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Research has also shown flavor chemicals to be toxic in both e-liquid and aerosol form. While many flavor chemicals used in vaping products have been approved for ingestion, they have not yet been tested for safety when aerosolized. Flavor chemicals are typically not listed on e-cigarette packaging, and most e-liquids contain more than one flavor chemical. Benzaldehyde (used in cherry-flavored products) and 2, 5-dimethyprazine (used in chocolate-flavored products), specifically, may harm human health.

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.

While e-cigarette use prevalence has declined significantly since the heyday of JUUL — 10% of high school students reported using e-cigarettes in 2023 — e-cigarette use among young people remains a concern. Thousands of flavored, high-nicotine, and relatively cheap e-cigarette products remain on the market — many of them illegally — driving youth use and nicotine addiction. Equally concerning, nearly half of young people who have ever tried e-cigarettes continue to use them, and many do so daily. As encouraging as the data was a few years ago, it’s starting to look like that’s not the case. The FDA is yet to approve them as a smoking cessation aid and a recent CDC study found that most adult e-cigarette users — 58.8 percent of them — don't stop smoking cigarettes and instead wind up using both products. The few scientists actively trying to fill the gap in the research literature are running into obstacles.

A Yale study in 2019 found that, among students at three Connecticut public schools, those who used e-cigarettes were more likely to smoke regular cigarettes in the future. Most e-cigarettes have a battery, a heating element, and place to hold a liquid (such as a cartridge or pod). The e-liquid usually contains nicotine, flavorings, and other chemicals. As the user draws on the device, the battery heats the e-liquid to produce aerosol (not water vapor).

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%.

E-cigarettes have been allowed to stay on the market for years without undergoing a full review of their public health impact, sparking a sustained and ongoing crisis of youth use. As of November 2023, the FDA has not completed reviewing all applications from e-cigarette makers to market their products, leaving many e-cigarettes on the market while waiting for a decision. To date, the FDA has denied permission to market flavored and menthol e-cigarette products such as Vuse Solo, Vuse Vibe, Vuse Ciro, and Vuse Alto. The FDA has denied permission to market many non-tobacco and non-menthol flavored e-cigarette products, however, many of those denials are currently under judicial or supervisory review. In recent years, the FDA has increased enforcement efforts around e-cigarette manufacturers and retailers for continuing to sell youth-appealing e-cigarettes. These actions include issuing warning letters, fines, injunctions, and joint operations with other federal officials to seize imports of unauthorized e-cigarette products.

The Centers for Disease Control and Prevention reports that nicotine can also harm parts of the brain that control attention, mood and impulse control. Electronic Nicotine Delivery Systems (ENDS) represent a rapidly changing class of tobacco products known by many different names, including e-cigarettes, e-cigs, vapes, mods, and tank systems. ENDS deliver an aerosol to the user that typically contains nicotine, propylene glycol, vegetable glycerin and flavoring chemicals. In 2018, 3.2% of U.S. adults (age 18 and older) reported current ("every day" or "someday") use of ENDS. Since 2014, ENDS have been the most used tobacco product among U.S. youth. In 2020, about 3.6 million U.S. youth, including about 1 in 5 high school students and 1 in 20 middle school students, reported current (past 30 day) use of ENDS.

Among adolescents who both vaped and smoked traditional cigarettes, a higher proportion in the This is Quitting program, about 51%, reported not vaping nor smoking at seven months, compared with 30% of the assessment-only group. Withdrawal from tobacco products can cause temporary congestion and respiratory discomfort as your lungs and airways begin to heal. Increased mucus production right after quitting smoking may be a positive sign that your respiratory system is recovering. What might be considered safe for the average workplace employee could still pose serious health risks for more medically vulnerable populations.

The program’s curriculum includes a four-part series of lessons, with one set for fifth through eighth graders and another for high schoolers. The lessons teach students about the dangers of vaping, vaping marketing and resources for quitting vaping. Students that go through the program are 45% less likely to vape, according to Bianco. This is Quitting was developed by Truth Initiative, a nonprofit focused on ending tobacco use, as a free and anonymous text messaging program to help young people quit vaping.

Surgeon General’s recommendation urging those who influence youth, young adults and people who are pregnant to discourage nicotine use in any form, including e-cigarettes. To protect kids now, states and cities must also continue their growing efforts to end the sale of flavored e-cigarettes, as well as other flavored tobacco products. Electronic cigarettes, or e-cigarettes, are part of a category of products called Electronic Smoking Devices (ESDs), which are designed to mimic combustible tobacco cigarettes and, in most cases, contain varying levels of nicotine. Our compassionate providers can help both you and your child understand the dangers of vaping and provide resources that help people quit using tobacco products like e-cigarettes. During this time, the brain is constantly rewiring itself, which makes it far more vulnerable to nicotine addiction. This is part of why teens who vape are nearly three times more likely to begin smoking cigarettes.

According to the CDC, 15% of EVALI patients were less than 18 years old. In addition, e-cigarettes and e-cigarette vapor may contain the chemicals or substances listed below. E-cigarettes are known by many different names, and sometimes people find it hard to understand what is really known about these devices.

