An electronic cigarette, also known as e-cigarette among other names,[notes 1] is an electronic device that simulates tobacco smoking. Electronic cigarettes are noncombustible tobacco products. Using an e-cigarette is called "vaping". Instead of cigarette smoke, the user inhales an aerosol, commonly called vapor. E-cigarettes typically have a heating element that atomizes a liquid solution called e-liquid. They may look like traditional cigarettes, or come in other variations.
The benefits and risks of e-cigarettes are uncertain. For an individual they are likely safer than smoking tobacco, with NHS England estimating them to be around 95% less harmful. The National Academy of Medicine and World Health Organization have raised concerns that use among young people may increase the later use of cigarettes. Regulated nicotine replacement products are safer than e-cigarettes, but e-cigarettes are likely safer than tobacco products.[notes 2] There is tentative evidence that they can help people quit smoking. The risk from serious adverse events is low.
E-cigarettes create vapor made of fine and ultrafine particles of particulate matter, and may contain toxicants, carcinogens, heavy metals, metal nanoparticles, and other substances. Its exact composition varies, and depends on several factors including user behaviour.[notes 3] E-liquid solutions which contain nicotine typically use either free-base or protonated (found in but not limited to newer pod mod devices) nicotine.
Most peoples' reason for using e-cigarettes involve trying to quit smoking, though a large proportion use them recreationally. Because of overlap with tobacco laws and medical drug policies, e-cigarette legislation is being debated in many countries. The revised EU Tobacco Products Directive came into effect in May 2016, providing stricter regulations for e-cigarettes. As of August 2016, the US FDA extended its regulatory power to include e-cigarettes.
There are concerns about youth use of E-cigarettes due to their potential lack of awareness of nicotine's toxicity and high addictiveness, the differing physiological effects between youth and adults, and the ease of adulteration of e-liquids with other substances. In 2014, about 13% of American high school students reported using them at least once in the previous month.
They were invented in China in 2003, first marketed in Europe in 2005, and internationally patented in 2007. In the UK, users have increased from 700,000 in 2012 to 2.6 million in 2015, and in 2015 around 10% of American adults were users. About 60% of UK users are smokers and about 40% are ex-smokers, while use among never-smokers in the UK is negligible.
As the e-cigarette industry evolves, new products are developed and brought to market. First-generation e-cigarettes tend to look like traditional cigarettes and so are called "cigalikes". Most cigalikes look like cigarettes but there is some variation in size. Second-generation devices are larger overall and look less like traditional cigarettes. Third-generation devices include mechanical mods and variable voltage devices. The fourth-generation includes Sub ohm tanks (meaning that they have electrical resistance of less than 1 Ohm) and temperature control devices. The voltage for first-generation e-cigarettes is about 3.7 and second-generation e-cigarettes can be adjusted from 3 V to 6 V, while more recent devices can go up to 8 V. The latest generation of e-cigarettes are pod mods, which provide higher levels of nicotine than regular e-cigarettes through the production of aerosolized protonated nicotine.
E-liquid is the mixture used in vapor products such as e-cigarettes and usually contain propylene glycol, glycerin, nicotine, flavorings, additives, and differing amounts of contaminants. E-liquid formulations greatly vary due to fast growth and changes in manufacturing designs of e-cigarettes. The composition of the e-liquid for additives such as nicotine and flavors vary across and within brands. The liquid typically consists of a combined total of 95% propylene glycol and glycerin, and the remaining 5% being flavorings, nicotine, and other additives. There are e-liquids sold without propylene glycol, nicotine, or flavors. The flavorings may be natural, artificial, or organic. Over 80 chemicals such as formaldehyde and metallic nanoparticles have been found in the e-liquid. There are many e-liquids manufacturers in the US and worldwide, and more than 15,500 flavors existed in 2018. Under the US Food and Drug Administration (US FDA) rules, e-liquid manufacturers are required to comply with a number of manufacturing standards. The revision to the EU Tobacco Products Directive has some standards for e-liquids. Industry standards have been created and published by the American E-liquid Manufacturing Standards Association (AEMSA).
Since the introduction of e-cigarettes into global markets, their usage has risen exponentially. In 2011 there were about 7 million adult e-cigarette users globally in 2011 rising to 41 million in 2018. Awareness and use of e-cigarettes greatly increased over the few years leading up to 2014, particularly among young people and women in some parts of the world. Since their introduction vaping has increased in the majority of high-income countries. E-cigarette use is highest in China, the US, and Europe, with China having the greatest number of e-cigarette users. Growth in the UK as of January 2018[update] had reportedly slowed since 2013. The growing frequency of e-cigarette use may be due to heavy promotion in youth-driven media channels, their low cost, and the misbelief that e-cigarettes are safer than traditional cigarettes, according to a 2016 review.
The prevalence of vaping among adolescents is increasing worldwide. There is substantial variability in vaping in youth worldwide across countries. Rates have grown every year since these devices were first introduced to the market. There appears to be an increase of one-time e-cigarette use among young people worldwide. Most e-cigarette users among youth have never smoked. Many youth who use e-cigarettes also smoke traditional cigarettes. Vaping seems to be a gateway to using traditional cigarettes in adolescents. Youth who use e-cigarettes are more likely to go on to use traditional cigarettes. The evidence suggests that young people who vape are also at greater risk for subsequent long-term tobacco use. E-cigarettes are expanding the nicotine market by attracting low-risk youth who would be unlikely to initiate nicotine use with traditional cigarettes. Adolescents were more likely to initiate vaping through flavored e-cigarettes.
There are varied reasons for e-cigarette use. Most users' motivation is related to trying to quit smoking, but a large proportion of use is recreational. Adults cite predominantly three reasons for trying and using e-cigarettes: as an aid to smoking cessation, as a safer alternative to traditional cigarettes, and as a way to conveniently get around smoke-free laws. Many users vape because they believe it is healthier than smoking for themselves or bystanders. Usually, only a small proportion of users are concerned about the potential adverse health effects. Seniors seem to vape to quit smoking or to get around smoke‐free policies. There appears to be a hereditary component to tobacco use, which probably plays a part in transitioning of e-cigarette use from experimentation to routine use. The introduction of e-cigarettes has given cannabis smokers a different way of inhaling cannabinoids. Recreational cannabis users can individually "vape" deodorized or flavored cannabis extracts with minimal annoyance to the people around them and less chance of detection, known as "stealth vaping".
- Growth in the U.S.
- Growth in the U.K.
- In the UK, users have increased from 700,000 in 2012 to 2.6 million in 2015. About 60% of UK users are smokers and about 40% are ex-smokers, while use among never-smokers in the UK is negligible. Most still use traditional cigarettes, raising concern that dual use may "delay or deter quitting". Most peoples' reason for using e-cigarettes involve trying to quit smoking, though a large proportion use them recreationally. It is commonly stated that the modern e-cigarette was invented in 2003 by Chinese pharmacist Hon Lik, but tobacco companies had been developing nicotine aerosol generation devices since as early as 1963. As of 2018[update], 95% of e-cigarettes were made in China.
Many users may begin by using a disposable e-cigarette. Users often start with e-cigarettes resembling traditional cigarettes, eventually moving to a later-generation device. Most later-generation e-cigarette users shifted to their present device to get a "more satisfying hit", and users may adjust their devices to provide more vapor for better "throat hits". A 2014 study reported that experienced users preferred rechargeable e-cigarettes over disposable ones. The most commonly used e-cigarettes in the UK are devices with refillable tanks. Most users used either closed systems or open systems, and rarely used both. Women were found to prefer disposable e-cigarettes, and young adults were found to pay more attention to modifiability. Modifiability also was found to increase the probability of initiating e-cigarettes among adolescents.
A 2013 study found that about three-fourths of smokers used a tank system, which allows users to choose flavors and strength to mix their own liquid. Experienced e-cigarette users even ranked the ability to customize as the most important characteristic. Users ranked nicotine strength as an important factor for choosing among various e-cigarettes, though such preference could vary by smoking status, e-cigarette use history, and gender. Non-smokers and inexperienced e-cigarettes users tended to prefer no nicotine or low nicotine e-cigarettes while smokers and experienced e-cigarettes users preferred medium and high nicotine e-cigarettes. There is an abundance of colors, designs, carrying cases, and accessories to accommodate the diversity in personal preferences.
The prevalence of vaping among adolescents is increasing worldwide. There is substantial variability in vaping in youth worldwide across countries. Since e-cigarettes have become widely available, young people have been smoking cigarettes about a quarter as often. Over the years leading up to 2017 vaping among adolescents has grown every year since these devices were first introduced to the market. There appears to be an increase of one-time e-cigarette use among young people worldwide. The frequency of vaping in youth is low. The result of youth e-cigarette use leading to smoking is negligible. Most e-cigarette users among youth have never smoked. Many youth who use e-cigarettes also smoke traditional cigarettes. Some youths who have tried an e-cigarette have never used a traditional cigarette; indicating e-cigarettes may be a starting point for nicotine use. Adolescents who would have not been using nicotine products to begin with are vaping. Twice as many youth vaped in 2014 than also used traditional cigarettes. Vaping seems to be a gateway to using traditional cigarettes in adolescents. Youth who use e-cigarettes are more likely to go on to use traditional cigarettes. The evidence suggests that young people who vape are also at greater risk for subsequent long-term tobacco use. E-cigarettes are expanding the nicotine market by attracting low-risk youth who would be unlikely to initiate nicotine use with traditional cigarettes. Data from a longitudinal cohort study of children with alcoholic parents found that adolescents (both middle and late adolescence) who used cigarettes, marijuana, or alcohol were significantly more likely to have ever used e-cigarettes. Adolescents were more likely to initiate vaping through flavored e-cigarettes. Among youth who have ever tried an e-cigarette, a majority used a flavored product the first time they tried an e-cigarette. There is a greater likelihood of past or present and later cannabis use among youth and young adults who have vaped.
Most youth are not vaping to help them quit tobacco. Adolescent vaping is unlikely to be associated with trying to reduce or quit tobacco. While adolescents who vape but do not smoke are more likely to intend to try smoking than their peers who do not vape, the extent to which vaping causes smoking in light of the dramatic reduction in teen smoking since e-cigarettes have been available. Vaping is correlated with a higher occurrence of cigarette smoking among adolescents, even in those who otherwise may not have been interested in smoking. Adolescence experimenting with e-cigarettes appears to encourage continued use of traditional cigarettes. A 2015 study found minors had little resistance to buying e-cigarettes online. Teenagers may not admit using e-cigarettes, but use, for instance, a hookah pen. As a result, self-reporting may be lower in surveys. Experts suggest that candy-like flavors could lead youths to experiment with vaping. E-cigarette advertisements seen by youth could increase the likelihood among youths to experiment with vaping. A 2016 review found "The reasons for the increasing use of e-cigarettes by minors (persons between 12 and 17 years of age) may include robust marketing and advertising campaigns that showcase celebrities, popular activities, evocative images, and appealing flavors, such as cotton candy." A 2014 survey stated that vapers may have less social and behavioral stigma than cigarette smokers, causing concern that vaping products are enticing youth who may not under other circumstances have used these products. The frequency of vaping is higher in adolescent with asthma than in adolescent who do not have asthma.
There are varied reasons for e-cigarette use. Most users' motivation is related to trying to quit smoking, but a large proportion of use is recreational. Adults cite predominantly three reasons for trying and using e-cigarettes: as an aid to smoking cessation, a belief that they are a safer alternative to traditional cigarettes, and as a way to conveniently get around smoke-free laws. Some users vape for the enjoyment of the activity. Many e-cigarette users use them because they believe they are safer than traditional cigarettes. People who think they pose less risk than cigarette smoking are more likely to vape. A 2017 report found that smokers who previously vaped and quit though continued smoking, 51.5% believed that vaping is less risky than smoking  In contrast, 90% of former-smokers who vape believed vaping as less risky than cigarettes. A 2017 report found that a minority of the respondents believed that replacing cigarettes with e-cigarettes would be helpful for their health. Many users vape because they believe it is healthier than smoking for themselves or bystanders. Usually, only a small proportion of users are concerned about the potential adverse health effects. Some people say they want to quit smoking by vaping, but others vape to circumvent smoke-free laws and policies, or to cut back on cigarette smoking. 56% of respondents in a US 2013 survey had tried vaping to quit or reduce their smoking. In the same survey, 26% of respondents would use them in areas where smoking was banned. Continuing dual use among smokers is correlated with trying to cut down on smoking and to get around smoking bans, increased desire to quit smoking, and a decreased smoking dependence. Seniors seem to vape to quit smoking or to get around smoke‐free policies. Concerns over avoiding stains on teeth or odor from smoke on clothes in some cases prompted interest in or use of e-cigarettes. Some e-cigarettes appeal considerably to people curious in technology who want to customize their devices. There appears to be a hereditary component to tobacco use, which probably plays a part in transitioning of e-cigarette use from experimentation to routine use.
It is conceivable that former smokers may be tempted to use nicotine again as a result of e-cigarettes, and possibly start smoking again. E-liquid flavors are enticing to a range of smokers and non-smokers. Non-smoking adults tried e-cigarettes due to curiosity, because a relative was using them, or because they were given one. College students often vape for experimentation. Millions of dollars spent on marketing aimed at smokers suggests e-cigarettes are "newer, healthier, cheaper and easier to use in smoke-free situations, all reasons that e-cigarette users claim motivate their use". Marketing messages echo well-established cigarette themes, including freedom, good taste, romance, sexuality, and sociability as well as messages stating that e-cigarettes are healthy, are useful for smoking cessation, and can be used in smoke free environments. These messages are mirrored in the reasons that adults and youth cite for using e-cigarettes. Exposure to e-cigarette advertising influences people to try them.
The belief that e-cigarettes are safer than traditional cigarettes could widen their use among pregnant women. If tobacco businesses persuade women that e-cigarettes are a small risk, non-smoking women of reproductive age might start using them and women smoking during pregnancy might switch to their use or use these devices to reduce smoking, instead of quitting smoking altogether. Traditional cigarette users who have not used e-cigarettes had mixed ideas about their possible satisfaction and around a third thought that e-cigarettes might taste bad. Among current e-cigarette users, e-liquid flavor availability is very appealing. They feel or taste similar to traditional cigarettes, and vapers disagree about whether this is a benefit or a drawback. Some users like that e-cigarettes resembled traditional cigarettes, but others did not. E-cigarettes users' views about saving money from using e-cigarettes compared to traditional cigarettes are inconsistent. The majority of committed e-cigarette users interviewed at an e-cigarette convention found them cheaper than traditional cigarettes.
Some users stopped vaping due to issues with the devices. Dissatisfaction and concerns over safety can discourage ongoing e-cigarette use. Commonly reported issues with using e-cigarettes were that the devices were hard to refill, the cartridges might leak and that altering the dose was hard. Smokers mainly quit vaping because it did not feel similar to traditional cigarettes, did not aid with cravings, and because they wanted to use them only to know what they were like.
In the context of drugs, the gateway hypothesis predicts that the use of less deleterious drugs can lead to a future risk of using more dangerous hard drugs or crime. There is wide concern that vaping may be a "gateway" to cigarette smoking. Vaping may also act as a gateway to recreational use of illegal drugs. Studies indicate vaping serves as a gateway to traditional cigarettes and cannabis use. Nicotine is a gateway to opioid addiction, as nicotine lowers the threshold for addiction to other agents. Under the common liability model, some researchers have suggested that any favorable relation between vaping and beginning to smoke is a result of common risk factors. This includes impulsive and sensation seeking personality types or exposure to people who are sympathetic with smoking and relatives. A 2014 review using animal models found that nicotine exposure may increase the likelihood to using other drugs, independent of factors associated with a common liability.[notes 4] The gateway theory suggests vaping by non-smokers, and especially by children, may result in smoking independent of other factors associated with initially choosing to smoke. Some see the gateway model as a way to illustrate the potential risk-heightening effect of vaping and going on to use combusted tobacco products.
There is concern regarding that the accessibility of e-liquid flavors could lead to using additional tobacco products among non-smokers. It is argued to implement the precautionary principle because vaping by non-smokers may lead to smoking. There is a concern with the possibility that non-smokers as well as children may start nicotine use with e-cigarettes at a rate higher than anticipated than if they were never created. In certain cases, e-cigarettes might increase the likelihood of being exposed to nicotine itself, especially for never-nicotine users who start using nicotine products only as a result of these devices. A 2015 review concluded that "Nicotine acts as a gateway drug on the brain, and this effect is likely to occur whether the exposure is from smoking tobacco, passive tobacco smoke or e-cigarettes." Because those with mental illness are highly predisposed to nicotine addiction, those who try e-cigarettes may be more likely to become dependent, raising concerns about facilitating a transition to combustible tobacco use. Even if an e-cigarette contains no nicotine, the user mimics the actions of smoking. This may renormalize tobacco use in the general public. Normalization of e-cigarette use may lead former cigarette smokers to begin using them, thereby reinstating their nicotine dependence and fostering a return to tobacco use. There is a possible risk of re-normalizing of tobacco use in areas where smoking is banned. Government intervention is recommended to keep children safe from the re-normalizing of tobacco, according to a 2017 review.
The "catalyst model" suggests that vaping may proliferate smoking in minors by sensitizing minors to nicotine with the use of a type of nicotine that is more pleasing and without the negative attributes of regular cigarettes. A 2016 review, based on the catalyst model, "indicate that the perceived health risks, specific product characteristics (such as taste, price and inconspicuous use), and higher levels of acceptance among peers and others potentially make e-cigarettes initially more attractive to adolescents than tobacco cigarettes. Later, increasing familiarity with nicotine could lead to the reevaluation of both electronic and tobacco cigarettes and subsequently to a potential transition to tobacco smoking."
