Electronic Cigarette Background
An electronic cigarette is a battery-powered vaporizer which simulates the feeling of smoking, but without burning tobacco. The three main types of e cigarettes are cigalikes, eGos, and MODs. Their use is commonly called "vaping". The user activates the e cigarette by taking a puff or pressing a button. They are often cylindrical, but come in many variations. Some look like traditional cigarettes. Most are reusable but there are also disposable versions called first generation cigalikes. There are also second, third, and fourth generation devices. Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor. E cigarettes typically have a heating element that atomizes a liquid solution known as e liquid. E liquids usually contain propylene glycol, glycerin, nicotine, and flavorings.
The benefits and the health risks of e cigarettes are uncertain. There is tentative evidence that they can help people quit smoking, but they have not been proven better than regulated medication. Their usefulness in tobacco harm reduction is unclear, but they could form part of future strategies to decrease tobacco related death and disease. Their safety risk to users is similar to that of smokeless tobacco. Regulated nicotine replacement products are safer than e cigarettes, but e cigarettes are probably safer than smoking.
Nicotine is associated with a range of harmful effects. Non-smokers who use e cigarettes risk nicotine addiction and their use may delay or deter quitting smoking. E cigarettes create vapor consisting of ultrafine particles. The vapor contains similar chemicals to the e liquid, together with tiny amounts of toxicants and heavy metals.
The composition of the vapor varies across and within manufacturers. E cigarette vapor can contain harmful chemicals not found in tobacco smoke. Later-generation e cigarettes may generate more formaldehyde than tobacco does, but reduced voltage e cigarettes produce very low levels of formaldehyde. E cigarette vapor contains fewer toxic substances than cigarette smoke. It also has lower concentrations of potential toxic substances than cigarette smoke, and is probably less harmful to users and bystanders. No serious adverse effects from e cigarettes have been reported in trials. Less serious adverse effects include throat and mouth inflammation, vomiting, nausea, and cough.
The long-term effects of e cigarette use are unknown.
Since their introduction to the market in 2004, global usage has risen exponentially. As of 2012, up to 10% of American high school students had used them at least once, and around 3.4% of American adults as of 2011. In the UK user numbers have increased from 700,000 in 2012 to 2.6 million in 2015. Most US e cigarette users still smoke traditional cigarettes. About 60% of UK users are smokers and about 40% are ex-smokers, while use among never-smokers remains "negligible". Most peoples' reason for using e cigarettes is related to quitting, but a considerable proportion use them recreationally. The modern e cigarette arose from a 2003 invention by Hon Lik in China and as of 2015 most devices are made there. Because of the potential relationship with tobacco laws and medical drug policies, e cigarette legislation is being debated in many countries. The European Parliament passed regulations in February 2014, to come into effect by 2016, standardizing liquids and personal vaporizers, listing ingredients, and child-proofing liquid containers. The US FDA published proposed regulations in April 2014 with some similar measures. Manufacturers have increased advertising, using marketing techniques like those used to sell cigarettes in the 1950s and 1960s. As of 2014, there were 466 brands with sales of around $7 billion.
Aerosol (vapor) exhaled by an e cigarette user using a nicotine free e cigarette.
Since their introduction to the market in 2004, global usage of e cigarettes has risen exponentially. By 2013, there were several million users globally. Awareness and use of e cigarettes greatly increased over the few years to 2014, particularly among young people and women in some countries But in both the US and UK the growth in usage seemed to have slowed in 2015.
In the US, vaping among young people exceeded smoking in 2014. In 2014, it was projected that vaping would exceed smoking in about three decades. People with higher incomes are more likely to have heard of e cigarettes, but those with lower incomes are more likely to have tried them. Trying e cigarettes was common among less educated people. Whites are more likely to use them than non-whites. Most users have a history of smoking regular cigarettes At least 52% of current or former smokers have used e cigarettes. Of smokers who use e cigarettes, less than 15% turn into everyday e cigarette users. E cigarette use in never-smokers is very low but is rising. A 2015 review suggests that 1% of e cigarette users use liquid without nicotine. As of 2012, up to 10% of American high school students had used them at least once, and around 3.4% of American adults as of 2011.
