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In fact, the overall evidence points to e-cigarettes actually helping people to give up smoking tobacco. There is no evidence that e-cigarettes are undermining England’s falling smoking rates. Instead the evidence consistently finds that e-cigarettes are another tool for stopping smoking and in my view smokers should try vaping and vapers should stop smoking entirely. E-cigarettes not only pose substantial health risks to youth and young adults, they pose a significant environmental threat (see the Truth Initiative fact sheet on Tobacco and the Environment). Almost half (49.1%) of young people don’t know what to do with used e-cigarette pods and disposable devices. A second brand of e-cigarettes—marketed as Nixotine, Nixodine, Nixamide and Nic-Safe—contained a nicotine analog called nicotinamide, also at levels lower than the labels indicated, and combined with undisclosed amounts of 6-methyl nicotine.

This was a large increase from 2019, when only 11.3% of people had ever used e‑cigarettes, and 2.5% were currently using them (Figure 1). The proportion of people who used e‑cigarettes daily in 2022–‍2023 was 3.5%, rising from 1.1% in 2019. In smokers who smoke tobacco cigarettes, blood flow increased modestly after cigarette inhalation and then decreased with subsequent stress. However, with those who vaped, blood flow decreased after inhalation at rest and also after handgrip stress. Finally, lung health effects are not expected to be seen for 20 to 30 years.

It can damage your heart, arteries, and lungs, increasing the risk for heart attack, stroke, and chronic lung disease. E-cigarettes recently surpassed conventional cigarettes as the most commonly used tobacco product among youth.1 It is critical that public health officials and the general public understand the potential risks of using them. The FDA recently approved its first menthol-flavored electronic cigarettes for adult smokers. In contrast to the clear evidence that flavored products fueled the youth e-cigarette epidemic, every major U.S. public health authority – including the U.S. Preventive Services Task Force, the CDC and even the FDA itself – has found there is inadequate evidence to conclude that e-cigarettes are effective at helping smokers quit. E-cigarettes are battery-operated devices used for a type of smoking called vaping.

Since This is Quitting launched as a text message program in 2019, more than 750,000 young people have enrolled from across the U.S. Grounded in clinical guidelines for treating tobacco dependence, This is Quitting incorporates powerful messages from other young e-cigarette users who have offered their advice about how to quit. Teens and young adults can text DITCHVAPE to to receive free quit vaping support from the program. This study is the first published randomized clinical trial of a quit vaping program among teens, filling an important gap in the scientific literature and providing much needed evidence for pediatricians, school administrators, and public health agencies. Although stopping smoking can cause short-term side effects such as reversible weight gain, smoking cessation services and activities are cost-effective because of the positive health benefits. Further, educational aspirations and school engagement are tied to student composition and school-based networks and norms, which have had different associations with smoking between schools [28].

It would seem that future studies should analyse the possible toxic effects of humectants and related products at concentrations similar to those that e-cigarette vapers are exposed to reach conclusive results. Vape aerosols are not just harmless water vapors that are inhaled and exhaled (as marketed). Vape aerosol exposure is unsafe and contains chemicals, metals (i.e., lead, nickel), and other particles that can interfere with lung development and health.

The flavored vape juice inside contains only vegetable glycerine and organic fruit extracts. That means it's free from all the harmful chemicals we mentioned above. It's a stripped-down, vegan-friendly, nicotine-free vaping experience. When I smoked cigarettes, I dealt with inconveniences due to my addiction. I would be forced to leave the company of my friends and family to go stand outdoors, like an outcast or lesser human, so that I could prevent myself from having a withdrawal meltdown.

If you are not sure whether disposables are for you, these kits would be a great place to start. The leading disposable vape kits are Elf Bars, Lost Mary and Crystal Bar. Both come in a wide range of tastes to suit anyone looking to switch from smoking but also work well as a cheap back up kit for existing vapers. The Perelman School of Medicine is consistently among the nation's top recipients of funding from the National Institutes of Health, with $550 million awarded in the 2022 fiscal year. Data from the 2019 Minnesota Student Survey shows a steep rise in e-cigarette use among students. This study was supported by funding from the National Institute on Drug Abuse of the NIH and the FDA Center for Tobacco Products.

Please be advised that many of these stories contain graphic and upsetting photos of injuries. Exposure to nicotine can also rewire a young brain to become more easily addicted to other substances, including cocaine and alcohol. Even if a cartridge doesn’t contain nicotine, other harmful chemicals may be present.

One of the first studies in humans involved the analysis of 9 volunteers that consumed e-cigarettes, with or without nicotine, in a ventilated room for 2 h [8]. Pollutants in indoor air, exhaled nitric oxide (NO) and urinary metabolite profiles were analysed. The results of this acute experiment revealed that e-cigarettes are not emission-free, and ultrafine particles formed from propylene glycol (PG) could be detected in the lungs. In line with these observations, dysregulation of lung homeostasis has been documented in non-smokers subjected to acute inhalation of e-cigarette aerosols [10]. Globally, there is an ongoing debate about whether e-cigarettes are a threat or an opportunity to public health.

E-cigarette use has remained relatively low and stable among adult users since around 2012, although use has gone up slightly among adults recently, from 4.5% in 2021 to 6% in 2022. In 2022, the greatest e-cigarette use among adults was among 23- to 24-year-olds, 22.8% of whom were current users, according to Monitoring the Future. Get the latest facts and analyses on the most important issues related to smoking, vaping, nicotine and substance use. Also, we've published an article on where to buy nicotine free vapes, to help you make a more informed decision. We have yet to encounter an e-liquid company as committed to transparency as VaporFi. Their products are made in the U.S.A., in FDA-registered labs, and all of their various test results and certifications are available for customers to view.

In general, e-cigarettes are not safe for young people or people who are pregnant. Vaping is no safer for developing fetuses than smoking traditional cigarettes. They may also resemble sleek electronic devices, making them appealing to younger users.

Susceptibility to smoking or non-combustible nicotine use is also influenced by national tobacco control policies. In Europe, Finland has been among the countries with most advanced tobacco control regulations [31]. Still, there is a large difference in smoking and snus use between students in academically and non-academically oriented education [7]. For snus, Finland follows the EU-wide sales ban but cross-border traveller imports from Sweden are permitted and an illicit market exists [32]. For e-cigarettes, comprehensive regulations were introduced in 2016 including retail sale licensing and ban for distance sales, display and advertising at point-of-sale, other flavours than tobacco and use of e-cigarettes in smoke-free places [33].