Encourage your teen to look into the warnings and media stories related to vaping, or reach out to her primary care provider with questions. BackgroundThe clinical trial was conducted by Truth Initiative with oversight from Advarra Institutional Review Board. All participants received incentivized text message assessments regarding e-cigarette use and abstinence at 14 days post-randomization and monthly thereafter through 6 months. All participants were compensated $5 via digital card per response (7 assessments total, maximum $35).

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.

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.

They found that the amounts of nicotine in the blood were similar between the two groups after 10 minutes of smoking at a constant rate. The flavoring liquid for electronic cigarettes, or e-cigarettes, may increase the risk of cardiovascular disease when inhaled, according to a study led by researchers at the School of Medicine. My reading of the evidence is that smokers who switch to vaping remove almost all the risks smoking poses to their health. Smokers differ in their needs and I would advise them not to give up on e-cigarettes if they do not like the first one they try. It may take some experimentation with different products and e-liquids to find the right one. An expert independent evidence review published today by Public Health England (PHE) concludes that e-cigarettes are significantly less harmful to health than tobacco and have the potential to help smokers quit smoking.

Starting to use e-cigarettes or switching from tobacco products to e-cigarettes increases your risk of adverse health effects. Interestingly, there is a strong difference of opinion on e-cigarettes between countries. Whereas countries such as Brazil, Uruguay and India have banned the sale of e-cigarettes, others such as the United Kingdom support this device to quit smoking.

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.

The most important points to know are that the long-term health effects of e-cigarettes are still unknown, and all tobacco products, including e-cigarettes, can pose health risks to the user. The tobacco industry has co-opted the term harm reduction to further its own interests of reduced tobacco product regulation and expand its user base. E-cigarette use among adults has been more stable, with adult use remaining relatively low since around 2012. Recent data, however, showed a slight uptick in adult e-cigarette use from 4.5% in 2021 to 6% in 2022. While switching completely from cigarettes to e-cigarettes can be less harmful than smoking, many adult smokers use e-cigarettes and cigarettes concurrently — increasing overall exposure to nicotine. Randomized control trials provide growing evidence that e-cigarettes with nicotine can increase quitting rates when compared to nicotine replacement therapies.

Most factory-made cigarettes are equipped with a filter; those who roll their own can buy them separately. Filters can reduce some substances from smoke but do not make cigarettes any safer to smoke. A recipe-specified combination of brightleaf, burley-leaf, and oriental-leaf tobacco is mixed with various additives to improve its flavors. Most commercially available cigarettes today contain tobacco that is treated with sugar to counter the harshness of the smoke. At the start of the 20th century, the per capita annual consumption in the U.S. was 54 cigarettes (with fewer than 0.5% of the population smoking more than 100 cigarettes per year), and consumption there peaked at 4,259 per capita in 1965. The authors wish to thank all adolescents and schools that participated in the SHP study in 2017, and the SHP study coordinators from the Finnish Institute for Health and Welfare who prepared the initial data and provided practical support with it.

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.

Turkey, which has one of the highest percentage of smokers in its population,[126] has a legal age of 18. Japan is one of the highest tobacco-consuming nations, and requires purchasers to be 20 years of age. Since July 2008, Japan has enforced this age limit at cigarette vending machines through use of the taspo smart card. In other countries, such as Egypt, it is legal to use and purchase tobacco products regardless of age.[citation needed] Germany raised the purchase age from 16 to 18 on September 1, 2007. In the unadjusted analyses (Table 3), those planning for vocational education or extra year/discontinuation had higher S-EC compared with those planning for GUSS. Among girls, those without educational aspirations also had higher S-EC.

If you purchase e-cigarettes and nicotine refill products, store them out of reach of your children and pets. With these products, it’s the liquid nicotine that can be dangerous, especially to children. According to the American Academy of Pediatrics, as little as one teaspoon of liquid nicotine can be fatal to a 26-pound child.

You need to start at a nicotine level that matches your cigarette use – how frequently and how long does a blu electronic disposable cigarette last much you smoke. A specialist vape shop or your local Stop Smoking Service can advise you. Vaping has not been around for long enough to know the risks of long-term use. While vaping is substantially less harmful than smoking, it is unlikely to be totally harmless. These examples are programmatically compiled from various online sources to illustrate current usage of the word 'electronic cigarette.' Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors.

More research is needed to address the potential long-term adverse effects of vaping on vascular health, but he predicts that e-cigarettes are potentially much more hazardous than previously assumed. Earlier this year, for instance, his research group found that acute exposure to e-cigarettes causes vascular inflammation. One in four middle school and high school students in Minnesota had tried e-cigarettes (teens call it vaping or juuling). Half of high school seniors reported having tried e-cigarettes at least once. The growing popularity of e-cigarettes among Minnesota’s youth caused the first rise in overall tobacco use in over two decades.

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.

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%.

