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Therefore, this 2016 report documents the scientific literature on these new products and their marketing, within the context of youth and young adults. However, the 2012 report was prepared before e-cigarettes were as widely promoted and used in the United States as they are now. That report also found that the tobacco industry’s advertising and promotional activities are causal to the onset of smoking in youth and young adults and the continuation of such use as adults ( USDHHS 2012). More recently, the 2012 report documented the evidence regarding tobacco use among youth and young adults, concluding that declines in cigarette smoking had slowed and that decreases in the use of smokeless tobacco had stalled. The first Surgeon General’s report on the health consequences of smoking was published in 1964 of the subsequent reports, those published in 19 focused solely on youth and young adults ( USDHHS 1994, 2012). Similarly, youth e-cigarette experimentation and use could also extend into adulthood however, e-cigarette use in this population has not been examined in previous reports of the Surgeon General. Understanding e-cigarette use among young persons is critical because previous research suggests that about 9 in 10 adult smokers first try conventional cigarettes during adolescence ( USDHHS 2012). This report focuses on research conducted among youth and young adults because of the implications of e-cigarette use in this population, particularly the potential for future public health problems.

For example, some refer to all cigarette-shaped products as “e-cigarettes” or as “cigalikes,” and some may refer to the pen-style e-cigarettes as “hookah pens” or “vape pens” ( Richtel 2014 Lempert et al. The terms may differ by geographic region or simply by the prevailing preferences among young users. These devices are referred to, by the companies themselves, and by consumers, as “e-cigarettes,” “e-cigs,” “cigalikes,” “e-hookahs,” “mods,” “vape pens,” “vapes,” and “tank systems.” In this report, the term “e-cigarette” is used to represent all of the various products in this rapidly diversifying product category. A key challenge for surveillance of the products and understanding their patterns of use is the diverse and nonstandard nomenclature for the devices ( Alexander et al. E-cigarettes vary widely in design and appearance, but generally operate in a similar manner and are composed of similar components ( Figure 1.1). This Surgeon General’s report focuses on the history, epidemiology, and health effects of e-cigarette use among youth and young adults the companies involved with marketing and promoting these products and existing and proposed public health policies regarding the use of these products by youth and young adults.Į-cigarettes include a diverse group of devices that allow users to inhale an aerosol, which typically contains nicotine, flavorings, and other additives. It is crucial that the progress made in reducing cigarette smoking among youth and young adults not be compromised by the initiation and use of e-cigarettes. Among these increases has been a dramatic rise in electronic cigarette (e-cigarette) use among youth and young adults. Department of Health and Human Services 2012), there have been substantial increases in the use of emerging tobacco products among these populations in recent years ( Centers for Disease Control and Prevention 2015c). Although conventional cigarette smoking has declined markedly over the past several decades among youth and young adults in the United States ( U.S.

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