E-cigarettes and Vaping: Understanding the Growing Trend

E-cigarettes, also known as electronic nicotine delivery systems (ENDS), were first introduced in the US market around 2007. They were designed and marketed as a safer alternative to traditional combustible cigarettes. Unlike cigarettes that burn tobacco, e-cigarettes work by heating a liquid solution, known as e-liquid or vape juice, that usually contains nicotine, flavorings, propylene glycol, vegetable glycerin and other chemicals. This creates an aerosol that the user inhales.

The e-cigarette industry has grown exponentially over the past decade. In 2012, there were an estimated 3 million adult e-cigarette users in the US. By 2020, that number had risen to over 11 million. Sales of e-cigarettes in the US increased from approximately $2.5 billion in 2017 to over $5.8 billion in 2019. Their increasing popularity, especially among teenagers and young adults, has prompted serious health concerns and regulatory action from public health experts and government agencies.

Health Effects of E-cigarettes

While e-cigarettes may expose users to fewer toxicants than combustible tobacco cigarettes, they still pose significant health risks. Most e-liquids contain nicotine, the addictive constituent in regular cigarettes. Nicotine can harm brain development in teenagers and young adults under age 25. It also increases the risks of developing heart disease and cancer.

The other aerosolized chemicals in E-cigarettes such as flavorings, propylene glycol and vegetable glycerin, produce toxic substances when inhaled. Long-term inhalation of these chemicals can damage lung function and potentially lead to lung disease. There have also been case reports of e-cigarette or vaping use associated lung injury (EVALI), with symptoms including cough, shortness of breath, and fatigue. As of February 2020, over 2,800 hospitalized EVALI cases and 68 confirmed deaths have been reported to CDC from all 50 states.

Secondhand aerosol exposure from e-cigarettes poses dangers as well. Bystanders inhale nicotine, particulate matter, and toxic chemicals emitted during the vaping process. This can cause a variety of health issues like eye, nose, and throat irritation. Pregnant women and their developing babies are especially at risk of complications. Even occasional exposure to secondhand vape aerosol significantly increases non-users’ chances of lung and heart disease.

The Youth Vaping Epidemic

One of the major public health concerns around e-cigarettes is the sharp rise in youth vaping and nicotine addiction. Between 2011 and 2019, current e-cigarette use among high school students increased by more than 1,000%. The availability of kid-friendly flavors like cotton candy, gummy bear and fruit punch, combined with pervasive social media influencer marketing have made these products especially appealing to minors.

Many teenagers and young adults mistakenly believe that the aerosol from e-cigarettes and JUUL is harmless water vapor. But surveys show most youth ENDS users are inhaling nicotine on a regular basis and becoming dependent. Nicotine exposure during the adolescent years when the brain is still developing can cause long-lasting cognitive and behavioral issues. It also makes kids more likely to start smoking cigarettes later in life if they are already vaping. With tobacco industry involvement ramping up in the ENDS market, many experts warn that we may lose another generation to nicotine addiction through e-cigarettes.

Regulation and Harm Reduction Debate

In response to the public health threat posed by the youth vaping epidemic, the FDA banned the sale of flavored cartridge-based e-cigarettes in early 2020, except for menthol and tobacco flavors. Many states and localities have also raised the minimum legal sales age for tobacco and e-cigarette products to 21. However, the long-term health impacts of e-cigarette use remain largely unknown. There is an ongoing debate around whether strict regulation is warranted or if e-cigarettes could potentially serve as a reduced risk alternative for adult smokers seeking to quit combustible cigarettes.

While nicotine replacement therapies like patches and gums have proven effectiveness as smoking cessation aids, the evidence on e-cigarettes is less conclusive. A 2020 Cochrane review found that e-cigarettes may help smokers quit or reduce smoking compared to no support. But when compared to nicotine replacement therapy, studies showed no significant difference in quit rates. For adults unable or unwilling to pursue approved nicotine replacement options, some harm reduction advocates argue that regulated vaping products should remain accessible as a last resort. However, others counter that the health risks are still too great and promotion of e-cigarettes will undermine decades of anti-smoking efforts.

Overall, e-cigarettes and vaping represent an ongoing challenge from both public health and regulatory standpoints. Further research is needed to determine their long-term effects and potential role, if any, as smoking alternatives for addicted adult smokers. In the meantime, preventing youth initiation through strict advertising/sales restrictions and broad education about health harms will be critical to curbing the youth vaping epidemic. With youth e-cigarette use in the US showing signs of leveling off in recent years, the initial regulatory actions may be starting to turn the tide. But continued vigilance is warranted given the evolving nature of the ENDS market and uncertain long-term consequences.

About Author:

Alice Mutum is a seasoned senior content editor at Coherent Market Insights, leveraging extensive expertise gained from her previous role as a content writer. With seven years in content development, Alice masterfully employs SEO best practices and cutting-edge digital marketing strategies to craft high-ranking, impactful content. As an editor, she meticulously ensures flawless grammar and punctuation, precise data accuracy, and perfect alignment with audience needs in every research report. Alice's dedication to excellence and her strategic approach to content make her an invaluable asset in the world of market insights.
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