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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.

Whilst long-term health effects are not fully known, we do know that they generate toxic substances, some of which are known to cause cancer and some that increase the risk of heart and lung disorders. Electronic delivery systems have also been linked to a number of physical injuries, including burns from explosions or malfunctions, when the products are not of the expected standard or are tampered with by users. The Preventing Online Sales of E-Cigarettes to Children Act was created in 2019 to reduce children and teens access to online sales of smokeless tobacco products. According to a 2020 study by the Centers for Disease Control and Prevention (CDC), 85% of high school students and 74% of middle school students who used tobacco products in the past 30 days reported using a flavored tobacco product during that time. The electronic cigarette (e-cigarette), for many considered as a safe alternative to conventional cigarettes, has revolutionised the tobacco industry in the last decades.

For example, in an analysis using primary human umbilical vein endothelial cells (HUVEC) exposed to 11 commercially-available vapours, 5 were found to be acutely cytotoxic, and only 3 of those contained nicotine [24]. In addition, 5 of the 11 vapours tested (including 4 that were cytotoxic) reduced HUVEC proliferation and one of them increased the production of intracellular reactive oxygen species (ROS) [24]. Three of the most cytotoxic vapours—with effects similar to those of conventional high-nicotine CS extracts—also caused comparable morphological changes [24]. Endothelial cell migration is an important mechanism of vascular repair than can be disrupted in smokers due to endothelial dysfunction [25, 26]. E-cigarettes are sometimes called e-cigs, vapes, vape pens, e-hookahs, and electronic nicotine delivery systems or ENDS.

Nicotine levels ranged 0.10–0.32&nbsp