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Opened Sep 19, 2024 by Bernard Roxon@bernardroxon84
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This solution typically contains propylene glycol or glycerol, nicotine, and flavouring agents. Indeed, the "vapor" may have a lot more than those five ingredients listed above. Some studies have found it to contain lead, nickel, tin, and silver from the machinery inside the devices along with formaldehyde, manganese, tolulene, and other ingredients linked to cancer, central nervous system problems, and other possible health issues. A 2018 study of e-cig smokers’ urine found at least five of the same carcinogens found in cigarettes.

And nicotine use in young adults still can lead to other illicit substance use. The request from the Federal Trade Commission asks six companies to turn over data by January dealing with the sale and promotion of their products for the years 2015 to 2018. In the United States, states are a primary determinant of the total tax rate on cigarettes. As part of the Family Smoking Prevention and Tobacco Control Act, the federal government collects user fees to fund Food and Drug Administration (FDA) regulatory measures over tobacco.

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.

Some of the research for Tobacco Tactics was funded by Cancer Research UK Limited and Bloomberg Philanthropies. This work has previously received funding from The New Venture Fund, Smokefree South West, and the Economic and Social Research Council (ESRC) Knowledge Exchange Opportunities scheme. These funders have had no input into the research reported on this website or its conclusions. They are not responsible for its content or publication, nor do they necessarily endorse it.

In the case of the enzymatic reaction, the two substrates (reactants) are again acetic ester and H2O, the two products of the reaction are alcohol and acetate. Once the acetate group is removed from the cellulose chain, the polymer can be readily degraded by cellulase, which is another enzyme found in fungi, bacteria, and protozoans. Cellulases break down the cellulose molecule into monosaccharides ("simple sugars") such as beta-glucose, or shorter polysaccharides and oligosaccharides. Discarded cigarette filters usually end up in the water system through drainage ditches and are transported by rivers and other waterways to the ocean.

Currently, e-cigarettes are not mentioned in the Illinois Smoke-free Illinois Act, which prohibits smoking in virtually all public places and workplaces, but some local ordinances do include e-cigarettes. E-cigarette aerosol is not harmless; it can contain harmful and potentially harmful substances, including nicotine and cancer-causing chemicals. While e-cigarettes typically have fewer chemicals than regular cigarettes, researchers found e-cigarettes present their own unique health risks and can increase the odds of chronic cough, phlegm, bronchitis, and asthma. Some cigarette smokers have replaced traditional smoking with electronic cigarettes (e-cigarettes) or vaping, thinking it is not as dangerous. There are significant negative health effects from smoking cigarettes such as cancer, chronic obstructive pulmonary disease (COPD), heart disease, birth defects, and other health problems relating to nearly every organ of the body.

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.

The FDA does not currently require testing of all the substances in e-cigarettes to ensure they are safe. It's also hard to know exactly what chemicals are in an e-cigarette because most products do not list all of the harmful or potentially harmful substances contained in them. E-cigarettes do not contain tobacco, but many of them contain nicotine, which comes from tobacco. Because of this, the Food and Drug Administration (FDA) classifies them as "tobacco products." For adults who smoke, switching completely from cigarettes to e-cigarettes may reduce exposure to many harmful chemicals present in cigarettes. However, it is important that they switch completely from cigarettes to e-cigarettes to get the full health benefit.

This is why it took as long as it did for the negative health effects of cigarettes to be widely recognized. There is abundant evidence that e-cigarettes can help some individuals to quit smoking, so they should be more widely recommended as smoking cessation aids. Vaping and smoking share similar negative effects on the body, such as damage to the lungs and increased cancer risk.

The 2023 National Youth Tobacco Survey, released in November by the US Centers for Disease Control and Prevention and the US Food and Drug Administration, found that about 2.1 million middle and high school students were e-cigarette users. Get more information on small cell lung cancer, non-small cell lung cancer, and the diagnosis of lung cancer stages. Also, "it is clear from the scientific literature that a variety of toxic compounds besides nicotine are present in aerosolized e-liquid," the researchers added. These chemicals have been linked to lung inflammation, chronic coughs, shortness of breath and lung disease.

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.

There are different types of e-cigarette, including vape pens, vape bars, pod devices, mods, and cigalikes. Strong decisive action is needed to prevent the uptake of e-cigarettes based on the growing body of evidence of use by children and adolescents and health harms. How a country approaches ENDS will depend on factors particular to its situation. In others they are regulated as consumer products, as pharmaceutical products, as tobacco products, in other categories or totally unregulated. Nicotine exposure in pregnant women can adversely affect the development of the fetus. Further, the consumption of nicotine in children and adolescents has negative impacts on brain development, leading to long-term consequences for brain development and potentially leading to learning and anxiety disorders.

