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  • Julia Egnaczyk

E-Cigarettes: An Update on America’s Tobacco Crisis

America has had a long-standing tobacco crisis since cigarettes were first introduced to the United States in the early 19th century. Thanks to mass marketing and production, they grew in popularity throughout the early 1900s, but became linked to the lung cancer epidemic beginning in the 1940s and 1950s (Proctor, 2012). Smoking rates reached their peak in 1964, and then with the release of U.S. Surgeon General’s reports that further examined risks, they began to decline. Numerous interventions were set in place to change the public image of cigarettes, including taxes on tobacco products, counter-advertising and media campaigns such as the Truth Campaign, legal restrictions on public smoking, among other measures (Cummings & Proctor, 2014). The decline in cigarette use is seen as a major public health success, although there is still more work to be done.

Today, cigarettes remain a major threat to preventable disease in America. As of 2020, 30.8 million U.S. adults continue to smoke cigarettes and 480,000 Americans die from cigarette smoking each year (CDC, 2022). However, there are a whole other range of tobacco products that have now become problematic to American youth. E-cigarettes were introduced to the U.S. in 2007, and beginning in 2014, became the most common form of cigarette used by young people (CDC, 2022). When e-cigarettes first entered the market there were no federal regulations protecting against them and limited research on their negative effects. The FDA was only just granted approval to regulate tobacco products in 2016, which included minimum age restrictions on purchasing tobacco products, required nicotine warnings on packaging, and release of ingredients and other health information (Tobacco Stops with Me, 2020). Despite these restrictions, the 2022 National Youth Tobacco Survey reported that 2.5 million high school and middle school students use e-cigarettes, with 55.3% using disposables and 25.2% using refillable cartridges (FDA, 2022). E-cigarettes often appeal to the younger demographic because they are more accessible and cheaper than traditional cigarettes, and tobacco companies market towards young people using flavored products (Truth Initiative, 2018). And, quite frankly, it works. Nearly 85% of e-cigarette users opt for flavors from fruits to sweets (FDA, 2022).

There is huge concern around the adamant appeal of e-cigarettes to young people. Nicotine, the addictive drug found in e-cigarettes and other tobacco products, can impact learning ability, memory, and attention, when teenagers are exposed to the substance. Additionally, Aerosol from e-cigarettes may expose users and those around them to heavy metals and other volatile substances (CDC, 2022). While e-cigarette use may be a safer alternative for adult smokers looking to quit, it may increase risk of future drug addiction for young users. Now, many young users suffer from addiction to nicotine and the health impacts are just the tip of the iceberg.

In September of 2022, it was announced that one e-cigarette company, Juul, would pay $438.5 million to 33 states and Puerto Rico for their advertising tactics to attract young smokers (McLean, 2022). Juul even presented their products to kids as being “totally safe”, provided free samples, and launched social media campaigns to promote their products. While Juul claimed their products were safer, there are still a number of health risks associated with e-cigarettes including popcorn lung, nicotine poisoning and addiction, lung or respiratory failure, and heart complications (TorHoerman Law, 2022). E-cigarettes have no doubt had a vast negative impact on the wellbeing of adolescents and young adults. Let’s hope that this is the first of many large tobacco companies who should be held accountable for their role in the health of our nation.

If you or someone you know is looking to quit vaping, here are some helpful resources:


Cummings, K. M., & Proctor, R. N. (2014). The changing public image of smoking in the United States: 1964-2014. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 23(1), 32–36.

Proctor R. N. (2012). The history of the discovery of the cigarette-lung cancer link: evidentiary traditions, corporate denial, global toll. Tobacco control, 21(2), 87–91.

The 3 main reasons youth use e-cigarettes. Truth Initiative. (2018, March 18). Retrieved January 12, 2023, from,as%20cigarettes%2C%20are%20not%20allowed.

Burden of Cigarette Use in the U.S. Centers for Disease Control and Prevention. (2022, August 3). Retrieved January 12, 2023, from

FDA. (2022). Results from the annual National Youth Tobacco Survey (NYTS). U.S. Food and Drug Administration. Retrieved January 12, 2023, from

Juul Lawsuit Update January 2023: Juul Lawsuit Compensation Info. TorHoerman Law. (2022, December 7). Retrieved January 13, 2023, from,marketing%20its%20products%20to%20minors.

McLean, R. (2022, December 6). Juul labs settles litigation in the United States. CNN. Retrieved January 13, 2023, from

Surgeon General's Advisory on E-Cigarette Use Among Youth. Centers for Disease Control and Prevention. (2022, October 21). Retrieved January 12, 2023, from

Vaping & E-Cigarette Statistics. Tobacco Stops With Me. (2020, October 2). Retrieved January 12, 2023, from

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