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Helping a teen understand what sources to trust can give them a powerful tool to educate themselves. Don’t just tell them that there’s no good reason to start, help them learn why there’s no good reason. Talk about peer pressure, the tricks advertisers use and the importance of health.
A lack of data has led to classification of methylgloxal as a Group 3 carcinogen (carcinogenicity to humans not classifiable) by IARC. Both compounds have been previously detected in e-cigarette emissions at concentrations of 0.07–0.94 and 0.09–33 µg puff–1, respectively86,88. In our study, glyoxal was present at lower levels (BB57 and BB18, 0.02 and 0.05 µg puff–1, respectively), while methylglyoxal was at concentrations of 0.13 and 0.19 µg puff–1 in BB57 and BB18, respectively (Table 3). Glyoxal was detected in the method air blank and therefore the actual levels in the e-cigarette emissions are potentially lower than reported in Table 3.
Watch the UK Health Security Agency's video demonstration on the impact of smoking versus vaping. As of July 1, 2024, 1,061 municipalities, plus 26 states, commonwealths, and territories restrict e-cigarette use in 100% smokefree venues. The Royal Children’s Hospital (RCH) acknowledges the traditional owners of the land on which the RCH is situated, the Wurundjeri people of the Kulin Nation, and we pay our respects to their Elders past and present. Dr. Tan provides care to adults alongside an entire team of lung specialists at Loma Linda University Health.
And, our starter kits and disposable vape pens are a great, simple way to make the switch from smoking to vaping. We also have a wide selection of advanced kits for vapers who prefer high-powered cloud chasing e-cigs. Increasing consumer awareness of the environmental toxicity and dangers posed by discarding e-cigarette waste into landfills and encouraging vapers to quit are the best ways to protect the environment from tobacco product waste. Currently, there is no standardized way to recycle e-cigarettes in the U.S. Starting in 2019, the Drug Enforcement Agency (DEA) began accepting e-cigarette devices and cartridges during their annual National Prescription Take Back Day, although the DEA cannot accept devices containing lithium ion batteries.
This national credential was developed for individuals who are currently coaching or aspire to coach at the interscholastic level. The goal is to enhance the ability of the coach to better serve students, the school, the community, and the profession of coaching. What we do know is that many cartridges contain nicotine, the dangerously addictive chemical found in normal cigarettes. Every provider at Loma Linda University Health can tell you how important it is to keep your lungs healthy. Our lung specialists, like Dr. Laren Tan, see patients every day who suffer from debilitating lung issues caused by smoking. Since the end of 2019, it is illegal to sell vaping products to people younger than 21 years.
The e-liquid is quickly heated and converted to an aerosol that can be inhaled into the lungs. As smoking has declined dramatically in the U.S., vaping has gained tremendous popularity very quickly. A 2018 study reported 20% of high schoolers vaped at least once in the past 30 days. Since e-cigarettes often contain the same chemicals as traditional cigarettes, smoke produced by vaping may be toxic to people nearby. Manufacturers claim that e-cigarettes bypass many of the health risks of tobacco smoking, providing a healthful alternative.
In general, most of the cytokines detected in BALF were significantly increased in WT mice exposed to PG with nicotine compared to PG alone or air control [42]. Some of these effects were found to be through nicotine activation of NF-κB signalling albeit in females but not in males. In addition, PG with nicotine caused increased macrophage and CD4+/CD8+ T-lymphocytes cell counts in BALF compared to air control, but these effects were ameliorated when animals were sub-chronically exposed to PG alone [42]. Researchers know more about the long-term effects of smoking than those of vaping. However, vaping products contain a great deal fewer harmful chemicals than cigarettes and can be an effective tool in quitting smoking altogether.
Vaping works by heating liquid in a small device so you can breathe it into your lungs. The e-cigarette, vape pen or other vaping device heats the liquid in the device to create an aerosol. Mist from e-cigarettes contains particles of nicotine, flavoring and other substances suspended in air. You breathe these particles into your mouth from the mouthpiece, where they go down your throat and into your lungs. But, Blaha says, interpreting the data is tricky, since young people change their preferences often, and, when surveyed, may not consider using disposable products such as "puff bars" as vaping. The same CDC report says disposable e-cigarette use has increased 1,000% among high school students and 400% among middle school students since 2019.
For example, in an analysis using primary human umbilical vein endothelial cells (HUVEC) exposed to 11 commercially-available vapours, 5 were found to be acutely cytotoxic, and only 3 of those contained nicotine [24]. In addition, 5 of the 11 vapours tested (including 4 that were cytotoxic) reduced HUVEC proliferation and one of them increased the production of intracellular reactive oxygen species (ROS) [24]. Three of the most cytotoxic vapours—with effects similar to those of conventional high-nicotine CS extracts—also caused comparable morphological changes [24]. Endothelial cell migration is an important mechanism of vascular repair than can be disrupted in smokers due to endothelial dysfunction [25, 26]. E-cigarettes are sometimes called e-cigs, vapes, vape pens, e-hookahs, and electronic nicotine delivery systems or ENDS.
In regard to COVID-19 pandemic, the actual literature suggests that nicotine vaping may display adverse outcomes. Therefore, follow up studies are necessary to clarify the impact of e-cigarette consumption on human health in SARS-CoV-2 infection. Recently, a commonly commercialized crème brûlée-flavoured aerosol was found to contain high concentrations of benzoic acid (86.9 μg/puff), a well-established respiratory irritant [88]. When human lung epithelial cells (BEAS-2B and H292) were exposed to this aerosol for 1 h, a marked cytotoxicity was observed in BEAS-2B but not in H292 cells, 24 h later.
The length of time spent vaping can be much longer than smoking a standard cigarette. While most cigarettes are smoked within two to five minutes, e-cigarettes can last up to 20 minutes, delivering more nicotine and damaging chemicals to the lungs. In addition, some vaping mixtures can contain 20 times the nicotine that a single cigarette contains. This study builds on the findings of an earlier randomized clinical trial of This is Quitting conducted among roughly 2,600 young adults ages 18 to 24.
The composition of e-liquids requires stricter regulation, as they can be easily bought online and many incidences of mislabelling have been detected, which can seriously affect consumers’ health. Beyond their unknown long-term effects on human health, the extended list of appealing flavours available seems to attract new "never-smokers", which is especially worrying among young users. Additionally, there is still a lack of evidence of e-cigarette consumption as a smoking cessation method. Indeed, e-cigarettes containing nicotine may relieve the craving for smoking, but not the conventional cigarette smoking habit.
