Companies should not be able to claim that e-cigarettes are a cessation aid unless they are approved by the FDA for that purpose...There is not yet enough evidence for clinicians to counsel their patients who are using combustible tobacco products to use e-cigarettes as a primary cessation aid. The association will continue to monitor the evidence concerning e-cigarettes as cessation devices to determine whether they might be integrated into comprehensive cessation strategies. For patients with existing cardiovascular disease and stroke, or at risk of a cardiovascular disease event, intensive cessation counseling should be offered as soon as possible." [27] In one of the few studies identified, a 2015 survey of 316 pregnant women in a Maryland clinic found that the majority had heard of e-cigarettes, 13% had used them, and 0.6% were current daily users. [85] These findings are of concern because the dose of nicotine delivered by e-cigarettes can be as high or higher than that delivered by traditional cigarettes. [85] McNeill, A; Brose, LS; Calder, R; Bauld, L; Robson, D (February 2018). "Evidence review of e-cigarettes and heated tobacco products 2018" (PDF). Public Health England. UK. pp.1–243. In 1927, Joseph Robinson applied for a patent for an electronic vaporizer to be used with medicinal compounds. [243] The patent was approved in 1930 but the device was never marketed. [244] In 1930, the United States Patent and Trademark Office reported a patent stating, "for holding medicinal compounds which are electrically or otherwise heated to produce vapors for inhalation." [245] In 1934 and 1936, further similar patents were applied for. [245]

In October 2021, researchers at Johns Hopkins University reported over 2,000 unknown chemicals in the vape clouds that they tested from Vuse, Juul, Blu and Mi-Salt vape devices. [183] a b c Weaver, Michael; Breland, Alison; Spindle, Tory; Eissenberg, Thomas (2014). "Electronic Cigarettes". Journal of Addiction Medicine. 8 (4): 234–240. doi: 10.1097/ADM.0000000000000043. ISSN 1932-0620. PMC 4123220. PMID 25089953. Also known as an e-cig, vaporizer, vape pen, hookah pen, e-pipe, or, formally, electronic nicotine delivery system ( ENDS). [1] Harm reduction refers to any reduction in harm from a prior level. [117] Harm minimization strives to reduce harms to the lowest achievable level. [117] When a person does not want to quit nicotine, harm minimization means striving to eliminate tobacco exposure by replacing it with vaping. [117] E-cigarettes can reduce smokers' exposure to carcinogens and other toxic chemicals found in tobacco. [4] Regulation of e-cigarettes varies across countries and states, ranging from no regulation to banning them entirely. [308] For instance, e-cigarettes containing nicotine are illegal in Japan, forcing the market to use heated tobacco products for cigarette alternatives. [309] Others have introduced strict restrictions and some have licensed devices as medicines such as in the UK. [159] However, as of February 2018 [update], there is no e-cigarette device that has been given a medical license that is commercially sold or available by prescription in the UK. [310] As of 2015 [update], around two thirds of major nations have regulated e-cigarettes in some way. [311]

What is an Electronic Cigar?

David, Grégory; Parmentier, Evelyne A.; Taurino, Irene; Signorell, Ruth (December 2020). "Tracing the composition of single e-cigarette aerosol droplets in situ by laser-trapping and Raman scattering". Scientific Reports. 10 (1): 7929. Bibcode: 2020NatSR..10.7929D. doi: 10.1038/s41598-020-64886-5. PMC 7220912. PMID 32404884. Marques, Patrice; Piqueras, Laura; Sanz, Maria-Jesus (December 2021). "An updated overview of e-cigarette impact on human health". Respiratory Research. 22 (1): 151. doi: 10.1186/s12931-021-01737-5. PMC 8129966. PMID 34006276. S2CID 234753956. the safety of e-cigarette consumption and its potential as a smoking cessation method remain controversial due to limited evidence...the potential long-term effects of e-cigarette consumption have been scarcely investigated. E-cigarettes have evolved over time, and the different designs are classified in generations. First-generation e-cigarettes tend to look like traditional cigarettes and are called "cigalikes". [26] [27] Second-generation devices are larger and look less like traditional cigarettes. [28] Third-generation devices include mechanical mods and variable voltage devices. [26] The fourth-generation includes sub-ohm tanks (meaning they have electrical resistance of less than 1 ohm) and temperature control. [29] There are also pod mod devices that use protonated nicotine, rather than free-base nicotine found in earlier generations, [30] providing higher nicotine yields. [31] [32] E-liquid Dautzenberg, B.; Adler, M.; Garelik, D.; Loubrieu, J.F.; Mathern, G.; Peiffer, G.; Perriot, J.; Rouquet, R.M.; Schmitt, A.; Underner, M.; Urban, T. (2017). "Practical guidelines on e-cigarettes for practitioners and others health professionals. A French 2016 expert's statement". Revue des Maladies Respiratoires. 34 (2): 155–164. doi: 10.1016/j.rmr.2017.0

