Electronic cigarettes, or e-cigarettes, are cigarette-shaped devices that deliver nicotine-laced vapor when the user inhales (called vaping). Some e-cigarettes look like traditional tobacco cigarettes, but many newer devices do not. An e-cigarette has a mouthpiece with an air-activated sensor that uses a battery to power a heating element. The heat vaporizes liquid nicotine or other substances contained in a small, replaceable cartridge. In most cases, a terminal end lights when the heating element activates, mimicking the glow from the end of a cigarette or cigar.
Background and Scientific Foundations
Electronic cigarettes were first developed in Hong Kong in 2004 by the Ruyan company. After a handover from the British in 1997, smoking restrictions began to increase in the new Special Administrative Region of the People's Republic of China. E-cigarettes became a popular way to evade these laws. By 2008, Ruyan reported annual sales of 300,000 e-cigarettes. Since then, e-cigarettes have diversified in terms of size, shape, and flavors of nicotine and other substances used.
Vaping cartridges do not contain tobacco, but many include liquefied synthetic nicotine. Nicotine-free and flavored options came to market during the first decade of e-cigarette development. Cartridges also traditionally carry small amounts of propylene glycol, the same substance used to produce visible smoke for film, television, and stage productions where actual smoking is prohibited due to health and fire safety restrictions.
A typical canister holds up to 3 milliliters of liquid nicotine with concentrations ranging from 6 milligrams per milliliter to 24 milligrams per milliliter. Accordingly, in comparison to a traditional cigarette, which normally contains 8 to 20 milligrams of nicotine, an e-cigarette may contain 18 to 72 milligrams of nicotine.
Psychologically the electronic cigarette experience mimics many of the same behaviors and sensations of actual smoking. The user feels a puff of warm gas as the vaporized propylene glycol produces a small puff of vapor or smoke. Unlike smoke from cigarettes, e-cigarette vapor does not contain particulate matter from combustion, and so the puff of vapor quickly diffuses and dissipates. E-cigarettes are sometimes touted as an aid for those who wish to stop smoking tobacco, but their benefit has not been proven.
Usage worldwide has soared, often in populations too young to legally use tobacco products. In the United States, according to the Centers for Disease Control and Prevention (CDC), in 2010, e-cigarettes comprised less than two percent of all tobacco-related sales, but since that time, use has increased rapidly and dramatically.
In May 2016, the U.S. Food and Drug Administration (FDA) announced it would regulate electronic nicotine delivery systems, including vaporizers, electronic cigarettes (e-cigs), and related devices, The FDA banned the purchase of e-cigarettes for those under 18-years-old and required that products entering the market since 2007 must seek prior approval via an application process that often costs manufacturers in excess of a million dollars.
In 2015, both the CDC and FDA estimated that more than three million American middle and high school students used e-cigarettes in 2015, an increase from 2.36 million users estimated in 2014. In response to government surveys, 16 percent of high school students and 5.3 percent of middle school students said they were current users of e-cigarettes, making electronic nicotine delivery systems (ENDS) the most common way young people use tobacco.
The danger of e-cigarettes lies in the high dose of nicotine available through the device. In addition to inhalation toxicity, nicotine is easily absorbed through the skin, and so the handling of used or damaged cartridges is also a mechanism for excess nicotine exposure. Nicotine, even in synthetic form, is highly toxic and e-cigarettes usually contain much higher amounts of nicotine than traditional cigarettes.
With increased use in the United States came an increase in vaping's adverse consequences. Vaping especially presents an increasing hazard for small children. By 2014, more than 40 percent of calls to poison control centers in the United States—half of which involved children less than five years of age—related to e-cigarette use. Health officials argue that flavorings make the e-cigarettes more attractive to small children. Delivered in such a concentrated form, a single puff on an e-cigarette can induce vomiting in a small child. With sufficient exposure, nicotine can cause muscle paralysis and death in small children.
There is an ongoing public health debate about the long-term impacts of electronic cigarette use. Some studies show that they offer the promise of a physiologically less-harmful alternative to traditional tobacco smoking, including the elimination of carcinogenic tars. Other public health experts counter that vaping is a portal for teens and other users to start smoking.
According to CDC data, between 2013 and 2014, there was a 3.5 percent drop in the use of tobacco cigarettes within 30 days of the sampling date by high school students (a decline from 12.7 percent in 2013 to 9.2 percent in 2014). Among middle school students, there was also a decline, but it was not statistically significant. Based on those figures, critics argue that instead of vaping being a portal to cigarette smoking, it is acting as a diversion to a safer alternative to traditional tobacco smoking.
E-cigarette sales with nicotine are banned in Canada. In the European Union, vaping products are regulated like tobacco, with commensurate taxes to discourage use and product standards designed to reduce identified dangers associated with vaping.