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As with high school students, e-cigarette use was much more common than cigarette use. E-cigarettes come in many shapes and sizes and can also be called e-cigs, e-hookahs, vapes, vape pens, personal diffusers or diffuser sticks. But one vape can contain the equivalent of 50 cigarettes of nicotine in the one product. They also contain a complex combination of chemicals including nicotine, nickel, tin, arsenic, chlorine and lead. These substances can be harmful to the body, with different flavourings helping to mask these poisons when they are taken into the body. An electronic cigarette (e-cigarette) is a battery-operated device that heats liquid nicotine, flavoring, and other additives to create an aerosol.

The composition of e-liquids requires stricter regulation, as they can be easily bought online and many incidences of mislabelling have been detected, which can seriously affect consumers’ health. Beyond their unknown long-term effects on human health, the extended list of appealing flavours available seems to attract new "never-smokers", which is especially worrying among young users. Additionally, there is still a lack of evidence of e-cigarette consumption as a smoking cessation method. Indeed, e-cigarettes containing nicotine may relieve the craving for smoking, but not the conventional cigarette smoking habit.

Collectively, these devices are known as electronic nicotine delivery systems. E-cigarette use is often referred to as "vaping" and the aerosol created from their use referred to as "vapor." E-cigarettes come in many colors, shapes, and sizes and can look like USB flash drives, pens, highlighters, or toys. The liquid in e-cigarettes is sometimes called e-juice, e-liquid, vape juice, or vape liquid.

The availability of "vape wear," such as backpacks and hoodies, also allow the user to vape while concealing the product. The study showed that the e-liquids of certain cig-a-like brands contain high levels of nickel and chromium, which may come from the nichrome heating coils of the vaporizing device. Cig-a-likes may also contain low levels of cadmium, a toxic metal also found in cigarette smoke that can cause breathing problems and disease.11 More research is needed on the health consequences of repeated exposure to these chemicals.

You should use the vape as much as you need to manage your cravings and withdrawal symptoms. Here are some of the most common myths, and the facts based on scientific evidence and data. Nicotine itself is not very harmful and has been used safely for many years in medicines to help people stop smoking. E-liquids come in different nicotine strengths, so you control how much nicotine you need to help with cravings and other withdrawal symptoms, such as feeling irritable and having low mood. Electronic cigarettes and ESDs also pose a risk of fire and explosions, which result in serious injuries and property damage.

Some of the research for Tobacco Tactics was funded by Cancer Research UK Limited and Bloomberg Philanthropies. This work has previously received funding from&nbsp