The benefits and the health risks of e-cigarettes are uncertain; including the long-term effects. There is tentative evidence they may help people quit smoking, but smoking cessation medicine is at least as effective. Pods contain different doses of nicotine, and these levels are regulated in some countries. Following the possibility of nicotine addiction from e-cigarette use, there is concern children and young people may start smoking cigarettes. Their part in tobacco harm reduction is unclear, while another review found they appear to have the potential to lower tobacco-related death and disease. Regulated US Food and Drug Administration (US FDA) nicotine replacement products may be safer than e-cigarettes, but e-cigarettes are generally seen as safer than combusted tobacco products.[notes 5] The risk of early death is anticipated to be similar to that of smokeless tobacco. The risk from serious adverse events was reported in 2016 to be low. Less serious adverse effects include abdominal pain, headache, blurry vision, throat and mouth irritation, vomiting, nausea, and coughing. Nicotine is harmful. In 2019 and 2020, an outbreak of severe vaping lung illness in the US was strongly linked to vitamin E acetate by CDC.[notes 6]
E-cigarettes produce similarly high levels of fine and ultrafine particles in the air as tobacco-cigarettes. There is "only limited evidence showing adverse respiratory and cardiovascular effects in humans", with the authors calling for more long-term studies on the subject.
Some groups feel that e-cigarettes are not suitable for use by pregnant women. The Royal College of Midwives states that "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 said, adding that “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." .The Smoking in Pregnancy Challenge Group says that e-cigarettes likely to be significantly less harmful to a pregnant woman and her baby than continuing to smoke.  Action on Smoking and Health states that "Nicotine alone is relatively harmless; the main harm from smoking is from the toxic chemicals in tobacco smoke" 
The rate of e-cigarette use during pregnancy is unknown. Many women who vape continue to do so during pregnancy because of the perceived safety of e-cigarettes compared to tobacco. 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 ever used them, and 0.6% were current daily users. 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. The rate of e-cigarette use among pregnant adolescents is unknown.
As of 2018, the health effects of Electronic Cigarette Use in Pregnancy for mother or fetus remain unknown. In its summary review  the U.S. National Institute of medicine concluded that "Although the extensive research on tobacco and limited evidence on nicotine in isolation gives some focus to the questions regarding the potential effects of e-cigarettes, the need for direct evaluation is clear.", (Conclusion 13-1) "There is no available evidence whether or not e-cigarettes affect pregnancy outcomes.", and (Conclusion 13-2) "There is insufficient evidence whether or not maternal e-cigarette use affects fetal development."
The available research on the efficacy of e-cigarette use for smoking cessation is limited. Data regarding their use includes four randomized controlled trials and a number of user surveys, case reports, and cohort studies. There is tentative evidence they may help people quit smoking. Vaping does not greatly increase the odds of quitting smoking. Their use for quitting smoking is controversial. The evidence is conflicting to support or dismiss vaping for quit smoking. As a result of the data being confronted with methodological and study design limitations, no firm conclusions can be drawn in respect to their efficacy and safety. A 2016 review found that the combined abstinence rate among smokers using e-cigarettes in prospective studies was 29.1%. The same review noted that few clinical trials and prospective studies had yet been conducted on their effectiveness, and only one randomized clinical trial had included a group using other quit smoking methods. No long-term trials have been conducted for their use as a smoking cessation aid. It is still not evident as to whether vaping can adequately assist with quitting smoking at the population level. A 2015 PHE report recommends for smokers who cannot or do not want to quit to use e-cigarettes as one of the main steps to lower smoking-related disease, while a 2015 US PSTF statement found there is not enough evidence to recommend e-cigarettes for quitting smoking in adults, pregnant women, and adolescents. As of January 2018[update], systematic reviews collectively agreed that there is insufficient evidence to unequivocally determine whether vaping helped people abstain from smoking.
Studies pertaining to their potential impact on smoking reduction are very limited. E-cigarette use may decrease the number of cigarettes smoked, but smoking just one to four cigarettes daily greatly increases the risk of cardiovascular disease compared to not smoking. The extent to which decreasing cigarette smoking with vaping leads to quitting is unknown. Randomized controlled trials have not shown that vaping is effective for quitting smoking. A 2016 meta-analysis based on 20 different studies found that smokers who used e-cigarettes were 28% less likely to quit than those who had not tried e-cigarettes. This finding persisted whether the smokers were initially interested in quitting or not. Tentative evidence indicates that health warnings on vaping products may influence users to give up vaping.
It is unclear whether e-cigarettes are only helpful for particular types of smokers. Vaping with nicotine may reduce tobacco use among daily smokers. Whether or not vaping is potentially effective for quitting smoking may rely upon whether it was used as part of making an effort to quit or not.
Vaping is not clearly more or less effective than regulated nicotine replacement products or 'usual care' for quitting smoking. The available research suggests e-cigarettes are likely equal or slightly better than nicotine patches for quitting smoking. People who vaped were not more likely to give up smoking than people who did not vape. Compared to many alternative quitting smoking medicines in early development in clinical trials including e-cigarettes, cytisine appears to be most encouraging in efﬁcacy and safety with an inexpensive price. E-cigarettes have not been proven to be more effective than smoking cessation medicine and regulated US FDA medicine. A 2014 review found they may be as effective, but not more, compared to nicotine patches for short-term quitting smoking. They also found that a randomized trial stated 29% of e-cigarette users were still vaping at 6 months, while only 8% of patch users still wore patches at 6 months. Some individuals who quit smoking with a vaping device are continuing to vape after a year. Vaping appears to be as effective as nicotine replacement products, though its potential adverse effects such as normalizing smoking have not been adequately studied. While some surveys reported improved quitting smoking, particularly with intensive e-cigarette users, several studies showed a decline in quitting smoking in dual users. A 2015 overview of systematic reviews indicates that e-cigarettes has no benefit for smokers trying to quit, and that the high rate of dual use indicates that e-cigarettes are used for supporting their nicotine addiction. Other kinds of nicotine replacement products are usually covered by health systems, but because e-cigarettes are not medically licensed they are not covered.
It is difficult to reach a general conclusion from e-cigarette use for smoking cessation because there are hundreds of brands and models of e-cigarettes sold that vary in the composition of the liquid. E-cigarettes have not been subjected to the same type of efficacy testing as nicotine replacement products. The similarity of e-cigarettes' vapor, looking like cigarette smoke, may prolong traditional cigarette use for people who could have quit instead, but the growing support of e-cigarettes could put extra pressure on smokers to stop cigarette smoking because smoking may be seen as socially unacceptable compared to a smokeless e-cigarette. The evidence indicates smokers are more frequently able to completely quit smoking using tank devices compared to cigalikes, which may be due to their more efficient nicotine delivery. There is low quality evidence that vaping assists smokers to quit smoking in the long-term compared with nicotine-free vaping. Nicotine-containing e-cigarettes were associated with greater effectiveness for quitting smoking than e-cigarettes without nicotine. A 2013 study in smokers who were not trying to quit, found that vaping, with or without nicotine decreased the number of cigarettes consumed. E-cigarettes without nicotine may reduce tobacco cravings because of the smoking-related physical stimuli. A 2015 meta-analysis on clinical trials found that e-cigarettes containing nicotine are more effective than nicotine-free ones for quitting smoking. They compared their finding that nicotine-containing e-cigarettes helped 20% of people quit with the results from other studies that found nicotine replacement products helps 10% of people quit. A 2016 review found low quality evidence of a trend towards benefit of e-cigarettes with nicotine for smoking cessation. In terms of whether flavored e-cigarettes assisted quitting smoking, the evidence is inconclusive.
The efficacy and safety of vaping for quitting smoking during pregnancy is unknown. No research is available to provide details on the efficacy of vaping for quitting smoking during pregnancy. There is robust evidence that vaping is not effective for quitting smoking among adolescents. In view of the shortage of evidence, vaping is not recommend for cancer patients. The effectiveness of vaping for quitting smoking among vulnerable groups is uncertain.
The term harm reduction implies any reduction in relative harm from a prior level, even a small reduction such as reducing smoking by one or two cigarettes per day. Harm minimization strives to reduce harms to zero (i.e., ideally to no use and thus no harmful exposure). When a consumer does not want to stop all nicotine use, then harm minimization implies striving for the complete elimination of smoked tobacco exposure by substituting it with the use of less harmful noncombusted forms of nicotine instead of smoking. Tobacco harm reduction (THR) may serve as a substitute for traditional cigarettes with lower risk products to reduce tobacco-related death and disease. Tobacco harm reduction has been a controversial area of tobacco control. Health advocates have been slow to support a harm reduction method out of concern that tobacco companies cannot be trusted to sell products that will lower the risks associated with tobacco use. E-cigarettes can reduce smokers' exposure to carcinogens and other toxic chemicals found in tobacco. A large number of smokers want to reduce harm from smoking by using e-cigarettes. The argument for harm reduction does not take into account the adverse effects of nicotine. There cannot be a defensible reason for harm reduction in children who are vaping with a base of nicotine. Quitting smoking is the most eﬀective strategy to tobacco harm reduction.
Tobacco smoke contains 100 known carcinogens, and 900 potentially cancer causing chemicals, but e-cigarette vapor contains less of the potential carcinogens than found in tobacco smoke. A study in 2015 using a third-generation device found levels of formaldehyde were greater than with cigarette smoke when adjusted to a maximum power setting. E-cigarettes cannot be considered safe because there is no safe level for carcinogens. Due to their similarity to traditional cigarettes, e-cigarettes could play a valuable role in tobacco harm reduction. However, the public health community remains divided concerning the appropriateness of endorsing a device whose safety and efficacy for smoking cessation remain unclear. Overall, the available evidence supports the cautionary implementation of harm reduction interventions aimed at promoting e-cigarettes as attractive and competitive alternatives to cigarette smoking, while taking measures to protect vulnerable groups and individuals.
The core concern is that smokers who could have quit entirely will develop an alternative nicotine addiction. Dual use may be an increased risk to a smoker who continues to use even a minimal amount of traditional cigarettes, rather than quitting. The promotion of vaping as a harm reduction aid is premature, while a 2011 review found they appear to have the potential to lower tobacco-related death and disease. Evidence to substantiate the potential of vaping to lower tobacco-related death and disease is unknown. The health benefits of reducing cigarette use while vaping is unclear. E-cigarettes could have an influential role in tobacco harm reduction. The authors warned against the potential harm of excessive regulation and advised health professionals to consider advising smokers who are reluctant to quit by other methods to switch to e-cigarettes as a safer alternative to smoking. A 2014 review recommended that regulations for e-cigarettes could be similar to those for dietary supplements or cosmetic products to not limit their potential for harm reduction. A 2012 review found e-cigarettes could considerably reduce traditional cigarettes use and they likely could be used as a lower risk replacement for traditional cigarettes, but there is not enough data on their safety and efficacy to draw definite conclusions. There is no research available on vaping for reducing harm in high-risk groups such as people with mental disorders.
A 2014 PHE report concluded that hazards associated with products currently on the market are probably low, and apparently much lower than smoking. However, harms could be reduced further through reasonable product standards. The British Medical Association encourages health professionals to recommend conventional nicotine replacement therapies, but for patients unwilling to use or continue using such methods, health professionals may present e-cigarettes as a lower-risk option than tobacco smoking. 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. A 2014 WHO report concluded that some smokers will switch completely to e-cigarettes from traditional tobacco but a "sizeable" number will use both. 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."
The risks of e-cigarette use are uncertain. There is little data about their safety, and considerable variation among e-cigarettes and in their liquid ingredients and thus the contents of the aerosol delivered to the user. Reviews on the safety of e-cigarettes have reached significantly different conclusions. A 2014 WHO report cautioned about potential risks of using e-cigarettes. Regulated US FDA products such as nicotine inhalers may be safer than e-cigarettes, but e-cigarettes are generally seen as safer than combusted tobacco products such as cigarettes and cigars. The risk of early death is anticipated to be similar to that of smokeless tobacco. Since vapor does not contain tobacco and does not involve combustion, users may avoid several harmful constituents usually found in tobacco smoke, such as ash, tar, and carbon monoxide. However, e-cigarette use with or without nicotine cannot be considered harmless. Repeated exposure over a long time to e-cigarette vapor poses substantial potential risk.
The long-term effects of e-cigarette use are unknown. The risk from serious adverse events, including death, was reported in 2016 to be low. Serious adverse events related to e-cigarettes were hypotension, seizure, chest pain, rapid heartbeat, disorientation, and congestive heart failure but it was unclear the degree to which they were the result of e-cigarettes. Less serious adverse effects include abdominal pain, headache, blurry vision, throat and mouth irritation, vomiting, nausea, and coughing. They may produce less adverse effects compared to tobacco products. E-cigarettes reduce lung function, but to a much lower extent than with traditional cigarettes, and they reduce cardiac muscle function and increase inflammation, but these changes were only substantial with traditional cigarettes. A 2014 WHO report said, "ENDS [Electronic nicotine delivery system] use poses serious threats to adolescents and fetuses." Aside from toxicity exposure in normal use, there are also risks from misuse or accidents such as nicotine poisoning (especially among small children), contact with liquid nicotine, fires caused by vaporizer malfunction, and explosions resulting from extended charging, unsuitable chargers, or design flaws. Battery explosions are caused by an increase in internal battery temperature and some have resulted in severe skin burns. There is a small risk of battery explosion in devices modified to increase battery power.
The cytotoxicity of e-liquids varies, and contamination with various chemicals have been detected in the liquid. Metal parts of e-cigarettes in contact with the e-liquid can contaminate it with metal particles. Many chemicals including carbonyl compounds such as formaldehyde can inadvertently be produced when the nichrome wire (heating element) that touches the e-liquid is heated and chemically reacted with the liquid. Normal usage of e-cigarettes, and reduced voltage (3.0 V) devices generate very low levels of formaldehyde. The later-generation and "tank-style" e-cigarettes with a higher voltage (5.0 V) may generate equal or higher levels of formaldehyde compared to smoking. A 2015 PHE report found that high levels of formaldehyde only occurred in overheated "dry-puffing". Users detect the "dry puff" (also known as a "dry hit") and avoid it, and they concluded that "There is no indication that EC users are exposed to dangerous levels of aldehydes." However, e-cigarette users may "learn" to overcome the unpleasant taste due to elevated aldehyde formation, when the nicotine craving is high enough. E-cigarette users who use devices that contain nicotine are exposed to its potentially harmful effects. Nicotine is associated with cardiovascular disease, possible birth defects, and poisoning. In vitro studies of nicotine have associated it with cancer, but carcinogenicity has not been demonstrated in vivo. There is inadequate research to show that nicotine is associated with cancer in humans. The risk is probably low from the inhalation of propylene glycol and glycerin. No information is available on the long-term effects of the inhalation of flavors.
E-cigarettes create vapor that consists of fine and ultrafine particles of particulate matter, with the majority of particles in the ultrafine range. The vapor have been found to contain propylene glycol, glycerin, nicotine, flavors, small amounts of toxicants, carcinogens, and heavy metals, as well as metal nanoparticles, and other substances. Exactly what the vapor consists of varies in composition and concentration across and within manufacturers, and depends on the contents of the liquid, the physical and electrical design of the device, and user behavior, among other factors. E-cigarette vapor potentially contains harmful chemicals not found in tobacco smoke. The majority of toxic chemicals found in cigarette smoke are absent in e-cigarette vapor. E-cigarette vapor contains lower concentrations of potentially toxic chemicals than with cigarette smoke. Those which are present, are mostly below 1% of the corresponding levels permissible by workplace safety standards. 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. Concern exists that some of the mainstream vapor exhaled by e-cigarette users may be inhaled by bystanders, particularly indoors. E-cigarette use by a parent might lead to inadvertent health risks to offspring. A 2014 review recommended that e-cigarettes should be regulated for consumer safety. There is limited information available on the environmental issues around production, use, and disposal of e-cigarettes that use cartridges. E-cigarettes that are not reusable may contribute to the problem of electronic waste.
Addiction and dependence
Nicotine, a key ingredient in most e-liquids,[notes 7] is well-recognized as one of the most addictive substances, as addictive as heroin and cocaine. Addiction is believed to be a disorder of experience-dependent brain plasticity. The reinforcing effects of nicotine play a significant role in the beginning and continuing use of the drug. First-time nicotine users develop a dependence about 32% of the time. Chronic nicotine use involves both psychological and physical dependence. Nicotine-containing e-cigarette vapor induces addiction-related neurochemical, physiological and behavioral changes. Nicotine affects neurological, neuromuscular, cardiovascular, respiratory, immunological and gastrointestinal systems. Neuroplasticity within the brain's reward system occurs as a result of long-term nicotine use, leading to nicotine dependence. The neurophysiological activities that are the basis of nicotine dependence are intricate. It includes genetic components, age, gender, and the environment. Nicotine addiction is a disorder which alters different neural systems such as dopaminergic, glutamatergic, GABAergic, serotoninergic, that take part in reacting to nicotine. Long-term nicotine use affects a broad range of genes associated with neurotransmission, signal transduction, and synaptic architecture. The ability to quitting smoking is affected by genetic factors, including genetically based differences in the way nicotine is metabolized.
Nicotine is a parasympathomimetic stimulant that binds to and activates nicotinic acetylcholine receptors in the brain, which subsequently causes the release of dopamine and other neurotransmitters, such as norepinephrine, acetylcholine, serotonin, gamma-aminobutyric acid, glutamate, endorphins, and several neuropeptides, including proopiomelanocortin-derived α-MSH and adrenocorticotropic hormone. Corticotropin-releasing factor, Neuropeptide Y, orexins, and norepinephrine are involved in nicotine addiction. Continuous exposure to nicotine can cause an increase in the number of nicotinic receptors, which is believed to be a result of receptor desensitization and subsequent receptor upregulation. Long-term exposure to nicotine can also result in downregulation of glutamate transporter 1. Long-term nicotine exposure upregulates cortical nicotinic receptors, but it also lowers the activity of the nicotinic receptors in the cortical vasodilation region. These effects are not easily understood. With constant use of nicotine, tolerance occurs at least partially as a result of the development of new nicotinic acetylcholine receptors in the brain. After several months of nicotine abstinence, the number of receptors go back to normal. The extent to which alterations in the brain caused by nicotine use are reversible is not fully understood. Nicotine also stimulates nicotinic acetylcholine receptors in the adrenal medulla, resulting in increased levels of epinephrine and beta-endorphin. Its physiological effects stem from the stimulation of nicotinic acetylcholine receptors, which are located throughout the central and peripheral nervous systems.
