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Children 13–15-years old are using e-cigarettes at rates higher than adults in all WHO regions. In Canada, the rates of e-cigarette use among 16–19-year-olds has doubled between 2017–2022, and in England (the United Kingdom) the number of young users has tripled in the past three years. The Alabama Tobacco Quitline is a free telephone and online coaching service for any Alabamian who is ready to quit tobacco or e-cigarette use. A PDF is a digital representation of the print book, so while it can be loaded into most e-reader programs, it doesn't allow for resizable text or advanced, interactive functionality. The eBook is optimized for e-reader devices and apps, which means that it offers a much better digital reading experience than a PDF, including resizable text and interactive features (when available).
Once discarded into the environment, the filters create a large waste problem. Synthetic particulate filters may remove some of the tar before it reaches the smoker. The data underlying this article cannot be shared publicly due to the privacy of individuals that participated in the study.
Since This is Quitting launched as a text message program in 2019, more than 750,000 young people have enrolled from across the U.S. Grounded in clinical guidelines for treating tobacco dependence, This is Quitting incorporates powerful messages from other young e-cigarette users who have offered their advice about how to quit. Teens and young adults can text DITCHVAPE to to receive free quit vaping support from the program. This study is the first published randomized clinical trial of a quit vaping program among teens, filling an important gap in the scientific literature and providing much needed evidence for pediatricians, school administrators, and public health agencies. Although stopping smoking can cause short-term side effects such as reversible weight gain, smoking cessation services and activities are cost-effective because of the positive health benefits. Further, educational aspirations and school engagement are tied to student composition and school-based networks and norms, which have had different associations with smoking between schools [28].
"Vaping products containing nicotine are subject to federal laws that prohibit sales to people under the age of 21," said study co-author Sairam V. Jabba, D.V.M., Ph.D., a senior research scientist at Duke University School of Medicine. Previous studies of such policies have mostly examined local or temporary post-2019 state policies. The Yale study was the first to assess how flavor restrictions across most of the United States influence sales of both vapes and cigarettes. The U.S. Food and Drug Administration's (FDA) "The Real Cost" campaign seeks to prevent susceptible youth from trying tobacco or becoming regular users.
Enrollees in the program receive interactive daily text messages tailored to their sign-up date or their target quit date if they set one. Program users who set a quit date (which they can change) receive messages for at least one week prior to the quit date and for at least two months following the quit date. Those brands have been sold in the U.S. for years, awaiting FDA action on their scientific applications. To stay on the market, companies must show that their e-cigarettes provide an overall health benefit for smokers, without significantly appealing to kids.
Levels below the LOD or LOQ, or even below the threshold levels proposed by the AFNOR standard guidelines, provide evidence of the optimal operation conditions (e.g., adequate wick saturation without extreme coil heating) of the ceramic wick-based device. E-cigarettes are battery-powered devices designed to deliver nicotine and/or other substances including, in some cases, flavourings. Although e-cigarettes were first proposed in 1927 by Joseph Robinson1, it was only in the early 2000s that the 1st generation of e-cigarettes or ‘cig-a-likes’ became commercially available2,3,4. Subsequent generations of devices have evolved since then, ranging from e-cigarettes with prefilled or refillable cartridges (2nd generation) to rechargeable tank-style devices (3rd generation) with modifiable or ‘‘Mods’’ components3,4,5,6. The 4th generation of devices, known as ‘Pods’, has been driven by advances in electronic atomization technology3,7,8,9.
At least one of the three chemicals was detected in 47 of the 51 flavors tested. Diacetyl was detected above the laboratory limit of detection in 39 of the flavors tested. Acetoin and 2,3-pentanedione were detected in 46 and 23 and of the flavors, respectively. The association between student- and school-level factors and susceptibility to snus use. FDA Real Cost Campaign"The Real Cost" campaign website and social media channels are intended for the campaign target audience only -- youth ages 12-17.
He encourages people committed to quitting to try non-inhaled methods such as the nicotine replacement patch or another FDA-approved smoking cessation product, as well as counseling. E-cigarettes are battery-operated devices that convert liquid into aerosol, which is inhaled into the user’s lungs. Typically, the liquid contains addictive nicotine, as well as flavors. More than 10 million adults in the United States use e-cigarettes, and vaping has become especially popular among teenagers.
Kasza's group also pointed to dual use of cigarettes and e-cigarettes, which has increased over time and usually involves smoking cigarettes more frequently than using e-cigarettes. "Individuals who dual use remain exposed to cigarette smoking toxicants, making complete rather than partial substitution of cigarettes with e-cigarettes important for risk reduction," they wrote. "Indeed, healthcare clinicians are now encouraged to discuss e-cigarettes as a cessation tool with patients who smoke cigarettes and have already tried FDA-approved cessation medications." A comparison of the serum levels of nicotine from e-cigarette or conventional cigarette consumption has been recently reported [39].
"One of the real problems [with] these things is that because of the low quality control, you never quite know what you are getting," he says. Those who support minimal regulation contend that limiting the use of e-cigarettes would encourage more people to smoke conventional cigarettes. Wild WestAs scientists struggle to test the safety of e-cigarettes, the devices are becoming more and more popular among teens and preteens. E-cigarette use among U.S. high school students more than doubled from 4.7 percent in 2011 to 10 percent in 2012, according to recent data from the Centers for Disease Control and Prevention's National Youth Tobacco Survey. At least 160,000 students who had never tried conventional cigarettes puffed on e-cigs.
That figure is controversial and might be a little high, says Kenneth Warner, a tobacco policy researcher at the University of Michigan. But, he adds, "The worst critics of e-cigarettes would probably argue they're a half to two-thirds less dangerous. But from a practical view, they're probably on the order of 80% to 85% less dangerous, at least." A 2015 expert review from Public Health England estimated e-cigs are 95% less harmful than the real thing.
"Recent studies should make us all more concerned about the impact of traditional and e-cigarettes on the heart as well," Dr. Cireddu says. According to the 2018 NAP report, secondhand vapor contains nicotine, particulate matter, and volatile organic compounds (VOCs) at concentrations that are above recommended levels. The 2018 NAP report found that there’s some evidence that e-cigarette exposure has adverse effects on the respiratory system. Some studies suggest that vaping may have negative effects on the lungs, but more research is needed.
