E-cigarettes emerged in the U.S. market in 2007, advertised as a safer alternative to traditional tobacco products. These handheld, battery-powered devices are purported to deliver nicotine without the carcinogens that accompany burning tobacco leaves. However, studies link electronic cigarettes to safety issues and side effects.
Invented by a Chinese pharmacist in 2003, the e-cigarette is powered by a lithium-ion battery and delivers nicotine via vapor rather than smoke. E-cigarette usage has developed a significant following, and users have nicknamed the practice “vaping” or using “smokeless tobacco.” With four million American users in 2015, vaping grew to a $1.5 billion industry in the U.S. alone.
There are currently over 250 varieties of e-cigarettes on the market, many crafted to look like everyday items such as pens, USB drives, flashlights and cigars. Pricing for these devices varies from $30–$300, making e-cigarettes accessible to most every American’s budget.
Each device has a refillable cartridge, which contains nicotine-filled, flavored liquid derived from tobacco. When the user inhales through the device’s mouthpiece, a heating element turns the oily liquid into vapor and doles out individual “puffs,” just like a traditional cigarette.
E-cigarette manufacturers claim that their products are safe. For example, on its website, the e-cigarette maker Smoore states: “No chemical reaction happens during vaporization and consequently Smoore E-cigarette vapor is safe, because all the components that make up the cartridge solution have well-known safety records, and these constituents are widely used in the pharmaceutical and food industries.”
However, 2015 research from Portland State University showed that the vaping process can produce the embalming chemical formaldehyde, which is considered a group 1 carcinogen by the International Agency for Research on Cancer. In addition, vaporizers have exploded in users’ mouths and caused house fires.
These safety and health issues led to a number of lawsuits against manufacturers. Manufacturers also sued government agencies over new regulations that affect the industry and its profitability.
In 2015, the Centers for Disease Control and Prevention (CDC) reported that 3.7 percent of Americans regularly vape, and 12.6 percent had tried vaping at least once. Men and women use e-cigarettes at similar rates, though men are more likely to have tried the products without becoming regular users. Although adults of all ages choose to regularly vape, studies show that younger generations are more likely to have tried vaping. ‘
|Age Group||Percentage of Regular E-Cigarette Users|
Vaping Among Youth
The CDC also found that the rate of vaping among teenagers tripled in 2014, which they consider a massive and rapid growth rate. Most online e-cigarette sources do not have a reliable way to prove a customer’s age, and teens are able to easily purchase vaping materials. This is concerning, because evidence suggests that e-cigarettes and nicotine may be a gateway to other substances. In fact, a 2015 study found that teens who vaped were four times more likely to smoke cigarettes in the future.
In 2016, U.S. Secretary of the Department of Health and Human Services Sylvia Burwell commented on teen vaping, “We’ve agreed for many years that nicotine does not belong in the hands of children. Progress has been made, but the context has changed so we need to act.”
The U.S. Food and Drug Administration (FDA) banned all sales of e-cigarettes to minors in 2016. However, there are thousands of e-cigarette vapor flavors on the market — many of them sweet and fruity — and some parties argue that such flavor varieties are intended to target youth. The 2016 legislature requires that smokeless tobacco buyers who appear under age 26 show identification prior to purchase, in a similar fashion to the guidelines surrounding alcohol purchase.
Risks of E-Cigarette Use
Oftentimes, a new product makes it on the market and its dangers are not recognized until years — even decades — after consumers begin using it. This could very well be the case with e-cigarettes. Despite manufacturers’ claims of safety, there is not yet enough data on e-cigarettes to determine if they are safer than tobacco products.
There have been a number of accidents directly caused by e-cigarettes, some of which resulted in serious injuries. Between September 2010 and February 2014, U.S. poison control centers fielded 2,405 calls that involved e-cigarettes. E-cigarette liquid contains nicotine, the same chemical that is in traditional tobacco products. In small doses, such as a few puffs on an e-cigarette, nicotine simply provides a “buzz” to users. However, e-cigarette liquid contains very concentrated amounts of nicotine, and can cause significant problems if consumed in its liquid form.
Although e-cigarettes may not contain the tar of tobacco products, they are not free from other chemicals. For example, the chemical formaldehyde — which can be produced during the vaping process — is highly toxic to humans and animals. The Environmental Protection Agency considers the inhalation of this chemical to be a possible cause of cancer.
E-cig users reported multiple incidents of device explosions, some even causing injuries. There is no single cause for these explosions, but several factors contribute. For instance, lithium-ion batteries that power the devices can malfunction and burst when exposed to extreme temperatures or when they are overcharged or charged too quickly.
