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Inter-Tribal Council of Michigan launches free e-cigarette quit program for tribal young adults
E-Cigarettes, also called personal vaporizers or “vapes”, present another way for smokers to ingest nicotine. E-Cigarettes have been marketed to young adults and adolescents through the use of candy and fruit flavors. They are also touted by some users as a “safer” alternative to smoking, and as a way to either quit smoking cigarettes, or to smoke in places where cigarette smoking is not allowed.
Research on health effects of secondhand exposure to e-cigarettes is still emerging. The quantity of these carcinogens is less that what is found in conventional cigarettes. While some young people may be able to quit e-cigarette use on their own, others, particularly daily users, are likely to find this to be very difficult.
In short, the ingredients in e-cigarette liquid have caused users health problems. The health effects of e-cigarettes are still being studied but nicotine addiction, harmful chemical additives, battery explosions causing injury, acute nicotine poisoning and vaping related lung injury have all been linked to use of e-cigarettes and vaping. An e-cigarette is a battery-operated device that heats liquid into an aerosol that the user inhales. E-cigarettes typically operate on a rechargeable lithium-ion battery.
Smoking is the leading cause of lung cancer, and people who smoke are 20 times more likely than nonsmokers to be diagnosed with lung cancer. Tobacco products contain unsafe substances, from acetone and tar to nicotine and carbon monoxide. The inhaled substances can affect your lungs and the other organs in your body.
Surgeon General’s recommendation urging those who influence youth, young adults and people who are pregnant to discourage nicotine use in any form, including e-cigarettes. To protect kids now, states and cities must also continue their growing efforts to end the sale of flavored e-cigarettes, as well as other flavored tobacco products. Electronic cigarettes, or e-cigarettes, are part of a category of products called Electronic Smoking Devices (ESDs), which are designed to mimic combustible tobacco cigarettes and, in most cases, contain varying levels of nicotine. Our compassionate providers can help both you and your child understand the dangers of vaping and provide resources that help people quit using tobacco products like e-cigarettes. During this time, the brain is constantly rewiring itself, which makes it far more vulnerable to nicotine addiction. This is part of why teens who vape are nearly three times more likely to begin smoking cigarettes.
Studies have found that nearly two-thirds of adult e-cigarette users plan to quit, and almost a quarter of adolescents want to quit and have made a quit attempt. We hope this article helps you feel a little more secure about your choice of vaping products. Remember that the safest way to use any vape is in moderation, so try not to overdo it, no matter which one you choose. Flavored vapes without nicotine (and other types of vapes) come in hundreds of different sizes and styles, and some are less risky than others. How can you decide which ones are safest and what's considered a healthy vape brand. Our only gripe with CAPNOS is that they're a little vague about where exactly their flavors come from.
We would argue that further studies with chronic administration of low doses of nicotine are required to clearly evaluate its impact on carcinogenicity. In this line, a study compared the acute impact of CS vs. e-cigarette vaping with equivalent nicotine content in healthy smokers and non-smokers. Both increased markers of oxidative stress and decreased NO bioavailability, flow-mediated dilation, and vitamin E levels showing no significant differences between tobacco and e-cigarette exposure (reviewed in [20]). Inasmuch, short-term e-cigarette use in healthy smokers resulted in marked impairment of endothelial function and an increase in arterial stiffness (reviewed in [20]). Similar effects on endothelial dysfunction and arterial stiffness were found in animals when they were exposed to e-cigarette vapor either for several days or chronically (reviewed in [20]).
Next, we examined the e-cigarette emissions of flavouring compounds, together with acetic acid and propionic acid, as listed by the U.S. These compounds were not analysed in cigarette smoke because the Ky1R6F cigarette used in the study is an unflavoured US-blended cigarette and validated analytical methods for these compounds were not available. From the studied carbonyls, only acetaldehyde, acrolein and formaldehyde are included in the nine WHO TobReg priority smoke toxicants55. Relative to cigarette smoke, their percentage of reduction in the e-cigarette emissions was ≥ 98.8%. Liquid refills are sold in quantities of 10 mL to more than 30 mL (about two to six teaspoons) in a variety of nicotine strengths. The products come in flavors with attractive scents and inviting packaging.
With so many adults kicking the cigarette smoking habit, Altria was looking for ways to sustain its financial stability. Outside of addiction, nicotine can also have other long-term and permanent effects on developing brains. Because vaping has only recently gained popularity, we don’t yet have the data to tell us all its health effects. E-cigarettes are also called e-cigs, vape pens, vapes, mods, and other terms.
Carbonyls in cigarette smoke are formed mainly by pyrolysis of tobacco sugars83, whereas those in e-cigarettes are formed mainly by thermal degradation of PG and/or VG83,84,85. Flavourings may also contribute to the formation of carbonyls, as well as the characteristics of the e-cigarette devices, especially the applied voltage, coil resistance and wicking material47,48,49,86,87. Poor wicking efficiency may lead to a dry wick and overheated e-liquid (dry puff), which promotes the formation of carbonyls and other toxic compounds2,10,13,15. Coil location, orientation, resistance and wick material, as well as power output, have been shown to affect carbonyl generation significantly13,15,86.
WASHINGTON (AP) — The Food and Drug Administration on Friday authorized the first menthol-flavored electronic cigarettes for adult smokers, acknowledging that vaping flavors can reduce the harms of traditional tobacco smoking. Some people believe e-cigarettes may help lower nicotine cravings in those who are trying to quit smoking. However, e-cigarettes are not an FDA-approved quit aid, and there is no conclusive scientific evidence on the effectiveness of vaping for long-term smoking cessation. It should be noted that there are seven FDA-approved quit aids that are proven safe and can be effective when used as directed.
However, when they looked at other scenarios, such as bar settings where many people were vaping, the researchers found that the concentration of toxins in the air was generally much higher than in residential settings. The more people were vaping and the higher voltages were used, the worse the air quality. In some scenarios, levels of both formaldehyde and acrolein were above OEHHA safety standards for bar employees. This article explains the toxins found in vaping aerosol, the factors affecting secondhand vaping, and potential health effects. MARIE — The Inter-Tribal Council of Michigan has partnered with Truth Initiative to offer a first-of-its-kind free and anonymous text message quit vaping program through the This is Quitting for teens and young adults.