Because there is no safe tobacco product, quitting use of all tobacco products is the best way to protect your health. Most e-cigarettes contain nicotine, which is highly addictive and can harm adolescent brain development, which continues into the early to mid-20s. E-cigarettes can contain other harmful substances, including cancer-causing chemicals; chemicals linked to serious lung disease; and heavy metals, such as nickel, tin, and lead. Young people who use e-cigarettes may be more likely to smoke traditional cigarettes in the future. Vapor products produce aerosol by heating a liquid solution, which is inhaled as an aerosol. The process is referred to as "vaping." Vapor products often contain nicotine.

This solution typically contains propylene glycol or glycerol, nicotine, and flavouring agents. Indeed, the "vapor" may have a lot more than those five ingredients listed above. Some studies have found it to contain lead, nickel, tin, and silver from the machinery inside the devices along with formaldehyde, manganese, tolulene, and other ingredients linked to cancer, central nervous system problems, and other possible health issues. A 2018 study of e-cig smokers’ urine found at least five of the same carcinogens found in cigarettes.

However, the state's largely rural landscape and small population could be partly to blame for its high youth vaping rate. About 80 percent of Wyoming's residents live in rural areas, as much of the land area is used for farming and national parks. Researchers combed through state-by-state data from the Campaign for Tobacco-Free Kids, an advocacy group aimed at stopping youth smoking. Since 2020, emergency department visits in Virginia by patients who said they vape jumped significantly, while visits by those who use traditional tobacco declined, according to stats from Virginia Hospital & Healthcare Association.

E-cigarettes first entered the market in 2007 and have evolved many times since then, with older versions designed to resemble regular cigarettes, cigars, pipes, and pens. E-cigarettes next evolved into "pod mods" with e-liquid sold in disposable pods. In 2015, the emergence of the brand JUUL took pod mods to the next level with high tech design, high-nicotine delivery, and youth- appealing marketing that hooked a new generation to nicotine. Without regulations, it is the "Wild West" for e-cigarette companies, says Stanton Glantz, director of the Center for Tobacco Control Research and Education at the University of California, San Francisco, and a self-described e-cigarette pessimist. He argues that given the paucity of health data, current indoor smoking bans should apply to e-cigs as well.

Children and adults can develop nicotine poisoning from swallowing, breathing, or absorbing e-liquid through their skin or eyes. E-cigarette use can also result in serious injury due to defective batteries that have caused fires and explosions. Vaping and smoking both involve inhaling nicotine and other substances into the lungs. While cigarettes burn tobacco that produces smoke, e-cigarettes heat liquid to make an aerosol that often contains nicotine, various chemicals, heavy metals (nickel, tin, and lead) and small particles that can be inhaled deeply into the lungs.

That’s about twice as many people as those who used other methods to quit smoking. Of people who used other methods, 91% kicked nicotine products altogether. People usually think vaping isn’t as bad as cigarette smoking, but the mist you breathe in still has nicotine and other harmful chemicals in it. Vaping isn’t safe and can cause health problems, including life-threatening lung injuries.

Federal, state, and/or local governments need to set clear standards on environmentally responsible e-cigarette waste disposal and hold the industry accountable for adhering to them. E-cigarette manufacturers introduced a new tobacco product that soared in popularity with little thought on how to responsibly dispose of the resulting tons of e-cigarette waste. The group then performed a statistical analysis to determine group differences in vascular function before and after vaping.

The FDA does not currently require testing of all the substances in e-cigarettes to ensure they are safe. It's also hard to know exactly what chemicals are in an e-cigarette because most products do not list all of the harmful or potentially harmful substances contained in them. E-cigarettes do not contain tobacco, but many of them contain nicotine, which comes from tobacco. Because of this, the Food and Drug Administration (FDA) classifies them as "tobacco products." For adults who smoke, switching completely from cigarettes to e-cigarettes may reduce exposure to many harmful chemicals present in cigarettes. However, it is important that they switch completely from cigarettes to e-cigarettes to get the full health benefit.

The survey also found that Minnesota youth are ill-informed about the health risks of e-cigarettes with 76.1% of 11th graders saying there is either no, slight, or a moderate risk to using e-cigarettes. 11th grade students responding to the student survey said that the top ways they got e-cigarettes included getting products from friends (72.3%), getting products at a vape shop (14.0%), and on the Internet (9.6%). Among 8th grade students, e-cigarette use nearly doubled from 2016 to 2019, and one in four 11th graders now use e-cigarettes. Students in all grades surveyed now use e-cigarettes and vapes at five times the rate of conventional cigarettes. In Australia, during the survey period, it was not legal to obtain e‑cigarettes containing nicotine without a prescription (TGA 2020).

Results of toxicological analyses suggest that e-cigarettes can be safer than conventional cigarettes, although harmful effects from short-term e-cigarette use have been described. Worryingly, the potential long-term effects of e-cigarette consumption have been scarcely investigated. In this review, we take stock of the main findings in this field and their consequences for human health including coronavirus disease 2019 (COVID-19). Heart failure is a condition affecting more than 6 million U.S. adults in which the heart becomes too stiff or too weak to pump blood as effectively as it should.

The harms of e-cigarette use in young people include not only the deleterious effects of nicotine, but also exposure of the lungs and airways to potentially toxic solvents and flavoring chemicals. The rapidly rising rates of use in young people and the high rates of daily use strongly suggest that many are addicted to nicotine and will have difficulty in stopping use of all tobacco products. One study found that people who use only e-cigarettes increase their risk of developing lung disease by about 30% compared with nonusers. Electronic cigarettes (e-cigarettes) and other vapor products are devices used to heat and aerosolize (turn into particles) highly addictive nicotine or other substances that a person can inhale into their lungs.

We would argue that further studies with chronic administration of low doses of nicotine are required to clearly evaluate its impact on carcinogenicity. In this line, a study compared the acute impact of CS vs. e-cigarette vaping with equivalent nicotine content in healthy smokers and non-smokers. Both increased markers of oxidative stress and decreased NO bioavailability, flow-mediated dilation, and vitamin E levels showing no significant differences between tobacco and e-cigarette exposure (reviewed in [20]). Inasmuch, short-term e-cigarette use in healthy smokers resulted in marked impairment of endothelial function and an increase in arterial stiffness (reviewed in [20]). Similar effects on endothelial dysfunction and arterial stiffness were found in animals when they were exposed to e-cigarette vapor either for several days or chronically (reviewed in [20]).