When nicotine intake stops, the upregulated nicotinic acetylcholine receptors induce withdrawal symptoms. These symptoms can include cravings for nicotine, anger, irritability, anxiety, depression, impatience, trouble sleeping, restlessness, hunger, weight gain, and difficulty concentrating. When trying to quit smoking with vaping a base containing nicotine, symptoms of withdrawal can include irritability, restlessness, poor concentration, anxiety, depression, and hunger. The changes in the brain cause a nicotine user to feel abnormal when not using nicotine. In order to feel normal, the user has to keep his or her body supplied with nicotine. E-cigarettes may reduce cigarette craving and withdrawal symptoms. It is not clear whether e-cigarette use will decrease or increase overall nicotine addiction, but the nicotine content in e-cigarettes is adequate to sustain nicotine dependence. Chronic nicotine use causes a broad range of neuroplastic adaptations, making quitting hard to accomplish. A 2015 study found that users vaping non-nicotine e-liquid exhibited signs of dependence. Experienced users tend to take longer puffs which may result in higher nicotine intake. It is difficult to assess the impact of nicotine dependence from e-cigarette use because of the wide range of e-cigarette products. The addiction potential of e-cigarettes may have risen because as they have progressed, they delivery nicotine better.
A 2015 American Academy of Pediatrics (AAP) policy statement stressed "the potential for these products to addict a new generation of youth to nicotine and reverse more than 50 years of public health gains in tobacco control." The World Health Organization (WHO) is concerned about starting nicotine use among non-smokers, and the National Institute on Drug Abuse said e-cigarettes could maintain nicotine addiction in those who are attempting to quit. The limited available data suggests that the likelihood of abuse from e-cigarettes is smaller than traditional cigarettes. No long-term studies have been done on the effectiveness of e-cigarettes in treating tobacco addiction, but some evidence suggests that dual use of e-cigarettes and traditional cigarettes may be associated with greater nicotine dependence.
Following the possibility of nicotine addiction via e-cigarettes, there is concern that children may start smoking cigarettes. Adolescents are likely to underestimate nicotine's addictiveness. Vulnerability to the brain-modifying effects of nicotine, along with youthful experimentation with e-cigarettes, could lead to a lifelong addiction. A long-term nicotine addiction from using a vape may result in using other tobacco products. The majority of addiction to nicotine starts during youth and young adulthood. Adolescents are more likely to become nicotine dependent than adults. The adolescent brain seems to be particularly sensitive to neuroplasticity as a result of nicotine. Minimal exposure could be enough to produce neuroplastic alterations in the very sensitive adolescent brain. A 2014 review found that in studies up to a third of youth who have not tried a traditional cigarette have used e-cigarettes. The degree to which teens are using e-cigarettes in ways the manufacturers did not intend, such as increasing the nicotine delivery, is unknown, as is the extent to which e-cigarette use may lead to addiction or substance dependence in youth.
Regulatory, Scientific, and Medical Positions
Because of overlap with tobacco laws and medical drug policies, e-cigarette legislation is being debated in many countries. The revised EU Tobacco Products Directive came into effect in May 2016, providing stricter regulations for e-cigarettes. In February 2010 the US District Court ruled against the FDA's seizure of E-Cigarettes as a "drug-device" and in December 2010 the US Court of Appeals confirmed them to be tobacco products which were by then subject to regulation under the 2009 FSPTC Act. In August 2016, the US FDA extended its regulatory power to include e-cigarettes, cigars, and "all other tobacco products". Large tobacco companies have greatly increased their marketing efforts. As of 2014[update], there were 466 brands of e-cigarettes. Global sales were around $19.3 billion in 2019.
The scientific community in US and Europe are primarily concerned with their possible effect on public health. There is concern among public health experts that e-cigarettes could renormalize smoking, weaken measures to control tobacco, and serve as a gateway for smoking among youth. The public health community is divided over whether to support e-cigarettes, because their safety and efficacy for quitting smoking is unclear. Many in the public health community acknowledge the potential for their quitting smoking and decreasing harm benefits, but there remains a concern over their long-term safety and potential for a new era of users to get addicted to nicotine and then tobacco. There is concern among tobacco control academics and advocates that prevalent universal vaping "will bring its own distinct but as yet unknown health risks in the same way tobacco smoking did, as a result of chronic exposure", among other things.
Medical organizations differ in their views about the health implications of vaping. There is general agreement that e-cigarettes expose users to fewer toxicants than tobacco cigarettes. Some healthcare groups and policy makers have hesitated to recommend e-cigarettes for quitting smoking, because of limited evidence of effectiveness and safety. Some have advocated bans on e-cigarette sales and others have suggested that e-cigarettes may be regulated as tobacco products but with less nicotine content or be regulated as a medicinal product. A 2016 World Health Organization (WHO) report found that the scientific evidence for the effectiveness of vaping for quitting smoking is "scant and of low certainty". Healthcare organizations in the UK in 2015 have encouraged smokers to try e-cigarettes to help them quit smoking and also encouraged e-cigarette users to quit smoking tobacco entirely. 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." 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." 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.
In 1927, Joseph Robinson applied for a patent for an electronic vaporizer. Its purpose was to be used with medicinal compounds. The patent was approved in 1930. The device was never made available for sale. 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." In 1934, a patent stated that a product was "adapted for transforming volatile liquid medicaments into vapors or into mists of exceedingly fine particles." In 1936, a comparable patent was reported. These instances are in regard to vaporization for medicinal use. The earliest e-cigarette can be traced to American Herbert A. Gilbert, who in 1963 patented "a smokeless non-tobacco cigarette" that involved "replacing burning tobacco and paper with heated, moist, flavored air". This device produced flavored steam without nicotine. The patent was granted in 1965. Gilbert's invention was ahead of its time. There were prototypes, but it received little attention and was never commercialized because smoking was still fashionable at that time. Gilbert said in 2013 that today's electric cigarettes follow the basic design set forth in his original patent. The Favor cigarette, introduced in 1986, was another early noncombustible product promoted as an alternative nicotine-containing tobacco product.
Hon Lik, a Chinese pharmacist and inventor, who worked as a research pharmacist for a company producing ginseng products, is frequently credited with the invention of the modern e-cigarette. But tobacco companies have been developing nicotine aerosol generation devices since as early as 1963. Philip Morris' division NuMark, launched in 2013 the MarkTen e-cigarette that Philip Morris had been working on since 1990, 13 years prior to Hon Lik creating his e-cigarette. Hon quit smoking after his father, also a heavy smoker, died of lung cancer. In 2001, he thought of using a high frequency, piezoelectric ultrasound-emitting element to vaporize a pressurized jet of liquid containing nicotine. This design creates a smoke-like vapor. Hon said that using resistance heating obtained better results and the difficulty was to scale down the device to a small enough size. Hon's invention was intended to be an alternative to smoking. Hon Lik sees the e-cigarette as comparable to the "digital camera taking over from the analogue camera."
Hon Lik registered a patent for the modern e-cigarette design in 2003. Hon is credited with developing the first commercially successful electronic cigarette. The e-cigarette was first introduced to the Chinese domestic market in 2004. Many versions made their way to the US, sold mostly over the Internet by small marketing firms. E-cigarettes entered the European market and the US market in 2006 and 2007. The company that Hon worked for, Golden Dragon Holdings, registered an international patent in November 2007. The company changed its name to Ruyan (如烟, literally "like smoke") later the same month, and started exporting its products. 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). Ruyan later changed its company name to Dragonite International Limited. Most e-cigarettes today use a battery-powered heating element rather than the earlier ultrasonic technology design.
Initially, their performance did not meet the expectations of users. The e-cigarette continued to evolve from the first-generation three-part device. In 2007 British entrepreneurs Umer and Tariq Sheikh invented the cartomizer. This is a mechanism that integrates the heating coil into the liquid chamber. They launched this new device in the UK in 2008 under their Gamucci brand and the design is now widely adopted by most "cigalike" brands. Other users tinkered with various parts to produce more satisfactory homemade devices, and the hobby of "modding" was born. The first mod to replace the e-cigarette's case to accommodate a longer-lasting battery, dubbed the "screwdriver", was developed by Ted and Matt Rogers in 2008. Other enthusiasts built their own mods to improve functionality or aesthetics. When pictures of mods appeared at online vaping forums many people wanted them, so some mod makers produced more for sale.
In 2008, a consumer created an e-cigarette called the screwdriver. The device generated a lot of interest back then, as it let the user to vape for hours at one time. The invention led to demand for customizable e-cigarettes, prompting manufacturers to produce devices with interchangeable components that could be selected by the user. In 2009, Joyetech developed the eGo series which offered the power of the screwdriver model and a user-activated switch to a wide market. The clearomizer was invented in 2009. Originating from the cartomizer design, it contained the wicking material, an e-liquid chamber, and an atomizer coil within a single clear component. The clearomizer allows the user to monitor the liquid level in the device. Soon after the clearomizer reached the market, replaceable atomizer coils and variable voltage batteries were introduced. Clearomizers and eGo batteries became the best-selling customizable e-cigarette components in early 2012.
|Tobacco company||Subsidiary company||Electronic cigarette|
|Imperial Tobacco||Fontem Ventures and Dragonite||Puritane blu eCigs|
|British American Tobacco||CN Creative and Nicoventures||Vype|
|R. J. Reynolds Tobacco Company||R. J. Reynolds Vapor Company||Vuse|
|Altria ∗No longer sells e-cigarettes.
Altria acquired a 30% stake in Juul Labs.
|Nu Mark, LLC||MarkTen, Green Smoke|
|Japan Tobacco International||Ploom||E-lites LOGIC|
International tobacco companies dismissed e-cigarettes as a fad at first. However, recognizing the development of a potential new market sector that could render traditional tobacco products obsolete, they began to produce and market their own brands of e-cigarettes and acquire existing e-cigarette companies. They bought the largest e-cigarette companies. blu eCigs, a prominent US e-cigarette manufacturer, was acquired by Lorillard Inc. for $135 million in April 2012. British American Tobacco was the first tobacco business to sell e-cigarettes in the UK. They launched the e-cigarette Vype in July 2013. They launched Vype in 2013, while Imperial Tobacco's Fontem Ventures acquired the intellectual property owned by Hon Lik through Dragonite International Limited for $US 75 million in 2013 and launched Puritane in partnership with Boots UK. On 1 October 2013 Lorillard Inc. acquired another e-cigarette company, this time the UK based company SKYCIG. SKY was rebranded as blu. On 3 February 2014, Altria Group, Inc. acquired popular e-cigarette brand Green Smoke for $110 million. The deal was finalized in April 2014 for $110 million with $20 million in incentive payments. Altria also markets its own e-cigarette, the MarkTen, while Reynolds American has entered the sector with its Vuse product. Philip Morris, the world's largest tobacco company, purchased UK's Nicocigs in June 2014. On 30 April 2015, Japan Tobacco bought the US Logic e-cigarette brand. Japan Tobacco also bought the UK E-Lites brand in June 2014. On 15 July 2014, Lorillard sold blu to Imperial Tobacco as part of a deal for $7.1 billion.
Society and culture
Consumers of e-cigarettes have shown passionate support for e-cigarettes that other nicotine replacement products did not receive. They have the potential mass appeal that could challenge combustible tobacco's market position.
A subculture has emerged which calls itself "the vaping community". Members of this emerging subculture often see e-cigarettes as a safer alternative to smoking, and some view it as a hobby. The online forum E-Cig-Reviews.com was one of the first major communities. It and other online forums, such as UKVaper.org, were the origins of the hobby of modding. There are also groups on Facebook and Reddit. Online forums based around modding have grown in the vaping community. Vapers energetically embrace activities associated with e-cigarettes and in some circumstances act as unpaid evangelicals, according to a 2011 study. E-cigarette companies have a substantial online presence, as well as many individual vapers who blog and tweet about e-cigarette related products. A 2014 Postgraduate Medical Journal editorial stated that vapers "also engage in grossly offensive online attacks on anyone who has the temerity to suggest that ENDS are anything other than an innovation that can save thousands of lives with no risks". Contempt for Big Tobacco is part of vaping culture. A 2014 review stated that tobacco and e-cigarette companies interact with consumers for their policy agenda. The companies use websites, social media, and marketing to get consumers involved in opposing bills that include e-cigarettes in smoke-free laws. This is similar to tobacco industry activity going back to the 1980s. These approaches were used in Europe to minimize the EU Tobacco Products Directive in October 2013. Grassroots lobbying also influenced the Tobacco Products Directive decision. Tobacco companies have worked with organizations conceived to promote e-cigarette use, and these organizations have worked to hamper legislation intended at restricting e-cigarette use.
A popular vaporizer used by American youth is the Juul. Close to 80% of respondents in a 2017 Truth Initiative study aged 15–24 reported using Juul also used the device in the last 30 days. Teenagers use the verb "Juuling" to describe their use of Juul, and Juuling is the subject of many memes on social media. Students commented on Twitter about using the Juul device in class.
Large gatherings of vapers, called vape meets, take place around the US. They focus on e-cigarette devices, accessories, and the lifestyle that accompanies them. Vapefest, which started in 2010, is an annual show hosted by different cities. People attending these meetings are usually enthusiasts that use specialized, community-made products not found in convenience stores or gas stations. These products are mostly available online or in dedicated "vape" storefronts where mainstream e-cigarettes brands from the tobacco industry and larger e-cig manufacturers are not as popular. Some vape shops have a vape bar where patrons can test out different e-liquids and socialize. The Electronic Cigarette Convention in North America which started in 2013, is an annual show where companies and consumers meet up.
A subclass of vapers configure their atomizers to produce large amounts of vapor by using low-resistance heating coils. This practice is called "cloud-chasing". By using a coil with very low resistance, the batteries are stressed to a potentially unsafe extent. This could present a risk of dangerous battery failures. As vaping comes under increased scrutiny, some members of the vaping community have voiced their concerns about cloud-chasing, stating the practice gives vapers a bad reputation when doing it in public. The Oxford Dictionaries' word of the year for 2014 was "vape".
Regulation of e-cigarettes varies across countries and states, ranging from no regulation to banning them entirely. For instance, e-cigarettes are illegal in Japan, forcing the market to use heat-not-burn tobacco products for cigarette alternatives. Others have introduced strict restrictions and some have licensed devices as medicines such as in the UK. 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. As of 2015[update], around two thirds of major nations have regulated e-cigarettes in some way. Because of the potential relationship with tobacco laws and medical drug policies, e-cigarette legislation is being debated in many countries. The companies that make e-cigarettes have been pushing for laws that support their interests. In 2016 the US Department of Transportation banned the use of e-cigarettes on commercial flights. This regulation applies to all flights to and from the US. 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.
The legal status of e-cigarettes is currently pending in many countries. Many countries such as Brazil, Singapore, Uruguay, and India have banned e-cigarettes. Canada-wide in 2014, they were technically illegal to sell, as no nicotine-containing e-cigarettes are not regulated by Health Canada, but this is generally unenforced and they are commonly available for sale Canada-wide. In 2016, Health Canada announced plans to regulate vaping products. In the US and the UK, the use and sale to adults of e-cigarettes are legal.:US:UK The revised EU Tobacco Products Directive came into effect in May 2016, providing stricter regulations for e-cigarettes. It limits e-cigarette advertising in print, on television and radio, along with reducing the level of nicotine in liquids and reducing the flavors used. It does not ban vaping in public places. It requires the purchaser for e-cigarettes to be at least 18 and does not permit buying them for anyone less than 18 years of age. The updated Tobacco Products Directive has been disputed by tobacco lobbyists whose businesses could be impacted by these revisions. As of 8 August 2016, the US FDA extended its regulatory power to include e-cigarettes, e-liquid and all related products. Under this ruling the FDA will evaluate certain issues, including ingredients, product features and health risks, as well their appeal to minors and non-users. The FDA rule also bans access to minors. A photo ID is now required to buy e-cigarettes, and their sale in all-ages vending machines is not permitted in the US. As of August 2017, regulatory compliance deadlines relating to premarket review requirements for most e-cigarette and e-liquid products have been extended from November 2017 to 8 August 2022, which attracted a lawsuit filed by the American Heart Association, American Academy of Pediatrics, the Campaign for Tobacco-Free Kids, and other plaintiffs. In May 2016 the US FDA used its authority under the Family Smoking Prevention and Tobacco Control Act to deem e-cigarette devices and e-liquids to be tobacco products, which meant it intended to regulate the marketing, labelling, and manufacture of devices and liquids; vape shops that mix e-liquids or make or modify devices were considered manufacturing sites that needed to register with US FDA and comply with good manufacturing practice regulation. E-cigarette and tobacco companies have recruited lobbyists in an effort to prevent the US FDA from evaluating e-cigarette products or banning existing products already on the market.
In February 2014 the European Parliament passed regulations requiring standardization and quality control for liquids and vaporizers, disclosure of ingredients in liquids, and child-proofing and tamper-proofing for liquid packaging. In April 2014 the US FDA published proposed regulations for e-cigarettes. In the US some states tax e-cigarettes as tobacco products, and some state and regional governments have broadened their indoor smoking bans to include e-cigarettes. As of April 2017[update], 12 US states and 615 localities had prohibited the use of e-cigarettes in venues in which traditional cigarette smoking was prohibited. In 2015, at least 48 states and 2 territories had banned e-cigarette sales to minors.
E-cigarettes containing nicotine have been listed as drug delivery devices in a number of countries, and the marketing of such products has been restricted or put on hold until safety and efficacy clinical trials are conclusive. Since they do not contain tobacco, television advertising in the US is not restricted. Some countries have regulated e-cigarettes as a medical product even though they have not approved them as a smoking cessation aid. A 2014 review stated the emerging phenomenon of e-cigarettes has raised concerns in the health community, governments, and the general public and recommended that e-cigarettes should be regulated to protect consumers. It added, "heavy regulation by restricting access to e-cigarettes would just encourage continuing use of much unhealthier tobacco smoking." A 2014 review said regulation of the e-cigarette should be considered on the basis of reported adverse health effects.
They are marketed to men, women, and children as being safer than traditional cigarettes. They are also marketed to non-smokers. E-cigarette marketing is common. There are growing concerns that e-cigarette advertising campaigns unjustifiably focus on young adults, adolescents, and women. Large tobacco companies have greatly increased their marketing efforts. This marketing trend may expand the use of e-cigarettes and contribute to re-glamorizing smoking. Some companies may use e-cigarette advertising to advocate smoking, deliberately, or inadvertently, is an area of concern. 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." E-cigarette companies are using methods that were once used by the tobacco industry to persuade young people to starting using cigarettes. E-cigarettes are promoted to a certain extent to forge a vaping culture that entices non-smokers. Themes in e-cigarette marketing, including sexual content and customer satisfaction, are parallel to themes and techniques that have been found to be appealing to youth and young adults in traditional cigarette advertising and promotion. A 2017 review found "The tobacco industry sees a future where ENDS accompany and perpetuate, rather than supplant, tobacco use, especially targeting the youth." E-cigarettes and nicotine are regularly promoted as safe and even healthy in the media and on brand websites, is an area of concern.