The cells are also less able to form new vascular tubes and to migrate and participate in wound healing. With a 399.73% increase in retail e-cigarette sales (excluding internet sales and tobacco-specialty stores) from 2015 through 2020, the environmental consequences of e-cigarette waste are enormous. The fourth-generation vaporizers can also be customized and come with different types of heating coils — some intended for vaporizing solids, not liquids. In general, people using e‑cigarettes did not report doing so in order to quit smoking regular tobacco cigarettes. In 2022–2023, only 1 in 5 (21%) people who had ever used e‑cigarettes reported that they first used e‑cigarettes to help them quit smoking (Figure 5). The most common reason people gave for using e‑cigarettes was out of curiosity (58%).
Simply select your manager software from the list below and click Download.For more information or tips please see 'Downloading to a citation manager' in the Help menu. The Vital Records service window in the Lucas State Office Building will be closed on August 6-7 due to construction. As of April 1st, 2024, 1,061 municipalities, plus 26 states, commonwealths, and territories restrict e-cigarette use in 100% smokefree venues.
Truth Initiative forcefully rejects, however, the notion that this requires the further development of a huge commercial market in addictive nicotine products focused on growth and the acquisition of new users, most of whom are youth and young adults. Because the youth e-cigarette crisis in the United States and the youth appeal of flavored e-cigarettes go hand in hand, Truth Initiative strongly supports removing all flavored e-cigarettes from the market, regardless of device type. Based on the evidence already collected, the question shouldn’t be whether e-cigarettes are less dangerous than cigarettes, Christiani says, but whether vaping can be very harmful to health too. “To protect public health, I discourage the use of vaping—even to quit smoking,” he stresses.
We appreciate all forms of engagement from our readers and listeners, and welcome your support. These simple sugars are not harmful to the environment and are in fact are a useful product for many plants and animals. The breakdown of cellulose is of interest in the field of biofuel.[183] Due to the conditions that affect the process, large variation in the degradation time of cellulose acetate occurs. Cigarette filters are made up of thousands of polymer chains of cellulose acetate, which has the chemical structure shown to the right.
The ACS encourages young people currently using any of these products to ask for help in quitting and to quit as soon as possible. E-cigarettes can be especially harmful for young people because nicotine affects them in different ways than adults. People who use e-cigarettes should make sure they do not vape around children and ensure they always store e-cigarettes and e-liquids out of reach of children when not in use.
However, within the adult demographic, 12.7 percent of 18- to 24-year-old adults and 21.3 percent of males, ages 18-24, are "current users" of e-cigarettes. The e-cigarette device (Vype ePod1.0, Nicoventures Trading Ltd., Blackburn, UK) consists of a metallic outer device case, a printed circuit board to control the device, a lithium-ion rechargeable battery (350 mAh) and an e-cigarette cartridge (Fig. 1). The voltage ranges from 2.2 to 3.1 V and is not adjustable by the user. The device has dimensions (h × w × d) of 104.2 × 19.1 × 10.5 mm and a power output of 6.5 ± 0.5 W. The cartridges or pods consist of a plastic case holding the ceramic wick material and a flat metal heating element (NiCr, 0.8 –1.4-Ω resistance). Each pod is pre-filled with Vype e-liquid (1.9 mL) and is magnetically attached to the device.
All this evidence would suggest that e-cigarettes are potentially less harmful than conventional cigarettes (Fig. 2) [11, 14, 22, 24, 27,28,29]. Importantly, however, most of these studies have investigated only short-term effects [10, 14, 15, 22, 27,28,29, 31, 32], and the long-term effects of e-cigarette consumption on human health are still unclear and require further study. Vapes come in colorful, fun, and unique product designs, along with many flavors, all of which come together as part of the attraction for youth who believe that these products are not addictive and are safe to use. Many users believe vaping will reduce stress, anxiety, and depression.
Children 13–15-years old are using e-cigarettes at rates higher than adults in all WHO regions. In Canada, the rates of e-cigarette use among 16–19-year-olds has doubled between 2017–2022, and in England (the United Kingdom) the number of young users has tripled in the past three years. The Alabama Tobacco Quitline is a free telephone and online coaching service for any Alabamian who is ready to quit tobacco or e-cigarette use. A PDF is a digital representation of the print book, so while it can be loaded into most e-reader programs, it doesn't allow for resizable text or advanced, interactive functionality. The eBook is optimized for e-reader devices and apps, which means that it offers a much better digital reading experience than a PDF, including resizable text and interactive features (when available).
Youth vaping has declined from all-time highs in recent years, with about 10% of high schoolers reporting e-cigarette use last year. Vaping is not completely risk-free, but it poses a small fraction of the risk of smoking cigarettes. The aerosols generated by ENDS typically raise the concentration of particulate matter in indoor environments and contain nicotine and other potentially toxic substances. ENDS emissions therefore pose potential risks to both users and non-users. Accidental exposure of children to ENDS e-liquids pose serious risks as devices may leak or children may swallow the poisonous e-liquid.
In December 2019, the legislation was included in the federal year-end legislative package and passed by both houses of Congress. President Trump signed the bill into law on December 20, 2019 and it immediately took effect. This legislation, which applies to all states, raises the minimum age of sale for all tobacco products— including e-cigarette—to 21. We provide the facts about smoking, vaping, nicotine, and the tobacco industry. We engage individuals and groups to make change in their communities, innovate ways to end nicotine addiction, and join forces with collaborators committed to preventing youth and young adult nicotine addiction and empowering quitting for all. That's hard to say — the potential health risks of vaping CBD are still hotly debated.
Further, synthetic nicotine may pose challenges in countries that regulate products with tobacco-derived nicotine. “We are beginning to see the robust supply chains and lack of enforcement that supports the illicit e-vapor market (is) enabling increased illicit activity across multiple tobacco categories,” Gifford said. Three years after puffing my first e-cig had led to me vaping all the goddamn time. All night when I’m out with friends and now all day while I’m at work.
They observed, on average, a 34 percent reduction in the femoral artery’s dilation. These findings suggest that vaping can cause significant changes to the inner lining of blood vessels, said study lead author Alessandra Caporale, PhD, a post-doctoral researcher in the Laboratory for Structural, Physiologic, and Functional Imaging at Penn. In this study, the researchers examined the impact of an e-cigarette that contained propylene glycol and glycerol with tobacco flavoring, but no nicotine, which study participants took 16, three-second puffs from. To evaluate vascular reactivity, researchers constricted the vessels of the study participants’ thigh with a cuff and then measured how quickly the blood flowed after its release. Using a multi-parametric MRI procedure, researchers scanned the femoral artery and vein in the leg before and after each vaping episode to see how vascular function changed.
