Electronic cigarette

[73][74][75] Smoking rates have continually declined as e-cigarettes have grown in popularity, especially among young people, suggesting that there is little evidence for a gateway effect at the population level.

[18][note 6] Some of the most common but less serious adverse effects include abdominal pain, headache, blurry vision,[102] throat and mouth irritation, vomiting, nausea, and coughing.

[100] The British Royal College of Midwives states: "While vaping devices such as electronic cigarettes (e-cigs) do contain some toxins, they are at far lower levels than found in tobacco smoke.

[110] A health economic study found that passing an e-cigarette minimum legal sale age law in the United States increased teenage prenatal smoking by 0.6 percentage points and had no effect on birth outcomes.

[127] Overall, the available evidence supports the cautionary implementation of harm reduction interventions aimed at promoting e-cigarettes as attractive and competitive alternatives to cigarette smoking, while taking measures to protect vulnerable groups and individuals.

[127] The evidence indicates smokers are more frequently able to completely quit smoking using tank devices compared to cigalikes, which may be due to their more efficient nicotine delivery.

[174] Exactly what the vapor consists of varies in composition and concentration across and within manufacturers, and depends on the contents of the liquid, the physical and electrical design of the device, and user behavior, among other factors.

[99] But workplace safety standards do not recognize exposure to certain vulnerable groups such as people with medical ailments, children, and infants who may be exposed to second-hand vapor.

[144] These symptoms can include cravings for nicotine, anger, irritability, anxiety, depression, impatience, trouble sleeping, restlessness, hunger, weight gain, and difficulty concentrating.

[200] When trying to quit smoking with vaping a base containing nicotine, symptoms of withdrawal can include irritability, restlessness, poor concentration, anxiety, depression, and hunger.

[206] A 2015 American Academy of Pediatrics (AAP) policy statement stressed "the potential for these products to addict a new generation of youth to nicotine and reverse more than 50 years of public health gains in tobacco control.

[222][223][224] Healthcare organizations in the UK (including the Royal College of Physicians and Public Health England) have encouraged smokers to switch to e-cigarettes or other nicotine replacements if they cannot quit, as this would potentially save millions of lives.

[230] It is commonly stated that the modern e-cigarette was invented in 2003 by Chinese pharmacist Hon Lik, but tobacco companies had been developing nicotine aerosol generation devices since as early as 1963.

[235] In 1963, Gilbert applied for a patent for "a smokeless non-tobacco cigarette" that involved "replacing burning tobacco and paper with heated, moist, flavored air".

[242] Favor was a "plastic, smoke-free product shaped and colored like a conventional cigarette that contained a filter paper soaked with liquid nicotine so users could draw a small dose by inhaling.

[248] Many US and Chinese e-cigarette makers copied his designs illegally, so Hon has not received much financial reward for his invention (although some US manufacturers have compensated him through out-of-court settlements).

[269] Imperial Tobacco's Fontem Ventures acquired the intellectual property owned by Hon Lik through Dragonite International Limited for $US 75 million in 2013 and launched Puritane in partnership with Boots UK.

[282] The surge was driven by non-tobacco flavors such as menthol (for prefilled cartridges) and fruit and candy (for disposables), according to the CDC's health economist Fatma Romeh Ali.

[282] In the UK, where most vaping uses refillable sets and e-liquid, there is now support from the National Health Service,[283] and other medical bodies now embrace the use of e-cigarettes as a viable way to quit smoking.

[292] A 2014 Postgraduate Medical Journal editorial said vapers "also engage in grossly offensive online attacks on anyone who has the temerity to suggest that ENDS are anything other than an innovation that can save thousands of lives with no risks".

[216] Under this ruling the FDA will evaluate certain issues, including ingredients, product features and health risks, as well their appeal to minors and non-users.

[333] E-cigarettes containing nicotine have been listed as drug delivery devices in a number of countries, and the marketing of such products has been restricted or put on hold until safety and efficacy clinical trials are conclusive.

[336] In 2022, after two years of review, the Food and Drug Administration (FDA) denied Juul's application to keep its tobacco and menthol flavored vaping products on the market.

[268] University of Pennsylvania communications professor Joseph Cappella stated that the setting of the advertisement near an ocean was meant to suggest an association of clean air with the nicotine product.

[354] The channels to which e-cigarette advertising reached the largest numbers of young people (ages 12–17) were AMC, Country Music Television, Comedy Central, WGN America, TV Land, and VH1.

[360] E-cigarette companies commonly promote that their products contain only water, nicotine, glycerin, propylene glycol, and flavoring but this assertion is misleading as researchers have found differing amounts of heavy metals in the vapor, including chromium, nickel, tin, silver, cadmium, mercury, and aluminum.

