how nicotine caused vaping epidemic

• Tobacco use remains the leading cause of preventable death in our country.
• Studies show that nearly all adult smokers started before the age of 21.
• Colorado has the nation's highest rate of teenagers using e-cigarettes.
• Experts agree kid-friendly flavors of liquid nicotine have caused the recent spike in teen vaping

Full Answer

Is there an outbreak of lung disease associated with vaping?

Outbreak of Lung Disease Associated with E-Cigarette Use, or Vaping. CDC, the U.S. Food and Drug Administration (FDA), state and local health departments, and other clinical and public health partners are investigating a multistate outbreak of lung disease associated with e-cigarette product (devices, liquids, refill pods, and/or cartridges) use.

Is vaping harmful to your health?

Both tobacco and vaping devices contain other harmful chemicals; burning tobacco can create these chemicals and vaping devices turn chemicals and flavorings into mist that combines with synthetic nicotine. Learn about the health effects of tobacco/nicotine and read the DrugFacts. 26.6% of high school seniors vaped nicotine in the past year.

Why is it so hard to quit smoking or vaping?

Tobacco and vaping devices contain nicotine, an ingredient that can lead to addiction, which is why so many people who smoke or vape find it difficult to quit.

Who should not use e-cigarettes or vaping?

E-cigarette, or vaping, products (nicotine- or THC-containing) should never be used by youths, young adults, or women who are pregnant. Adults who do not currently use tobacco products should not start using e-cigarette, or vaping, products.

Why is vaping an epidemic?

Nicotine is highly addictive and is responsible for many health-related sequelae. Lack of awareness of nicotine in vaping products by adolescents has been one of the factors that may have fueled the current epidemic. In 2010, the US Surgeon General declared nicotine as addictive as heroin and cocaine.

Why did vaping become so popular?

Public Health England, the UK's national health body, conducted a widely-cited study concluding that vaping was 95 percent safer than smoking. Emboldened by these findings, even more smokers began to take to vaping, particularly in England, where the adult smoking rate dropped precipitously.

Is vaping a public health epidemic?

Vaping is causing an epidemic of nicotine addiction in teens Tobacco is the leading cause of disease and death in the United States, and its use is entirely preventable. Repeated vaping can lead to the same risk of addiction to nicotine that comes with smoking.

When did vaping become a problem?

E-cigarettes entered the U.S. marketplace around 2007, and since 2014, they have been the most commonly used tobacco product among U.S. youth. E-cigarette use among U.S. middle and high school students increased 900% during 2011-2015, before declining for the first time during 2015-2017.

How did nicotine become popular?

The arrival of Spain introduced tobacco to the Europeans, and it became a lucrative, heavily traded commodity to support the popular habit of smoking. Following the industrial revolution, cigarettes became hugely popular worldwide.

How did vaping spread?

Everything from the billboards to the packaging to the product itself has been aimed at teens. Ads on social media were widely distributed. From 2014 to 2016, advertising for vaping exploded and one study found that 78% of middle and high school students had been exposed to at least one advertisement.

How does vaping affect society?

Vaping can lead children and teenagers to start smoking It can also reduce impulse control for teenagers and even alter their brain development. Studies show that young people who vape regularly are more likely to start smoking than young people who don't vape.

Why is vaping an urgent threat to public health?

E-cigarettes are smoking initiation devices However, e-cigarettes still contain potentially harmful substances — such as heavy metals like lead, volatile organic compounds and cancer-causing agents — and evidence of vaping being an effective cessation method is limited and, in many cases, ambiguous.

Is vaping a growing problem?

A new survey found an alarming rise in the number of American teens who tried vaping last year. The study suggests that vaping may be driving an increase in nicotine use for teens. In vaping, a battery powered device called an e-cigarette heats a liquid into a vapor that can be inhaled.

What is the history of vaping?

The e-cigarette was invented in 2003 by Chinese pharmacist Hon Lik, who initially developed the device to serve as an alternative to conventional smoking. In addition to the battery component, an e-cigarette comprises an atomizer and a cartridge containing either a nicotine or a non-nicotine liquid solution.

Why do teenagers start vaping?

Young people start smoking or vaping for a variety of reasons; peer pressure, the belief that it relieves stress or looks cool, to lose or control weight, easy access, and role models or family members who use tobacco.

Is vaping worse than smoking?

1: Vaping is less harmful than smoking, but it's still not safe. E-cigarettes heat nicotine (extracted from tobacco), flavorings and other chemicals to create an aerosol that you inhale. Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic.

Why is vaping more popular than cigarettes?

