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[[File:Ecig usb charger.jpg|thumb|Battery connected to a USB charger]]
[[File:Ecig usb charger.jpg|thumb|Battery connected to a USB charger]]


Most electronic cigarettes take an overall cylindrical shape although a wide array of shapes can be found: box, pipe styles etc. Many are made to look like tobacco cigarettes. Common components include a liquid delivery and container system, an atomizer, and a power source.<ref name="howstuffworks">{{cite web|last=Cassidy |first=Susan |url=http://science.howstuffworks.com/innovation/everyday-innovations/electronic-cigarette1.htm |title=HowStuffWorks "How Electronic Cigarettes Work" |publisher=Science.howstuffworks.com |date=26 October 2011 |accessdate=27 August 2013}}</ref> Many electronic cigarettes are composed of streamlined replaceable parts, while disposable devices combine all components into a single part that is discarded when its liquid is depleted.<ref>{{cite web|url=http://www.blucigs.com/disposables/|title=Disposable eCig Features|publisher=Blu cigs|accessdate=19 November 2013}}</ref>
Most electronic cigarettes take an overall cylindrical shape although a wide array of shapes can be found: box, pipe styles etc. First generation electronic cigarettes were usually designed to simulate smoking implements, such as [[cigarette]]s or [[cigar]]s, in their use and appearance.<ref name=Farsalinos2014/> New generation electronic cigarettes have an increased nicotine-dispersal performance,<ref name=Farsalinos2014/> housing higher capacity batteries,<ref name="mcqueen2011"/> and come in various form factors, including metal tubes and boxes.<ref name="mcqueen2011">{{Cite journal|pmid=21571692|doi=10.1093/ntr/ntr088|journal=Nicotine & Tobacco Research|year=2011|volume=13|issue=9|title=Interviews with "vapers": implications for future research with electronic cigarettes|url=http://www.stop-tabac.ch/fra/images/stories/documents_stop_tabac/interview%20with%20vapers.pdf|last2=Tower|author3-last=Sumner|first=Amy|last=McQueen|first2=Stephanie|first3=Walton|pages=860–7}}</ref><ref>{{cite web|url=http://www.lasvegassun.com/news/2013/oct/18/faqs-about-electronic-cigarettes/ |title=FAQs about electronic cigarettes – Las Vegas Sun News |publisher=[[Las Vegas Sun]] |accessdate=20 November 2013}}</ref><ref>{{cite web|url=http://www.stgeorgeutah.com/news/archive/2013/10/07/da-vaping-nicotine-gadget-craze-reaches-southern-utah/ |title=Vaping; nicotine gadget craze reaches Southern Utah |publisher=St George News |accessdate=20 November 2013}}</ref> Many electronic cigarettes are composed of streamlined replaceable parts, while disposable devices combine all components into a single part that is discarded when its liquid is depleted.<ref>{{cite web|url=http://www.blucigs.com/disposables/|title=Disposable eCig Features|publisher=Blu cigs|accessdate=19 November 2013}}</ref> Common components include a liquid delivery and container system, an atomizer, and a power source.<ref name="howstuffworks">{{cite web|last=Cassidy |first=Susan |url=http://science.howstuffworks.com/innovation/everyday-innovations/electronic-cigarette1.htm |title=HowStuffWorks "How Electronic Cigarettes Work" |publisher=Science.howstuffworks.com |date=26 October 2011 |accessdate=27 August 2013}}</ref>



=== Atomizer ===
=== Atomizer ===

Revision as of 07:19, 3 June 2014

First generation electronic cigarette resembling a tobacco cigarette
Second generation types of electronic cigarettes

An electronic cigarette (e-cig or e-cigarette), personal vaporizer (PV) or electronic nicotine delivery system (ENDS) is a battery-powered device which simulates tobacco smoking by producing a vapor that resembles smoke. It generally uses a heating element known as an atomizer, that vaporizes a liquid solution. Solutions usually contain a mixture of propylene glycol, vegetable glycerin, nicotine, and flavorings, while others release a flavored vapor without nicotine.

