What Are E-Cigarettes?
E-cigarettes come in many shapes and sizes, but most have a battery, a heating element, and a place to
hold a liquid. The liquid typically contains nicotine—which is the addictive drug in regular cigarettes—as
well as chemicals like propylene glycol or glycerin and flavorings such as fruit and chocolate. E-cigarettes
are a type of electronic nicotine delivery system (ENDS). Other ENDS products include e-hookahs, ecigars, e-pipes, vape pens, and many more. These devices warm the liquid and produce an aerosol that
commonly contains a variety of chemicals. Users breathe this chemical solution directly from the
mouthpiece. Puffing on an e-cigarette is sometimes called "vaping." Bystanders can breathe in this
aerosol, too, which is exhaled into the air.
How Do E-Cigarettes Affect Your Health?
E-cigarettes are fairly new. There are important questions about their ingredients and how those
ingredients may affect the health of people who use e-cigarettes and bystanders around them, both in
the short term and over time. E-cigarettes and their ingredients are not regulated by the Food and Drug
Administration (FDA) right now. So there's no way to know for sure what is in them or how much
nicotine they contain. Current research shows that:
 Nicotine from e-cigarettes is absorbed by users and bystanders.
 Nicotine is highly addictive.
 Nicotine is especially a health danger to youth who use e-cigarettes. It may have long-term,
negative effects on brain growth.
 Nicotine is a health danger for pregnant women and their developing babies. Using an ecigarette and even being around someone else using an e-cigarette can expose pregnant women
to nicotine and other chemicals that may be toxic.
E-cigarette aerosol is not "water vapor." It contains nicotine and can contain other chemicals. It is not as
safe as clean air.
The nicotine solution in e-cigarettes is not harmless “juice.” Children and adults have been poisoned by
swallowing, breathing, or absorbing the liquid through their skin or eyes.
Additional chemicals that are harmful or may be harmful have been found in some e-cigarettes. These
substances include traces of metal, volatile organic compounds, and nitrosamines. The levels tend to be
lower than in regular cigarettes, but there's no way to know what you're getting because e-cigarettes
are not yet regulated. E-cigarettes are not approved by FDA to help people quit smoking.
Hookahs
Hookahs are water pipes that are used to smoke specially made tobacco that comes in different flavors,
such as apple, mint, cherry, chocolate, coconut, licorice, cappuccino, and watermelon. Although many
users think it is less harmful, hookah smoking has many of the same health risks as cigarette smoking.
Hookah smoking is typically done in groups, with the same mouthpiece passed from person to person.
Tobacco users should quit all tobacco products to reduce health risks.
Hookah smoking is NOT a safe alternative to smoking cigarettes.
Hookah Smoke and Cancer
The charcoal used to heat the tobacco can raise health risks by producing high levels of carbon
monoxide, metals, and cancer-causing chemicals. Even after it has passed through water, the smoke
from a hookah has high levels of these toxic agents. Hookah tobacco and smoke contain several toxic
agents known to cause lung, bladder, and oral cancers. Tobacco juices from hookahs irritate the mouth
and increase the risk of developing oral cancers.
Other Health Effects of Hookah Smoke
Hookah tobacco and smoke contain many toxic agents that can cause clogged arteries and heart
disease. Infections may be passed to other smokers by sharing a hookah. Babies born to women who
smoked water pipes every day while pregnant weigh less at birth (at least 3½ ounces less) than babies
born to nonsmokers. Babies born to hookah smokers are also at increased risk for respiratory diseases.
Hookah Smoking Compared with Cigarette Smoking
While many hookah smokers may think this practice is less harmful than smoking cigarettes, hookah
smoking has many of the same health risks as cigarette smoking.
Water pipe smoking delivers nicotine—the same highly addictive drug found in other tobacco products.
The tobacco in hookahs is exposed to high heat from burning charcoal, and the smoke is at least as toxic
as cigarette smoke. Because of the way a hookah is used, smokers may absorb more of the toxic
substances also found in cigarette smoke than cigarette smokers do. An hour-long hookah smoking
session involves 200 puffs, while smoking an average cigarette involves 20 puffs. The amount of smoke
inhaled during a typical hookah session is about 90,000 milliliters (ml), compared with 500–600 ml
inhaled when smoking a cigarette.
Hookah smokers may be at risk for some of the same diseases as cigarette smokers. These include:
 Oral cancer
 Lung cancer Stomach cancer
 Cancer of the esophagus Reduced lung function
 Decreased fertility
Hookahs and Secondhand Smoke
Secondhand smoke from hookahs can be a health risk for nonsmokers. It contains smoke from the
tobacco as well as smoke from the heat source (e.g., charcoal) used in the hookah.
Nontobacco Hookah Products
Some sweetened and flavored nontobacco products are sold for use in hookahs. Labels and ads for
these products often claim that users can enjoy the same taste without the harmful effects of tobacco.
Studies of tobacco-based shisha and “herbal” shisha show that smoke from both preparations contain
carbon monoxide and other toxic agents known to increase the risks for smoking-related cancers, heart
disease, and lung disease.
The above information was taken from the CDC websites on 6/23/16:
http://www.cdc.gov/tobacco/data_statistics/fact_sheets/tobacco_industry/hookahs/
http://www.cdc.gov/tobacco/campaign/tips/diseases/dual-tobacco-use.html