While advertising of tobacco products is banned in most countries, television and radio e-cigarette advertising in several countries may be indirectly encouraging traditional cigarette use. E-cigarette advertisements are also in magazines, newspapers, online, and in retail stores. Between 2010 and 2014, e-cigarettes were second only to cigarettes as the top advertised product in magazines. As cigarette companies have acquired the largest e-cigarette brands, they currently benefit from a dual market of smokers and e-cigarette users while simultaneously presenting themselves as agents of harm reduction. This raises concerns about the appropriateness of endorsing a product that directly profits the tobacco industry. There is no evidence that the cigarette brands are selling e-cigarettes as part of a plan to phase out traditional cigarettes, despite some stating to want to cooperate in "harm reduction". E-cigarette advertising for using e-cigarettes as a quitting tool have been seen in the US, UK, and China, which have not been supported by regulatory bodies. In the US, six large e-cigarette businesses spent $59.3 million on promoting e-cigarettes in 2013. In the US and Canada, over $2 million is spent yearly on promoting e-cigarettes online. E-cigarette websites often made unscientific health statements in 2012. The ease to get past the age verification system at e-cigarette company websites allows underage individuals to access and be exposed to marketing. Around half of e-cigarette company websites have a minimum age notice that prohibited underage individuals from entering.
Celebrity endorsements are used to encourage e-cigarette use. A 2012 national US television advertising campaign for e-cigarettes starred Stephen Dorff exhaling a "thick flume" of what the advertisement describes as "vapor, not tobacco smoke", exhorting smokers with the message "We are all adults here, it's time to take our freedom back." Opponents of the tobacco industry state that the blu advertisement, in a context of longstanding prohibition of tobacco advertising on television, seems to have resorted to advertising tactics that got former generations of people in the US addicted to traditional cigarettes. Cynthia Hallett of Americans for Non-Smokers' Rights described the US advertising campaign as attempting to "re-establish a norm that smoking is okay, that smoking is glamorous and acceptable". University of Pennsylvania communications professor Joseph Cappella stated that the setting of the advertisement near an ocean was meant to suggest an association of clean air with the nicotine product. In 2012 and 2013, e-cigarette companies advertised to a large television audience in the US which included 24 million youth. The channels to which e-cigarette advertising reached the largest numbers of youth (ages 12–17) were AMC, Country Music Television, Comedy Central, WGN America, TV Land, and VH1.
E-cigarettes are heavily promoted across all media outlets. They are vigorously advertised, mostly through the Internet, as a safe substitute to traditional cigarettes, among other things. E-cigarette companies promote their e-cigarette products on Facebook, Instagram, YouTube, and Twitter. They are promoted on YouTube by movies with sexual material and music icons, who encourage minors to "take their freedom back." They have partenered with a number of sports and music icons to promote their products. Tobacco companies intensely market e-cigarettes to youth, with industry strategies including cartoon characters and candy flavors. Fruit flavored e-liquid is the most commonly marketed e-liquid flavor on social media. E-cigarette companies commonly promote that their products contain only water, nicotine, glycerin, propylene glycol, and flavoring but this assertion is misleading as researchers have found differing amounts of heavy metals in the vapor, including chromium, nickel, tin, silver, cadmium, mercury, and aluminum. The widespread assertion that e-cigarettes emit "only water vapor" is not true because the evidence demonstrates e-cigarette vapor contains possibly harmful chemicals such as nicotine, carbonyls, metals, and volatile organic compounds, in addition to particulate matter. Massive advertising included the assertion that they would present little risk to non-users. Though, "disadvantages and side effects have been reported in many articles, and the unfavorable effects of its secondhand vapor have been demonstrated in many studies." Many e-cigarette companies market their products as a smoking cessation aid without evidence of effectiveness. E-cigarette marketing has been found to make unsubstantiated health statements (e.g., that they help one quit smoking) including statements about improving psychiatric symptoms, which may be particularly appealing to smokers with mental illness. E-cigarette marketing advocate weight control and emphasize use of nicotine with many flavors. These marketing angles could particularly entice overweight people, youth, and vulnerable groups. Some e-cigarette companies state that their products are green without supporting evidence which may be purely to increase their sales.
The number of e-cigarettes sold increased every year from 2003 to 2014. In 2015 a slowdown in the growth in usage occurred in the US. As of January 2018, the growth in usage in the UK has slowed down since 2013. As of 2014[update] there were at least 466 e-cigarette brands. Worldwide e-cigarette sales in 2014 were around US$7 billion. Worldwide e-cigarette sales in 2019 were about $19.3 billion. E-cigarette sales could exceed traditional cigarette sales by 2023. Approximately 30–50% of total e-cigarettes sales are handled on the internet. Established tobacco companies have a significant share of the e-cigarette market.
As of 2018[update], 95% of e-cigarette devices were made in China, mainly in Shenzhen. Chinese companies' market share of e-liquid is low. In 2014, online and offline sales starting increases. Since combustible cigarettes are relatively inexpensive in China a lower price may not be large factor in marketing vaping products over there.
In 2015, 80% of all e-cigarette sales in convenience stores in the US were products made by tobacco companies. According to Nielsen Holdings, convenience store e-cigarette sales in the US went down for the first time during the four-week period ending on 10 May 2014. Wells Fargo analyst Bonnie Herzog attributes this decline to a shift in consumers' behavior, buying more specialized devices or what she calls "vapors-tanks-mods (VTMs)" that are not tracked by Nielsen. Wells Fargo estimated that VTMs accounted for 57% of the 3.5 billion dollar market in the US for vapor products in 2015. In 2014, dollar sales of customizable e-cigarettes and e-liquid surpassed sales of cigalikes in the US, even though, overall, customizables are a less expensive vaping option. In 2014, the Smoke-Free Alternatives Trade Association estimated that there were 35,000 vape shops in the US, more than triple the number a year earlier. However the 2015 slowdown in market growth affected VTMs as well. Large tobacco retailers are leading the cigalike market. "We saw the market's sudden recognition that the cigarette industry seems to be in serious trouble, disrupted by the rise of vaping," Mad Money's Jim Cramer stated April 2018. "Over the course of three short days, the tobacco stocks were bent, they were spindled and they were mutilated by the realization that electronic cigarettes have become a serious threat to the old-school cigarette makers," he added. In 2019, a vaping industry organization released a report stating that a possible US ban on e-cigarettes flavors can potentially effect greater than 150,000 jobs around the US.
The leading seller in the e-cigarette market in the US is the Juul e-cigarette, which was introduced in June 2015. As of August 2018[update], Juul accounts for over 72% of the US e-cigarette market monitored by Nielsen, and its closest competitor—RJ Reynolds' Vuse—makes up less than 10% of the market. Juul rose to popularity quickly, growing by 700% in 2016 alone. On 17 July 2018 Reynolds announced it will debut in August 2018 a pod mod type device similar Juul. The popularity of the Juul pod system has led to a flood of other pod devices hitting the market.
In Canada, e-cigarettes had an estimated value of 140 million CAD in 2015. There are numerous e-cigarette retail shops in Canada. A 2014 audit of retailers in four Canadian cities found that 94% of grocery stores, convenience stores, and tobacconist shops which sold e-cigarettes sold nicotine-free varieties only, while all vape shops stocked at least one nicotine-containing product.
By 2015 the e-cigarette market had only reached a twentieth of the size of the tobacco market in the UK. In the UK in 2015 the "most prominent brands of cigalikes" were owned by tobacco companies, however, with the exception of one model, all the tank types came from "non-tobacco industry companies". Yet some tobacco industry products, while using prefilled cartridges, resemble tank models.
France's e-cigarette market was estimated by Groupe Xerfi to be €130 million in 2015. Additionally, France's e-liquid market was estimated at €265 million. In December 2015, there were 2,400 vape shops in France, 400 fewer than in March of the same year. Industry organization Fivape said the reduction was due to consolidation, not to reduced demand.
Electronic cigarettes are variously known as e-cigarettes, e-Cigarettes, e-cigs, eCigs, E-Cigs, ECIGs, ECs, eCig vaping, electronic nicotine delivery devices (ENDD), electronic nicotine delivery systems (ENDS), electronic non-nicotine delivery systems (ENNDS), electrically heated cigarettes, non‐medicinal nicotine delivery systems (NMNDS), electrically heated smoking systems, electric cigarettes, electronic cigs, electronic smoking devices, electronic tobaccos, electronic vaping devices, electronic vaporizing devices, electronic vaporizers, electronic vaporisers, e-vaporizers, vaporizers, battery-powered devices, battery-powered vaporizers, personal battery powered vaporizers, personal vaporizers, personal vaporisers, (sp), PVs, vapourisers, advanced generation devices, advanced generation products, advanced refillable personal vaporizers advanced personal vaporizers, APVs, alternative nicotine delivery systems, ANDS, alternative nicotine products, vaporized nicotine products, VNPs, nicotine vaping products, NVPs disposable electronic cigarettes, disposable ECs, rechargeable e-cigarettes, digital cigarettes, digital vapor devices, e-vapor devices, vape devices, vaping devices, electronic vapor products, EVPs, e-vapor products, vapor products, vapor devices, vapour devices, vaporing devices, vaporizer pens, vapor pens, vape pens, vape pipes, vape sticks, vapes, cigalikes, cig-alikes, cig-a-likes, vapors-tanks-mods, VTMs, vape tanks, tanks, tank systems, eGo units, eGos, electronic cigarette mods electronic mods, e-cigarette mods, e-cig mods, mechanical e-cig mods, mechanical mods, mods, vape mods, pocket vapes, pod mods, pod vapes, pod systems, pod products, electronic cigars, e-cigars, electronic pipes, e-pipes, electronic hookahs, e-hookahs, hookah pens, hookah sticks, G-pens, electronic shishas, e-shishas, shisha pens, electronic smokes, e-smokes, electronic cigarillos, smokeless cigarillos, smokeless cigarettes, smokeless cigars, tobacco-free electronic cigarettes, tobacco-free cigarettes, vaporettes, technofoggers, or cloud-chasing vaporizers.
British American Tobacco, through their subsidiary Nicoventures, licensed a nicotine delivery system based on existing asthma inhaler technology from UK-based healthcare company Kind Consumer. In September 2014 a product based on this named Voke obtained approval from the United Kingdom's Medicines and Healthcare Products Regulatory Agency.
In 2011 Philip Morris International bought the rights to a nicotine pyruvate technology developed by Jed Rose at Duke University. The technology is based on the chemical reaction between pyruvic acid and nicotine, which produces an inhalable nicotine pyruvate vapor. Philip Morris Products S.A. created a different kind e-cigarette named P3L. The device is supplied with a cartridge that contains nicotine and lactic acid in different cavities. When turned on and heated, the nicotine salt called nicotine lactate forms an aerosol.
The IQOS is a heat-not-burn tobacco product marketed by Philip Morris International. It heats tobacco at a lower temperature than traditional cigarettes. The tobacco sticks reach a temperature up to 350 °C. It sold first in Japan since November 2014. On 2 December 2016, the United Tobacco Vapor Group's (UTVG) stated that they have been given a patent for their vaporizing component system. qmos from UTVG does not contain a wick or sponge and the number of components is 5 compared to 20 for traditional e-cigarettes. Pax Labs has developed vaporizers that heats the leaves of tobacco to deliver nicotine in a vapor. On 1 June 2015, they introduced Juul a type of e-cigarette which delivers 10 times as much nicotine as other e-cigarettes, equivalent to an actual cigarette puff. Juul was spun off from Pax Labs in June 2017 and is now available by the independent company Juul Labs. The eTron 3T from Vapor Tobacco Manufacturing, launched in December 2014, employs a patented, aqueous system whereby the tobacco is extracted into water. The e-liquid contains organic tobacco, organic glycerin, and water.
In December 2013 Japan Tobacco launched Ploom in Japan. In January 2016 they launched Ploom TECH that produces a vapor from a heated liquid that moves through a capsule of granulated tobacco leaves. In 2016 British American Tobacco (BAT) released its own version of the heat but not burn technology called glo in Japan and Switzerland. It uses tobacco sticks rather than nicotine liquid, and does not directly heat or burn tobacco. In 2015 the glo iFuse was released in Romania by BAT. It uses a coil to heat a liquid that produces a vapor that moves through mixed tobacco. Heat-not-burn tobacco products were first introduced in 1988, but were not a commercial success.
BLOW started selling e-hookahs, an electronic version of the hookah, in 2014. The handle of each hose for the e-hookah contains a heating element and a liquid, which produces vapor. Gopal Bhatnagar based in Toronto, Canada invented a 3D printed adapter to turn a traditional hookah into an e-hookah. It is used instead of the ceramic bowl that contains shisha tobacco. Rather than the tobacco, users can insert e-cigarettes. KanaVape is an e-cigarette containing cannabidiol (CBD) and no THC. Several companies including Canada's Eagle Energy Vapor are selling caffeine-based e-cigarettes instead of containing nicotine.
Robbing the Future - Advertising Aimed at Children.
California teens talk about their real experiences with vaping.
Tobacco Use By Youth Is Rising – February 2019 – Vital Signs.
Julius Dein Performs A Magic Trick on a Vape.
- Vapes, vaporizers, vape pens, hookah pens, electronic cigarettes (e-cigarettes or e-cigs), and e-pipes are some of the many terms used to describe electronic nicotine delivery systems (ENDS).
- A 2019 review concluded that, "no long term vaping toxicological/safety studies have been done in humans; without these data, saying with certainty that e-cigarettes are safer than combustible cigarettes is impossible,"
- A 2014 review found "In addition to the uniqueness of the liquid compositions in each brand, inconsistency of both the device performance properties and the data collection methodologies used by researchers contribute to the observed variation in constituent levels and to the range of particle size distributions among products."
- A 2012 review found "Whereas the "gateway" hypothesis does not specify mechanistic connections between "stages", and does not extend to the risks for addictions, the concept of common liability to addictions incorporates sequencing of drug use initiation as well as extends to related addictions and their severity, provides a parsimonious explanation of substance use and addiction co-occurrence, and establishes a theoretical and empirical foundation to research in etiology, quantitative risk and severity measurement, as well as targeted non-drug-specific prevention and early intervention."
- A 2019 review concluded that, "no long term vaping toxicological/safety studies have been done in humans; without these data, saying with certainty that e-cigarettes are safer than combustible cigarettes is impossible."
- While it is still widely debated which particular component of vape liquid is the cause of illness, vitamin E acetate, specifically, has been identified as a potential culprit in vape-related illnesses. There is likely more than one cause of the outbreak.
- Since 2016 the US Food and Drug Administration (US FDA) regulated e-cigarettes under the classification of tobacco products and labeled them as electronic nicotine delivery systems. A 2018 report commissioned by the US FDA decided to use the term e-cigarettes, indicating that for some use e-liquids containing no nicotine.
- 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.
- Stratton, Kathleen; Kwan, Leslie Y.; Eaton, David L. (January 2018). Public Health Consequences of E-Cigarettes (PDF). National Academies of Sciences, Engineering, and Medicine. National Academies Press. pp. 1–774. doi:10.17226/24952. ISBN 978-0-309-46834-3. PMID 29894118.
- Wilder, Natalie; Daley, Claire; Sugarman, Jane; Partridge, James (April 2016). "Nicotine without smoke: Tobacco harm reduction". Royal College of Physicians. UK. pp. 1–191.
- McNeill, A; Brose, LS; Calder, R; Hitchman, SC; Hajek, P; McRobbie, H (August 2015). "E-cigarettes: an evidence update" (PDF). Public Health England. UK. pp. 1–113.
- "State Health Officer's Report on E-Cigarettes: A Community Health Threat" (PDF). California Tobacco Control Program. California Department of Public Health. January 2015. pp. 1–21. This article incorporates text from this source, which is in the public domain.
- "Electronic nicotine delivery systems" (PDF). World Health Organization. 21 July 2014. pp. 1–13.
- Linda Bauld; Kathryn Angus; Marisa de Andrade (May 2014). "E-cigarette uptake and marketing" (PDF). Public Health England. UK. pp. 1–19.
- National Center for Chronic Disease Prevention Health Promotion (US) Office on Smoking Health (2014). The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Surgeon General of the United States. pp. 1–943. PMID 24455788.
- "Vaporizers, E-Cigarettes, and other Electronic Nicotine Delivery Systems (ENDS)". United States Food and Drug Administration. 14 February 2020. This article incorporates text from this source, which is in the public domain.
- Orellana-Barrios, Menfil A.; Payne, Drew; Mulkey, Zachary; Nugent, Kenneth (2015). "Electronic cigarettes-a narrative review for clinicians". The American Journal of Medicine. 128 (7): 674–81. doi:10.1016/j.amjmed.2015.01.033. ISSN 0002-9343. PMID 25731134.
- Cheng, T. (2014). "Chemical evaluation of electronic cigarettes". Tobacco Control. 23 (Supplement 2): ii11–ii17. doi:10.1136/tobaccocontrol-2013-051482. ISSN 0964-4563. PMC 3995255. PMID 24732157.
- 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.
- Pepper, J. K.; Brewer, N. T. (2013). "Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review". Tobacco Control. 23 (5): 375–384. doi:10.1136/tobaccocontrol-2013-051122. ISSN 0964-4563. PMC 4520227. PMID 24259045.
- Ebbert, Jon O.; Agunwamba, Amenah A.; Rutten, Lila J. (2015). "Counseling Patients on the Use of Electronic Cigarettes". Mayo Clinic Proceedings. 90 (1): 128–134. doi:10.1016/j.mayocp.2014.11.004. ISSN 0025-6196. PMID 25572196.
- Siu, AL (22 September 2015). "Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women: U.S. Preventive Services Task Force Recommendation Statement". Annals of Internal Medicine. 163 (8): 622–34. doi:10.7326/M15-2023. PMID 26389730.