The benefits and risks of electronic cigarette use are uncertain. Some research indicates that the health risks are much lower than regular cigarettes and similar to nicotine replacement therapy (NRT). They carry a risk of addiction in those who do not already smoke, and possibly promote continuation of addiction in those who already smoke. With the spread of e-cigarette use, accidental nicotine poisoning has increased, especially among children, due to ingestion or skin exposure to e-cigarette liquids.

The frequency of use has increased with up to 10% of American high school students having ever used them as of 2012 and around 3.4% of American adults as of 2011. In the UK the number of e-cigarette users has increased from 700,000 in 2012 to 2.1 million in 2013. About 60% are either smokers and the most of the rest are ex-smokers. The majority of users who tried e-cigarettes continued to smoke traditional cigarettes.

Currently marketed e-cigarette devices arose from an invention made in China in 2003 and devices are predominantly manufactured in China. E-cigarette brands have been rapidly expanding using aggressive marketing campaigns similar to those used to popularize cigarettes in the 1950s and 1960s. Because of the relative novelty of the technology and the possible relationship to tobacco laws and medical drug policies, electronic cigarette legislation and public health investigations are currently pending and are being debated in many countries. The European Parliament passed regulations in February 2014 requiring standardization of liquids and vaporizers, disclosure of ingredients, and child- and tamper-proofing of liquid containers; the US FDA published proposed regulations in April 2014 along similar lines.

Health

Smoking cessation

The World Health Organization (WHO) has stated the efficacy of electronic cigarettes in aiding smoking cessation has not been demonstrated. The WHO recommend that "consumers should be strongly advised not to use" electronic cigarettes unless a reputable national regulatory body has found them safe and effective.[1]

The concept of harm reduction has largely been controversial in the public health approach of tobacco control.[2] A 2011 review article states how electronic cigarettes may aid in smoking cessation and may likely be more effective than traditional pharmacotherapy, as the physical stimuli of holding and puffing on the electronic cigarette may better reduce short-term cravings.[2] The review found no studies that directly measured the effectiveness of electronic cigarettes in smoking cessation, and examined two published studies that indirectly consider the issue by measuring the effect of the product on cravings and other short-term indicators.[2] A 2014 review asserted how electronic cigarettes may be a reasonable substitute for cigarette smoking.[3] The review also states that even individuals that did not intend to quit smoking before being introduced to e-cigarettes may subsequently do so.[3]

The American Association of Public Health Physicians (AAPHP) suggests those who are unwilling to quit tobacco smoking or unable to quit with medical advice and pharmaceutical methods should consider other nicotine containing products such as electronic cigarettes and chewing tobacco for long term use instead of smoking.[4]

The British Medical Association (BMA) reports there is a possibility for smoking cessation benefits, but has concerns that e-cigarettes are less regulated than nicotine replacement therapy (NRT), and that there is no peer reviewed evidence concerning their safety or efficacy. Recommendations point to a "strong regulatory framework" for e-cigarette distribution in order to ensure the safety, quality, and that marketing and sales are restricted to adults. The BMA encourages health professionals to recommend conventional nicotine replacement therapies, but for patients unwilling to use or continue using such methods, health professionals may present e-cigarettes as a lower-risk option than tobacco smoking.[5]

A report commissioned by Public Health England concluded that there is large potential for health benefits when switching from tobacco use to other nicotine delivery devices such as electronic cigarettes, but realizing the full potential requires regulation and monitoring to minimize possible risks.[6]

A 2012 review found electronic systems appear to generally deliver less nicotine than smoking, raising the question of whether they can effectively substitute for tobacco smoking over a long-term period.[7]

A 2013 randomized controlled trial found no difference in smoking cessation rates between e-cigarettes with nicotine, e-cigarettes without nicotine and traditional NRT patches.[8] There are some non-controlled studies which have reported possible benefit.[9]

Electronic cigarettes were not regularly associated with trying to quit tobacco among young people.[10] Adults most often used electronic cigarettes as a replacement for tobacco, although not invariably to quit.[10] The majority of e-cigarette users continue to smoke traditional cigarettes.[11] Although the majority of youth using e-cigarettes are dual users, some youth who used an e-cigarette have never tried a traditional cigarette.[11] Although some people have a desire to quit smoking by using e-cigarettes, other common explanations for the use of these products are to evade smoke-free laws, to reduce harm from smoking [12] and to cut back on traditional cigarettes, which may reinforce delaying or deterring to quit smoking.[11]