If you experience side effects from vaping, get advice from a stop smoking adviser or specialist vape retailer before you decide to stop using a vape as your quit smoking tool. Almost two-thirds of people who use a vape along with support from a local Stop Smoking Service successfully quit smoking. Vaping is not completely harmless and we only recommend it for adult smokers, to support quitting smoking and staying quit. It made sense – Altria, the bad actor formerly known as Philip Morris, maker of Marlboro cigarettes, owned a 35% stake in JUUL.
When smoking an e-cigarette, the user inhales and exhales the vapour, which can look similar to cigarette smoke. The best way to protect your children is to never smoke or vape near them. Never smoke indoors, in your car, or in places where children spend time. Most teens who vape use disposable e-cigarettes, including brands like Elf Bar, which come in flavors such as watermelon and blueberry ice. New York State youth, ages 13-17, and young adults, ages 18-24, can text DropTheVape to to sign up to receive age-appropriate supportive and motivating text messages to support quit efforts.
The "e-juice" that fills the cartridges usually contains nicotine (which is extracted from tobacco), propylene glycol, flavorings and other chemicals. Studies have found that even e-cigarettes claiming to be nicotine-free contain trace amounts of nicotine. Additionally, when the e-liquid heats up, more toxic chemicals are formed. Among youth, e-cigarettes, especially the disposable kind, are more popular than any traditional tobacco product.
Read this paper by NCI’s Dr. Ned Sharpless and CRUK’s Dr. Iain Foulkes. Drug forums and e-liquid vendors were monitored by the researchers for e-liquids that "purportedly contained alternative pharmaceuticals." A clue in searching for e-liquids that contain illicit drugs is cost, the scientists said. Most nicotine e-liquids range from $5 to $10, while alternative drug e-liquids go for five to twenty times as much. In comparison to the general population, support for these measures varied greatly among people who currently used e‑cigarettes. The most supported measure was prohibiting the sale of e‑cigarettes to people under 18 years of age (67%), while the least supported measure was banning all additives in e‑cigarettes, to make them less attractive to young people (33%) (Figure 7).
Learn more about the symptoms and overall effects of smoking on the body below. For example, in New York and Vermont, vaping is prohibited in all smoke-free venues (like workplaces, bars, restaurants, and gambling facilities) except e-cigarette stores. The makeup of these devices—combined with individual or group vaping patterns—can significantly impact what pollutants get into the air and how many. The program provides participants with tailored advice, cognitive and behavioral coping strategies, and social support to help them quit. Now that ebay is starting to allow sellers like myself to utilize the site again why cant they allow a process to become a pre approved seller for vape products.
E-cigarettes are known by many different names, including "vapes," "e-cigs," "puff bars," and "electronic nicotine delivery systems (ENDS)." E-cigarettes are devices which produce an aerosol by heating a liquid that usually contains nicotine—the addictive drug in regular cigarettes, cigars, and other tobacco products—flavorings, and other chemicals that help to make the aerosol. Bystanders can also breathe in this aerosol when the user exhales into the air. The nicotine in e-cigarettes and regular cigarettes is highly addictive. While these devices may help some people quit smoking, there is growing evidence that e-cigarettes can pose serious health risks, especially to people who do not smoke traditional cigarettes.
Krishnan-Sarin points to progress that has been made—finally—in recent years to reduce regular cigarette smoking rates among young adults. In her opinion, the significant decline is due to the success of large-scale public health campaigns and a general awareness among youth that cigarettes are harmful to health. The liquid they contain also has many monikers—it might be called e-juice, e-liquid, cartridges, pods, or oil.
All this evidence would suggest that e-cigarettes are potentially less harmful than conventional cigarettes (Fig. 2) [11, 14, 22, 24, 27,28,29]. Importantly, however, most of these studies have investigated only short-term effects [10, 14, 15, 22, 27,28,29, 31, 32], and the long-term effects of e-cigarette consumption on human health are still unclear and require further study. Vapes come in colorful, fun, and unique product designs, along with many flavors, all of which come together as part of the attraction for youth who believe that these products are not addictive and are safe to use. Many users believe vaping will reduce stress, anxiety, and depression.
WASHINGTON (AP) — The Food and Drug Administration on Friday authorized the first menthol-flavored electronic cigarettes for adult smokers, acknowledging that vaping flavors can reduce the harms of traditional tobacco smoking. Some people believe e-cigarettes may help lower nicotine cravings in those who are trying to quit smoking. However, e-cigarettes are not an FDA-approved quit aid, and there is no conclusive scientific evidence on the effectiveness of vaping for long-term smoking cessation. It should be noted that there are seven FDA-approved quit aids that are proven safe and can be effective when used as directed.
In short, the ingredients in e-cigarette liquid have caused users health problems. The health effects of e-cigarettes are still being studied but nicotine addiction, harmful chemical additives, battery explosions causing injury, acute nicotine poisoning and vaping related lung injury have all been linked to use of e-cigarettes and vaping. An e-cigarette is a battery-operated device that heats liquid into an aerosol that the user inhales. E-cigarettes typically operate on a rechargeable lithium-ion battery.
An assessment from the agency, issued in 2008, references only a couple of studies that cover inhalation exposures—all with laboratory animals rather than people. The minimum age to purchase e-cigarettes and other tobacco products has also been raised to 21. A bill was also introduced in 2022 to raise the minimum age to purchase tobacco products and vapes from 19 to 21, but it was vetoed by Governor Mike Dunleavy.
Vape aerosols may also increase the risk of heart disease, lung cancer, and asthma complications. The substitution was especially evident among cigarette brands popular with young people aged 20 and under, suggesting that flavor restrictions may increase smoking among youth as well as adults. The immense popularity of electronic cigarettes, or e-cigarettes, among young people has led many policymakers to restrict the sale of flavored varieties. Proponents of e-cigarettes claim they’re safer than smoking because they don’t contain the more than 60 cancer-causing chemicals in tobacco smoke and are not combustible. But e-cigs still deliver harmful chemicals, including nicotine, the extremely addictive substance in cigarettes.
To be clear, I never even used to smoke during the day when I was using cigarettes. But if a project is particularly stressful (or just slightly vexatious, any excuse will do), my sleek little e-cig is just sitting in my bag at my feet. Like a never-ending pipe, you don’t know when you’ve had enough, when you’ve had a cigarette’s worth of nicotine. One quick puff to slay your stress can turn into one puff every few minutes, then whenever I get the slightest urge.