Parental smoking, positive attitude towards e-cigarette use in one’s age group, current smoking, and snus use increased S-EC, whereas liking school lowered it. At school level, both among girls and boys, a higher proportion of students liking school and being never-users lowered S-EC, whereas a higher proportion of students with positive attitudes towards e-cigarette use increased it. Among girls, a higher proportion of girls in the school, students with a high parental education and planning for GUSS lowered S-EC, but a higher proportion of students with parental smoking increased it.

Dr Goel praised the central government’s initiatives to discourage tobacco consumption, including establishment of over 429 Tobacco Cessation Centers (TCCs), awareness campaigns, and the National Tobacco Quit Line. More information about youth vaping and CATCH My Breath is available on the program’s website. While the federal purchasing age of tobacco is 21, North Carolina law still lists it as 18, and many vape shops are operating under that age.

But they may also contain other compounds including artificial flavors, nicotine, THC, and cannabinoid (CBD) oil. E-cigarettes are known by many different names, including e-cigs, electronic nicotine delivery systems (ENDS), alternative nicotine delivery systems (ANDS), e-hookahs, mods, vape pens, vaporizers, vapes, and tank systems. We know nicotine and other ingredients in e-liquids can hurt your body and we still don’t know what long-term health problems vaping could cause. There are online resources, texting and phone services and apps that connect you with real people to help you on your journey to kick the habit. E-cigarettes, aka JUULs and vape pens, use a battery to heat up a special liquid into an aerosol that users inhale.

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.

We've curated a selection of authentic premium quality vape products from the best vaporiser manufacturers worldwide. We have high-quality products and knowledge to ensure an exceptional vaping experience customised to your needs. Electronic cigarettes—or e-cigarettes—are battery-powered devices that convert a liquid, usually with nicotine, into an inhalable aerosol. They are designed as an alternative to smoking traditional cigarettes. First introduced in the United States about 15 years ago, e-cigarettes have evolved from disposable, single-use products to more sophisticated devices that can be refilled and customized (fig. 1). PHILADELPHIA – Smoking e-cigarettes, also called vaping, has been marketed as a safe alternative to tobacco cigarettes and is rising in popularity among non-smoking adolescents.

Long periods of dual use of cigarettes and e-cigarettes can result in harms to health similar to, or in addition to, the harms from exclusive use of cigarettes. Nicotine is the primary agent in regular cigarettes and e-cigarettes, and it is highly addictive. It causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving.

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.

There's always a chance that the fail-safe could fail, though, which is why we don't consider these as safe as other vaping devices. The biggest risks in vaping devices come when you get into highly customizable "mods." These devices allow for lots of fine-tuning in terms of the internal electrical setup. But this added flexibility means more possibilities for health hazards. You'll have to be careful not to buy knock-off vape liquids with unhealthy contaminants, for one thing.

Meanwhile, some influential conservatives are calling for the Trump administration to hold back on its plans to ban flavored tobacco. They argue such a move would hurt small vape business owners and people trying to quit smoking. Many governments impose restrictions on smoking tobacco, especially in public areas. The primary justification has been the negative health effects of second-hand smoke.[124] Laws vary by country and locality. Nearly all countries have laws restricting places where people can smoke in public, and over 40 countries have comprehensive smoke-free laws that prohibit smoking in virtually all public venues. During World War I and World War II, cigarettes were rationed to soldiers.

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.

If you think ENDS or other tobacco products are being sold to people who are underage, or you see another potential violation of the FD&C Act or FDA’s tobacco regulations, please report the potential tobacco product violation. Learn about public education efforts and resources that have been created to reach youth who are at higher risk of or more vulnerable to cigarette use and nicotine addiction. FDA created a toolkit, Resources for Professionals About Vaping & E-Cigarettes, for adults and professionals who work with youth. This FREE resource provides fast facts about youth vaping and e-cigarettes. Vaping exposes you to some of the same chemicals that cigarette smoking does. Vaping while pregnant can cause low birth weight, lung damage and brain damage in the developing fetus.

Fetal exposure to e-cigarettes can adversely affect the development of the fetus in pregnant women. Exposure to emissions from e-cigarettes also poses risks to bystanders. E-cigarettes may help nonpregnant adults quit smoking cigarettes if they are used as a complete substitute for all smoked tobacco products. However, e-cigarettes are not currently approved by the FDA to help people quit smoking. If you are using e-cigarettes for smoking cessation, it is important to make a plan to quit vaping.

Vape aerosols may also increase the risk of heart disease, lung cancer, and asthma complications. The substitution was especially evident among cigarette brands popular with young people aged 20 and under, suggesting that flavor restrictions may increase smoking among youth as well as adults. The immense popularity of electronic cigarettes, or e-cigarettes, among young people has led many policymakers to restrict the sale of flavored varieties. Proponents of e-cigarettes claim they’re safer than smoking because they don’t contain the more than 60 cancer-causing chemicals in tobacco smoke and are not combustible. But e-cigs still deliver harmful chemicals, including nicotine, the extremely addictive substance in cigarettes.

