Also known as e-cigarettes or electronic nicotine delivery systems, electronic cigarettes are generally battery-operated devices that are designed to deliver nicotine, flavorings, and chemicals in the form of a vapor. Most often, puffing activates the heating device, which vaporizes the liquid in the cartridge. The resulting aerosol or vapor is inhaled; this is called “vaping.”
Electronic cigarettes are intended to simulate the act of smoking by producing an aromatic aerosol that looks and feels like tobacco smoke without the toxic chemicals associated with the burning of tobacco. Electronic cigarettes tend to be marketed as a healthier alternative to tobacco cigarettes. But like tobacco, they contain nicotine, which is addictive, and other chemicals, which may be harmful. Surely, using these products does not support health. Yet, among teens, electronic cigarettes appear to be gaining popularity. And, they are readily available; they may easily be purchased online. Another possible reason for concern about electronic cigarettes is that they need to be refilled. When refilling these cigarettes, users may be exposing themselves to toxic levels of nicotine. 1
In a study published in 2014 in JAMA Pediatrics, researchers based in San Francisco wanted to learn more about the use of electronic and tobacco cigarettes in adolescents. As a result, they used the 2011 and 2012 National Youth Tobacco Surveys to conduct cross-sectional analyses of a representative sample of U.S. middle and high school students, from grade 6 to grade 12. Their 2011 sample had 17,353 students, and their 2012 sample had 22,529 students; the students lived in all 50 states and the District of Columbia. The researchers learned that smoking electronic cigarettes was associated with higher odds of smoking tobacco cigarettes. Use of electronic cigarettes was also associated with lower odds of abstinence from tobacco cigarettes. According to these researchers, “e-cigarette use is aggravating rather than ameliorating the tobacco epidemic among youths.” And, they noted that their findings “called into question claims that e-cigarettes are effective as smoking cessation aids.” 3
In a study published in the journal Birth Defects Research. Part A, Clinical and Molecular Teratology, researchers from Texas noted that electronic cigarettes and other nicotine-containing products are often used by women of reproductive age. That is why it is important to determine the effect nicotine has on a growing fetus. It is known that nicotine easily crosses the placenta and enters fetal circulation. From animal studies, the researchers learned that nicotine is associated with adverse effects for the lungs, cardiovascular systems, and brains. Lung problems included reduce surface area, weight, and volume. Fetuses exposed to nicotine may develop into adults with high blood pressure, pulmonary disorders such as asthma, and, possibly, a predisposition to diabetes. The researchers concluded that “no amount of nicotine is known to be safe during pregnancy.” 4
In a study published in 2015 in the journal Nicotine & Tobacco Research researchers from Buffalo, New York, noted that when people smoke electronic cigarettes, nicotine remains on nearby surfaces. Nicotine reacts with oxidizing chemicals in the air and forms secondary pollutants, such as cancer-causing nitrosamines. The researchers filled three brands of electronic cigarettes with varying concentrations of nicotine. They released 100 puffs of each product directly into an exposure chamber. Surface wipe samples were taken pre- and postrelease of the vapors. The researchers found that three of their four experiments showed significant increases in the amount of nicotine on all the surfaces. The largest increases in nicotine were seen on the floors and glass windows. The researchers noted that their findings “indicated that there is a risk for thirdhand exposure to nicotine from e-cigarettes.” 6
In a study published in 2015 in the Journal of American College Health, researchers from Lubbock, Texas, examined the use of electronic cigarettes in college students in relation to gender, race/ethnicity, traditional tobacco use, and heavy drinking. The cohort, which consisted of 599 college students enrolled in General Psychology at a state university in Texas, completed questionnaires in January 2014. Sixty-five percent of the cohort was female; the cohort had a mean age of 19.19 years. Twenty-nine percent of the students reported prior use of electronic cigarettes, with 14 percent using in the previous 30 days. Males were more likely than females to use electronic cigarettes, but the use was not associated with race or ethnicity. Use of both tobacco and electronic cigarettes was associated with heavier use of both types of cigarettes and heavy drinking. The researchers concluded that “e-cigarette use among college students is exponentially on the rise and its co-use with alcohol may contribute to negative outcomes in this population.” 8
1. National Institute on Drug Abuse, www.drugabuse.gov.
2. Danielle Ramo, Kelly C. Young-Wolff, and Judith J. Prochaska, “Prevalence and Correlates of Electronic-Cigarette Use in Young Adults: Findings from Three Studies Over Five Years,” Addictive Behaviors 41 (2015): 142-47.