Safety

The risks of electronic cigarette use are uncertain.[13][1] This is due to there being little data regarding their health effects[14] and to the variability of vaporizers and variability in liquid ingredients and in their concentration and quality, and thus variability of the contents of vapor delivered to the user.[11][13][1][7][14][15][16] However, some evidence suggests e-cigarettes may be safer than smoking tobacco products, and possibly as safe as other nicotine replacement products but there is insufficient data to draw conclusions.[11][7] Switching from smoking to tobacco to using e-cigarettes may result in reduced exposure to nicotine and reduced potential risk of disease from smoking.[5][15][17]

A preliminary analysis of e-cigarette cartridges by the US Food and Drug Administration (FDA) in 2009 identified that some contain tobacco-specific nitrosamines (TSNAs), known cancer-causing agents.[18][19] The amounts of TSNAs present were on par with existing NRT products like nicotine gum and inhalers. The FDA's analysis also detected diethylene glycol, a poisonous and hygroscopic liquid, in a single cartridge manufactured by Smoking Everywhere and nicotine in one[20] cartridge claimed to be nicotine-free.[18][19] Diethylene glycol was found in a cartridge tested in 2009 by the FDA, but in 2011 researchers reviewed the data and noted that 15 other studies had failed to find any evidence of this chemical in e-cigarettes.[21] Further concerns were raised over inconsistent amounts of nicotine delivered when drawing on the device.[20] In some e-cigarettes, "Tobacco-specific impurities suspected of being harmful to humans – anabasine, myosmine, and β-nicotyrine – were detected in a majority of the samples tested."[22] The UK National Health Service noted that the toxic chemicals found by the FDA were at levels one-thousandth that of cigarette smoke, and that while there is no certainty that these small traces are harmless, initial test results are reassuring.[23] While propylene glycol and other chemicals commonly used as solvents or carrier compounds in c-cigarettes liquids are generally recognized as safe, they have not been used before in vaporized form over long periods of time. The risks, especially to the lungs, are not understood and are of concern to public health authorities and some reviewers.[1][6][14][24] Some reviewers have noted that while there is variability in the ingredients and concentrations of ingredients in e-cigarette liquids, tobacco smoke contains thousands of chemicals, most of which are not understood and many of which are known to harmful.[3][14]

Major injuries and illness have occurred from using e-cigarettes such as explosions and fires.[11] Less serious adverse events included throat and mouth inflammation, cough, nausea, and vomiting.[11] Liquids used with e-cigarettes also pose a risk if they are ingested or if the skin is exposed to them, especially for children. In the US, the number of cases of accidental nicotine poisoning associated with e-cigarette liquid increased 300% in 2013 over 2012, and as of March 2014 was on track to double again.[25]

Second hand smoke

Generally e-cigarettes appear to significantly reduce the dangers to others from second hand smoke,[3][14] but some studies have found that nonsmokers exposed to secondhand e-cigarette aerosol have detectable levels of the nicotine metabolite cotinine in their blood.[11]

Addiction

A number of organizations have concerns that e-cigarettes might increase addiction to and use of nicotine and tobacco products in children.[26][27][28] This including: the Centers for Disease Control and Prevention,[15] the International Union Against Tuberculosis and Lung Disease,[24] the American Academy of Pediatrics[29] and the Food and Drug Administration.[30] The World Health Organization raises the concern of addiction for nonsmokers from their use.[31] It is not clear whether using e-cigarettes will decrease or increase overall nicotine addiction.[32]

Construction

Disassembled cigarette-styled electronic cigarette.
A. LED light cover
B. battery (also houses circuitry)
C. atomizer (heating element)
D. cartridge (mouthpiece)
Battery connected to a USB charger