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In December 2019, Congress raised the minimum age to buy tobacco products, including e-cigarettes, from 18 to 21. Because of the popularity of certain flavored e-cigarette products among children, FDA stated in January 2020 that it would prioritize enforcement actions against the manufacture and sale of most flavors in cartridge-based e-cigarettes. In April 2020, FDA extended from May to September 2020 the deadline for manufacturers to apply for premarket authorization, a process that includes the scientific evaluation of risks and benefits of e-cigarettes for the U.S. population. NCI supports research to understand the potential impact of ENDS use on both individual and population health, as it relates to cancer control and prevention.

Research on health effects of secondhand exposure to e-cigarettes is still emerging. The quantity of these carcinogens is less that what is found in conventional cigarettes. While some young people may be able to quit e-cigarette use on their own, others, particularly daily users, are likely to find this to be very difficult.

Most have a battery, heating element, and place to hold a liquid, usually containing highly addictive nicotine, that is added or included in the device. The heating element aerosolizes the liquid for the inhalation of the liquid nicotine or other substance. E-cigarettes are called many different names, including "vapes," "e-cigs," "vapor products," and "electronic nicotine delivery systems (ENDS)." The chemicals in electronic cigarettes, commonly called vapes, can severely damage the lungs, according to studies reviewed by the American Lung Association. The nicotine in them, which can be in higher quantities than traditional cigarettes, can also impact a child’s brain development. Several peer-reviewed studies found that nicotine negatively affects teens’ memory and attention and can increase their risk of developing other mental and behavioral problems later in life.

We also have leading brands of e-liquid from some of the biggest manufacturers in the UK. So, if you feel like trying more than one, make sure you check out our multi-buy deals. Unlike cigarette butts, e-cigarette waste won’t biodegrade even under severe conditions. E-cigarettes left on the street eventually break down into microplastics and chemicals that flow into the storm drains to pollute our waterways and wildlife.

However, within the adult demographic, 12.7 percent of 18- to 24-year-old adults and 21.3 percent of males, ages 18-24, are "current users" of e-cigarettes. The e-cigarette device (Vype ePod1.0, Nicoventures Trading Ltd., Blackburn, UK) consists of a metallic outer device case, a printed circuit board to control the device, a lithium-ion rechargeable battery (350 mAh) and an e-cigarette cartridge (Fig. 1). The voltage ranges from 2.2 to 3.1 V and is not adjustable by the user. The device has dimensions (h × w × d) of 104.2 × 19.1 × 10.5 mm and a power output of 6.5 ± 0.5 W. The cartridges or pods consist of a plastic case holding the ceramic wick material and a flat metal heating element (NiCr, 0.8 –1.4-Ω resistance). Each pod is pre-filled with Vype e-liquid (1.9 mL) and is magnetically attached to the device.

They then compiled these rates into one score to determine the 'healthiest' and 'unhealthiest' states for kids. Overall, recent figures from JAMA suggest more than 2million kids under 18 vape regularly, along with 17million adults. Combined with smoking, it may accelerate these effects, leading to osteoporosis. Nicotine causes blood vessels to tighten, which restricts the flow of blood. Smoking also raises blood pressure, weakens blood vessel walls, and increases your risk of blood clots. It can also damage the DNA in sperm, making it difficult to conceive and increasing the risk of miscarriage and certain birth defects.

Cessation strategies should be based on the best available evidence of efficacy, to go with other tobacco control measures and subject to monitoring and evaluation. Based on the current evidence, it is not recommended that governments permit sale of e-cigarettes as consumer products in pursuit of a cessation objective. While they may help some people stop smoking, vaping products do not have FDA approval as a tool for quitting. E-cigarettes may even keep people from trying proven methods of quitting smoking.

In the multivariate model (Table 3), results were similar for both girls and boys. S-EC remained higher for those planning for vocational education, and lower with liking school. Further, S-EC was higher with parental smoking, positive attitudes towards e-cigarette use in one’s age group, current smoking, and current snus use. Between-school differences were larger for girls (MOR 1.23) than boys (MOR 1.16). Educational aspirations were measured with ‘Where do you primarily want to go to study after comprehensive school?

E-cigarettes are popular among teens and young adults, according to the Centers for Disease Control and Prevention (CDC). In 2019, nearly 28 percent of high-school students and 11 percent of middle-school students reported using e-cigarettes. About 8 percent of young adults ages 18 to 24 reported using e-cigarettes in 2018. In 2019, nearly 28% of high-school students and 11% of middle-school students reported using e-cigarettes. E-cigarettes are battery-powered devices that generate an inhalable aerosol that usually contains nicotine. Minnesota teens are using e-cigarettes and vapes at alarming rates, exposing themselves to the harms of nicotine and risking addiction.

In general, most of the cytokines detected in BALF were significantly increased in WT mice exposed to PG with nicotine compared to PG alone or air control [42]. Some of these effects were found to be through nicotine activation of NF-κB signalling albeit in females but not in males. In addition, PG with nicotine caused increased macrophage and CD4+/CD8+ T-lymphocytes cell counts in BALF compared to air control, but these effects were ameliorated when animals were sub-chronically exposed to PG alone [42]. Researchers know more about the long-term effects of smoking than those of vaping. However, vaping products contain a great deal fewer harmful chemicals than cigarettes and can be an effective tool in quitting smoking altogether.

Bianco recalled an instance where her son was even subject to content in which a fishing YouTuber he watched was sponsored by a spitless tobacco brand. He notes that the most effective methods involve some sort of pharmaceutical, either nicotine replacement patches or pills, combined with a program that helps you deal with the problems of quitting smoking. (The American Lung Association recommends Freedom From Smoking.) Even then the average quit rate is just 25 percent, so even the best methods only have a one in four chance of succeeding. While saturated fat and alcohol still have their supporters, nobody is rushing to cigarettes’ defense. The new study included more than 1,500 adolescents in the United States, ages 13 to 17, who reported vaping in the previous 30 days, with many of them — about 76% — reporting that they vape within 30 minutes of waking up, a signal of nicotine dependence. Moreover, people who both vaped and smoked were four times more likely to go on to develop lung cancer compared to people who had only smoked, Bittoni's group found.

