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.
Since initially alerting the public on April 3 to reports of some e-cigarette users experiencing seizures, FDA has since received 118 new reports of similar incidents. In total, including those posted in April, the agency has received 127 reports of neurological events following e-cigarette use that occurred between 2010 and 2019. This does not necessarily indicate an increase in frequency or prevalence of such incidents.
At this time, the FDA reports it has not been able to identify any specific brand of tobacco product, or identifiable product problem, associated with these incidents. However, the agency remains concerned about the possibility of an association between e-cigarette use and seizures or other similar medical conditions and encourages the public, including e-cigarette users and medical professionals, to provide as much information as possible when reporting health or safety problems stemming from tobacco products through the online Safety Reporting Portal (SRP).
Youth Vaping and Smoking According to the CDC, current use of JUUL among 15–17 year olds in 2018 (6.1%) is more than threefold higher than adult current use estimates in this study (2.0%).
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.
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.
Poison Control: Meanwhile, poison centers are reporting an increase in calls about exposures to e-cigarette devices and liquid nicotine. In 2014, there were 3,783 exposures, according to the American Association of Poison Control Centers. In the first three months of 2015, there were 975 reported exposures. During January 2010 to October 2015, a total of 98 e-cigarette exposure calls were reported in Wisconsin, and annual exposure calls increased approximately 17-fold, from 2 to 35, according to the Wisconsin Medical Journal. The frequency of e-cigarette exposure calls to the Wisconsin Poison Center has increased and is highest among children aged ≤5 years and adults.
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.
In 2015, 3.5% of U.S. adults were current e-cigarette users. Among adult e-cigarette users overall, 58.8% also were current cigarette smokers, 29.8% were former cigarette smokers, and 11.4% had never been cigarette smokers. Among current e-cigarette users aged ≥45 years, 98.7% were either current or former cigarette smokers, and 1.3% had never been cigarette smokers. In contrast, among current e-cigarette users aged 18–24 years, 40.0% had never been cigarette smokers.4
A survey from the Action on Smoking and Health released in May 2017 found that more than half of British vapers were former smokers. These results were reported by the individuals and not confirmed with tests that can biochemically check smoking status. In addition, 1.3 million British residents surveyed reported they both smoke and vape.
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