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Tobacco Industry Monitor

Southeast Asia Tobacco Control Alliance

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Frequently asked questions

Q1: What are electronic smoking devices? 

Electronic smoking devices is the term SEATCA uses to refer to various types of electronic gadgets that mimic smoking a regular combustible (burnable) cigarette. These devices fall under two broad categories, electronic nicotine delivery systems (ENDS) and heated tobacco products (HTPs). 

Electronic nicotine delivery systems (ENDS) are battery-operated devices that heat a non-tobacco-containing solid, liquid, or gel to produce an aerosol. This aerosol contains nicotine and various other chemicals, including toxicants and carcinogens, which are inhaled by the user through a mouthpiece. ENDS were initially designed to mimic the look and action of using conventional tobacco products but are now produced in thousands of different formats (including as toys, writing pens, and snacks), often in bright, attractive colors, and in one or more of over 16,000 flavors, mostly candy and fruit flavors. ENDS are commonly known as e-cigarettes or vapes. The liquids used in ENDS (commonly called e-liquid or e-juice) typically contain nicotine, flavorings, and other ingredients like propylene glycol and vegetable glycerin[1].

Heated tobacco products (HTPs) are devices that heat up tobacco, sometimes in combination with an e-liquid, to produce a chemical aerosol similar to combustible tobacco smoke. HTPs generate heat with or without an electronically controlled heating system[2].

From a scientific perspective, aerosols produced by ESDs are classifiable as smoke[3], as they contain fine and ultrafine carbon particles and various toxic chemicals and carcinogens. Smoke is produced when substances like tobacco and e-liquids are heated, even in the absence of combustion or flame. HTP smoke is unambiguously tobacco smoke.

Q2: Is it true that electronic smoking devices are 95% less harmful than cigarettes?

A: No. Electronic smoking devices are not 95% less harmful than cigarettes. This claim from 2014 is outdated, and misleading because it was not based on any hard evidence that these products were less harmful[4],[5]. In fact, there is conclusive evidence that these devices are harmful, especially for young people, who are three times more likely to take up smoking combustible cigarettes[6].

The World Health Organization (WHO) has consistently warned that all tobacco products are harmful, and electronic smoking devices are not a safer alternative to combustible cigarettes[7]. Cigarettes are not and never have been safe.

Heating tobacco and/or e-liquids releases harmful chemicals. Heating e-liquids in ENDS, or tobacco (with or without e-liquid) in HTPs, creates an aerosol containing nicotine, carcinogens, and other toxic chemicals, many of which are also found in combustible cigarette smoke[8],[9]

Q3: What makes electronic smoking devices harmful?

A: Like combustible cigarettes, most electronic smoking devices contain and release the addictive substance nicotine, as well as other toxic substances, which can cause multiple diseases including lung cancer and cardiovascular issues[10]. In 2019, the US Centers for Disease Control and Prevention have identified a clear link between serious lung injury and e-cigarette use, known as EVALI – e-cigarette or vaping product use-associated lung injury[11]. In 2022, researchers at the National Heart, Lung, and Blood Institute within the National Institutes of Health found that electronic smoking devices can impair blood vessel function in humans, which may lead to heart disease[12],[13].

Furthermore, the attractive and kid-friendly flavors (e.g. bubblegum, cola, cinnamon, mango) that are available for these devices have also been found to contain toxic compounds. Flavorings that have been declared food-safe are not assured to be also safe when inhaled via electronic smoking devices[14]. Yet, flavored e-liquids are widely available, and lack of regulation allows these to be sold with limited information about what is in them. 

If the tobacco industry’s claims over the past few decades are to be believed, nicotine’s effects are similar to the effects of caffeine found in coffee and tea. Now, the same claim is being recycled for electronic smoking devices[15]. These are the industry’s efforts to normalize nicotine and minimize its addictive properties.