Set firm expectations that they do not use any type of commercial tobacco product, including e-cigarettes and vapes. For more guidance, here's a tip sheet for talking to your children about e-cigarettes. Electronic smoking devices (ESDs) do not just emit "harmless water vapor." Secondhand aerosol (incorrectly called vapor by the industry) from ESDs contains nicotine, ultrafine particles and low levels of toxins that are known to cause cancer.

Choose from the most popular bar salts like MaryLiq, ElfLiq by Elf Bar, Elux Legend Nic Salts and Crystal Bar E-liquid. If you need more than 10ml bottles, we have an incredibly diverse range of shortfill e-liquids. They offer great value for money and are available in 50ml-150ml options. Or, if you prefer, you can add a nic shot to create your blend of nicotine e-liquid. We stock a fantastic range of vape liquids to cater to any vaper and vaping style.

He encourages people committed to quitting to try non-inhaled methods such as the nicotine replacement patch or another FDA-approved smoking cessation product, as well as counseling. E-cigarettes are battery-operated devices that convert liquid into aerosol, which is inhaled into the user’s lungs. Typically, the liquid contains addictive nicotine, as well as flavors. More than 10 million adults in the United States use e-cigarettes, and vaping has become especially popular among teenagers.

Nicotine pouches, led by top-selling Zyn by Swedish Match, have become increasingly popular among adult tobacco consumers, particularly those trying to lower or end their traditional or electronic cigarette consumption. Chalmers said some students are realizing the dangers of vaping after seeing their peers struggle with nicotine addictions. She believes that adding the CATCH My Breath education only solidifies it for them.

A Foundation-led study presented at the 2024 Society for Research on Nicotine and Tobacco annual meeting found that monthly e-cigarette sales in California declined by 41% after statewide restrictions on the sale of flavored tobacco products took effect. However, the report also noted that the tobacco industry continues to market products to offset these declines, including non-menthol cigarettes that contain other cooling chemicals. Continuing to monitor flavored tobacco product sales is key to assessing policies like these and informing further policy development and implementation. Toxicity is not the only factor in considering risk to an individual or a population from exposure to ENDS emissions.

E-cigarettes produce an aerosolized liquid (vapor) that usually contains nicotine and other chemicals inhaled by the user. Months after the release of that advisory, Yale researchers found that byproducts, called acetals, form when flavoring agents mix with solvents in the liquid. It is not yet known if this has negative effects on the body, but Sven-Eric Jordt, PhD, one of the study’s authors, says he hopes that the FDA will begin to study the short- and long-term effects of inhaled acetals. Under the PACT Act, delivery sales of electronic nicotine delivery systems must also comply with state, local or tribal laws involving excise taxes on these devices.

"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).

Silica was commonly the first material to be used as a wick, followed by cotton and ceramic3,13,14,15. Cotton has good wicking properties but is less thermally stable than silica14,16,17, while ceramic is chemically stable and heat-resistant18. The use of microporous ceramic as a wicking material has increased in the past few years14,16,18,19,20. Its application has been reported to improve heating efficiency and reduce charring14,16,18,19,20. Additional research is ongoing to clarify the dangers from vaping, and how vaping damages the lungs and other organs. Long-term human studies, in particular, could bring the risks from e-cigarettes into better focus, Crotty Alexander says.

Just like people around smokers can breathe in cigarette smoke, it’s possible to breathe in e-cigarette aerosol if you’re around someone vaping. This is called secondhand vaping, and there isn't a lot of published research yet on how inhaling this aerosol affects the body, especially among adolescents. If you spend time around someone who vapes, you might be wondering if you can get secondhand smoke from a vape. While there's still a lot we don’t know about the harms of secondhand vaping, research suggests that bystanders who breathe in the aerosol might be exposed to many of the same toxins found in e-cigarettes and even some found in traditional tobacco. E-cigarettes and vapes are electronic devices that vaporize an e-liquid to produce vapor without combustion. With a wide range of flavours and nicotine strengths available in disposable, closed pod, and refillable systems you are sure to enjoy a more discreet and customizable experience that caters to your personal preferences with greater convenience.

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.

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.

Protect the environment and ensure safe disposal of e-cigarette products by discarding them properly. Vapes, e-cigarettes, refills and cartridges should be treated like hazardous waste and taken to your local hazardous waste facility or hazardous waste collection event for disposal. Always remove the device's battery before dropping off to prevent unintentional burns, fires, and explosions. Store these products safely to protect yourself and any children in and around the home from accidental exposure.

The FDA has the legal authority to regulate tobacco products containing nicotine from any source, including synthetic nicotine. In 2016, the FDA established a rule for e-cigarettes and their liquid solutions. Because e-cigarettes contain nicotine derived from tobacco, they are now subject to government regulation as tobacco products.

Our experts provide care to both kids and adults with complex lung issues from all over Southern California and beyond. Teens today have access to more potentially misleading information than at any other time in history. They’re also bombarded by more sources of advertising than ever before.

