1. Electronic Nicotine Delivery Systems
Erin McClain, MA, MPH
Center for Maternal and Infant Health
The University of North Carolina at Chapel Hill

2. How do they work?

3. ENDS Aerosol is Not Clean Air
The National Institute for Occupational Safety and Health (NIOSH) recommends that workplaces be tobacco-free, including e-cigarette-free.
The perception currently out there is that these products just produce a harmless water vapor. In fact Electronic cigarettes generate a mixture of vapors and aerosols. The aerosol contains potentially harmful ingredients that you see in the graphic here including fine and ultrafine particles that can penetrate the lungs.
The CDC has stated that Air containing electronic nicotine delivery systems (ENDS) aerosol is less safe than clean air
ENDS use has the potential to involuntarily expose children adolescents, pregnant women, and non-users to aerosolized nicotine, toxic substances and, if the products are altered, to other psychoactive substances.
Therefore, clean air—free of both smoke and ENDS aerosol—remains the standard to protect health.

4. Examples of ENDS Products

5. Most Popular ENDS Product: JUUL

6. ENDS are the Most Common Tobacco Product for Youth/Young Adults
Villanti AC, Johnson AL, Ambrose BK, et al. Use of flavored tobacco products among U.S. youth and adults; findings from the first wave of the PATH Study ( ).
Among current e-cigarette users age18–24,
40.0% had NEVER BEEN regular cigarette smokers

7. ENDS & Reproductive Age Women
The health effects of using e-cigarettes & other ENDS before or during pregnancy have not been adequately studied, but we do know:
Vegetable glycerin, propylene glycol, and flavoring compounds are respiratory irritants that have been shown to cause airway/lung cell inflammation and damage, including cell death
Nicotine
negatively affects the brain development of adolescents and young adults up to age 25
adversely affects cardiovascular health
is a known reproductive toxicant and has adverse effects on fetal development, including lung and brain development
The use of other smokeless tobacco products, such as snus, during pregnancy has been associated with preterm delivery, stillbirth, and infant apnea
Recent research suggests that women perceive ENDS to be less harmful and less stigmatizing than cigarette use in general and during pregnancy.
CDC; England, et al. 2016; Mark, et al. 2015;

8. ENDS and Poison Control
Exposures to e-cigarettes & liquid nicotine can be fatal for infants and young children
Even a teaspoon of liquid nicotine can be fatal; smaller amounts can cause severe illness
E-cigarette Device & Liquid Nicotine
Reported Exposures to Poison Centers

9. Questions? YouQuitTwoQuit.org Erin McClain 919-808-0989
YouQuitTwoQuit.org