- Harrell, PT; Simmons, VN; Correa, JB; Padhya, TA; Brandon, TH (4 June 2014). "Electronic Nicotine Delivery Systems ("E-cigarettes"): Review of Safety and Smoking Cessation Efficacy". Otolaryngology–Head and Neck Surgery. 151 (3): 381–393. doi:10.1177/0194599814536847. PMC 4376316. PMID 24898072.
- Hartmann-Boyce, Jamie; McRobbie, Hayden; Bullen, Chris; Begh, Rachna; Stead, Lindsay F; Hajek, Peter; Hartmann-Boyce, Jamie (2016). "Electronic cigarettes for smoking cessation". Cochrane Database Syst Rev. 9: CD010216. doi:10.1002/14651858.CD010216.pub3. PMC 6457845. PMID 27622384.
- Brady, Benjamin R.; De La Rosa, Jennifer S.; Nair, Uma S.; Leischow, Scott J. (2019). "Electronic Cigarette Policy Recommendations: A Scoping Review". American Journal of Health Behavior. 43 (1): 88–104. doi:10.5993/AJHB.43.1.8. ISSN 1087-3244. PMID 30522569.
- Bals, Robert; Boyd, Jeanette; Esposito, Susanna; Foronjy, Robert; Hiemstra, Pieter S.; Jiménez-Ruiz, Carlos A.; Katsaounou, Paraskevi; Lindberg, Anne; Metz, Carlos; Schober, Wolfgang; Spira, Avrum; Blasi, Francesco (2019). "Electronic cigarettes: a task force report from the European Respiratory Society". European Respiratory Journal. 53 (2): 1801151. doi:10.1183/13993003.01151-2018. ISSN 0903-1936. PMID 30464018.
- Glasser, Allison M.; Collins, Lauren; Pearson, Jennifer L.; Abudayyeh, Haneen; Niaura, Raymond S.; Abrams, David B.; Villanti, Andrea C. (1 February 2017). "Overview of Electronic Nicotine Delivery Systems: A Systematic Review". American Journal of Preventive Medicine. 52 (2): e33–e66. doi:10.1016/j.amepre.2016.10.036. ISSN 0749-3797. PMC 5253272. PMID 27914771. Retrieved 24 February 2020.
- Farsalinos, Konstantinos (1 January 2018). "Electronic cigarettes: an aid in smoking cessation, or a new health hazard?". Therapeutic Advances in Respiratory Disease. 12: 1753465817744960. doi:10.1177/1753465817744960. ISSN 1753-4666. PMC 5937152. PMID 29214890.
- "E-cigarettes around 95% less harmful than tobacco estimates landmark review". gov.uk. Public Health England.
- "Public Health Consequences of E-Cigarettes" (PDF). Retrieved 27 February 2020.
For youth and young adults, there is substantial evidence that e-cigarette use increases the risk of ever using combustible tobacco cigarettes.
- "E-cigarettes". www.who.int. Retrieved 27 February 2020.
Furthermore, there is a growing body of evidence in some settings that never-smoker minors who use ENDS at least double their chance of starting to smoke conventional tobacco cigarettes later in life.
- Drummond, MB; Upson, D (February 2014). "Electronic cigarettes. Potential harms and benefits". Annals of the American Thoracic Society. 11 (2): 236–42. doi:10.1513/annalsats.201311-391fr. PMC 5469426. PMID 24575993.
- Gotts, Jeffrey E; Jordt, Sven-Eric; McConnell, Rob; Tarran, Robert (2019). "What are the respiratory effects of e-cigarettes?". BMJ. 366: l5275. doi:10.1136/bmj.l5275. ISSN 0959-8138. PMID 31570493.
- Knorst, Marli Maria; Benedetto, Igor Gorski; Hoffmeister, Mariana Costa; Gazzana, Marcelo Basso (2014). "The electronic cigarette: the new cigarette of the 21st century?". Jornal Brasileiro de Pneumologia. 40 (5): 564–572. doi:10.1590/S1806-37132014000500013. ISSN 1806-3713. PMC 4263338. PMID 25410845.
- Burstyn, Igor (9 January 2014). "Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks". BMC Public Health. 14 (1): 18. doi:10.1186/1471-2458-14-18. ISSN 1471-2458. PMC 3937158. PMID 24406205.
- Hartmann‐Boyce, Jamie; McRobbie, Hayden; Bullen, Chris; Begh, Rachna; Stead, Lindsay F.; Hajek, Peter (2016). "Electronic cigarettes for smoking cessation". Cochrane Database of Systematic Reviews. 9 (9): CD010216. doi:10.1002/14651858.CD010216.pub3. ISSN 1465-1858. PMC 6457845. PMID 27622384.
However, the small number of trials, low event rates and wide confidence intervals around the estimates mean that our confidence in the result is rated 'low' by GRADE standards.
- Paley, Grace L.; Echalier, Elizabeth; Eck, Thomas W.; Hong, Augustine R.; Farooq, Asim V.; Gregory, Darren G.; Lubniewski, Anthony J. (2016). "Corneoscleral Laceration and Ocular Burns Caused by Electronic Cigarette Explosions". Cornea. 35 (7): 1015–1018. doi:10.1097/ICO.0000000000000881. ISSN 0277-3740. PMC 4900417. PMID 27191672.
- Grana, R; Benowitz, N; Glantz, SA (13 May 2014). "E-cigarettes: a scientific review". Circulation. 129 (19): 1972–86. doi:10.1161/circulationaha.114.007667. PMC 4018182. PMID 24821826.
- NASEM/IOM. "Public Health Consequences of E-Cigarettes". National Academies Press. p. 198. Retrieved 24 February 2020.
Conclusion 5-2- There is conclusive evidence that, other than nicotine, the number, quantity, and characteristics of potentially toxic substances emitted from e-cigarettes are highly variable and depend on product characteristics (including device and e-liquid characteristics) and how the device is operated
- Hajek, P; Etter, JF; Benowitz, N; Eissenberg, T; McRobbie, H (31 July 2014). "Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit". Addiction. 109 (11): 1801–10. doi:10.1111/add.12659. PMC 4487785. PMID 25078252.
- Jenssen, Brian P.; Boykan, Rachel (2019). "Electronic Cigarettes and Youth in the United States: A Call to Action (at the Local, National and Global Levels)". Children. 6 (2): 30. doi:10.3390/children6020030. ISSN 2227-9067. PMC 6406299. PMID 30791645. This article incorporates text by Brian P. Jenssen and Rachel Boykan available under the CC BY 4.0 license.
- Rahman, Muhammad; Hann, Nicholas; Wilson, Andrew; Worrall-Carter, Linda (2014). "Electronic cigarettes: patterns of use, health effects, use in smoking cessation and regulatory issues". Tobacco Induced Diseases. 12 (1): 21. doi:10.1186/1617-9625-12-21. PMC 4350653. PMID 25745382.
- Kim, Ki-Hyun; Kabir, Ehsanul; Jahan, Shamin Ara (2016). "Review of electronic cigarettes as tobacco cigarette substitutes: their potential human health impact". Journal of Environmental Science and Health, Part C. 34 (4): 262–275. doi:10.1080/10590501.2016.1236604. ISSN 1059-0501. PMID 27635466.
- "European court: Tougher rules on electronic cigarettes". Business Insider. Associated Press. 4 May 2016.
- "FDA's New Regulations for E-Cigarettes, Cigars, and All Other Tobacco Products". United States Food and Drug Administration. 17 August 2017.
- "E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General" (PDF). Surgeon General of the United States. 2016. pp. 1–298. This article incorporates text from this source, which is in the public domain.
- "Parents Against Vaping E-cigarettes". Retrieved 24 February 2020.
- "Home - Campaign for Tobacco-Free Kids". Retrieved 24 February 2020.
- Wang, Teresa W. (2019). "Tobacco Product Use and Associated Factors Among Middle and High School Students — United States, 2019". MMWR. Surveillance Summaries. 68 (12): 1–22. doi:10.15585/mmwr.ss6812a1. PMC 6903396. PMID 31805035.
- "E-cigarette use triples among middle and high school students in just one year". Centers for Disease Control and Prevention. 16 April 2015.
- PHE (15 May 2014). "Electronic cigarettes: reports commissioned by PHE". GOV.UK. Retrieved 29 October 2019.
- Bhatnagar, A.; Whitsel, L. P.; Ribisl, K. M.; Bullen, C.; Chaloupka, F.; Piano, M. R.; Robertson, R. M.; McAuley, T.; Goff, D.; Benowitz, N. (24 August 2014). "Electronic Cigarettes: A Policy Statement From the American Heart Association". Circulation. 130 (16): 1418–1436. doi:10.1161/CIR.0000000000000107. PMID 25156991.
- Mincer, Jilian (10 June 2015). "E-cigarette usage surges in past year: Reuters/Ipsos poll". Reuters.
- "Use of electronic cigarettes (vaporisers) among adults in Great Britain" (PDF). ASH UK. May 2016.
- Glasser, A. M.; Cobb, C. O.; Teplitskaya, L.; Ganz, O.; Katz, L.; Rose, S. W.; Feirman, S.; Villanti, A. C. (2015). "Electronic nicotine delivery devices, and their impact on health and patterns of tobacco use: a systematic review protocol". BMJ Open. 5 (4): e007688. doi:10.1136/bmjopen-2015-007688. ISSN 2044-6055. PMC 4420972. PMID 25926149.
- Farsalinos KE; Spyrou A; Tsimopoulou K; Stefopoulos C; Romagna G; Voudris V (2014). "Nicotine absorption from electronic cigarette use: Comparison between first and new-generation devices". Scientific Reports. 4: 4133. Bibcode:2014NatSR...4E4133F. doi:10.1038/srep04133. PMC 3935206. PMID 24569565.
- Hayden McRobbie (2014). "Electronic cigarettes" (PDF). National Centre for Smoking Cessation and Training. pp. 1–16.
- Konstantinos Farsalinos (2015). "Electronic cigarette evolution from the first to fourth generation and beyond" (PDF). Global Forum on Nicotine. p. 23. Archived from the original (PDF) on 8 July 2015.
- Crotty Alexander LE; Vyas A; Schraufnagel DE; Malhotra A (2015). "Electronic cigarettes: the new face of nicotine delivery and addiction". J Thorac Dis. 7 (8): E248–51. doi:10.3978/j.issn.2072-1439.2015.07.37. PMC 4561260. PMID 26380791.
- Tom McBride (11 February 2013). "Vaping Basics – VAPE GEAR". Spinfuel eMagazine.
- Weedston, Lindsey (8 April 2019). "FDA To Investigate Whether Vaping Causes Seizures". The Fix.
- Barrington-Trimis, Jessica L.; Leventhal, Adam M. (2018). "Adolescents' Use of "Pod Mod" E-Cigarettes — Urgent Concerns". New England Journal of Medicine. 379 (12): 1099–1102. doi:10.1056/NEJMp1805758. ISSN 0028-4793. PMID 30134127.
- Jankowski, Mateusz; Brożek, Grzegorz; Lawson, Joshua; Skoczyński, Szymon; Zejda, Jan (2017). "E-smoking: Emerging public health problem?". International Journal of Occupational Medicine and Environmental Health. 30 (3): 329–344. doi:10.13075/ijomeh.1896.01046. ISSN 1232-1087. PMID 28481369.
- England, Lucinda J.; Bunnell, Rebecca E.; Pechacek, Terry F.; Tong, Van T.; McAfee, Tim A. (2015). "Nicotine and the Developing Human". American Journal of Preventive Medicine. 49 (2): 286–93. doi:10.1016/j.amepre.2015.01.015. ISSN 0749-3797. PMC 4594223. PMID 25794473.
- Bertholon, J.F.; Becquemin, M.H.; Annesi-Maesano, I.; Dautzenberg, B. (2013). "Electronic Cigarettes: A Short Review". Respiration. 86 (5): 433–8. doi:10.1159/000353253. ISSN 1423-0356. PMID 24080743.
- Jimenez Ruiz, CA; Solano Reina, S; de Granda Orive, JI; Signes-Costa Minaya, J; de Higes Martinez, E; Riesco Miranda, JA; Altet Gómez, N; Lorza Blasco, JJ; Barrueco Ferrero, M; de Lucas Ramos, P (August 2014). "The electronic cigarette. Official statement of the Spanish Society of Pneumology and Thoracic Surgery (SEPAR) on the efficacy, safety and regulation of electronic cigarettes". Archivos de Bronconeumologia. 50 (8): 362–7. doi:10.1016/j.arbres.2014.02.006. PMID 24684764.
- Oh, Anne Y.; Kacker, Ashutosh (December 2014). "Do electronic cigarettes impart a lower potential disease burden than conventional tobacco cigarettes?: Review on e-cigarette vapor versus tobacco smoke". The Laryngoscope. 124 (12): 2702–2706. doi:10.1002/lary.24750. PMID 25302452.
- Leduc, Charlotte; Quoix, Elisabeth (2016). "Is there a role for e-cigarettes in smoking cessation?". Therapeutic Advances in Respiratory Disease. 10 (2): 130–135. doi:10.1177/1753465815621233. ISSN 1753-4658. PMC 5933562. PMID 26668136.
- Wilder 2016, p. 82.
- Dan Nosowitz (5 June 2015). "America's First Certified Organic E-Cigarette Vaping Liquid Is Here". Modern Farmer.
- Thirión-Romero, Ireri; Pérez-Padilla, Rogelio; Zabert, Gustavo; Barrientos-Gutiérrez, Inti (2019). "Respiratory Impact of Electronic Cigarettes and Low-Risk Tobacco". Revista de investigación Clínica. 71 (1): 17–27. doi:10.24875/RIC.18002616. ISSN 0034-8376. PMID 30810544.
- John Reid Blackwell (7 June 2015). "Avail Vapor offers glimpse into the 'art and science' of e-liquids". Richmond Times-Dispatch.
- Henry, Travis S.; Kligerman, Seth J.; Raptis, Constantine A.; Mann, Howard; Sechrist, Jacob W.; Kanne, Jeffrey P. (2020). "Imaging Findings of Vaping-Associated Lung Injury". American Journal of Roentgenology. 214 (3): 498–505. doi:10.2214/AJR.19.22251. ISSN 0361-803X. PMID 31593518.
- "Manufacturing". United States Food and Drug Administration. 12 August 2016.
- Famele, M.; Ferranti, C.; Abenavoli, C.; Palleschi, L.; Mancinelli, R.; Draisci, R. (2014). "The Chemical Components of Electronic Cigarette Cartridges and Refill Fluids: Review of Analytical Methods". Nicotine & Tobacco Research. 17 (3): 271–279. doi:10.1093/ntr/ntu197. ISSN 1462-2203. PMC 5479507. PMID 25257980.
- E-Liquid Manufacturing Standards (PDF). US: American E-Liquid Manufacturing Standards Association (AEMSA). 4 September 2015. pp. 1–13.
- Rom, Oren; Pecorelli, Alessandra; Valacchi, Giuseppe; Reznick, Abraham Z. (2014). "Are E-cigarettes a safe and good alternative to cigarette smoking?". Annals of the New York Academy of Sciences. 1340 (1): 65–74. Bibcode:2015NYASA1340...65R. doi:10.1111/nyas.12609. ISSN 0077-8923. PMID 25557889.
- Jones, Lora (15 September 2019). "Vaping: How popular are e-cigarettes? - Spending on e-cigarettes is growing". BBC News.
- 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.
- Bourke, Liam; Bauld, Linda; Bullen, Christopher; Cumberbatch, Marcus; Giovannucci, Edward; Islami, Farhad; McRobbie, Hayden; Silverman, Debra T.; Catto, James W.F. (2017). "E-cigarettes and Urologic Health: A Collaborative Review of Toxicology, Epidemiology, and Potential Risks" (PDF). European Urology. 71 (6): 915–923. doi:10.1016/j.eururo.2016.12.022. hdl:1893/24937. ISSN 0302-2838. PMID 28073600.
- Cai, Hua; Wang, Chen (2017). "Graphical review: The redox dark side of e-cigarettes; exposure to oxidants and public health concerns". Redox Biology. 13: 402–406. doi:10.1016/j.redox.2017.05.013. ISSN 2213-2317. PMC 5493817. PMID 28667909.
- West, Robert; Beard, Emma; Brown, Jamie (9 January 2018). "Electronic cigarettes in England - latest trends (STS140122)". Smoking in England. p. 28.
- Camenga, Deepa R.; Klein, Jonathan D. (2016). "Tobacco Use Disorders". Child and Adolescent Psychiatric Clinics of North America. 25 (3): 445–460. doi:10.1016/j.chc.2016.02.003. ISSN 1056-4993. PMC 4920978. PMID 27338966.
- Schneider, Sven; Diehl, Katharina (2016). "Vaping as a Catalyst for Smoking? An Initial Model on the Initiation of Electronic Cigarette Use and the Transition to Tobacco Smoking Among Adolescents". Nicotine & Tobacco Research. 18 (5): 647–653. doi:10.1093/ntr/ntv193. ISSN 1462-2203. PMID 26386472.
- Yoong, Sze Lin; Stockings, Emily; Chai, Li Kheng; Tzelepis, Flora; Wiggers, John; Oldmeadow, Christopher; Paul, Christine; Peruga, Armando; Kingsland, Melanie; Attia, John; Wolfenden, Luke (2018). "Prevalence of electronic nicotine delivery systems (ENDS) use among youth globally: a systematic review and meta-analysis of country level data". Australian and New Zealand Journal of Public Health. 42 (3): 303–308. doi:10.1111/1753-6405.12777. ISSN 1326-0200. PMID 29528527.
- Biyani, Sneh; Derkay, Craig S. (2017). "E-cigarettes: An update on considerations for the otolaryngologist". International Journal of Pediatric Otorhinolaryngology. 94: 14–16. doi:10.1016/j.ijporl.2016.12.027. ISSN 0165-5876. PMID 28167004.
- McNeill 2015, p. 87.
- Zhong, Jieming; Cao, Shuangshuang; Gong, Weiwei; Fei, Fangrong; Wang, Meng (2016). "Electronic Cigarettes Use and Intention to Cigarette Smoking among Never-Smoking Adolescents and Young Adults: A Meta-Analysis". International Journal of Environmental Research and Public Health. 13 (5): 465. doi:10.3390/ijerph13050465. ISSN 1660-4601. PMC 4881090. PMID 27153077.