The researchers — from Truth Initiative and Brown University — found that after seven months had gone by, about 38% of participants in the This is Quitting program reported not vaping in the previous 30 days, compared with 28% in the assessment-only group. E-cigarettes are the most commonly used tobacco product among adolescents. (CNN) — For teens who want to stop vaping nicotine, an interactive text message program was found to be effective at helping them quit.
The most consistent predictors have been descriptive norms of parents’ and close friends’ smoking, indicating that addressing close network members might be the most effective in interventions [27]. In our study, parental smoking reported by adolescents increased all types of susceptibility when analysed independently. In the multivariate models, it did not have clear associations with S-SN and S-EC among girls.
The ACS encourages adolescent users who find it difficult to quit to ask for help from health care professionals. Parents should learn all they can about e-cigarette use and be prepared to help their children get the assistance they need. In 2019, more than one in six (15.2%) New York City high school students reported using e-cigarettes.
Consequently, stricter regulation and a higher quality control in the e-liquid industry are required. The mislabelling of nicotine content in e-liquids has been previously addressed [8, 34]. Of note, several studies have detected nicotine in those e-liquids labelled as nicotine-free [5, 35, 36]. Among the 17 samples tested in this latter study 14 were identified to be counterfeit or suspected counterfeit. A third study detected nicotine in 7 of 10 nicotine-free refills, although the concentrations were lower than those identified in the previous analyses (0.1–15 µg/mL) [5].
High level of parental education was operationalized as at least one parent having tertiary education, and parental smoking as at least one parent smoking currently. ’ and dichotomized from responses Very much/quite a lot (vs. fairly little/not at all). Delaware Kick Butts Generation A youth-led program in schools and communities to counter tobacco marketing. E-cigarette flavorings damage human blood vessel cells grown in the lab even in the absence of nicotine, Stanford researchers and their colleagues found. Children are much more prone to nicotine overdose because of their smaller body size. Nicotine poisoning in children comes mostly from eating cigarettes and consuming liquid nicotine — either from absorbing spilled nicotine through their skin or through the mucous membrane in their mouth or from swallowing liquid nicotine.
Most modern cigarettes are filtered, although this does not make the smoke inhaled from them contain fewer carcinogens and harmful chemicals. Nicotine, the psychoactive drug in tobacco, makes cigarettes highly addictive. About half of cigarette smokers die of tobacco-related disease and lose on average 14 years of life.
In addition to the battery component, an e-cigarette comprises an atomizer and a cartridge containing either a nicotine or a non-nicotine liquid solution. When the device is operated, the battery heats the liquid in the cartridge, and the atomizer vaporizes the liquid, emitting it as a mist that the user inhales. Hence, e-cigarette use is commonly described as vaping, a term also used in reference to the use of similar devices, including vape pens and e-hookas. Electronic cigarettes (e-cigarettes) go by many names, including but not limited to electronic nicotine delivery systems, vapes, vape pens, e-cigars, and hookah pens.
Learn more about the symptoms and overall effects of smoking on the body below. For example, in New York and Vermont, vaping is prohibited in all smoke-free venues (like workplaces, bars, restaurants, and gambling facilities) except e-cigarette stores. The makeup of these devices—combined with individual or group vaping patterns—can significantly impact what pollutants get into the air and how many. The program provides participants with tailored advice, cognitive and behavioral coping strategies, and social support to help them quit. Now that ebay is starting to allow sellers like myself to utilize the site again why cant they allow a process to become a pre approved seller for vape products.
Teens and young adults can join for free by texting DITCHVAPE to 88709. See “ Local restrictions on flavored tobacco and e-cigarette products ” for a full report on local flavored tobacco policies. For those who prefer a more "natural" vape experience, Kind Juice provides a range of liquids derived entirely from organically grown plants. The flavors are extracted using relatively gentle solvents, while the vegetable glycerine carrier fluid is made from plant oils using hydrolysis. Kind Juice products contain no additives, nicotine, or psychoactive ingredients, though some have CBD. Many people stick to regulated mods, which include circuit boards that can help prevent problems like power surges.
Helping a teen understand what sources to trust can give them a powerful tool to educate themselves. Don’t just tell them that there’s no good reason to start, help them learn why there’s no good reason. Talk about peer pressure, the tricks advertisers use and the importance of health.
The availability of “vape wear,” such as backpacks and hoodies, also allow the user to vape while concealing the product. The study showed that the e-liquids of certain cig-a-like brands contain high levels of nickel and chromium, which may come from the nichrome heating coils of the vaporizing device. Cig-a-likes may also contain low levels of cadmium, a toxic metal also found in cigarette smoke that can cause breathing problems and disease.11 More research is needed on the health consequences of repeated exposure to these chemicals.
Do we really know the composition of the inhaled vapour during the heating process and its impact on health? In the present review, we have attempted to clarify these questions based on the existing scientific literature, and we have compiled new insights related with the toxicity derived from the use of these devices. With the rise in electronic cigarettes (e-cigarette, e-cigs or vapes) and vaping use among youth, teens and young adults, the Health Department and our team are working to prevent initiation and reduce vaping of all substances in Vermont. As of 2021, 16% of Vermont high school students said they used e-cigarettes at least once in the past 30 days. Students who smoke cigarettes, tried flavored tobacco before age 13, binge drink or use cannabis vape at the highest rates.
We want to make a difference in the lives of our users, and create products that can fit all levels and styles of vapers, to help as many as possible. Stanford Medicine Tobacco Prevention ToolkitTheory-based and evidence-informed resources created by educators, parents, and researchers aimed at preventing middle and high school students' use of tobacco and nicotine. There are several resources available to assist with learning more about e-cigarettes and educating youth about the risks. Resources are available for parents, educators, and health care providers. According to the 2017 Behavior Risk Factor Survey (BRFS) conducted by DHSS, 4.8 percent of Delaware adults currently use e-cigarettes, roughly the same percentage reported in the 2016 survey.