First, many teens believe vaping is less harmful than smoking. Second, e-cigarettes have a lower per-use cost than traditional cigarettes. Finally, youths and adults find the lack of smoke appealing. With no smell, e-cigarettes reduce some of the stigma of smoking.

When did vaping become popular in high school?

Vaping became more popular than smoking cigarettes among students for the first time in 2014.

Why is vaping so addictive?

Nicotine is very addictive. The more you vape, the more your brain and body get used to having nicotine, and the harder it is to go without it. When you go without vaping, the nicotine level in your bloodstream drops, which may cause unpleasant feelings, physical symptoms, and strong urges to vape.

Is vaping worse than smoking?

Smoking has been proven to cause cancer, which can kill you. But vaping has been proven to cause serious lung illness, which can also kill you. The bottom line is: Smoking kills. Vaping kills you faster.

How does nicotine affect the brain?

Adolescent brains are still developing, and nicotine exposure has been linked with cognitive deficits and impairment in memory and executive function. Electronic cigarettes have been connected with increased impulsivity, with one animal study demonstrating that exposure to e-cigarette vapor during times of rapid brain growth (like during adolescence) can cause hyperactivity and impulsive behavior changes.4Another study looking specifically at the teen population found increased risks of physical fighting, attempted suicide, and alcohol/marijuana use when comparing non-users to teens who smoked or vaped.8

How can physicians help with vaping?

The other way physicians can help address vaping in adolescents is by participating in advocacy at a local, state or national level. Currently in the state of Missouri, e-cigarettes are not included in the definition of “Tobacco Products” and thus are not subject to the same restrictions as combustible cigarettes. The sale of e-cigarettes to those under 18 years of age is prohibited, just as with tobacco. But the only regulation in place for e-cigarette packaging is that the liquid must be in child-resistant containers. The American Academy of Pediatrics is currently advocating for Missouri to include e-cigarettes in smoke-free laws and to increase the minimum age to purchase electronic cigarettes to 21 years.16Organizations like the American Academy of Pediatrics and the American College of Physicians have both released position papers on vaping and offer further ways to join the fight. It is time for physicians to ask their adolescent patients about vaping and to provide education to the child and parents on the dangers of vaping. Physicians have the responsibility to be advocates for their patients working with medical organizations, state and local governments to address the adolescent vaping epidemic.

What is the advertising for e-cigarettes?

Advertising for e-cigarettes has been heavily aimed at adolescents. Everything from the billboards to the packaging to the product itself has been aimed at teens. Ads on social media were widely distributed. From 2014 to 2016, advertising for vaping exploded and one study found that 78% of middle and high school students had been exposed to at least one advertisement.1Pods come in fun packaging and the different pods are flavored to be attractive to adolescents, with everything from mint to gummi bear to frosted sugar cookie. This is especially concerning because studies have shown that flavor is one of the most important factors adolescents consider in trying e-cigarettes.4The devices to aerosolize the pods are designed to look like anything from USBs to pens to inhalers. They can be personalized much like a cell phone case and backpacks have special pockets for the mod devices.

What is an electronic cigarette?

Electronic cigarettes are battery-operated devices that use an electric pulse to heat and aerosolize a flavored liquid that typically contains nicotine. They were first introduced to the U.S. in 2007, and they were advertised by the tobacco companies as an adjunct method to help patients quit smoking. This claim never had evidence to support it, as studies comparing the use of electronic cigarettes, placebos, and nicotine patches demonstrated no significant differences in abstinence rates.3But because e-cigarettes were seen as a treatment option, they were not subjected to the same regulations as combustible cigarettes. It wasn’t until 2016 that the Congress passed the Child Nicotine Poisoning Prevention Act, giving the FDA the authority to regulate e-cigarette packaging.1

Do e-cigarettes increase the chance of smoking?

There has also been evidence that suggests e-cigarette use increases an individual’s chance of using combustible cigarettes . Adolescents who use e-cigarettes are 3.6 times more likely to report using combustible cigarettes later in life.9Teens have also been shown to be more susceptible to addiction. We know that nicotine addiction often originates in adolescence with studies showing that close to 90% of adult daily smokers started before the age of 18.10Thus, e-cigarettes are effectively helping to create a new generation addicted to nicotine.

Is e-cigarette use increasing?

Electronic cigarette (e-cigarette) use has recently risen to the forefront of medical discussions across the country. A significant increase in e-cigarette use by adolescents has been observed over the last decade. This article discusses the targeting of adolescents by e-cigarette companies. It looks at how teenagers are uniquely affected by nicotine and at risk for progressing to using combustible cigarettes and marijuana. Lastly, it discusses the role of physicians in combating the spread of e-cigarettes.

Can vaping be used to inhale cannabinoids?