- Peterson, Lisa A.; Hecht, Stephen S. (2017). "Tobacco, e-cigarettes, and child health". Current Opinion in Pediatrics. 29 (2): 225–230. doi:10.1097/MOP.0000000000000456. ISSN 1040-8703. PMC 5598780. PMID 28059903.
- "E-Cigarette Use Among Youth and Young Adults A Report of the Surgeon General: Fact Sheet" (PDF). Surgeon General of the United States. 2016. This article incorporates text from this source, which is in the public domain.
- Stratton 2018, p. Summary, 16.
- "American Cancer Society Position Statement on Electronic Cigarettes". American Cancer Society. February 2018.
- Glantz, Stanton A.; Bareham, David W. (January 2018). "E-Cigarettes: Use, Effects on Smoking, Risks, and Policy Implications". Annual Review of Public Health. 39 (1): 215–235. doi:10.1146/annurev-publhealth-040617-013757. ISSN 0163-7525. PMC 6251310. PMID 29323609. This article incorporates text by Stanton A. Glantz and David W. Bareham available under the CC BY 4.0 license.
- Cormet-Boyaka, Estelle; Zare, Samane; Nemati, Mehdi; Zheng, Yuqing (2018). "A systematic review of consumer preference for e-cigarette attributes: Flavor, nicotine strength, and type". PLOS One. 13 (3): e0194145. Bibcode:2018PLoSO..1394145Z. doi:10.1371/journal.pone.0194145. ISSN 1932-6203. PMC 5854347. PMID 29543907. This article incorporates text by Samane Zare, Mehdi Nemati, and Yuqing Zheng available under the CC BY 4.0 license.
- Qasim, Hanan; Karim, Zubair A.; Rivera, Jose O.; Khasawneh, Fadi T.; Alshbool, Fatima Z. (2017). "Impact of Electronic Cigarettes on the Cardiovascular System". Journal of the American Heart Association. 6 (9): e006353. doi:10.1161/JAHA.117.006353. ISSN 2047-9980. PMC 5634286. PMID 28855171.
- Giroud, Christian; de Cesare, Mariangela; Berthet, Aurélie; Varlet, Vincent; Concha-Lozano, Nicolas; Favrat, Bernard (2015). "E-Cigarettes: A Review of New Trends in Cannabis Use". International Journal of Environmental Research and Public Health. 12 (8): 9988–10008. doi:10.3390/ijerph120809988. ISSN 1660-4601. PMC 4555324. PMID 26308021. This article incorporates text by Christian Giroud, Mariangela de Cesare, Aurélie Berthet, Vincent Varlet, Nicolas Concha-Lozano, and Bernard Favrat available under the CC BY 4.0 license.
- Dutra, Lauren M; Grana, Rachel; Glantz, Stanton A (2016). "Philip Morris research on precursors to the modern e-cigarette since 1990". Tobacco Control. 26 (e2): tobaccocontrol–2016–053406. doi:10.1136/tobaccocontrol-2016-053406. ISSN 0964-4563. PMC 5432409. PMID 27852893.
- Brandon, T. H.; Goniewicz, M. L.; Hanna, N. H.; Hatsukami, D. K.; Herbst, R. S.; Hobin, J. A.; Ostroff, J. S.; Shields, P. G.; Toll, B. A.; Tyne, C. A.; Viswanath, K.; Warren, G. W. (2015). "Electronic Nicotine Delivery Systems: A Policy Statement from the American Association for Cancer Research and the American Society of Clinical Oncology". Clinical Cancer Research. 21 (3): 514–525. doi:10.1158/1078-0432.CCR-14-2544. ISSN 1078-0432. PMID 25573384.
- Yingst, J. M.; Veldheer, S.; Hrabovsky, S.; Nichols, T. T.; Wilson, S. J.; Foulds, J. (2015). "Factors associated with electronic cigarette users' device preferences and transition from first generation to advanced generation devices". Nicotine Tob Res. 17 (10): 1242–6. doi:10.1093/ntr/ntv052. ISSN 1462-2203. PMC 4592341. PMID 25744966.
- Sanford Z; Goebel L (2014). "E-cigarettes: an up to date review and discussion of the controversy". W V Med J. 110 (4): 10–5. PMID 25322582.
- McNeill 2018, p. 14.
- "THE FACTS on e-cigarette use among youth and young adults". Surgeon General of the United States. 2016. This article incorporates text from this source, which is in the public domain.
- Levy, David T.; Warner, Kenneth E.; Cummings, K. Michael; Hammond, David; Kuo, Charlene; Fong, Geoffrey T.; Thrasher, James F.; Goniewicz, Maciej Lukasz; Borland, Ron (1 November 2019). "Examining the relationship of vaping to smoking initiation among US youth and young adults: a reality check". Tobacco Control. 28 (6): 629–635. doi:10.1136/tobaccocontrol-2018-054446. ISSN 0964-4563. PMC 6860409. PMID 30459182. Retrieved 23 February 2020.
- West, Robert; Brown, Jamie; Jarvis, Martin (7 October 2019). "Epidemic of youth nicotine addiction? What does the National Youth Tobacco Survey reveal about high school e-cigarette use in the USA? (Preprint)". Qeios. doi:10.32388/745076.3. ISSN 2632-3834. Retrieved 24 February 2020.
- Hallingberg, Britt; Maynard, Olivia M.; Bauld, Linda; Brown, Rachel; Gray, Linsay; Lowthian, Emily; MacKintosh, Anne-Marie; Moore, Laurence; Munafo, Marcus R.; Moore, Graham (1 March 2020). "Have e-cigarettes renormalised or displaced youth smoking? Results of a segmented regression analysis of repeated cross sectional survey data in England, Scotland and Wales". Tobacco Control. 29 (2): 207–216. doi:10.1136/tobaccocontrol-2018-054584. ISSN 0964-4563. PMC 7036293. PMID 30936390. Retrieved 24 February 2020.
- "Historical NYTS Data and Documentation | CDC". www.cdc.gov. Centers for Disease Control and Prevention. 17 December 2019. Retrieved 24 February 2020.
- Modesto-Lowe, Vania; Alvarado, Camille (2017). "E-cigs . . . Are They Cool? Talking to Teens About E-Cigarettes". Clinical Pediatrics. 56 (10): 947–952. doi:10.1177/0009922817705188. ISSN 0009-9228. PMID 28443340.
- England, Lucinda J.; Aagaard, Kjersti; Bloch, Michele; Conway, Kevin; Cosgrove, Kelly; Grana, Rachel; Gould, Thomas J.; Hatsukami, Dorothy; Jensen, Frances; Kandel, Denise; Lanphear, Bruce; Leslie, Frances; Pauly, James R.; Neiderhiser, Jenae; Rubinstein, Mark; Slotkin, Theodore A.; Spindel, Eliot; Stroud, Laura; Wakschlag, Lauren (2017). "Developmental toxicity of nicotine: A transdisciplinary synthesis and implications for emerging tobacco products". Neuroscience & Biobehavioral Reviews. 72: 176–189. doi:10.1016/j.neubiorev.2016.11.013. ISSN 0149-7634. PMC 5965681. PMID 27890689.
- Chadi, Nicholas; Schroeder, Rachel; Jensen, Jens Winther; Levy, Sharon (2019). "Association Between Electronic Cigarette Use and Marijuana Use Among Adolescents and Young Adults". JAMA Pediatrics. 173 (10): e192574. doi:10.1001/jamapediatrics.2019.2574. ISSN 2168-6203. PMC 6692686. PMID 31403684.
- "More than a quarter-million youth who had never smoked a cigarette used e-cigarettes in 2013". Centers for Disease Control and Prevention. 25 August 2014.
- Carroll Chapman, SL; Wu, LT (18 March 2014). "E-cigarette prevalence and correlates of use among adolescents versus adults: A review and comparison". Journal of Psychiatric Research. 54: 43–54. doi:10.1016/j.jpsychires.2014.03.005. PMC 4055566. PMID 24680203.
- Chatterjee, Kshitij; Alzghoul, Bashar; Innabi, Ayoub; Meena, Nikhil (2018). "Is vaping a gateway to smoking: a review of the longitudinal studies". International Journal of Adolescent Medicine and Health. 0 (3). doi:10.1515/ijamh-2016-0033. ISSN 2191-0278. PMID 27505084.
- Hildick-Smith, Gordon J.; Pesko, Michael F.; Shearer, Lee; Hughes, Jenna M.; Chang, Jane; Loughlin, Gerald M.; Ipp, Lisa S. (2015). "A Practitioner's Guide to Electronic Cigarettes in the Adolescent Population". Journal of Adolescent Health. 57 (6): 574–9. doi:10.1016/j.jadohealth.2015.07.020. ISSN 1054-139X. PMID 26422289.
- Schraufnagel, Dean E. (2015). "Electronic Cigarettes: Vulnerability of Youth". Pediatric Allergy, Immunology, and Pulmonology. 28 (1): 2–6. doi:10.1089/ped.2015.0490. ISSN 2151-321X. PMC 4359356. PMID 25830075.
- WHO 2014, p. 6.
- Singh, Tushar; Marynak, Kristy; Arrazola, René A.; Cox, Shanna; Rolle, Italia V.; King, Brian A. (2016). "Vital Signs: Exposure to Electronic Cigarette Advertising Among Middle School and High School Students — United States, 2014". MMWR. Morbidity and Mortality Weekly Report. 64 (52): 1403–1408. doi:10.15585/mmwr.mm6452a3. ISSN 0149-2195. PMID 26741522.
- Dinakar, Chitra; Longo, Dan L.; O’Connor, George T. (2016). "The Health Effects of Electronic Cigarettes". New England Journal of Medicine. 375 (14): 1372–1381. doi:10.1056/NEJMra1502466. ISSN 0028-4793. PMID 27705269.
- Jenssen, Brian P.; Wilson, Karen M. (2017). "Tobacco Control and Treatment for the Pediatric Clinician: Practice, Policy, and Research Updates". Academic Pediatrics. 17 (3): 233–242. doi:10.1016/j.acap.2016.12.010. ISSN 1876-2859. PMID 28069410.
- Clapp, Phillip W.; Jaspers, Ilona (2017). "Electronic Cigarettes: Their Constituents and Potential Links to Asthma". Current Allergy and Asthma Reports. 17 (11): 79. doi:10.1007/s11882-017-0747-5. ISSN 1529-7322. PMC 5995565. PMID 28983782.
- "Regulation of Electronic Cigarettes ("E-Cigarettes")" (PDF). National Association of County and City Health Officials. Archived from the original (PDF) on 6 November 2014.
- Grana, Rachel A.; Ling, Pamela M. (2014). ""Smoking revolution": a content analysis of electronic cigarette retail websites". Am J Prev Med. 46 (4): 395–403. doi:10.1016/j.amepre.2013.12.010. PMC 3989286. PMID 24650842.
- Tomashefski, A (21 March 2016). "The perceived effects of electronic cigarettes on health by adult users: A state of the science systematic literature review". Journal of the American Association of Nurse Practitioners. 28 (9): 510–515. doi:10.1002/2327-6924.12358. PMID 26997487.
- 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.
- McNeill 2018, p. 178.
- McNeill 2018, p. 179.
- Gibson, Laura A.; Creamer, MeLisa R.; Breland, Alison B.; Giachello, Aida Luz; Kaufman, Annette; Kong, Grace; Pechacek, Terry F.; Pepper, Jessica K.; Soule, Eric K.; Halpern-Felsher, Bonnie (2018). "Measuring perceptions related to e-cigarettes: Important principles and next steps to enhance study validity". Addictive Behaviors. 79: 219–225. doi:10.1016/j.addbeh.2017.11.017. ISSN 0306-4603. PMC 5807230. PMID 29175027.
- Drope, Jeffrey; Cahn, Zachary; Kennedy, Rosemary; Liber, Alex C.; Stoklosa, Michal; Henson, Rosemarie; Douglas, Clifford E.; Drope, Jacqui (2017). "Key issues surrounding the health impacts of electronic nicotine delivery systems (ENDS) and other sources of nicotine". CA: A Cancer Journal for Clinicians. 67 (6): 449–471. doi:10.3322/caac.21413. ISSN 0007-9235. PMID 28961314.
- Shields, Peter G.; Berman, Micah; Brasky, Theodore M.; Freudenheim, Jo L.; Mathe, Ewy A; McElroy, Joseph; Song, Min-Ae; Wewers, Mark D. (2017). "A Review of Pulmonary Toxicity of Electronic Cigarettes In The Context of Smoking: A Focus On Inflammation". Cancer Epidemiology, Biomarkers & Prevention. 26 (8): 1175–1191. doi:10.1158/1055-9965.EPI-17-0358. ISSN 1055-9965. PMC 5614602. PMID 28642230.
- Cooke, Andrew; Fergeson, Jennifer; Bulkhi, Adeeb; Casale, Thomas B. (2015). "The Electronic Cigarette: The Good, the Bad, and the Ugly". The Journal of Allergy and Clinical Immunology: In Practice. 3 (4): 498–505. doi:10.1016/j.jaip.2015.05.022. ISSN 2213-2198. PMID 26164573.
- Crowley, Ryan A. (2015). "Electronic Nicotine Delivery Systems: Executive Summary of a Policy Position Paper From the American College of Physicians". Annals of Internal Medicine. 162 (8): 583–4. doi:10.7326/M14-2481. ISSN 0003-4819. PMID 25894027.
- Aguilar, Carmen (11 June 2018). "Lung cancer deaths on the rise in two thirds of European countries". VoxEurop/The European Data Journalism Network (EDJNet).
- Hefner, Kathryn; Valentine, Gerald; Sofuoglu, Mehmet (2017). "Electronic cigarettes and mental illness: Reviewing the evidence for help and harm among those with psychiatric and substance use disorders". The American Journal on Addictions. 26 (4): 306–315. doi:10.1111/ajad.12504. ISSN 1055-0496. PMID 28152247. This article incorporates text from this source, which is in the public domain.
- McNeill 2015, p. 11.
- Dagaonkar RS, R.S.; Udwadi, Z.F. (2014). "Water pipes and E-cigarettes: new faces of an ancient enemy" (PDF). Journal of the Association of Physicians of India. 62 (4): 324–328. PMID 25327035.
- Lee, Peter N (2015). "Appropriate and inappropriate methods for investigating the "gateway" hypothesis, with a review of the evidence linking prior snus use to later cigarette smoking". Harm Reduction Journal. 12 (1): 8. doi:10.1186/s12954-015-0040-7. ISSN 1477-7517. PMC 4369866. PMID 25889396. This article incorporates text available under the CC BY 4.0 license.
- Franck, C.; Budlovsky, T.; Windle, S. B.; Filion, K. B.; Eisenberg, M. J. (2014). "Electronic Cigarettes in North America: History, Use, and Implications for Smoking Cessation". Circulation. 129 (19): 1945–1952. doi:10.1161/CIRCULATIONAHA.113.006416. ISSN 0009-7322. PMID 24821825.
- Fadus, Matthew C.; Smith, Tracy T.; Squeglia, Lindsay M. (2019). "The rise of e-cigarettes, pod mod devices, and JUUL among youth: Factors influencing use, health implications, and downstream effects". Drug and Alcohol Dependence. 201: 85–93. doi:10.1016/j.drugalcdep.2019.04.011. ISSN 0376-8716. PMID 31200279.
- Lee, Peter N.; Coombs, Katharine J.; Afolalu, Esther F. (22 July 2019). "Considerations related to vaping as a possible gateway into cigarette smoking: an analytical review". F1000Research. 7: 1915. doi:10.12688/f1000research.16928.3. ISSN 2046-1402. PMC 6652100. PMID 31354936.
- "E-cigarettes are a gateway to marijuana, too". Center for Tobacco Control Research and Education. Retrieved 28 February 2020.
- Galper Grossman, Sharon (2019). "Vape Gods and Judaism—E-cigarettes and Jewish Law". Rambam Maimonides Medical Journal. 10 (3): e0019. doi:10.5041/RMMJ.10372. ISSN 2076-9172. PMC 6649778. PMID 31335312. This article incorporates text by Sharon Galper Grossman available under the CC BY 3.0 license.
- Stratton 2018, p. Conceptual Framework: Patterns of Use Among Youth and Young Adults; 497.
- Chapman, Simon; Bareham, David; Maziak, Wasim (6 April 2018). "The Gateway Effect of E-cigarettes: Reflections on Main Criticisms". Nicotine & Tobacco Research. 21 (5): 695–698. doi:10.1093/ntr/nty067. ISSN 1462-2203. PMC 6468127. PMID 29660054.
- Vanyukov, Michael M.; Tarter, Ralph E.; Kirillova, Galina P.; Kirisci, Levent; Reynolds, Maureen D.; Kreek, Mary Jeanne; Conway, Kevin P.; Maher, Brion S.; Iacono, William G.; Bierut, Laura; Neale, Michael C.; Clark, Duncan B.; Ridenour, Ty A. (2012). "Common liability to addiction and "gateway hypothesis": Theoretical, empirical and evolutionary perspective". Drug and Alcohol Dependence. 123: S3–S17. doi:10.1016/j.drugalcdep.2011.12.018. ISSN 0376-8716. PMC 3600369. PMID 22261179.
- Wilder 2016, p. 123.
- Stratton 2018, p. Conceptual Framework: Patterns of Use Among Youth and Young Adults; 496.
- Farsalinos, Konstantinos; LeHouezec, Jacques (2015). "Regulation in the face of uncertainty: the evidence on electronic nicotine delivery systems (e-cigarettes)". Risk Management and Healthcare Policy. 8: 157–67. doi:10.2147/RMHP.S62116. ISSN 1179-1594. PMC 4598199. PMID 26457058.
- Kandel, Denise; Kandel, Eric (2015). "The Gateway Hypothesis of substance abuse: developmental, biological and societal perspectives". Acta Paediatrica. 104 (2): 130–137. doi:10.1111/apa.12851. ISSN 0803-5253. PMID 25377988.
- 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.2017.01.001. ISSN 0761-8425. PMID 28189437.
- Nansseu, Jobert Richie N.; Bigna, Jean Joel R. (2016). "Electronic Cigarettes for Curbing the Tobacco-Induced Burden of Noncommunicable Diseases: Evidence Revisited with Emphasis on Challenges in Sub-Saharan Africa". Pulmonary Medicine. 2016: 1–9. doi:10.1155/2016/4894352. ISSN 2090-1836. PMC 5220510. PMID 28116156. This article incorporates text by Jobert Richie N. Nansseu and Jean Joel R. Bigna available under the CC BY 4.0 license.
