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E-cigarettes are devices that allow you to inhale nicotine in a vapor rather than smoke. Vaping is often pushed as a healthier alternative to smoking and used as a tool to get smokers to quit, which could have contributed to the state's high vaping rate. The findings come as damning research mounts on the harms of e-cigarettes, particularly in young people, including irreversible lung damage and even cancer. Smoking can lead to ongoing complications and long-term effects on your body systems.

This includes quit coaching, up to 2 weeks of nicotine replacement therapy, and a youth digital program for those ages 13-17. Vuse, owned by Reynolds American, and Juul control about 60% of the market, while hundreds of disposable brands account for the rest. While nicotine is the addictive substance in cigarettes, most of the harm from smoking comes from the thousands of other chemicals in tobacco smoke, many of which are toxic.

Besides nicotine, e-cigarettes and e-cigarette vapor typically contain propylene glycol and/or vegetable glycerin. These are substances used to produce stage or theatrical fog which have been found to increase lung and airway irritation after concentrated exposure. FDA’s award-winning public education campaign, "The Real Cost," continues to prevent youth from tobacco initiation and use.

Of the 544 young people who owned e-cigarette devices, 75.7% said that they considered recycling e-cigarettes. Respondents also reported keeping or selling the devices, or returning them to a vape shop. "We do not know what these chemicals do when they are heated and inhaled. These are questions that should be answered before we allow products on the market." One chemical, known as 6-methyl nicotine, has been shown in rodent experiments to be far more potent than nicotine in targeting the brain's nicotine receptors and more toxic than nicotine. Another, called nicotinamide, is marketed as targeting the same brain receptors as nicotine, despite evidence it does not bind to these receptors.

The study was supported by the National Institutes of Health, the American Heart Association, the Stanford Diabetes Research Center, the University of California Tobacco Related Disease Research Program and the FDA. We acknowledge the assistance of Belinda Zonnestein in sourcing and testing of the products. We further acknowledge My-Linh Tran and Joseph Sutton for their contribution to product development and provision of product details and to Sandra Costigan and Elaine Brown for the toxicological inputs. Death typically happens due to paralysis of the muscles that control your breathing, fluid buildup in your airways and heart and blood vessel failure (cardiovascular collapse).

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