Vapor products, also known as e-cigarettes or vape pens, represent a market that has grown exponentially since they were first introduced in the mid-2000s. They are typically equipped with a battery, a heating device and a cartridge containing nicotine, flavorings, and solvents. The nicotine solution is heated to produce an aerosol that is inhaled or vaped. There are more than 400 different brands of e-cigarettes and more than 7,000 flavoring chemicals.

Video: The History and Harms of E-cigarettes and Vaping

Hot Topic: What we know about vaping and quitting tobacco cigarettes

Vaping companies have long promoted their products as aids to help people stop using tobacco cigarettes. Companies urge smokers to make the switch with catchy slogans and enticing imagery. But what do we really know about vaping and quitting cigarettes? Not enough. 

• At this time, the U.S. Food and Drug Administration (FDA) has not approved vaping as a method of cigarette cessation. There is not enough evidence on the effectiveness of vaping as a cessation aid compared to no treatment or to FDA-approved methods of cessation.
• Some research suggests that using nicotine-containing vaping devices is associated with greater likelihood of quitting tobacco compared to vapes that don’t contain nicotine. However, there is not enough evidence to prove that vaping is a safe and effective method of quitting tobacco cigarettes. 
• There is substantial evidence that vaping increases the risk of ever using tobacco cigarettes among youth and young adults.
• People who smoke should talk to their doctor about proven methods to quit. 

Youth Vaping

Washington’s 2021 Healthy Youth survey showed that vaping among youth has declined significantly in Snohomish County and across the state compared with the 2018 study. 

Even with these positive findings, youth vaping continues to be a public health concern. A CDC report released in October 2022 illustrates that while teen vaping fell during the COVD-19 pandemic, youth vaping has increased to near pre-pandemic levels with the reopening of schools. The report describes that in 2022, 2.55 million middle and high school students reported vaping. Among this group, 40% of older high school students reported vaping daily. 

Disposable vape devices have become the most popular option for youth. These products are sold at very low-price points ($10-$25) and are available in a wide variety of flavors.

Brain Development 

Nicotine is particularly addictive and harmful to developing brains. While effects may differ from person to person, using products that contain nicotine can impact attention span, impulse control, mood, and cognitive ability. For more information on and short-term health impact of vaping on youth, visit the CDC website.

Policy

Snohomish County 

The Smoking in Public Places Law was passed in 2005, making Washington the 10th state in the country to implement a law that prohibits smoking in all public places and places of employment. The Board of Health in Snohomish County amended the state’s Smoking in Public Places law (Chapter 70.160 RCW) to include marijuana, hookah, e-cigarettes, and vapes.

Washington State

In January 2020, the legal age for purchasing tobacco and vape products was raised from 18-21. It is now illegal (a gross misdemeanor) to sell or give tobacco or vapor products to anyone under the age of 21. More information on this effort can be found on the Washington Department of Health website.

Federal 

Effective February 2020, the FDA issued an enforcement policy prohibiting the sale of flavored, prefilled cartridges. The ban does not apply to tobacco-and menthol-flavored prefilled cartridges, e-liquids, or single-use disposable products. Excluding these products created loopholes for certain brands, like Puff Bar, which is still able to sell flavored, disposable vape devices that appeal to youth.

JUUL

In June of 2022, the FDA ordered JUUL Labs, a vaping company currently under investigation for marketing to youth, to stop selling its products. One day later, a federal court of appeals blocked the government ban. JUUL products are currently available. See below for more information on JUUL products and relevant news: 

• FDA Denies Authorization to Market JUUL Products
• Campaign for Tobacco-Free Kids: What are JUULs? 

Important Issues

COVID-19 and Vaping

Vaping can worsen the effects of COVID-19. Vape emissions can cause chronic inflammation of your airways. According to the American Lung Association, this can make it much harder for our lungs to fight COVID and increases the likelihood of more severe respiratory problems. More research is currently happening to explore a possible link between vaping and COVID-19 risk. 

Whether you have a positive COVID test or not, anyone who has breathing problems after vaping, (cough, shortness of breath, chest pain that worsens with deep breathing) should seek medical attention without delay. 

Menthol Flavoring

Menthol is a chemical compound that has been used since the 1920s to reduce the harshness of commercial tobacco products. It can be produced in a lab or found naturally in peppermint and similar plants. Menthol creates a cooling sensation in the throat and airways, allowing individuals to inhale smoke and vapor more deeply into the lungs. Additionally, menthol interacts with nicotine in the brain to enhance addictive effects. Menthol’s soothing effects and interaction with nicotine on the brain can make it easy to start using tobacco products and harder to quit.

Another health concern for those who vape menthol is a compound called pulegone that is found in certain mint plants. It is a known carcinogen - a substance that can cause cancer. While the FDA banned it as a food additive in 2018, recent studies have identified concerning levels of pulegone in menthol vaping liquids specifically in the U.S.

Using mentholated products is more common among youth, Black communities, and other racial and ethnic minority groups, as well as those who identify as LGBTQIA+. Research has attributed this to the tobacco industry’s long history of strategic marketing campaigns designed to create appeal and increased accessibility among these groups.  

Menthol-flavored vaping product sales have increased significantly since the FDA’s flavor ban was implemented in January 2020, which allowed menthol-flavored vaping products to remain on the market. Between February 2020 - July 2022, menthol-flavored e-cigarette sales increased by 39%. This includes a 43% increase in menthol-flavored cartridge sales. According to a recent study, many people switched to menthol as other flavors have become harder to come by. 

For more information, visit the following resources: 

• Truth Initiative: Facts, stats, and regulations
• Menthol e-cigarette sales rise following 2020 FDA guidance
• CDC