In the UK user numbers have increased from 700,000 in 2012 to 2.6 million in 2015, but use by current smokers remained flat at 17.6% from 2014 into 2015 (in 2010 it was 2.7%). About 60% of UK users are smokers and about 40% are ex-smokers, while use among never-smokers remains "negligible".
The majority of e cigarette users use them every day. E cigarette users mostly keep smoking traditional cigarettes
Many say e cigarettes help them cut down or quit smoking Adults often vape to replace tobacco, but not always to quit. Most e cigarette users are middle-aged men who also smoke traditional cigarettes, either to help them quit or for recreational use. Among young adults e cigarette use is not regularly associated with trying to quit smoking E cigarette use is also rising among women. Women smokers who are poorer and did not finish high school, are more likely to have tried vaping. Dual use of e cigarettes and traditional tobacco is still a definite concern. There is wide concern that vaping may be a "gateway" to smoking. A 2014 review raised ethical concerns about minors' e cigarette use and the potential to weaken cigarette smoking reduction efforts.
As well as the usual nicotine e liquid, liquids containing the active ingredients of cannabis are already being made, and e cigarettes could potentially be used to deliver other psychoactive drugs, including methamphetamine, cocaine, heroin, orcathinones. The "very limited" data so far available, "from a small community of 55 users [in Switzerland], suggest that cannabis vaping via e cigs or e-vaporizers are infrequent behaviors among cannabis users", and mostly practiced by middle-aged men.
In the US, the recent fall in smoking has accompanied a rapid growth in the use of alternative nicotine products among young people and young adults. 56% of respondents in a US 2013 survey admitted having used e cigarettes to quit or reduce their smoking, and 26% of respondents would use them in areas where smoking was banned. In the US, as of 2014, 12.6% of adults have used an e cigarette at least once and about 3.7% are still using them. Among grade 6 to 12 students in the US, the proportion who have tried them rose from 3.3% in 2011 to 6.8% in 2012. Those still vaping over the last month rose from 1.1% to 2.1% and dual use rose from 0.8% to 1.6%. Over the same period the proportion of grade 6 to 12 students who regularly smoke tobacco fell from 7.5% to 6.7%.
Use frequency has risen: as of 2012, up to 10% of American high school students have used them. In 2013 the Centers for Disease Control and Prevention (CDC) estimated that around 160,000 students between 2011 to 2012 who had tried vaping had never smoked. Between 2013 and 2014, vaping among students tripled. The majority of young people who vape also smoke. E cigarette use among never-smoking youth in the US correlates with elevated desires to use traditional cigarettes.
About one in 20 adults in the UK uses e cigarettes. In the UK in 2015, 18% of regular smokers said they used e cigarettes and 59% said they had used them in the past. Among those who had never smoked, 1.1% said they had tried them and 0.2% still use them. In 2013, among those under 18, 7% have used e cigarettes at least once. Among non-smokers' children, 1% reported having tried e cigarettes "once or twice", and there was no evidence of continued use. About 60% of all users are smokers and most of the rest are ex-smokers, with "negligible" numbers of never-smokers. In 2015 figures showed around 2% monthly EC-usage among under-18s, and 0.5% weekly, and despite experimentation, "nearly all those using EC regularly were cigarette smokers". 10-11-year-old Welsh never-smokers are more likely to use e cigarettes if a parent used e cigarettes.
National Institute on Drug Abusedirector Nora Volkow discussing aNational Institutes of Health-funded study showing teens using e cigarettes are more likely to start smoking tobacco.
A February 2014 survey in France estimated between 7.7 and 9.2 million people had tried e cigarettes. 1.1 to 1.9 million use them on a daily basis. 67% of smokers in the survey used e cigarettes to reduce or quit smoking. 9% of those who tried e cigarettes had never smoked tobacco. Of the 1.2% who had recently stopped tobacco smoking at the time of the survey, 84% (or 1% of the population surveyed) credited e cigarettes as essential in quitting.
Many young people who use e cigarettes also smoke tobacco. Some young people who have tried an e cigarette have never smoked tobacco, so ECs can be a starting point for nicotine use. There are high levels of dual use with e cigarettes and traditional cigarettes. Some young people who have never smoked have tried e cigarettes at least once. Most young people are not using e cigarettes to help them quit tobacco. Teenagers who had used an e cigarette were more inclined to become smokers than those who had not. Young people who vape are more likely to use hookah and blunts than smokers.
