A contestant produces an artistic plume during a competition at a vaping convention in Baltimore, MD. Photo by Angela Aherrera. Printed with permission.
A new trend in nicotine addiction is arising in the United States and across the globe. With the invention of electronic cigarette devices, former and even never smokers are now able to get a nicotine fix without the irritating effects and social stigma of cigarette smoke. However, the health implications of e-cigarettes and the impact of e-cigarette emissions are still unclear.
The accompanying image was taken in April 2016 at a vaping convention in Baltimore, Maryland. A notice outside the event stated the prohibition of cigarette and e-cigarette use inside the building. Yet, hundreds of people were vaping inside the convention center, creating a dense aerosol that disseminated throughout the indoor space, hindered visibility, and affected breathing.
Attendees were primarily young adults of all racial and ethnic backgrounds, and included some families with young children. Approximately 100 vendors promoted their newest flavors and handcrafted modified e-cigarette devices. Female models gave away free samples while sporting the names of famous vaping brands. To receive more free merchandise, “cloud competitions” were held to discover who could generate the largest, densest, or most artistic plume.
There are currently more than 30 annual vaping conventions held in the United States.1 Vape clubs hold both national and local conventions with thousands of attendees at each event. Of concern to public health professionals is who is joining this emerging culture, because it is not only former cigarette smokers. With flavors such as “Captain Crunch Berries” and “Cookies and Cream,” it may be no surprise that e-cigarette use is increasing most rapidly among middle school– and high school–aged youths.2,3 Research has shown an alarming rate of e-cigarette uptake among adolescents, with estimates of use tripling in just one year.4 Rather than promoting these devices as a tobacco cessation method, this culture may be encouraging nicotine addiction among youths. As both devices and liquid (many containing nicotine) are available for purchase online, there is no way to verify the age of the consumer.
The present situation of e-cigarette safety and regulation distinctly resembles the efforts to regulate tobacco cigarettes in the 1960s, when cigarette marketing was widespread and research on the health effects of smoking was scarce and contested. To inform policy and public health action, research is urgently needed to characterize e-cigarette aerosols and to assess the health implications of e-cigarette use and secondhand exposures to e-cigarette emissions.
ACKNOWLEDGMENTS
The research related to this article is funded by the State of Maryland Department of Health and Mental Hygiene (Cigarette Restitution Fund Program; grant PHPA-G2034). A. Aherrera is funded by the American Heart Association Tobacco Regulation and Addiction Center (grant 1P50HL120163). P. Olmedo is funded by the Alfonso Martín Escudero Foundation (postdoctoral fellowship 2014).
ENDNOTES
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