But in reality, nicotine has been shown to be as addictive as cocaine and heroin[16]. Electronic smoking devices can deliver nicotine to the brain as rapidly as combustible cigarettes, and in similar or larger quantities, promoting nicotine dependence in users[17].  In addition to being addictive, nicotine is a poison that can significantly and irreversibly damage the human body, including the respiratory, cardiovascular, reproductive, renal, and immune systems[18].

Q4: Is secondhand exposure to electronic smoking devices dangerous?

A: The dangers of secondhand cigarette smoke is well-researched and established. But evidence on the health risks of secondhand electronic smoking device emissions is still limited, though research has already shown that these emissions contain harmful particles and substances that can penetrate deep into the lungs and negatively affect health[19]. A systematic review of the evidence to date concluded that passive exposure to the emissions produced by electronic smoking devices can have adverse health effects[20].

Due to the false perception that electronic smoking devices are “safer” than smoking combustible cigarettes, these devices are often not subjected to the same restrictions as combustible cigarettes. Because it is more socially acceptable to use electronic smoking devices even in places where smoking is prohibited, levels of secondhand exposure are high.

Q5: Aren’t electronic smoking devices supposed to help people quit smoking?

A: No, and they should not be recommended as aids to help people quit smoking and using any kind of tobacco product. Electronic smoking devices do not help people to quit smoking combustible cigarettes, or to smoke fewer cigarettes[21]. Many people who attempt to quit smoking combustible cigarettes by switching to electronic smoking devices end up becoming dual or poly users of two or more types of products. Dual/poly use also occurs among never-smokers; they begin by using electronic smoking devices, which become a gateway to combustible cigarette use and addiction[22],[23].

Tobacco companies like Philip Morris International (PMI) claim to be invested in offering consumers “smoke-free” product alternatives for current adult smokers, but openly admit that these products are addictive and not risk-free; PMI has also assured its shareholders that combustible cigarette sales will remain at the core of the company’s business model, and continues to expand its consumer base by targeting young people[24]. Exposure to nicotine significantly harms brain development in young people, affecting attention, mood, and impulse control, among other functions[25].

Q6: Why are so many young people using electronic smoking devices like vapes?

A: Smoking kills up to half of its users. To continue making money, it is necessary for tobacco companies to work on replenishing their consumer base. By targeting children and young adults with their new and existing products, the tobacco industry has access to a whole new generation of customers. Young people are being targeted with advertising campaigns that glamorize, romanticize, and normalize vaping while downplaying its addictiveness[26]

Social media influencers are being recruited to promote these products as trendy lifestyle accessories. Electronic smoking devices are designed to be sleek and stylish or cute and colorful, featuring iconic brands (e.g. Coca-Cola) and popular characters (e.g. Disney and Marvel characters)[27]. A multitude of flavor and fragrance options make these products even more appealing to young people.

Q7: Should electronic smoking devices be banned?

A: Yes! There is no evidence to suggest that electronic smoking devices aid smoking cessation. Most smokers who quit do so without a cessation aid[28]; many countries have achieved a low smoking prevalence without the use of these devices.

The tobacco industry has not been honest about its intentions; it is more concerned about profits than it is about the health and wellbeing of current smokers and nonsmokers, especially given the way these products are openly marketed to young people. The tobacco industry has always fought efforts to restrict and regulate its products; it is not interested in being a part of a health-focused solution.

Banning these devices is a workable solution. Over 45 countries globally currently ban electronic smoking devices, including five ASEAN countries: Brunei, Cambodia, Lao PDR, Singapore, and Thailand.

Many countries have attempted to regulate these products instead of banning them. In 2021, Australia rolled out a strategy making nicotine-containing electronic smoking devices available by prescription only. This strategy failed due to the flood of imported non-prescription devices entering Australia, making it easy for anyone to access. The country is now dealing with a vaping crisis among teenagers, and has taken decisive action to stop imports of non-prescription devices, ban all single use vapes, and strengthen the prescription pathway of these products[29].

It is not impossible to ban established products that have been shown to be lethal; it has been done with asbestos, mercury, and multiple pesticides. Banning electronic smoking devices will help us avoid repeating our past mistakes which led to the current cigarette smoking epidemic. We do not need to add a vaping epidemic.

