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ABSTRACT
While developed as a means for adult combustible cigarette smokers to avoid the cancer-causing tars in burning tobacco while still satisfying their addiction to nicotine, and used successfully by tens of thousands in the UK, to quit smoking altogether, millions of Americans including those under the age of 21 now use e-cigarettes to inhale vaporized nicotine recreationally. Most of the existing science clearly indicates that at least in the short run, while undoubtedly still adverse medically to those without a previous tobacco dependency, vaping is far less dangerous to one’s health than the initiation or continuation of combustible cigarette smoking. However, the increasing use of refills of vaping devices with untested fluids, specifically those with THC to which vitamin E acetate has been added, and perhaps the ability to increase significantly the amounts of nicotine delivered by customizing their underlying technology, may be factors contributing to an increase within the US in serious lung diseases and deaths, even among some novice users. As of November 20, 2019, the CDC has reported 2,290 cases of e-cigarette, or vaping, product use associated lung injury (EVALI) nationwide with 47 confirmed deaths in 25 states and Washington, DC.