By Camryn Zornes 

Health educator for Lawrence County Health Department 

Although traditional cigarette smoking rates have recently declined, other tobacco product use, particularly electronic cigarette use (“e-cigarettes”, “vaping”), has increased nationally. 

According to the CDC, adult e-cigarette use rose from 3.7 percent in 2020 to 6 percent in 2022.  This may be due to the suggested message by big tobacco companies that e-cigarettes are less dangerous than traditional cigarettes. However, e-cigarettes contain many of the same toxins found in traditional cigarettes including nicotine, volatile organic compounds, small particles and heavy metals like lead and nickel. 

E-cigarettes also contain other harmful chemicals that are not often found in traditional cigarettes that are used for flavorings and are not recognized by the FDA as safe to inhale. 

E-cigarettes also pose secondhand exposure risks such as throat irritation, shortness of breath, bronchitis-like symptoms and asthma attacks.

Disposable e-cigarettes, most common among youth and young adult users, can legally contain thousands of toxic flavoring chemicals compared to rechargeable e-cigarettes. This is because disposable vapor products are not included in the FDA’s 2020 flavor ban on e-cigarettes. E-cigarettes, especially rechargeable types, can also be changed by the user to contain THC (marijuana), illicit substances such as LSD and methamphetamine, and laced with opiates such as fentanyl. 

Ninety-nine percent of e-cigarettes, even those marketed as nicotine-free, contain nicotine, which is the addictive chemical in the tobacco plant. But, you may have noticed that many e-cigarette labels list “nicotine salts” as an ingredient. 

While traditional cigarettes contain freebase nicotine, the type of nicotine in the tobacco plant, most disposable e-cigarettes, including popular brands like Elf Bar and Juul, contain nicotine salts. Nicotine salts are taken from tobacco and combined with other chemicals to change the pH level- making each puff feel smoother on the throat and delivering a higher dose of nicotine to the user.

 In a 2023 study of 39,030 e-cigarettes, those containing nicotine salts were found to have a higher amount of nicotine (14 mg/ml) than products containing freebase nicotine (6mg/ml).

To better understand the effects of nicotine salts and their higher concentration in e-cigarettes compared to freebase nicotine, a study was conducted in 2023.  Study findings showed that nicotine salts took less than half the time to reach maximum nicotine concentration than freebase nicotine, as demonstrated in the graph below.

More research on the known and unknown harms of e-cigarettes(especially those containing nicotine salts), regulations, and health outreach is critical to protect the public. As more information about the effects of e-cigarette use comes to light, we advise the public to take precaution and understand that research suggests nicotine salts in e-cigarettes may lead to addiction at a faster rate than those containing freebase nicotine.