[1] Electronic nicotine and non-nicotine delivery systems: A brief. https://apps.who.int/iris/bitstream/handle/10665/350474/WHO-EURO-2020-4572-44335-62638-eng.pdf?sequence=1&isAllowed=y

[2] Heated tobacco products (HTPs) information sheet. https://apps.who.int/iris/bitstream/handle/10665/272875/WHO-NMH-PND-17.6-eng.pdf

[3] Challenges posed by and classification of novel and emerging tobacco products. Report by the Convention Secretariat. https://storage.googleapis.com/who-fctc-cop10-source/Main%20documents/fctc-cop10-9-en.pdf  

[4] An often-made claim that e-cigarettes are ‘95% safer’ is not valid.https://news.vcu.edu/article/An_oftenmade_claim_that_ecigarettes_are_95_safer_is_not_valid

[5] Invalidity of an oft-cited estimate of the relative harms of electronic cigarettes.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6951374/

[6] Progress report on technical matters related to Articles 9 and 10 of the WHO FCTC (Regulation of contents and disclosure of tobacco products, including waterpipe, smokeless tobacco and heated tobacco products). Report by the World Health Organization. https://storage.googleapis.com/who-fctc-cop10-source/Main%20documents/fctc-cop10-7-en.pdf

[7] WHO report on the global tobacco epidemic 2021: addressing new and emerging products. https://www.who.int/teams/health-promotion/tobacco-control/global-tobacco-report-2021

[8] Heat-not-burn tobacco cigarettes: Smoke by any other name. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5543320/

[9] Harmful chemicals emitted from electronic cigarettes and potential deleterious effects in the oral cavity.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233525/#cit0007

[10] The impact of e-cigarettes on the lung. https://www.lung.org/quit-smoking/e-cigarettes-vaping/impact-of-e-cigarettes-on-lung#:~:text=E%2Dcigarettes%20produce%20a%20number,as%20cardiovascular%20(heart)%20disease.&text=E%2Dcigarettes%20also%20contain%20acrolein,primarily%20used%20to%20kill%20weeds.

[11] Update: Interim guidance for health care providers evaluating and caring for patients with suspected e-cigarette, or vaping, product use associated lung injury – Unites States, October 2019.https://www.cdc.gov/mmwr/volumes/68/wr/pdfs/mm6841e3-H.pdf

[12] NIH-funded studies show damaging effects of vaping, smoking on blood vessels. https://www.nih.gov/news-events/news-releases/nih-funded-studies-show-damaging-effects-vaping-smoking-blood-vessels

[13] Chronic e-cigarette use impairs endothelial function on the physiological and cellular levels.https://www.ahajournals.org/doi/10.1161/ATVBAHA.121.317749?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

[14] Toxicity assessment of flavour chemicals used in e-cigarettes: current state and future challenges.https://link.springer.com/article/10.1007/s00204-021-03080-6#ref-CR14

[15] Why Big Tobacco and Big Vape love comparing nicotine to caffeine.https://www.theverge.com/2019/4/26/18513312/vape-tobacco-big-companies-nicotine-caffeine-comparison-drugs-chemicals

[16] Why it’s so hard to quit smoking. https://www.heart.org/en/news/2018/10/17/why-its-so-hard-to-quit-smoking

[17] American Cancer Society position statement on electronic cigarettes. https://www.cancer.org/cancer/risk-prevention/tobacco/e-cigarettes-vaping/e-cigarette-position-statement.html

[18] Harmful effects of nicotine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4363846/

[19] In secondhand vape, scientists smell risk. https://www.heart.org/en/news/2022/05/31/in-secondhand-vape-scientists-smell-risk

[20] A systematic review of the health risks from passive exposure to electronic cigarette vapour.https://www.phrp.com.au/issues/april-2016-volume-26-issue-2/a-systematic-review-of-the-health-risks-from-passive-exposure-to-electronic-cigarette-vapour/