District Court for the District of Columbia ruled that e-cigarettes did not meet the criteria for drug-delivery devices and therefore were exempt from regulation under the FFDCA. The court did rule, however, that the FDA could regulate e-cigarettes as tobacco products under the Family Smoking Prevention and Tobacco Control Act (TCA), since the nicotine contained in some of the e-cigarette cartridges was derived from tobacco. Reports in 2018 of increased e-cigarette use among adolescents and teenagers in the United States prompted the FDA to identify strategies for combating e-cigarette use by minors. Altria’s data showed Njoy e-cigarettes helped smokers reduce their exposure to the harmful chemicals in traditional cigarettes, the FDA said. The agency stressed the products are neither safe nor "FDA approved," and that people who don’t smoke shouldn’t use them. The FDA regulates the manufacture, distribution, and marketing of tobacco products, such as cigarettes, cigars, and e-cigarettes (sometimes called "vapes").
Electronic cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavorings and other chemicals. Richmond-based Altria previously took a $13 billion stake in Juul in 2018, when the brand controlled most of the U.S. vaping market. But Juul’s value plummeted after it was hit with lawsuits and investigations over its role in sparking a national spike in underage vaping.
Median odds ratio (MOR), which shows the difference between two respondents with identical student-level characteristics from two randomly chosen different schools, was calculated to express between-school variance on the odds ratio scale [36]. The analysis was not pre-registered, and the results should be considered exploratory. Scholastic Real Cost of VapingThe FDA collaborated with the Scholastic Corporation to develop lessons, activities and resources for teachers to increase awareness about the health consequences of youth e-cigarette use. Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. This study was the first to use endothelial cells derived from iPS cells to directly investigate the effect of e-liquids with and without nicotine on their viability and function.
Use of microporous ceramic as a wicking material improves heating efficiency, but how it affects the chemical emissions of these devices is unclear. We assessed the emissions of a pod e-cigarette with innovative ceramic wick-based technology and two flavoured e-liquids containing nicotine lactate and nicotine benzoate (57 and 18 mg mL−1 nicotine, respectively). Among the studied harmful and potentially harmful constituents (HPHCs) listed by the US FDA and/or WHO TobReg, only 5 (acetone, acetaldehyde, formaldehyde, naphthalene and nornicotine) were quantified at levels of 0.14 to 100 ng puff−1. In the combustible cigarette (Kentucky reference 1R6F), levels were from 0.131 to 168 µg puff−1.
As with high school students, e-cigarette use was much more common than cigarette use. E-cigarettes come in many shapes and sizes and can also be called e-cigs, e-hookahs, vapes, vape pens, personal diffusers or diffuser sticks. But one vape can contain the equivalent of 50 cigarettes of nicotine in the one product. They also contain a complex combination of chemicals including nicotine, nickel, tin, arsenic, chlorine and lead. These substances can be harmful to the body, with different flavourings helping to mask these poisons when they are taken into the body. An electronic cigarette (e-cigarette) is a battery-operated device that heats liquid nicotine, flavoring, and other additives to create an aerosol.
In fact, they are widely used as alimentary and pharmaceutical products [2]. In an analysis of 54 commercially available e-liquids, PG and glycerol were detected in almost all samples at concentrations ranging from 0.4% to 98% (average 57%) and from 0.3% to 95% (average 37%), respectively [35]. According to a 2018 study examining infrequent cannabis smoking in adults, vaping THC produced stronger mind-altering effects than smoking a similar amount of weed. However, nicotine alone is relatively harmless, and switching from daily tobacco smoking to daily e-cigarette use can be an important step for people to stop smoking completely. However, researchers found that only daily e-cigarette use had a statistically significant effect on smoking cessation rates. Research generally accepts that while vaping can harm the lungs and other bodily systems, its impact is much less than tobacco smoking.
Reynolds’ Velo nicotine pouches, while holding just a 1.2% market share, has had a 25.8% year over year sales growth, as well as up 96.7% for the four-week period. Nicotine pouches have a 5.1% market share with sales up 73.4% over the year. Dr Goel underscored the importance of dispelling misinformation and promoting evidence-based approaches to tobacco cessation.
If you experience side effects from vaping, get advice from a stop smoking adviser or specialist vape retailer before you decide to stop using a vape as your quit smoking tool. Almost two-thirds of people who use a vape along with support from a local Stop Smoking Service successfully quit smoking. Vaping is not completely harmless and we only recommend it for adult smokers, to support quitting smoking and staying quit. It made sense – Altria, the bad actor formerly known as Philip Morris, maker of Marlboro cigarettes, owned a 35% stake in JUUL.
In this latter regard, no differences were encountered in the frequency of tumour appearance in rats subjected to long-term (2 years) inhalation of nicotine when compared with control rats [48]. Despite the lack of carcinogenicity evidence, it has been reported that nicotine promotes tumour cell survival by decreasing apoptosis and increasing proliferation [49], indicating that it may work as a "tumour enhancer". In a very recent study, chronic administration of nicotine to mice (1 mg/kg every 3 days for a 60-day period) enhanced brain metastasis by skewing the polarity of M2 microglia, which increases metastatic tumour growth [50]. Assuming that a conventional cigarette contains 0.172–1.702 mg of nicotine [51], the daily nicotine dose administered to these animals corresponds to 40–400 cigarettes for a 70 kg-adult, which is a dose of an extremely heavy smoker.
In the multivariate model (Table 3), results were similar for both girls and boys. S-EC remained higher for those planning for vocational education, and lower with liking school. Further, S-EC was higher with parental smoking, positive attitudes towards e-cigarette use in one’s age group, current smoking, and current snus use. Between-school differences were larger for girls (MOR 1.23) than boys (MOR 1.16). Educational aspirations were measured with ‘Where do you primarily want to go to study after comprehensive school?
But with its plant-derived, additive-free formula and rigorous testing, this device from Tribe Tokes is one of the safest vape products for CBD lovers. Like the previous entries on our list, the BC5000 uses e-liquid that's free of diacetyl and vitamin E acetate. This is one of the safest vapes for quitting smoking while still enjoying the effects of nicotine.
