'Teens & Vaping: What You Need to Know
'Dripping' may be a new, dangerous trend for teens who vape
How to Know if Your Kid is Vaping Marijuana — and What to Do About It
Public health Q&A: Are e-cigarettes safe?
Study: New concerns raised over teen e-cigarette use
E-cigarettes, Teenagers and Oral Health
E-Cigarettes Also Damage Lung Cells
The Pros and Cons of E-Cigarettes
4 Facts You Need to Know About E-Cigarettes
3 reasons to say no to e-cigarettes - Kaiser Permanente

Real Time Death Toll as of

Teens & Vaping: What You Need to Know

In 2015, more than 25% of students in grades 6 through 12 and more than 33% of young adults had tried e-cigarettes.[1] This number shows no signs of slowing as emerging research indicates an uptick in use by teens as the dangers of e-cigarettes remain largely unknown. We’ve written before that most tobacco use begins in young adulthood, and about the risks of smoking at this young age. Studies indicate e-cigarette use presents an equally troubling trend that demands further research.

What Are E-Cigarettes?

Electronic cigarettes came on the market several years ago as an alternative to smoking traditional cigarettes made from tobacco. Also known a e-cigarettes, vapes, and vape pens, these battery-operated devices allow users to inhale an aerosol that typically (but not always) contains nicotine, flavorings, and chemicals like propylene glycol.[2] Some e-cigarette brands are designed to resemble real cigarettes while others may look more like a USB stick. As of 2014, there were nearly 500 brands of e-cigarettes on the market.[3] Brands like JUUL have exploded onto the market with a flashy, high-tech appearance and high nicotine delivery through their use of nicotine salt e-liquid formulations.[4]

Teens and E-Cigarettes

Many kids and adults perceive e-cigarettes as less harmful than tobacco. While they may be less damaging to teen bodies than inhaling tobacco smoke, e-cigarettes still deliver harmful chemicals in their so-called “vapor.”[5] Their use also can lead to a habit of smoking traditional cigarettes: 30.7% of e-cigarette users started smoking (tobacco products) within six months while only 8.1% of non-users began smoking in the same time frame.[6]

And the use of these devices is more prevalent than cigarettes, perhaps due to a lack of understanding the dangers. According to research from the National Institute on Drug Abuse, 3.6% of 8th-graders used cigarettes in the past month versus 9.5% using e-cigarettes. For 10th-graders, 6.3% smoked while 14% used e-cigarettes. By 12th grade, the numbers climb to 11.4% of students who have smoked in the last 30 days and 16.2% who have vaped.[7]

Our Pride Surveys Questionnaire for Grades 6-12 Standard Report from 2016-17 revealed that while more than 94% of students in 6th-12th grade had not smoked cigarettes in the last 30 days, 4% still used tobacco every week.[8] In this same report, 66% of students said their friends never use tobacco while 6% said they use tobacco a lot.[9]

In another survey of children aged 12 to 17 years, the majority who reported ever experimenting with tobacco said they started with a flavored product, and 85% of current e-cigarette users aged 12-17 use some form of flavoring.[10],.[11]

Minors are federally banned from purchasing (or being sold) vaporizers, e-juice, and other related products and states across the U.S. have raised the age to buy cigarettes or vaping products to 21. However, none of us would be surprised to find that teens are still getting their hands on these products and using them. In fact, flavored non-cigarette tobacco products like JUUL seem to be designed to appeal to youth with eye-catching packaging and popular flavors like mint, vanilla, cherry and piña colada. According to JUUL, a single pod contains as much nicotine as a pack of 20 regular cigarettes.[12]

Research on Teens and Vaping

Because e-cigarettes are still relatively new, there is little information on student perception, use, and prevalence in schools and communities. To begin to gather more data, the Pride Surveys Plus added two categories to the existing core measures including prescription opioids as well as e-cigarettes in 2018. Our Pride Surveys Questionnaire for grades 6-12 still contains the updated Core Measures required by the Substance Abuse and Mental Health Services Administration (SAMHSA) for their Drug-Free Communities Grant. Community coalitions and other grantees can use this survey to provide data for funding applications and evaluation. The survey is also compatible with many other grants including CARA, STOP ACT, Tobacco Cessation, and more.