[21] Can vaping help people quit smoking? It’s unlikely. https://theconversation.com/can-vaping-help-people-quit-smoking-its-unlikely-204812

[22] Association of electronic cigarette use with initiation of combustible tobacco product smoking in early adolescence. https://jamanetwork.com/journals/jama/fullarticle/2428954

[23] Exploring the gateway hypothesis of e-cigarettes and tobacco: a prospective replication study among adolescents in the Netherlands and Flanders. https://tobaccocontrol.bmj.com/content/32/2/170

[24] Unsmoke is a joke: A 12-month look at the campaign from Philip Morris International.https://exposetobacco.org/news/unsmoke-is-a-joke/

[25] Short- and long-term consequences of nicotine exposure during adolescence for prefrontal cortex neuronal network function. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543069/

[26] 10 ways the tobacco industry targets youth. https://exposetobacco.org/news/10-ways-tobacco-targets-youth/

[27] Opinion: On using fruity flavors and Pikachu to hook Pinoy youth on nicotine.https://www.rappler.com/voices/thought-leaders/opinion-fruity-flavors-pikachu-hook-youth-nicotine/

[28] The Global Research Neglect of Unassisted Smoking Cessation: Causes and Consequences.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2817714/#:~:text=Research%20shows%20that%20two%2Dthirds,of%20ex%2Dsmokers%20stop%20unaided.

[29] Cancer Council congratulates the Federal Government on announcing decisive actions to address vaping epidemic and smoking. https://www.cancer.org.au/media-releases/2023/cancer-council-congratulates-federal-government-decisive-actions-vaping-epidemic

Q1: What are e-cigarettes and how do they work?

A: Electronic nicotine delivery systems (ENDS) are noncombustible battery-operated devices that heat a liquid to produce an aerosol, composed of nicotine and various other chemicals, which is inhaled by the user through a mouthpiece. ENDS devices come in various forms and are often designed to mimic the look of combustible tobacco products, e.g. e-cigarettes, e-cigars, e-pipes, or e-shisha/hookah. They are commonly referred to as e-cigarettes and vapes or vape pens. The liquids used in ENDS (commonly called e-liquid or e-juice) typically contain nicotine, flavorings, and other ingredients like propylene glycol and vegetable glycerin.[i],[ii]

Heated tobacco products (HTPs) heat tobacco, sometimes in combination with e-liquid, to produce a chemical aerosol similar to tobacco smoke. HTPs generate heat with or without an electronically controlled heating system.

Q2: Is it true that heating (not burning) e-liquids or tobacco does not release harmful chemicals?

A: Heating e-liquids in ENDS or tobacco (with or without e-liquid) in HTPs creates an aerosol composed of nicotine and various carcinogens and toxic chemicals, many of which are also found in tobacco smoke. Burning has also been observed in the wicks and heating coils of ENDS and in the tobacco sticks of HTPs.

Q3: Are e-cigarettes really 95% safer than cigarettes?

A: No. This claim of reduced harm is made on the basis of lower concentrations of toxicants found in ENDS and HTP aerosols when compared to conventional cigarette smoke; however, reduced exposure to these toxicants does not necessarily equate to reduced risk, and there is still no long term scientific evidence to support this claim. The World Health Organization (WHO) has consistently warned that all tobacco products, including HTPS, are harmful[iii] and recently (July 2019) declared that e-cigarettes are “undoubtedly harmful” and not a safer alternative to conventional cigarettes.[iv]

Q4: Some experiments on mice show that e-cigarettes cause various diseases, including cancer. Are these studies relevant for humans?

A: When experiments in mice in the 1950s first established the clear link between cigarette smoking and cancer, tobacco companies also denied the evidence. E-cigarette vapor causes lung cancer and potentially bladder cancer in mice, damaging their DNA and leading researchers at New York University (NYU) to conclude that vaping is likely “very harmful” to humans as well. In the NYU study, researchers found that e-cigarette vapor caused DNA damage in the lungs and bladder and “inhibits DNA repair in lung tissues.” These findings should not be dismissed as being irrelevant to humans.[v]

Q5: Is nicotine as harmless as caffeine?

