essay on tobacco

Essay on Smoking

500 words essay on  smoking.

One of the most common problems we are facing in today’s world which is killing people is smoking. A lot of people pick up this habit because of stress , personal issues and more. In fact, some even begin showing it off. When someone smokes a cigarette, they not only hurt themselves but everyone around them. It has many ill-effects on the human body which we will go through in the essay on smoking.

Ill-Effects of Smoking

Tobacco can have a disastrous impact on our health. Nonetheless, people consume it daily for a long period of time till it’s too late. Nearly one billion people in the whole world smoke. It is a shocking figure as that 1 billion puts millions of people at risk along with themselves.

Cigarettes have a major impact on the lungs. Around a third of all cancer cases happen due to smoking. For instance, it can affect breathing and causes shortness of breath and coughing. Further, it also increases the risk of respiratory tract infection which ultimately reduces the quality of life.

In addition to these serious health consequences, smoking impacts the well-being of a person as well. It alters the sense of smell and taste. Further, it also reduces the ability to perform physical exercises.

It also hampers your physical appearances like giving yellow teeth and aged skin. You also get a greater risk of depression or anxiety . Smoking also affects our relationship with our family, friends and colleagues.

Most importantly, it is also an expensive habit. In other words, it entails heavy financial costs. Even though some people don’t have money to get by, they waste it on cigarettes because of their addiction.

How to Quit Smoking?

There are many ways through which one can quit smoking. The first one is preparing for the day when you will quit. It is not easy to quit a habit abruptly, so set a date to give yourself time to prepare mentally.

Further, you can also use NRTs for your nicotine dependence. They can reduce your craving and withdrawal symptoms. NRTs like skin patches, chewing gums, lozenges, nasal spray and inhalers can help greatly.

Moreover, you can also consider non-nicotine medications. They require a prescription so it is essential to talk to your doctor to get access to it. Most importantly, seek behavioural support. To tackle your dependence on nicotine, it is essential to get counselling services, self-materials or more to get through this phase.

One can also try alternative therapies if they want to try them. There is no harm in trying as long as you are determined to quit smoking. For instance, filters, smoking deterrents, e-cigarettes, acupuncture, cold laser therapy, yoga and more can work for some people.

Always remember that you cannot quit smoking instantly as it will be bad for you as well. Try cutting down on it and then slowly and steadily give it up altogether.

Get the huge list of more than 500 Essay Topics and Ideas

Conclusion of the Essay on Smoking

Thus, if anyone is a slave to cigarettes, it is essential for them to understand that it is never too late to stop smoking. With the help and a good action plan, anyone can quit it for good. Moreover, the benefits will be evident within a few days of quitting.

FAQ of Essay on Smoking

Question 1: What are the effects of smoking?

Answer 1: Smoking has major effects like cancer, heart disease, stroke, lung diseases, diabetes, and more. It also increases the risk for tuberculosis, certain eye diseases, and problems with the immune system .

Question 2: Why should we avoid smoking?

Answer 2: We must avoid smoking as it can lengthen your life expectancy. Moreover, by not smoking, you decrease your risk of disease which includes lung cancer, throat cancer, heart disease, high blood pressure, and more.

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Smoking: Effects, Reasons and Solutions Essay

Reasons for smoking, harmful health effects of smoking, solution to smoking.

Smoking is the inhalation and exhalation of substances or fumes that come from burning tobacco. In the past, smoking was believed to be risk-free, but medical studies have recently reported that tobacco smoking has about 4000 chemical elements. These chemical elements contain toxic components. This presentation provides harmful health effects of smoking, reasons for smoking, and solutions to smoking.