Any smoking is harmful and you will only get the full benefits of vaping if you stop smoking completely. Some people manage to make a full switch very quickly, while for others it can take a bit longer. The NFHS Learning Center offers a 3-level national coaching credential that helps you gain knowledge you can use to provide a fun, educational, and a safer environment for your students.
"When you are out and about with your children and see an advertisement, for example, take the opportunity to talk about it," she says. As they grow older, parents can expand on their thoughts and expectations. "It’s also important to give teens and young adults the space to ask questions," she says. The 2023 NYTS showed that about 2 million middle and high school students reported using e-cigarettes in the last 30 days. Another study that year found that the rates of youth who say they vaped with nicotine in the past month more than doubled in two years. About 11% of high school seniors reported this habit in 2017, compared to 25%, or one in four seniors, in 2019.
It acknowledges the wisdom of Elders past and present, and pays respect to all Aboriginal communities of today. Always be considerate when vaping around anyone else, especially people with health conditions like asthma or other respiratory conditions, or people who do not like vaping. But as a precaution, it is best not to vape around babies and children if you can avoid it. Remember, if you have stopped smoking completely you have already achieved a huge step in protecting your health, so don't worry if it takes you a while to stop vaping. You can buy them from specialist vape shops, some pharmacies, supermarkets and other retailers, or from an online vape store.
Whether you're an experienced connoisseur or just getting started out, we're confident you'll find a device that suits your needs here at 180 Smoke Vape Store. We pride ourselves on being customer-driven and committed to partnering with top brands and manufacturers to offer the best value for your money. We leverage our product and vape expertise and years of customer support, to provide the best shopping experience possible.
A growing body of research indicates that truth campaigns to prevent young people from vaping are poised to move in the same direction as the organization’s successful smoking prevention campaigns. See " Quitting Tobacco " for more information on quitting tobacco products. Let's say you love the feel and flavor you get from puffing on a vape — but you can't quite bring yourself to trust that it's safe. It uses a puff of pressurized, flavored air to simulate the "throat hit" of a vape, with no heating element whatsoever.
Dr. Amanda Graham, chief of innovations at Truth Initiative, said youth e-cigarette use remains a serious public health concern. Launched in January 2019, the This is Quitting program has amassed more than 750,000 enrolled to date and is designed for teens and young adults looking to quit e-cigarettes. Although advertising may make it look convenient and appealing, it’s important to know that these products deliver varying amounts of the addictive chemical nicotine, which can negatively impact your learning, attention span and proneness to addiction. Many teens are taking things a step further, adding cannabis, CBD oils and other dangerous additives to vaping devices. When patients show up to the emergency department in respiratory distress from vaping, it can be challenging for physicians to treat them due to the difficulty in correctly identifying what they inhaled, especially when they are intubated or unconscious. Truth Initiative, the organization behind truth
It may also increase the risk of developing mood disorders and problems with impulse control. They appeared on the U.S. market in 2015 and are now the top-selling brand of e-cigarette in the country. Although secondhand vapor may not affect the lungs the same way as vaping, it is better to avoid it, if possible. E-cigarettes have been strongly linked to continued tobacco use and are not recommended for young people.
Quitting smoking is one of the best things you can do for your health — smoking harms nearly every organ in your body, including your heart. Nearly one-third of deaths from heart disease are the result of smoking and secondhand smoke. The Food and Drug Administration has not found any e-cigarette to be safe and effective in helping smokers quit. If smokers are ready to quit smoking for good, they should call QUITNOW or talk with their doctor about finding the best way to quit using proven methods and FDA-approved treatments and counseling. Mass media campaigns such as truth
A lack of data has led to classification of methylgloxal as a Group 3 carcinogen (carcinogenicity to humans not classifiable) by IARC. Both compounds have been previously detected in e-cigarette emissions at concentrations of 0.07–0.94 and 0.09–33 µg puff–1, respectively86,88. In our study, glyoxal was present at lower levels (BB57 and BB18, 0.02 and 0.05 µg puff–1, respectively), while methylglyoxal was at concentrations of 0.13 and 0.19 µg puff–1 in BB57 and BB18, respectively (Table 3). Glyoxal was detected in the method air blank and therefore the actual levels in the e-cigarette emissions are potentially lower than reported in Table 3.
If you are not sure whether disposables are for you, these kits would be a great place to start. The leading disposable vape kits are Elf Bars, Lost Mary and Crystal Bar. Both come in a wide range of tastes to suit anyone looking to switch from smoking but also work well as a cheap back up kit for existing vapers. The Perelman School of Medicine is consistently among the nation's top recipients of funding from the National Institutes of Health, with $550 million awarded in the 2022 fiscal year. Data from the 2019 Minnesota Student Survey shows a steep rise in e-cigarette use among students. This study was supported by funding from the National Institute on Drug Abuse of the NIH and the FDA Center for Tobacco Products.
If you think ENDS or other tobacco products are being sold to people who are underage, or you see another potential violation of the FD&C Act or FDA’s tobacco regulations, please report the potential tobacco product violation. Learn about public education efforts and resources that have been created to reach youth who are at higher risk of or more vulnerable to cigarette use and nicotine addiction. FDA created a toolkit, Resources for Professionals About Vaping & E-Cigarettes, for adults and professionals who work with youth. This FREE resource provides fast facts about youth vaping and e-cigarettes. Vaping exposes you to some of the same chemicals that cigarette smoking does. Vaping while pregnant can cause low birth weight, lung damage and brain damage in the developing fetus.
FDA published a rule clarifying when products made or derived from tobacco are regulated as tobacco products, drugs, and/ or devices. Vaping is when you use a handheld electronic device to breathe a mist ("vapor") into your lungs. An e-cigarette, vape pen or other electronic nicotine delivery system (ENDS) heats a liquid of nicotine, flavoring, propylene glycol and other additives into an aerosol that you inhale through a mouthpiece.
Recent guidance from the Center for Tobacco Products indicates the importance of switching completely away from combustible cigarettes for those who are also using e-cigarettes," she added. The investigators revealed that daily vs nondaily use of e-cigarettes was linked to higher overall rates of quitting combustible cigarettes (12.8% vs 6.1%). The adults who used e-cigarettes in 2019 were more likely to stop smoking traditional cigarettes compared with those who used the e-cigarettes between 2014 and 2015 (12.0% vs 5.3%). There was limited evidence that flavor or device type impacted cigarette cessation. The findings suggest that daily e-cigarette use may help some patients to quit smoking combustible cigarettes.