A: Various industry documents, court testimony, and advertisements show that the tobacco industry has been working for decades to equate nicotine with harmless consumer products such as coffee, tea, or gummy bears. This effort to dissociate nicotine from addictive and harmful drugs (such as heroin or cocaine) that was previously used to normalize conventional cigarettes is now being applied to e-cigarettes. However, the vast majority of people don’t become addicted to caffeine. According to Neal Benowitz, a pharmacologist and professor at the University of California, San Francisco, “if a doctor tells someone to switch to decaf, most people can…. But people have a harder time ignoring nicotine cravings when they’re trying to stop smoking.”[vi]

Nicotine also increases the risk of cardiovascular, respiratory, gastrointestinal, and reproductive and perinatal disorders, suppresses the immune response, and plays a clear role in cancer growth.[vii] It also impairs adolescent brain maturation with both short-term and long-term consequences for teen addiction, cognition, and emotional regulation.[viii], [ix]

Q6: Is second-hand exposure to e-cigarette aerosols dangerous?

A: Given the chemical profile of ENDS and HTP aerosols, there is a potential risk of harm from secondhand exposure, even when emissions are not clearly visible. Both the WHO and US National Academies of Sciences, Engineering, and Medicine (NASEM) have determined that there is conclusive evidence that exhaled e-cigarette aerosols increase airborne concentrations of particulate matter, nicotine, and some toxicants compared with background levels.[x], [xi] While very limited studies have examined the health risks of passive exposure to e-cigarette aerosols, a systematic review of evidence concluded that passive exposure to the air pollutants in ENDS aerosols is at concentrations associated with potential adverse health effects.[xii], [xiii]

Q7: Can e-cigarettes help smokers quit smoking?

A: While some vaping proponents argue that vaping is an effective smoking cessation tool, population-level studies show that majority of e-cigarette users are dual users (using both conventional and electronic cigarettes) and that e-cigarette use blocks or delays actual cessation.[xiv] Even manufacturers of ENDS and HTPs state that their products are switching products (from smoking conventional cigarettes to smoking electronic ones) and not intended to be smoking cessation products.[xv]

If conventional cigarettes were to be introduced into the consumer market today, they would never be approved for sale. Unfortunately, they were allowed for sale and legalized at a time when there was still no evidence of their safety or harm. This was a historical mistake that worldwide has led to a staggering 1.2 billion tobacco users and now costs eight million people their lives each year. Governments must act swiftly and not make the same mistake for e-cigarettes.

Q8: E-cigarettes have been in the US market for more than 10 years, why are people getting sick only now?

A: People may have been getting sick earlier, but their sickness was not recognized at the time as being caused by e-cigarettes. The US Centers for Disease Control and Prevention (CDC) have now identified a clear link between serious lung injury and e-cigarette use: e-cigarette or vaping product use-associated lung injury (EVALI).[xvi] As of November 5, 2019, 2,051 cases of EVALI, including 39 deaths, have been reported in the USA. The CDC has now issued guidance to health care providers on this injury, which was not commonly recognized before. However, case reports of similar lung injuries exist from as early as 2011.

Q9: Why are e-cigarette users in the US getting sick but not in other countries?

A: There have been 74 health problems (49 classified as “serious”),[xvii] one hospital admission, and possibly one death linked to e-cigarettes use in the UK.[xviii] Elsewhere there have been reports of one hospital admission in Malaysia[xix] and one in Canada[xx] linked to ENDS and two cases in Japan linked to HTP use. There is always the possibility that the number of EVALI incidence and deaths may increase in other countries as people continue to use e-cigarettes and as more doctors and nurses recognize the disease. 

Q10: Isn’t THC (tetrahydrocannabinol) vaping the actual cause of the outbreak of lung diseases in the US?