Most electronic cigarettes take an overall cylindrical shape although a wide array of shapes can be found: box, pipe styles etc. First generation electronic cigarettes were usually designed to simulate smoking implements, such as cigarettes or cigars, in their use and appearance.[33] New generation electronic cigarettes have an increased nicotine-dispersal performance,[33] housing higher capacity batteries,[34] and come in various form factors, including metal tubes and boxes.[34][35][36] Many electronic cigarettes are composed of streamlined replaceable parts, while disposable devices combine all components into a single part that is discarded when its liquid is depleted.[37] Common components include a liquid delivery and container system, an atomizer, and a power source.[38]


Atomizer

Along with the battery, the atomizer is the central component of every personal vaporizer. Although many kinds of atomizers are in use, they generally consist of a small heating element responsible for vaporizing liquid, as well as a wicking material that draws liquid in. The difference in atomizers from device to device, may result in differences in what ingredients and what concentration is delivered to the user even with the same liquid.[11]

A small length of resistance wire is wrapped around the wicking material and then connected to the positive and negative poles of the device. When activated the resistance wire (or coil) quickly heats up thus turning the liquid into a vapor, which is then inhaled by the user.[39]

The electrical resistance of the coil, the voltage output of the device, the airflow of the atomizer and the efficiency of the wick play important roles in the perceived quality of the vapor that is produced by an atomizer. They also greatly affect the quantity or volume of vapor that will be produced by the atomizer.

Atomizer resistances usually vary from 1.5Ω (ohms) to 3.0Ω from one atomizer to the next but can go as low as 0.1Ω in the most extreme cases of DIY coil building which produce large amounts of vapor but could present a fire hazard and other dangerous battery failures if the user is not knowledgeable enough about basic electrical principles and how they relate to battery safety.[40][41]

Wicking materials vary greatly from one atomizer to another but silica fibers are the most commonly used in manufactured atomizers. "Rebuildable" or "do it yourself" atomizers can use silica, cotton, porous ceramic, hemp, bamboo yarn, oxidized stainless steel mesh and even wire rope cables as wicking materials.[42]

A wide array of atomizers and e-liquid container combinations are available:[43]

Cartomizers

Most of the devices that imitate the cigarette form factor use a "cartomizer" (a portmanteau of cartridge and atomizer) or "carto" as an e-liquid delivery system. The piece consists of a heating element surrounded by a liquid-soaked poly-foam that acts as an e-liquid holder. It is usually disposed of once the e-liquid acquires a burnt taste, which is usually due to an activation when the coil is dry or when the cartomizer gets consistently flooded (gurgling) because of sedimentation of the wick. Most cartomizers are refillable even if not advertised as such.[44]

Cartomizers can be used on their own or in conjunction with a tank that allows more e-liquid capacity. In this case the portmanteau word of "cartotank" has been coined. When used in a tank, the cartomizer is inserted in a plastic, glass or metal tube and holes or slots have to be punched on the sides of the cartomizer to allow liquid to reach the coil.

Clearomizers

eGo style e-cigarette with a top-coil clearomizer. Silica fibers are hanging down freely inside of the tank, drawing e-liquid by capillary action to the coil that is located directly under the mouthpiece.

Clearomizers or "clearos", not unlike cartotanks, use a clear tank in which an atomizer is inserted.[45] Unlike cartotanks, however, no poly-foam material can be found in them. There are a lot of different wicking systems employed inside of clearomizers to ensure good moistening of the wick without flooding the coil. Some rely on gravity to bring the e-liquid to the wick and coil assembly (bottom coil clearomizers for example) whereas others rely on capillary action and to some degree the user agitating the e-liquid while handling the clearomizer (top coil clearomizers).[46]

Rebuildable Atomizers

A rebuildable atomizer or an RBA is an atomizer that allows the user to assemble or "build" the wick and coil themselves instead of replacing them by an off-the-shelf atomizer "head". They also allow the user to build atomizers at any desired electrical resistance. The materials needed to "rebuild" the atomizers are usually much cheaper than the usual prefabricated replaceable wick and coil assemblies destined to clearomizers.

These atomizers are divided into two main categories; rebuildable tank atomizers (RTA's) and rebuildable dripping atomizers (RDA's).