The benefit of choosing a survey company is that we take the guesswork out of the surveying process to ask the difficult questions. For more than thirty years, Pride Surveys has been helping schools collect data on teen substance abuse perceptions and drug use trends. We offer multiple drug-free community survey options as well as student risk perception surveys designed to help assess teen substance abuse and risk, including our student surveys for grades 6-12, and our supplemental surveys like the Drug-Free Community Survey Supplement. The Pride Survey Plus for Grades 6-12 will allow you to obtain a better understanding of your school climate and the safety of your students. Please contact us online or call (800) 279-6361 for more information.

Setting a good example is also essential when it comes to preventing smoking. Quitting is one of the best things you can do for your health as it almost immediately improves your lung, heart, and brain function. If you need help quitting smoking, please call 1-800-QUIT-NOW.

[1] “Get the Facts: E-Cigarettes.” Retrieved 30 December 2018 at e-cigarettes.surgeongeneral.gov/getthefacts.html

[2] “What Are Electronic Cigarettes?” Retrieved 30 December 2018 at www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes

[3] “What Are Electronic Cigarettes?” Retrieved 30 December 2018 at www.drugabuse.gov/publications/drugfacts/electronic-cigarettes-e-cigarettes

[4] “E-Cigarettes: Facts, Stats and Regulations.” Retrieved 30 December 2018 at truthinitiative.org/news/e-cigarettes-facts-stats-and-regulations

[5] “E-Cigarettes: Facts, Stats and Regulations.” Retrieved 30 December 2018 at truthinitiative.org/news/e-cigarettes-facts-stats-and-regulations

[6] “Teens & E-Cigarettes: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.” Retrieved 30 December 2018 at www.drugabuse.gov/related-topics/trends-statistics/infographics/teens-e-cigarettes

[7] “Teens & E-Cigarettes: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.” Retrieved 30 December 2018 at www.drugabuse.gov/related-topics/trends-statistics/infographics/teens-e-cigarettes

[8] “Pride Surveys Questionnaire for Grades 6-12 Standard Report 2016-17.”

[9] “Pride Surveys Questionnaire for Grades 6-12 Standard Report 2016-17.”

[10] “Flavored Tobacco Product Use Among Middle and high School Students – United States 2014.” Retrieved December 30 2018 at www.cdc.gov/mmwr/preview/mmwrhtml/mm6438a2.htm

[11] “Get the Facts.” Retrieved 30 December 2018 at e-cigarettes.surgeongeneral.gov/getthefacts.html

[12] “Recognition, Use, and Perceptions of JUUL Among Youth and Young Adults.” Retrieved 30 December 2018 at tobaccocontrol.bmj.com/content/28/1/115
Source: www.pridesurveys.com/index.php/blog/teens-vaping-what-you-need-to-know/

E-cigarettes, Teenagers and Oral Health

More teenagers have tried Electronic Cigarettes than adults, with statistics showing as many as 10% of high school students having tried the latest trend in smoking compared with only 2.7% of adults. E-cig use has exploded in the past few years, and many people claim to have stopped smoking traditional cigarettes because of them. While many users also believe e-cigarettes to be safer than regular cigarettes, no definitive studies have proven that they are a safe alternative.

When looking at e-cigarettes and oral health, especially in relation to teenagers, it’s important to remember that an e-cigarette is still primarily a nicotine delivery device and there’s little debate as to the effects of nicotine on the body.

The truth is, no one is completely sure about the long-term health effects of e-cigarettes which can make them a particular concern for adolescents. Many teenagers are smoking e-cigarettes because they feel they are safe or cool. Regardless of how it’s delivered, however, nicotine is still a highly addictive drug that should be avoided by everyone, especially growing teens. With few laws banning their use among young people, it’s important to educate your children about the potential hazards of this growing trend.

E-Cigarettes Also Damage Lung Cells

Recently thought to be a safer alternative to cigarettes, a new study shows that increasingly popular e-cigarettes still cause negative effects similar to those caused by smoking.

The researchers tested both mice and human cells, exposing them to cigarette and e-cigarette smoke with and without nicotine. They found that nicotine in both types of cigarettes caused lung damage. Interestingly, the nicotine-free e-cigarettes also contained a substance that damaged lung cells. So, are e-cigarettes really a better option than cigarettes? While it may not seem that way right now, more research is needed to confirm.

The Pros and Cons of E-Cigarettes

Is the Electronic Cigarette a Safe Stop Smoking Aid?

What made you decide to try the e-cigarette? After reading this article, share your comments and read what others have to say.

