The Background of E Liquid
E liquid is the mixture used in vapor products such as e cigarettes. The main ingredients in the e liquid usually are propylene glycol, glycerin, water, nicotine, and flavorings. However, there are e liquids sold without propylene glycol, nicotine, or flavors. The liquid typically contains 95% propylene glycol and glycerin. The flavorings may be natural or artificial. About 8,000 flavors exist as of 2014. There are many e liquids manufacturers in the USA and worldwide. While there are currently no US Food and Drug Administration (FDA) manufacturing standards for e liquid, the FDA has proposed regulations that are expected to be finalized in late 2015. Industry standards have been created and published by the American E liquid Manufacturing Standards Association (AEMSA).
Positions of medical organizations
Main article: Positions of medical organizations on electronic cigarettes
2014 Centers for Disease Control(CDC) press release concerning e cigarettes.
Physicians and public health officials have been concerned about the health implications of e cigarette use. Numerous medical organizations have made statements about their health and safety. All agree that more research is needed. Some healthcare groups have hesitated to recommend e cigarettes for quitting smoking, because of limited evidence of effectiveness and safety.
In July 2014, a report produced by the World Health Organization (WHO) found there was not enough evidence to determine if electronic cigarettes could help people quit smoking, suggesting smokers be encouraged to use approved methods for help with quitting. The same report also notes expert opinion which suggests e cigarettes have a role in helping those who have failed to quit by other means.Smokers will get the maximum health benefit if they completely quit all nicotine use. The World Lung Foundation has applauded the WHO report's recommendation of tighter regulation due to safety concerns and the risk of increased nicotine or tobacco addiction among youth.
In a 2015 joint statement, Public Health England and other UK medical bodies concluded "e cigarettes are significantly less harmful than smoking." In 2015, the Public Health England released a report stating that e cigarettes are estimated to be 95% less harmful than smoking, and said that "PHE looks forward to the arrival on the market of a choice of medicinally regulated products that can be made available to smokers by the NHS on prescription." The UK National Health Service followed with the statement that e cigarettes have approximately 5% of the risk of tobacco cigarettes, while also concluding that there won't be a complete understanding of their safety for many years. As of 2014 there are clinical trials in progress to test the quality, safety and effectiveness of e cigarettes, but until these are complete the NHS maintains that the government could not give any advice on them or to recommend their use."
In October 2015, the American Academy of Pediatrics recommends against e cigarettes for quitting smoking and stated among adolescents, e cigarette use is related with reduced quitting smoking.[ In August 2014, the American Heart Association released a policy statement in which they support "effective FDA regulation of e cigarettes that addresses marketing, youth access, labeling, quality control over manufacturing, free sampling, and standards for contaminants." In 2015 the California Department of Public Health issued a report that stated the "aerosol has been found to contain at least ten chemicals that are on California’s Proposition 65 list of chemicals known to cause cancer, birth defects, or other reproductive harm."[ In 2014, the US FDA said "E cigarettes have not been fully studied, so consumers currently don't know: the potential risks of e cigarettes when used as intended, how much nicotine or other potentially harmful chemicals are being inhaled during use, or whether there are any benefits associated with using these products. Additionally, it is not known whether e cigarettes may lead young people to try other tobacco products, including conventional cigarettes, which are known to cause disease and lead to premature death."