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. Other devices to deliver inhaled nicotine have been developed. [397] They aim to mimic the ritual and behavioral aspects of traditional cigarettes. [397] 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.

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. S2CID 203985885. There is concern that children may progress from vaping to smoking. [61] Adolescents are likely to underestimate nicotine's addictiveness. [222] Vulnerability to the brain-modifying effects of nicotine, along with youthful experimentation with e-cigarettes, could lead to a lifelong addiction. [91] A long-term nicotine addiction from using a vape may result in using other tobacco products. [223] The majority of addiction to nicotine starts during youth and young adulthood. [224] Adolescents are more likely to become nicotine dependent than adults. [88] a b 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. Linda Bauld; Kathryn Angus; Marisa de Andrade (May 2014). "E-cigarette uptake and marketing" (PDF). Public Health England. UK. pp.1–19. The British Royal College of Midwives states: "While vaping devices such as electronic cigarettes (e-cigs) do contain some toxins, they are at far lower levels than found in tobacco smoke. If a pregnant woman who has been smoking chooses to use an e-cig and it helps her to quit smoking and stay smokefree, she should be supported to do so." Based on the available evidence on e-cigarette safety, there was also "no reason to believe that use of an e-cig has any adverse effect on breastfeeding." The statement went on to say, "vaping should continue, if it is helpful to quitting smoking and staying smokefree". The UK National Health Service says: "If using an e-cigarette helps you to stop smoking, it is much safer for you and your baby than continuing to smoke." Many women who vape continue to do so during pregnancy because of the perceived safety of e-cigarettes compared to tobacco. [105] United States

Electronic Cigar Starter Kits

A popular vaporizer named Juul was widely used by American young people until 2022, when the FDA banned its products from sale. [111] [112] 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. [113] In the 2010s, US teenagers used the verb "Juuling" to describe vaping, [114] and Juuling was the subject of widespread memes on social media. [115] Harm reduction Effects of vaping, compared to tobacco smoking [116]

They are marketed to men, women, and children as being safer than traditional cigarettes. [346] They are also marketed to non-smokers. [50] E-cigarette marketing is common. [230] There are growing concerns that e-cigarette advertising campaigns unjustifiably focus on young adults, adolescents, and women. [174] Large tobacco companies have greatly increased their marketing efforts. [126] This marketing trend may expand the use of e-cigarettes and contribute to re-glamorizing smoking. [347] Some companies may use e-cigarette advertising to advocate smoking, deliberately, or inadvertently, is an area of concern. [152] A 2014 review said, "the e-cigarette companies have been rapidly expanding using aggressive marketing messages similar to those used to promote cigarettes in the 1950s and 1960s." [83] 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. [83] E-cigarette advertisements are also in magazines, newspapers, online, and in retail stores. [349] Between 2010 and 2014, e-cigarettes were second only to cigarettes as the top advertised product in magazines. [350] 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. [124] This raises concerns about the appropriateness of endorsing a product that directly profits the tobacco industry. [124] 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". [83] 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. [351] 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. [242] Early prototypes & barriers to entry: 1920s – 90s In 2016, the US Food and Drug Administration (US FDA) stated that "Although ENDS [electronic nicotine delivery systems] may potentially provide cessation benefits to individual smokers, no ENDS have been approved as effective cessation aids." [239] In 2019 the European Respiratory Society stated that "The long-term effects of ECIG use are unknown, and there is therefore no evidence that ECIGs are safer than tobacco in the long term" [21] and that "[t]he tobacco harm reduction strategy is based on well-meaning but incorrect or undocumented claims or assumptions." [240] [235] Following hundreds of possible cases of severe lung illness and five confirmed deaths associated with vaping in the US, the Centers for Disease Control and Prevention stated on 6 September 2019 that people should consider not using vaping products while their investigation is ongoing. [241] History

E-Cigar Flavours

The gateway hypothesis is the idea that using less harmful drugs can lead to more harmful ones. [59] Evidence shows that many users who begin by vaping will go on to also smoke traditional cigarettes. [60] [61] [62] [63] People with mental illnesses, who as a group are more susceptible to nicotine addiction, are at particularly high risk of dual use. [64] [65] a b 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. The risk of early death is anticipated to be similar to that of smokeless tobacco. [172] Since vapor does not contain tobacco and does not involve combustion, users may avoid several harmful constituents usually found in tobacco smoke, [173] such as ash, tar, and carbon monoxide. [174] However, e-cigarette use with or without nicotine cannot be considered risk-free [175] because the long-term effects of e-cigarette use are unknown. [21] [162] [172] Possible side effects of nicotine [176]