The survey also found that Minnesota youth are ill-informed about the health risks of e-cigarettes with 76.1% of 11th graders saying there is either no, slight, or a moderate risk to using e-cigarettes. 11th grade students responding to the student survey said that the top ways they got e-cigarettes included getting products from friends (72.3%), getting products at a vape shop (14.0%), and on the Internet (9.6%). Among 8th grade students, e-cigarette use nearly doubled from 2016 to 2019, and one in four 11th graders now use e-cigarettes. Students in all grades surveyed now use e-cigarettes and vapes at five times the rate of conventional cigarettes. In Australia, during the survey period, it was not legal to obtain e‑cigarettes containing nicotine without a prescription (TGA 2020).

Given that nicotine easily diffuses from the dermis to the bloodstream, acute nicotine exposure by e-liquid spilling (5 mL of a 20 mg/mL nicotine-containing refill is equivalent to 100 mg of nicotine) can easily be toxic or even deadly [8]. Thus, devices with rechargeable refills are another issue of concern with e-cigarettes, especially when e-liquids are not sold in child-safe containers, increasing the risk of spilling, swallowing or breathing. An E-cigarette is any device or delivery system sold in combination with nicotine for a single price which can be used to deliver to a person nicotine in aerosolized or vaporized form. An E-cigarettes may also be known as e-cigar, e-pipe, vape pen, or e-hookah or other names. The definition of E-cigarettes includes any liquid or substance containing nicotine, whether sold separately or sold in combination with any device that could be used to deliver to a person nicotine in aerosolized or vaporized form. For each 0.7 milliliters of e-cigarette e-liquid not sold due to these policies, the authors calculated that 15 additional cigarettes were purchased.

Prior to that, it was the Wild West, where a variety of companies started making and selling products with their own personal spin. Per the survey, 10.0% of students (2.80 million) reported current use of any tobacco product; 12.6% (1.97 million) high school students and 6.6% (800,000) middle school students reported current use of any tobacco product. Importantly, the researchers found strong evidence of the program's effectiveness among key subgroups defined by race, ethnicity, gender, higher levels of nicotine dependence, smoking and other substance use, mental health challenges, and household dysfunction. "For many years, healthcare providers, teachers, and parents have been asking how to help teens quit vaping," said Dr. Amanda Graham, Chief Health Officer at Truth Initiative and principal investigator of the study.

This ban builds upon legislation signed in July by Governor Cuomo that immediately banned the use of e-cigarettes on all public and private school grounds in New York State. The CDC’s Office on Smoking and Health (OSH) developed this presentation to educate youth on e-cigarettes, including the health risks, the factors that lead to e-cigarette use, and what youth can do to avoid all tobacco products, including e-cigarettes. This resource is intended for adults who educate or serve youth ages (teachers, youth ministers, coaches, scout leaders, etc.). Utilizing the talking points and information for the users' document, the presenter does not require additional information, nor permission to deliver the presentation. Today, nicotine poisoning has become a growing concern because of new nicotine products on the market, particularly electronic cigarettes (e-cigarettes) and pure liquid nicotine. The concentration of nicotine in liquid products is higher than most other tobacco products.

At that point, levels of formaldehyde exceeded limits set by the California Office of Environmental Health Hazard Assessment (OEHHA), though other compounds didn’t come close. About a quarter of middle and high school students surveyed in 2017 said they had been around someone vaping at least once in the past 30 days. In 2021, only about 11 percent of high school students and 3 percent of middle school students surveyed said they had tried e-cigarettes. Results from a clinical trial published by JAMA Internal Medicine found that young adults ages who used This is Quitting from Truth had nearly 40% higher odds of quitting compared to a control group.

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?

In 2017, the campaign began prioritizing e-cigarette prevention messaging to combat increasing youth vaping rates. "The Real Cost" campaign also educates teens on the health consequences of smoking cigarettes. Given that there is no safe tobacco product, youth and adults who do not use tobacco products should not start using e-cigarettes. Vaping and smoking both involve inhaling nicotine and other substances into your lungs. E-cigarettes heat liquid to make an aerosol; cigarettes burn tobacco, which creates smoke.

Such policies are critical in the absence of strong federal regulation of e-cigarettes. As of March 31, 2023, seven states and an estimated 388 counties, cities, towns, and tribes have restricted the sale of flavored tobacco products. However, this leaves a large majority of the U.S. population not covered by such restrictions. E-cigarette sales have rapidly escalated in the relatively short history of the products. Overall e-cigarette sales, as well as the total number of e-cigarette brands, increased by more than 46% between January 2020 and December 2022. Disposable e-cigarettes have nearly tripled in nicotine strength, quintupled in e-liquid capacity, and dropped in price by nearly 70% between 2017 and 2022.

They do contain propylene glycol, but the concentrations are far below levels usually considered harmful. Though this might make the VITAs hit slightly harsher than vapes without this ingredient, it shouldn't pose much risk to your health. But levels are usually low and generally far lower than in tobacco cigarettes. I don’t sit around inhaling lungful after lungful of vape for seven minutes at a time, like I would a real cigarette, so the lingering aura from my habit certainly isn’t hovering for extended periods of time.

Upon the selection of the educational track, students may already have normative perceptions of smoking in vocational schools, such as understanding of smoking as an integral and expected practice in these schools and professions [8]. These perceptions may increase S-SM and other nicotine product use, also among students with better academic performance. Student network characteristics and their associations with smoking vary between schools [28].