Rebuildable tank atomizers or RTA's are similar to clearomizers in that they use a tank or container to hold and bring liquid to the coil. They usually hold a lot more e-liquid than their RDA counterparts.

Rebuildable dripping atomizers or RDA's on the other hand lack the container section and hold very little liquid compared to RTA's but are usually a lot smaller. They usually consist only of an atomizer "building deck" which can accept one or more coils and a "top cap" to cover the coils where a mouth piece can be attached. The user needs to manually keep the atomizer wet by dripping liquid on the bare wick and coil assembly, hence their name.

Power

Most portable devices contain a rechargeable battery, which tends to be the largest component of an electronic cigarette. The battery may contain an electronic airflow sensor whereby activation is triggered simply by drawing breath through the device, while other models employ a power button that must be held during operation. An LED to indicate activation may also be employed. Some manufacturers also offer a cigarette pack-shaped portable charging case (PCC), which contains a larger battery capable of charging e-cigarettes. Devices aimed at more experienced users may sport additional features, such as variable power output and support of a wide range of internal batteries and atomizer configurations and tend to stray away from the cigarette form factor. Some cheaper recent devices use an electret microphone with a custom IC to detect airflow and indicate battery status on the included blue LED.[47][failed verification]

Variable power and voltage devices

PV with variable and regulated power offering battery protection

Variable voltage or power personal vaporizers are devices that contain a built in electronic chip that allows the user to adjust the power that goes through the heating element. They usually incorporate a LED screen to display various information. Variable PV's eliminate the need of having to replace an atomizer with another one of lower or higher electrical resistance to change the intensity of the vapor.[48] They also feature voltage regulation and some battery protection.[49][50]

Some of these devices offer additional features through their menu system such as: atomizer resistance checker, remaining battery voltage, puff counter, activation cut-off etc.[51]

Mechanical personal vaporizers

Mechanical PV with a rebuildable atomizer

Mechanical PVs or mechanical "mods", often called "mechs" are devices without electronic components and battery protection (apart from vent holes drilled in some mechanical devices) or electric regulation. Because there is neither protection nor regulation, they will work either way the battery is inserted. They are activated by spring loaded or opposing magnetic mechanical switches, hence their name. They rely entirely on the natural voltage output of a battery.[citation needed]

They are commonly used with "low resistance" (1.0Ω ~ 0.2Ω) rebuildable atomizers. Seeing that most e-cigarettes containing electronic battery protection will interpret sub ohm resistance coils as a short circuit, thus prohibiting the device from being activated, mechanical mods are among the only devices that will accept such atomizer resistances although more recent (2013) electronic devices offers this possibility as well[citation needed]

Since mechanical PVs are unregulated and unprotected, they require special attention on the user's part that other regulated and protected PVs do not need. Making sure that the battery does not over-discharge and that the atomizer will not require more amperage than what the battery can safely allow are the user's responsibilities.[citation needed]

Liquid

Liquid for producing vapor in electronic cigarettes, commonly known as e-juice or e-liquid, is usually a solution of propylene glycol (PG), vegetable glycerin (VG), and/or polyethylene glycol 400 (PEG400) mixed with concentrated flavors; and optionally, a variable concentration of nicotine.[9][52] There is variability in the purity, kinds and concentrations of chemicals used in liquids, and significant variability between labeled content and concentration and actual content and concentration.[14][7][53][54][24] Additionally, retail stores and users can customize some liquids, adding additional uncertainty about liquid contents,[55] and making it impossible to make general statements about the safety or dangers of liquids.[56][57]

The solution is often sold in a bottle or in pre-filled disposable cartridges. They are manufactured with various tobacco, fruit, and other flavors, as well as variable nicotine concentrations (including nicotine-free versions). The standard notation "mg/ml" is often used in labeling for denoting nicotine concentration, and is sometimes shortened to a simple "mg".[58]

Various e-liquid flavors include tobacco, menthol, coffee, fruit, candy, and alcohol flavors, as well as less common flavors such as cola and Belgian waffle.[11]