a b c d e f g h Bhatnagar, Aruni; Whitsel, Laurie P.; Ribisl, Kurt M.; Bullen, Chris; Chaloupka, Frank; Piano, Mariann R.; Robertson, Rose Marie; McAuley, Timothy; Goff, David; Benowitz, Neal (14 October 2014) [Published online 24 August 2014]. "Electronic Cigarettes: A Policy Statement From the American Heart Association". Circulation. 130 (16): 1418–1436. doi: 10.1161/CIR.0000000000000107. PMC 7643636. PMID 25156991. E-cigarette vapor potentially contains harmful chemicals not found in tobacco smoke. [90] The majority of toxic chemicals found in cigarette smoke are absent in e-cigarette vapor. [187] E-cigarette vapor contains lower concentrations of potentially toxic chemicals than with cigarette smoke. [188] Those which are present, are mostly below 1% of the corresponding levels permissible by workplace safety standards. [96] But workplace safety standards do not recognize exposure to certain vulnerable groups such as people with medical ailments, children, and infants who may be exposed to second-hand vapor. [83] Worldwide, increasing numbers of young people are vaping. [76] [77] With access to e-cigarettes, young people's tobacco use has dropped by about 75%. [78] [79] [80] [81] a b Schraufnagel, Dean E.; Blasi, Francesco; Drummond, M. Bradley; Lam, David C. L.; Latif, Ehsan; Rosen, Mark J.; Sansores, Raul; Van Zyl-Smit, Richard (2014). "Electronic Cigarettes. A Position Statement of the Forum of International Respiratory Societies". American Journal of Respiratory and Critical Care Medicine. 190 (6): 611–618. doi: 10.1164/rccm.201407-1198PP. ISSN 1073-449X. PMID 25006874. S2CID 43763340. Many US and Chinese e-cigarette makers copied his designs illegally, so Hon has not received much financial reward for his invention (although some US manufacturers have compensated him through out-of-court settlements). [261] Ruyan later changed its company name to Dragonite International Limited. [266] As of 2014, most e-cigarettes used a battery-powered heating element rather than the earlier ultrasonic technology design. [27]

What Is an Electronic Cigar?

There is concern that children may progress from vaping to smoking. [61] Adolescents are likely to underestimate nicotine's addictiveness. [222] Vulnerability to the brain-modifying effects of nicotine, along with youthful experimentation with e-cigarettes, could lead to a lifelong addiction. [91] A long-term nicotine addiction from using a vape may result in using other tobacco products. [223] The majority of addiction to nicotine starts during youth and young adulthood. [224] Adolescents are more likely to become nicotine dependent than adults. [88]