The Mountain state has fewer restrictions than Wyoming and allows the sale of e-cigarettes to people under 21. Researchers from online prescription marketplace Universal Drugstore, analyzed federal and state health data on air quality, youth obesity, sports participation, mental health, test scores, and youth e-cigarette use. Based on a 2023 survey, the team found Wyoming had the highest rate of youth vaping, with nearly one in three teens using e-cigarettes in the last year, despite the state's no-sale laws for residents under 21. Smoking cigarettes increases your risk for health conditions that can affect the whole body.
"Recent studies should make us all more concerned about the impact of traditional and e-cigarettes on the heart as well," Dr. Cireddu says. According to the 2018 NAP report, secondhand vapor contains nicotine, particulate matter, and volatile organic compounds (VOCs) at concentrations that are above recommended levels. The 2018 NAP report found that there’s some evidence that e-cigarette exposure has adverse effects on the respiratory system. Some studies suggest that vaping may have negative effects on the lungs, but more research is needed.
Njoy is one of only three companies that previously received FDA’s OK for vaping products. Like those products, two of the Njoy menthol varieties come as cartridges that plug into a reusable device that heats liquid nicotine, turning it into an inhalable aerosol. E-cigarettes come in many shapes and sizes and can look like USB flash drives, pens, and other everyday items. Larger devices, such as tank systems or "mods," do not look like other tobacco products.
"It’s young people doing something terrible for them that’s supposed to be healthy," he said. There’s a whole genre of throwing-away-my-Juul videos on social media, with people tossing their vape into a river or a snowbank as dramatic music plays. New research led by Roswell Park experts in health behavior and published today in the journal JAMA Network Open suggests that daily e-cigarette use may help some people to quit using combustible cigarettes.
Restrictions on importation, packaging and flavourings will come into effect in early 2024 (TGA 2023). Between 2012 and 2022, most Australian jurisdictions have amended their laws to further restrict the advertising and sale of e‑cigarettes (Department of Health and Aged Care 2023b). Recent reports have linked serious lung injury – and even deaths – to vaping. According to the CDC, cigarette smoking causes nearly 1 out of every five deaths in the United States. It’s possible that we don’t yet know all the physical effects of vaping. Numerous studies have been performed to evaluate the safety/toxicity of e-cigarette use both in vivo and in in vitro cell culture.
Cessation strategies should be based on the best available evidence of efficacy, to go with other tobacco control measures and subject to monitoring and evaluation. Based on the current evidence, it is not recommended that governments permit sale of e-cigarettes as consumer products in pursuit of a cessation objective. While they may help some people stop smoking, vaping products do not have FDA approval as a tool for quitting. E-cigarettes may even keep people from trying proven methods of quitting smoking.
The researchers said that the findings suggest that if tobacco cigarette smokers who use e-cigarettes for a healthier alternative to tobacco won’t benefit by the switch. Cannabis and CBD e-liquids usually contain other chemicals, such as base liquids or flavoring agents. They may cause side effects similar to those of nicotine-free e-cigarettes. Young people who vape nicotine are more likely to start smoking cigarettes in the future. The 2018 NAP report concluded there’s some evidence that nicotine and nicotine-free e-cigarettes can damage oral cells and tissues in people who don’t smoke cigarettes.
What if you're not vaping to get energized or chill out, but because you want to kick your nicotine addiction? It's an aromatherapy inhaler that gives you a burst of pure flavor with no added chemicals. That way, you can quit smoking and vaping nicotine but still satisfy your oral fixation. Like the HELO Air, the HealthVape avoids common harmful additives known to cause respiratory problems in vape users. It's made with USP-grade ingredients, and each pen is assembled in a laboratory-quality clean room to avoid contamination. That's why the CHILL is one of our favorite healthy alternatives to electronic cigarettes.
Please be advised that many of these stories contain graphic and upsetting photos of injuries. Exposure to nicotine can also rewire a young brain to become more easily addicted to other substances, including cocaine and alcohol. Even if a cartridge doesn’t contain nicotine, other harmful chemicals may be present.
Any smoking is harmful and you will only get the full benefits of vaping if you stop smoking completely. Some people manage to make a full switch very quickly, while for others it can take a bit longer. The NFHS Learning Center offers a 3-level national coaching credential that helps you gain knowledge you can use to provide a fun, educational, and a safer environment for your students.
A 2018 study assessed the lung function of 10 people who had never smoked cigarettes immediately after vaping fluids, either with or without nicotine. However, the researchers concluded that, overall, vaping is thought to be less harmful to the heart than smoking cigarettes. However, they found that people who smoked conventional cigarettes and e-cigarettes were more likely to have heart disease. In a recently published randomised trial of 886 subjects who were willing to quit smoking [100], the abstinence rate was found to be twice as high in the e-cigarette group than in the nicotine-replacement group (18.0% vs. 9.9%) after 1 year.
With so many adults kicking the cigarette smoking habit, Altria was looking for ways to sustain its financial stability. Outside of addiction, nicotine can also have other long-term and permanent effects on developing brains. Because vaping has only recently gained popularity, we don’t yet have the data to tell us all its health effects. E-cigarettes are also called e-cigs, vape pens, vapes, mods, and other terms.
"From a public health perspective, we have always been concerned about dual-use of both traditional and e-cig products," said study lead author Marisa Bittoni, an oncology researcher at Ohio State University in Columbus. The U.S. Food and Drug Administration and the European Union are grappling with these issues as they decide how much do electronic cigarettes cost to regulate the products. Unfettered access could leave people vulnerable to unknown health hazards, but there is also the chance that greater restrictions might hurt folks who are trying to forgo conventional—and more dangerous—tobacco products.
Guidance exists on best practices on this concept of accountability — known as end-producer responsibility — but isn’t enforced across the industry by any governing body. Substances from inhaled aerosol particles reaching the e-cigarette user’s lungs, blood, and brain. Minnesota’s middle school and high school students who have asthma who vaped or smoked in the past 30 days reported experiencing more frequent symptoms of asthma than students who did not have asthma who had not vaped or smoked.
WHO regularly monitors and reviews the evidence on ENDS and health and offers guidance to governments. "Yale physicians have been at the forefront in identifying EVALI cases," Dr. Weiss says. She explains that even before CDC guidelines on treating the illness were released, Yale doctors were successfully treating patients with a combination of antibiotics and steroids. Doctors at Yale Medicine also collaborate with researchers in the fields of tobacco and addiction medicine to provide care for patients with EVALI.