There are hundreds of brands, and they're sometimes marketed as a way to get your nicotine fix without the danger of cigarettes. The Electronic Cigarette Company is one of the original online vape stores in the UK, founded in 2008. We stock a wide range of electronic cigarettes, vape starter kits, and vaping accessories from leading manufacturers such as Elf Bar, Lost Mary, SMOK, Aspire, Vaporesso, VOOPOO, Innokin, Double Drip, ElfLiq and Riot Squad. Many of those who vape were likely to report issues that kept them from being able to safely dispose of their used and empty e-cigarette products. More than half (57.8%) of those who had used e-cigarettes in the past month found it inconvenient to dispose of e-cigarette waste responsibly.
Take the edge off stress by trying ways to relax, such as deep breathing, muscle relaxation, yoga, visualization, massage or listening to calming music. Even short bursts of activity — such as running up and down the stairs a few times — can make a tobacco craving go away. You might be tempted to have just one cigarette to satisfy a tobacco craving. If you usually smoked while you talked on the phone, for instance, keep a pen and paper nearby to keep busy with doodling rather than smoking. Here are 10 ways to help you resist the urge to smoke or use tobacco when a craving strikes. Smoking remains England’s number one killer and the best thing a smoker can do is to quit completely, now and forever.
The flavored vape juice inside contains only vegetable glycerine and organic fruit extracts. That means it's free from all the harmful chemicals we mentioned above. It's a stripped-down, vegan-friendly, nicotine-free vaping experience. When I smoked cigarettes, I dealt with inconveniences due to my addiction. I would be forced to leave the company of my friends and family to go stand outdoors, like an outcast or lesser human, so that I could prevent myself from having a withdrawal meltdown.
FDA regulates the manufacture, import, packaging, labeling, advertising, promotion, sale, and distribution of ENDS, including components and parts of ENDS but excluding accessories. An outbreak of EVALI in late 2019 and early 2020 put thousands of people in the hospital. Since then, EVALI cases have been declining, but people who vape can still get EVALI. Research from the CDC shows that vaping among youth has declined somewhat since 2020.
Vape products are taxed at the sales tax rate rather than the tobacco or cigarette tax rate. While vape products are not covered by the Smoke-free Air Act, each business can prohibit the use of vape devices indoors, but this is not required by state law. Iowa law places several restrictions on youth access to e-cigarettes, including but not limited to, prohibiting the sale, distribution, possession, purchase and use of vapor products to anyone under the age of 21. There are health and safety concerns related to the use of vapor products.
Experts have long suspected it, but a new study confirms that folks who vape and smoke tobacco face higher risks for lung cancer than if they'd done either alone. Propylene glycol, for example, is usually eaten (in cupcakes, soft drinks and salad dressings) or slathered onto the body (in soaps, shampoos and antiperspirants)—not breathed into the lungs. Many things that can be safely eaten—such as flour—can damage the lungs when inhaled. “We have little information about what happens to propylene glycol in the air,” the federal Agency for Toxic Substances and Disease Registry says on its Web site.
Some products claiming to be nicotine-free (ENNDS) have been found to contain nicotine. Your doctor will begin his or her diagnosis by asking you about your use of e-cigarettes within the past three months and whether you vaped a product containing nicotine, THC, or both. During the physical exam, your doctor will use a stethoscope to listen to your lungs, check your heartrate, and measure your blood oxygen saturation using a pulse oximeter. A chest X-ray or computed tomography (CT) scan is usually necessary for diagnosis and will show hazy looking spots (called opacities) in the lungs. Your doctor may also order bloodwork to rule out other possible causes of your illness.
There is no single test for EVALI; it’s what is known as a “diagnosis of exclusion,” which means that a doctor will conduct tests to rule out other potential diseases and conditions. The primary risk factor for EVALI is current or previous use of a vaping device. They can look like cigarettes, cigars, pipes, pens, USB flash drives, or may be in other forms. We fund research that explores how risk factors such as smoking, poor nutrition, and lack of physical activity can affect the development of cancer. For instance, 68 people died in an outbreak of vaping-related illness (EVALI) in 2019 and 2020. Links to E-Cigarette Resources Links other websites, reports educational materials, toolkits and more information on e-cigarettes.
Aug. 9, 2023, News Staff — New CDC data suggest that e-cigarette use is becoming more popular among young adults, even as their use of tobacco decreases. Freebase nicotine is nicotine that has been dissolved in a liquid mixture, typically propylene glycol and/or vegetable glycerin, and other chemicals such as flavouring ingredients. E-cigarettes contain nicotine and lithium batteries, making them hazardous waste.
The agency says companies were blocked because they couldn’t show the possible benefits for adult smokers outweighed the risk of underage use. The companies say they had prepared detailed plans to avoid appealing to young people. Vaping is the inhaling of an aerosol (mist) created by an electronic cigarette (e-cigarette) or other vaping device. As a result of the FDA’s missed deadlines and inadequate enforcement, flavored e-cigarettes remain widely available online and in stores across the country. Every day flavored e-cigarettes remain on the market, our kids remain at risk.
This guide supports health care providers, systems, and communities seeking to prevent vaping. These resources and others are on the AAFP’s Tobacco and Nicotine Prevention and Control webpage. Familydoctor.org, the Academy’s patient-facing web resource, has additional materials on tobacco addiction, the harms of vaping and several related topics. Young adults with family incomes of less than 200% of the federal poverty level also were more likely to use e-cigarettes than those with greater family income.
Nonetheless, adults who smoke who switch to using e-cigarettes expose themselves to potentially serious ongoing health risks. If they are unable to quit e-cigarettes on their own, they should seek help from a health care professional or quitline. Individuals who are not yet able to stop using e-cigarettes should be strongly discouraged from simultaneous, or “dual,” use of any combustible tobacco products, including cigarettes. Continuing to smoke exposes the individual to enormous harms, irrespective of whether the individual is using e-cigarettes part of the time. All individuals should also be strongly counseled to not revert to smoking. Some look like a regular cigarette, but many resemble everyday products like pens, USB drives, highlighting markers, or colorful toy-like items.
Many people believe electronic cigarettes (also called e-cigarettes or vapes) are a safe alternative to traditional cigarettes. But with a recent report from the U.S. surgeon general calling e-cigarette use “a major public health concern,” this may not be the case. The FDA reports an alarming 900% rise in e-cigarette use among high school students from 2011 to 2015 and the number of high school students using them increased 78% in 2018 alone. Vaping doesn’t create second-hand smoke.Breathing in second-hand smoke is a health risk for people who are around cigarette smokers, including vapers. In addition, third-hand smoke on clothes and furniture is smelly and can be dangerous for people with respiratory conditions. Vaping doesn’t produce the same smelly fumes as cigarettes, but the secondhand vapor contains chemicals and compounds that pollute the indoor air.