A: According to the US CDC, all EVALI patients have reported a history of using e-cigarette, or vaping, products. While most patients report using THC vape products, particularly those obtained off the street or from other informal sources, some patients have reported using only nicotine-containing products. In addition:

  • No one compound or ingredient has emerged as the cause of these illnesses to date; and it may be that there is more than one cause of this outbreak. Many different substances and product sources are still under investigation.
  • While it appears that vitamin E acetate is associated with EVALI, evidence is not yet sufficient to rule out contribution of other chemicals of concern to EVALI.[xxi] 

Q11: The teen vaping epidemic in the US is due to bad parenting. Why is the vaping industry being blamed?

A: It is convenient to blame poor parenting for vaping. In reality the vaping industry has been targeting and luring teenagers with dishonest advertising campaigns and kid-friendly flavors, and both parents and teens have been misled on the harmful effects of e-cigarettes on health.[xxii]While the Office of the US Surgeon General now provides updated information on its website to educate and alert parents to convince their children not to vape,[xxiii] the vaping industry has resisted US government regulatory efforts in the past[xxiv] and continues to do so.

Q12: How many countries ban e-cigarettes?

A: More than 40 countries currently ban ENDS and HTPs, including five (5) ASEAN countries: Brunei, Cambodia, Lao PDR, Singapore and Thailand.

Q13: If e-cigarettes are banned, will people will go back to smoking?

A: Prior to the advent of e-cigarettes, the alternative for smokers was to quit smoking and breathe in only air. This is still the best alternative, and all smokers are capable of quitting smoking without switching to ENDS/HTPs. Governments should be promoting tobacco cessation and relapse prevention to help smokers achieve long-term abstinence and freedom from nicotine addiction.

Q14: Why are some countries banning e-cigarettes but not cigarettes?

A: While there is still no long term evidence of the safety or relative risk of e-cigarette use, health research has already confirmed the serious addiction and health risks of e-cigarettes. Banning these products based on the precautionary principle is warranted to protect the health of people. Governments should learn from the regulatory mistakes of the tobacco pandemic, which was allowed to proliferate and currently is addicting over a billion people worldwide. Banning e-cigarettes is the strictest form of regulation and is recommended in cases where regulatory capacity or enforcement is relatively weak. Governments should prioritize and accelerate tobacco control measures in line with the WHO FCTC to fast track the tobacco endgame and eventually ban the sale of traditional cigarettes.

Q15: Why are flavors in e-cigarettes being targeted for regulations?

A: Flavored products, particularly sweet and fruity ones, such as bubble gum, cotton candy, gummy bear, and cola, are clearly attractive to youths Most youths who smoke e-cigarettes use a flavored product.[xxv]  Flavorings also make e-cigarettes more harmful.[xxix]

Q16: How have e-cigarettes been marketed to children and young people?

A: Youths are exposed to e-cigarette product marketing through a range of channels, including social media/social influencers, product displays in stores, and ads outside of stores.[xxvi] Very similar to cigarette ads that are now banned in many countries, e-cigarette ads are associated with youth, fun, success, and sensuality.[xxvii]

Q17: What’s Big Tobacco’s role in e-cigarettes?

A: All major tobacco companies, such as Philip Morris International (PMI), Altria/Philip Morris USA, British American Tobacco (BAT), Japan Tobacco International, (JTI), Imperial Brands, and RJ Reynolds produce their own brands of ENDS and HTPs.[xxviii]

CompanyENDS brandsHTP brands
Philip Morris International (PMI)Nicocig, Vivid, IQOS MESHIQOS, TEEPS
Altria/Philip Morris USAMark Ten,* Green Smoke,* owns 35% of JuulSells PMI’s IQOS in USA
British American Tobacco (BAT)Vype, Chic, VIP, Ten Motivesglo, glo iFuse
Japan Tobacco International (JTI)Logic, PloomPloom Tech, Ploom Tech+, Ploom S
Imperial BrandsbluPulze
RJ Reynolds (owned by BAT)VuseRevo,* Eclipse*

*discontinued

Vaping is harmful, not safer

In the ASEAN region, Brunei Darussalam, Cambodia, Lao PDR, Singapore and Thailand have banned electronic smoking devices, while Malaysia, Philippines and Vietnam and currently considering legislation.