To learn more about tobacco and its health effects, see Tobacco and Cancer. There have been reports of e-cigarettes exploding and causing serious injuries. Usually the explosions are caused by faulty batteries or because the batteries were not handled as they should be. Visit the Food and Drug Administration website for safety tips to help avoid an e-cigarette battery explosion. Among people who were hospitalized with severe EVALI, most were younger than 35 and used THC-containing vapes from informal sources (online, family or friends). However, EVALI can happen in anyone using either nicotine or THC-containing vapes.
Despite that, e-cigarettes are more popular among U.S. teens than any other form of tobacco. Electronic cigarettes are battery powered devices that people use to heat liquid into a vapor that can be inhaled. Some studies have shown that vaping by some youth may be linked to later use of regular cigarettes and other tobacco products. Using e-cigarettes may play a part in some kids or teens wanting to use other, more harmful tobacco products. Although the term "vapor" may sound harmless, the aerosol that comes out of an e-cigarette is not water vapor and can be harmful. The aerosol from an e-cigarette can contain nicotine and other substances that are addictive and can cause lung disease, heart disease, and cancer.
A recent study compared the acute effects of e-cigarette vapor (with PG/vegetable glycerine plus tobacco flavouring but without nicotine) generated from stainless‐steel atomizer (SS) heating element or from a nickel‐chromium alloy (NC) [92]. Neither the air‐exposed rats nor those exposed to e-cigarette vapor using SS heating elements developed respiratory distress. In contrast, 80% of the rats exposed to e-cigarette vapor using NC heating units developed clinical acute respiratory distress when a 70‐W power setting was employed. Thus, suggesting that operating units at higher than recommended settings can cause adverse effects. Nevertheless, there is no doubt that the deleterious effects of battery output voltage are not comparable to those exerted by CS extracts [30] (Figs. 1 and 2). "Our findings are consistent with earlier evidence that sufficient nicotine replacement can be helpful for quitting smoking.
Last year, 9.4% of individuals ages 12 years and above reported vaping nicotine within the previous month, up from 8.3% in 2022. "This research has provided greater understanding in the court systems nationwide as to the nature of drug usage, abuse, and overdose cases in which electronic cigarettes were used to deliver an illicit drug," the researchers concluded. THC, synthetic cannabinoids, and dextromethorphan, a drug found in some cough medicines, "were identified in e-liquids purportedly containing only CBD to be consumed for ‘health benefits,’" the researchers said. Results from the National Drug Strategy Household Survey do not provide evidence for or against the use of e-cigarettes as a smoking cessation tool, or as a gateway to tobacco smoking. The age groups most likely to smoke tobacco in 2019 and 2022–2023 were the least likely to use e-cigarettes, and the age groups most likely to use e-cigarettes had low tobacco smoking rates in 2019 and 2022–2023. In 2022–2023, 1 in 5 (19.8%) people aged 14 and over in Australia reported having used e‑cigarettes at least once in their lifetime, with 7% currently using e‑cigarettes at least daily, weekly, monthly, or less often than monthly.
Not to mention the smell that lingers on a person’s body after finishing a cigarette, even if it was outside, far outlasts a vape any day. At Cornell, Jason told me, people Juuled in bathrooms and classrooms, in "every nook and cranny of this campus." In the fall, he’d started a group text, with a few friends, to coördinate pod runs. He called the group Juuluminati, and it has since grown to three hundred and twenty-four members. Jason was Juuling while he talked to me, on the third floor of an academic building. "I know for a fact that there are two or three of my good friends sitting on the first floor of this building eating ham sandwiches and just Juuling away," he said.
Similarly, a 2014 review reported that vaping may trigger gum, mouth, and throat irritation. In particular, a 2015 study examined the effects of flavored e-juices on both human lung cells and lung cells in mice. Here’s what we currently know about the effects of vaping fluids with and without nicotine and vaping cannabis or CBD. In cultured human airway epithelial cells, both e-cigarette aerosol and CS extract induced IL-8/CXCL8 (neutrophil chemoattractant) release [28]. Researchers noted that study participants using both types of cigarettes had a higher nicotine dependence in relation to e-cigarettes. Find more resources on tobacco, e-cigarettes, and vaping on the SAMHSA Store.
However, more research is needed to fully understand emissions from e-cigarettes and their impact on human health. These aerosols can contain potentially harmful substances — including nicotine, formaldehyde and metals — some of which cause cancer and other harmful health effects. Some e-cigarette brands and other nicotine products state they contain synthetic nicotine rather than nicotine made from or derived from tobacco.
We constantly monitor the latest topics and trends in commercial tobacco and substance use. These statements have not been evaluated by the Food and Drug Administration or other medicinal products evaluation agency. Melo Labs Inc. expressly makes no health or medical claims for this product. This product is not intended to diagnose, treat, cure or prevent any disease. As you can probably guess from the name, these lack the sophisticated internal controllers that help safeguard regulated mods.
I never kidded myself into thinking that this habit was harmless, but my conviction that they were less harmful than cigarettes made the endeavor seem worthwhile, even praiseworthy. A May analysis found that vaping increases the risk of asthma by 200 percent and previous studies have linked the products to lung cancer, respiratory conditions, lung disease and organ damage. It’s still not clear how the toxins found in vaping can affect the health of non-vapers, especially long-term. The limited research available so far has largely focused on immediate health effects.
Research on health effects of secondhand exposure to e-cigarettes is still emerging. The quantity of these carcinogens is less that what is found in conventional cigarettes. While some young people may be able to quit e-cigarette use on their own, others, particularly daily users, are likely to find this to be very difficult.
E-cigarettes may be disposable, be refillable with e-liquid, or have a prefilled cartridge or pod for reuse. Some e-cigarettes can also be used to deliver cannabis and other drugs. Additionally, high quality epidemiology studies consistently demonstrate that e-cigarettes use increases conventional cigarette uptake, particularly among non-smoking youth, by nearly 3 times. Evidence reveals that these products are harmful to health and are not safe. However, it is too early to provide a clear answer on the long-term impact of using them or being exposed to them.
This is why it took as long as it did for the negative health effects of cigarettes to be widely recognized. There is abundant evidence that e-cigarettes can help some individuals to quit smoking, so they should be more widely recommended as smoking cessation aids. Vaping and smoking share similar negative effects on the body, such as damage to the lungs and increased cancer risk.