You can smoke them virtually anywhere. Many say they will help you quit smoking, a plus for people with COPD who often struggle with smoking cessation. Others are skeptical and afraid to try them. The FDA would like to regulate them as medical products. The e-cigarette industry feels that the FDA has no substantiated reason to do so.

There's a lot of talk going on about e-cigarettes, so before making a decision to use them, learn the facts about their pros and cons.

What are E-Cigarettes?

Electronic cigarettes, or e-cigarettes for short, are battery-powered devices filled with liquid nicotine (a highly addictive chemical) that is dissolved in a solution of water and propylene glycol. Many of them look like real cigarettes, with a white cylindrical tube, brown filter, and red-glowing tip. Others come in less conspicuous, darker colors.

How Do They Work?

Often termed "vaping," when you take a puff on the end of the e-cigarette tube, a battery heats up the nicotine, which creates a vapor that is then inhaled into the lungs. The end result is a sensation of smoke in the mouth and lungs without really smoking.

The Upside to E-Cigarettes

Unlike tobacco products, there are no current laws in effect prohibiting the use of e-cigarettes in public places. Case in point, I work in a hospital and a fellow nurse smokes them right there in the nursing station.

Here's what current research says about the positive aspects of this product:

  • In a study of 40 tobacco-dependent smokers, researchers concluded that smoking e-cigarettes alleviated the desire to smoke (after abstaining from smoking overnight), was well-tolerated, and pharmacologically more like a Nicorette inhaler than tobacco.
  • Another study of 50 smokers who wanted to reduce the health risks associated with smoking, but not quit completely, concluded that the Eclipse brand of e-cigarettes dramatically decreased the consumption of cigarettes without causing withdrawal symptoms. In addition, when participants smoked Eclipse, the nicotine concentrations in their blood remained fairly stable and their desire to quit altogether remained intact. However, the study concluded that because the Eclipse increased carbon monoxide concentrations in the blood, it may not be a safer choice of cigarette. On the other hand, it caused few, significant adverse events.
  • In a case study series, the e-cigarette was found to help three study participants -- who all had a documented history of repeated failed attempts at smoking cessation using professional smoking cessation assistance methods -- quit smoking and remain abstinent for at least 6 months.
  • During an online survey conducted in 2010, researchers polled visitors of websites and discussion forums dedicated to the use of the e-cigarette and smoking cessation. Of the 3,587 participants, 70% were former smokers, 61% were men, and the median age was 41 years. On average, participants used the e-cigarette for approximately 3 months, drew 120 puffs/day, and used 5 cartridges/day. Almost all of them used cartridges that contained nicotine. Ninety-six percent said that the e-cigarette helped them quit smoking, while 92% said that it made them smoke less. A majority of the participants said the e-cigarette helped them fight cravings, cope with withdrawal symptoms, and avoid relapsing on cigarettes.

The Downside of E-Cigarettes

If you are a savvy consumer, both positive and negative aspects of the the product you are considering should be scrutinized before you purchase it. The e-cigarette is no exception. Take a look at what some of the research says about the negative aspects of the e-cigarette:

  • A 2010 research paper published in Tobacco Control suggests that the e-cigarette lacks important regulatory factors, such as essential health warnings, proper labeling, clear instructions on how to use them, and safe disposal methods. The authors of the study also found that some of the e-cigarette cartridges leaked, which could cause toxic exposure to nicotine.
  • A study published in the December 2011 issue of CHEST found that the e-cigarette caused acute pulmonary effects after smoking it for only five minutes, although study authors pointed out that these effects may not be of clinical significance. During the study, 40 healthy non-smokers (30 experimental/10 control) were asked to smoke the e-cigarette ad lib for five minutes. The experimental group used the e-cigarette with the nicotine cartridge in place, while the control group smoked it with the nicotine cartridge removed.

    After five minutes, lung function was assessed using a variety of tests. Results showed that smoking the device for just five minutes caused an increase in impedance, peripheral airway flow resistance, and oxidative stress in the lungs of healthy smokers (smokers who are not diagnosed with lung disease or chronic health conditions.) They also pointed out that the study only measured results from smoking the e-cigarette for five minutes -- because the average consumer is likely to smoke the e-cigarette many times a day, this might increase the risks. However, the authors suggested that it is possible that if the e-cigarette were used as a short-term bridge to smoking cessation, the benefits might outweigh the risks.