Several of these explosions have occurred when e-cigarettes were in users’ mouths, resulting in severe burns. In early 2016, a 14-year-old boy suffered permanent blindness when his vaporizer exploded in his face. Unfortunately, this is only one example of an e-cigarette explosion.
In addition to physical injuries, exploding e-cigarettes have caused several house fires. In the majority of the documented fire cases, the e-cigarette battery was being charged at the time of the explosion.
Researchers from the University of Portland found that the overall cancer risk from long-term formaldehyde inhalation is up to 15 times as high as the cancer risk of long-term smoking —assuming that inhaling formaldehyde-releasing agents carries the same risk as inhaling gaseous formaldehyde.
In 2015, Harvard researchers found that some e-cigarette flavoring ingredients, such as diacetyl, can cause an irreversible form of lung degradation called bronchiolitis obliterans. This condition can be so severe that treatment may require a lung transplant. Its nickname, “popcorn lung,” comes from the fact that the disease was found among popcorn factory workers who were exposed to diacetyl in the air.
Lung cancer risk has yet to be specifically assessed, but the American Lung Association (ALA) does not support vaping. In fact, the organization reported that e-cigarette users suffer from lung issues such as decreased function, inflammation and even some changes at the cellular level. In light of these findings, the ALA wishes to see e-cigarettes banned until more thorough safety research is conducted.
E-cigarette liquid is derived from tobacco, which contains nicotine. The FDA found that even vapor products that are labeled “nicotine-free” contain trace amounts of the drug. Nicotine is highly addictive, and particularly hazardous to pregnant women and developing adolescents.
Nicotine can be toxic to all humans when consumed in very concentrated doses. That said, e-cigarette refill cartridges are a potential problem. If a user orally consumes an adequate amount of pure vaping liquid, they will experience a nicotine overdose. Cartridges often smell sweet like candy, and small children mistake the liquid for something edible. Half of the vaping accident calls that U.S. poison control centers receives involves a victim aged five or below.
E-cigarettes are quite new to the market, so the FDA’s warnings about vaping products are limited. Until 2016, the only FDA warning on e-cigarettes was as follows: “WARNING: This product contains nicotine. Nicotine is an addictive chemical.”
However, in 2016, so the FDA decided that all vaping products should be subject to the same regulations as other tobacco products. The Administration began officially regulating e-cigarettes in May 2016, and e-cigarette manufacturers must now disclose all of their products’ ingredients to the FDA. Additionally, the ruling banned minors from purchasing vaping products.
This ruling is an extension of the Family and Smoking Prevention and Tobacco Control Act of 2009, a bipartisan effort intended to reduce Americans’ usage of tobacco products. Mitch Zeller, director of the FDA’s Center for Tobacco Products, said, “This […] rule is a foundational step that enables the FDA to regulate products young people were using at alarming rates, like e-cigarettes […] that had gone largely unregulated.”
Since the vaping industry has been largely unregulated, the FDA has not been able to keep track of recalls. Companies issue voluntary recalls for products and sometimes customers may not be properly informed.
Device manufacturers recalled items on multiple occasions because of safety concerns. For example, in 2015, e-cigarette maker Cloupor issued a recall on their product the Cloupor mini, following reports of the device overheating. Canadian e-cigarette manufacturer Flavour Crafters recalled 5,000 bottles of its liquid flavor Groovy Grape, after a study linked an ingredient in that flavor to a very serious lung disease called bronchiolitis obliterans.
The new FDA regulations issued in May 2016 should allow consumers to more easily find information about recalls in the future.
Because of the FDA’s 2016 regulations, e-cigarette liquid manufacturer Nicopure Labs filed a lawsuit against the agency, claiming that the new regulations were unnecessary and violated the First Amendment. Other manufacturers are considering following suit.
In February 2016, the U.S. Department of Transportation (DOT) banned vaping during flights. The vaping community responded with outrage over the ruling, and shortly thereafter, the Competitive Enterprise Institute and the Consumer Advocates for Smoke-free Alternatives Association sued the DOT. The lawsuit is ongoing.
Vaping lawsuits are not a one-way street — e-cigarette makers themselves are being targeted as well. On October 16, 2015, 23-year-old Vicente Garza was using his e-cigarette when it exploded, spilling burning hot liquid all over his mouth, tongue and hand. The burns were so bad that doctors needed to amputate the index finger on Mr. Garza’s dominant hand. He spent seven days in the hospital and required multiple surgeries on his mouth and his hand. Mr. Garza has filed product liability lawsuits against his e-cigarette’s manufacturer, as well as the stores where he purchased his device and its charger. Results of the lawsuit are pending.
When a product injures a consumer, as in the case of Mr. Garza, it is not uncommon for that consumer to file a lawsuit against the companies responsible for the faulty product. As the public learns more about the dangers of e-cigarettes, more lawsuits may follow.