However, your local Stop Smoking Service may offer a free vaping starter pack. Make sure you buy your vaping products from a reputable retailer so you can be confident they are covered by UK safety and quality regulations. Get advice from a specialist vape shop or a local Stop Smoking Service. Finding the right device and strength of nicotine in your e-liquid may take time – so stick with it.

Nearly five times as many high school students use e-cigarettes than smoke cigarettes. The particle matter (PM) that is emitted by e-cigarettes is also potentially dangerous to those who inhale it, just as passive smoking is harmful to those who share a contained space with regular smokers. Nicotine is a poison which is particularly dangerous if ingested (swallowed or inhaled) by young children which has led to poisoning and even death when swallowed by infants. It is also highly addictive and use by teenagers can have a long-term effect on the development of the brain, which continues until the age of 25 years.

Nicotine poisoning refers to the toxic effects of consuming nicotine. Nicotine poisoning is the result of having too much nicotine in your body. Most cases resulted from the use of nicotine as an insecticide, accidental ingestion of tobacco or ingestion of nicotine-containing plants. The best vape kit for beginners requires little to assemble and maintain - for example, a disposable device such as the Crystal Bar or Lost Mary or a pod device like the Riot Connex vape kit where the pods simply 'snap' on with magnets - it couldn't be easier! You can get closed pod mod systems, which use cartridges prefilled with e-liquid. This type of device is suitable for beginners as it eliminates the hassle of messy refills and fiddly coil changes.

Of the participants who were not using e-cigarettes, only 5.8% had quit smoking altogether by the end of the survey, while 9.9% had stopped smoking daily. At the end of the survey, 28% of smokers using e-cigarettes daily had ceased smoking tobacco altogether, while 45.5% had ceased smoking tobacco daily. The AHA notes that while vaping liquids contain fewer contaminants than cigarettes, they are not entirely safe. Based on the available evidence, smoking appears more harmful than vaping, but this does not mean that vaping is safe.

I want to carry the stink and taste that won’t let me forget I’m damaging myself when I’m smoking. The way to quit isn’t through a device that made a nicotine hit easier, or fun. In other words, just because something is safe to eat doesn’t mean it’s safe to be inhaled. (Duh.) Vaping also seems to trigger potentially harmful immune responses in the lungs.

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].

If you suspect you have experienced a health-related side effect from using your e-cigarette or would like to report a product defect, report these via the Yellow Card Scheme. Getting expert help from your local Stop Smoking Service gives you the best chance of quitting smoking for good. To get the best out of it, make sure you're using it as much as you need to and with the right strength of nicotine in your e-liquid.

Vaping can cause lung injury and may affect lung health in other ways. Since COVID-19 can also affect your lungs, vaping may put your lungs at increased risk. Keep all vaping supplies and refill materials in child-resistant packaging out of the reach of children. Vaping hasn’t been around that long, so its health risks aren’t all known. The Australia Government has recently tightened the regulation of e-cigarette products.

This mixture is typically made up of propylene glycol and/or glycerol (vegetable glycerin) and other chemicals. Flavouring ingredients include chemicals and blends of chemicals used to make different flavours. Disposable e-cigarettes are not covered by the flavor restrictions imposed by the Food and Drug Administration.

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.

Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, and more. If your device does not have a lithium battery, you may pack it in either you checked or carry-on bag. Some use a buttery-tasting chemical called diacetyl, which is often added to foods like popcorn. Stores selling them -- called "vape shops" -- are everywhere across the country. Our blog has an easy-to-read guide on the latest vaping regulations and the changes to how you vape. We also have a selection of cheap disposable vapes, featuring top brands at great value prices.

So I must ask that you not make them about you and respectfully let me and my vape alone. I can be conscious not to blow my vapor in your direction, if you will be conscious not to send your judgment and complaints in mine. Dr Sonu Goel, a distinguished public health expert and chairperson of the Tobacco Control Section explained that e-cigarettes, also known as Electronic Nicotine Delivery Systems (ENDS), vaporise a nicotine solution instead of burning tobacco leaves.

While there appears to be some consensus that vaping may be less harmful to health than tobacco cigarette smoking, the dangers of e-cigarettes remain unclear. The range of e-liquid flavours available to consumers is extensive and is used to attract both current smokers and new e-cigarette users, which is a growing public health concern [6]. In fact, over 5 million middle- and high-school students were current users of e-cigarettes in 2019 [75], and appealing flavours have been identified as the primary reason for e-cigarette consumption in 81% of young users [76]. Since 2016, the FDA regulates the flavours used in the e-cigarette market and has recently published an enforcement policy on unauthorised flavours, including fruit and mint flavours, which are more appealing to young users [77].

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.