[376] Wells Fargo analyst Bonnie Herzog attributes this decline to a shift in consumers' behavior, buying more specialized devices or what she calls "vapors-tanks-mods (VTMs)" that are not tracked by Nielsen.

[380] "We saw the market's sudden recognition that the cigarette industry seems to be in serious trouble, disrupted by the rise of vaping," Mad Money's Jim Cramer stated April 2018.

[409] British American Tobacco, through their subsidiary Nicoventures, licensed a nicotine delivery system based on existing asthma inhaler technology from UK-based healthcare company Kind Consumer.

[427] In 2016, British American Tobacco (BAT) released its own version of the heat but not burn technology called glo in Japan[428] and Switzerland.

Photo of device
A first-generation e-cigarette that resembles a tobacco cigarette, with a battery portion that can be disconnected and recharged using the USB power charger
Photo of devices
Various types of e-cigarettes from 2015, including a disposable e-cigarette, a rechargeable e-cigarette, a medium-size tank device, large-size tank devices, an e-cigar, and an e-pipe
The first image is displaying an exploded view of an e-cigarette with a transparent clearomizer and changeable dual-coil head.
An exploded view of a typical e-cigarette design with transparent atomizer (labeled clearomizer in diagram) and changeable dual-coil head.
Estimated trends in the global number of vapers
Reasons for initiating e-cigarette use in the European Union , in a 2018 Eurobarometer poll [ 52 ]
Switching from tobacco to vaping may reduce weight gain after smoking cessation, increase exercise tolerance, reduce exposure to toxic chemicals, and reduce risk of death. Vaping may reduce shortness of breath, reduce coughing, reduce spitting, and reduce sore throat compared to tobacco.
Effects of vaping, compared to tobacco smoking [ 119 ]
Possible side effects of nicotine include increased clotting tendency, atherosclerosis, enlargement of the aorta, bronchospasm, muscular tremor and pain, gastrointestinal nausea, dry mouth, dyspepsia, diarrhea, heartburn, peptic ulcer, cancer, lightheadedness, headache, sleep disturbances, abnormal dreams, irritability, dizziness, blood restriction, increased or decreased heart rate, increased blood pressure, tachycardia, more (or less) arrhythmias, coronary artery constriction, coronary artery disease, high insulin, insulin resistance, and risks to the child later in life during pregnancy include type 2 diabetes, obesity, hypertension, neurobehavioral defects, respiratory dysfunction, and infertility.
Possible side effects of nicotine [ 164 ]
An image of the human brain. The reinforcing effects of addictive drugs, such as nicotine, are associated with their ability to excite the mesolimbic and dopaminergic systems. How does the nicotine in e-cigarettes affect the brain? Until about age 25, the brain is still growing. Each time a new memory is created or a new skill is learned, stronger connections – or synapses – are built between brain cells. Young people's brains build synapses faster than adult brains. Because addiction is a form of learning, adolescents can get addicted more easily than adults. The nicotine in e-cigarettes and other tobacco products can also prime the adolescent brain for addiction to other drugs such as cocaine.
The reinforcing effects of addictive drugs , such as nicotine , are associated with its ability to excite the mesolimbic and dopaminergic systems. [ 191 ]
How does the nicotine in e-cigarettes affect the brain ? [ 192 ] Until about age 25, the brain is still growing. [ 192 ] Each time a new memory is created or a new skill is learned, stronger connections – or synapses – are built between brain cells. [ 192 ] Young people's brains build synapses faster than adult brains. [ 192 ] Because addiction is a form of learning, adolescents can get addicted more easily than adults. [ 192 ] The nicotine in e-cigarettes and other tobacco products can also prime the adolescent brain for addiction to other drugs such as cocaine. [ 192 ]
Ruyan first-generation electronic cigar.
The Ruyan e-cigar was first launched in China in 2004. [ 252 ]
Various e-cigarettes from 2018. From left to right: Phix, Juno, Von Erl, Juul
E-cigarette user blowing a large cloud of aerosol (vapor). This activity is known as cloud-chasing.
E-cigarette user blowing a cloud of aerosol (vapor). The activity is known as cloud-chasing . [ 296 ]
Displaying a diagram of e-cigarette use among youth is rising as e-cigarette advertising increases.
From 2011 to 2014, e-cigarette use among young people in the US was rising as e-cigarette advertising increased. [ 355 ]
A discarded e-cigarette next to a traditional cigarette in a car park
A discarded e-cigarette next to a traditional cigarette in a car park
Philip Morris International's iQOS device with charger and tobacco stick.
Philip Morris International's IQOS device with charger and tobacco stick