- Funded by NIDA and FDA.
- Study uses data from Wave 1 of the PATH study (Population Assessment of Tobacco and Health) that asked youth about ever and past 30-day use of tobacco products including ENDS products.
- About 81.5% (77.9–85.0) stated that they use e-cigarettes because of the flavors, therefore, the study confirmed that flavors appeal to youth.
- Tobacco control and prevention strategies should be considered to prevent youth from harms of e-cigarettes.


E-Cigarette Use Among Youth

-	This study is funded by the Imperial Brands, which is a tobacco company.
-	The study by Malt et al. (2020) looks at the perception of relative harm from e-cigarettes versus regular cigarettes using publicly available national data from PATH (Population Assessment of Tobacco and Health).
-	The article found that the proportion of US adults who thought of ENDS products as less harmful than regular cigarettes decreased over the past few years: from 41.1% (CI 40.1–42.1%) in 2013–2014, 31.5% (CI 30.8–32.2%) in 2014–2015 and 25.3% (CI 24.6–26.0%) in 2015–2016. On the other hand, the proportion of US adults who perceived ENDSs as equally, or more, harmful than cigarettes increased: from 53.7% (CI 52.3–55.1%), 64.9% (CI 63.6–66.2%) to 72.7% (CI 71.5–73.9%).
-	Although the data seem to show reasonable trends, the authors noticeably use biased language. For example, they claim that those who perceived ENDS as less harmful "correctly perceived" the fact, and those who did not, "incorrectly perceived". They also claimed "Current adult smokers appear to be poorly informed about the relative risks of e-cigarettes yet have potentially the most to gain from transitioning to these products."


Perceived risks of e-cigarettes

Since electronic cigarettes are relatively new, it is not surprising that there is not much research available to state accurate facts about the harms. However, both government health organizations and private tobacco companies are currently investigating the harms. Tobacco industries fund a lot of research and publish papers that mask accurate information. The child nodes from this node will therefore state whether the research was funded by a tobacco agency or no.


University of Rochester

According to one of the biggest e-cigarette manufacturer (JUUL), they started e-cigarettes to provide an alternative to help people quit smoking regular cigarettes. They do not state anywhere in their website that e-cigarettes are more or less harmful but increasing research shows that they might be more harmful. CDC claims more research is necessary.
Some of the biggest concerns with e-cigarettes is that they contain flavors which are targeted towards children (ex. cotton candy, fruit flavors, etc.). They also contain concerning amounts of nicotine and metals that are harmful. Moreover, some flavors might be more harmful than others depending on the chemical composition, but research is still ongoing.


Are Electronic Cigarettes Less Harmful than Traditional Cigarettes?

1.  About the Office on Smoking and Health. Centers for Disease Control and Prevention. Retrieved 9 August 2021, from https://www.cdc.gov/tobacco/about/osh/index.htm.
2. Ambrose, B. K., Day, H. R., Rostron, B., Conway, K. P., Borek, N., Hyland, A., & Villanti, A. C. (2015). Flavored Tobacco Product Use Among US Youth Aged 12-17 Years, 2013-2014. JAMA, 314(17), 1871–1873. https://doi.org/10.1001/jama.2015.13802 
3. E-Cigarettes are harmful to health. World Health Organization. Retrieved 9 August 2021, from https://www.who.int/news/item/05-02-2020-e-cigarettes-are-harmful-to-health. 
4. E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General. (2016). Retrieved 9 August 2021, from https://www.cdc.gov/tobacco/data_statistics/sgr/e-cigarettes/pdfs/2016_sgr_entire_report_508.pdf. 
5. Malt, L., Verron, T., Cahours, X. et al. Perception of the relative harm of electronic cigarettes compared to cigarettes amongst US adults from 2013 to 2016: analysis of the Population Assessment of Tobacco and Health (PATH) study data. Harm Reduct J 17, 65 (2020). https://doi.org/10.1186/s12954-020-00410-2
6. PATH (Population Assessment of Tobacco and Health) Study - Home. Pathstudyinfo.nih.gov. Retrieved 9 August 2021, from https://pathstudyinfo.nih.gov/. 
7. Quick Facts on the Risks of E-cigarettes for Young People. Centers for Disease Control and Prevention. Retrieved 9 August 2021, from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html#six.

References: Smoking and Vaping 

According to the CDC website: 
- E-cigarettes expose users to fewer harmful chemicals than burned cigarettes.
- E-cigarettes are harmful for youth even though they have fewer chemicals than burned cigarettes.
- Flavors contained in e-cigarettes make them more appealing for youth, causing them to become addicted and regular users. 
- Even though many vapes are claimed to contain no nicotine, research has proven otherwise.
- Some of the harmful known chemicals in vapes include: Nicotine. Ultrafine particles that can be inhaled deep into the lungs, Flavorings such as diacetyl, a chemical linked to a serious lung disease, Volatile organic compounds, Cancer-causing chemicals, Heavy metals such as nickel, tin, and lead.


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