Electronic Cigarettes

electronic cigarettesElectronic cigarette use has grown substantially over the past few years, among both adults and teens in Florida. Tobacco Free Florida is concerned about the increased use of these devices and the possible public health implications of this trend.

In 2014, 3.7 percent of adults in the U.S. used e-cigarettes daily or some days.1 In Florida, 6.2 percent of adults used e-cigarettes.2 The number of Florida high school students who were current e-cigarette users increased by 72 percent in just two years – from 10.8 percent in 2014 to 18.0 percent in 2016.3

THE ISSUE

There is considerable debate regarding e-cigarettes’ safety and ability to help smokers quit. The Food and Drug Administration has not approved these devices as a quit aid, and as of May 2016, regulates them as tobacco products. Many e-liquids contain nicotine, which is highly addictive.4 Nicotine addiction is the fundamental reason people continue using tobacco, which remains the leading cause of preventable disease and death in the country.5,6 While many tout e-cigarettes’ ability to help smokers quit, nearly 6 in 10 e-cigarette users were also conventional cigarette smokers in 2015.7 Using e-cigarettes while continuing to smoke conventional cigarettes is referred to as “dual use” and does not safeguard your health.

The number of children and young adults trying e-cigarettes is especially alarming, particularly because there is evidence that adolescents who use e-cigarettes are more likely to start smoking conventional cigarettes.8,9 Because the adolescent brain is still developing, nicotine use during adolescence can affect teens’ susceptibility to addiction.10

E-cigarettes have simply not been around long enough to determine their long-term health effects. However, studies have shown that probable cancer-causing chemicals, such as formaldehyde and acetaldehyde, are measurable in some e-cigarette vapor.11 There are more than 460 brands on the market, which vary widely in chemicals used and in the amount of nicotine they deliver.12,13


1 Schoenborn CA, Gindi RM. Electronic cigarette use among adults: United States, 2014. NCHS data brief, no. 217. Hyattsville, MD: National Center for Health Statistics, 2015.

2 Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, [2014].

3 Florida Youth Tobacco Survey (FYTS), Florida Department of Health, Bureau of Epidemiology, 2016.

4 U.S. Department of Health and Human Services. The Health Consequences of Smoking: Nicotine Addiction. A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1988. DHHS Publication No. (CDC) 88-8406.

5 U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010.

6 U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. Printed with corrections, January 2014.

7 QuickStats: Cigarette Smoking Status Among Current Adult E-cigarette Users, by Age Group — National Health Interview Survey, United States, 2015. MMWR Morb Mortal Wkly Rep 2016;65:1177. DOI: http://dx.doi.org/10.15585/mmwr.mm6542a7.

8 Coleman BN, Apelberg BJ, Ambrose BK, et al. Association between electronic cigarette use and openness to cigarette smoking among US young adults. Nicotine Tob Res. 2015; 17(2):212-218.

9 Thomas A Wills, Rebecca Knight, James D Sargent, Frederick X Gibbons, Ian Pagano, Rebecca J Williams Longitudinal study of e-cigarette use and onset of cigarette smoking among high school students in Hawaii. Tob Control doi:10.1136/tobaccocontrol-2015-052705.

10 England, L. et al. Nicotine and the Developing Human: A Neglected Element of the E -cigarette Debate. Am J Prev Med. 2015 Mar 7. [Epub ahead of print].

11 U.S. National Library of Medicine National Institutes of Health. Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review. Ther Adv Drug Saf. 2014.

12 British Medical Journal. Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation. (12 May 2014). http://tobaccocontrol.bmj.com/content/23/suppl_3/iii3.full.

13 World Health Organization (WHO). Questions and answers on electronic cigarettes or electronic nicotine delivery systems (ENDS). (10 Jul 2013). http://www.who.int/tobacco/communciations/statements/electronic_cigarettes/en/index.html.

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