Globally about 40 countries have banned electronic smoking devices (ESD). Most recently, the Hong Kong legislature banned the sale of ESD.

Governments need to take a precautionary approach and protect youth from harmful substances. It has been challenging for regulators to stop the promotion of e-cigarettes on social media and their sales online.

University of Curtin research: Vape products contain harmful chemicals

New Australian research on vape products has found a ‘suite of chemicals’ in liquids used in them, some at ‘dangerously high’ levels. The research found many of the vape brands tested contained carcinogenic, pesticides, cleaning agents and other potentially dangerous chemicals. Trace elements of nicotine were also found in products that claimed to be nicotine-free.

Curtin University respiratory physiologist Dr Alexander Larcombe studied 65 common liquids used in vapes from local suppliers in Australia. Main findings are as follows.

Pesticides, hospital cleaning agents and carcinogens

The researchers detected a chemical called 2-chlorophenol in about 30 samples, which is commonly used in disinfectants and pesticides. The researchers suspected it was residue from pesticides sprayed on the crops used to generate glycerol, one of the main ingredients in the liquids.

Researchers found chemicals called polycyclic aromatic hydrocarbons (PAHs) which has been linked to lung, bladder and gastrointestinal cancers.

These vape products affect the lungs

Many of the chemicals found are known to have negative impacts on the lungs. The researchers found “dangerously high levels” of lung irritant, benzaldehyde, which is added to vapes to give them an almond flavour, in 61 of the 65 samples. This chemical impairs the lungs that are responsible for cleaning the pathogens. 

Johns Hopkins University research: Thousands of unknown chemicals and substances found in e-cigarettes

Researchers at Johns Hopkins University found thousands of unknown chemicals in the e-liquid and a number of compounds in the aerosol. They also detected hydrocarbon-like compounds, typically associated with combustion, which manufacturers claim does not happen during vaping.

The researchers found nearly 2,000 chemicals, the vast majority of which are unidentified. Of those the team could identify six substances were potentially harmful, including three chemicals never previously found in e-cigarettes.

The team found three industrial chemicals, a pesticide and two flavors linked with possible toxic effects and respiratory irritation.

For more information, please contact

Irene Reyes, Tobacco Industry Denormalization Program Manager, Email: irene@seatca.org