Although there’s no definitive answer at this point, experts do have a theory about how vaping harms lungs. Young people who vape may be more likely to become addicted than adults. Nicotine exposure during this vital time can affect brain development in subtle and important ways. Research published in 2017 found that the high temperatures needed to form the mist for vaping can create dozens of toxic chemicals, such as formaldehyde, which is thought to cause cancer.
On this webpage, these products are collectively referred to as e-cigarettes. E-cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavorings, and other chemicals that make the aerosols. The liquid is sometimes called e-juice, e-liquid, vape juice, or vape liquid. Bystanders can also breathe in this aerosol when the user exhales it into the air. E-cigarette devices can be used to deliver marijuana and other drugs. Additionally, a study of adult smokers in Europe found those who vaped nicotine were less like to have stopped smoking than those who did not.
Jabba and colleagues, including co-senior author Sven Eric Jordt, Ph.D., analyzed an e-cigarette product sold under the brand name Spree Bar, which comes in at least nine flavors and is listed as containing 5 percent 6-methyl nicotine. Study results showed the actual amount of the chemical was about 88% less than labeled. The e-cigarettes also included an artificial sweetener that is up to 13,000 times sweeter than table sugar, and an artificial coolant that mimics menthol’s effects. Talk to your patients, including youth and young adults, about the dangers of tobacco use.
When the human body breaks down a foreign substance, one can typically find chemical by-products in hair or urine that provide clues about how it has interacted with cells. This is true for nicotine, but in the case of propylene glycol, no one has established what the relevant by-product is or how to best detect it. Boston, MA – Diacetyl, a flavoring chemical linked to cases of severe respiratory disease, was found in more than 75% of flavored electronic cigarettes and refill liquids tested by researchers at Harvard T.H. Chan School of Public Health. Two other potentially harmful related compounds were also found in many of the tested flavors, which included varieties with potential appeal to young people such as Cotton Candy, Fruit Squirts, and Cupcake. In conclusion, the prevalence of susceptibility among adolescents differs by product type. Liking school and academically oriented educational aspirations appear as consistent protective factors, while the use of other tobacco or nicotine products and positive attitudes towards product use in one’s age group appear as risk factors.
Learn more about e-cigarettes lung health risks and get downloadable resources for parents, schools and teens. Today's rapidly evolving e-cigarette market includes many varieties of disposable e-cigarettes, or single-use e-cigarettes, that do not use pre-filled pods containing e-liquid. The latest e-cigarettes also contain some of the highest nicotine levels ever seen in tobacco products. While some claim to be "tobacco-free" — made with lab-created synthetic nicotine, or with nicotine that does not come from tobacco — synthetic nicotine products still contain nicotine. E-cigarettes are products that heat a solution that typically includes nicotine and flavoring.
Several states have imposed restrictions on the sale of e-cigarettes. There are also restrictions on liquids with flavors that may be more attractive to younger people. The researchers also noted a lack of evidence that vaping is an effective means of quitting smoking. The marketing of e-cigarettes and their range of flavors can give the impression that vaping is not harmful.
This includes banning the sale of all non-prescription e-cigarettes and prohibiting the sale of any disposable or single-use e-cigarettes. Health experts are concerned about the various chemical ingredients within e-cigarettes. Even though it is illegal to sell e-cigarettes and e-liquids containing nicotine in Victoria, there is no guarantee that products purchased will not contain nicotine. Research now shows that young people who initially use e-cigarettes, who have never smoked before, are 3 times more likely to take up tobacco smoking. That aerosol is often called ‘vapour’ and inhaling it from an e-cigarette is known as ‘vaping’.
For example, in an analysis using primary human umbilical vein endothelial cells (HUVEC) exposed to 11 commercially-available vapours, 5 were found to be acutely cytotoxic, and only 3 of those contained nicotine [24]. In addition, 5 of the 11 vapours tested (including 4 that were cytotoxic) reduced HUVEC proliferation and one of them increased the production of intracellular reactive oxygen species (ROS) [24]. Three of the most cytotoxic vapours—with effects similar to those of conventional high-nicotine CS extracts—also caused comparable morphological changes [24]. Endothelial cell migration is an important mechanism of vascular repair than can be disrupted in smokers due to endothelial dysfunction [25, 26]. E-cigarettes are sometimes called e-cigs, vapes, vape pens, e-hookahs, and electronic nicotine delivery systems or ENDS.
Smoking may also contribute to fertility issues and lower sex hormone levels in males and females, leading to decreased sexual desire. Smoking is an environmental risk factor for conditions such as rheumatoid arthritis, though researchers do not yet understand the mechanism behind the connection. The actual policy is below, and it looks like a lot of hoop jumping is involved - age verification upon delivery? Not sure how you would even do this unless sent some sort of signed restricted delivery.
Poisoning from nicotine and e-cigarette liquid can occur by drinking it, spilling it on the skin, and breathing too much vapor. Cases of accidental eye exposure have also been reported as refill bottles are similar to commercially available eye dropper bottles used for therapeutic eye drops. Prohibiting e-cigarette use inside or near buildings, vehicles and other enclosed spaces is the only way to eliminate exposure to secondhand e-cigarette aerosol and health risks that may come with it. Other electronic vapor products that use e-liquids include e-cigars, e-pipes, and hookah pens (e-hookah).
Electronic nicotine and vapor delivery systems, which include e-cigarettes, vaping pens, e-hookah and similar devices, typically contain nicotine. Some ingredients found in e-cigarettes are considered toxic and there is no regulation of what chemicals e-cigarettes contain or how much nicotine the user is inhaling. These factors could lead to long-term adverse health effects for e-cigarette users and bystanders. This new law will reduce exposure to the potentially dangerous chemicals for e-cigarette users and those around them. Prior to electronic cigarettes being added to the Clean Indoor Air Act, only the smoking of substances containing tobacco, including cigars, cigarettes or pipes, were restricted in public places. While many counties have already banned the use of e-cigarettes in public places, including restaurants, bars and other work places, this bill makes the law consistent across New York State.