The review authors conclude that further research could help untangle how vapers’ bodies develop disease. These types of studies, they say, promise to identify early indicators of—and ultimately treatments for—vaping-related disease. While some tout e-cigarettes as a solution to quitting conventional smoking, the truth about relative risks is complicated, says Crotty Alexander, who is a researcher in addition to providing patient care and teaching.
However, to date, no e-cigarette product has been approved by the FDA for quitting smoking. Although e-cigarettes have been sold in the U.S. for nearly 20 years, use patterns have shifted dramatically. As newer iterations brought higher levels of nicotine in an increasing array of flavors and product designs, youth use skyrocketed.
The FDA does not currently require testing of all the substances in e-cigarettes to ensure they are safe. It's also hard to know exactly what chemicals are in an e-cigarette because most products do not list all of the harmful or potentially harmful substances contained in them. E-cigarettes do not contain tobacco, but many of them contain nicotine, which comes from tobacco. Because of this, the Food and Drug Administration (FDA) classifies them as "tobacco products." For adults who smoke, switching completely from cigarettes to e-cigarettes may reduce exposure to many harmful chemicals present in cigarettes. However, it is important that they switch completely from cigarettes to e-cigarettes to get the full health benefit.
Read this paper by NCI’s Dr. Ned Sharpless and CRUK’s Dr. Iain Foulkes. Drug forums and e-liquid vendors were monitored by the researchers for e-liquids that "purportedly contained alternative pharmaceuticals." A clue in searching for e-liquids that contain illicit drugs is cost, the scientists said. Most nicotine e-liquids range from $5 to $10, while alternative drug e-liquids go for five to twenty times as much. In comparison to the general population, support for these measures varied greatly among people who currently used e‑cigarettes. The most supported measure was prohibiting the sale of e‑cigarettes to people under 18 years of age (67%), while the least supported measure was banning all additives in e‑cigarettes, to make them less attractive to young people (33%) (Figure 7).
"More research about the health effects of alternative tobacco products is critically needed to put science behind the regulation of the tobacco industry." As the debate blazes, deep-pocketed big tobacco investors are buying up e-cig companies, injecting millions of dollars into the market and banking on a bright future for the devices. More than 100 e-cigarette companies are now jockeying for the business of smokers and nonsmokers alike.
The decision lends new credibility to vaping companies’ longstanding claim that their products can help blunt the toll of smoking, which is blamed for 480,000 U.S. deaths annually due to cancer, lung disease and heart disease. E-cigarettes have been sold in the U.S. since 2007 but in recent years their potential benefits for smokers have been overshadowed by their use by adolescents and teens. Vaping nicotine has not been thoroughly evaluated in scientific studies. For now, not enough data exists on the safety of e-cigarettes, how the health effects compare to traditional cigarettes, and if they are helpful for people trying to quit smoking.
E-cigarettes hit the market in the early 2000s and have since soared in popularity, especially among teens and young adults. Once believed to be a "safer" way to smoke, vaping is now considered a public health crisis by many health groups. Stay up to date on the adverse health effects of smoking and vaping tobacco while gaining important guidance on how to counsel patients on the risks and quitting.
The vapor produced by e-cigarettes usually contains nicotine, heavy metals, volatile organic compounds, carcinogens (cancer causing chemicals), and in some cases, flavoring linked to serious lung disease. These and other harmful substances present in e-cigarette vapor can negatively affect the respiratory health of users. The monitoring of other tobacco product sales in conjunction with the monitoring of e-cigarette sales is necessary to provide a comprehensive picture of the overall U.S. tobacco product market. These cigarette data briefs provide estimates of cigarette sales in the U.S. market overall and select U.S. states. In January 2020, the US Food and Drug Administration (FDA) ordered the removal of flavored cartridge-based e-cigarettes from the market. This rule does not prohibit the sale of tobacco and menthol flavored cartridge-based e-cigarettes, flavored disposable e-cigarettes, or refillable flavored e-cigarette products.
Researchers noted that they were unable to assess any association between e-cigarette nicotine formulation and cigarette cessation outcomes. Another potential limitation was that the study only included adult participants who reported smoking within the previous 30 days, limiting information about younger smokers and former smokers. In that same vein, 5.9 million people began vaping, bringing the total use of tobacco products among those 12 and older to 64.4 million.
Most of the harmful chemicals in tobacco smoke, including tar and carbon monoxide, are not contained in vape aerosol. Switching to vaping significantly reduces your exposure to toxins that can cause cancer, lung disease, and diseases of the heart and circulation like heart attack and stroke. These diseases are not caused by nicotine, which is relatively harmless to health.
But if you find using an e-cigarette helpful for quitting and staying smoke-free, it's much safer for you and your baby than continuing to smoke. It's also important to choose the right strength of nicotine in your e-liquid, which will depend on how much you smoke. You can get advice on models and e-liquids from a specialist vape shop. You will not get the full benefit from vaping unless you stop smoking cigarettes completely. E-cigarettes do not burn tobacco and do not produce tar or carbon monoxide, two of the most damaging elements in tobacco smoke. At Yale Medicine, most pediatricians have started asking middle- and high school-age patients about their exposure to vaping, in large part to identify patients who might be at higher risk for developing related problems.
U.S. Surgeon General Vivek Murthy, MD, MBA, also highlighted that vaping "could be a major form of harm reduction for adults," although "not zero risk," but expressed strong concern over youth vaping. With the increasing use of e‑cigarettes, there has been greater support for policies aimed at controlling the prevalence of e‑cigarettes. You may also want to make an appointment with a doctor if you think vaping is behind any new symptoms, such as coughing, difficulty breathing, or increased heart rate.
A growing body of research indicates that truth campaigns to prevent young people from vaping are poised to move in the same direction as the organization’s successful smoking prevention campaigns. See " Quitting Tobacco " for more information on quitting tobacco products. Let's say you love the feel and flavor you get from puffing on a vape — but you can't quite bring yourself to trust that it's safe. It uses a puff of pressurized, flavored air to simulate the "throat hit" of a vape, with no heating element whatsoever.
"From a public health perspective, we have always been concerned about dual-use of both traditional and e-cig products," said study lead author Marisa Bittoni, an oncology researcher at Ohio State University in Columbus. A second brand of e-cigarettes — marketed as Nixotine, Nixodine, Nixamide and Nic-Safe – contained a nicotine analog called nicotinamide, also at levels lower than the labels indicated, and combined with undisclosed amounts of 6-methyl nicotine. He emphasised that e-cigarettes are not an effective tobacco cessation tool, as they are not approved by food regulatory bodies. Additionally, they often lead to dual usage with people continuing to use traditional cigarettes along e-cigarettes.