  • On their website, the FDA states that states that "E-cigarettes may contain ingredients that are known to be toxic to humans, and may contain other ingredients that may not be safe." They also suggest that because e-cigarette manufacturers are not required to submit clinical study data to them, the public has no way of knowing "whether e-cigarettes are safe for their intended use, what types or concentrations of potentially harmful chemicals are found in these products, or how much nicotine they are inhaling when they use these products." The FDA is also concerned that the marketing efforts of e-cigarettes may increase addiction to nicotine, especially in young people, encouraging them to experiment with real tobacco products.

The Best Way To Quit Smoking

How you choose to quit smoking is a matter of personal choice. The best method is the one that works for you. With this in mind, doing whatever it takes to be successful -- and safe -- is how many people ultimately approach it.

Consult your health care provider about different stop smoking aids, including nicotine replacement therapy, quit smoking medications such as Clonidine and Wellbutrin, quit smoking support groups, and educational materials.

If you decide to try the e-cigarette, be sure to discuss this with your doctor and do your homework. Understand the pros, cons, and safety concerns, and then make an informed decision. The most important thing to remember is, no matter how you do it, you are making the best decision of your life when you finally decide to quit smoking, especially if you have COPD.

If you're interested in purchasing an e-cigarette starter kit, compare prices here.


Etter JF, Bullen C. Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction. 2011 Nov;106(11):2017-28. Epub 2011 Jul 27.

Bullen C, McRobbie H, Thornley S, Glover M, Lin R, Laugesen M. Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial. Tob Control. 2010 Apr;19(2):98-103.

Caponnetto P, Polosa R, Russo C, Leotta C, Campagna D. J. Successful smoking cessation with electronic cigarettes in smokers with a documented history of recurring relapses: a case series. Med Case Reports. 2011 Dec 20;5(1):585.

Evangelopoulou, Gregory N. Connolly and Panagiotis K. Behrakis Constantine I. Vardavas, Nektarios Anagnostopoulos, Marios Kougias, Vassiliki. Acute pulmonary effects of using an e-cigarette: impact on respiratory flow resistance, impedance and exhaled nitric oxide. Chest; Prepublished online December 22, 2011.

Fagerström KO, Hughes JR, Rasmussen T, Callas PW. Randomized trial investigating effect of a novel nicotine delivery device (Eclipse) and a nicotine oral inhaler on smoking behavior, nicotine and carbon monoxide exposure, and motivation to quit. Tob Control. 2000 Sep;9(3):327-33.

Fagerström KO, Hughes JR, Callas PW. Long-term effects of the Eclipse cigarette substitute and the nicotine inhaler in smokers not interested in quitting. Nicotine Tob Res. 2002;4 Suppl 2:S141-5.

Food and Drug Administration News and Events: Public Health Focus. http://www.fda.gov/newsevents/publichealthfocus/ucm172906.htm. Accessed 1/24/2011.

Anna Trtchounian and Prue Talbot. Electronic nicotine delivery systems: is there a need for regulation? Tob Control published online December 7, 2010.


Public health Q&A: Are e-cigarettes safe?

Question: It seems like everywhere we look, a new "vaping" shop is opening up. I know that e-cigarettes contain nicotine, which is addictive. But since they don't involve smoke, it seems like they must not damage your lungs as much as regular cigarettes. What do we really know about how they compare with smoking?

Answer: In 2010, Wisconsin implemented the Smoke-free Air law and almost five years later 86 percent of Wisconsinites enjoy and expect smoke-free air. E-cigarettes have recently exploded on the market and this new popular trend has created confusion regarding the statewide Smoke-free Air law. This new trend is invading the clean air we have come to expect.

An electronic cigarette is an oral device that can be used to simulate smoking and that produces an aerosol of nicotine or other substances. The term e-cigarette is use to reference and array of products including, e-hookahs, hookah pens, vape pens, vaporizers, e-cigars, and e-pipes.

You may be asking yourself, "But are they healthy?" As many as 10 different toxic or carcinogenic chemicals have been identified in e-cigarettes including, highly addictive nicotine. Studies have also found some e-cigarettes contain high levels of formaldehyde and diacetyl — chemicals harmful to the human body. Currently, e-cigarettes aren't regulated and haven't been proven to be safe.

E-cigarettes are being marketed as a healthy alternative to smoking, an effective cessation strategy and a way around existing smoke-free air laws. But smokers who use e-cigarettes for cessation often continue to smoke regular cigarettes. In addition, allowing e-cigarettes to be used indoors where cigarettes are not allowed undermines the smoke-free air law. The use of e-cigarettes indoors threatens Wisconsin's standard of clean air and makes enforcement confusing.