In addition to these laws, e-cigarettes are prohibited from being used in child care facilities, and people purchasing tobacco products have to pay a 15 percent tax. While not all the effects of smoking are immediate, the complications and damage can last for years. The good news is that quitting smoking can reduce many risk factors for the conditions and diseases below. For a long time, e-cigarettes and other electronic aerosolizers weren’t regulated by the Food and Drug Administration (FDA). They only came under the purview of the FDA in 2016, after they had been on the market for nearly a decade.
Nicotine pouches, led by top-selling Zyn by Swedish Match, have become increasingly popular among adult tobacco consumers, particularly those trying to lower or end their traditional or electronic cigarette consumption. Chalmers said some students are realizing the dangers of vaping after seeing their peers struggle with nicotine addictions. She believes that adding the CATCH My Breath education only solidifies it for them.
While FDA has made progress in reviewing marketing applications for flavored e-cigarettes, it has repeatedly missed deadlines to complete its review of major products and failed to clear the market of these illegal flavored products. Here you will find the facts on vaping, based on scientific evidence and research, plus advice on how to use vapes (sometimes called e-cigarettes or e-cigs) as a tool to quit smoking. Battery-powered vape devices create an aerosol that looks like water vapor but contains nicotine, flavoring, and more than 30 other chemicals. The aerosol is inhaled into the lungs where the nicotine and chemicals cross over into the bloodstream.The earliest vape devices looked like cigarettes. With Americans puffing less each year, the cigarette industry sees ESDs and other smokeless products as financial saviors. E-cigarette sales tripled between 2012 and 2013 rising from $500 million to over $1.5 billion and are expected to soon exceed the sales of traditional cigarettes, motivating giant tobacco and other non-cigarette companies to market this product.
We've curated a selection of authentic premium quality vape products from the best vaporiser manufacturers worldwide. We have high-quality products and knowledge to ensure an exceptional vaping experience customised to your needs. Electronic cigarettes—or e-cigarettes—are battery-powered devices that convert a liquid, usually with nicotine, into an inhalable aerosol. They are designed as an alternative to smoking traditional cigarettes. First introduced in the United States about 15 years ago, e-cigarettes have evolved from disposable, single-use products to more sophisticated devices that can be refilled and customized (fig. 1). PHILADELPHIA – Smoking e-cigarettes, also called vaping, has been marketed as a safe alternative to tobacco cigarettes and is rising in popularity among non-smoking adolescents.
The authors gratefully acknowledge the support from late Dr Ari Haukkala from the University of Helsinki for the dissertation of which this article is part of. The first author was supported for doctoral research including this work by a grant from the Juho Vainio Foundation. The severity of the damage, aspects of which occur even in the absence of nicotine, varies among popular flavors, the researchers said. When you choose The Electric Tobacconist for your vape kits, you're selecting a trusted and experienced retailer. Established in 2013 as one of the first online vape shops, we've been at the forefront of the industry ever since. Our impressive 98% recommendation rating on reviews.io reflects our dedication to customer satisfaction.
According to the manufacturer, a single JUUL pod contains as much nicotine as a pack of 20 regular cigarettes. Although JUUL is currently the top-selling e-cigarette in the U.S., other e-cigarettes are becoming available that look like USB flash drives. Because of their shape, school teachers, administrators, and parents may not notice students using these devices in school, including in classrooms and bathrooms. Adults who use tobacco and are trying to quit should use proven quit tools, like group or phone counseling, paired with medications or nicotine replacement therapy patches, gum or lozenges. The agency says the sweet flavored e-liquids pose a "serious, well-documented risk" of enticing more young people to pick up a nicotine habit. In 2020, nearly 20% of high school students and almost 5% of middle-school students used e-cigarettes, and almost all of those kids used flavored products, the agency said in court documents.
During the Vietnam War, cigarettes were included with C-ration meals. In 1975, the U.S. government stopped putting cigarettes in military rations. During the second half of the 20th century, the adverse health effects of tobacco smoking started to become widely known and printed health warnings became common on cigarette packets. This health advisory is being issued by the State Health Officer to inform the public about the alarming statistics on current e-cigarette use among youth in Wisconsin. In Wisconsin, current e-cigarette use among Wisconsin high school students increased 154% between 2014 and 2018.
Tetrahydrocannabinol (THC)-containing e-cigarette or vaping products was linked to most EVALI cases. Emergency department visits related to e-cigarette, or vaping, products have sharply declined in recent years, but the CDC continues to monitor reports. In 2022, e-cigarettes remained the most common tobacco product used by high school (16.5%) and middle school (4.5%) students in the last 30 days. And more than a quarter (27.6%) of current youth e-cigarette users say they use an e-cigarette product every day.
Please be advised that many of these stories contain graphic and upsetting photos of injuries. Exposure to nicotine can also rewire a young brain to become more easily addicted to other substances, including cocaine and alcohol. Even if a cartridge doesn’t contain nicotine, other harmful chemicals may be present.
In the case of the enzymatic reaction, the two substrates (reactants) are again acetic ester and H2O, the two products of the reaction are alcohol and acetate. Once the acetate group is removed from the cellulose chain, the polymer can be readily degraded by cellulase, which is another enzyme found in fungi, bacteria, and protozoans. Cellulases break down the cellulose molecule into monosaccharides ("simple sugars") such as beta-glucose, or shorter polysaccharides and oligosaccharides. Discarded cigarette filters usually end up in the water system through drainage ditches and are transported by rivers and other waterways to the ocean.
Public health experts and tobacco researchers are trying to find out. Recycle your used vapes and pods for free with New Zealand’s first vape recycling programme. We have an exclusive range of our own brand e-liquids ideal for vapers to use all day, every day.
There are also reports of lung illnesses and deaths related to inhalation of certain vaping oils into the lungs, which have no way to filter out toxic ingredients. You might be tempted to turn to electronic cigarettes (e-cigarettes, vape pens, and other nondisposable and disposable vaping devices) as a way to ease the transition from traditional cigarettes to not smoking at all. But is smoking e-cigarettes (also called vaping) better for you than using tobacco products? Michael Blaha, M.D., M.P.H., director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, shares health information about vaping. Truth Initiative supports regulation that encourages the development of consistently safer nicotine delivery alternatives that allow smokers to quit tobacco altogether or switch completely to a much less harmful, well-regulated product.