A cigarette is a narrow cylinder containing a combustible material, typically tobacco, that is rolled into thin paper for smoking. The cigarette is ignited at one end, causing it to smolder; the resulting smoke is orally inhaled via the opposite end. The term cigarette, as commonly used, refers to a tobacco cigarette, but the word is sometimes used to refer to other substances, such as a cannabis cigarette or a herbal cigarette. A cigarette is distinguished from a cigar by its usually smaller size, use of processed leaf, different smoking method, and paper wrapping, which is typically white. Not everyone is aware that there is nicotine in most e-cigarettes in varying amounts. Some pods of e-cigarettes contain as much nicotine as one pack of cigarettes (Truth Initiative, 2019).

Australia, New Zealand, Poland, and Pakistan have a nationwide ban on the selling of all tobacco products to people under the age of 18. "Since most of the health concerns about e-cigarettes have focused on nicotine, there is still much we do not know about e-cigarettes. The present study utilized a nationwide school survey which covers the majority of the respective Finnish student population and a validated measure for susceptibility, adapted to cover also e-cigarettes and snus. The limitations include self-reporting, lack of class-level data and a measure on school performance, and potential bias in parental education and smoking when reported by students. Further, no causal conclusions can be made from this cross-sectional data. Some adolescents experience first dependence symptoms early [2], which makes prevention of nicotine use essential.

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.

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.

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.

The data shows that in 2021, 69.2 percent of e-cigarette cartridges either sold or given away contained menthol-flavored e-liquids, and the rest were tobacco-flavored. E-cigarette companies also spent $90.6 million more advertising and promoting their products in 2021 than in 2020. Flavored e-cigarettes are very popular, especially among young people.

New national laws to strengthen controls on the importation, manufacture, and supply of all e-cigarette products are now in place. If you prefer to stop vaping in one step, you can ask your pharmacist or stop smoking adviser about switching to a suitable nicotine replacement therapy (NRT) product. This is an alternative way of cutting down your nicotine use until you are ready to stop completely. Remember to keep vapes and e-liquid out of the reach of children and pets, as there is a risk of poisoning if nicotine is swallowed. It's important to choose an e-liquid with enough nicotine to reduce withdrawal symptoms and urges to 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.

Several states have imposed restrictions on the sale of e-cigarettes. There are also restrictions on liquids with flavors that may be more attractive to younger people. The researchers also noted a lack of evidence that vaping is an effective means of quitting smoking. The marketing of e-cigarettes and their range of flavors can give the impression that vaping is not harmful.

Federal, state, and/or local governments need to set clear standards on environmentally responsible e-cigarette waste disposal and hold the industry accountable for adhering to them. E-cigarette manufacturers introduced a new tobacco product that soared in popularity with little thought on how to responsibly dispose of the resulting tons of e-cigarette waste. The group then performed a statistical analysis to determine group differences in vascular function before and after vaping.

It's a faster-acting alternative to gummies and other edible supplements. Unfortunately, there have been some cases of negative health effects from unhealthy additives in CBD pens. That's why you're better off with these disposable vapes from Tribe Tokes, which are routinely tested by third-party labs to ensure their purity. Most disposable e-cigarettes heat nicotine to around 390 degrees, and the Elf Bar is no exception. Since it's so much hotter than the vapes listed above, it may put more stress on your lungs. Though we're always cautious about recommending nicotine products, it's hard to deny that they're less dangerous than cigarette smoking.

The study was supported by the National Institutes of Health, the American Heart Association, the Stanford Diabetes Research Center, the University of California Tobacco Related Disease Research Program and the FDA. We acknowledge the assistance of Belinda Zonnestein in sourcing and testing of the products. We further acknowledge My-Linh Tran and Joseph Sutton for their contribution to product development and provision of product details and to Sandra Costigan and Elaine Brown for the toxicological inputs. Death typically happens due to paralysis of the muscles that control your breathing, fluid buildup in your airways and heart and blood vessel failure (cardiovascular collapse).

In December 2019, Congress raised the minimum age to buy tobacco products, including e-cigarettes, from 18 to 21. Because of the popularity of certain flavored e-cigarette products among children, FDA stated in January 2020 that it would prioritize enforcement actions against the manufacture and sale of most flavors in cartridge-based e-cigarettes. In April 2020, FDA extended from May to September 2020 the deadline for manufacturers to apply for premarket authorization, a process that includes the scientific evaluation of risks and benefits of e-cigarettes for the U.S. population. NCI supports research to understand the potential impact of ENDS use on both individual and population health, as it relates to cancer control and prevention.

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.

Ebay recently has allowed pre approved sellers to sell products on ebay that were not allowed in the past. Yet ebay has been allowing the same accounts with ebay stores to continue selling without issue. This website hosts promotional and sales material for adults only (18/19+), not intended for minors. Our customer service team is available 7-days a week to provide courteous and prompt support on anything vaping-related. We understand that you may have questions or concerns about vaping, order details, product warranties, and more, so we've compiled a list of frequently asked questions to help you make informed decisions about your experience. Remember, it’s important to have conversations rather than suspicion and accusations.