Consequently, stricter regulation and a higher quality control in the e-liquid industry are required. The mislabelling of nicotine content in e-liquids has been previously addressed [8, 34]. Of note, several studies have detected nicotine in those e-liquids labelled as nicotine-free [5, 35, 36]. Among the 17 samples tested in this latter study 14 were identified to be counterfeit or suspected counterfeit. A third study detected nicotine in 7 of 10 nicotine-free refills, although the concentrations were lower than those identified in the previous analyses (0.1–15 µg/mL) [5].

Starting to use e-cigarettes or switching from tobacco products to e-cigarettes increases your risk of adverse health effects. Interestingly, there is a strong difference of opinion on e-cigarettes between countries. Whereas countries such as Brazil, Uruguay and India have banned the sale of e-cigarettes, others such as the United Kingdom support this device to quit smoking.

Researchers noted that they were unable to assess any association between e-cigarette nicotine formulation and cigarette cessation outcomes. Another potential limitation was that the study only included adult participants who reported smoking within the previous 30 days, limiting information about younger smokers and former smokers. In that same vein, 5.9 million people began vaping, bringing the total use of tobacco products among those 12 and older to 64.4 million.

See your general practitioner, youth health service, or other health services to help quit vaping. All e-cigarettes & e-liquids (with and without nicotine) and e-cigarette accessories can now only be supplied by a pharmacist, medical practitioner, or nurse practitioner. If at any point you feel at risk of going back to smoking, increase your nicotine strength or vaping frequency until the feelings go away. Only reduce your vaping frequency or nicotine strength when you feel you will not go back to smoking and do not have to puff more to compensate. Your local Stop Smoking Service can give more advice on quitting vaping if you need it. So far, no vaping products have been licensed as stop smoking medicines in the UK, so they are not available on prescription from the NHS or from a GP.

A 2016 study found that people who use or have used e-cigarettes are less likely to stop smoking altogether. Flavors vary widely, from "traditional" and menthol to watermelon and "lava flow." Some e-cigarettes taste like traditional cigarettes and even mimic the tastes of specific brands. When the user sucks on the mouthpiece, the heating element vaporizes the solution, which the person then "vapes," or inhales. The nicotine content of the liquid can range from "very high" to zero. Refills come in flavors such as cool cucumber, mango, and mint, which may seem natural and harmless, but a single JUUL refill contains as much nicotine as a pack of 20 cigarettes. To inform this work and evaluate the effectiveness of policy, the CDC Foundation is collecting and analyzing information about e-cigarette sales, teen e-cigarette use, and teens’ attitudes about the epidemic.

The liquid and vapour contain some potentially harmful chemicals also found in cigarette smoke, but at a much lower level. Find out more about e-cigarettes, e-liquids and vaping to quit smoking on the Better Health website. In many e-cigarettes, puffing activates the battery-powered heating device, which vaporizes the liquid in the cartridge. The person then inhales the resulting aerosol or vapor (called vaping).

The ACS encourages young people currently using any of these products to ask for help in quitting and to quit as soon as possible. E-cigarettes can be especially harmful for young people because nicotine affects them in different ways than adults. People who use e-cigarettes should make sure they do not vape around children and ensure they always store e-cigarettes and e-liquids out of reach of children when not in use.

Based on the current literature, it seems that several factors have led to the success of e-cigarette use as a smoking cessation tool. First, some e-cigarette flavours positively affect smoking cessation outcomes among smokers [102]. Second, e-cigarettes have been described to improve smoking cessation rate only among highly-dependent smokers and not among conventional smokers, suggesting that the individual degree of nicotine dependence plays an important role in this process [97]. Third, the general belief of their relative harmfulness to consumers' health compared with conventional combustible tobacco [103]. And finally, the exposure to point-of-sale marketing of e-cigarette has also been identified to affect the smoking cessation success [96].

In December 2019, the legislation was included in the federal year-end legislative package and passed by both houses of Congress. President Trump signed the bill into law on December 20, 2019 and it immediately took effect. This legislation, which applies to all states, raises the minimum age of sale for all tobacco products— including e-cigarette—to 21. We provide the facts about smoking, vaping, nicotine, and the tobacco industry. We engage individuals and groups to make change in their communities, innovate ways to end nicotine addiction, and join forces with collaborators committed to preventing youth and young adult nicotine addiction and empowering quitting for all. That's hard to say — the potential health risks of vaping CBD are still hotly debated.

The Lung Association remains extremely troubled about the rapid increase of youth using these products and has repeatedly called upon the Food and Drug Administration (FDA) to increase their oversight and scrutiny of these products to protect kids. This is Quitting is a free and anonymous text messaging program from Truth Initiative designed to help young people quit vaping. The first-of-its-kind quit program has helped over 700,000 youth and young adults quit vaping by incorporating messages from other young people like them who have attempted to, or successfully quit, e-cigarettes. Truth Initiative is America's largest nonprofit public health organization committed to preventing youth and young adult nicotine addiction and empowering quitting for all.

A growing body of research indicates that truth campaigns to prevent young people from vaping are poised to move in the same direction as the organization’s successful smoking prevention campaigns. See " Quitting Tobacco " for more information on quitting tobacco products. Let's say you love the feel and flavor you get from puffing on a vape — but you can't quite bring yourself to trust that it's safe. It uses a puff of pressurized, flavored air to simulate the "throat hit" of a vape, with no heating element whatsoever.

As registered members of UKVIA, we prioritise industry standards, ensuring top-notch product quality and safety for the user. With over two million successfully shipped orders, we've built a reliable reputation. Count on The Electric Tobacconist for premium vape kits backed by a legacy of expertise and customer satisfaction. Or read a quitter's blog and post encouraging thoughts for someone else who might be dealing with tobacco cravings.

If you experience side effects from vaping, get advice from a stop smoking adviser or specialist vape retailer before you decide to stop using a vape as your quit smoking tool. Almost two-thirds of people who use a vape along with support from a local Stop Smoking Service successfully quit smoking. Vaping is not completely harmless and we only recommend it for adult smokers, to support quitting smoking and staying quit. It made sense – Altria, the bad actor formerly known as Philip Morris, maker of Marlboro cigarettes, owned a 35% stake in JUUL.

