Electronic nicotine delivery systems (ENDS, or e-cigarettes) are devices that deliver nicotine in a way that mimics to some extent the look and feel of tobacco cigarettes, but do not include any tobacco. They were created by an engineer in China, and typically include a battery, heating element, nicotine, medium for carrying nicotine molecules into the mouth once heated (eg propylene glycol) and sometimes flavoring. In the US, a court case declared that ENDS products should be considered ‘tobacco’ from a regulatory perspective, and they will eventually be regulated by the US FDA under its authority to regulate tobacco products. In the meantime, they are being sold extensively in convenience stores and the internet, and social media has increased awareness and use of the products. Sales of e-cigarettes have become a multi-billion dollar industry, and financial analysts anticipate that sales will continue to expand depending on regulatory decisions.

E-cigarettes are controversial for several reasons. They are used in much the same way as a cigarette (puffed), and the user exhales a vapor that looks like smoke. Thus, some in public health are concerned that they could become a ‘gateway’ to use of tobacco cigarettes. Moreover, there is concern that youth will begin using the products given the easy access to them, become addicted, and perhaps eventually switch to tobacco cigarettes. However, even though some studies have found toxic substances in some brands of e-cigarettes, use by both and adults continues to increase dramatically. Several studies have suggested that most adults use e-cigarettes to help them to quit smoking, so there is both promise and risk from these unique nicotine delivery systems.

In this presentation, an overview of how e-cigarettes work will be presented, and surveillance data (including on social media) will be presented that demonstrates the rapid increase in use that has occurred in the US. This presentation will provide a primer on e-cigarettes to serve as a background for the papers and discussion that will come after it.

Citation Format: Scott J. Leischow. Nature and epidemiology of e-cigarettes. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr SS02-01.