[i] Google Books. (2019). Public Health Consequences of E-Cigarettes. [online] Available at: https://bit.ly/2Xa0bvN.
[ii] U.S. Food and Drug Administration. (2019). Vaporizers, E-Cigarettes, and other ENDS. [online] Available at: https://bit.ly/2Qac3g4.
[iii] World Health Organization. (2019). Heated tobacco products (HTPs) information sheet. [online] Available at: https://bit.ly/2O2giY7.
[iv] World Health Organization. (2019). WHO Report on the Global Tobacco Epidemic, 2019. Geneva: World Health Organization
[v] Bursztynsky, J. (2019). Researchers find e-cigarettes cause lung cancer in mice in first study tying vaping to cancer. [online] CNBC. Available at: https://cnb.cx/2QaQZ9g.
[vi] Becker, R. (2019). Why Big Tobacco and Big Vape love comparing nicotine to caffeine. [online] Available at: https://bit.ly/2X4jPcC.
[vii] Mishra A, Chaturvedi P, Datta S, et al. (2015). Harmful effects of nicotine. Indian Journal of Medical and Paediatric Oncology. DOI: 10.4103/0971-5851.151771
[viii] Goriounova, N. A., & Mansvelder, H. D. (2012). Short- and long-term consequences of nicotine exposure during adolescence for prefrontal cortex neuronal network function. Cold Spring Harbor perspectives in medicine2(12), a012120. DOI:10.1101/cshperspect.a012120
[ix] Yuan, M., Cross, S. J., Loughlin, S. E., & Leslie, F. M. (2015). Nicotine and the adolescent brain. The Journal of physiology593(16), 3397–3412. DOI:10.1113/JP270492
[x] World Health Organization. (2014). Electronic nicotine delivery systems: Report by WHO [online] Available at: https://bit.ly/2K9HPFR.
[xi] National Academies of Sciences, Engineering, and Medicine. (2018). Public health consequences of e-cigarettes. Washington, DC: The National Academies Press. DOI: https://doi.org/10.17226/24952.
[xii] Hess IMR, Lachireddy K, & Capon A. (2016). A systematic review of the health risks from passive exposure to electronic cigarette vapour. Public Health Res Pract 26(2):e2621617. DOI: http://dx.doi.org/10.17061/phrp2621617
[xiii] National Academies of Sciences, Engineering, and Medicine. (2018). Public health consequences of e-cigarettes. Washington, DC: The National Academies Press. DOI: https://doi.org/10.17226/24952.
[xiv] Rapaport, L. (2019). Vaping may aid smoking cessation but also boost relapse risk. [online] U.S. Available at: https://reut.rs/2NEeiGQ.
[xv] Juul Labs. (2019). Juul Marketing & Social Media Code. https://www.juul.com/ourresponsibility# marketing-code.
[xvi] Siegel, D.A, et al. (2019). Update: Interim Guidance for Health Care Providers Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use Associated Lung Injury — United States, October 2019.
[xvii] Sally Robertson, B. (2019). Vaping linked to over 200 health problems, but still safer than smoking. [online] News-Medical.net. Available at: https://bit.ly/34NNWYk [Accessed 11 Nov. 2019].
[xviii] Snaith, E. (2019). What are the dangers of vaping?. [online] The Independent. Available at: https://bit.ly/2O3K8LV.
[xix] Ridzaimi, S. (2019). M’sian Shares How Vaping Caused Tonsil & Tumour Growth, Had to Spend RM20k for Surgery – Southeast Asia Tobacco Control Alliance. [online] Seatca.org. Available at: https://bit.ly/2O6hnyj.
[xx] France-Presse, A. (2019). First Vaping Hospitalization Reported in Canada. [online] Voice of America. Available at: https://bit.ly/2CDITO4.
[xxi] Centers for Disease Control and Prevention. (2019). [online] Available at: https://bit.ly/32GHrFo.
[xxii] David G. Allan, C. (2019). How to convince, scare or bribe your kids not to vape. [online] CNN. Available at: https://cnn.it/2qL0rFk.
[xxiii] US Surgeon General. (2019) Know the Risks: E-cigarettes & Young people. Available at: https://bit.ly/33Iymxa.
[xxiv] Nytimes.com. (2019). E-Cigarettes Went Unchecked in 10 Years of Federal Inaction. [online] Available at: https://nyti.ms/2O0VXCM.
[xxv] Rogers, L. and Health, J. (2019). Vaping Q&A: Johns Hopkins Expert on E-Cigarettes and Tobacco Alternatives. [online] Johns Hopkins Bloomberg School of Public Health. Available at: https://bit.ly/2O6hE4j.
[xxvi] Ibid.
[xxvii] Chaykowski, K. (2019). The Disturbing Focus Of Juul’s Early Marketing Campaigns. [online] Forbes.com. Available at: https://bit.ly/2CCsJVw.
[xxviii] Rogers, L. and Health, J. (2019). Vaping Q&A: Johns Hopkins Expert on E-Cigarettes and Tobacco Alternatives. [online] Johns Hopkins Bloomberg School of Public Health. Available at: https://bit.ly/2O6hE4j.Q
[xxviiii] Physicians for a Smoke-Free Canada (2022). Flavourings make e-cigarettes more harmful. Another good reason to ban them. [online]. Available at: https://smoke-free-canada.blogspot.com/2022/02/flavourings-make-e-cigarettes-more.html
[xxix] Physicians for a Smoke-Free Canada. (2022). Flavourings make e-cigarettes more harmful. Another good reason to ban them. [online]. Available at: https://smoke-free-canada.blogspot.com/2022/02/flavourings-make-e-cigarettes-more.html