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Nicotine salts can be used in refill liquids and in cartridges for closed systems. In March 2019, the Secretariat of the WHO FCTC issued an Information Note which compiled all Conference of the Parties (COP) decisions related to e-cigarettes. Information on current e-cigarette regulation can also be found on relevant pages of government websites (see Relevant Links below). See this page for information on the situation in 2014, when there was little regulation in place.
As such, it is imperative that e-cigarette cessation programs focused on adolescents are developed, evaluated, and implemented," Halpern-Felsher wrote. "This may point to the changing norms around e-cigarette use and the fact that quitting vaping among young people is becoming more normative and accepted," she said. Most of the study participants, about 87%, reported that they had tried to quit in the previous year, and about 94% reported feeling somewhat or very addicted to vaping. E-cigarettes usage by adolescents has become an epidemic according to the American Lung Association–20% (5 million) of all youth use e-cigarettes, a 135% increase in just two years.
Due to what has been called an ‘epidemic’ of youth use of these products, FDA has prioritized prevention efforts. The agency has taken a multitude of actions to keep ENDS out of the hands of youth, from policy making to enforcement to education. While e-cigarettes can generally be a lower-risk alternative for adults who smoke cigarettes, the use of e-cigarettes is not risk-free. These products deliver harmful chemicals and contain nicotine, which is highly addictive. Moreover, given the harmful chemicals found in e-cigarettes, further high-quality research on both short- and long-term health outcomes is needed. The longer ENDS and other e-cigarettes are on the market, the more information we know about their impacts on health.
A 2016 study found that people who use or have used e-cigarettes are less likely to stop smoking altogether. Flavors vary widely, from "traditional" and menthol to watermelon and "lava flow." Some e-cigarettes taste like traditional cigarettes and even mimic the tastes of specific brands. When the user sucks on the mouthpiece, the heating element vaporizes the solution, which the person then "vapes," or inhales. The nicotine content of the liquid can range from "very high" to zero. Refills come in flavors such as cool cucumber, mango, and mint, which may seem natural and harmless, but a single JUUL refill contains as much nicotine as a pack of 20 cigarettes. To inform this work and evaluate the effectiveness of policy, the CDC Foundation is collecting and analyzing information about e-cigarette sales, teen e-cigarette use, and teens’ attitudes about the epidemic.
"From a public health perspective, we have always been concerned about dual-use of both traditional and e-cig products," said study lead author Marisa Bittoni, an oncology researcher at Ohio State University in Columbus. The U.S. Food and Drug Administration and the European Union are grappling with these issues as they decide how to regulate the products. Unfettered access could leave people vulnerable to unknown health hazards, but there is also the chance that greater restrictions might hurt folks who are trying to forgo conventional—and more dangerous—tobacco products.
With millions of teens and young adults using e-cigarettes, a new generation could become addicted to nicotine and face other health risks. For some adult smokers, e-cigarettes may offer a less harmful substitute for traditional cigarettes. However, long-term effects on users, second-hand exposure, and environmental effects are not yet fully known. The e-liquid typically contains humectants and flavourings, with or without nicotine