According to the CDC, 15% of EVALI patients were less than 18 years old. In addition, e-cigarettes and e-cigarette vapor may contain the chemicals or substances listed below. E-cigarettes are known by many different names, and sometimes people find it hard to understand what is really known about these devices.
However, we do allow certain pre-approved sellers to list e-cigarettes, Electronic Nicotine Delivery Systems (ENDS), and e-liquids on the US eBay website (eBay.com) provided they follow federal, state, local, and other applicable laws and regulations. This policy is applicable to those approved sellers, and buyers who transact with them. Our team of vaping experts regularly updates our blog to bring you the latest trends, product reviews, and tips for optimizing your vaping experience. Sit back, relax, and start exploring our insightful articles and informative guides to take your vaping journey to the next level. We also offer heat-not-burn tobacco devices, and an extensive selection of cannabis vaporizers for dry herb and concentrates.
Ebay recently has allowed pre approved sellers to sell products on ebay that were not allowed in the past. Yet ebay has been allowing the same accounts with ebay stores to continue selling without issue. This website hosts promotional and sales material for adults only (18/19+), not intended for minors. Our customer service team is available 7-days a week to provide courteous and prompt support on anything vaping-related. We understand that you may have questions or concerns about vaping, order details, product warranties, and more, so we've compiled a list of frequently asked questions to help you make informed decisions about your experience. Remember, it’s important to have conversations rather than suspicion and accusations.
Another potential risk posed by vaping indoors is allergic reactions, especially among children. According to research, roughly 8% of kids in the United States have food allergies. Nuts (a common food allergy) are sometimes used to make added flavors in vaping fluids.
To our knowledge, no studies in Europe have examined susceptibility to e-cigarette (S-EC) use and snus use (S-SN). Glyoxal and methylglyoxal are formed by thermal degradation or oxidation of PG and VG87. Glyoxal is considered mutagenic, while the related compound methylglyoxal has been identified as a metabolite during glycolysis and is thus naturally present in the body. Methylglyoxal is also present in foods and drinks such as honey and coffee.
A cigarette is a narrow cylinder containing a combustible material, typically tobacco, that is rolled into thin paper for smoking. The cigarette is ignited at one end, causing it to smolder; the resulting smoke is orally inhaled via the opposite end. The term cigarette, as commonly used, refers to a tobacco cigarette, but the word is sometimes used to refer to other substances, such as a cannabis cigarette or a herbal cigarette. A cigarette is distinguished from a cigar by its usually smaller size, use of processed leaf, different smoking method, and paper wrapping, which is typically white. Not everyone is aware that there is nicotine in most e-cigarettes in varying amounts. Some pods of e-cigarettes contain as much nicotine as one pack of cigarettes (Truth Initiative, 2019).
In 2022, PMI launched a "disposable" e-cigarette called VEEBA (see below). However, PMI’s interests in e-cigarettes are relatively minor compared to its interests in HTPs. This page gives an overview of TTCs interests in e-cigarettes, which have been acquired, developed and sold by these companies since 2012. Products produced by other companies which do not have links to TTCs are not covered on TobaccoTactics. JUUL is a type of e-cigarette/vapor product that has become increasingly popular, especially among youth.
In addition, the VITA only heats its vape liquid to about 240 degrees Fahrenheit. That's much lower than many other kinds of vapes, so it won't be as rough on your lungs. LUVV also says their products are tested to "safeguard against" harmful byproducts of heating metal and vape fluid. They don't provide much detail to support this claim, though, so take it with a grain of salt. Like HELO, LUVV vapes are free of diacetyl, vitamin E acetate, and nicotine.
There is no single test for EVALI; it’s what is known as a "diagnosis of exclusion," which means that a doctor will conduct tests to rule out other potential diseases and conditions. The primary risk factor for EVALI is current or previous use of a vaping device. They can look like cigarettes, cigars, pipes, pens, USB flash drives, or may be in other forms. We fund research that explores how risk factors such as smoking, poor nutrition, and lack of physical activity can affect the development of cancer. For instance, 68 people died in an outbreak of vaping-related illness (EVALI) in 2019 and 2020. Links to E-Cigarette Resources Links other websites, reports educational materials, toolkits and more information on e-cigarettes.
We want to make a difference in the lives of our users, and create products that can fit all levels and styles of vapers, to help as many as possible. Stanford Medicine Tobacco Prevention ToolkitTheory-based and evidence-informed resources created by educators, parents, and researchers aimed at preventing middle and high school students' use of tobacco and nicotine. There are several resources available to assist with learning more about e-cigarettes and educating youth about the risks. Resources are available for parents, educators, and health care providers. According to the 2017 Behavior Risk Factor Survey (BRFS) conducted by DHSS, 4.8 percent of Delaware adults currently use e-cigarettes, roughly the same percentage reported in the 2016 survey.
Just like people around smokers can breathe in cigarette smoke, it’s possible to breathe in e-cigarette aerosol if you’re around someone vaping. This is called secondhand vaping, and there isn't a lot of published research yet on how inhaling this aerosol affects the body, especially among adolescents. If you spend time around someone who vapes, you might be wondering if you can get secondhand smoke from a vape. While there's still a lot we don’t know about the harms of secondhand vaping, research suggests that bystanders who breathe in the aerosol might be exposed to many of the same toxins found in e-cigarettes and even some found in traditional tobacco. E-cigarettes and vapes are electronic devices that vaporize an e-liquid to produce vapor without combustion. With a wide range of flavours and nicotine strengths available in disposable, closed pod, and refillable systems you are sure to enjoy a more discreet and customizable experience that caters to your personal preferences with greater convenience.
The success of all these enterprises hinges on the claim that e-cigarettes are healthier than traditional cigarettes. Companies like to paint a black-and-white picture of a new era of safe smoking. "Cigarettes, you've met your match," NJOY proudly proclaims in its Super Bowl ads. E-cigarettes and vaping are part of a trend going back at least nine years in the U.S. First publicized as a safer alternative to smoking tobacco, vaping caught on because it didn’t contain the carcinogens or tars found in most smoking tobacco products. Also, vaping was supposed to eliminate the dangers of secondhand smoke to those nearby.
