RHA Statement on E-Cigarettes & Vaping Products

Respiratory Health Association Statement on Electronic Cigarettes & Vaping Products

As conventional cigarette use in the United States has declined, electronic cigarette (e-cigarette) use rates have continued to climb, particularly among youth. Vaping devices, such as the widely popularized Juul, have become a mainstay in places of education, with 42.2 percent of U.S. high school students having used an e-cigarette. Recent data show that U.S. youth e-cigarette use increased by 78 percent in 2018, prompting U.S. Food and Drug Administration (FDA) Commissioner Gottlieb to declare youth use of e-cigarettes an “epidemic”.

The increased use of e-cigarettes and vaping devices by youth poses a grave public health concern. These products are unregulated and contain at least 60 different chemical compounds, some of which are known to be toxic, carcinogenic and linked to cardiac disease. E-cigarette vapor is not just water vapor. E-cigarettes have not been proven safe—especially for young people. Exposure to nicotine during adolescence can negatively impact brain development and cognition and can serve as a gateway to conventional tobacco use. E-cigarette use is also associated with an increased risk of heart attack, heart disease and stroke.

Studies show that flavored tobacco products serve as starter products for many smokers, which lead to nicotine addiction and can serve as a gateway to traditional tobacco use. According to data from 2013-2014, 4 out of 5 youth who are current tobacco users started by using a flavored product. Flavors can also alter youth perception of the dangers of tobacco products, including e-cigarettes (which come in over 15,000 flavors), which results in increased use of these products.

E-cigarettes are not an FDA-approved tobacco cessation product. Although a recent study published in the New England Journal of Medicine found that e-cigarettes are more effective in smoking cessation than nicotine-replacement therapy, the results are not generalizable. The study was conducted in the United Kingdom with different e-cigarette products than those offered in the U.S., and the treatment included intensive behavioral support. In addition, it is difficult to assign a standard risk-reduction label to all e-cigarette products because they are not currently regulated, and the array of available e-cigarette products and technologies can vary so much. The long-term health effects of e-cigarette use are still not known, and the study did not address the dangers of nicotine addiction. At the conclusion of the study, 80 percent of those in the e-cigarette treatment group were still using e-cigarettes, compared with 9 percent of those in the nicotine-replacement group still using nicotine replacement. In the U.S., more than half of all e-cigarette users aged 25 and older are also current cigarette smokers.

Respiratory Health Association is committed to taking action to reduce the toll of all tobacco products, including e-cigarettes, on our communities, including:

  • Raising the minimum legal sales age of tobacco products, including e-cigarettes and vaping products, from 18 to 21
  • Adding e-cigarettes to existing smoke-free laws
  • Clarifying definitions of tobacco to include e-cigarette and vaping products
  • Licensing tobacco and e-cigarette retailers
  • Restricting the sales of flavored tobacco and vape products
  • Raising the tax on e-cigarettes and vaping products