• Advertising causes mainly young people to smoke. Cigarette smoking is advertised several times more than any commodity apart from cars. Several tobacco advertisements are carried out in attractive and amusing places. For young people to be part of these gorgeous places, they might consider the necessity to buy that product.
• Another reason is the “everybody’s doing it” attitude, where during adolescent stage, teenagers are urgently attempting to squeeze in and be cool.
• For some young people, smoking might signify independence or freedom. One key development role of teenage stage is to declare independence from their parents or guardians through building personal identity.
• Weight control is a significant concern among adolescent girls and is demonstrated in cigarette adverts and posters. Adolescents are not at all shown what cigarette smoking does to teenagers’ lungs and heart.
• Adults smoke for certain motives. They may have numerous stress and pressure cases due to financial and private difficulties.
• Finally, most lifetime smokers state that they love smoking. Smoking offers them enjoyment and only makes smokers have a sense of happiness.
• Thousands of tobacco users die around the world annually due to smoke-related illness.
• Some tobacco users are reported to die due to their habit, where most deaths occur in middle age.
• The combination of carbon dioxide and nicotine substances in all cigarettes that are being smoked momentarily raises blood pressure and heart rate. This damages the blood vessels.
• Smoking can result in stroke and heart attacks since it hinders blood flow, interrupting oxygen to various parts of the body, such as feet and hands.
• Introduction of cigarettes with low tar does not reduce these effects since smokers often prefer deeper puffs and hold the smoke in lungs for a long period. This smoking practice draws the tar deeper into the deeper parts of the lungs.
• Carbon dioxide takes away oxygen from muscles, body, and brain tissues, this process makes entire body, particularly the heart, work extra hard. Eventually, the airways puff up and allow inadequate air, especially oxygen, into the lungs.
• Tobacco usage during pregnancy raises the possibility of low birth weight, unplanned abortion, prematurity, and prenatal mortality in women. This has been considered by medical practitioners a fetal cigarette smoking disorder.
• Nicotine substitute substances are accessible through medical professions and health clinics, which comprise doses, nasal sprays, and transdermal. Most smokers believe that smoking is more economical to relieve desires while they concentrate on taking away the psychological position of the addiction.
• Mentally organizing yourself to give up smoking allows the smoker to adapt to the concept of becoming a nonsmoker. Smokers should take some time to cope with the concept rather than making instant decision in quitting smoking.
• NRT raises the success rate for smokers under cessation sessions since every form of NRT has been reported to be efficient. They have minimal or no severe side effects to smokers.
• Combination therapy that engages the drug Zyban, the concurrent using of NRT (bubble gum) and counseling of smokers under smoking cessation program appear to be an efficient solution for most tobacco users.
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IvyPanda. (2019, November 20). Smoking: Effects, Reasons and Solutions. https://ivypanda.com/essays/smoking/

"Smoking: Effects, Reasons and Solutions." IvyPanda , 20 Nov. 2019, ivypanda.com/essays/smoking/.

IvyPanda . (2019) 'Smoking: Effects, Reasons and Solutions'. 20 November.

IvyPanda . 2019. "Smoking: Effects, Reasons and Solutions." November 20, 2019. https://ivypanda.com/essays/smoking/.

1. IvyPanda . "Smoking: Effects, Reasons and Solutions." November 20, 2019. https://ivypanda.com/essays/smoking/.

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How To Write A Smoking Essay That Will Blow Your Classmates out of the Water

A smoking essay might not be your first choice, but it is a common enough topic, whether it is assigned by a professor or left to your choice. Today we’ll take you through the paces of creating a compelling piece, share fresh ideas for writing teen smoking essays, and tackle the specifics of the essential parts of any paper, including an introduction and a conclusion.

Why Choose a Smoking Essay?

If you are free to select any topic, why would you open this can of worms? There are several compelling arguments in favor, such as:

• A smoking essay can fit any type of writing assignment. You can craft an argumentative essay about smoking, a persuasive piece, or even a narration about someone’s struggle with quitting. It’s a rare case of a one-size-fits-all topic.
• There is an endless number of  environmental essay topics ideas . From the reasons and history of smoking to health and economic impact, as well as psychological and physiological factors that make quitting so challenging.
• A staggering number of reliable sources are available online. You won’t have to dig deep to find medical or economic research, there are thousands of papers published in peer-reviewed journals, ready and waiting for you to use them. 

Essential Considerations for Your Essay on Smoking

Whether you are writing a teenage smoking essay or a study of health-related issues, you need to stay objective and avoid including any judgment into your assignment. Even if you are firmly against smoking, do not let emotions direct your writing. You should also keep your language tolerant and free of offensive remarks or generalizations.

The rule of thumb is to keep your piece academic. It is an essay about smoking cigarettes you have to submit to your professor, not a blog post to share with friends.

How to Generate Endless Smoking Essay Topic Ideas

At first, it might seem that every theme has been covered by countless generations of your predecessors. However, there are ways to add a new spin to the dullest of topics. We’ll share a unique approach to generating new ideas and take the teenage smoking essay as an example. To make it fresh and exciting, you can:

• Add a historic twist to your topic. For instance, research the teenage smoking statistics through the years and theorize the factors that influence the numbers.
• Compare the data across the globe. You can select the best scale for your paper, comparing smoking rates in the neighboring cities, states, or countries.
• Look at the question from an unexpected perspective. For instance, research how the adoption of social media influenced smoking or whether music preferences can be related to this habit.