The tobacco industry profits from destroying health and is using these newer products to get a seat at the policy making table with governments to lobby against health policies. WHO is concerned that the tobacco industry funds and promotes false evidence to argue that these products reduce harm, while at the same time heavily promoting these products to children and non-smokers and continuing to sell billions of cigarettes. Nicotine affects the development of the brain’s reward system and brain circuits that control attention and learning. Continued use of nicotine can lead to addiction and raise the risk for addiction to other drugs. In a recent study, about 18% of people who switched to vaping had been able to quit smoking.

Over the years, Evans tried to quit by using the nicotine patch, gum, and even hypnosis. When you stop using it, you can go into withdrawal and feel depressed and crabby. We have lots of detailed vaping guides and blog posts to help new vapers make the transition to vaping. Find everything you need to know about e-liquids, starter kits, and what to expect when switching to vaping. Alternatively, why not speak to one of our customer service advisors? Great for new vapers, disposable vape kits are the simplest way to vape.

Because there is no safe tobacco product, quitting use of all tobacco products is the best way to protect your health. Most e-cigarettes contain nicotine, which is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s. E-cigarettes can contain other harmful substances, including cancer-causing chemicals; chemicals linked to serious lung disease; and heavy metals, such as nickel, tin, and lead. Young people who use e-cigarettes may be more likely to smoke traditional cigarettes in the future. Vapor products produce aerosol by heating a liquid solution, which is inhaled as an aerosol. The process is referred to as "vaping." Vapor products often contain nicotine.

EBook files are now available for a large number of reports on the NAP.edu website. If an eBook is available, you'll see the option to purchase it on the book page. An uncorrected copy, or prepublication, is an uncorrected proof of the book. We publish prepublications to facilitate timely access to the committee's findings. As an example, NIDA point to the practice of "dripping." This involves inhaling solutions dripped directly onto the heater coil "to produce a stronger throat hit." The specific risks of these practices are still unclear.

In January, the Cumberland County Board of Commissioners passed a new ordinance that prevents new vape shops from opening within 1,000 feet of a school to address youth nicotine consumption. On the rare occasions I partake, instead of filling my nostrils with the taste of a warm crème brûlée, my mouth tastes like a street gutter for an hour. I like the nicotine, but everything else about the experience is viscerally revolting. About 43% of the study participants were LGBTQ+ adolescents, for instance, and research suggests that LGBTQ+ young people smoke and vape at a higher prevalence than their non-LGBTQ+ peers. The new study included a diverse group of adolescents, indicating how the text message program could be helpful for marginalized communities, said Dr. Suchitra Krishnan-Sarin, a professor of psychiatry at the Yale School of Medicine. "Text messaging is a scalable and cost-efficient approach to delivering vaping cessation treatment on a population basis," the researchers wrote in the study.

These assessments were designed solely to maximize retention; they were not analyzed as outcomes. Thank you for your interest in supporting Kaiser Health News (KHN), the nation’s leading nonprofit newsroom focused on health and health policy. We distribute our journalism for free and without advertising through media partners of all sizes and in communities large and small.

They found that kids who used e-cigs were more likely than non-users to smoke cigarettes or other tobacco products over the next year. To study the short-term impacts of vaping, the researchers performed MRI exams on 31 healthy, non-smoking adults before and after vaping a nicotine-free e-cigarette. Comparing the pre- and post-MRI data, the single episode of vaping resulted in reduced blood flow and impaired endothelial function in the large (femoral) artery that supplies blood to the thigh and leg. The endothelium, which lines the inside surface of blood vessels, is essential to proper blood circulation. Once the endothelium is damaged, arteries thicken, and blood flow to the heart and the brain can be cut off, resulting in heart attack or stroke.

In the vaping liquids that contain nicotine, the level of nicotine can vary widely. Prior to July 2021 in Canada, vaping substance nicotine strengths ranged from 0 to over 60 mg/ml of nicotine. Since July 2021, the Nicotine Concentration in Vaping Products Regulations establish a maximum concentration of 20 mg/mL for vaping products manufactured in or imported into Canada. Market size is clearly affected by national laws governing the sale of e-cigarette products. In 2016, the Washington State Legislature passed a law (RCW 70.345) to regulate vapor products.

This data brief demonstrates that teens whose environments put them at risk for use of e-cigarettes are more likely to try them. The study, published on May 23, 2022, in Tobacco Control, is the first to look at the health care costs of e-cigarette use among adults 18 and older. The second most supported measure, strengthening restrictions on the advertising and promotion of e‑cigarettes, was supported by 82% of people. In 2019, only 67% of people in Australia supported strengthening these restrictions. The proportion of people neither smoking regular cigarettes nor using e‑cigarettes has remained stable (Figure 3).

The Mountain state has fewer restrictions than Wyoming and allows the sale of e-cigarettes to people under 21. Researchers from online prescription marketplace Universal Drugstore, analyzed federal and state health data on air quality, youth obesity, sports participation, mental health, test scores, and youth e-cigarette use. Based on a 2023 survey, the team found Wyoming had the highest rate of youth vaping, with nearly one in three teens using e-cigarettes in the last year, despite the state's no-sale laws for residents under 21. Smoking cigarettes increases your risk for health conditions that can affect the whole body.