To view or search for local policies, search Tobacco Use Prevention and Control’s Policy Database. This video is about e-cigarettes and the emerging threat faced by rising youth use rates from Tobacco Control Network (TCN), Luci Longoria, and Dr. Brian King, FDA's Center for Tobacco Products Director. In addition, young adults were significantly more likely to use both cigarettes and e-cigarettes than adults 45 and older. Among young adults, men were slightly more likely to use e-cigarettes than women, while those who are white were more likely to use e-cigarettes than young Black adults and significantly more likely than young Asian or Hispanic/Latino adults. Some are small and look like USB drives or pens, while others are much larger.
E-cigarettes have been allowed to stay on the market for years without undergoing a full review of their public health impact, sparking a sustained and ongoing crisis of youth use. As of November 2023, the FDA has not completed reviewing all applications from e-cigarette makers to market their products, leaving many e-cigarettes on the market while waiting for a decision. To date, the FDA has denied permission to market flavored and menthol e-cigarette products such as Vuse Solo, Vuse Vibe, Vuse Ciro, and Vuse Alto. The FDA has denied permission to market many non-tobacco and non-menthol flavored e-cigarette products, however, many of those denials are currently under judicial or supervisory review. In recent years, the FDA has increased enforcement efforts around e-cigarette manufacturers and retailers for continuing to sell youth-appealing e-cigarettes. These actions include issuing warning letters, fines, injunctions, and joint operations with other federal officials to seize imports of unauthorized e-cigarette products.
Jabba and colleagues, including co-senior author Sven Eric Jordt, Ph.D., analyzed an e-cigarette product sold under the brand name Spree Bar, which comes in at least nine flavors and is listed as containing 5 percent 6-methyl nicotine. Study results showed the actual amount of the chemical was about 88% less than labeled. The e-cigarettes also included an artificial sweetener that is up to 13,000 times sweeter than table sugar, and an artificial coolant that mimics menthol’s effects. Talk to your patients, including youth and young adults, about the dangers of tobacco use.
They found that the amounts of nicotine in the blood were similar between the two groups after 10 minutes of smoking at a constant rate. The flavoring liquid for electronic cigarettes, or e-cigarettes, may increase the risk of cardiovascular disease when inhaled, according to a study led by researchers at the School of Medicine. My reading of the evidence is that smokers who switch to vaping remove almost all the risks smoking poses to their health. Smokers differ in their needs and I would advise them not to give up on e-cigarettes if they do not like the first one they try. It may take some experimentation with different products and e-liquids to find the right one. An expert independent evidence review published today by Public Health England (PHE) concludes that e-cigarettes are significantly less harmful to health than tobacco and have the potential to help smokers quit smoking.
WASHINGTON (AP) — The Food and Drug Administration on Friday authorized the first menthol-flavored electronic cigarettes for adult smokers, acknowledging that vaping flavors can reduce the harms of traditional tobacco smoking. Some people believe e-cigarettes may help lower nicotine cravings in those who are trying to quit smoking. However, e-cigarettes are not an FDA-approved quit aid, and there is no conclusive scientific evidence on the effectiveness of vaping for long-term smoking cessation. It should be noted that there are seven FDA-approved quit aids that are proven safe and can be effective when used as directed.
This guide supports health care providers, systems, and communities seeking to prevent vaping. These resources and others are on the AAFP’s Tobacco and Nicotine Prevention and Control webpage. Familydoctor.org, the Academy’s patient-facing web resource, has additional materials on tobacco addiction, the harms of vaping and several related topics. Young adults with family incomes of less than 200% of the federal poverty level also were more likely to use e-cigarettes than those with greater family income.
Nicotine pouches, led by top-selling Zyn by Swedish Match, have become increasingly popular among adult tobacco consumers, particularly those trying to lower or end their traditional or electronic cigarette consumption. Chalmers said some students are realizing the dangers of vaping after seeing their peers struggle with nicotine addictions. She believes that adding the CATCH My Breath education only solidifies it for them.
JUULs very closely resemble a USB drive, can be charged in a USB port, and emit little to no detectable vapor or odor. Due to their easily concealable design, they are of particular concern with regard to youth use. DOH urges all people to be very careful when it comes to your health. Even if a substance has not yet been proven to be dangerous, there is no guarantee it is safe. You don’t actually light up an e-cig; they’re powered by a rechargeable lithium battery. Instead of burning tobacco, the "e-liquid" is vaporized in a heating chamber when the user inhales.
Although e-cigarettes do not give off smoke like tobacco cigarettes, they do expose people to secondhand aerosol or "vapor" that may contain harmful substances. Scientists are still learning about the health effects of being exposed to secondhand e-cigarette aerosol. The FDA monitors the national usage rates for all tobacco products, including an annual youth survey, and has seen a drastic increase in youth use of e-cigarette products in recent years.
This was especially the case for people aged 14 to 17 (74%) and 18 to 24 (68%). The 2022–2023 NDSHS was conducted before these restrictions were put into place. At the time, in most jurisdictions, it was legal for adults to purchase e‑cigarettes that did not contain nicotine from a broad range of retail settings, including those used to purchase tobacco products. Prior to 2024, adults could also import nicotine e‑cigarettes with a prescription via the personal importation scheme. The first study found that vaping can worsen several heart disease risk factors at levels equal to tobacco cigarettes, while the second found that e-cigarettes decrease blood flow in the heart even more than tobacco cigarettes. However, e-cigarettes still pose health risks, even without nicotine.
Electronic nicotine delivery systems (ENDS), or e-cigarettes, are battery-powered devices used to vape a flavoured solution containing varying concentrations of nicotine, an addictive chemical found in tobacco products. Some people take up vaping – or inhaling vapor from electronic cigarettes – to avoid the health hazards of smoking cigarettes made with tobacco. But when it comes to your heart health, a pair of recent studies show e-cigarettes are just as dangerous – and possibly are even more dangerous – than traditional cigarettes. The long-term effects of smoking cigarettes are well-documented and include an increased risk of stroke, heart disease, and lung cancer.
