May 31 each year marks World No Tobacco Day, and in 2024, the World Health Organization (WHO) released a report titled "Connecting the Next Generation," which warned against the risks of the spread of electronic cigarettes, or "vapes," among youth, particularly children, creating a new wave of addiction. According to the report, major tobacco companies have tailored their messages and products to target children in an effort to replace millions of customers who die each year due to their products.
Recent data shows that children use electronic cigarettes at higher rates than adults in many countries worldwide, with an estimated 37 million young people aged 13 to 15 using tobacco, according to the WHO. The report states that children are excellent targets for these companies because if they become addicted to nicotine before the age of 21, they are likely to remain addicted for life.
The WHO indicated that the industry targets children by selling fruit- and candy-flavored products and cartoonish designs, while companies deny explicitly targeting children. The report noted that in the period from 2018 to 2019, public health officials in the United States recognized a "public health crisis stemming from e-cigarette use."
What is "Vaping"?
Electronic cigarettes, or "vapes," are designed to resemble traditional cigarettes, but they use "freebase" nicotine. Freebase nicotine means that the nicotine is in its purest form compared to other nicotine derivatives. This form of nicotine becomes more effective when heated and is absorbed more quickly into the lungs and brain. Freebase nicotine has been around since the 1960s when tobacco companies realized that by adding ammonia to nicotine, they could strip the nicotine of its protons to make it more intense when heated and inhaled. This type of nicotine is extracted directly from the tobacco plant, according to the organization.
Early versions of e-cigarettes typically contained between 3 to 12 milligrams of nicotine. In 2016, Juul introduced a device featuring a new method of nicotine delivery, namely nicotine salts that contain a lower pH solution, which essentially eliminates the throat hit associated with freebase nicotine, even at very high concentrations. These devices entered the U.S. market with a high addiction potential of 50 milligrams. In Europe, these electronic cigarettes cannot be sold with concentrations higher than 20 milligrams.
What are the Risks of "Vaping"?
When it comes to appealing to children, these electronic cigarettes are more dangerous than regular ones because they are easy to use and can be smoked anywhere, with fruity odors lingering in a room for only a few minutes. Unlike traditional cigarettes, which have a strong odor, e-cigarettes can be easily hidden from parents.
However, the long-term health effects of vaping are not precisely known. The WHO points out that in addition to investing millions of dollars in public health policy regarding vaping, tobacco companies are also trying to influence scientific research being conducted to measure the health effects of vaping devices.
The authors noted that in 2024, Philip Morris International funded a series of training courses on smoking cessation on Medscape, a U.S.-based medical news site, which portrayed "nicotine products as relatively harmless," and these courses were canceled following complaints.
Scientific communication regarding electronic cigarettes is confusing, including guidance on vaping during pregnancy or as a means to quit traditional cigarettes, and whether vaping causes cancers. According to the Cleveland Clinic, numerous studies have shown that nicotine negatively impacts brain development, increases cancer risk, and affects heart health. It has also been noted that nicotine use can impact reproductive health, cause decreased immune response, affect cell proliferation and tumors, and lead to resistance to chemotherapy agents.