According to Blaha, there are three reasons e-cigarettes may be particularly enticing to young people. Second, e-cigarettes have a lower per-use cost than traditional cigarettes. State and local authorities can restrict the sale of flavored tobacco products, including e-cigarettes.

Again assuming a worst-case exposure of 300 puffs day–1 spread over 8 h, the levels of glyoxal exposure to a consumer would still be more than 40 times lower than the occupational exposure limit of 0.10 mg m–377,94,95. The high standard deviation for glyoxal and methylglyoxal observed in BB18 e-cigarette emissions is probably related to an analytical sample matrix effect and/or batch variability83,96,97. Despite the high standard deviation, the percentage reduction of glyoxal and methylglyoxal in both e-cigarette emissions relative to cigarette smoke was ≥ 97.0% and ≥ 94.5%, respectively (Table 3).

There are also reports of lung illnesses and deaths related to inhalation of certain vaping oils into the lungs, which have no way to filter out toxic ingredients. You might be tempted to turn to electronic cigarettes (e-cigarettes, vape pens, and other nondisposable and disposable vaping devices) as a way to ease the transition from traditional cigarettes to not smoking at all. But is smoking e-cigarettes (also called vaping) better for you than using tobacco products? Michael Blaha, M.D., M.P.H., director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, shares health information about vaping. Truth Initiative supports regulation that encourages the development of consistently safer nicotine delivery alternatives that allow smokers to quit tobacco altogether or switch completely to a much less harmful, well-regulated product.

Guidance exists on best practices on this concept of accountability — known as end-producer responsibility — but isn’t enforced across the industry by any governing body. Substances from inhaled aerosol particles reaching the e-cigarette user’s lungs, blood, and brain. Minnesota’s middle school and high school students who have asthma who vaped or smoked in the past 30 days reported experiencing more frequent symptoms of asthma than students who did not have asthma who had not vaped or smoked.

Levels below the LOD or LOQ, or even below the threshold levels proposed by the AFNOR standard guidelines, provide evidence of the optimal operation conditions (e.g., adequate wick saturation without extreme coil heating) of the ceramic wick-based device. E-cigarettes are battery-powered devices designed to deliver nicotine and/or other substances including, in some cases, flavourings. Although e-cigarettes were first proposed in 1927 by Joseph Robinson1, it was only in the early 2000s that the 1st generation of e-cigarettes or ‘cig-a-likes’ became commercially available2,3,4. Subsequent generations of devices have evolved since then, ranging from e-cigarettes with prefilled or refillable cartridges (2nd generation) to rechargeable tank-style devices (3rd generation) with modifiable or ‘‘Mods’’ components3,4,5,6. The 4th generation of devices, known as ‘Pods’, has been driven by advances in electronic atomization technology3,7,8,9.

Still, many people, including teens and young adults drawn to vaping, may not realize that, Bittoni said. Other popular brands, like Puff Bar, have received warnings from regulators about the sale of flavored devices as well. Following the Golden State, Washington had the second-lowest amount of youth vapers, at eight percent. In the Evergreen state, the legal age to purchase vapes is 21, and there is a ban on all flavored varieties. Last year, Alaska Senate President Gary Stevens, a Republican, introduced Senate Bill 89, aimed at imposing the state's first-ever tax on e-cigarette products. Wyoming had the highest rate of youth vapers, with 30 percent of kids under 18 reporting they had used e-cigarettes in 2023.

They also contain toxins that can damage your lungs and overall health. One of the reasons why the e-cigarette epidemic among young people is so troubling is that e-cigarette use seems to lead to the use of traditional cigarettes. This makes them a better choice for people who already smoke or use other tobacco products. Vaping may have some benefits for smokers who switch to it as a complete substitute for using other tobacco products. E-cigarette manufacturers are using marketing tactics used by the tobacco industry to lure kids to conventional cigarettes.

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.

The ACS encourages adolescent users who find it difficult to quit to ask for help from health care professionals. Parents should learn all they can about e-cigarette use and be prepared to help their children get the assistance they need. In 2019, more than one in six (15.2%) New York City high school students reported using e-cigarettes.

Even if you’re a tobacco user, having an open, honest discussion with your teen can help. The most important thing to understand is that the liquid in e-cigarette cartridges is not regulated by the FDA. Keep reading to learn more about vaping and how it’s affecting young people.

That legal decision allowed sales of e-cigarettes to proceed but left many questions about their safety unaddressed. To lower the potential risks posed by secondhand aerosol exposure from vaping, some U.S. states, territories, and cities have started restricting where people can vape. There are currently more than 7,000 varieties of flavored e-cigarettes and e-juice (liquid containing nicotine that is used in refillable devices) on the market. Although the popularity and use of e-cigarettes continues to increase, there is a lack of data on their potential health effects. Food and Drug Administration (FDA) has issued a proposed rule to include e-cigarettes under its authority to regulate certain tobacco and nicotine-containing products. Fourth-generation ‘pod’ e-cigarette devices have been driven by technological advances in electronic atomization of the e-liquid.