Last year, 9.4% of individuals ages 12 years and above reported vaping nicotine within the previous month, up from 8.3% in 2022. "This research has provided greater understanding in the court systems nationwide as to the nature of drug usage, abuse, and overdose cases in which electronic cigarettes were used to deliver an illicit drug," the researchers concluded. THC, synthetic cannabinoids, and dextromethorphan, a drug found in some cough medicines, "were identified in e-liquids purportedly containing only CBD to be consumed for ‘health benefits,’" the researchers said. Results from the National Drug Strategy Household Survey do not provide evidence for or against the use of e-cigarettes as a smoking cessation tool, or as a gateway to tobacco smoking. The age groups most likely to smoke tobacco in 2019 and 2022–2023 were the least likely to use e-cigarettes, and the age groups most likely to use e-cigarettes had low tobacco smoking rates in 2019 and 2022–‍2023. In 2022–‍2023, 1 in 5 (19.8%) people aged 14 and over in Australia reported having used e‑cigarettes at least once in their lifetime, with 7% currently using e‑cigarettes at least daily, weekly, monthly, or less often than monthly.

It can damage your heart, arteries, and lungs, increasing the risk for heart attack, stroke, and chronic lung disease. E-cigarettes recently surpassed conventional cigarettes as the most commonly used tobacco product among youth.1 It is critical that public health officials and the general public understand the potential risks of using them. The FDA recently approved its first menthol-flavored electronic cigarettes for adult smokers. In contrast to the clear evidence that flavored products fueled the youth e-cigarette epidemic, every major U.S. public health authority – including the U.S. Preventive Services Task Force, the CDC and even the FDA itself – has found there is inadequate evidence to conclude that e-cigarettes are effective at helping smokers quit. E-cigarettes are battery-operated devices used for a type of smoking called vaping.

When the human body breaks down a foreign substance, one can typically find chemical by-products in hair or urine that provide clues about how it has interacted with cells. This is true for nicotine, but in the case of propylene glycol, no one has established what the relevant by-product is or how to best detect it. Boston, MA – Diacetyl, a flavoring chemical linked to cases of severe respiratory disease, was found in more than 75% of flavored electronic cigarettes and refill liquids tested by researchers at Harvard T.H. Chan School of Public Health. Two other potentially harmful related compounds were also found in many of the tested flavors, which included varieties with potential appeal to young people such as Cotton Candy, Fruit Squirts, and Cupcake. In conclusion, the prevalence of susceptibility among adolescents differs by product type. Liking school and academically oriented educational aspirations appear as consistent protective factors, while the use of other tobacco or nicotine products and positive attitudes towards product use in one’s age group appear as risk factors.

JUULs very closely resemble a USB drive, can be charged in a USB port, and emit little to no detectable vapor or odor. Due to their easily concealable design, they are of particular concern with regard to youth use. DOH urges all people to be very careful when it comes to your health. Even if a substance has not yet been proven to be dangerous, there is no guarantee it is safe. You don’t actually light up an e-cig; they’re powered by a rechargeable lithium battery. Instead of burning tobacco, the "e-liquid" is vaporized in a heating chamber when the user inhales.

Njoy is one of only three companies that previously received FDA’s OK for vaping products. Like those products, two of the Njoy menthol varieties come as cartridges that plug into a reusable device that heats liquid nicotine, turning it into an inhalable aerosol. E-cigarettes come in many shapes and sizes and can look like USB flash drives, pens, and other everyday items. Larger devices, such as tank systems or "mods," do not look like other tobacco products.

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.

Vapes are often viewed and marketed as a safe alternative to smoking. Secondhand smoke can cause heart disease, stroke, and lung cancer in people who don’t smoke. They compared this information against vape and cigarette sales data over four-week intervals from January 2018 through March 2023, a period during which flavor restrictions went from affecting 1.3% of the U.S. population to affecting 38%.

Yet there has been hardly any definitive legislation regarding the sale and consumption of e-cigs in the U.S. Meanwhile Canada has made it illegal to sell e-cigarettes preloaded with nicotine in stores, but the regulation is not well enforced, and customers can buy vials of nicotine online. At press time, the European Parliament had approved a ban on e-cigarette advertising starting in mid-2016, and the ban seemed likely to get approval from the E.U.'s member states. Vaping products in the state also have to include health warnings per California state laws regarding the use of nicotine and other chemicals.

Based on the current literature, it seems that several factors have led to the success of e-cigarette use as a smoking cessation tool. First, some e-cigarette flavours positively affect smoking cessation outcomes among smokers [102]. Second, e-cigarettes have been described to improve smoking cessation rate only among highly-dependent smokers and not among conventional smokers, suggesting that the individual degree of nicotine dependence plays an important role in this process [97]. Third, the general belief of their relative harmfulness to consumers' health compared with conventional combustible tobacco [103]. And finally, the exposure to point-of-sale marketing of e-cigarette has also been identified to affect the smoking cessation success [96].

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.