The researchers — from Truth Initiative and Brown University — found that after seven months had gone by, about 38% of participants in the This is Quitting program reported not vaping in the previous 30 days, compared with 28% in the assessment-only group. E-cigarettes are the most commonly used tobacco product among adolescents. (CNN) — For teens who want to stop vaping nicotine, an interactive text message program was found to be effective at helping them quit.
A great example of this is the Riot Connex Pod Kit which uses magnets to attach replaceable cartridge-like flaovured pods to the batter. You can also get refillable pod mod kits, which use pods with built-in coils but require filling with your e-liquid. These can also appeal to beginners who like to experiment with different flavours but wish to keep the set-up as minimal as possible.
A 2019 randomized control study also found that daily e-cigarette use leads to an almost doubled rate of smoking abstinence than other nicotine-replacement products after one year. Vaping involves breathing in an aerosol that contains several chemicals, including nicotine and flavoring, through an e-cigarette or vape. SAMHSA's mission is to lead public health and service delivery efforts that promote mental health, prevent substance misuse, and provide treatments and supports to foster recovery while ensuring equitable access and better outcomes.
Protect the environment and ensure safe disposal of e-cigarette products by discarding them properly. Vapes, e-cigarettes, refills and cartridges should be treated like hazardous waste and taken to your local hazardous waste facility or hazardous waste collection event for disposal. Always remove the device's battery before dropping off to prevent unintentional burns, fires, and explosions. Store these products safely to protect yourself and any children in and around the home from accidental exposure.
As one addiction expert has said, "The modern cigarette does to nicotine what crack does to cocaine." Pax Labs discovered that by adding benzoic acid to nicotine salts, which occur naturally in tobacco, they could mimic a cigarette’s rapid nicotine delivery. Both British American Tobacco Plc and Altria are prodding the FDA for heightened enforcement on "illicit" synthetic nicotine electronic cigarettes in the U.S. vaping market. The companies have estimated those synthetic products represent about half of the overall domestic e-cigarette market.
Yet another analysis linked e-cig use with greater odds of trying tobacco. They come in kid-friendly flavors, including chocolate, bubble gum and gummy bear. Sold online and in the mall, e-cigarettes are also easy for minors to acquire.
E-cigarettes contain many of the same cancer-causing chemicals that regular cigarettes do. Nicotine is highly addictive, and most e-cigarettes include it as a main ingredient. The AMA promotes the art and science of medicine and the betterment of public health. The rise of e-cigarettes and vaping has raised concerns that another generation may become dependent on nicotine. The AMA has been a leading force to eliminate public smoking and warn people about the dangers of smoking, including secondhand smoke, since the 1960s.
This includes the biennial WHO Report on the Global Tobacco Epidemic, which tracks the status of the tobacco epidemic and interventions to combat it and other relevant resources. Because of the lack of long-term data and the fact that patients have died from EVALI, the prognosis for those affected remains uncertain. Researchers are working hard to learn as much as possible about the illness, its causes, and the odds for making a full recovery. "We recommend that patients see a pulmonologist within one to two weeks after being discharged to undergo testing of lung function and pulse oximetry [level of oxygen in the blood]," she says.
These devices are permitted on planes, but the FAA recently notified airlines that the lithium batteries used in these devices are fire hazards and should not be packed in checked baggage. This page may contain information that is outdated and may not reflect current policy or programs. But, CDC stats on teen smoking show that while use of e-cigs went up to 24% in 2015, cigarette smoking dropped to an historic low -- to just under 11%.
Susceptibility to smoking or non-combustible nicotine use is also influenced by national tobacco control policies. In Europe, Finland has been among the countries with most advanced tobacco control regulations [31]. Still, there is a large difference in smoking and snus use between students in academically and non-academically oriented education [7]. For snus, Finland follows the EU-wide sales ban but cross-border traveller imports from Sweden are permitted and an illicit market exists [32]. For e-cigarettes, comprehensive regulations were introduced in 2016 including retail sale licensing and ban for distance sales, display and advertising at point-of-sale, other flavours than tobacco and use of e-cigarettes in smoke-free places [33].
See your general practitioner, youth health service, or other health services to help quit vaping. All e-cigarettes & e-liquids (with and without nicotine) and e-cigarette accessories can now only be supplied by a pharmacist, medical practitioner, or nurse practitioner. If at any point you feel at risk of going back to smoking, increase your nicotine strength or vaping frequency until the feelings go away. Only reduce your vaping frequency or nicotine strength when you feel you will not go back to smoking and do not have to puff more to compensate. Your local Stop Smoking Service can give more advice on quitting vaping if you need it. So far, no vaping products have been licensed as stop smoking medicines in the UK, so they are not available on prescription from the NHS or from a GP.
If you think ENDS or other tobacco products are being sold to people who are underage, or you see another potential violation of the FD&C Act or FDA’s tobacco regulations, please report the potential tobacco product violation. Learn about public education efforts and resources that have been created to reach youth who are at higher risk of or more vulnerable to cigarette use and nicotine addiction. FDA created a toolkit, Resources for Professionals About Vaping & E-Cigarettes, for adults and professionals who work with youth. This FREE resource provides fast facts about youth vaping and e-cigarettes. Vaping exposes you to some of the same chemicals that cigarette smoking does. Vaping while pregnant can cause low birth weight, lung damage and brain damage in the developing fetus.
In December 2019, the federal government raised the legal minimum age of sale of tobacco products from 18 to 21 years, and in January 2020, the FDA issued a policy on the sale of flavored vaping cartridges. The e-liquid in most e-cigarettes contains nicotine, the same addictive drug that is in regular cigarettes, cigars, hookah, and other tobacco products. However, nicotine levels are not the same in all types of e-cigarettes, and sometimes product labels do not list the true nicotine content. Products marketed for therapeutic purposes (for example, marketed as a product to help people quit smoking) are regulated by FDA’s Center for Drug Evaluation and Research (CDER).
This data brief demonstrates that teens whose environments put them at risk for use of e-cigarettes are more likely to try them. The study, published on May 23, 2022, in Tobacco Control, is the first to look at the health care costs of e-cigarette use among adults 18 and older. The second most supported measure, strengthening restrictions on the advertising and promotion of e‑cigarettes, was supported by 82% of people. In 2019, only 67% of people in Australia supported strengthening these restrictions. The proportion of people neither smoking regular cigarettes nor using e‑cigarettes has remained stable (Figure 3).
