Electronic cigarettes, also known as e-cigarettes, rapidly grew in popularity after the first international patent was issued in 2007. Originally marketed as devices for smoking cessation, over the years they have acquired a more fashionable status and have become commonly available in retail stores and through websites. With their increased popularity, electronic cigarettes have attracted scrutiny from health and consumer organizations regarding their actual effectiveness as tobacco replacement devices. The debate on the health hazards linked to e-cigarettes is still in flux, although several research studies have determined that they are harmful to human lungs. Because of the uncertain consequences of electronic cigarettes, legislation varies greatly from country to country. Different options may include the complete ban of the product, age restrictions on its sale, or prohibition against its advertising.
Electronic cigarettes are devices that vaporize nicotine or non-nicotine solutions that are then inhaled by the smoker. This gives the smoker a similar experience to that of tobacco but without the combustion and therefore the smoke of a traditional cigarette, which contains numerous harmful chemicals. In electronic cigarettes, the vaporization is not induced by the process of combustion, but by a battery-activated atomizer that heats up the liquid solution contained in a cartridge (also called mouthpiece), thus producing the vapor that can be inhaled. These liquid solutions may or may not contain nicotine, which is diluted into propylene glycol.
Proponents of electronic cigarettes claimed that they were less harmful than regular cigarettes and other traditional tobacco products, and could help smokers quit. Some studies did provide a degree of support for these claims, but health experts increasingly found that electronic cigarettes still were harmful and also might attract nonsmokers. Critics warned that the liquid solutions were unregulated and could include a variety of potentially harmful substances without the consumer's knowledge. Many products still contain the addictive power of nicotine, nitrosamines (a type of carcinogenic that is also found in traditional cigarettes), and the toxin dietylene glycol. In addition, users of electronic cigarettes seem to develop an increased airway resistance, which is damaging to the lungs, and according to the director of the US Centers for Disease Control and Prevention (CDC), exposure to nicotine at a young age can affect brain development. Concerns over the health hazards of electronic cigarettes especially focused on their possible appeal to children and teenagers for their flavored solutions.
Though in-depth reports or consistent statistics on such incidents were not regularly maintained, cases of exploding e-cigarettes and subsequent injuries also led to concern regarding the safety of the batteries and power mechanisms used on the devices. While relatively rare, e-cigarette explosions had been linked to two deaths in early 2019. By October 2019, the CDC and the FDA were also reporting an outbreak across several states of severe respiratory illness believed to be linked to the use of e-cigarettes. According to the CDC, over 1,800 cases of what was being referred to as e-cigarette, or vaping, product use associated lung injury had been reported from forty-nine states, and approximately thirty-seven deaths had been confirmed. The organizations also reported finding that tetrahydrocannabinol (THC), the active ingredient in cannabis (marijuana), was present in many of the cases. As concerns over such illnesses grew, some states, including Rhode Island, New York, and Michigan, instituted bans on the sales of flavored e-cigarette products, some of which were challenged. Massachusetts put a contested four-month ban on the sale of all vaping products in place. Some critics of such bans expressed concerns that people with nicotine addictions would then smoke cigarettes or purchase e-cigarettes from unregulated sources.