Because of this and other studies, vitamin E acetate is considered the main cause of EVALI. Other chemicals found in nicotine- and THC-containing vaping products may also play a role in the condition. It is important to know that most e-cigarettes contain addictive nicotine. There is evidence that nicotine harms the brain development of teenagers. Again, it is important to know that most e-cigarettes contain nicotine.

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.

This guidance is intended to support healthcare providers in their understanding and tracking of -cigarette and vaping product use. 20% (5 million) of all youth use e-cigarettes, a 135% increase in just two years. Additional data, rates and trends can be found in the American Lung Association’s Tobacco Trends Brief.

District Court for the District of Columbia ruled that e-cigarettes did not meet the criteria for drug-delivery devices and therefore were exempt from regulation under the FFDCA. The court did rule, however, that the FDA could regulate e-cigarettes as tobacco products under the Family Smoking Prevention and Tobacco Control Act (TCA), since the nicotine contained in some of the e-cigarette cartridges was derived from tobacco. Reports in 2018 of increased e-cigarette use among adolescents and teenagers in the United States prompted the FDA to identify strategies for combating e-cigarette use by minors. Altria’s data showed Njoy e-cigarettes helped smokers reduce their exposure to the harmful chemicals in traditional cigarettes, the FDA said. The agency stressed the products are neither safe nor "FDA approved," and that people who don’t smoke shouldn’t use them. The FDA regulates the manufacture, distribution, and marketing of tobacco products, such as cigarettes, cigars, and e-cigarettes (sometimes called "vapes").

But with its plant-derived, additive-free formula and rigorous testing, this device from Tribe Tokes is one of the safest vape products for CBD lovers. Like the previous entries on our list, the BC5000 uses e-liquid that's free of diacetyl and vitamin E acetate. This is one of the safest vapes for quitting smoking while still enjoying the effects of nicotine.

Among people who were currently using e‑cigarettes, the proportion of people who used them daily remained stable from 2016 (42%) to 2019 (42%), then increased in 2022–‍2023 (49%). While more males than females used e‑cigarettes daily, the change among females was much greater than among males, rising from 36% in 2019 to 51% in 2022–‍2023. This corresponds to a fourfold increase in the number of females using e‑cigarettes daily, from approximately 70,000 to 300,000 (Figure 2).

It can also reduce fertility, increase the chance of developing type 2 diabetes, and contribute to bone loss. Even people who "smoke but don’t inhale" face an increased risk of mouth cancer. By Robyn Correll, MPHCorrell holds a master of public health degree and has over a decade of experience working in the prevention of infectious diseases. Researchers spent decades studying the health consequences of secondhand smoke. It might be a while before we have a clear picture of how secondhand vaping can impact a person’s long-term health, especially for young children.

According to the 2021 National Youth Tobacco Survey, more than 2 million U.S. middle and high school students reported using e-cigarettes in 2021, with more than 8 in 10 of those youth using flavored e-cigarettes. The mid-to-long-term consequences of e-cigarettes are not yet known, as it's a new product and has been sold for less than a decade in the U.S. While much remains to be determined about these lasting health consequences of these products, we are very troubled by what we see so far. The inhalation of harmful chemicals can cause irreversible lung damage and lung diseases.

This national credential was developed for individuals who are currently coaching or aspire to coach at the interscholastic level. The goal is to enhance the ability of the coach to better serve students, the school, the community, and the profession of coaching. What we do know is that many cartridges contain nicotine, the dangerously addictive chemical found in normal cigarettes. Every provider at Loma Linda University Health can tell you how important it is to keep your lungs healthy. Our lung specialists, like Dr. Laren Tan, see patients every day who suffer from debilitating lung issues caused by smoking. Since the end of 2019, it is illegal to sell vaping products to people younger than 21 years.

There's no evidence so far that vaping causes harm to other people around you. If you're pregnant, licensed NRT products such as patches and gum are the recommended option to help you stop smoking. Nicotine replacement therapy (NRT) has been widely used for many years to help people stop smoking and is a safe treatment. In the UK, e-cigarettes are tightly regulated for safety and quality.

Despite this trend all current evidence finds that e-cigarettes carry a fraction of the risk of smoking. The 966 respondents who had never vaped more often believed that e-cigarette waste was dangerous to throw in trash compared to the 1,083 respondents who had vaped at least once (81.4% vs. 71%). Fewer of those who had vaped at least once (79.3%) believed that e-cigarettes contained toxic substances compared to those who had never vaped (89.6%). Young respondents clearly recognized the dangers of e-cigarette waste to humans and the environment and want an appropriate method to recycle.

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.

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; once vapourised by the atomiser, the aerosol (vapour) provides a sensation similar to tobacco smoking, but purportedly without harmful effects [3].

There have also been cases of e-cigarettes exploding or catching fire. Some chronic users have developed obstructions in their lung pathways that cause them to suffer 'asthma-like' symptoms. Similar to Wyoming, the state's vast rural areas might contribute to difficulty enforcing regulations surrounding youth vaping. West Virginia came in second place, with 28 percent of teens vaping last year. The large rural area may make it more difficult to enforce the state's vaping laws. Rural areas also tend to have less access to clinics and resources about the health harms surrounding vaping.