To inform schools of intervention needs, the susceptibility measure could be utilized in school surveys and relevant student services as a screening tool. Simultaneously, it would support the evaluation of existing policies and programmes and monitoring of potential counter-effects. For example, an earlier study observed that school-based programmes and policies had resulted in higher susceptibility risk at some intervention schools [37]. Effective and non-counter-productive interventions are especially important for products where susceptibility is at a high level, like e-cigarettes. Interventions to reduce susceptibility therefore need to address product regulation and marketing as well as social influence, norms, and perceptions.
The harms of e-cigarette use in young people include not only the deleterious effects of nicotine, but also exposure of the lungs and airways to potentially toxic solvents and flavoring chemicals. The rapidly rising rates of use in young people and the high rates of daily use strongly suggest that many are addicted to nicotine and will have difficulty in stopping use of all tobacco products. One study found that people who use only e-cigarettes increase their risk of developing lung disease by about 30% compared with nonusers. Electronic cigarettes (e-cigarettes) and other vapor products are devices used to heat and aerosolize (turn into particles) highly addictive nicotine or other substances that a person can inhale into their lungs.
Many e-cigarettes sold in the U.S. contain far more nicotine than e-cigarettes sold elsewhere, which increases the risk of addiction and harm to the developing brains of youth and young adults. Marketing tactics targeting young people have contributed to the rapid increase in use. The long-term risks of exclusive use of e-cigarettes are not fully known but evidence is accumulating that e-cigarette use has negative effects on the cardiovascular system and lungs.
Probably the worst thing a parent could do for their child would be to buy an e-cigarette under the misconception that this might prevent them from smoking regular cigarettes, Krishnan-Sarin says. She encourages parents to talk openly and freely about vaping—with the caveat that they provide accurate information. "I think the problem is that parents lose credibility if they say something to try and convince their child, who then finds out that it isn’t true," she says. Vape pen and e-cigarette explosions from overheated, defective and/or modified device batteries have occurred, causing injury and serious health problems to users. Learn more about how much nicotine is in a 21st century electronic cigarette to avoid vape battery explosions from the FDA or download the FDA's tips for avoiding battery explosions.
Our experts provide care to both kids and adults with complex lung issues from all over Southern California and beyond. Teens today have access to more potentially misleading information than at any other time in history. They’re also bombarded by more sources of advertising than ever before.
Yet there has been hardly any definitive legislation regarding the sale and consumption of e-cigs in the U.S. Meanwhile Canada has made it illegal to sell e-cigarettes preloaded with nicotine in stores, but the regulation is not well enforced, and customers can buy vials of nicotine online. At press time, the European Parliament had approved a ban on e-cigarette advertising starting in mid-2016, and the ban seemed likely to get approval from the E.U.'s member states. Vaping products in the state also have to include health warnings per California state laws regarding the use of nicotine and other chemicals.
We also have leading brands of e-liquid from some of the biggest manufacturers in the UK. So, if you feel like trying more than one, make sure you check out our multi-buy deals. Unlike cigarette butts, e-cigarette waste won’t biodegrade even under severe conditions. E-cigarettes left on the street eventually break down into microplastics and chemicals that flow into the storm drains to pollute our waterways and wildlife.
The results showed that people who used e-cigarettes at any point were 19% more likely to develop heart failure compared with people who had never used e-cigarettes. In calculating this difference, researchers accounted for a variety of demographic and socioeconomic factors, other heart disease risk factors and participants’ past and current use of other substances, including alcohol and tobacco products. The researchers also found no evidence that participants’ age, sex or smoking status modified the relationship between e-cigarettes and heart failure. While teen smoking has fallen by 80% over the past 20 years, a new generation is now at risk of becoming addicted to nicotine — and possibly at risk for other serious health problems — through e-cigarettes. More than 2.5 million U.S. middle and high school students are now using e-cigarettes, with nearly 85% of them using flavored products.
Vapes are often viewed and marketed as a safe alternative to smoking. Secondhand smoke can cause heart disease, stroke, and lung cancer in people who don’t smoke. They compared this information against vape and cigarette sales data over four-week intervals from January 2018 through March 2023, a period during which flavor restrictions went from affecting 1.3% of the U.S. population to affecting 38%.
Electronic smoking devices (or ESDs), which are often called e-cigarettes, heat and vaporize a solution that typically contains nicotine. The devices are metal or plastic tubes that contain a cartridge filled with a liquid that is vaporized by a battery-powered heating element. The aerosol is inhaled by the user when they draw on the device, as they would a regular tobacco cigarette, and the user exhales the aerosol into the environment. Electronic cigarettes (E-Cigarettes) are battery-powered devices that function by heating a liquid into an aerosol that is inhaled by the user.
Prior to that, it was the Wild West, where a variety of companies started making and selling products with their own personal spin. Per the survey, 10.0% of students (2.80 million) reported current use of any tobacco product; 12.6% (1.97 million) high school students and 6.6% (800,000) middle school students reported current use of any tobacco product. Importantly, the researchers found strong evidence of the program's effectiveness among key subgroups defined by race, ethnicity, gender, higher levels of nicotine dependence, smoking and other substance use, mental health challenges, and household dysfunction. "For many years, healthcare providers, teachers, and parents have been asking how to help teens quit vaping," said Dr. Amanda Graham, Chief Health Officer at Truth Initiative and principal investigator of the study.
In December 2019, the legislation was included in the federal year-end legislative package and passed by both houses of Congress. President Trump signed the bill into law on December 20, 2019 and it immediately took effect. This legislation, which applies to all states, raises the minimum age of sale for all tobacco products— including e-cigarette—to 21. We provide the facts about smoking, vaping, nicotine, and the tobacco industry. We engage individuals and groups to make change in their communities, innovate ways to end nicotine addiction, and join forces with collaborators committed to preventing youth and young adult nicotine addiction and empowering quitting for all. That's hard to say — the potential health risks of vaping CBD are still hotly debated.
We also left out propylene glycol, a petroleum byproduct often used as a flavor enhancer. This stuff isn't considered toxic, but it adds a harsh edge to your inhale, and we wanted to stick to strictly plant-based components. I understand that for a few moments during your meal you may have a sniff of my vape that you don’t care for, but I’m sure that it isn’t as horrible as you make it sound in your rant. Life is full of mild unpleasantries that we all must deal with on a daily basis, but we can choose to deal with them or let them torment us.