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Electronic cigarettes (E-cigarettes) are devices that deliver nicotine to a user by heating and converting to an aerosol a liquid mixture typically composed of propylene glycol, vegetable glycerin, flavoring chemicals, and nicotine1 (Figure). E-cigarette use doubled in just 1 year among both adults and children, from 3.4% to 6.2% in adults (2010–2011) and 3.3% to 6.8% in youth (2011–2012), with high levels of dual use with tobacco cigarettes.1 Although most youth using e-cigarettes are dual users, up to one third of adolescents who tried an e-cigarette have never smoked a conventional cigarette, indicating that some youth are initiating use of the addictive drug nicotine with e-cigarettes.1
E-cigarettes are aggressively advertised on television, on the radio, on the Internet, and in magazines, and e-cigarettes companies sponsor sporting events and music festivals.1 E-cigarette advertising is very similar to cigarette advertising from the 1950s and 1960s, and e-cigarette products come in kid-friendly flavors (including grape, chocolate, bubble gum, and gummy bear). E-cigarette advertising promises to deliver nicotine, the addictive drug in cigarettes, without the toxic chemicals produced by burning tobacco cigarettes and without exposing others to secondhand smoke. Marketing for e-cigarettes often describes them as emitting only “harmless water vapor.”1 This message is often coupled with claims that one can “smoke” anytime and anywhere, often with a list of places where tobacco smoking is restricted, including restaurants, bars, offices, and airplanes.
What Is Known About E-Cigarettes?
The claim …