Overall, more research is needed to show the long-term health consequences of e-cigarettes. Every month more information is coming out about what is actually in e-cigarettes and e-juice. It's more than just water vapor.

The Central Wisconsin Tobacco Free Coalition strives to reduce tobacco/nicotine related death and disability through education and advocacy, creating a community environment that encourages tobacco free living.

Destinee Coenen is a public health educator with the Marathon County Health Department who is part of the Central Wisconsin Tobacco Free Coalition. Have a question about public health? Email it to opinion@wdhmedia.com.
Source:  www.usatoday.com/story/life/2015/04/14/public-health-qa-cigarettes-safe/25766131/

Study: New concerns raised over teen e-cigarette use

As e-cigarette use among teens rapidly increases, a national health report suggests adolescents who would not have otherwise used tobacco products are now turning to electronic smoking devices.

The report, released Monday by the American Academy of Pediatrics, is based on a study that found overall smoking prevalence among youth in Southern California declined, but the combined e-cigarette or cigarette use was substantially greater than before e-cigarettes became available.

The conclusion raises the question of whether e-cigarettes are merely substituting for cigarettes or being used by teens who wouldn’t otherwise be smoking.

In 2014, the Centers for Disease Control and Prevention reported e-cigarettes were the most commonly used tobacco product among middle and high school students, with an estimated 2 million users in that age group.

Cigarette smoking declined among American teens in recent years, but the use of other tobacco products — like e-cigarettes and hookahs — increased, the report says.

More teens now try vaping than smoking

The potential safety of e-cigarettes, devices that heat a liquid consisting of nicotine, flavorings and other chemicals to create a vapor, is hotly debated. Unlike traditional cigarettes, e-cigarettes do not contain tar or other chemicals generated by the combustion of tobacco that are responsible for harmful tobacco-related diseases. They are, therefore, seen as a safer alternative to conventional tobacco use, the leading cause of preventable death in the U.S.

Health care experts worry e-cigarettes could normalize cigarette use and create a new generation of smokers and nicotine addicts that will be likely to transition to more traditional tobacco products.

But Brian Carter, the director of scientific communications at The Consumer Advocates for Smoke-free Alternatives Association, a group dedicated to ensuring the availability of smoking alternatives, asks why someone who prefers not to smoke but tries e-cigarettes would make the transition to a “really nasty alternative.”

Aruni Bhatnagar, lead author of the American Heart Association’s policy statement on e-cigarettes, said even if teens don’t switch to other tobacco products, nicotine itself isn’t benign. It increases heart rate and blood pressure and can, over time, contribute to cardiovascular and heart disease, he said.

“We are not entirely convinced that (e-cigarettes) are innocuous and contain minimal harm,” said Bhatnagar, who also teaches medicine at the University of Louisville. “We don’t know what the harm is, it’s not clear cut yet.”

Tobacco use and addiction mostly begin during youth and young adulthood. Nicotine exposure during adolescent years, a critical time for brain development, can have lasting adverse consequences, according to the CDC report.

Harold Farber, policy chair at the American Academy of Pediatrics Section on Tobacco Control and pediatric pulmonologist at Texas Children’s Hospital, said the adolescent brain is highly malleable, so addiction to nicotine is much more severe and difficult to kick in those who start using at a young age.

E-cigarettes, which are sold in a variety of different flavors, are like a highly addictive candy directly marketed to youth, Farber said.

Gregory Conley, president of the American Vaping Association, an advocacy group that champions vapor products for smokers looking to quit, argued most teens who do use e-cigarettes aren’t necessarily using vapes that contain nicotine.

A 2015 National Institute on Drug Abuse report says over 60% of middle and high school students reported vaporizing “just flavoring.” However, some products labeled nicotine-free may actually contain nicotine, it added.

The Food and Drug Administration issued new rules in May that for the first time extended federal regulation to e-cigarettes, with the intent to keep tobacco products out of the hands of minors.

The new rules ban the sale of e-cigarettes to anyone under 18 and require manufacturers to register with the FDA, disclose detailed reports of their products’ ingredients and obtain permission to sell their products.

FDA went way too far on e-cigarettes

While these regulations are a move in the right direction, Bhatnagar says they could have gone even farther by increasing the age to 21, banning the different e-cigarette flavors and regulating advertisements on TV and in magazines.

