The increasing use of e-cigarettes, powered by batteries – the activity known as vaping – has sparked one of the most stable debates among public health professionals in years. The debate has intensified as some users of vaping devices thought to be safer than lit cigarettes have faced mysterious and serious respiratory illnesses.
1. What is vaping?
This is a way of ingesting nicotine, an addictive alkaloid present in tobacco without smoke and tar, which comes from the burning of tobacco. The vaping device contains a battery that heats spiked fluid with nicotine, produces steam that the user inhales. Vaping devices like the popular Juul come in a sleek design and are small enough that a juvenile vaper, say, palpate, discreetly take a hit when a teacher or parent isn't looking, and breathe the resulting aerosol into a sleeve or collar, they offer delicious flavors like mango and cream.
2. Is it safer than smoking cigarettes?
This was one of its major sales – that the use of e-cigarettes can help smokers get rid of traditional cigarettes and have a less health-conscious habit. But now it turns out that vaping is hurting more and more people. A mysterious lung disease, which is linked to the inhalation of money, has killed six people and injured hundreds more in the US this summer. Doctors have seen hundreds of cases where patients – often young people, previously healthy adults – showed up in the emergency room, suddenly struck with dangerous respiratory damage. State and federal investigators are racing to identify the exact cause of the disease.
3. How popular is vaping?
The worldwide vaping product market is valued at approximately $ 11.5 billion in 2018 and is growing rapidly. Juul sales in the United States rose by over 600% year over year to 16.2 million in 2017, according to the Centers for Disease Control and Prevention. Scott Gottlieb, a former commissioner of the Food and Drug Administration, described teen typing as an epidemic, even though children under the age of 18 are not legally allowed to buy such products. According to a study by the US government, vaping among high school students has increased by 78% from 2017 to 2018, which means that about 21% of these students give up. Among high school students, the number of reporters on vaping increased by 48% to almost 5% of the group. These increases mean that the total use of tobacco among young people has increased by 38%, declining in recent years. Of the 80 countries that regulate e-cigarettes, 29 – including Brazil, Greece, Saudi Arabia, Turkey and Thailand – have banned their sale altogether.
4. What are the concerns?
One is that, even if e-cigarettes help adults quit the more harmful traditional cigarettes, they can attract hordes of new young people into the nicotine habit. Furthermore, as recent headlines can attest, there is not enough long-term data to conclude that vaping is a safer choice than ignition. It is likely, although it has not been proven that e-cigarette aerosols can damage tissues and cause disease, including cancer. The effects of nicotine on humans have not been well studied, although adolescents appear to be particularly vulnerable to it, with some evidence suggesting that it may be detrimental to brain development. A report from the US National Academies of Sciences says there is substantial evidence that young people are more likely than regular cigarettes to try cigarettes on a regular basis.
5. What is the US Government doing?
Declaring that the United States is experiencing a teenage epidemic, the National Food and Drug Administration announced in November 2018 plans to curb the sale of most flavored e-cigarettes to vaping shops and online retailers who confirm they are a buyer is 18 years or older. Now, at the behest of President Donald Trump, the FDA plans to issue regulatory guidelines to force the removal of all vaping products that taste anything other than tobacco from the market. Sales can only be resumed with FDA approval. (Michael R. Bloomberg, founder and majority owner of Bloomberg News parent Bloomberg LP, is campaigning and giving money to ban tobacco flavored e-cigarettes and tobacco.)
6. What has the e-cigarette industry done?
At the end of last year, Juul stated that it had temporarily stopped selling nicotine pods in its stores with flavors of mango, fruit, cream and cucumber and provided only flavors of tobacco, menthol and mint. The measure was expected to reduce retail sales at the Juul store by 45%, according to a person familiar with the company's forecasts. Juul said it will continue to sell fruit pods through its website, but the company said it is adding age verification systems to ensure customers are at least 21. The tobacco giant Altria Group Inc. Earlier, it announced that it was temporarily withdrawing its MarkTen Elite and Apex MarkTen electronic cigarettes from the market until the FDA gave the green light. (Altria bought a 35% stake in Juul last December.) Altria, Reynolds and Juul Labs say they will support the law to increase the legal age for tobacco buyers to 21.
(An earlier version of this story incorrectly stated a minimum age Juul calls for website sales.)
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