E-Cigarettes and Vaping Overview

Offered for sale in 2007 among much buzz and lure as an alternative way to kick smoking, e-cigarettes have soared, not only in the number and selection of products that have come to market, but also in usage among teens and young adults. Despite e-cigarette companies massive marketing campaigns, there have been some major concerns about the safety of e-cigarettes. Specifically, research findings have linked usage to a variety of health risks, such as nicotine addiction, nicotine poisoning, lung and heart disease, and seizures. What’s more, e-cigarette devices have been known to catch fire, explode and seriously injure the user in the face, hands, or eyes. 

By the numbers, the CDC found that e-cigarettes use is the most commonly used form of tobacco among youth in the United States, surpassing regular cigarettes. There were 1.5 million more young e-cigarettes users in 2018 than 2017, a 78% increase in high school students, and a 48% increase in middle school students, based on the data in the National Youth Tobacco Survey, released by the CDC, NCI and FDA.  Moreover, youth e-cigarette users, suggests the CDC, may be more prone to smoke conventional cigarettes.

What are e-cigarettes?

Electronic cigarettes are hand-held, battery-operated devices that heat up liquid nicotine as well as varying compositions of flavorings and chemicals to generate an aerosol in which a user inhales, or “vapes”. The device mimics the look and feel of smoking … without the tobacco and the tobacco smoke. There are 460 different e-brands in the marketplace and more than 7700 unique flavors on the market, most of them fruit or mint-flavored.

E-cigarette devices are referred by a variety of names including e-cigs, vape pens, vapes, electronic nicotine delivery systems, hookah pens, e-hookahs, tank systems, personal vaporizers (PVs), and mods.

E-cigarettes devices come in many different looks, configurations, packaging, and mechanisms.  They can look like regular cigarettes, pipes and cigars, or resemble writing pens and other everyday items. USB flash drives and cell phone cases with built-in e-cigarettes are also available.

How do e-cigarettes work?

Though e-cigarettes vary in design and appearance, they all have a cartridge filled with vaping juice (or e-liquid), a battery, and a heating element (or atomizer).  When the vaping device is turned on, puffing by the user activates the heating element which vaporizes the liquid in the cartridge that the user inhales, or vapes, much life smoking a regular cigarette.   

Most manufactured devices have built-in time out features to prevent overheating; some have locking mechanisms to prevent unintentional activation in a user’s pocket or purse. Still other devices have a LED light to simulate the glow of a burning cigarette.

Government regulation

E-cigarettes are regulated by the FDA, similar to tobacco products. Companies must now must undergo pre-market approval of new products, a review of modified risk products, as well as disclose ingredients, including those potentially harmful.  (In mid-August, 2019, the vapor industry group sued the federal government to delay the review of e-cigarettes.) The government agency also banned free samples and prohibited sale of cigarettes to anyone under age 18 and through vending machines in facilities that are age-restricted. Furthermore, the agency requires e-cigarettes to carry a nicotine health warning on product packages and in advertisements. For background information, see the FDA’s online publication “The Facts on the FDA's New Tobacco Rule”.  In March, 2019, the Agency proposed guidelines to restrict store sales of flavored vaping products.

At the state level, American Nonsmoker’s Rights Foundation (2019) reports that 18 states, 2 territories, and 861 local jurisdictions have laws restricting e-cigarette use in smoke-free venues; 13 states and 680 local jurisdictions have laws that restrict e-cigarette use in other venues. In July 2019, San Francisco banned the sale and distribution of e-cigarettes citywide.