Bhatnagar says smoking was de-normalized when it was banned from public spaces and discouraged from display in TV and movies, which he credits for the major gains in decreased tobacco use and addiction. But vaping, which people do publicly in a variety of different environments, reverses these gains, he said.

Carter, who has a background in clinical psychology, argues it is highly premature to conclude that “something bad is going on” with youth e-cigarette use.

“At best, this is a study that offers some small potential clue about what may be happening,” he said. “To suggest anything more concrete than this is to be very unscientific by touting speculation as fact.”

Farber says e-cigarettes are a huge experiment to be conducting on our future generations.

“With e-cigarettes we’re seeing a step back in our battle,” he said. “But I’m hoping we realize the errors of our ways and decide it’s worth protecting our children.”
Source: www.usatoday.com/story/news/2016/07/11/study-new-concerns-raised-over-teen-e-cigarette-use/86866056/

4 Facts You Need to Know About E-Cigarettes

E-cigarette research is underway, but much still needs to be learned about this smoking alternative, including the effects it has on health over the long term.

We do know that traditional cigarette smoke contains upwards of 7000 toxins, including 250 poisonous and 70 cancer-causing chemical compounds. No level of secondhand cigarette smoke is considered safe to breathe.

E-cigarette emissions on the other hand contain far fewer toxins, in part because the vapor is not a byproduct of burning organic matter, but of heating the nicotine-containing liquid, which causes it to vaporize.

While e-cigarettes are less hazardous than traditional cigarettes, they're not harmless. Let's take a closer look at the issues you should be concerned with if you're thinking about using e-cigarettes as a smoking alternative or a quit aid.

1. Electronic Cigarettes are Not Regulated

In the United States, tobacco products that are regulated must adhere to strict rules imposed by the U.S. Food and Drug Administration (FDA).

These include:

  • Requiring manufacturers to register existing products and report product ingredients.
  • New products must be reviewed and approved by FDA before going on the market.
  • Claims that products offer a reduced health risk must be backed up by science that the FDA confirms and also agrees that the product offers a benefit to society as a whole.
  • Tobacco products cannot be sold or given as samples to minors.

Currently, regulated tobacco products include cigarettes, cigarette tobacco, smokeless tobacco, and roll-your-own tobacco.

The FDA plans to extend their umbrella of control over more tobacco products soon. They are: e-cigarettes, cigars, pipe tobacco, nicotine gels, hookah tobacco and dissolvables.

These products would be subject to the rules noted above and would also have to include health warnings, not be sold in vending machines at locations that are accessible to children, and adhere to minimum age and I.D. restrictions for sales.

How Lack of Regulation Hurts Consumers

The current lack of regulation on e-cigarettes means that you can't trust that the product you're buying contains the amount of nicotine it claims to, or that it is produced with any quality control. Pharmaceutical grade nicotine is used in all U.S. NRT products, but consumers can't count on that with unregulated tobacco products.

Similarly, information on packaging regarding nicotine-free cartridges cannot be trusted. They may, and often do contain nicotine. This is especially bad if you're using e-cigarettes as a quit aid and trying to decrease nicotine gradually to zero.

Finally, the quality of electronic cigarette devices themselves vary widely, which can affect vapor composition and toxicity.

2. E-Cigarettes Contain Some Surprising Toxins

In a study reviewing available information about e-cigarette liquid, cartridges, vapor and exhaled emissions, authors noted the presence of a number of toxins in varying amounts, including formaldehyde, acetaldehyde, acrolein, o-Methyl benzaldehyde, acetone, volatile organic compounds, phenolic compounds, polycyclic aromatic hydrocarbons.

While the amounts of these chemicals are much less in e-cigarettes than in traditional cigarettes, there is a risk of exposure to some of the same chemicals that are hazardous in cigarette smoke.

TSNAs in e-Cigarettes

E-Cigarette liquid and vapor has been shown to contain TSNAs, a group of four chemical compounds that are thought to be some of the most potent carcinogens in tobacco products and tobacco smoke. TSNAs are present in green tobacco and processed tobacco, including liquid nicotine.

TSNAs are associated with lung cancer, oral and esophageal cancer, liver cancer and pancreatic cancer. There is growing evidence that TSNAs may contribute to cervical cancer.