This guidance is intended to support healthcare providers in their understanding and tracking of -cigarette and vaping product use. 20% (5 million) of all youth use e-cigarettes, a 135% increase in just two years. Additional data, rates and trends can be found in the American Lung Association’s Tobacco Trends Brief.
Sales data did not include e-cigarette sales made online, in vape shops, or via illicit markets. While the study was not a randomized experiment, the analytical methods used were robust enough to identify causal relationships. ESD aerosol is a new source of pollution and toxins being emitted into the environment. We do not know the long-term health effects of ESD use and although the industry marketing of the product implies that these products are harmless, the aerosol that ESD emit is not purely water vapor. These figures coincide with additional research that indicates an overall increase in e-cigarette use. Vaping is the act of inhaling and exhaling an aerosol produced by a vaping product, such as an electronic cigarette.
Among adolescents who both vaped and smoked traditional cigarettes, a higher proportion in the This is Quitting program, about 51%, reported not vaping nor smoking at seven months, compared with 30% of the assessment-only group. Withdrawal from tobacco products can cause temporary congestion and respiratory discomfort as your lungs and airways begin to heal. Increased mucus production right after quitting smoking may be a positive sign that your respiratory system is recovering. What might be considered safe for the average workplace employee could still pose serious health risks for more medically vulnerable populations.
That legal decision allowed sales of e-cigarettes to proceed but left many questions about their safety unaddressed. To lower the potential risks posed by secondhand aerosol exposure from vaping, some U.S. states, territories, and cities have started restricting where people can vape. There are currently more than 7,000 varieties of flavored e-cigarettes and e-juice (liquid containing nicotine that is used in refillable devices) on the market. Although the popularity and use of e-cigarettes continues to increase, there is a lack of data on their potential health effects. Food and Drug Administration (FDA) has issued a proposed rule to include e-cigarettes under its authority to regulate certain tobacco and nicotine-containing products. Fourth-generation ‘pod’ e-cigarette devices have been driven by technological advances in electronic atomization of the e-liquid.
These products may have reusable parts, or they may be disposable and only used once before they are thrown away. Some damage to your lungs from vaping can heal or get better with medications. Over time, constant irritation to your lungs can lead to health problems (like asthma and COPD) that won’t go away. It actually creates an aerosol (or mist) that contains small particles of nicotine, metal and other harmful substances. Your tax-deductible donation funds lung disease and lung cancer research, new treatments, lung health education, and more. Youth and young adult e-cigarette users, many of whom never previously used tobacco, also need support to quit.
That said, there are some concerns about how repeatedly inhaling e-cigarette aerosol over an extended period of time could affect bystanders’ long-term lung function and risk of allergic reactions. "I applaud Governor Cuomo for taking action to prevent exposure to secondhand e-cigarette emissions in public places for all New Yorkers." ALBANY, NY (November 22, 2017) - The New York State Department of Health is reminding all New Yorkers that beginning today the use of electronic cigarettes is banned indoors everywhere that smoking tobacco products are prohibited in New York. Despite these uncertainties, the use of e-cigarettes has skyrocketed since their introduction about a decade ago, particularly among young people. The Food and Drug Administration estimates that more than 3.5 million middle and high school students used e-cigarettes in 2018, though sales to minors are prohibited. In 2018, the FDA restricted the sale of flavored e-cigarettes to adult-only venues, with the exception of tobacco, menthol and mint flavors, which can be sold wherever traditional cigarettes are sold.
While FDA has made progress in reviewing marketing applications for flavored e-cigarettes, it has repeatedly missed deadlines to complete its review of major products and failed to clear the market of these illegal flavored products. Here you will find the facts on vaping, based on scientific evidence and research, plus advice on how to use vapes (sometimes called e-cigarettes or e-cigs) as a tool to quit smoking. Battery-powered vape devices create an aerosol that looks like water vapor but contains nicotine, flavoring, and more than 30 other chemicals. The aerosol is inhaled into the lungs where the nicotine and chemicals cross over into the bloodstream.The earliest vape devices looked like cigarettes. With Americans puffing less each year, the cigarette industry sees ESDs and other smokeless products as financial saviors. E-cigarette sales tripled between 2012 and 2013 rising from $500 million to over $1.5 billion and are expected to soon exceed the sales of traditional cigarettes, motivating giant tobacco and other non-cigarette companies to market this product.
The device heats a liquid into an aerosol (sometimes known as "vapour" and mistakenly called "water vapour"). Nicotine is a highly addictive substance found in tobacco products, including cigarettes, cigars, chewing tobacco, e-cigarettes, and pouches. Over 50% of middle school and high school students reported seeing e-cigarette advertising. Only 28% of young people in the U.S. believe e-cigarettes have the potential to cause a lot of harm. Up to 40% of teens who vape are unaware their e-cigarette cartridges contain nicotine. E-cigarettes can also be used to vape marijuana’s psychoactive ingredient, THC.
He also highlighted the ban on e-cigarettes in India under the Prohibition of Electronic Cigarettes Act, 2019, aimed at preventing health risks and curbing their use among youth. These ingredients pose significant health risks, particularly to pregnant women, children, and adolescents, and leads to issues like impaired brain development and respiratory diseases, said Dr Goel. Cumberland County Schools is implementing a national vaping and nicotine prevention program in each of its middle and high schools to try and curb rates of youth vaping. Cigarettes pushed me back to shivering outside the bar where a nicotine habit belongs.
They found that kids who used e-cigs were more likely than non-users to smoke cigarettes or other tobacco products over the next year. To study the short-term impacts of vaping, the researchers performed MRI exams on 31 healthy, non-smoking adults before and after vaping a nicotine-free e-cigarette. Comparing the pre- and post-MRI data, the single episode of vaping resulted in reduced blood flow and impaired endothelial function in the large (femoral) artery that supplies blood to the thigh and leg. The endothelium, which lines the inside surface of blood vessels, is essential to proper blood circulation. Once the endothelium is damaged, arteries thicken, and blood flow to the heart and the brain can be cut off, resulting in heart attack or stroke.