This can also increase the levels of other toxicants to the user and also expose bystanders to harmful emissions. Vapes, vaporizers, vape pens, hookah pens, electronic cigarettes (e-cigarettes or e-cigs), e-cigars, and e-pipes are some of the many tobacco product terms used to describe electronic nicotine delivery systems (ENDS). An electronic cigarette (e-cigarette) is a device that heats up the liquid nicotine and flavoring for you to breathe in. There are many varieties of e-cigarettes that go by different names, including vapes, vape pens or sticks, e-hookahs, hookah sticks, mods and personal vaporizers (PVs). They can also be collectively called electronic nicotine delivery systems (ENDS).

New 'pod-mod' style vape products are similar in shape and size to JUUL® and other vape sticks but are disposable. New York State has enacted strong policies to protect youth from accessing tobacco products and denormalize tobacco and nicotine use to prevent lifelong addiction, illness, and early death. Policies include banning the sale of flavored vapor products, ending price discounts on tobacco and vapor products, and banning the exterior display of tobacco and vapor product ads near schools. E-cigarettes also are controversial because of various regulatory issues. In January 2010, following a lawsuit by an e-cigarette distributor, the U.S.

The State of Victoria and the Department of Health shall not bear any side effects from electronic cigarettes liability for reliance by any user on the materials contained on this website. The products available in Australia are often made up of many parts, from all over the world, which makes it difficult to assess the safety of the overall product. Most e-cigarettes available in retail stores have not been tested or approved by the TGA, which means their safety cannot be guaranteed. Children are exposed to e-cigarette advertising online and on TV, in magazines and billboards. Although it is illegal for e-cigarettes to be sold to youth under age 21, they can be ordered online. While flavors were nationally banned in 2019, this ban excludes mint and menthol flavors.

Cessation strategies should be based on the best available evidence of efficacy, to go with other tobacco control measures and subject to monitoring and evaluation. Based on the current evidence, it is not recommended that governments permit sale of e-cigarettes as consumer products in pursuit of a cessation objective. While they may help some people stop smoking, vaping products do not have FDA approval as a tool for quitting. E-cigarettes may even keep people from trying proven methods of quitting smoking.

Kids being stuck at home under their parents’ supervision during the COVID-19 pandemic could contribute to that trend. Although there is no federal excise tax on e-cigarettes, states have the authority to tax e-cigarettes. Thirty-two states, the District of Columbia, and two territories have imposed a tax on e-cigarettes as of June 15, 2023. Open-system vapes also often allow you to modify things like temperature and airflow. And since you're not going to be using them over the long run, there's very little chance that their internal components will suffer significant wear and tear. The company makes the test results available for anyone to view, so you can easily verify that the CBD All-In-One vape contains exactly what the label says.

"More research about the health effects of alternative tobacco products is critically needed to put science behind the regulation of the tobacco industry." As the debate blazes, deep-pocketed big tobacco investors are buying up e-cig companies, injecting millions of dollars into the market and banking on a bright future for the devices. More than 100 e-cigarette companies are now jockeying for the business of smokers and nonsmokers alike.

The replaceable liquid cartridge contains nicotine mixed with a base (usually propylene glycol), along with flavorings and chemicals. The tip often contains LED lights that simulate the glow of a burning cigarette. Nicotine poisoning can occur when someone ingests, inhales, or absorbs nicotine through the skin or eyes. It can be particularly dangerous for children and young adults, as they are more susceptible to the effects of nicotine. The tax must be broken out as a separate amount from the products sold in any transaction.

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 and the solution inside them.

The sales data came from ordinary brick-and-mortar establishments like gas stations, groceries, and convenience stores. Statistical analyses took into account a host of other factors that may affect tobacco product sales, such as concurrent restrictions on flavored cigar and menthol cigarette sales, tax rates, cannabis availability, and unemployment rates. We are also proud to announce a new cessation service from Quitline Iowa - My Life My Quit - a program designed especially for youth between 12 and 17 years of age to quit using tobacco and vape products.

Where e-cigarette flavor restrictions had been in effect for at least a year, sales of cigarette brands favored by adults went up by 10%, while sales of cigarette brands that disproportionately attract underage smokers saw a 20% bump. During the study period, hundreds of localities and seven states restricted or prohibited flavored e-cigarette sales. While these policies did reduce per-capita vape sales, they also substantially boosted cigarette sales. To date, there is no state excise or special tax placed on e-cigarettes. In vaping liquids, nicotine and/or flavouring ingredients are dissolved in a liquid mixture.

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.

E-cigarette use has remained relatively low and stable among adult users since around 2012, although use has gone up slightly among adults recently, from 4.5% in 2021 to 6% in 2022. In 2022, the greatest e-cigarette use among adults was among 23- to 24-year-olds, 22.8% of whom were current users, according to Monitoring the Future. Get the latest facts and analyses on the most important issues related to smoking, vaping, nicotine and substance use. Also, we've published an article on where to buy nicotine free vapes, to help you make a more informed decision. We have yet to encounter an e-liquid company as committed to transparency as VaporFi. Their products are made in the U.S.A., in FDA-registered labs, and all of their various test results and certifications are available for customers to view.