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More research needs to be done to understand the long-term health effects of secondhand exposure to e-cigarette vapor. Secondhand exposure to e-cigarette vapor is said to be less toxic than secondhand exposure to cigarette smoke. However, secondhand vapor is still a form of air pollution that probably poses health risks. N.L.B. serves as a consultant to pharmaceutical companies that market or are developing smoking cessation medications, and has provided expert testimony in litigation against tobacco companies. N.A.R. consults with and has received a research grant from Achieve Life Sciences for development of a smoking cessation medication, and receives royalties from UpToDate (an online medical textbook) as author of sections on e-cigarettes.

Kasza's group also pointed to dual use of cigarettes and e-cigarettes, which has increased over time and usually involves smoking cigarettes more frequently than using e-cigarettes. "Individuals who dual use remain exposed to cigarette smoking toxicants, making complete rather than partial substitution of cigarettes with e-cigarettes important for risk reduction," they wrote. "Indeed, healthcare clinicians are now encouraged to discuss e-cigarettes as a cessation tool with patients who smoke cigarettes and have already tried FDA-approved cessation medications." A comparison of the serum levels of nicotine from e-cigarette or conventional cigarette consumption has been recently reported [39].

During the Vietnam War, cigarettes were included with C-ration meals. In 1975, the U.S. government stopped putting cigarettes in military rations. During the second half of the 20th century, the adverse health effects of tobacco smoking started to become widely known and printed health warnings became common on cigarette packets. This health advisory is being issued by the State Health Officer to inform the public about the alarming statistics on current e-cigarette use among youth in Wisconsin. In Wisconsin, current e-cigarette use among Wisconsin high school students increased 154% between 2014 and 2018.

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.

Almost 9 in 10 people (86%) supported prohibiting the sale of e‑cigarettes to people under 18 years of age, a substantial increase from 2019 (79%). Social and economic factors shape people’s behaviours of vaping or smoking. Generally, people living in the most disadvantaged socioeconomic areas were the most likely to currently smoke regular cigarettes but not use e‑cigarettes (13.2%). In contrast, people living in the most advantaged socioeconomic areas were the most likely to use e‑cigarettes but not smoke regular cigarettes (6.6%) (Figure 4). Young people aged 18 to 24 were the most likely to have used e‑cigarettes in 2022–‍2023, with almost 1 in 2 (49%) having used them at least once in their lifetime, and over 1 in 5 (21%) currently using e‑cigarettes in 2022–‍2023. More information on young people’s use of vapes and e-cigarettes can be found online.

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.

This solution typically contains propylene glycol or glycerol, nicotine, and flavouring agents. Indeed, the "vapor" may have a lot more than those five ingredients listed above. Some studies have found it to contain lead, nickel, tin, and silver from the machinery inside the devices along with formaldehyde, manganese, tolulene, and other ingredients linked to cancer, central nervous system problems, and other possible health issues. A 2018 study of e-cig smokers’ urine found at least five of the same carcinogens found in cigarettes.

According to the manufacturer, a single JUUL pod contains as much nicotine as a pack of 20 regular cigarettes. Although JUUL is currently the top-selling e-cigarette in the U.S., other e-cigarettes are becoming available that look like USB flash drives. Because of their shape, school teachers, administrators, and parents may not notice students using these devices in school, including in classrooms and bathrooms. Adults who use tobacco and are trying to quit should use proven quit tools, like group or phone counseling, paired with medications or nicotine replacement therapy patches, gum or lozenges. The agency says the sweet flavored e-liquids pose a "serious, well-documented risk" of enticing more young people to pick up a nicotine habit. In 2020, nearly 20% of high school students and almost 5% of middle-school students used e-cigarettes, and almost all of those kids used flavored products, the agency said in court documents.

Where e-cigarette flavor restrictions had been in effect for at least a year, sales of cigarette brands favored by adults went up by 10%, while sales of cigarette brands that disproportionately attract underage smokers saw a 20% bump. During the study period, hundreds of localities and seven states restricted or prohibited flavored e-cigarette sales. While these policies did reduce per-capita vape sales, they also substantially boosted cigarette sales. To date, there is&nbsp