Pediatric Environmental Health Center | E-Cigarettes

E-cigarettes are electronic devices, or electronic nicotine delivery systems (ENDS), that deliver nicotine via a chemical aerosol that is inhaled by the lungs. They are commonly referred to as e-devices, e-pens, e-hookahs, vapes, vape pipes, vape pens, dab pens, dab rigs, mod pods, mods, JUULS, juice, and cigalikes. They come in a variety of brands, sizes, shapes, and flavors.

E-cigarette aerosol is NOT water vapor

The chemical aerosol is created from a liquid, or juice, that is made of nicotine, glycerin, propylene glycol, and other flavorings and unknown ingredients. The aerosol contains harmful chemicals such as nicotine, volatile organic compounds, heavy metals, cancer-causing chemicals, flavorings known to cause disease, and ultrafine particles that can block airways.10

E-cigarette Aerosol Contents CDC Image

Image source: CDC website

Many have been led to believe that the e-cigarette aerosol is a water vapor. This is just not true. Proposition 65 (Prop 65) is the Safe Drinking Water and Toxic Enforcement Act of 1986, which requires the State of California to publish a list of chemicals known to cause cancer, birth defects, or other reproductive harm. Chemicals on the Prop 65 list have been found in the e-cigarette aerosol, such as acetaldehyde, formaldehyde, isoprene, toluene, lead, nickel, nicotine, and N-nitrosonornicotine.2 Metals have also been found in the aerosol. They include aluminum, chromium, copper, iron, manganese, nickel, lead, antimony, tin, and zinc.2

Contents of E-cigarette Aerosol

In addition, cancer causing chemicals, also known as carcinogens, have been found in the urine of people who vape or use e-cigarettes. These carcinogens include acrylonitrile, acrolein, propylene oxide, acrylamide, and crotonaldehyde.9

How harmful is the liquid in e-cigarettes?

  • A nicotine dependence is similar to an addiction to alcohol, cocaine, and heroin.8
  • Adults and children can be poisoned by the e-cigarette liquid, or juice, by swallowing, breathing, or absorbing it through the skin and eyes.10
  • Nicotine can harm brain development in adolescents and young adults.10
  • 3 out of 10 teens who vape start smoking cigarettes, cigars, or hookahs within six months.7

Sifting thru the smoke

Facts about e-cigarette labeling

  • 9 out of 10 e-cigarettes sold in the United States contain nicotine.5, 3
  • When tested, some products labeled as 0% nicotine (no nicotine) actually did contain nicotine.10
  • Over half of teens think they are only vaping "flavoring."3
  • 6 out of 10 JUUL users did not know that this brand of e-cigarettes contained nicotine.7

Learn more about e-cigarettes

Downloadable handout

The “How Safe Is Vaping for Teens” resource on e-cigarettes and vaping is available for download and distribution.

References

  1. 6 important facts about juul. (2018). Retrieved from https://truthinitiative.org/news/6-important-facts-about-juul
  2. Cheng, T. (2014, May 23). Chemical evaluation of electronic cigarettes. Tobacco Control, ii11-ii17. http://dx.doi.org/10.1136/tobaccocontrol-2013-051482
  3. Johnston, L. D., Miech, R. A., O'Malley, P. M., Bachman, J. G., Schulenberg, J. E., & Patrick, M. E. (2018). Monitoring the Future national survey results on drug use; 1975-2017: Overview, key findings on adolescent drug use. [http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2017.pdf]. Retrieved from Ann Arbor: Institute for Social Research, The University of Michigan
  4. Kann, L., McManus, T., Harris, W. A., Shanklin, S. L., Flint, K. H., & Queen, B. (2018). Youth risk behavior surveillance- United States, 2017. MMWR Surveill Summ, 67(8), 32-38. Retrieved from https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/ss6708.pdf
  5. Marynak, K. L., Gammon, D. G., Rogers, T., Coats, E. M., Singh, T., & King, B. A. (2017, April 11). Sales of Nicotine-Containing Electronic Cigarette Products: United States 2015. American Journal of Public Health, 107, 702-705. http://dx.doi.org/doi: 10.2105/AJPH.2017.303660
  6. McLaughlin, I., Dani, J., & De Biasi, M. (2015). Nicotine withdrawal. In D. Balfour & M. Munafo (Eds.), The neuropharmacology of nicotine dependence, pp. 99-123). http://dx.doi.org/10.1007/978-3-319-13482-6_4
  7. National Institute on Drug Abuse. (2016). Teens and e-cigarettes[Infographic]. Retrieved from www.drugabuse.gov/related-topics/trends-statistics/infographics/teens-e-cigarettes
  8. Orleans, C. T., & Slade, J. (Eds.). (1994). Nicotine. Nicotine addiction: Principles and management(p. 1221). New York, NY: Oxford University Press.
  9. Rubinstein, M. L., Delucchi, K., Benowitz, N. L., & Ramo, D. E. (2018, April). Adolescent exposure to toxic volatile organic chemicals from e-cigarettes. Pediatrics,141(4). Retrieved from http://pediatrics.aappublications.org/content/141/4/e20173557.short
  10. Smoking and tobacco use. (2018). Retrieved November 27, from www.cdc.gov/tobacco
  11. Williams, R. S., Derrick, J., & Liebman, A. K. (2018). Content analysis of age verification, purchase and delivery methods of internet e-cigarette vendors, 2013 and 2014. Tobacco Control, 27, 287-293. http://dx.doi.org/10.1136/tobaccocontrol-2016-053616