But they may also contain other compounds including artificial flavors, nicotine, THC, and cannabinoid (CBD) oil. E-cigarettes are known by many different names, including e-cigs, electronic nicotine delivery systems (ENDS), alternative nicotine delivery systems (ANDS), e-hookahs, mods, vape pens, vaporizers, vapes, and tank systems. We know nicotine and other ingredients in e-liquids can hurt your body and we still don’t know what long-term health problems vaping could cause. There are online resources, texting and phone services and apps that connect you with real people to help you on your journey to kick the habit. E-cigarettes, aka JUULs and vape pens, use a battery to heat up a special liquid into an aerosol that users inhale.

The 2023 National Youth Tobacco Survey, released in November by the US Centers for Disease Control and Prevention and the US Food and Drug Administration, found that about 2.1 million middle and high school students were e-cigarette users. Get more information on small cell lung cancer, non-small cell lung cancer, and the diagnosis of lung cancer stages. Also, "it is clear from the scientific literature that a variety of toxic compounds besides nicotine are present in aerosolized e-liquid," the researchers added. These chemicals have been linked to lung inflammation, chronic coughs, shortness of breath and lung disease.

To vape is to inhale vapor created from a liquid heated up inside a device. The devices have many names—vape pens, pod mods, tanks, electronic nicotine delivery devices (ENDS), e-hookahs and e-cigarettes. Most e-cigarettes contain nicotine and their repeated use can lead to nicotine addiction or increase the user's risk of addiction. Some e-cigarette brands contain nicotine salts to mask the harshness of nicotine and make it more palatable. As of 2018, all tobacco products must bear the required nicotine addictiveness warning statement on product packages and advertisements in order to warn consumers about the presence of and addictive nature of nicotine.

Their tactics include slick magazine ads, sponsorship of concerts and auto races, celebrity endorsements and sweet, colorful flavors.21 In addition, e-cigarettes are often aggressively placed in convenience stores near candy. Flavors, including mint and menthol, are one of the top reasons young people use e-cigarettes. Candy and fruit-flavored e-liquids can make e-cigarettes appealing and seem harmless. As of July 2020, the sale of flavored e-cigarettes is prohibited in NYC. Further, in 2018, one in 15 (6.7%) middle school students reported using e-cigarettes. E-cigarette use was higher among older students, with one in 11 (9%) seventh grade students reporting use, compared to one in 38 (2.6%) in sixth grade.

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. Smoking harms nearly every organ in the body ― heart and blood vessel disease; lung disease; cancer (almost anywhere in your body); and impacts to your bones, eyes, teeth, gums, fertility and pregnancy. Individual businesses can prohibit the use of vape devices indoors but this is not required by state law. More adults 18 to 24 years old used e-cigarettes (11.0%, or roughly 3.4 million people) compared with adults 25 to 44 (6.5%) or 45 and older (2.0%). The latest research, published in a July National Center for Health Statistics data brief, shows that in 2021, e-cigarette use was highest among adults 18 to 24 years old.

Manufacturers claim e-cigarettes are a safe alternative to smoking regular cigarettes. Cancer is definitely a concern, given that vaping introduces a host of chemicals into the lungs. But vaping products haven’t been around long enough for us to learn whether or not they cause cancer. In 2018, 3.6 million U.S. high school and middle school students smoked an e-cigarette within 30 days of polling, making it the most common tobacco product used among this group.

The FDA lists 93 harmful or potentially harmful chemicals found in regular cigarettes, and the National Cancer Institute (NCI) describes cigarettes as having more than 7,000 chemicals in them. Because e-cigarettes contain fewer chemicals the industry has presented them as a healthier alternative to regular cigarettes. But vape liquids can still contain nicotine, a highly addictive drug.

"From a public health perspective, we have always been concerned about dual-use of both traditional and e-cig products," said study lead author Marisa Bittoni, an oncology researcher at Ohio State University in Columbus. The U.S. Food and Drug Administration and the European Union are grappling with these issues as they decide how to regulate the products. Unfettered access could leave people vulnerable to unknown health hazards, but there is also the chance that greater restrictions might hurt folks who are trying to forgo conventional—and more dangerous—tobacco products.

According to the National Institute for Occupational Safety and Health, the lethal dose of inhaled nicotine is 50 to 60 mg/kg in a 70-kg adult (154 pounds). The UK government is working on the ongoing launch of a new and unprecedented incentive, encouraging smokers to switch to vap... The public consultation is now open to the public, and it's time to have your say. They can be seen in corner shops, supermarkets, and vape shops across the UK, peering out from behind the... Vaping has come a long way over the last few years, and the market is more diverse than ever.

In response to this issue, the PACT Act Amendment prohibits sellers from using the U.S. Post Office to ship e-cigarettes, vapes, flavored and smokeless tobacco products. The PACT Act applies to all shipments in interstate commerce (15 U.S.C. § 376) as well as to all delivery sales. Some people who smoke choose to use both cigarettes and e-cigarettes at the same time on an ongoing basis, whether they are trying to quit or not.

To our knowledge, no studies in Europe have examined susceptibility to e-cigarette (S-EC) use and snus use (S-SN). Glyoxal and methylglyoxal are formed by thermal degradation or oxidation of PG and VG87. Glyoxal is considered mutagenic, while the related compound methylglyoxal has been identified as a metabolite during glycolysis and is thus naturally present in the body. Methylglyoxal is also present in foods and drinks such as honey and coffee.

The researchers — from Truth Initiative and Brown University — found that after seven months had gone by, about 38% of participants in the This is Quitting program reported not vaping in the previous 30 days, compared with 28% in the assessment-only group. E-cigarettes are the most commonly used tobacco product among adolescents. (CNN) — For teens who want to stop vaping nicotine, an interactive text message program was found to be effective at helping them quit.

Some of the research for Tobacco Tactics was funded by Cancer Research UK Limited and Bloomberg Philanthropies. This work has previously received funding from The New Venture Fund, Smokefree South West, and the Economic and Social Research Council (ESRC) Knowledge Exchange Opportunities scheme. These funders have had no input into the research reported on this website or its conclusions. They are not responsible for its content or publication, nor do they necessarily endorse it.

The researchers said that the findings suggest that if tobacco cigarette smokers who use e-cigarettes for a healthier alternative to tobacco won’t benefit by the switch. Cannabis and CBD e-liquids usually contain other chemicals, such as base liquids or flavoring agents. They may cause side effects similar to those of nicotine-free e-cigarettes. Young people who vape nicotine are more likely to start smoking cigarettes in the future. The 2018 NAP report concluded there’s some evidence that nicotine and nicotine-free e-cigarettes can damage oral cells and tissues in people who don’t smoke cigarettes.