I can go for six months at a time without catching a nasty, lingering cough. My clothing doesn’t reek of smoke all of the time and my car actually smells nice. So, though they are far from perfect, I am enjoying the changes that not smoking cigarettes has brought to my life. "Since there is no safe tobacco product, eventual abstinence from all tobacco products is the end goal," says Dr. Hyland, who is senior author on the new work. Adults in the U.S. who used e-cigarettes daily and also smoked combustible cigarettes were more likely to quit smoking than those who smoked but used e-cigarettes less frequently. Justice announced the task force that they say will address the illegal domestic distribution and sale of electronic cigarettes.

The campaign works to counteract the "cost-free" mentality held by many adolescents regarding e-cigarette use, showing them how e-cigarettes, just like cigarettes, puts them at risk for addiction and other health consequences. Besides nicotine, e-cigarette aerosol can contain harmful and cancer-causing chemicals. Defective batteries have caused fires and explosions resulting in serious injuries. Nicotine salts refer to nicotine that has been dissolved in a liquid mixture that is chemically adjusted to be weakly acidic.

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 is known as "dual use." The dual use of e-cigarettes and tobacco cigarettes can lead to significant health risks because smoking any amount of regular cigarettes is very harmful. People should not use both products at the same time and are strongly encouraged to completely stop using all tobacco products. Beyond the three main ingredients, some researchers worry about by-products from heating electronic cigarettes e cigarette v2 cigs cigarettes and the solution inside them.

These retail sales data briefs are intended to provide information about population trends in sales for participating retailers; they do not include online sales or vape store sales and cannot be used to make conclusions about subgroup purchasing or behaviors. These estimates are based on the information available at the time of publication and may be subject to updates as more information becomes available. The nicotine in e-liquids is readily absorbed from the lungs into the bloodstream when a person vapes an e-cigarette.

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%.

If you’re scratching your head and wondering what @AskTSA is, it’s a small team of TSA professionals from various agency offices who answer TSA related questions from the traveling public that are sent via Twitter. You can read more about the program in this recent USA Today article. "It has become clear to me that e-cigarettes cause their own set of diseases that seem to impact just about every organ in the body—from the brain to the bladder." Critics of e-cigarettes fear that vaping will get kids hooked on nicotine and that they'll "graduate" to cigarettes when they want a bigger kick, Warner says. Vaping worked in a month, and she's been off cigarettes for more than two years. "I'm breathing, sleeping, and eating much better since I started vaping. My 'smoker's laugh' went away, and I no longer smell like an ashtray."

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.

This includes data on youth use of these products, which has led to development of several educational programs designed to prevent adolescents and teens from using these products. Through tobacco product problem reports and tobacco product violation reports, the FDA also knows much more about many safety and health hazards they may pose. The Surgeon General reports e-cigarette use among youth is a significant public health concern and steps must be taken by parents, educators and especially policymakers to discourage use of e-cigarettes.

A 2018 study assessed the lung function of 10 people who had never smoked cigarettes immediately after vaping fluids, either with or without nicotine. However, the researchers concluded that, overall, vaping is thought to be less harmful to the heart than smoking cigarettes. However, they found that people who smoked conventional cigarettes and e-cigarettes were more likely to have heart disease. In a recently published randomised trial of 886 subjects who were willing to quit smoking [100], the abstinence rate was found to be twice as high in the e-cigarette group than in the nicotine-replacement group (18.0% vs. 9.9%) after 1 year.

The composition of e-liquids requires stricter regulation, as they can be easily bought online and many incidences of mislabelling have been detected, which can seriously affect consumers’ health. Beyond their unknown long-term effects on human health, the extended list of appealing flavours available seems to attract new "never-smokers", which is especially worrying among young users. Additionally, there is still a lack of evidence of e-cigarette consumption as a smoking cessation method. Indeed, e-cigarettes containing nicotine may relieve the craving for smoking, but not the conventional cigarette smoking habit.

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.

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 use of e-cigarettes has increased exponentially in recent years, and vaping has become preferred to traditional cigarette smoking among today’s young people and those looking for alternative to traditional tobacco and nicotine products. As use and availability of these products increases, reports have cast more light on the health effects of e-cigarettes. Here, Kenneth Uy, a health coach at Henry Ford Health, clarifies some information about these products and how their use can impact your health.

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.

In 2019, four years after JUUL introduced a new nicotine delivery system coupled with a relentless online, youth-focused marketing campaign, more than a quarter (27.5%) of high school students reported using e-cigarettes. Short-term studies haven't found evidence that exposure to secondhand aerosol from e-cigarettes hurts lung function, with one notable exception. Researchers found that people who were around vaping aerosol showed increases in serum cotinine, which is a marker that someone was exposed to nicotine (an ingredient often found in e-cigarettes). Given the long list of health risks posed by nicotine, more research needs to be done on how this exposure could affect someone’s lungs long-term like it can with secondhand smoke. The significant reductions in smoking rates in the United States, United Kingdom, Australia, Brazil, and other countries that implemented strong tobacco control programs[according to whom?