Heavy Metals in e-Cigarettes

Researchers studying e-cigarette emissions have identified chromium, a metal not present in cigarette smoke, as well as a number of other heavy metals that are, including zinc and lead. The concentrations are much lower than in traditional cigarette smoke, but are not zero. Nickel is present in levels 4 times higher than in regular cigarette smoke.

It appears that the metals probably come from the cartridges and that standardizing the quality of their construction may reduce these toxins.

3. E-Juice is Poisonous

The "active" ingredient in e-cigarettes and the reason people use them is nicotine, and nicotine is a poison. It has been used in insecticides for years and is the addictive ingredient in both cigarettes and e-cigarettes.

According to a CDC study that reviewed calls to poison centers across the United States involving e-cigarette liquid containing nicotine, the incidence of accidental poisoning has skyrocketed in the last few years as e-cigarettes have gained in popularity.

There was just one call per month pertaining to liquid nicotine in September of 2010 and 215 calls per month by February of 2014. Approximately half of the calls involved children under the age of 5 being exposed to e-cigarette liquid, and 42 percent from people over the age of 20.

E-liquid comes in several sweet, candy flavors, which is appealing to kids. Poisoning occurs when nicotine-laced e-liquid is inhaled, ingested or absorbed through the skin or eyes.

In December, 2014, what may be the first death of a child due to liquid nicotine occurred in upstate New York state when a one year old who ingested liquid nicotine died soon after. Local police didn't confirm that the liquid nicotine was associated with e-cigarettes, however it is likely.

And, earlier in 2014, a puppy in Britain got hold of an e-liquid cartridge and was dead within hours of chewing through it and ingesting a small amount of the liquid.

4. E-Cigarettes are a Smoking Alternative, Not a Quit Aid

It's probable that e-cigarettes will be a regulated product in the future. When that occurs, it's also likely that a physician designed and endorsed regimen for smoking cessation using electronic cigarettes will eventually become available.

When and if that happens, consumers will be able to count on a consistent level of manufacturing quality and nicotine quality and content. They will also have a program for stepping down and off of nicotine completely, which is the purpose of any quit aid.

People are already using the e-cigarette as a means to quit nicotine altogether, and some are achieving success with it. On the flip side, many e-cigarette users either transfer their addiction from tobacco to the device, or eventually go back to smoking traditional cigarettes full-time because they're still actively addicted to nicotine.

If you're thinking of using the e-cigarette to quit smoking, do some research first on the quit aids available on the market today, and have a discussion about them with your doctor, who can offer advice on the best choice for you.

U.S. Food and Drug Administration. FDA proposes to extend its tobacco authority to additional tobacco products, including e-cigarettes. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm394667.htm . Accessed March 2015.

British Medical Journal. Chemical Evaluation of Cigarettes. http://tobaccocontrol.bmj.com/content/23/suppl_2/ii11.full . Accessed March 2015.

University of Southern California. Secondhand E-Cigarette Smoke: Healthier Than Regular Cigarette Smoke, But Still Contains Some Toxic Elements. http://pressroom.usc.edu/second-hand-e-cigarette-smoke-healthier-than-regular-cigarette-smoke-but-still-contains-some-toxic-elements/ . Accessed March 2015.

3 reasons to say no to e-cigarettes - Kaiser Permanente

Electronic cigarettes (e-cigarettes) are marketed as a safer alternative to traditional cigarettes and a way to manage nicotine cravings if you’re trying to quit. But here are 3 good reasons to give them a thumbs down.

1. Safety concerns

After analyzing e-cigarette samples, the U.S. Food and Drug Administration (FDA) found that some products contain cancer-causing agents and toxic chemicals such as diethylene glycol, an ingredient used in antifreeze.

2. No convincing evidence they will help you quit

In fact, there is evidence suggesting the opposite: A 2014 study by researchers at the University of California, San Francisco, revealed that smokers who use e-cigarettes are a third less likely to quit than those who don’t use them.

3. What’s proven to work still works

Evidence shows the most effective way to quit is to use a combination of FDA-approved medications (like the nicotine patch, gum, lozenge, or bupropion) and counseling support. Choose what works for you: Kaiser Permanente’s Wellness Coaching by Phone, tap into the power of a group in a Health Education stop smoking class, or try the online, self-paced program called HealthMedia® Breathe.(TM) Learn more at kp.org/quitsmoking.

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Tobacco (read e-cigarettes too) surely was designed to poison and destroy mankind - Philip Freneau 

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