The Policy Scan Project, by the Institute for Global Tobacco Control (at Johns Hopkins University) tracks and reports regulatory approaches to e-cigarettes around the world. In 2012 and 2013 there was a flurry of tobacco company investment in e-cigarettes, both in the United Kingdom (UK) and in the United States (US), a trend which continued in subsequent years. In 2018, 8% of Pierce County 12th graders said they had smoked a cigarette in the past 30 days. NSW Health acknowledges the people of the many traditional countries and language groups of New South Wales.

E-cigarettes can be used to smoke or "vape" marijuana products, herbs, waxes and oils. In the US, e-cigarettes are the most commonly used tobacco product among middle- and high-school students. In 2023, 2.1 million students (10% of high-school students and 4.6% of middle-school students) reported current e-cigarette use.

The device heats a liquid into an aerosol (sometimes known as "vapour" and mistakenly called "water vapour"). Nicotine is a highly addictive substance found in tobacco products, including cigarettes, cigars, chewing tobacco, e-cigarettes, and pouches. Over 50% of middle school and high school students reported seeing e-cigarette advertising. Only 28% of young people in the U.S. believe e-cigarettes have the potential to cause a lot of harm. Up to 40% of teens who vape are unaware their e-cigarette cartridges contain nicotine. E-cigarettes can also be used to vape marijuana’s psychoactive ingredient, THC.

According to the manufacturer, a single JUUL pod contains as much nicotine as a pack of 20 regular cigarettes. Although JUUL is currently the top-selling e-cigarette in the U.S., other e-cigarettes are becoming available that look like USB flash drives. Because of their shape, school teachers, administrators, and parents may not notice students using these devices in school, including in classrooms and bathrooms. Adults who use tobacco and are trying to quit should use proven quit tools, like group or phone counseling, paired with medications or nicotine replacement therapy patches, gum or lozenges. The agency says the sweet flavored e-liquids pose a "serious, well-documented risk" of enticing more young people to pick up a nicotine habit. In 2020, nearly 20% of high school students and almost 5% of middle-school students used e-cigarettes, and almost all of those kids used flavored products, the agency said in court documents.

Youth and young adults who want to quit vaping are invited to text DITCHVAPE to to sign up for a totally free, anonymous texting service that provides 24/7 support, daily tips and motivation to keep you focused on your end goal. This service incorporates messages from young people who have attempted to quit, or successfully quit, e-cigarettes. Visit Truth Initiative to learn more about the This is Quitting campaign. According to a 2017 study, teens who use e-cigarettes are more likely to smoke regular tobacco products later on, compared with their peers. An electronic cigarette is a battery-operated device that emits a vaporized solution to inhale. These devices have various names, including e-cigarettes, e-hookahs, vaporizer cigarettes, vapes, and vape pens.They come in a range of shapes.

To date, no e-cigarette product has been approved by the FDA for smoking cessation. In contrast, nicotine replacement therapies (e.g., patch, gum, lozenge) and some prescription medications (i.e., varenicline, bupropion) have been evaluated by the FDA and found to be safe and effective at helping people quit smoking. Manufacturers and sellers of e-cigarettes aggressively target young people.

To be clear, I never even used to smoke during the day when I was using cigarettes. But if a project is particularly stressful (or just slightly vexatious, any excuse will do), my sleek little e-cig is just sitting in my bag at my feet. Like a never-ending pipe, you don’t know when you’ve had enough, when you’ve had a cigarette’s worth of nicotine. One quick puff to slay your stress can turn into one puff every few minutes, then whenever I get the slightest urge.

There's no evidence so far that vaping causes harm to other people around you. If you're pregnant, licensed NRT products such as patches and gum are the recommended option to help you stop smoking. Nicotine replacement therapy (NRT) has been widely used for many years to help people stop smoking and is a safe treatment. In the UK, e-cigarettes are tightly regulated for safety and quality.

This includes data on youth use of these products, which has led to development of several educational programs designed to prevent adolescents and teens from using these products. Through tobacco product problem reports and tobacco product violation reports, the FDA also knows much more about many safety and health hazards they may pose. The Surgeon General reports e-cigarette use among youth is a significant public health concern and steps must be taken by parents, educators and especially policymakers to discourage use of e-cigarettes.

However, more research is needed to fully understand emissions from e-cigarettes and their impact on human health electronic cigarette essential for smoking cessation. These aerosols can contain potentially harmful substances — including nicotine, formaldehyde and metals — some of which cause cancer and other harmful health effects. Some e-cigarette brands and other nicotine products state they contain synthetic nicotine rather than nicotine made from or derived from tobacco.

Moreover, we just don’t know the long-term effects of vaping," said Dr. Bhavna Barmi, a senior clinical psychologist. Vaping, still at epidemic levels among youth with about one in five high school students using e-cigarettes in 2020, generates a significant amount of toxic and plastic waste. Many popular e-cigarettes, like JUUL, are pod-based with single-use plastic cartridges containing nicotine. Generating even more waste are disposable e-cigarettes like Puff Bar, which are designed entirely for one-time use and have skyrocketed in popularity with a 1,000% increase in use among high school students between 2019 and 2020. Nicotine exposure during adolescence can affect learning, memory, and attention. It can also increase risk for future addiction to nicotine and other drugs.

Because of this and other studies, vitamin E acetate is considered the main cause of EVALI. Other chemicals found in nicotine- and THC-containing vaping products may also play a role in the condition. It is important to know that most e-cigarettes contain addictive nicotine. There is evidence that nicotine harms the brain development of teenagers. Again, it is important to know that most e-cigarettes contain nicotine.

Vape aerosols may also increase the risk of heart disease, lung cancer, and asthma complications. The substitution was especially evident among cigarette brands popular with young people aged 20 and under, suggesting that flavor restrictions may increase smoking among youth as well as adults. The immense popularity of electronic cigarettes, or e-cigarettes, among young people has led many policymakers to restrict the sale of flavored varieties. Proponents of e-cigarettes claim they’re safer than smoking because they don’t contain the more than 60 cancer-causing chemicals in tobacco smoke and are not combustible. But e-cigs still deliver harmful chemicals, including nicotine, the extremely addictive substance in cigarettes.