They then compiled these rates into one score to determine the 'healthiest' and 'unhealthiest' states for kids. Overall, recent figures from JAMA suggest more than 2million kids under 18 vape regularly, along with 17million adults. Combined with smoking, it may accelerate these effects, leading to osteoporosis. Nicotine causes blood vessels to tighten, which restricts the flow of blood. Smoking also raises blood pressure, weakens blood vessel walls, and increases your risk of blood clots. It can also damage the DNA in sperm, making it difficult to conceive and increasing the risk of miscarriage and certain birth defects.
Still, many people, including teens and young adults drawn to vaping, may not realize that, Bittoni said. Other popular brands, like Puff Bar, have received warnings from regulators about the sale of flavored devices as well. Following the Golden State, Washington had the second-lowest amount of youth vapers, at eight percent. In the Evergreen state, the legal age to purchase vapes is 21, and there is a ban on all flavored varieties. Last year, Alaska Senate President Gary Stevens, a Republican, introduced Senate Bill 89, aimed at imposing the state's first-ever tax on e-cigarette products. Wyoming had the highest rate of youth vapers, with 30 percent of kids under 18 reporting they had used e-cigarettes in 2023.
The main danger with a closed-system vape comes from the lithium-ion battery. If you try to charge it using an incompatible device, there's a small but real chance of a fire or explosion. If you're new to vaping, we'd suggest starting out with a disposable vape pen. Because these devices are pre-assembled and standardized, there's no need to worry about making a dangerous mistake with the power supply that causes overheating. There's no e-liquid at all in this device, just natural, food-grade flavor extracts. And third-party testing has confirmed that the E-Z contains no allergens, carcinogens, or toxins of any kind.
As a non-profit organization, we accept no government or tobacco industry funding. We rely on contributions from individuals, philanthropic foundations, corporations and other non-profit organizations to continue working toward a tobacco-free future. The U.S. Surgeon General declared vaping an epidemic among our youth in 2018. Additional collection points are being added all the time, you can use your postcode to find your nearest vape recycling locations. You can take vapes for recycling to the shop where you buy your replacements or to your local authority household waste recycling centre. Once you have bought the kit, it's been estimated that vaping costs about a third as much as smoking.
Median odds ratio (MOR), which shows the difference between two respondents with identical student-level characteristics from two randomly chosen different schools, was calculated to express between-school variance on the odds ratio scale [36]. The analysis was not pre-registered, and the results should be considered exploratory. Scholastic Real Cost of VapingThe FDA collaborated with the Scholastic Corporation to develop lessons, activities and resources for teachers to increase awareness about the health consequences of youth e-cigarette use. Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. This study was the first to use endothelial cells derived from iPS cells to directly investigate the effect of e-liquids with and without nicotine on their viability and function.
Many e-cigarettes sold in the U.S. contain far more nicotine than e-cigarettes sold elsewhere, which increases the risk of addiction and harm to the developing brains of youth and young adults. Marketing tactics targeting young people have contributed to the rapid increase in use. The long-term risks of exclusive use of e-cigarettes are not fully known but evidence is accumulating that e-cigarette use has negative effects on the cardiovascular system and lungs.
Using e-cigarettes, or “vaping,” are terms used synonymously to refer to the use of a wide variety of electronic, battery-operated devices that aerosolize, but do not burn, liquids to release nicotine and other substances. Nicotine-containing e-cigarettes are regulated as “tobacco products” by the FDA because the nicotine is derived from the tobacco plant. E-cigarettes pose a threat to the health of users and the harms are becoming increasingly apparent. In the past few years, the use of these products has increased at an alarming rate among young people in significant part because the newest, re-engineered generation of e-cigarettes more effectively delivers large amounts of nicotine to the brain.
This data brief demonstrates that teens whose environments put them at risk for use of e-cigarettes are more likely to try them. The study, published on May 23, 2022, in Tobacco Control, is the first to look at the health care costs of e-cigarette use among adults 18 and older. The second most supported measure, strengthening restrictions on the advertising and promotion of e‑cigarettes, was supported by 82% of people. In 2019, only 67% of people in Australia supported strengthening these restrictions. The proportion of people neither smoking regular cigarettes nor using e‑cigarettes has remained stable (Figure 3).
However, the FDA then paused its decision in July while it carries out an additional review on the company's products. Many physical retail locations neglect to check identification for customers, allowing children to access the devices. Like cigarettes, an American must be at least 21 years old to purchase a vape. They can come as vape pens — which are shaped like a pen or small tube with a tank to store e-liquid and batteries — or pod systems that are rechargeable and often shaped like USB sticks.
In e-cigarettes, tobacco combustion is replaced by e-liquid heating, leading some manufacturers to propose that e-cigarettes have less harmful respiratory effects than tobacco consumption. Other innovative features such as the adjustment of nicotine content and the choice of pleasant flavours have won over many users. Nevertheless, the safety of e-cigarette consumption and its potential as a smoking cessation method remain controversial due to limited evidence. Moreover, it has been reported that the heating process itself can lead to the formation of new decomposition compounds of questionable toxicity. Numerous in vivo and in vitro studies have been performed to better understand the impact of these new inhalable compounds on human health.
This can also increase the levels of other toxicants to the user and also expose bystanders to harmful emissions. Vapes, vaporizers, vape pens, hookah pens, electronic cigarettes (e-cigarettes or e-cigs), e-cigars, and e-pipes are some of the many tobacco product terms used to describe electronic nicotine delivery systems (ENDS). An electronic cigarette (e-cigarette) is a device that heats up the liquid nicotine and flavoring for you to breathe in. There are many varieties of e-cigarettes that go by different names, including vapes, vape pens or sticks, e-hookahs, hookah sticks, mods and personal vaporizers (PVs). They can also be collectively called electronic nicotine delivery systems (ENDS).
These devices are permitted on planes, but the FAA recently notified airlines that the lithium batteries used in these devices are fire hazards and should not be packed in checked baggage. This page may contain information that is outdated and may not reflect current policy or programs. But, CDC stats on teen smoking show that while use of e-cigs went up to 24% in 2015, cigarette smoking dropped to an historic low -- to just under 11%.
