Indiana University Indiana University IU

Indiana Prevention Resource Center (IPRC)

The Rise of Electronic Cigarettes

Electronic cigarettes are devices that provide doses of nicotine and other additives to users in a vapor form, often battery powered. Also called e-cigarettes (e-cig), personal vaporizers (PV) or electronic nicotine delivery systems (ENDS), they often simulate tobacco smoking without the inclusion of tobacco. The invention of the first generation e-cigs are attributed to a Chinese pharmacist in 2003, who received an international patent in 2007 for his creation. Since 2007, the use of e-cigs has increased in the U.S., both among adults and youth. Recently published data from the National Youth Tobacco Survey (NYTS) indicates the use of e-cigarettes was associated with higher odds of either lifetime or current cigarette smoking and lower odds of abstaining from conventional cigarettes (Dutra & Glantz, 2014). Most importantly, Dutra & Glantz found that the use of e-cigarettes does not discourage, and may actually encourage tobacco cigarette use among youth in the U.S (2014).

Source: http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm172906.htm

E-cigarettes work when a battery-operated heating element heats an atomizer, converting the contents of a cartridge (containing nicotine or other chemicals) into a vapor, which is then inhaled by the user. Often sold with flavors (such as strawberry, mint, chocolate, etc.), e-cigs are heavily advertised online, and on television and radio. While they are often marketed as a safe alternative to a traditional tobacco cigarette and as a smoking cessation aid, there hasn’t been any definitive publication or research on their public health effects and contents (either positive or negative).

While the Food and Drug Administration (FDA) has attempted to regulate the manufacturing and selling of all e-cigs, their petitions to the courts have been often been denied. Consequently, the manufacture and sale of e-cigarettes in the U.S. is largely unregulated, allowing e-cigs to be available online and in stores for purchase by youth and adults alike. However, e-cigarettes marketed for “therapeutic purposes” (i.e., for smoking cessation), are currently regulated by the FDA. The FDA has not approved e-cigarettes as an effective method to helping individuals quit smoking

As e-cigarettes are relatively new devices, there is not a large body of research into their effects and possible classification. Current data from the National Youth Tobacco Survey (NYTS), indicates a significant increase in electronic cigarette use by middle (from 0.6% to 1.1%) and high school (from 1.5% to 2.8%) students from 2011 to 2012 (Centers for Disease Control and Prevention, 2013). Additionally, from 2010 to 2011, the percentage of adults reporting use of e-cigs increased in both current and former smokers (King, Alam, Promoff, Arrazola, Dube, 2013). Furthermore, 20% of current cigarette smokers have used an e-cigarette, which is higher than those who are considered “never-smokers” or former smokers (King, Alam, Promoff, Arrazola, Dube, 2013). More and ongoing research is still needed to understand the possible public health impacts and the prevalence of use, especially as it relates to youth initiation of smoking and effects in assisting individuals struggling with smoking cessation.


  • Centers for Disease Control and Prevention. Tobacco product use among middle and high school students – United States, 2011 and 2012. Morbidity and Mortality Weekly Report, November 15, 2013. 62(45); 893-897.
  • Dutra, L.M., & Glantz, S.A. (2014). Electronic cigarettes and conventional cigarette use among US adolescents: A cross-sectional study. JAMA Pediatrics Online, Mar 6.
  • King, B.A., Alam, S., Promoff, G., Arrazola, R., & Dube, S.R., (2013). Awareness and ever use of electronic cigarettes among U.S. adults, 2010-2011. Nicotine & Tobacco Research, Feb. 2013, 15:1623-7.

By Kathleen Anderson, 3/25/2014