The review authors conclude that further research could help untangle how vapers’ bodies develop disease. These types of studies, they say, promise to identify early indicators of—and ultimately treatments for—vaping-related disease. While some tout e-cigarettes as a solution to quitting conventional smoking, the truth about relative risks is complicated, says Crotty Alexander, who is a researcher in addition to providing patient care and teaching.

It can also reduce fertility, increase the chance of developing type 2 diabetes, and contribute to bone loss. Even people who "smoke but don’t inhale" face an increased risk of mouth cancer. By Robyn Correll, MPHCorrell holds a master of public health degree and has over a decade of experience working in the prevention of infectious diseases. Researchers spent decades studying the health consequences of secondhand smoke. It might be a while before we have a clear picture of how secondhand vaping can impact a person’s long-term health, especially for young children.

Upon the selection of the educational track, students may already have normative perceptions of smoking in vocational schools, such as understanding of smoking as an integral and expected practice in these schools and professions [8]. These perceptions may increase S-SM and other nicotine product use, also among students with better academic performance. Student network characteristics and their associations with smoking vary between schools [28].

In 2019, four years after JUUL introduced a new nicotine delivery system coupled with a relentless online, youth-focused marketing campaign, more than a quarter (27.5%) of high school students reported using e-cigarettes. Short-term studies haven't found evidence that exposure to secondhand aerosol from e-cigarettes hurts lung function, with one notable exception. Researchers found that people who were around vaping aerosol showed increases in serum cotinine, which is a marker that someone was exposed to nicotine (an ingredient often found in e-cigarettes). Given the long list of health risks posed by nicotine, more research needs to be done on how this exposure could affect someone’s lungs long-term like it can with secondhand smoke. The significant reductions in smoking rates in the United States, United Kingdom, Australia, Brazil, and other countries that implemented strong tobacco control programs[according to whom?

To truly help tobacco users quit and to strengthen global tobacco control, governments need to scale up policies and interventions that we know work. Tried and tested interventions, such as brief advice from health professionals, national toll-free quit lines and mobile and digital cessation services are recommended. Where economically feasible, governments should also consider promoting nicotine replacement therapies and non-nicotine pharmacotherapies for cessation. E-cigarette emissions typically contain nicotine and other toxic substances that are harmful to both users and non-users who are exposed to the aerosols second-hand.

Be sure to meet all the following terms and conditions when buying or selling e-cigarettes, ENDS, or e-liquids on eBay. These terms and conditions may change over time and it is your responsibility to visit these pages to see if and how it may have changed, so that you can remain compliant. There is no data to show nicotine pouches as a safe or effective way to quit. University Health Center medical experts and Nebraska Medicine certified tobacco treatment specialist Jill Selzle, PA, do not recommend these products. Many providers ask their patients about alcohol, drug use and smoking, yet forget to ask about vaping. Project for Teens is an example of a local outreach program that provides support and education on the dangers of vaping.

Refillable pod mods use replaceable pods that contain either a built-in or removable coil. They are designed to be easier to use than vape pens as they adopt a secure magnetic connection between the pod and battery instead of a tank with a screw mechanism. They have few features and are compact, appealing to those new to the world of vaping and those wanting to upgrade to something simple. The term " vape pen" normally refers to a vape kit consisting of a refillable tank and a rechargeable battery; they are often slim and shaped like a pen, but not always!

If you’re having trouble quitting e-cigarettes on your own, get help from your doctor or from other support services, such as your state quitline (1-800-QUIT-NOW) or the American Cancer Society (1-800-ACS-2345). Electronic cigarettes (e-cigarettes) are sometimes called e-cigs, vapes, vape pens, and electronic nicotine delivery systems (ENDS). Get the facts about e-cigarettes, their health effects, and the risks of vaping.

However a recent study found that young people who are using ESDs to quit smoking might be smoking more, not less. Of great concern are the wide range of e-cigarette candy-flavors that appeal to youth. Urgent measures are necessary to prevent uptake of e-cigarettes and counter nicotine addiction alongside a comprehensive approach to tobacco control, and in light of national circumstances. E-cigarettes have been allowed on the open market and aggressively marketed to young people. Thirty-four countries ban the sale of e-cigarettes, 88 countries have no minimum age at which e-cigarettes can be bought and 74 countries have no regulations in place for these harmful products. E-cigarettes are nicotine-based products, and no nicotine use is safe.

E-cigarettes produce an aerosolized liquid (vapor) that usually contains nicotine and other chemicals inhaled by the user. Months after the release of that advisory, Yale researchers found that byproducts, called acetals, form when flavoring agents mix with solvents in the liquid. It is not yet known if this has negative effects on the body, but Sven-Eric Jordt, PhD, one of the study’s authors, says he hopes that the FDA will begin to study the short- and long-term effects of inhaled acetals. Under the PACT Act, delivery sales of electronic nicotine delivery systems must also comply with state, local or tribal laws involving excise taxes on these devices.

Death from nicotine poisoning is not common in adults because of their larger body size. However, using more than one type of nicotine-containing product at the same time can increase your risk. As the name suggests, cigalike kits are designed to look and feel like tobacco cigarettes. Cigarette-style vape kits are easy to use and, rather than being refillable, take prefilled flavour cartridges known as cartomizers or refills.

Although PG and glycerol are the major components of e-liquids other components have been detected. Of note, the analysis identified formaldehyde, acetaldehyde and acrolein [4], 3 carbonyl compounds with known high toxicity [63,64,65,66,67]. While no information was given regarding formaldehyde and acetaldehyde concentrations, the authors calculated that one puff could result in an acrolein exposure of 0.003–0.015 μg/mL [4]. However, given that e-cigarette units of vaping are not well established, users may puff intermittently throughout the whole day. Thus, assuming 400 to 500 puffs per cartridge, users could be exposed to up to 300 μg of acrolein.

Nearly five times as many high school students use e-cigarettes than smoke cigarettes. The particle matter (PM) that is emitted by e-cigarettes is also potentially dangerous to those who inhale it, just as passive smoking is harmful to those who share a contained space with regular smokers. Nicotine is a poison which is particularly dangerous if ingested (swallowed or inhaled) by young children which has led to poisoning and even death when swallowed by infants. It is also highly addictive and use by teenagers can have a long-term effect on the development of the brain, which continues until the age of 25 years.