Many vaping devices can also be used to inhale cannabinoids. One study demonstrated that teens who use nicotine liquid in e-cigarettes were 3.6 to 4 times more likely to use marijuana in the next two years.1Another study demonstrated that 1 in 10 seniors in high school vape cannabis.6This should be extremely distressing to physicians and medical providers because it is known that marijuana is extremely harmful to the development of the adolescent brain and studies have actually shown changes in brain structure. As a result, deficits in attention, learning, and memory associated with cannabis use in adolescents has been reported.11One study demonstrated that high schoolers who use marijuana were four times more likely to have multiple sexual partners when compared to students who only use tobacco or alcohol.12A sizable portion of adolescents who use marijuana report symptoms of paranoia, anxiety and hallucinations.13. Adverse effects from marijuana use, including cannabis hyperemesis syndrome have become common among pediatric patients.14

When did the FDA start regulating e-cigarettes?

It is important to note FDA’s initial efforts to regulate e-cigarettes began more than a decade ago. Between 2008 and 2010, FDA attempted to regulate e-cigarettes as unapproved drug/device combination products. FDA’s action was challenged and ultimately, the U.S. Court of Appeals for the D.C. Circuit ruled that while FDA could choose to regulate e-cigarettes and other products “made or derived from tobacco” under its new tobacco authorities, it could not regulate these products under FDA’s drug and device authority unless they were marketed for therapeutic purposes. 1

What is the FDA's role in tobacco?

In 2009, Congress passed the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act), which amended the Federal Food, Drug, and Cosmetic Act (FD&C Act) to authorize FDA to oversee the manufacture, marketing, distribution, and sale of tobacco products and protect the public from the harmful effects of tobacco product use.

How many inspections has the FDA done?

Since 2010, FDA has conducted more than 900 inspections of manufacturing establishments, some of which manufacture ENDS products (including e-liquids). Since the Deeming rule took effect on August 8, 2016, FDA has conducted more than 2,500 vape shop inspections.

What is the FDA's authority to regulate tobacco?

Under the statute, FDA had immediate authority to regulate cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco.

How many youth use e-cigarettes in 2020?

While we are seeing some progress in youth prevalence rates, the fact that there are still 3.6 million youth e-cigarettes users in 2020 is deeply concerning and underscores the critical need for FDA to address youth use of e-cigarettes and other ENDS.

Why did the FDA suspend inspections?

Suspending inspections was necessary to protect the health and safety of FDA’s staff and contractors (both adults and youth) who participate in the inspections. However, FDA’s monitoring and surveillance of websites, publications, and social media continued without interruption during that time.

Is nicotine an addictive substance?

Nicotine is an addictive chemical,” and. Prohibition of vending machine sales, unless in a facility that never admits youth. Following publication of the final deeming rule, FDA announced an enforcement policy with staggered timeframes.

What is the appeal of vaping?

The appeal of vaping advertising is also stronger and more focused on younger markets. Specifically, “vaping..attracts young people who have never even smoked cigarettes, encouraged by aggressive marketing and the variety of alcopops type flavors available.”.

Is vaping dangerous?

With this much public and government pressure to enforce health and safety, it would be wise to consider the potential dangers of vaping. Even despite the lack of clarity on e-cigarettes, data does show that the people of the United States and the larger global community should take the threat of this epidemic seriously. We must be aware of the potential injury it poses to ourselves and our country’s way of living.

Is it safe to smoke e-cigs?

Despite the significant increase in the amount of recent lung injury cases, the positive and empowering intentions of e-cigarettes should not be overlooked. E-cigarettes were originally introduced to the market about 15 years ago as a safe alternative to smoking, delivering nicotine through a seemingly less harmful heated liquid. Multiple professional studies, such as a British study, published as recently as February 2019 in the New England Journal of Medicine suggests that “e-cigarettes are more efficient than patches, gum or other products in helping people to stop smoking cigarettes.” Even though it’s currently difficult to quantify their health ramifications, these studies show that there is evidence that e-cigarettes are indeed less toxic than traditional cigarettes.

Does vaping increase the number of smokers?

Of further concern is that the growing number of vape users has been shown to also correlate to an increase in the number of first-time and daily smokers of real cigarettes, particularly in younger crowds, as noted before. This is quite opposite of the initially intended effect. William Shadel, a scientist at the RAND Corporation in Pittsburgh, Penn. says “vaping could make you more dependent on nicotine, and cause you to later want to take up cigarette smoking.” The role of vaping as an onramp to smoking real cigarettes cannot be cautioned against enough.

How does nicotine affect the brain?

Nicotine negatively impacts brain development and changes brain chemistry. Human brain development continues until the age of 25, and nicotine use during adolescence and young adulthood has been associated with lasting cognitive and behavioral impairments, including:

What are the effects of smoking and tobacco?