Usage statistics

Electronic cigarette sales increased from 50,000 in 2008 to 3.5 million in 2012.[52] As of 2011, in the United States, one in five adults who smoke have tried electronic cigarettes.[59]

In a UK survey conducted in 2013 of more than 12,000 adults, 11% of regular smokers in the sample identified themselves as using electronic cigarettes and 24% stated that they had used them in the past. Amongst those who had never smoked in the same sample, 1% said they had tried them and no evidence of continued use.[60][61] In 2014 the number of people who had every smoked who reported using electronic cigarettes was 52%.[62]

Among grade 6 to 12 students in the United States, those who have ever used the product increased from 3.3% in 2011 to 6.8% in 2012.[10][63] Those currently using electronic cigarettes increased from 0.6% to 1.1%. Over the same period the percentage of grade 6 to 12 students who regularly smoke tobacco cigarettes fell from 7.5% to 6.7%.[64] 10% of students who have used e-cigarettes at least once have never smoked.[63] A 2013 UK survey by Action on Smoking and Health found that among non-smokers under 18, 1% reported having tried e-cigarettes "once or twice," and no evidence of continued use. ASH concluded that among children who have heard of e-cigarettes, sustained use is rare and confined to children who smoke or have smoked.[60]

Most people who use electronic cigarettes have a history of smoking cigarettes while some young people who have never smoked cigarettes have tried electronic cigarettes at least once.[10] The frequency of use has increased with up to 10% of American high school students having ever used them as of 2012 and around 3.4% of American adults as of 2011.[10] The majority of e-cigarette users continue to smoke traditional cigarettes.[11]

A February 2014 survey by the French Monitoring Centre for Drugs and Drug Addiction of 2052 individuals estimated that between 7.7 and 9.2 million individuals have experimented with using electronic cigarettes, with between 1.1 and 1.9 million using on a daily basis. 67% of tobacco smokers in the survey used electronic cigarettes to reduce or quit tobacco smoking. 9% of those who experimented with electronic cigarettes had never smoked tobacco. Of the 1.2% that had recently stopped tobacco smoking at the time of the survey, 84% (or 1% of the population surveyed) credited electronic cigarettes for stopping tobacco use.[65]

History

The earliest electronic cigarette can be traced to Herbert A. Gilbert, who in 1963 patented a device described as "a smokeless non-tobacco cigarette" that involved "replacing burning tobacco and paper with heated, moist, flavored air." This device heated the nicotine solution and produced steam. It was never commercialized.[66][67]

Hon Lik, a Chinese pharmacist, is credited with the invention of the electronic cigarette.[68][69] In 2003,[70] he came up with the idea of using a piezoelectric ultrasound-emitting element to vaporise a pressurized jet of liquid containing nicotine diluted in a propylene glycol solution.[71] This design produces a smoke-like vapour that can be inhaled and provides a vehicle for nicotine delivery into the bloodstream via the lungs. He also proposed using propylene glycol to dilute nicotine and placing it in a disposable plastic cartridge which serves as a liquid reservoir and mouthpiece.

Electronic cigarettes using a different design were first introduced to the Chinese domestic market in May 2004 as an aid for smoking cessation and replacement. The company that Hon Lik worked for, Golden Dragon Holdings, changed its name to Ruyan (如烟, literally "Resembling smoking"), and started exporting its products in 2005–2006[68] before receiving its first international patent in 2007.[72] E-cigarette devices are predominately manufactured in China.[11] The e-cigarette brands have been rapidly expanding using aggressive marketing campaigns similar to those used to popularize cigarettes in the 1950s and 1960s.[11] Long banned comparative advertising for cigarettes and other tobacco products, e-cigarette advertising on television and radio in a number of countries may be indirectly advocating traditional cigarette smoking.[11]

The electronic cigarette continued to evolve from the first generation three-part device. In 2006 the "cartomizer" was invented by British entrepreneurs Umer and Tariq Sheikh of XL Distributors.[73] This is a mechanism which integrates the heating coil into the liquid chamber. The new device was launched in the UK in 2007 in their Gamucci brand and is now widely adopted by the majority of 'cigalike' brands. The grant of the UK patent for the "cartomizer" was made to XL Distributors in February 2013 and published by the UK Intellectual Property Office.[74]