- Stratton 2018, p. Conceptual Framework: Patterns of Use Among Youth and Young Adults; 531.
- McRobbie, Hayden; Bullen, Chris; Hartmann-Boyce, Jamie; Hajek, Peter; McRobbie, Hayden (2014). "Electronic cigarettes for smoking cessation and reduction". The Cochrane Database of Systematic Reviews. 12 (12): CD010216. doi:10.1002/14651858.CD010216.pub2. PMID 25515689.
- McDonough, Mike (2015). "Update on medicines for smoking cessation". Australian Prescriber. 38 (4): 106–111. doi:10.18773/austprescr.2015.038. ISSN 0312-8008. PMC 4653977. PMID 26648633.
- Cahn, Z.; Siegel, M. (February 2011). "Electronic cigarettes as a harm reduction strategy for tobacco control: a step forward or a repeat of past mistakes?". Journal of Public Health Policy. 32 (1): 16–31. doi:10.1057/jphp.2010.41. PMID 21150942.
- Breland, Alison B.; Spindle, Tory; Weaver, Michael; Eissenberg, Thomas (2014). "Science and Electronic Cigarettes". Journal of Addiction Medicine. 8 (4): 223–233. doi:10.1097/ADM.0000000000000049. ISSN 1932-0620. PMC 4122311. PMID 25089952.
- Edgar, Julie (12 November 2013). "E-Cigarettes: Expert Q&A With the CDC". WebMD.
- Boudi, F Brian; Patel, Sonia; Boudi, Ava; Chan, Connie (2019). "Vitamin E Acetate as a Plausible Cause of Acute Vaping-related Illness". Cureus. 11 (12): e6350. doi:10.7759/cureus.6350. ISSN 2168-8184. PMC 6952050. PMID 31938636. This article incorporates text by F Brian Boudi, Sonia Patel, Ava Boudi, Connie Chan available under the CC BY 3.0 license.
- King, Brian A.; Jones, Christopher M.; Baldwin, Grant T.; Briss, Peter A. (2020). "The EVALI and Youth Vaping Epidemics — Implications for Public Health". New England Journal of Medicine. 382 (8): 689–691. doi:10.1056/NEJMp1916171. ISSN 0028-4793. PMID 31951683.
- "Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products". Centers for Disease Control and Prevention. 17 January 2020.
- Li, Liqiao; Lin, Yan; Xia, Tian; Zhu, Yifang (7 January 2020). "Effects of Electronic Cigarettes on Indoor Air Quality and Health". Annual Review of Public Health. doi:10.1146/annurev-publhealth-040119-094043. ISSN 0163-7525.
- "Smoking and pregnancy: Understand the risks".
- "Stop smoking in pregnancy - NHS".
- NASEM - IOM (23 January 2018). Stratton, Kathleen; Kwan, Leslie Y; Eaton, David L (eds.). Public Health Consequences of E-Cigarettes. doi:10.17226/24952. ISBN 978-0-309-46834-3. PMID 29894118. Retrieved 6 March 2018.
- 13 Developmental and Reproductive Effects | Public Health Consequences of E-Cigarettes | The National Academies Press
- "CDC launches powerful new ads in "Tips From Former Smokers" campaign". Centers for Disease Control and Prevention. 26 March 2015.
- Ghosh, Sohini; Drummond, M. Bradley (2016). "Electronic cigarettes as smoking cessation tool: are we there?". Current Opinion in Pulmonary Medicine. 23 (2): 111–116. doi:10.1097/MCP.0000000000000348. ISSN 1070-5287. PMC 5480094. PMID 27906858.
- Bullen, Chris; Knight-West, Oliver (August 2016). "E-cigarettes for the management of nicotine addiction". Substance Abuse and Rehabilitation. 7: 111–118. doi:10.2147/SAR.S94264. ISSN 1179-8467. PMC 4993405. PMID 27574480.
- Patil, Shankargouda; Arakeri, Gururaj; Patil, Shekar; Ali Baeshen, Hosam; Raj, Thirumal; Sarode, Sachin C.; Sarode, Gargi S.; Awan, Kamran H.; Gomez, Ricardo; Brennan, Peter A (2019). "Are electronic nicotine delivery systems (ENDs) helping cigarette smokers quit? – A current evidence". Journal of Oral Pathology & Medicine. doi:10.1111/jop.12966. ISSN 0904-2512. PMID 31642553.
- Orellana-Barrios MA; Payne D; Medrano-Juarez RM; Yang S; Nugent K (2016). "Electronic Cigarettes for Smoking Cessation". The American Journal of the Medical Sciences. 52 (4): 420–426. doi:10.1016/j.amjms.2016.07.013. PMID 27776725.
- Khoudigian, S.; Devji, T.; Lytvyn, L.; Campbell, K.; Hopkins, R.; O'Reilly, D. (29 January 2016). "The efficacy and short-term effects of electronic cigarettes as a method for smoking cessation: a systematic review and a meta-analysis". International Journal of Public Health. 61 (2): 257–267. doi:10.1007/s00038-016-0786-z. ISSN 1661-8556. PMID 26825455.
- Mulhall, Patrick; Criner, Gerard (2016). "Non-pharmacological treatments for COPD". Respirology. 21 (5): 791–809. doi:10.1111/resp.12782. ISSN 1323-7799. PMID 27099216.
- Villanti, Andrea C.; Feirman, Shari P.; Niaura, Raymond S.; Pearson, Jennifer L.; Glasser, Allison M.; Collins, Lauren K.; Abrams, David B. (2018). "How do we determine the impact of e-cigarettes on cigarette smoking cessation or reduction? Review and recommendations for answering the research question with scientific rigor". Addiction. 113 (3): 391–404. doi:10.1111/add.14020. ISSN 0965-2140. PMC 6947656. PMID 28975720.
- McNeill 2015, p. 80.
- Stratton 2018, p. EVIDENCE REVIEW: RESULTS, Evaluation of the Evidence from Systematic Reviews; 576.
- El Dib, Regina; Suzumura, Erica A; Akl, Elie A; Gomaa, Huda; Agarwal, Arnav; Chang, Yaping; Prasad, Manya; Ashoorion, Vahid; Heels-Ansdell, Diane; Maziak, Wasim; Guyatt, Gordon (2017). "Electronic nicotine delivery systems and/or electronic non-nicotine delivery systems for tobacco smoking cessation or reduction: a systematic review and meta-analysis". BMJ Open. 7 (2): e012680. doi:10.1136/bmjopen-2016-012680. ISSN 2044-6055. PMC 5337697. PMID 28235965.
- Orr, KK; Asal, NJ (November 2014). "Efficacy of electronic cigarettes for smoking cessation". The Annals of Pharmacotherapy. 48 (11): 1502–6. doi:10.1177/1060028014547076. PMID 25136064.
- Bullen, Christopher (2014). "Electronic Cigarettes for Smoking Cessation". Current Cardiology Reports. 16 (11): 538. doi:10.1007/s11886-014-0538-8. ISSN 1523-3782. PMID 25303892.
- Kalkhoran, Sara; Glantz, Stanton A (2016). "E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis". The Lancet Respiratory Medicine. 4 (2): 116–128. doi:10.1016/S2213-2600(15)00521-4. ISSN 2213-2600. PMC 4752870. PMID 26776875.
- Al-Hamdani, Mohammed; Hopkins, D. Brett; Park, Tristan (2020). "Vaping among youth and young adults: a "red alert" state". Journal of Public Health Policy. 41 (1): 63–69. doi:10.1057/s41271-019-00193-2. ISSN 0197-5897. PMID 31664162.
- Malas, Muhannad; van der Tempel, Jan; Schwartz, Robert; Minichiello, Alexa; Lightfoot, Clayton; Noormohamed, Aliya; Andrews, Jaklyn; Zawertailo, Laurie; Ferrence, Roberta (25 April 2016). "Electronic Cigarettes for Smoking Cessation: A Systematic Review". Nicotine & Tobacco Research. 18 (10): 1926–1936. doi:10.1093/ntr/ntw119. ISSN 1462-2203. PMID 27113014.
- Vanderkam, Paul; Boussageon, Rémy; Underner, Michel; Langbourg, Nicolas; Brabant, Yann; Binder, Philippe; Freche, Bernard; Jaafari, Nematollah (2016). "Efficacité et sécurité de la cigarette électronique pour la réduction du tabagisme : revue systématique et méta-analyse". La Presse Médicale. 45 (11): 971–985. doi:10.1016/j.lpm.2016.05.026. ISSN 0755-4982. PMID 27597300.
- Rinkoo, ArvindVashishta; Kaur, Jagdish (2017). "Getting real with the upcoming challenge of electronic nicotine delivery systems: The way forward for the South-East Asia region". Indian Journal of Public Health. 61 (5): S7–S11. doi:10.4103/ijph.IJPH_240_17. ISSN 0019-557X. PMID 28928312.
- Beard, Emma; Shahab, Lion; Cummings, Damian M.; Michie, Susan; West, Robert (2016). "New Pharmacological Agents to Aid Smoking Cessation and Tobacco Harm Reduction: What Has Been Investigated, and What Is in the Pipeline?" (PDF). CNS Drugs. 30 (10): 951–83. doi:10.1007/s40263-016-0362-3. ISSN 1172-7047. PMID 27421270.
- Hartmann-Boyce, Jamie; Begh, Rachna; Aveyard, Paul (2018). "Electronic cigarettes for smoking cessation". BMJ. 360: j5543. doi:10.1136/bmj.j5543. ISSN 0959-8138. PMID 29343486.
- R. C. van de Graaf, O. C. P. van Schayck (2017). "[Helping people to give up smoking; efficacy and safety of smoking cessation interventions]". Nederlands Tijdschrift voor Geneeskunde. 161: D1131. PMID 28224877.
- Patnode, Carrie D.; Henderson, Jillian T.; Thompson, Jamie H.; Senger, Caitlyn A.; Fortmann, Stephen P.; Whitlock, Evelyn P. (September 2015). "Behavioral Counseling and Pharmacotherapy Interventions for Tobacco Cessation in Adults, Including Pregnant Women: A Review of Reviews for the U.S. Preventive Services Task Force" (PDF). Annals of Internal Medicine. 163 (8): 608. doi:10.7326/M15-0171. ISSN 0003-4819. PMID 26491759.
- Jerry JM; Collins GB; Streem D (2015). "E-cigarettes: Safe to recommend to patients?". Cleve Clin J Med. 82 (8): 521–6. doi:10.3949/ccjm.82a.14054. PMID 26270431.
- Franck, Caroline; Filion, Kristian B.; Kimmelman, Jonathan; Grad, Roland; Eisenberg, Mark J. (2016). "Ethical considerations of e-cigarette use for tobacco harm reduction". Respiratory Research. 17 (1): 53. doi:10.1186/s12931-016-0370-3. ISSN 1465-993X. PMC 4869264. PMID 27184265. This article incorporates text by Caroline Franck, Kristian B. Filion, Jonathan Kimmelman, Roland Grad and Mark J. Eisenberg available under the CC BY 4.0 license.
- Rahman, Muhammad Aziz (30 March 2015). "E-Cigarettes and Smoking Cessation: Evidence from a Systematic Review and Meta-Analysis". PLOS One. 10 (3): e0122544. Bibcode:2015PLoSO..1022544R. doi:10.1371/journal.pone.0122544. PMC 4378973. PMID 25822251.
- Lindson-Hawley, Nicola; Hartmann-Boyce, Jamie; Fanshawe, Thomas R; Begh, Rachna; Farley, Amanda; Lancaster, Tim; Lindson-Hawley, Nicola (2016). "Interventions to reduce harm from continued tobacco use". The Cochrane Database of Systematic Reviews. 10: CD005231. doi:10.1002/14651858.CD005231.pub3. PMC 6463938. PMID 27734465.
- Coleman, Tim; Chamberlain, Catherine; Davey, Mary-Ann; Cooper, Sue E; Leonardi-Bee, Jo; Coleman, Tim (2015). "Pharmacological interventions for promoting smoking cessation during pregnancy". The Cochrane Database of Systematic Reviews (12): CD010078. doi:10.1002/14651858.CD010078.pub2. hdl:11343/57346. PMID 26690977.
- Franks, Andrea S; Sando, Karen; McBane, Sarah (2018). "Do Electronic Cigarettes Have a Role in Tobacco Cessation?". Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 38 (5): 555–568. doi:10.1002/phar.2103. ISSN 0277-0008. PMID 29573440.
- Lucchiari, Claudio; Masiero, Marianna; Botturi, Andrea; Pravettoni, Gabriella (2016). "Helping patients to reduce tobacco consumption in oncology: a narrative review". SpringerPlus. 5 (1): 1136. doi:10.1186/s40064-016-2798-9. ISSN 2193-1801. PMC 4954805. PMID 27504234.
- Gentry, Sarah; Forouhi, Nita; Notley, Caitlin (2018). "Are Electronic Cigarettes an Effective Aid to Smoking Cessation or Reduction Among Vulnerable Groups? A Systematic Review of Quantitative and Qualitative Evidence". Nicotine & Tobacco Research. 21 (5): 602–616. doi:10.1093/ntr/nty054. ISSN 1462-2203. PMC 6697178. PMID 29608714.
- Detailed reference list is located at a separate image page.
- Abrams, David B.; Glasser, Allison M.; Pearson, Jennifer L.; Villanti, Andrea C.; Collins, Lauren K.; Niaura, Raymond S. (2018). "Harm Minimization and Tobacco Control: Reframing Societal Views of Nicotine Use to Rapidly Save Lives". Annual Review of Public Health. 39 (1): 193–213. doi:10.1146/annurev-publhealth-040617-013849. ISSN 0163-7525. PMC 6942997. PMID 29323611. This article incorporates text by David B. Abrams, Allison M. Glasser, Jennifer L. Pearson, Andrea C. Villanti, Lauren K. Collins, and Raymond S. Niaura available under the CC BY 4.0 license.
- Saitta, D; Ferro, GA; Polosa, R (March 2014). "Achieving appropriate regulations for electronic cigarettes". Therapeutic Advances in Chronic Disease. 5 (2): 50–61. doi:10.1177/2040622314521271. PMC 3926346. PMID 24587890.
- Britton, John; Bogdanovica, Ilze (15 May 2014). "Electronic cigarettes – A report commissioned by Public Health England" (PDF). Public Health England.
- Ferkol, Thomas W.; Farber, Harold J.; La Grutta, Stefania; Leone, Frank T.; Marshall, Henry M.; Neptune, Enid; Pisinger, Charlotta; Vanker, Aneesa; Wisotzky, Myra; Zabert, Gustavo E.; Schraufnagel, Dean E. (2018). "Electronic cigarette use in youths: a position statement of the Forum of International Respiratory Societies". European Respiratory Journal. 51 (5): 1800278. doi:10.1183/13993003.00278-2018. ISSN 0903-1936. PMID 29848575.
- Scherer, Gerhard (2018). "Suitability of biomarkers of biological effects (BOBEs) for assessing the likelihood of reducing the tobacco related disease risk by new and innovative tobacco products: A literature review". Regulatory Toxicology and Pharmacology. 94: 203–233. doi:10.1016/j.yrtph.2018.02.002. ISSN 0273-2300. PMID 29428304.
- V.Courtney Broaddus; Robert C Mason; Joel D Ernst; Talmadge E King Jr.; Stephen C Lazarus; John F. Murray; Jay A. Nadel; Arthur Slutsky; Michael Gotway (17 March 2015). Murray & Nadel's Textbook of Respiratory Medicine. Elsevier Health Sciences. p. 820. ISBN 978-0-323-26193-7.
- Caponnetto, Pasquale; Campagna, Davide; Papale, Gabriella; Russo, Cristina; Polosa, Riccardo (2012). "The emerging phenomenon of electronic cigarettes". Expert Review of Respiratory Medicine. 6 (1): 63–74. doi:10.1586/ers.11.92. ISSN 1747-6348. PMID 22283580.
- Nowak D; Jörres RA; Rüther T (2014). "E-cigarettes—prevention, pulmonary health, and addiction". Dtsch Arztebl Int. 111 (20): 349–55. doi:10.3238/arztebl.2014.0349. PMC 4047602. PMID 24882626.
- "BMA calls for stronger regulation of e-cigarettes" (PDF). British Medical Association. January 2013.
- "Principles to Guide AAPHP Tobacco Policy". American Association of Public Health Physicians. June 2013.
- Detailed reference list is located at a separate image page.
- WHO 2014, p. 10.
- Farsalinos, K. E.; Polosa, R. (2014). "Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review". Therapeutic Advances in Drug Safety. 5 (2): 67–86. doi:10.1177/2042098614524430. ISSN 2042-0986. PMC 4110871. PMID 25083263.
- Smith, L; Brar, K; Srinivasan, K; Enja, M; Lippmann, S (June 2016). "E-cigarettes: How "safe" are they?". J Fam Pract. 65 (6): 380–5. PMID 27474819.
- Glover, Marewa; Breier, Bernhard H.; Bauld, Linda (2016). "Could Vaping be a New Weapon in the Battle of the Bulge?". Nicotine & Tobacco Research. 19 (12): 1536–1540. doi:10.1093/ntr/ntw278. hdl:1893/26149. ISSN 1462-2203. PMID 27798086.
- Tegin, Gulay; Mekala, Hema Madhuri; Sarai, Simrat Kaur; Lippmann, Steven (2018). "E-Cigarette Toxicity?". Southern Medical Journal. 111 (1): 35–38. doi:10.14423/SMJ.0000000000000749. ISSN 1541-8243. PMID 29298367.
- "The Potential Adverse Health Consequences of Exposure to Electronic Cigarettes and Electronic Nicotine Delivery Systems". Oncology Nursing Forum. 42 (5): 445–446. 2015. doi:10.1188/15.ONF.445-446. ISSN 0190-535X. PMID 26302273.
- WHO 2014, p. 5.
- Durmowicz, E. L. (2014). "The impact of electronic cigarettes on the paediatric population". Tobacco Control. 23 (Supplement 2): ii41–ii46. doi:10.1136/tobaccocontrol-2013-051468. ISSN 0964-4563. PMC 3995262. PMID 24732163.