The American Association of Public Health Physicians (AAPHP) suggests those who are unwilling to quit tobacco smoking or unable to quit with medical advice and pharmaceutical methods should consider other nicotine-containing products such as e-cigarettes and smokeless tobacco for long-term use instead of smoking. [134] A 2014 WHO report concluded that some smokers will switch completely to e-cigarettes from traditional tobacco but a "sizeable" number will use both. [61] This report found that such "dual-use" of e-cigarettes and tobacco "will have much smaller beneficial effects on overall survival compared with quitting smoking completely." [61] Smoking cessation Critics of vaping bans state that vaping is a much safer alternative to smoking tobacco products and that vaping bans incentivize people to return to smoking cigarettes. [338] For example, critics cite the British Journal of Family Medicine in August 2015 which stated, "E-cigarettes are 95% safer than traditional smoking." [339] Additionally, San Francisco's chief economist, Ted Egan, when discussing the San Francisco vaping ban stated the city's ban on e-cigarette sales will increase smoking as vapers switch to combustible cigarettes. [340] Critics of smoking bans stress the absurdity of criminalizing the sale of a safer alternative to tobacco while tobacco continues to be legal. Prominent proponents of smoking bans are not in favor of criminalizing tobacco either, but rather allowing consumers to have the choice to choose whatever products they desire. [338] In 2016, the US Food and Drug Administration (US FDA) stated that "Although ENDS [electronic nicotine delivery systems] may potentially provide cessation benefits to individual smokers, no ENDS have been approved as effective cessation aids." [239] In 2019 the European Respiratory Society stated that "The long-term effects of ECIG use are unknown, and there is therefore no evidence that ECIGs are safer than tobacco in the long term" [21] and that "[t]he tobacco harm reduction strategy is based on well-meaning but incorrect or undocumented claims or assumptions." [240] [235] Following hundreds of possible cases of severe lung illness and five confirmed deaths associated with vaping in the US, the Centers for Disease Control and Prevention stated on 6 September 2019 that people should consider not using vaping products while their investigation is ongoing. [241] History The British Royal College of Midwives states: "While vaping devices such as electronic cigarettes (e-cigs) do contain some toxins, they are at far lower levels than found in tobacco smoke. If a pregnant woman who has been smoking chooses to use an e-cig and it helps her to quit smoking and stay smokefree, she should be supported to do so." Based on the available evidence on e-cigarette safety, there was also "no reason to believe that use of an e-cig has any adverse effect on breastfeeding." The statement went on to say, "vaping should continue, if it is helpful to quitting smoking and staying smokefree". The UK National Health Service says: "If using an e-cigarette helps you to stop smoking, it is much safer for you and your baby than continuing to smoke." Many women who vape continue to do so during pregnancy because of the perceived safety of e-cigarettes compared to tobacco. [105] United States Wang, Meng; Wang, Jian-Wei; Cao, Shuang-Shuang; Wang, Hui-Qin; Hu, Ru-Ying (2016). "Cigarette Smoking and Electronic Cigarettes Use: A Meta-Analysis". International Journal of Environmental Research and Public Health. 13 (1): 120. doi: 10.3390/ijerph13010120. ISSN 1660-4601. PMC 4730511. PMID 26771624.

Disposable e-Cigars

Other devices to deliver inhaled nicotine have been developed. [397] They aim to mimic the ritual and behavioral aspects of traditional cigarettes. [397] They are marketed to men, women, and children as being safer than traditional cigarettes. [346] They are also marketed to non-smokers. [50] E-cigarette marketing is common. [230] There are growing concerns that e-cigarette advertising campaigns unjustifiably focus on young adults, adolescents, and women. [174] Large tobacco companies have greatly increased their marketing efforts. [126] This marketing trend may expand the use of e-cigarettes and contribute to re-glamorizing smoking. [347] Some companies may use e-cigarette advertising to advocate smoking, deliberately, or inadvertently, is an area of concern. [152] A 2014 review said, "the e-cigarette companies have been rapidly expanding using aggressive marketing messages similar to those used to promote cigarettes in the 1950s and 1960s." [83] Despite these earlier efforts, Hon Lik, a Chinese pharmacist and inventor, who worked as a research pharmacist for a company producing ginseng products, [259] is frequently credited with the invention of the modern e-cigarette. [242] Hon quit smoking after his father, also a heavy smoker, died of lung cancer. [259] In 2001, he thought of using a high frequency, piezoelectric ultrasound-emitting element to vaporize a pressurized jet of liquid containing nicotine. [260] This design creates a smoke-like vapor. [259] Hon said that using resistance heating obtained better results and the difficulty was to scale down the device to a small enough size. [260] Hon's invention was intended to be an alternative to smoking. [260] Hon Lik sees the e-cigarette as comparable to the "digital camera taking over from the analogue camera." [261] Ultimately, Hon Lik did not quit smoking. He is now a dual user, both smoking and vaping. [262] The Ruyan e-cigar was first launched in China in 2004. [263] Because of the potential relationship with tobacco laws and medical drug policies, e-cigarette legislation is being debated in many countries. [187] The companies that make e-cigarettes have been pushing for laws that support their interests. [312] In 2016 the US Department of Transportation banned the use of e-cigarettes on commercial flights. [313] This regulation applies to all flights to and from the US. [313] In 2018, the Royal College of Physicians asked that a balance is found in regulations over e-cigarettes that ensure product safety while encouraging smokers to use them instead of tobacco, as well as keep an eye on any effects contrary to the control agencies for tobacco. [314]