That means you don't have to worry at all about the effects of hot vapor in your lungs. Part of the appeal of vaping is that it can help you quit smoking little by little instead of going cold turkey. These small disposables from Elf Bar make that easier by reducing the amount of nicotine per inhale. While many inhalers use e-liquid containing 5% nicotine salt, the ELFBAR 600 lets you choose between 2%, 1%, and 0%. It's a great way to gradually wean yourself off this addictive chemical. More and more people are vaping cannabidiol, or CBD, to feel the relaxing effects of cannabis without the intoxication.

Tobacco urges are likely to be strongest in the places where you smoked or chewed tobacco most often, such as at parties or bars, or at times when you were feeling stressed or sipping coffee. Find out your triggers and have a plan in place to avoid them or get through them without using tobacco. Queries sent to the health ministry’s tobacco cell remained unanswered till press time. From October this year it will be an offence to sell e-cigarettes to anyone under the age of 18 or to buy e-cigarettes for them. The government is consulting on a comprehensive array of regulations under the European Tobacco Products Directive.

Kids being stuck at home under their parents’ supervision during the COVID-19 pandemic could contribute to that trend. Although there is no federal excise tax on e-cigarettes, states have the authority to tax e-cigarettes. Thirty-two states, the District of Columbia, and two territories have imposed a tax on e-cigarettes as of June 15, 2023. Open-system vapes also often allow you to modify things like temperature and airflow. And since you're not going to be using them over the long run, there's very little chance that their internal components will suffer significant wear and tear. The company makes the test results available for anyone to view, so you can easily verify that the CBD All-In-One vape contains exactly what the label says.

Any product that does not submit an application by this deadline must be removed from the marketplace, which if properly enforced, could lead a significantly smaller marketplace. The main component of e-cigarettes is the e-liquid contained in cartridges or tanks. To create an e-liquid, nicotine is extracted from tobacco and mixed with a base (usually propylene glycol), and may also include flavorings, colorings and other chemicals (such as formaldehyde and acrolein, which can cause irreversible lung damage). The American Lung Association is very concerned that we are at risk of losing another generation to tobacco-caused diseases as the result of e-cigarettes.

"This is Our Watch" is a voluntary education program with resources to help tobacco retailers better understand and comply with FDA tobacco regulations. Tobacco retailers play a direct role in protecting kids from nicotine addiction and the deadly effects of tobacco use. Learn what tobacco retailers need to do to comply with the rules designed to prevent our nation's youth from becoming the next generation of Americans to die prematurely from tobacco-related disease.

Dual use, which is common, is at least as dangerous and likely more dangerous than smoking conventional cigarettes or using e-cigarettes alone. Further, not all ENDS are the same and the risks to health may differ from one product to another, and from user to user. E-cigarettes are still fairly new, and more research is needed over a longer period of time to know what the long-term effects may be.

Nicotine salts can be used in refill liquids and in cartridges for closed systems. In March 2019, the Secretariat of the WHO FCTC issued an Information Note which compiled all Conference of the Parties (COP) decisions related to e-cigarettes. Information on current e-cigarette regulation can also be found on relevant pages of government websites (see Relevant Links below). See this page for information on the situation in 2014, when there was little regulation in place.

If you purchase e-cigarettes and nicotine refill products, store them out of reach of your children and pets. With these products, it’s the liquid nicotine that can be dangerous, especially to children. According to the American Academy of Pediatrics, as little as one teaspoon of liquid nicotine can be fatal to a 26-pound child.

And Puerto Rico have passed comprehensive smoke-free indoor air laws that include e-cigarettes, as of March 31, 2023. These laws prohibit smoking and the use of e-cigarettes in indoor areas of private worksites, restaurants, and bars. In our fight to end youth and young adult nicotine addiction, we focus on the issues that matter most.

Altria Group chief executive William Gifford told analysts during a second-quarter conference call that makers of unregulated e-cigarettes are responding to consumers’ switching to nicotine pouches. According to the latest Nielsen convenience store report released Wednesday, Zyn sales have jumped 74.6% year-over-year with total annual sales now in the $2 billion range. Tobacco industry executives and analysts are sounding alarms about a surge of unregulated nicotine pouches entering the U.S. that is chipping away at regulated products.

Revenues collected, including interest and penalties, from the CECET are deposited into the California Electronic Cigarette Excise Tax Fund. In addition to the HOPE Act, we administer other cigarette and tobacco products laws affecting retailers of electronic cigarettes containing or sold with nicotine. Retailers of electronic cigarettes containing or sold with nicotine also have responsibilities under the Cigarette and Tobacco Products Licensing Act of 2003. For more information, please visit our Tax Guide for Cigarettes and Tobacco Products. To address this problem, the Campaign for Tobacco-Free Kids and other public health organizations have called on the U.S.

In e-cigarettes, tobacco combustion is replaced by e-liquid heating, leading some manufacturers to propose that e-cigarettes have less harmful respiratory effects than tobacco consumption. Other innovative features such as the adjustment of nicotine content and the choice of pleasant flavours have won over many users. Nevertheless, the safety of e-cigarette consumption and its potential as a smoking cessation method remain controversial due to limited evidence. Moreover, it has been reported that the heating process itself can lead to the formation of new decomposition compounds of questionable toxicity. Numerous in vivo and in vitro studies have been performed to better understand the impact of these new inhalable compounds on human health.

Vaping products, "vapes" or "e-cigarettes", comprise a wide range of products that heat a substance to produce an aerosol that is inhaled. We link to further pages giving more detailed information about each company’s products, market share and business strategy, including methods used to promote their products around the world. We also point to examples of lobbying activity conducted by, and on behalf of, tobacco companies, in order to influence regulation around e-cigarettes. Some have rechargeable batteries and changeable prefilled cartridges; others are disposable after running out of charge or e-liquid. Reported sales of cartridge products increased from $2.133 billion in 2020 to $2.496 billion in 2021; sales of disposable, non-refillable e-cigarette products increased from $261.9 million in 2020 to $267.1 million in 2021. Bene-Alhasan also said e-cigarettes are not recommended as a tool to quit smoking, since many people may continue vaping long after they quit smoking.

The data shows that in 2021, 69.2 percent of e-cigarette cartridges either sold or given away contained menthol-flavored e-liquids, and the rest were tobacco-flavored. E-cigarette companies also spent $90.6 million more advertising and promoting their products in 2021 than in 2020. Flavored e-cigarettes are very popular, especially among young people.