E-cigarettes: a new age of smoking

Cigarette smoking is the leading cause of preventable death and disability worldwide.  Electronic nicotine delivery systems (ENDS), also known as e-cigarettes or ‘vapes’, have been gaining significant traction and momentum in two main populations: adults attempting smoking cessation, and adolescents experimenting with nicotine products. ENDS are battery-operated devices, which form a vapour – by heating liquids containing nicotine, flavouring, and other chemicals – which is then inhaled by the user. This led to the term ‘vaping’ to describe the act of using an ENDS. There are three generations of ENDS, with each improving on its predecessor by offering the user new and enticing features such as rechargeability, compact size, and personalised touches. While ENDS are less harmful than combustible cigarettes (CCs), which contribute to the deaths of two in three long-term users, this does not mean that ENDS are safe. Inaccurate perceptions of ENDS can lead to harmful behaviour in those attempting to quit smoking and may even encourage non-smokers to use them.  ENDS entered the market without government regulation as they were produced by small companies, and they are currently not approved by the United States (US) Food and Drug Administration (FDA) for smoking cessation.