PACT Recommendation: Recognize the potential health risks of electronic and other tobacco products and focus on tobacco-free and nicotine-free policies and regulations rather than smoke-free policies and regulations.


In recent years, e-cigarette use among high school students was almost 14 times higher in 2018 than in 2011, with a 78 percent increase between 2017 and 2018 alone. These products are now the most commonly used form of tobacco among youth nationwide, and the Surgeon General has declared their use a major public health concern.[i]

While e-cigarettes generally emit fewer toxicants than combustible tobacco products, their aerosols are not harmless. [iv] Studies have shown formaldehyde, benzene and other items in secondhand e-cigarette emissions.  With over 470 brands and more than 7,700 flavored products available, there is little scientific based evidence of the long-range health impact on consumers.[v] The vast majority of current e-cigarette users are also current smokers, or dual users, including 59 percent of adult users and 76 percent of youth users.[vi] The CDC concluded that smokeless tobacco is not a safe alternative to smoking, and the FDA has not found any e-cigarettes to be safe and effective in helping smokers quit.

A number of steps have been taken towards regulating e-cigarettes and other smokeless tobacco products. In 2014, Philadelphia categorized e-cigarettes the same as regular tobacco, meaning the vapor producing products would be banned in most public places and those under 18 would be prohibited from buying them.

In 2016, the Food and Drug Administration’s (FDA) final “deeming rule” was put into law, giving the FDA the authority to regulate the manufacture, sales and marketing of all tobacco products including e-cigarettes, cigars, hookah, little cigars and other tobacco products. This rule means that the FDA can crack down on industry marketing to youth, unproven health claims and sales to minors. Unfortunately, the tobacco industry continues its attempts to weaken this rule by successfully urging the House of Representatives to attach so-called appropriations “riders” to the FDA’s funding bill, which would prohibit FDA from implementing key provisions of the final rule. We continue to advocate with our partners against these riders in order to keep the Tobacco Control Act strong and effective.

Foot Notes

[i] A Report of the Surgeon General. E-Cigarette Use Among Youth and Young Adults. Available

[ii] Centers for Disease Control and Prevention (CDC). Smoking & Tobacco Use: Smokeless Tobacco Use in the United States. Available

[iii] Centers for Disease Control and Prevention (CDC). State Tobacco Activities and Evaluation (STATE) System. YTS 2015. Available

[iv] A Report of the Surgeon General. E-Cigarette Use Among Youth and Young Adults. Available

[v] American Lung Association. E-cigarettes and Lung Health. Available

[vi] CDC, “Electronic Cigarette Use Among Middle and High School Students — United States, 2011 – 2012,” MMWR, 62(35), September 6, 2013; CDC, “Quick Stats: Cigarette Smoking Status Among Current Adult E-Cigarette Users, by Age Group—National Health Interview Survey, United States, 2015,” Morbidity and Mortality Weekly Report, 65(42): 1177. Available