3. Lauren M. Dutra and Stanton A. Glantz, “Electronic Cigarettes and Conventional Cigarette Use Among US Adolescents: A Cross-Sectional Study,” JAMA Pediatrics 168, no. 7 (2014): 610-17.
4. Melissa A. Suter, Joan Mastrobattista, Maike Sachs, and Kjersti Aagaard, “Is There Evidence for Potential Harm of Electronic Cigarette Use in Pregnancy?” Birth Defects Research. Part A, Clinical and Molecular Teratology 103, no. 3 (2015): 186-95.
5. Lucinda J. England, Rebecca E. Bunnell, Terry F. Pechacek et al., “Nicotine and the Developing Human: A Neglected Element in the Electronic Cigarette Debate,” American Journal of Preventive Medicine 49 (2015): 286-93.
6. Maciej L. Goniewicz and Lily Lee, “Electronic Cigarettes Are a Source of Thirdhand Exposure to Nicotine,” Nicotine & Tobacco Research 17, no. 2 (2015): 256-58.
7. Karen Hughes, Mark A. Bellis, Katherine A. Hardcastle et al., “Associations Between E-Cigarette Access and Smoking and Drinking Behaviours in Teenagers,” BMC Public Health 15 (2015): 244+.
8. Andrew K. Littlefield, Joshua C. Gottlieb, Lee M. Cohen, and David R. M. Trotter, “Electronic Cigarette Use Among College Students: Links to Gender, Race/Ethnicity, Smoking, and Heavy Drinking,” Journal of American College Health 63 (2015): 523.
Brose, Leonie, Sara C. Hitchman, Jamie Brown et al. “Is the Use of Electronic Cigarettes While Smoking Associated with Smoking Cessation Attempts, Cessation and Reduced Cigarette Consumption? A Survey with a 1-Year Follow-Up.” Addiction 110 (2015): 1160-68.
Bullen, Christopher, Colin Howe, Murray Laugesen et al. “Electronic Cigarettes for Smoking Cessation: A Randomised Controlled Trial.” Lancet 382 (2013): 1629-37.
Dutra, Lauren M., and Stanton A. Glantz. “Electronic Cigarettes and Conventional Cigarette Use Among US Adolescents: A Cross-Sectional Study.” JAMA Pediatrics 168, no. 7 (2014): 610-17.
England, Lucinda J., Rebecca E. Bunnell, Terry F. Pechacek et al. “Nicotine and the Developing Human: A Neglected Element in the Electronic Cigarette Debate.” American Journal of Preventive Medicine 49 (2015): 286-93.
Goniewicz, Maciej L., and Lily Lee. “Electronic Cigarettes Are a Source of Thirdhand Exposure to Nicotine.” Nicotine & Tobacco Research 17, no. 2 (2015): 256-58.
Hughes, Karen, Mark A. Bellis, Katherine A. Hardcastle et al. “Associations Between E-Cigarette Access and Smoking and Drinking Behaviours in Teenagers.” BMC Public Health 15 (2015): 244+.
Lee, Yong Hee, Michal Gawron, and Maciej Lukasz Goniewicz. “Changes in Puffing Behavior Among Smokers Who Switched from Tobacco to Electronic Cigarettes.” Addictive Behaviors 48 (2015): 1-4.
Littlefield, Andrew K., Joshua C. Gottlieb, Lee M. Cohen, and David R. M. Trotter. “Electronic Cigarette Use Among College Students: Links to Gender, Race/Ethnicity, Smoking, and Heavy Drinking.” Journal of American College Health 63 (2015): 523.
Popova, Lucy, and Pamela M. Ling. “Alternative Tobacco Product Use and Smoking Cessation: A National Study.” American Journal of Public Health 103, no. 5 (2013): 923-30.
Ramo, Danielle E., Kelly C. Young-Wolff, and Judith J. Prochaska. “Prevalence and Correlates of Electronic-Cigarette Use in Young Adults Findings From Three Studies over Five Years.” Addictive Behaviors 41 (2015): 142-47.
Suter, Melissa A., Joan Mastrobattista, Maike Sachs, and Kjersti Aagaard. “Is There Evidence for Potential Harm of Electronic Cigarette Use in Pregnancy?” Birth Defects Research. Part A, Clinical and Molecular Teratology 103, no. 3 (2015): 186-95.
National Institute on Drug Abuse. www.drugabuse.gov .