This guide supports health care providers, systems, and communities seeking to prevent vaping. These resources and others are on the AAFP’s Tobacco and Nicotine Prevention and Control webpage. Familydoctor.org, the Academy’s patient-facing web resource, has additional materials on tobacco addiction, the harms of vaping and several related topics. Young adults with family incomes of less than 200% of the federal poverty level also were more likely to use e-cigarettes than those with greater family income.
Not to mention the smell that lingers on a person’s body after finishing a cigarette, even if it was outside, far outlasts a vape any day. At Cornell, Jason told me, people Juuled in bathrooms and classrooms, in "every nook and cranny of this campus." In the fall, he’d started a group text, with a few friends, to coördinate pod runs. He called the group Juuluminati, and it has since grown to three hundred and twenty-four members. Jason was Juuling while he talked to me, on the third floor of an academic building. "I know for a fact that there are two or three of my good friends sitting on the first floor of this building eating ham sandwiches and just Juuling away," he said.
Over the years, Evans tried to quit by using the nicotine patch, gum, and even hypnosis. When you stop using it, you can go into withdrawal and feel depressed and crabby. We have lots of detailed vaping guides and blog posts to help new vapers make the transition to vaping. Find everything you need to know about e-liquids, starter kits, and what to expect when switching to vaping. Alternatively, why not speak to one of our customer service advisors? Great for new vapers, disposable vape kits are the simplest way to vape.
To date, FDA has authorized 34 tobacco- and menthol-flavored e-cigarette products and devices. These products have undergone rigorous scientific review, including toxicologic assessments, and have been found by FDA to meet the statutory public health standard. Vaping is often thought of as safer than cigarette smoking, but vaping causes health problems, too.
Sustained e-cigarette use among young people can in part be credited to products remaining on the market illegally for years without U.S. Standards, which prohibit the use of diacetyl in electronic cigarettes, Vapemate juice prioritizes safety. The ingredients are tested for contaminants before the manufacturing process begins, and production takes place in sanitized clean rooms. You can rest assured that you're getting high-quality vape juice with this brand. Smoking causes at least 16 different types of cancer so stopping smoking completely is the best thing you can do for your health.
We are aware of this issue and are diligently working on restoration. Check with your airline on any limitations on the number of devices that can be carried for personal use by a passenger. WHO strives to build a safer, healthier world for everyone, everywhere.
Kids being stuck at home under their parents’ supervision during the COVID-19 pandemic could contribute to that trend. Although there is no federal excise tax on e-cigarettes, states have the authority to tax e-cigarettes. Thirty-two states, the District of Columbia, and two territories have imposed a tax on e-cigarettes as of June 15, 2023. Open-system vapes also often allow you to modify things like temperature and airflow. And since you're not going to be using them over the long run, there's very little chance that their internal components will suffer significant wear and tear. The company makes the test results available for anyone to view, so you can easily verify that the CBD All-In-One vape contains exactly what the label says.
That’s about twice as many people as those who used other methods to quit smoking. Of people who used other methods, 91% kicked nicotine products altogether. People usually think vaping isn’t as bad as cigarette smoking, but the mist you breathe in still has nicotine and other harmful chemicals in it. Vaping isn’t safe and can cause health problems, including life-threatening lung injuries.
Turkey, which has one of the highest percentage of smokers in its population,[126] has a legal age of 18. Japan is one of the highest tobacco-consuming nations, and requires purchasers to be 20 years of age. Since July 2008, Japan has enforced this age limit at cigarette vending machines through use of the taspo smart card. In other countries, such as Egypt, it is legal to use and purchase tobacco products regardless of age.[citation needed] Germany raised the purchase age from 16 to 18 on September 1, 2007. In the unadjusted analyses (Table 3), those planning for vocational education or extra year/discontinuation had higher S-EC compared with those planning for GUSS. Among girls, those without educational aspirations also had higher S-EC.
And nicotine use in young adults still can lead to other illicit substance use. The request from the Federal Trade Commission asks six companies to turn over data by January dealing with the sale and promotion of their products for the years 2015 to 2018. In the United States, states are a primary determinant of the total tax rate on cigarettes. As part of the Family Smoking Prevention and Tobacco Control Act, the federal government collects user fees to fund Food and Drug Administration (FDA) regulatory measures over tobacco.
Commercial tobacco use is the leading cause of preventable disease, disability, and death in the United States.
The Therapeutic Goods Administration (TGA) has not approved any e-cigarette products as a medicine to help people quit smoking. This is because the quality and safety of e-cigarettes has not yet been thoroughly tested, and it is not clear whether they are actually helpful for people trying to quit. Electronic cigarettes (e-cigarettes or vapes) simulate the act of smoking, but you don’t burn tobacco when you use them. Instead, the e-cigarette is a battery-powered device that works by heating liquid into an aerosol, which you then inhale into your lungs. These electronic devices, also known as e-cigarettes, vapes, vape pens, personal vaporizers, e-cigars, pod systems, mods and e-hookah, are not a safe alternative to cigarette smoking. Talk with your teens about the health effects of nicotine and e-cigarettes.
However, the state's largely rural landscape and small population could be partly to blame for its high youth vaping rate. About 80 percent of Wyoming's residents live in rural areas, as much of the land area is used for farming and national parks. Researchers combed through state-by-state data from the Campaign for Tobacco-Free Kids, an advocacy group aimed at stopping youth smoking. Since 2020, emergency department visits in Virginia by patients who said they vape jumped significantly, while visits by those who use traditional tobacco declined, according to stats from Virginia Hospital & Healthcare Association.
The researchers said that the findings suggest that if tobacco cigarette smokers who use e-cigarettes for a healthier alternative to tobacco won’t benefit by the switch. Cannabis and CBD e-liquids usually contain other chemicals, such as base liquids or flavoring agents. They may cause side effects similar to those of nicotine-free e-cigarettes. Young people who vape nicotine are more likely to start smoking cigarettes in the future. The 2018 NAP report concluded there’s some evidence that nicotine and nicotine-free e-cigarettes can damage oral cells and tissues in people who don’t smoke cigarettes.
Electronic smoking devices (or ESDs), which are often called e-cigarettes, heat and vaporize a solution that typically contains nicotine. The devices are metal or plastic tubes that contain a cartridge filled with a liquid that is vaporized by a battery-powered heating element. The aerosol is inhaled by the user when they draw on the device, as they would a regular tobacco cigarette, and the user exhales the aerosol into the environment. Electronic cigarettes (E-Cigarettes) are battery-powered devices that function by heating a liquid into an aerosol that is inhaled by the user.