Not only is there evidence of mislabelling of nicotine content among refills labelled as nicotine-free, but there also seems to be a history of poor labelling accuracy in nicotine-containing e-liquids [37, 38]. "Since there is no safe tobacco product, eventual abstinence from all tobacco products is the end goal," concluded senior study author Andrew Hyland, PhD, Chair of Health Behavior at the Roswell Park Comprehensive Cancer Center. Meanwhile, people who were smoking e-cigarettes non-daily had a 3.1% rate of quitting smoking and a 10.2% rate of cutting down to non-daily tobacco smoking. However, the CDC states that there is insufficient evidence to suggest vaping can help people quit smoking. A second brand of e-cigarettes -- marketed as Nixotine, Nixodine, Nixamide and Nic-Safe – contained a nicotine analog called nicotinamide, also at levels lower than the labels indicated, and combined with undisclosed amounts of 6-methyl nicotine. The nicotine analogs were included in flavored e-cigarettes, which prior research has indicated are preferred by youths and those who vape for the first time.

Vaping products, "vapes" or "e-cigarettes", comprise a wide range of products that heat a substance to produce an aerosol that is inhaled. We link to further pages giving more detailed information about each company’s products, market share and business strategy, including methods used to promote their products around the world. We also point to examples of lobbying activity conducted by, and on behalf of, tobacco companies, in order to influence regulation around e-cigarettes. Some have rechargeable batteries and changeable prefilled cartridges; others are disposable after running out of charge or e-liquid. Reported sales of cartridge products increased from $2.133 billion in 2020 to $2.496 billion in 2021; sales of disposable, non-refillable e-cigarette products increased from $261.9 million in 2020 to $267.1 million in 2021. Bene-Alhasan also said e-cigarettes are not recommended as a tool to quit smoking, since many people may continue vaping long after they quit smoking.

Commercial tobacco use is the leading cause of preventable disease, disability, and death in the United States.

The vapor produced by e-cigarettes usually contains nicotine, heavy metals, volatile organic compounds, carcinogens (cancer causing chemicals), and in some cases, flavoring linked to serious lung disease. These and other harmful substances present in e-cigarette vapor can negatively affect the respiratory health of users. The monitoring of other tobacco product sales in conjunction with the monitoring of e-cigarette sales is necessary to provide a comprehensive picture of the overall U.S. tobacco product market. These cigarette data briefs provide estimates of cigarette sales in the U.S. market overall and select U.S. states. In January 2020, the US Food and Drug Administration (FDA) ordered the removal of flavored cartridge-based e-cigarettes from the market. This rule does not prohibit the sale of tobacco and menthol flavored cartridge-based e-cigarettes, flavored disposable e-cigarettes, or refillable flavored e-cigarette products.

A note from Cleveland ClinicNicotine poisoning is on the rise, mostly due to the availability of some of the newer forms of nicotine that are now popular. Children eat cigarettes and can be accidentally poisoned by touching, tasting or swallowing liquid nicotine or liquid nicotine-containing products used in e-cigarettes. To keep you and your family and pets safe from nicotine poisoning, the most effective approach would be to eliminate or ban tobacco-containing or nicotine-containing products in your home. If you're interested in quitting smoking, your healthcare team is here, ready and looking forward to helping you. All tobacco products contain nicotine and are harmful to your health. All are technically capable of causing poisoning if taken in large enough quantities.

If you’re having trouble quitting e-cigarettes on your own, get help from your doctor or from other support services, such as your state quitline (1-800-QUIT-NOW) or the American Cancer Society (1-800-ACS-2345). Electronic cigarettes (e-cigarettes) are sometimes called e-cigs, vapes, vape pens, and electronic cigarettes that look like cigarettes nicotine delivery systems (ENDS). Get the facts about e-cigarettes, their health effects, and the risks of vaping.

In regard to COVID-19 pandemic, the actual literature suggests that nicotine vaping may display adverse outcomes. Therefore, follow up studies are necessary to clarify the impact of e-cigarette consumption on human health in SARS-CoV-2 infection. Recently, a commonly commercialized crème brûlée-flavoured aerosol was found to contain high concentrations of benzoic acid (86.9 μg/puff), a well-established respiratory irritant [88]. When human lung epithelial cells (BEAS-2B and H292) were exposed to this aerosol for 1 h, a marked cytotoxicity was observed in BEAS-2B but not in H292 cells, 24 h later.

In Cumberland County, Chalmers McClain and Graham said the growing number of vape shops opening near schools with their colorful and bright lights to attract students is also part of the problem. For example, Ramsey Street Alternative High School has two vape shops within a six-minute walk from the school. Teacher concerns around increasing the suspension rates of students caught vaping on school property prompted the initial pilot and current implementation of CATCH My Breath into county schools, said Graham.

