Vaping and Electronic Cigarettes (E-cigs)

Electronic Cigarettes (e-cigs) and other “vaping” devices (such as JUUL or Suorin) are battery-operated products designed to deliver nicotine, flavor and other chemicals. They turn chemicals, including highly addictive nicotine, into an aerosol that is inhaled by the user. Most e-cigs are manufactured to look like conventional cigarettes, cigars, or pipes. Some resemble everyday items such as pens and USB memory sticks, and are known as tanks, vape pens, vaporizers, and e-pipes.

To Quit: Call the Quit Line at 800-784-8669

• Or text “DITCHJUUL” to 88709. This program offers youth and young adults encouragement and support to quit JUUL and other e-cigarettes.

Youth Vaping and Smoking

According to an article in JAMA Pediatrics, use of JUUL among teens increased again in 2019.

To assess the prevalence of youth tobacco product use, CDC and FDA analyzed data from the 2019 National Youth Tobacco Survey. They found:

• • In 2019, about 1 in 3 high school students (4.7 million) and about 1 in 8 middle school students (1.5 million) were current (past 30-day) tobacco product users.

Current (past 30-day) tobacco product use among high school students, 2019:

• • E-cigarettes, 27.5%.
  • Cigars, 7.6%.
  • Cigarettes, 5.8%. Smokeless tobacco, 4.8%.
  • Hookahs, 3.4%.
  • Pipe tobacco, 1.1%.
  • Current (past 30-day) tobacco product use among middle school students, 2019
  • E-cigarettes, 10.5%.
  • Cigars, 2.3%.
  • Cigarettes, 2.3%.
  • Smokeless tobacco, 1.8%.
  • Hookahs, 1.6%.
  • Flavored Tobacco Products: Nearly 7 in 10 (69.6%, 4.3 million) middle and high school student current tobacco product users reported flavored tobacco product use.

Why is youth vaping a concern?

• Nicotine alters the adolescent brain. It increases their risk for:
  • • Impulsivity.
    • Mood disorders.
    • Stunted learning and recall.
    • Diminished enjoyment of activities they normally adore.

• Vaping devices with THC can be deadly.
  • In the United States:
    • As of December 17, 2019, 2,668 hospitalized EVALI cases have been reported to CDC from all 50 states, the District of Columbia, and two U.S. territories (Puerto Rico and U.S. Virgin Islands).
    • Vaping has caused at least 60 deaths in 27 states and the District of Columbia (as of January 17, 2020).
    • Most of these deaths have reportedly involved vaping THC with vitamin E acetate.
  • Illinois and Wisconsin: Hospitalizations from Vaping “Street” Products
    • Latest tally of cases and deaths in Wisconsin

• Among youth — who use e-cigarettes at higher rates than adults do — there is substantial evidence that e-cigarette use increases the risk of transitioning to smoking conventional cigarettes. Smoking remains the leading cause of preventable disease and death in the United States.
  • A study in the Journal of the American Medical Association found youth who vaped e-cigs were nearly 4 times more likely to smoke. Current use of electronic cigarettes increased among middle and high school students from 2011 to 2015. About 5 of every 100 middle school students (5.3%) reported in 2015 that they used electronic cigarettes in the past 30 days—an increase from 0.6% in 2011. 16 of every 100 high school students (16.0%) reported in 2015 that they used electronic cigarettes in the past 30 days—an increase from 1.5% in 2011.
• Long-term health effects of vaping are unknown.
  • Researchers at Marquette and reporters at the Milwaukee Journal Sentinel collaborated to test popular e-cig juices: Lab Tests of E-cigs Reveal Harmful Chemicals
• Schools: Find resources to ensure tobacco-free schools here.

What is JUUL?

• JUUL is a type of e-cigarette that has surged in popularity since its introduction in 2015.
• According to an article in JAMA Pediatrics, use of JUUL among teens increased again in 2019.
• It is known for its unique use of nicotine + benzoic acid + flavors that deliver a smoother experience than other vaping devices while mimicking combustible cigarettes in their delivery of nicotine.
• JUUL has suspended sales of sweet flavors in the United States.
• JUUL is already the most widely purchased e-cigarette brand, representing nearly half of the market share in the last quarter of 2017.
• According to the journal JAMA Pediatrics, half of Juul’s Twitter followers are under the age to legally buy nicotine products.
• Kids have referred to use of the product as “juuling.”
• JUUL Fact Sheet from Tobwis.org
• JUUL Fact Sheet from the Office of Smoking and Health

Does Vaping Lead to Quitting Smoking? 

• According to a Cochrane review of published research, it is unclear if e-cigs are an effective way to quit smoking.
• In a UW-CTRI study, vaping can reduce nicotine dependence, but it is unclear if patients would quit vaping.
• Another UW-CTRI study found that participants who both smoked and vaped were more likely to quit vaping than to quit smoking.
• A British study published in the New England Journal of Medicine found e-cigarettes were more effective for smoking cessation than nicotine-replacement therapy (18% quit vs. 9%), when both products were accompanied by behavioral support.
• In its report, “Nicotine Without Smoke: Tobacco Harm Reduction,” the Royal College of Physicians in the United Kingdom recommended promoting both quit-smoking medications and e-cigarettes as a way to help people avoid the harms caused by smoking combustible tobacco products. The FDA has not made such recommendations.

How Many American Adults Vape? 

According to the CDC, 2.8% of U.S. adults vape.

UW-CTRI Research on Vaping

UW-CTRI is analyzing its second study on smoking and vaping. The first UW-CTRI study on smoking and vaping found no clear evidence that vaping e-cigs reduced smoking or lowered carbon monoxide levels in participants. The second study did find that dual users of e-cigs and regular cigarettes smoked fewer cigarettes per day, but were taking in the same amount of nicotine. UW is also conducting a study on the acute and long-term effects of vaping.

Big Business

According to the WHO 2014 E-Cigs Report, in 2014 there were 466 brands of e-cigs. In 2013, consumers spent $3 billion on e-cigs globally. Sales are forecasted to increase by a factor of 17 by 2030.¹

Regulation

On May 5, 2016, the FDA asserted authority to regulate all tobacco products, including vaping devices. On August 8, 2016, those regulations took effect. However, those regulations are still under debate and could be changed.

To view a list of vaping regulations by state, click here.

Taxes on Vaping

Wisconsin recently joined other states in taxing vaping products.

Other Fact Sheets on E-cigs

• Electronic-Cigarettes-Infographic-CDC
• For Employers: National Business Group on Health
• Printer-friendly version of UW-CTRI’s fact sheet
• For Nurses: Vaping Infographic from Georgetown School of Nursing
• For parents: teens and quitting vaping

Citations

1) WHO 2014 Report on E-Cigarettes. Conference of the Parties to the WHO Framework Convention on Tobacco Control, Sixth session, Moscow, Russian Federation, 13–18 October 2014.

2) National Health Interview Survey, 2015 data