There are varied reasons for e cigarette use, often related to quitting, but also for relaxation or recreation. Many vapers believe it is healthier than smoking for themselves and bystanders. Some are concerned about the possible adverse health effects. Others use them to circumvent smoke-free laws and policies, or to cut back on cigarette smoking. Not having odor from smoke on clothes on some occasions prompted interest in or use of e cigarettes. E cigarette users have contradictory views about using them to get around smoking bans.
Users sometimes use e cigarettes without nicotine around friends for the convenience. Non-smoking adults tried e cigarettes due to curiosity, because a relative was using them, or because they were given an e cigarette. College students often vape for experimentation. Expensive marketing aimed at smokers suggests e cigarettes are "newer, healthier, cheaper and easier to use in smoke-free situations, all reasons that e cigarette users claim motivate their use". Exposure to e cigarette advertising influenced people to try them.
If tobacco businesses persuade women that e cigarettes are a small risk, women might vape while pregnant. The belief that e cigarettes are safer than traditional cigarettes could widen their use among pregnant women. E cigarettes feel or taste similar to traditional cigarettes, and vapers disagreed about whether this was a benefit or a drawback. The majority of committed e cigarette users interviewed at an e cigarette convention found them cheaper than traditional cigarettes.
Some users stopped vaping due to issues with the devices. Dissatisfaction and concerns over safety can discourage ongoing e cigarette use. Some surveys found that a small percentage of users' motives were to avoid smoking bans, but other surveys found that over 40% of users said they used the device for this reason. The extent to which traditional cigarette users vape to avoid smoking bans is unclear.
The health and lifestyle appeal may also encourage young non-smokers to use e cigarettes, as they may perceive that trying e cigarettes is less risky and more socially appealing. This may ameliorate negative beliefs or concerns about nicotine addiction. Marketing might appeal to young people as well as adults. Adolescent experimenting with e cigarettes may be sensation seeking behavior, and is not likely to be associated with tobacco reduction or quitting smoking. Young people may view e cigarettes as a symbol of rebellion. Young people and children are tempted by flavored e cigarettes. The main reasons young people experimented with e cigarettes were due to curiosity, flavors, and peer influences. E cigarettes can appeal to youth because of their high-tech design, assortment of flavors, and accessibility online. Candy and fruit flavors e cigarettes are designed to appeal to young people. Infants and toddlers could ingest the e liquid from an e cigarette device out of curiosity.
Users may begin by using a disposable e cigarette, and e cigarette users often start with e cigarettes resembling normal cigarettes, eventually moving to a later-generation device. Most later-generation e cigarette users shifted to their present device to get a "more satisfying hit", and users may adjust their devices to provide more vapor for better "throat hits".
Disassembled parts of a first generation e cigarette.
A. LED light cover
B. battery (also houses circuitry)
C. atomizer (heating element)
D. cartridge (mouthpiece)
Parts of a second generation e cigarette.
Main article: Construction of electronic cigarettes
The primary parts that make up an e cigarette are a mouthpiece, a cartridge (tank), a heating element/atomizer, a microprocessor, a battery, and possibly a LED light on the end. An atomizer comprises a small heating element that vaporizes e liquid and wicking material that draws liquid onto the coil. When the user pushes a button. or inhales a pressure sensor activates the heating element that atomizes the liquid solution; The e liquid reaches a temperature of roughly 100-250 °C within a chamber to create an aerosolized vapor. The user inhales the aerosol, commonly called vapor, rather than cigarette smoke. The aerosol provides a flavor and feel similar to tobacco smoking.
There are three main types of e cigarettes: cigalikes, looking like cigarettes; eGos, bigger than cigalikes with refillable liquid tanks; and mods, assembled from basic parts or by altering existing products. As the e cigarette industry is growing, new products are quickly developed and brought to market. First generation e cigarettes tend to look like tobacco cigarettes and so are called "cigalikes". Most cigalikes look like cigarettes but there is some variation in size. A traditional cigarette is smooth and light while a cigalike is rigid and slightly heavier. Second generation devices are larger overall and look less like tobacco cigarettes. Third generation devices include mechanical mods and variable voltage devices. The fourth generation includes Sub ohm tanks and temperature control devices. The power source is the biggest component of an e cigarette, which is frequently a rechargeable lithium battery.