The timeline below illustrates the rapid pace of e-cigarette events.

5 MILLION YOUTH VAPERS

Editor’s note: Vapes go by many names, including “e-cigarettes,” “e-cigs,” “mods,” “vapes,” or “tanks.” We will refer to them as vapes for clarity. 

In 2019, over 5 million middle and high school students reported being current users of vapes.1 You may be wondering how vapes reached this level of popularity. Where did these devices come from and how did they become so widespread? 

Vapes have an intriguing history that highlights the way cigarette companies historically used “safety” as a platform for selling novel products to consumers.

Banner of cigarette brand

Since the early twentieth century, tobacco companies have advertised products that were touted to be healthier or safer alternatives to traditional cigarettes by claiming unique features like filters or lower-nicotine content.2 These claims have all generally been debunked by scientists. 

For example, there is no identified health benefit to smoking “light” or “low-tar” cigarettes, although they were marketed to consumers as a safer smoking option.3,4 In 1963, the first patent for a prototype resembling the current e-cigarette was submitted with claims of providing a “safe and harmless means for and method of smoking.”5

The inventors of the Favor cigarette, created in the 1980s, were the first to use the term vaping.6 Favor was a cigarette alternative that did not use heat and delivered pure nicotine to users via inhalation through a piece of nicotine-soaked paper. 

Then, the first iteration of the e-cigarette as it is known today was created in 2003 by a Chinese pharmacist and promoted as a possible cessation tool.5 This device entered the U.S. market by the mid-2000s, and sales have risen steadily since. Almost immediately, scientists expressed concern that there may be unintended consequences of marketing new tobacco products as safer, even raising the possibility that these products could potentially increase experimentation and youth tobacco use.2,5

In 2008, the World Health Organization (WHO) released a statement against the marketing of e-cigarettes as a cessation tool. Citing a basic lack of evidence, the Director of WHO’s Tobacco Free Initiative stated, “If the marketers of the electronic cigarette want to help smokers quit, then they need to conduct clinical studies and toxicity analyses and operate within the proper regulatory framework.”7 A 2014 report from WHO notes that electronic cigarette devices have yet to be evaluated and approved as a cessation tool by any governmental agency.

On the ground, however, use of vapes steadily increased following its market introduction. This increase was particularly noted among people who had never used cigarettes - youth. Through the years, striking trends in vape usage emerged, as depicted below:

  • In 2011, 1.5% of youth used vapes.9
  • In 2013, 4.5 % of high school students had used vapes in the past month.9
  • In 2015, 16% of high school students had used vapes in the past month.9
  • In 2017, 11% of high school students had used vapes in the past month.9
  • In 2018, 21% of high school students had used vapes in the past month.9
  • In 2019, 27.5% of high school students had used vapes in the past month.9

These trends represent an increase of more than 1,800% in 8 years.9

Today, current data from the 2019 National Youth Tobacco Survey report that 31.2% of high school students and 12.5% of middle school students are using some type of tobacco product, reaching the highest rate among high school students in 19 years. This same report states that 57% of students currently using tobacco products tried to quit in the last year.10

These statistics are alarming. In addition to the risks that nicotine and vapes pose for youth, research has shown that using vapes increases the likelihood of young people using conventional combustible cigarettes, acting as a gateway to even more harmful tobacco products.11

The rising popularity of vapes has outpaced their regulation. State and local government and organizations have responded with regulation. Indeed, the Tobacco Control Act (2009) maintains the authority of state and local governments to enact policy in addition to or stricter than what currently exists. States like New York, Massachusetts, and Michigan have already enacted stricter anti-vaping legislation.

In May 2016, the FDA’s “deeming rule” went into effect, giving the FDA’s Center for Tobacco Prevention regulatory authority over all Electronic Nicotine Device Systems (ENDS) which include e-cigarettes, vapes, e-liquids, e-cigars, e-pipes, and e-hookahs. Vapes are now subject to regulations including minimum age restrictions, requirements to include a nicotine warning, premarket review of new tobacco products, and required disclosure of existing health information, including lists of ingredients and documents on health effects.

As research unfolds, we are still learning about the negative consequences of vaping. Now is the time to take preventive measures to protect our communities and take action against youth vaping. Teens need the facts to help them make their own decisions to avoid vapes. Giving teens the tools and information they need to recognize risks is critical to the fight against youth vaping.

References:

  1. Cullen KA, Gentzke AS, Sawdey MD, et al. e-Cigarette Use Among Youth in the United States, 2019. JAMA. 2019;322(21):2095–2103. doi:https://doi.org/10.1001/jama.2019.18387
  2. U.S. Department of Health and Human Services (USDHHS). (2016). E-cigarette use among youth and young adults. A report of the Surgeon General. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center of Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
  3. Benowitz NL, et al., (1983) Smokers of low-yield cigarettes do not consume less nicotine. N Engl J Med, 309(3): p. 139–42.
  4. Herning RI (1981) Puff volume increases when low-nicotine cigarettes are smoked. Br Med J Clin Res Ed, 283: p. 187-89.
  5. Caraballo, R. S., Pederson, L. L., & Gupta, N. (2006). New tobacco products: do smokers like them?. Tobacco control15(1), 39–44. doi:10.1136/tc.2005.012856
  6. Consumer Advocates for Smoke Free Alternatives Association. (2016) A Historical Timeline of Electronic Cigarettes. <http://www.casaa.org/historical-timeline-of-electronic-cigarettes/>
  7. The World Health Organization. https://www.who.int/mediacentre/news/releases/2008/pr34/en/ 
  8. World Health Organization (2014) Electronic nicotine delivery systems (report). Conference of the Parties to the WHO Framework Convention on Tobacco Control. < http://apps.who.int/gb/fctc/PDF/cop6/FCTC_COP6_10-en.pdf?ua=1>
  9. The Truth Initiative (2019) E-cigarettes: Facts, stats and regulations. <https://truthinitiative.org/research-resources/emerging-tobacco-products/e-cigarettes-facts-stats-and-regulations>
  10. The Truth Initiative (2019) E-cigarettes drive overall youth tobacco use to highest rate in nearly two decades. Research and resources. <https://truthinitiative.org/research-resources/emerging-tobacco-products/e-cigarettes-drive-overall-youth-tobacco-use-highest>
  11. https://www.fda.gov/tobacco-products/youth-and-tobacco/2018-nyts-data-startling-rise-youth-e-cigarette-use#references