- Rowell, Temperance R; Tarran, Robert (2015). "Will Chronic E-Cigarette Use Cause Lung Disease?". American Journal of Physiology. Lung Cellular and Molecular Physiology. 309 (12): L1398–409. doi:10.1152/ajplung.00272.2015. ISSN 1040-0605. PMC 4683316. PMID 26408554.
- Detailed reference list is located at a separate image page.
- Bekki, Kanae; Uchiyama, Shigehisa; Ohta, Kazushi; Inaba, Yohei; Nakagome, Hideki; Kunugita, Naoki (2014). "Carbonyl Compounds Generated from Electronic Cigarettes". International Journal of Environmental Research and Public Health. 11 (11): 11192–11200. doi:10.3390/ijerph111111192. ISSN 1660-4601. PMC 4245608. PMID 25353061. This article incorporates text by Kanae Bekki, Shigehisa Uchiyama, Kazushi Ohta, Yohei Inaba, Hideki Nakagome and Naoki Kunugita available under the CC BY 4.0 license.
- McNeill 2015, p. 77.
- Stratton 2018, p. Characteristics of E-Cigarette Devices, 56.
- SGUS 2014, p. 115.
- Caplan, David (22 December 2016). "Man Suffers 3rd-Degree Burns After E-Cigarette Explodes in His Pocket While Riding Bus". ABC News.
- Fernández, Esteve; Ballbè, Montse; Sureda, Xisca; Fu, Marcela; Saltó, Esteve; Martínez-Sánchez, Jose M. (2015). "Particulate Matter from Electronic Cigarettes and Conventional Cigarettes: a Systematic Review and Observational Study". Current Environmental Health Reports. 2 (4): 423–9. doi:10.1007/s40572-015-0072-x. ISSN 2196-5412. PMID 26452675.
- Chang, H. (2014). "Research gaps related to the environmental impacts of electronic cigarettes". Tobacco Control. 23 (Supplement 2): ii54–ii58. doi:10.1136/tobaccocontrol-2013-051480. ISSN 0964-4563. PMC 3995274. PMID 24732165.
- "Republished: Nicotine and health". BMJ. 349 (nov26 9): 2014.7.0264rep. 2014. doi:10.1136/bmj.2014.7.0264rep. ISSN 1756-1833. PMID 25428425.
- Kaisar, Mohammad Abul; Prasad, Shikha; Liles, Tylor; Cucullo, Luca (2016). "A Decade of e-Cigarettes: Limited Research & Unresolved Safety Concerns". Toxicology. 365: 67–75. doi:10.1016/j.tox.2016.07.020. ISSN 0300-483X. PMC 4993660. PMID 27477296.
- "Experts Clear the Air on E-Cigarettes". Columbia University Mailman School of Public Health. 26 January 2018.
- Kenny, PJ (September 2014). "Genetics of Substance Use Disorders". Dialogues Clin Neurosci. 16 (3): 335–344. PMC 4214176. PMID 25364284.
- D'Souza, Manoranjan S. (2015). "Glutamatergic transmission in drug reward: implications for drug addiction". Frontiers in Neuroscience. 9: 404. doi:10.3389/fnins.2015.00404. ISSN 1662-453X. PMC 4633516. PMID 26594139.
- MacDonald, K; Pappa, K (April 2016). "WHY NOT POT?: A Review of the Brain-based Risks of Cannabis". Innov Clin Neurosci. 13 (3–4): 13–22. PMC 4911936. PMID 27354924.
- Kishioka, Shiroh; Kiguchi, Norikazu; Kobayashi, Yuka; Saika, Fumihiro (2014). "Nicotine Effects and the Endogenous Opioid System". Journal of Pharmacological Sciences. 125 (2): 117–124. doi:10.1254/jphs.14R03CP. ISSN 1347-8613. PMID 24882143.
- Hiemstra, Pieter S.; Bals, Robert (2016). "Basic science of electronic cigarettes: assessment in cell culture and in vivo models". Respiratory Research. 17 (1): 127. doi:10.1186/s12931-016-0447-z. ISSN 1465-993X. PMC 5055681. PMID 27717371.
- Lee, Peter N.; Fariss, Marc W. (2016). "A systematic review of possible serious adverse health effects of nicotine replacement therapy". Archives of Toxicology. 91 (4): 1565–1594. doi:10.1007/s00204-016-1856-y. ISSN 0340-5761. PMC 5364244. PMID 27699443.
- D'Souza MS; Markou A (2011). "Neuronal mechanisms underlying development of nicotine dependence: implications for novel smoking-cessation treatments". Addict Sci Clin Pract. 6 (1): 4–16. PMC 3188825. PMID 22003417.
- Jackson, K.J.; Muldoon, P.P.; De Biasi, M.; Damaj, M.I. (2015). "New mechanisms and perspectives in nicotine withdrawal". Neuropharmacology. 96 (Pt B): 223–234. doi:10.1016/j.neuropharm.2014.11.009. ISSN 0028-3908. PMC 4444410. PMID 25433149.
- Hadjiconstantinou, Maria; Neff, Norton H. (2011). "Nicotine and endogenous opioids: Neurochemical and pharmacological evidence". Neuropharmacology. 60 (7–8): 1209–1220. doi:10.1016/j.neuropharm.2010.11.010. ISSN 0028-3908. PMID 21108953.
- Korpi, E. R.; den Hollander, B.; Farooq, U.; Vashchinkina, E.; Rajkumar, R.; Nutt, D. J.; Hyytia, P.; Dawe, G. S. (2015). "Mechanisms of Action and Persistent Neuroplasticity by Drugs of Abuse". Pharmacological Reviews. 67 (4): 872–1004. doi:10.1124/pr.115.010967. ISSN 1521-0081. PMID 26403687.
- Chenoweth, Meghan J.; Tyndale, Rachel F. (2017). "Pharmacogenetic Optimization of Smoking Cessation Treatment". Trends in Pharmacological Sciences. 38 (1): 55–66. doi:10.1016/j.tips.2016.09.006. ISSN 0165-6147. PMC 5195866. PMID 27712845.
- Di Matteo, Vincenzo; Pierucci, Massimo; Di Giovanni, Giuseppe; Benigno, Arcangelo; Esposito, Ennio (2007). "The Neurobiological Bases for the Pharmacotherapy of Nicotine Addiction". Current Pharmaceutical Design. 13 (12): 1269–1284. doi:10.2174/138161207780618920. ISSN 1381-6128. PMID 17504235.
- "Know The Risks: E-Cigarettes & Young People – Addiction". Surgeon General of the United States. 2016. This article incorporates text from this source, which is in the public domain.
- Richard Beebe; Jeff Myers (19 July 2012). Professional Paramedic, Volume I: Foundations of Paramedic Care. Cengage Learning. pp. 640–. ISBN 978-1-133-71465-1.
- Atta-ur- Rahman; Allen B. Reitz (1 January 2005). Frontiers in Medicinal Chemistry. Bentham Science Publishers. pp. 279–. ISBN 978-1-60805-205-9.
- Bruijnzeel, Adrie W. (2012). "Tobacco addiction and the dysregulation of brain stress systems". Neuroscience & Biobehavioral Reviews. 36 (5): 1418–1441. doi:10.1016/j.neubiorev.2012.02.015. ISSN 0149-7634. PMC 3340450. PMID 22405889.
- Alasmari, Fawaz; Al-Rejaie, Salim S.; AlSharari, Shakir D.; Sari, Youssef (2016). "Targeting glutamate homeostasis for potential treatment of nicotine dependence". Brain Research Bulletin. 121: 1–8. doi:10.1016/j.brainresbull.2015.11.010. ISSN 0361-9230. PMC 4783195. PMID 26589642.
- Uchida, Sae; Hotta, Harumi (2009). "Cerebral Cortical Vasodilatation Mediated by Nicotinic Cholinergic Receptors: Effects of Old Age and of Chronic Nicotine Exposure". Biological & Pharmaceutical Bulletin. 32 (3): 341–344. doi:10.1248/bpb.32.341. ISSN 0918-6158. PMID 19252275.
- SGUS 2014, p. 111.
- Laura J. Martin; David Zieve; Isla Ogilvie (7 June 2016). "Nicotine and Tobacco". Medline Plus.
- "Nicotine". National Institute on Drug Abuse. June 2007. This article incorporates text from this source, which is in the public domain.
- Shahab, Lion; Brose, Leonie S.; West, Robert (2013). "Novel Delivery Systems for Nicotine Replacement Therapy as an Aid to Smoking Cessation and for Harm Reduction: Rationale, and Evidence for Advantages over Existing Systems". CNS Drugs. 27 (12): 1007–1019. doi:10.1007/s40263-013-0116-4. ISSN 1172-7047. PMID 24114587.
- Palazzolo, Dominic L. (November 2013). "Electronic cigarettes and vaping: a new challenge in clinical medicine and public health. A literature review". Frontiers in Public Health. 1 (56): 56. doi:10.3389/fpubh.2013.00056. PMC 3859972. PMID 24350225.
- Schroeder, M. J.; Hoffman, A. C. (2014). "Electronic cigarettes and nicotine clinical pharmacology". Tobacco Control. 23 (Supplement 2): ii30–ii35. doi:10.1136/tobaccocontrol-2013-051469. ISSN 0964-4563. PMC 3995273. PMID 24732160.
- Bold, Krysten W.; Sussman, Steve; O'Malley, Stephanie S.; Grana, Rachel; Foulds, Jonathan; Fishbein, Howard; Krishnan-Sarin, Suchitra (2018). "Measuring E-cigarette dependence: Initial guidance". Addictive Behaviors. 79: 213–218. doi:10.1016/j.addbeh.2017.11.015. ISSN 0306-4603. PMC 5807200. PMID 29174664.
- McNeill 2018, p. 12.
- "DrugFacts: Electronic Cigarettes (e-Cigarettes)". National Institute on Drug Abuse. September 2014.
- Evans, S. E.; Hoffman, A. C. (2014). "Electronic cigarettes: abuse liability, topography and subjective effects". Tobacco Control. 23 (Supplement 2): ii23–ii29. doi:10.1136/tobaccocontrol-2013-051489. ISSN 0964-4563. PMC 3995256. PMID 24732159.
- Chapman 2015, p. 5.
- "Teens like different forms of tobacco and nicotine". American Cancer Society. Archived from the original on 20 September 2015.
- Singh, Tushar; Arrazola, René A.; Corey, Catherine G.; Husten, Corinne G.; Neff, Linda J.; Homa, David M.; King, Brian A. (2016). "Tobacco Use Among Middle and High School Students — United States, 2011–2015". MMWR. Morbidity and Mortality Weekly Report. 65 (14): 361–367. doi:10.15585/mmwr.mm6514a1. ISSN 0149-2195. PMID 27077789.
- "Sottera v US Food and Drug Administration". Public Health Law Center.
- "Backgrounder on WHO report on regulation of e-cigarettes and similar products". World Health Organization. 26 August 2014.
- Gualano, Maria Rosaria; Passi, Stefano; Bert, Fabrizio; La Torre, Giuseppe; Scaioli, Giacomo; Siliquini, Roberta (September 2015). "Electronic cigarettes: assessing the efficacy and the adverse effects through a systematic review of published studies". Journal of Public Health. 37 (3): 488–497. doi:10.1093/pubmed/fdu055. ISSN 1741-3842. PMID 25108741.
- "Heart and Stroke Foundation: E-cigarettes in Canada". Heart and Stroke Foundation. September 2014. Archived from the original on 6 October 2014.
- "WHO Right to Call for E-Cigarette Regulation". World Lung Federation. 26 August 2014.
- "FCA Policy briefing Electronic Nicotine Delivery Systems" (PDF). Framework Convention Alliance on Tobacco Control. 13–18 October 2014.
- "Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems (ENDS/ENNDS)" (PDF). World Health Organization. August 2016. pp. 1–11.
- "E-cigarettes: an emerging public health consensus". UK: Public Health England. 15 September 2015.
- "Deeming Tobacco Products To Be Subject to the Federal Food, Drug, and Cosmetic Act, as Amended by the Family Smoking Prevention and Tobacco Control Act; Restrictions on the Sale and Distribution of Tobacco Products and Required Warning Statements for Tobacco Products". Federal Register. United States Food and Drug Administration. 81 (90): 28974–29106. 10 May 2016.
- Prashant Sharma (6 November 2015). "A Modern Device with an Illustrious History". TechPluto.
- "A Historical Timeline of Electronic Cigarettes". The Consumer Advocates for Smoke-free Alternatives Association. 2016.
- Konstantinos E. Farsalinos; I. Gene Gillman; Stephen S. Hecht; Riccardo Polosa; Jonathan Thornburg (16 November 2016). Analytical Assessment of e-Cigarettes: From Contents to Chemical and Particle Exposure Profiles. Elsevier Science. p. 1. ISBN 978-0-12-811242-7.
- Noah Charney (7 December 2014). "America's vaping revolution: How suspicious should we really be of the e-cigarette craze?". Salon (website).
- "US Patent 3200819. Smokeless non-tobacco cigarette". 17 August 1965.
- Mary Bellis (2015). "Who Invented Electronic Cigarettes?". About.com.
- P.H. (17 March 2014). "A case of the vapers". Economist Group.
- Julie Beck (13 June 2014). "Schrödinger's Cigarette: Is Electronic Safer?". The Atlantic.
- Millstein, Seth (25 April 2009). "The Push to Ban E-Cigarettes: Where's the Proof?". TimeLine. Archived from the original on 2 July 2015.
- "Electronic Cigarette Sales on the Rise". WalesOnline. 24 August 2011.
- Barbara Demick (25 April 2009). "A high-tech approach to getting a nicotine fix". Los Angeles Times.
- Sridi, Nicolas (10 July 2013). "I was sure that the electronic cigarette would be welcomed with open arms". Sciences et Avenir.
- Tom Hancock (1 October 2013). "China's e-cigarette inventor fights for financial rewards". Fox News Channel.
- "E-cigarettes attracting attention — and scrutiny". NBCNews.com. Associated Press. 27 February 2009.
- Tom Hancock (4 October 2013). "Chinese e-cigarette inventor fights for royalties". The Japan Times.
- "Electronic Atomization Cigarette". Worldwide.espacenet.com. 22 November 2007.
- Staff (21 August 2013). "Dragonite Sells E-Vapor Business To ITG". Convenient Store Decisions.
- Garner, Charles; Stevens, Robert (February 2014). "A Brief Description of History, Operation and Regulation" (PDF). Coresta. Archived from the original (PDF) on 3 March 2016.
- Mike K (9 June 2015). "What Does The Future Hold For Vaping Technology?". Steve K's Vaping World.
- Annabel Denham (10 June 2013). "Brothers who took a punt on a new market". CityAM. Archived from the original on 7 May 2016.
- Michael Grothaus (1 October 2014). "Trading addictions: the inside story of the e-cig modding scene". Engadget.
- Mangan, Dan (15 July 2014). "Feeling blu? E-cig company spun off in major tobacco deal". CNBC.
- Jordan Crook (20 December 2018). "Juul Labs gets $12.8 billion investment from Marlboro Maker Altria Group". TechCrunch.
- Younkman, Jon (12 November 2019). "Altria Has a Juul in the Rough". The Motley Fool.
- "Japan Tobacco's Global Ambitions Lead to Logic Acquisition". Convenience Store News. 30 April 2015.
- Akam, Simon (27 May 2015). "Big Tobacco fights back: how the cigarette kings bought the vaping industry". Newsweek.
- "Kodak moment". The Economist. 28 September 2013.
- Mike Esterl (3 February 2014). "Altria Expands in E-Cigarettes With Green Smoke". Wall Street Journal.
- Brian Montopoli (11 June 2013). "Tobacco companies bet on electronic cigarettes". CBS News.
- Daniel Nasaw (5 December 2012). "Electronic cigarettes challenge anti-smoking efforts". BBC News.
- Sanchez Manning (29 July 2013). "British American Tobacco enters electronic cigarette market in Britain with the 'Vype'". The Independent.
- Gustafsson, Katarina (2 September 2013). "Imperial Tobacco Agrees to Acquire Dragonite's E-Cigarette Unit". Bloomberg News.
- Arcieri, Katie (1 October 2013). "Lorillard acquires British e-cig maker for $48.6M". Triad Business Journal.
- "Lorillard to Rebrand SKYCIG as blu eCigs". Convenience Store News. 27 March 2014.
- "Altria Completes Acquisition of Green Smoke". TheStreet.com. Business Wire. 1 April 2014.
- Gideon Spanier (26 June 2014). "Philip Morris buys e-cigarette maker Nicocigs as it warns of falling profits". The Independent.
- Couts, Andrew (13 May 2013). "Inside the world of vapers, the subculture that might save smokers' lives". Digital Trends.
- Park, Andy (26 August 2013). "The Feed: The subculture around e-cigarettes". SBS World News.
- Barbeau, Amanda M; Burda, Jennifer; Siegel, Michael (2013). "Perceived efficacy of e-cigarettes versus nicotine replacement therapy among successful e-cigarette users: a qualitative approach". Addiction Science & Clinical Practice. 8 (1): 5. doi:10.1186/1940-0640-8-5. ISSN 1940-0640. PMC 3599549. PMID 23497603.
- Eric Larson (25 January 2014). "Pimp My Vape: The Rise of E-Cigarette Hackers". Mashable.
- Molly Osberg (25 February 2014). "CVape life: welcome to the weird world of e-cig evangelists". The Verge.
- McKee, M. (2014). "Electronic cigarettes: peering through the smokescreen". Postgraduate Medical Journal. 90 (1069): 607–609. doi:10.1136/postgradmedj-2014-133029. ISSN 0032-5473. PMID 25294933.
- Tom Gara (14 April 2014). "Are E-Cigarettes Losing Ground in the Vapor Market?". The Wall Street Journal.
- Sottile, Leah (8 October 2014). "The Right to Vape". The Atlantic.
- Jacobs, Emma; Robinson, Duncan (17 April 2014). "E-cigarettes: no smoke without fear". FT Magazine.
- Laura Kelly and Tom Howell Jr. (25 April 2018). "JUUL, maker of popular e-cigarettes, invests $30M in youth awareness". The Washington Times.
- Willett, Jeffrey G; Bennett, Morgane; Hair, Elizabeth C; Xiao, Haijuan; Greenberg, Marisa S; Harvey, Emily; Cantrell, Jennifer; Vallone, Donna (18 April 2018).