Health Effects of Smoking and Tobacco Products. Nicotine. Nicotine is the addictive drug in tobacco products. Cigarettes, cigars, smokeless tobacco and nearly all e-cigarettes contain nicotine. People who use tobacco products quickly become addicted to nicotine and have a very hard time stopping. Almost all tobacco users are dependent on nicotine. ...

Is nicotine a poison?

Nicotine causes specific changes in the brain that make it more vulnerable to chronic use of illicit drugs. In high enough doses, nicotine is also a poison—children have been harmed or even died from drinking e-cigarette liquid.

Can you take nicotine while pregnant?

Nicotine During Pregnancy. Nicotine exposure harms the developing fetus, and causes lasting consequences for the developing brain and lung function in newborns, according to the U.S. Surgeon General.

How does nicotine affect the brain?

Using nicotine in adolescence can harm the parts of the brain that control attention, learning, mood, and impulse control. 1.

Why are e-cigarettes not safe to eat?

For example, some e-cigarette flavorings may be safe to eat but not to inhale because the gut can process more substances than the lungs. 1. Defective e-cigarette batteries have caused some fires and explosions, a few of which have resulted in serious injuries.

How much nicotine is in Juul pods?

All JUUL e-cigarettes have a high level of nicotine. According to the manufacturer, a single JUUL pod contains as much nicotine as a pack of 20 regular cigarettes. 2

How do e-cigarettes produce aerosols?

E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavorings, and other chemicals that help to make the aerosol. The liquid used in e-cigarettes often contains nicotine and flavorings. This liquid is sometimes called “e-juice,” “e-liquid,” “vape juice,” or “vape liquid.”. Users inhale e-cigarette aerosol ...

What are the most popular flavors of e-cigarettes in 2020?

5 Among high school students who currently used any type of flavored e-cigarettes in 2020, the most commonly used flavors are fruit (73.1%), mint (55.8%), menthol (37.0%), and candy, desserts , or other sweets (36.4%). 5.

What are the flavors of e-cigarettes?

E-cigarettes come in various flavors, including fruit, candy, mint, and menthol. A study from 2013-2014 showed that most youth who use e-cigarettes first start with a flavored variety, and flavors are the primary reason youth report using e-cigarettes. 6.

What is an e-cigarette?

E-cigarettes are electronic devices that heat a liquid and produce an aerosol, or mix of small particles in the air. E-cigarettes come in many shapes and sizes. Most have a battery, a heating element, and a place to hold a liquid. Some e-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, ...

When will vaping peak?

Emergency department (ED) visits related to e-cigarette, or vaping, products continue to decline, after sharply increasing in August 2019 and peaking in September.

How to contact CDC about e-cigarettes?

If you have questions about CDC’s investigation into the lung injuries associated with use of e-cigarette, or vaping, products, contact CDC-INFO or call 1-800-232-4636.

How many deaths from evali in 2020?

As of February 18, 2020, a total of 2,807 hospitalized EVALI cases or deaths 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). Sixty-eight deaths have been confirmed in 29 states and the District of Columbia (as of February 18, 2020).

What is an e-cigarette?

Using an e-cigarette is commonly called vaping. E-cigarettes work by heating a liquid to produce an aerosol that users inhale into their lungs.

When did the CDC stop collecting data?

Due to the subsequent identification of the primary cause of EVALI, and the considerable decline in EVALI cases and deaths since a peak in September 2019, CDC stopped collecting these data from states as of February 2020.

Is vitamin E acetate linked to the eli outbreak?

Vitamin E acetate is strongly linked to the EVALI outbreak. Vitamin E acetate has been found in product samples tested by FDA and state laboratories and in patient lung fluid samples tested by CDC from geographically diverse states. Vitamin E acetate has not been found in the lung fluid of people that do not have EVALI.

When is the next vaping hospital admission?

Dates of symptom onset and hospital admission for patients with lung injury associated with e-cigarette use, or vaping — United States, March 31, 2019–February 15, 2020. Numbers do not sum to 2,807 due to missing admission dates.

Introduction

• Good morning, Chairman Krishnamoorthi, Ranking Member Cloud, and Members of the Subcommittee. Thank you for the opportunity to be here today to discuss the Food and Drug Administration’s (FDA or the Agency) efforts to address youth use of electronic nicotine delivery systems, or ENDS, which include e-cigarettes. I am Janet Woodcock, Acting FDA Comm...

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Background

Regulatory Requirements For Ends Products

Data on Youth Use of E-Cigarettes

FDA’s Actions to Address Youth Use of Ends Products

Conclusion