A cigarette is a narrow cylinder containing a combustible material, typically tobacco, that is rolled into thin paper for smoking. The cigarette is ignited at one end, causing it to smolder; the resulting smoke is orally inhaled via the opposite end. The term cigarette, as commonly used, refers to a tobacco cigarette, but the word is sometimes used to refer to other substances, such as a cannabis cigarette or a herbal cigarette. A cigarette is distinguished from a cigar by its usually smaller size, use of processed leaf, different smoking method, and paper wrapping, which is typically white. Not everyone is aware that there is nicotine in most e-cigarettes in varying amounts. Some pods of e-cigarettes contain as much nicotine as one pack of cigarettes (Truth Initiative, 2019).
More research needs to be done to understand the long-term health effects of secondhand exposure to e-cigarette vapor. Secondhand exposure to e-cigarette vapor is said to be less toxic than secondhand exposure to cigarette smoke. However, secondhand vapor is still a form of air pollution that probably poses health risks. N.L.B. serves as a consultant to pharmaceutical companies that market or are developing smoking cessation medications, and has provided expert testimony in litigation against tobacco companies. N.A.R. consults with and has received a research grant from Achieve Life Sciences for development of a smoking cessation medication, and receives royalties from UpToDate (an online medical textbook) as author of sections on e-cigarettes.
"Vaping products containing nicotine are subject to federal laws that prohibit sales to people under the age of 21," said study co-author Sairam V. Jabba, D.V.M., Ph.D., a senior research scientist at Duke University School of Medicine. “Even with the current relatively low use of e-cigarettes among adults – 3.7 percent – health care costs are already substantial, and likely to increase in the future if youth continue to use this product,” said Max. “Vaping products containing nicotine are subject to federal laws that prohibit sales to people under the age of 21,” said study co-author Sairam V. Jabba, D.V.M., Ph.D., a senior research scientist at Duke University School of Medicine. The 2022–2023 NDSHS had a series of questions regarding policy measures designed to address e‑cigarette use. Support increased for all e‑cigarette policy options among the Australian population (Figure 6).
An assessment from the agency, issued in 2008, references only a couple of studies that cover inhalation exposures—all with laboratory animals rather than people. The minimum age to purchase e-cigarettes and other tobacco products has also been raised to 21. A bill was also introduced in 2022 to raise the minimum age to purchase tobacco products and vapes from 19 to 21, but it was vetoed by Governor Mike Dunleavy.
Instead of bathing lung tissue with a therapeutic mist, just as a nebulizer does, vaping coats lungs with potentially harmful chemicals. E-liquid concoctions usually include some mix of flavorings, aromatic additives and nicotine or THC (the chemical in marijuana that causes psychological effects), dissolved in an oily liquid base. “We think that some of the vaporized elements of the oil are getting deep down into the lungs and causing an inflammatory response,” explains Broderick.
According to the manufacturer, a single JUUL pod contains as much nicotine as a pack of 20 regular cigarettes. Although JUUL is currently the top-selling e-cigarette in the U.S., other e-cigarettes are becoming available that look like USB flash drives. Because of their shape, school teachers, administrators, and parents may not notice students using these devices in school, including in classrooms and bathrooms. Adults who use tobacco and are trying to quit should use proven quit tools, like group or phone counseling, paired with medications or nicotine replacement therapy patches, gum or lozenges. The agency says the sweet flavored e-liquids pose a “serious, well-documented risk” of enticing more young people to pick up a nicotine habit. In 2020, nearly 20% of high school students and almost 5% of middle-school students used e-cigarettes, and almost all of those kids used flavored products, the agency said in court documents.
Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America’s oldest professional training program in public health. This study explored the prevalence of S-SM, S-EC, and S-SN among adolescents in a country with advanced tobacco control regulations. We found that the susceptibility was highest for e-cigarette use, followed by smoking and snus use. S-SM was more common among girls, whereas S-EC and S-SN were more common among boys. In our analysis, levels of carbonyls were considerably reduced relative both to other studies of e-cigarettes and to Ky1R6F cigarette smoke.
The vape juice in this device is tightly sealed inside its own compartment, with heat-resistant food-grade fibers to wick it up to the heating coil. This reduces the chances of liquid sloshing around inside and causing issues with the battery. There's also a smart chip designed to prevent overheating, making it much less likely that you'll burn yourself or start a fire. I stuck it in the wrist of my sweater, inhaled, and blew out a little cloud of vapor. As recently as May 2019, Juul held a 74.6% share in the U.S. e-cigarette market. That’s when a series of regulatory actions contributed to product-reduction concessions and lower consumer demand.
Little research has been conducted into the safety of e-cigarettes and e-liquids in pregnancy. It is not known whether the vapour is harmful to a baby in pregnancy. E-cigarettes do not produce tar or carbon monoxide, two of the most harmful elements in tobacco smoke.
Heating the liquid (e-juices) causes formation of an aerosol which users inhale into their lungs. These electronic smoking devices come in different shapes and sizes and can look like regular cigarettes, pens, and even flash drives (similar to the popular brand "JUUL"). E-cigarettes go by many names including vapes, e-cigs, e-pens, e-hookahs and mods. The Food and Drug Administration (FDA) extended its regulatory authority over tobacco products to include e-cigarettes in May 2016.
The Finnish Social and Health Data Permit Authority Findata grants permits to the secondary use of the SHP data. Conceptualized and designed the study, managed data, and conducted analyses. All authors contributed to manuscript revisions and have approved the final version of the article. The association between student- and school-level factors and susceptibility to e-cigarette use.
While their manufacturers say they are an alternative for tobacco smokers who want to avoid inhaling smoke, critics say too little is known about the safety of ESDs because they are not regulated. All tobacco products, including e-cigarettes, pose a risk to the health of the user. Beginning smoking, switching to smoking, or reverting to smoking exposes the user to potentially devastating health effects.
E-cigarettes are not risk-free but are believed to cause less harm than smoking. They do not burn tobacco or produce tar or carbon monoxide — two of the most harmful parts of tobacco smoke. Smoking can raise your risk for periodontal disease or disease affecting the gums.
As registered members of UKVIA, we prioritise industry standards, ensuring top-notch product quality and safety for the user. With over two million successfully shipped orders, we've built a reliable reputation. Count on The Electric Tobacconist for premium vape kits backed by a legacy of expertise and customer satisfaction. Or read a quitter's blog and post encouraging thoughts for someone else who might be dealing with tobacco cravings.