The international tobacco companies, recognising the development of a potential new market sector that could render traditional tobacco products obsolete,[75] are increasingly involved in the production and marketing of their own brands of e-cigarettes and in acquiring existing e-cigarette companies.[76] Blu, a prominent US e-cigarette producer, was acquired by Lorillard Inc. in 2012.[77] British American Tobacco launched Vype in 2013, while Imperial Tobacco's Fontem Ventures acquired the intellectual property owned by Hon Lik through Dragonite for $US 75 million in 2013 and launched Puritane in partnership with Boots UK.[78][79] On 3 February 2014, Altria Group, Inc. acquired popular electronic cigarette brand Green Smoke for $110 million. The deal is expected to be finalized during the second quarter of 2014.[80] Altria also markets its own e-cigarette, the MarkTen, while Reynolds American has entered the sector with its Vuse product.[76]

Society and culture

Consumers of electronic cigarettes or "vapers" as some calls them [43] have shown evident and passionate support for the product that other nicotine replacement therapy did not receive,[12] suggesting that these products have the potential mass appeal that could challenge the preeminence of combustible tobacco as the object of choice for nicotine users.[12]

As the electronic cigarette industry grows, a subculture has emerged which calls itself "the vaping community".[43][81][82] Members of this emerging subculture often view electronic cigarettes as a safer alternative to smoking and some even view it as a hobby. They tend to use highly customized devices that do not resemble what are known, by some, as "cig-a-likes," or electronic cigarettes that resemble real cigarettes.[83]

Large gatherings of vapers are happening around the United States which focus around e-cig paraphernalia and the life style that accompanies it.[43] People attending these meetings are usually enthusiasts that uses specialized, community-made products that are not found in typical places like convenient stores or gas stations.[43] These products are mostly available online or in dedicated "vape" storefronts where mainstream e-cigarettes brands from the tobacco industry are not available.[84]

Legal status

Main article: Legal status of Electronic Cigarettes

The emerging phenomenon of electronic cigarettes has raised concerns among the health community, pharmaceutical industry, health regulators and state governments.[3]

Because of the relative novelty of the technology and the possible relationship to tobacco laws and medical drug policies, electronic cigarette legislation and public health investigations are currently pending in many countries.[85] Current regulations vary widely, from regions with no regulations to others banning the devices entirely.[85]

In February 2014 the European Parliament passed regulations requiring standardization and quality control for liquids and vaporizers, disclosure of ingredients in liquids, and child-proofing and tamper-proofing for liquid packaging.[56][57] In April 2014 the US FDA published proposed regulations for e-cigarettes along similar lines.[54][53]

Related nicotine inhalation technologies

There are other technologies currently under development that seek to deliver nicotine for oral inhalation in an effort to mimic both the ritualistic and behavioural aspects of traditional cigarettes.

References

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  9. ^ a b Caponnetto P; Russo C; Bruno CM; Alamo A; Amaradio MD; Polosa R. (March 2013), "Electronic cigarette: a possible substitute for cigarette dependence." (PDF), Monaldi archives for chest disease, 79 (1): 12–19, PMID 23741941
  10. ^ a b c d e Carroll Chapman, SL; Wu, LT (18 March 2014). "E-cigarette prevalence and correlates of use among adolescents versus adults: A review and comparison". Journal of psychiatric research. PMID 24680203.
  11. ^ a b c d e f g h i j k l m n Grana, R (13 May 2014). "E-cigarettes: a scientific review". Circulation. 129 (19): 1972–86. doi:10.1161/circulationaha.114.007667. PMID 24821826. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  12. ^ a b c Britton, J. & Bogdanovica, I. (May 2014). "Electronic Cigarettes" (PDF). Public Health England. Retrieved 21 May 2014.{{cite web}}: CS1 maint: multiple names: authors list (link)
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  17. ^ Kufe, Donald W. (2009). Holland-Frei cancer medicine (8th ed.). New York: McGraw-Hill Medical. p. 395. ISBN 9781607950141.
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External links

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