carcinogens,[29] heavy metals, metal nanoparticles, and other substances.[28] Its exact composition varies, and depends on e-liquid contents, the device design, and user behavior, among other factors.[notes 4][5] E-cigarette vapor contains fewer toxic chemicals, in lower concentrations, than cigarette smoke, but does potentially contain harmful chemicals not found in tobacco smoke.[28] [30] [31] The vapor is probably much less harmful to users and bystanders than cigarette smoke,[29] although concern exists that the exhaled vapor may be inhaled by non-users, particularly indoors.[32]
The entered the market in 2003.[33] In a 2014, about 13% of American high school students reported using them at least once in the previous month,[34] and in 2015 around 10% of American adults were users.[35] In the UK, users have increased from 700,000 in 2012 to 2.6 million in 2015.[36] About 60% of UK users are smokers and about 40% are ex-smokers, while use among never-smokers in the UK is negligible.[36] Most peoples' reason for using e-cigarettes involve trying to quit smoking, though a large proportion use them recreationally.[37] Because of overlap with tobacco laws and medical drug policies, e-cigarette legislation is being debated in many countries.[38] The revised EU Tobacco Products Directive came into effect in May 2016, providing stricter regulations for e-cigarettes.[39] As of August 2016, the US FDA extended its regulatory power to include e-cigarettes.[40] Large tobacco companies have greatly increased their marketing efforts.[20] As of 2014[update], there were 466 brands of e-cigarettes.[41] Global sales were around $19.3 billion in 2019.[42]
- ↑ 1.0 1.1 "Vaporizers, E-Cigarettes, and other Electronic Nicotine Delivery Systems (ENDS)". United States Food and Drug Administration. 14 February 2020. This article incorporates text from this source, which is in the public domain.
- ↑ Cite error: Invalid
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- ↑ Caponnetto, Pasquale; Campagna, Davide; Papale, Gabriella; Russo, Cristina; Polosa, Riccardo (2012). "The emerging phenomenon of electronic cigarettes". Expert Review of Respiratory Medicine. 6 (1): 63–74. doi:10.1586/ers.11.92. ISSN 1747-6348. PMID 22283580.
- ↑ 4.0 4.1 Cite error: Invalid
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- ↑ 5.0 5.1 5.2 Cheng, T. (2014). "Chemical evaluation of electronic cigarettes". Tobacco Control. 23 (Supplement 2): ii11–ii17. doi:10.1136/tobaccocontrol-2013-051482. ISSN 0964-4563. PMC 3995255. PMID 24732157.
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- ↑ Ebbert, Jon O.; Agunwamba, Amenah A.; Rutten, Lila J. (2015). "Counseling Patients on the Use of Electronic Cigarettes". Mayo Clinic Proceedings. 90 (1): 128–134. doi:10.1016/j.mayocp.2014.11.004. ISSN 0025-6196. PMID 25572196.
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- ↑ McRobbie, Hayden; Bullen, Chris; Hartmann-Boyce, Jamie; Hajek, Peter; McRobbie, Hayden (2014). "Electronic cigarettes for smoking cessation and reduction". The Cochrane Database of Systematic Reviews. 12 (12): CD010216. doi:10.1002/14651858.CD010216.pub2. PMID 25515689.
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- ↑ WHO 2014, p. 6.
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- ↑ Stratton 2018, p. Summary, 16.
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- ↑ Gotts, Jeffrey E; Jordt, Sven-Eric; McConnell, Rob; Tarran, Robert (2019). "What are the respiratory effects of e-cigarettes?". BMJ. 366: l5275. doi:10.1136/bmj.l5275. ISSN 0959-8138. PMID 31570493.
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- ↑ Boudi, F Brian; Patel, Sonia; Boudi, Ava; Chan, Connie (2019). "Vitamin E Acetate as a Plausible Cause of Acute Vaping-related Illness". Cureus. doi:10.7759/cureus.6350. ISSN 2168-8184. PMC 6952050. PMID 31938636. This article incorporates text by F Brian Boudi, Sonia Patel, Ava Boudi, Connie Chan available under the CC BY 3.0 license.
- ↑ King, Brian A.; Jones, Christopher M.; Baldwin, Grant T.; Briss, Peter A. (2020). "The EVALI and Youth Vaping Epidemics — Implications for Public Health". New England Journal of Medicine. doi:10.1056/NEJMp1916171. ISSN 0028-4793.
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- ↑ Fernández, Esteve; Ballbè, Montse; Sureda, Xisca; Fu, Marcela; Saltó, Esteve; Martínez-Sánchez, Jose M. (2015). "Particulate Matter from Electronic Cigarettes and Conventional Cigarettes: a Systematic Review and Observational Study". Current Environmental Health Reports. 2 (4): 423–9. doi:10.1007/s40572-015-0072-x. ISSN 2196-5412. PMID 26452675.
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- ↑ "E-cigarette use triples among middle and high school students in just one year". Centers for Disease Control and Prevention. 16 April 2015.
- ↑ Mincer, Jilian (10 June 2015). "E-cigarette usage surges in past year: Reuters/Ipsos poll". Reuters.
- ↑ 36.0 36.1 "Use of electronic cigarettes (vaporisers) among adults in Great Britain" (PDF). ASH UK. May 2016.
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- ↑ "Backgrounder on WHO report on regulation of e-cigarettes and similar products". World Health Organization. 26 August 2014.
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