However, this is still one of the safest vape-like devices on the market. Overall, it's one of the best no nicotine vapes on the market for health conscious users. Because vaping is far less harmful than smoking, your health could benefit from switching from smoking to vaping. They can cause side effects such as throat and mouth irritation, headache, cough and feeling sick.
A 2016 report indicated that many vape fluids contain flavoring agents at concentrations that may pose risks to users. It carries the same health risks as vaping with any other e-cigarette brand. There’s limited evidence to date of the long-term effects of vaping because we know the lung effects of vaping will take decades to develop.
During the Vietnam War, cigarettes were included with C-ration meals. In 1975, the U.S. government stopped putting cigarettes in military rations. During the second half of the 20th century, the adverse health effects of tobacco smoking started to become widely known and printed health warnings became common on cigarette packets. This health advisory is being issued by the State Health Officer to inform the public about the alarming statistics on current e-cigarette use among youth in Wisconsin. In Wisconsin, current e-cigarette use among Wisconsin high school students increased 154% between 2014 and 2018.
Although e-liquids do not contain tobacco, they contain chemicals, usually including flavorings, and often contain nicotine, which is addictive. Aerosol from e-cigarettes can also include cancer-causing chemicals, and diacetyl, a chemical used in some e-cigarette flavorings, has been linked with serious lung disease. Some people (most commonly youths or young adults) have experienced seizures while using e-cigarettes.
Commercial tobacco use is the leading cause of preventable disease, disability, and death in the United States.
One study detected vitamin E acetate in the lung fluid of 48 out of 51 EVALI patients sampled across 16 states. By contrast, lung fluid samples taken from healthy people did not contain the vitamin. EVALI is a serious medical condition in which a person’s lungs become damaged from substances contained in e-cigarettes and vaping products. The smoke-free and tobacco-free policies at schools, businesses, healthcare institutions, and other organizations should also cover e-cigarettes. This will help non-users avoid being exposed to potentially harmful e-cigarette aerosol.
However, to date, no e-cigarette product has been approved by the FDA for quitting smoking. Although e-cigarettes have been sold in the U.S. for nearly 20 years, use patterns have shifted dramatically. As newer iterations brought higher levels of nicotine in an increasing array of flavors and product designs, youth use skyrocketed.
It's free of heavy metals, pesticides, solvents, microbes, and fungal toxins. It contains nothing but hemp extract and terpenes (the molecules that give cannabis its piney, citrusy flavors). All of the above meet United States Pharmacopeia standards for purity and quality. Our ultra-simple formula means you know exactly what's going into your lungs when you take a puff of a HELO Air. Find out more about the tools and support available to help you stop smoking. Read more about the research into e-cigarettes so far and what we still need to find out.
Taken together, the studies provide strong evidence that an interactive, tailored text message program can help teens and their older peers break free from nicotine addiction. These findings are especially important given the recent youth mental health crisis documented by the U.S. Adolescents in this study were characterized by high severity of past-year problems with depression, sleep, anxiety, trauma, and substance use. In addition, moderate to high levels of nicotine dependence were observed across multiple measures, with more than three-quarters (76.2%) of teens vaping within 30 minutes of waking — a common way to measure addiction. Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses.
E-cigarettes are available in flavors like cherry, bubble gum, and cotton candy, and are allowed to be advertised on TV, which may increase their appeal for children and teens. As of July 31, 2024, Poison Centers have managed 4,955 e-cigarette and liquid nicotine related exposure cases. For more information about the health effects of e-cigarettes, visit CardioSmart.org/StopSmoking. People who use e-cigarettes are significantly more likely to develop heart failure compared with those who have never used them, according to one of the largest prospective studies to date investigating possible links between vaping and heart failure. The findings are being presented at the American College of Cardiology’s Annual Scientific Session.
In this particular aspect, again the composition of the e-liquid varies significantly among different commercial brands [4, 35]. The most common and major components of e-liquids are PG or 1,2-propanediol, and glycerol or glycerine (propane-1,2,3-triol). Both types of compounds are used as humectants to prevent the e-liquid from drying out [2, 53] and are classified by the Food and Drug Administration (FDA) as “Generally Recognised as Safe” [54].
On the other hand, there is a large body of evidence clearly showing that FDA-approved medications are safe and effective ways to help people quit smoking, especially when combined with counseling. Scientists are still learning about how e-cigarettes affect health when they are used for long periods of time. It’s important to know that the aerosol ("vapor") from an e-cigarette contains some cancer-causing chemicals, although in significantly lower amounts than in cigarette smoke. The FDA has the authority to regulate all tobacco products, including e-cigarettes. The FDA is working on several options to prevent youth access to e-cigarettes.
Many thousands of people in the UK have already stopped smoking with the help of an e-cigarette. An e-cigarette is a device that allows you to inhale nicotine in a vapour rather than smoke. E-cigarettes refers to the device and vaping is the use of the device.
In addition, the VITA only heats its vape liquid to about 240 degrees Fahrenheit. That's much lower than many other kinds of vapes, so it won't be as rough on your lungs. LUVV also says their products are tested to "safeguard against" harmful byproducts of heating metal and vape fluid. They don't provide much detail to support this claim, though, so take it with a grain of salt. Like HELO, LUVV vapes are free of diacetyl, vitamin E acetate, and nicotine.
The most important points to know are that the long-term health effects of e-cigarettes are still unknown, and all tobacco products, including e-cigarettes, can pose health risks to the user. The tobacco industry has co-opted the term harm reduction to further its own interests of reduced tobacco product regulation and expand its user base. E-cigarette use among adults has been more stable, with adult use remaining relatively low since around 2012. Recent data, however, showed a slight uptick in adult e-cigarette use from 4.5% in 2021 to 6% in 2022. While switching completely from cigarettes to e-cigarettes can be less harmful than smoking, many adult smokers use e-cigarettes and cigarettes concurrently — increasing overall exposure to nicotine. Randomized control trials provide growing evidence that e-cigarettes with nicotine can increase quitting rates when compared to nicotine replacement therapies.
To be clear, I never even used to smoke during the day when I was using cigarettes. But if a project is particularly stressful (or just slightly vexatious, any excuse will do), my sleek little e-cig is just sitting in my bag at my feet. Like a never-ending pipe, you don’t know when you’ve had enough, when you’ve had a cigarette’s worth of nicotine. One quick puff to slay your stress can turn into one puff every few minutes, then whenever I get the slightest urge.
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