In some instances, because of its appearance and the vapours it emits, an e-cigarette may be confused with a regular cigarette. Other types of e-cigarettes, however, are similar to a cigar, a smoking pipe, or a ballpoint pen in appearance. This story has been updated to correct that two of the four menthol e-cigarettes from Njoy are disposable products.
Adjusted analyses revealed that the type of e-cigarette device used played no role in the rates of cigarette discontinuation. Data were taken from the nationally representative Population Assessment of Tobacco and Health Study (PATH), which assessed participants through audio-based, computer-assisted self-interviews in English or Spanish. Interviews were conducted in "waves" -- October 2014 to October 2015, October 2015 to October 2016, December 2016 to January 2018, and December 2018 to November 2019.
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.
According to the study, 40.1% of 1,018 adolescents between the ages of 14 and 29 surveyed said they refilled devices not intended to be refilled and 35.8% recharged the battery of vaping pods meant to be thrown out after one use. Others reported mixing nicotine and cannabis liquids in devices designed only for nicotine. The decision lends new credibility to vaping companies’ longstanding claim that their products can help blunt the toll of smoking, which is blamed for 480,000 U.S. deaths annually due to cancer, lung disease and heart disease. Some of the harmful substances emitted in secondhand e-cigarette aerosols are similar to those in secondhand tobacco smoke.
"More research about the health effects of alternative tobacco products is critically needed to put science behind the regulation of the tobacco industry." As the debate blazes, deep-pocketed big tobacco investors are buying up e-cig companies, injecting millions of dollars into the market and banking on a bright future for the devices. More than 100 e-cigarette companies are now jockeying for the business of smokers and nonsmokers alike.
In Cumberland County, Chalmers McClain and Graham said the growing number pros n cons of electronic cigarettes vape shops opening near schools with their colorful and bright lights to attract students is also part of the problem. For example, Ramsey Street Alternative High School has two vape shops within a six-minute walk from the school. Teacher concerns around increasing the suspension rates of students caught vaping on school property prompted the initial pilot and current implementation of CATCH My Breath into county schools, said Graham.
High level of parental education was operationalized as at least one parent having tertiary education, and parental smoking as at least one parent smoking currently. ’ and dichotomized from responses Very much/quite a lot (vs. fairly little/not at all). Delaware Kick Butts Generation A youth-led program in schools and communities to counter tobacco marketing. E-cigarette flavorings damage human blood vessel cells grown in the lab even in the absence of nicotine, Stanford researchers and their colleagues found. Children are much more prone to nicotine overdose because of their smaller body size. Nicotine poisoning in children comes mostly from eating cigarettes and consuming liquid nicotine — either from absorbing spilled nicotine through their skin or through the mucous membrane in their mouth or from swallowing liquid nicotine.
The program offers specially-trained coaches, real-time text or chat support, easy enrollment and youth-focused promotional and educational materials. The majority of cases reported to poison centers are due to accidental exposures in children less than 6 years old. This reflects the increasing availability of these products in the home due to use by guardians or older siblings. Additionally, in the last 5 years, the FDA has warned companies selling e-cigarette devices made in the shape of toys, foods or cartoons that specifically appeal to use by young people. Of this sample, 3,242 participants developed heart failure within a median follow-up time of 45 months. As e-cigarettes deliver flavorings, additives, and, typically, nicotine through an inhaled aerosol, they are harmful to both the user and those who are exposed secondhand.
E-cigarettes and vape products are not FDA-approved cessation devices. For more information and support to help you quit contact the Georgia Tobacco Quit Line. Electronic cigarettes (e-cigarettes) and other vapor products are used to heat and aerosolize (turn into particles) liquid known as e-juice (vape juice) containing highly addictive nicotine or other substances that a person can inhale into their lungs.
Though not all flavors have yet been scientifically studied, there is a strong chance others may also be harmful. We work with community partners to raise awareness of the harms of e-cigarettes and vaping and flavored tobacco products that attract youth, through the Unhyped and CounterBalance campaigns. We also review and share e-cigarette use data and trends and tailor our education efforts accordingly. Learn more about potential health hazards of secondhand aerosol (a.k.a. vapor) emitted by electronic cigarettes and electronic cigarette hand luggage smoking devices.
Simply select your manager software from the list below and click Download.For more information or tips please see 'Downloading to a citation manager' in the Help menu. The Vital Records service window in the Lucas State Office Building will be closed on August 6-7 due to construction. As of April 1st, 2024, 1,061 municipalities, plus 26 states, commonwealths, and territories restrict e-cigarette use in 100% smokefree venues.
Separate studies have shown that newer e-cigarettes may deliver higher doses of nicotine more efficiently, which could explain the recent findings. The investigators acknowledged that more frequent use of e-cigarettes may also reflect greater determination to quit smoking combustible cigarettes. They noted that their study did not evaluate the risks of youth e-cigarette use. E-cigarettes are the most commonly used commercial tobacco product among youth,1 so it is critical that public health officials and the general public understand the potential risks of using them.
With millions of teens and young adults using e-cigarettes, a new generation could become addicted to nicotine and face other health risks. For some adult smokers, e-cigarettes may offer a less harmful substitute for traditional cigarettes. However, long-term effects on users, second-hand exposure, and environmental effects are not yet fully known. The e-liquid typically contains humectants and flavourings, with or without nicotine; once vapourised by the atomiser, the aerosol (vapour) provides a sensation similar to tobacco smoking, but purportedly without harmful effects [3].
While e-cigarette use prevalence has declined significantly since the heyday of JUUL — 10% of high school students reported using e-cigarettes in 2023 — e-cigarette use among young people remains a concern. Thousands of flavored, high-nicotine, and relatively cheap e-cigarette products remain on the market — many of them illegally — driving youth use and nicotine addiction. Equally concerning, nearly half of young people who have ever tried e-cigarettes continue to use them, and many do so daily. As encouraging as the data was a few years ago, it’s starting to look like that’s not the case. The FDA is yet to approve them as a smoking cessation aid and a recent CDC study found that most adult e-cigarette users — 58.8 percent of them — don't stop smoking cigarettes and instead wind up using both products. The few scientists actively trying to fill the gap in the research literature are running into obstacles.