To truly help tobacco users quit and to strengthen global tobacco control, governments need to scale up policies and interventions that we know work. Tried and tested interventions, such as brief advice from health professionals, national toll-free quit lines and mobile and digital cessation services are recommended. Where economically feasible, governments should also consider promoting nicotine replacement therapies and non-nicotine pharmacotherapies for cessation. E-cigarette emissions typically contain nicotine and other toxic substances that are harmful to both users and non-users who are exposed to the aerosols second-hand.

Vaping works by heating liquid in a small device so you can breathe it into your lungs. The e-cigarette, vape pen or other vaping device heats the liquid in the device to create an aerosol. Mist from e-cigarettes contains particles of nicotine, flavoring and other substances suspended in air. You breathe these particles into your mouth from the mouthpiece, where they go down your throat and into your lungs. But, Blaha says, interpreting the data is tricky, since young people change their preferences often, and, when surveyed, may not consider using disposable products such as "puff bars" as vaping. The same CDC report says disposable e-cigarette use has increased 1,000% among high school students and 400% among middle school students since 2019.

However, the state's largely rural landscape and small population could be partly to blame for its high youth vaping rate. About 80 percent of Wyoming's residents live in rural areas, as much of the land area is used for farming and national parks. Researchers combed through state-by-state data from the Campaign for Tobacco-Free Kids, an advocacy group aimed at stopping youth smoking. Since 2020, emergency department visits in Virginia by patients who said they vape jumped significantly, while visits by those who use traditional tobacco declined, according to stats from Virginia Hospital & Healthcare Association.

Fortunately, there has been a substantial drop in cases since they peaked in August and September of 2020. What’s more, researchers have also identified vitamin E acetate, a chemical added to some THC-containing vaping products, as the main—but possibly not the only—cause of the illness. The outbreak of EVALI cases emerged against a backdrop of an ongoing vaping epidemic among youth.

One in five Minnesota teens (grades 6-12) have asthma, a serious chronic disease that can make it difficult to breathe. Minnesota youth who have asthma are more likely than their peers to smoke or vape, and people who have asthma who smoke or vape are likely to experience worsening symptoms and require medical treatment. Coauthors reported relationships with Pfizer and Johnson & Johnson, grants from nonprofits, and personal fees from public health authorities and from plaintiff law firms. Nine challenges have been released as part of this effort, including a challenge to address the impact of e-cigarette use. Expressions of interest for the challenges are now open, and final teams will be announced in 2022.

As vaping is still relatively new, we can’t be sure there aren’t any long-term effects to people who breathe in someone else’s vapour. E-cigarettes should only be used to help you stop smoking, or to stop you going back to tobacco. After using my vape (e-cigarette) for over a year now, my body feels so much better than when I was smoking cigarettes.

The last wave analyzed took place during the COVID-19 pandemic in March to November 2021 and was administered via audio computer-assisted self-interviews and telephone interviews. The study featured 1,985 participants; 49.4% were male and the average age was 40. The patient population was 80.7% white, 11.4% Black, 9.2% Hispanic, and 8% of another race. You can get health news and information from The Science of Health blog delivered right to your inbox every month.

The Lung Association remains extremely troubled about the rapid increase of youth using these products and has repeatedly called upon the Food and Drug Administration (FDA) to increase their oversight and scrutiny of these products to protect kids. This is Quitting is a free and anonymous text messaging program from Truth Initiative designed to help young people quit vaping. The first-of-its-kind quit program has helped over 700,000 youth and young adults quit vaping by incorporating messages from other young people like them who have attempted to, or successfully quit, e-cigarettes. Truth Initiative is America's largest nonprofit public health organization committed to preventing youth and young adult nicotine addiction and empowering quitting for all.

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.

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.

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.

Participants took one vape from an e-cigarette, with at least 12 mg/mL of nicotine, or inhaled a conventional cigarette, every 20 s for 10 min. Blood samples were collected 1, 2, 4, 6, 8, 10, 12 and 15 min after the first puff, and nicotine serum levels were measured by liquid chromatography-mass spectrometry (LC–MS). The results revealed higher serum levels of nicotine in the conventional CS group than in the e-cigarette group (25.9 ± 16.7 ng/mL vs. 11.5 ± 9.8 ng/mL). However, e-cigarettes containing 20 mg/mL of nicotine are more equivalent to normal cigarettes, based on the delivery of approximately 1 mg of nicotine every 5 min [40].

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.

In this data brief we use the 2017 MYTS to report e-cigarette initiation prevalence, which teens are trying e-cigarettes, and why initiation is a problem. The tobacco use landscape in the United States and Minnesota is evolving. E-cigarettes are rapidly increasing in popularity, especially among youth. However, products like cigarettes and smokeless tobacco continue to have a stronger hold in rural areas due to decades of targeted marketing by the tobacco industry, which integrated tobacco use into rural culture.

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Reference: bernardroxon84/logic-electronic-cigarette-where-to-gwt-refills1998#11