The latter approach on our list will generate endless ideas for writing teen smoking essays. Select the one that fits your interests or is the easiest to research, depending on the time and effort you are willing to put into essay writing .

How To Write An Essay About Smoking Cigarettes

A smoking essay follows the same rules as an academic paper on any other topic. You start with an introduction, fill the body paragraphs with individual points, and wrap up using a conclusion. The filling of your “essay sandwich” will depend on the topic, but we can tell for sure what your opening and closing paragraphs should be like.

Smoking Essay Introduction

Whether you are working on an argumentative essay about smoking or a persuasive paper, your introduction is nothing but a vessel for a thesis statement. It is the core of your essay, and its absence is the first strike against you. Properly constructed thesis sums up your point of view on the economic research topics and lists the critical points you are about to highlight. If you allude to the opposing views in your thesis statement, the professor is sure to add extra points to your grade.

The first sentence is crucial for your essay, as it sets the tone and makes the first impression. Make it surprising, exciting, powerful with facts, statistics, or vivid images, and it will become a hook to lure the reader in deeper. 

Round up the introduction with a transition to your first body passage and the point it will make. Otherwise, your essay might seem disjointed and patchy. Alternatively, you can use the first couple of sentences of the body paragraph as a transition.

Smoking Essay Conclusion

Any argumentative and persuasive essay on smoking must include a short conclusion. In the final passage, return to your thesis statement and repeat it in other words, highlighting the points you have made throughout the body paragraphs. You can also add final thoughts or even a personal opinion at the end to round up your assignment.

Think of the conclusion as a mirror reflection of your introduction. Start with a transition from the last body paragraph, follow it with a retelling of your thesis statement, and complete the passage with a powerful parting thought that will stay with the reader. After all, everyone remembers the first and last points most vividly, and your opening and closing sentences are likely to have a significant influence on the final grade.

Bonus Tips on How to Write a Persuasive Essay About Smoking

With the most challenging parts of the smoking essay out of the way, here are a couple of parting tips to ensure your paper gets the highest grade possible:

• Do not rely on samples you find online to guide your writing. You can never tell what grade a random essay about smoking cigarettes received. Unless you use winning submissions from essay competitions, you might copy faulty techniques and data into your paper and get a reduced grade.
• Do not forget to include references after the conclusion and cite the sources throughout the paper. Otherwise, you might get accused of academic dishonesty and ruin your academic record. Ask your professor about the appropriate citation style if you are not sure whether you should use APA, MLA, or Chicago.
• Do not submit your smoking essay without editing and proofreading first. The best thing you can do is leave the piece alone for a day or two and come back to it with fresh eyes and mind to check for redundancies, illogical argumentation, and irrelevant examples. Professional editing software, such as Grammarly, will help with most typos and glaring errors. Still, it is up to you to go through the paper a couple of times before submission to ensure it is as close to perfection as it can get.
• Do not be shy about getting help with writing smoking essays if you are out of time. Professional writers can take over any step of the writing process, from generating ideas to the final round of proofreading. Contact our agents or skip straight to the order form if you need our help to complete this assignment.

We hope our advice and ideas for writing teen smoking essays help you get out of the slump and produce a flawless piece of writing worthy of an A. For extra assistance with choosing the topic, outlining, writing, and editing, reach out to our support managers .

Home — Essay Samples — Nursing & Health — Nursing — Argumentative Essay On Smoking Cigarettes

Argumentative Essay on Smoking Cigarettes

• Categories: Nursing

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Words: 507 |

Published: Mar 13, 2024

Words: 507 | Page: 1 | 3 min read

Table of contents

Health effects of smoking, economic implications, impact on non-smokers, the case for regulation, references:.

• Centers for Disease Control and Prevention. (2020). Smoking & Tobacco Use. Retrieved from https://www.cdc.gov/tobacco/data_statistics/index.htm

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Persuasive Essay Guide

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Are you wondering how to write your next persuasive essay about smoking?

Smoking has been one of the most controversial topics in our society for years. It is associated with many health risks and can be seen as a danger to both individuals and communities.

Writing an effective persuasive essay about smoking can help sway public opinion. It can also encourage people to make healthier choices and stop smoking. 

But where do you begin?

In this blog, we’ll provide some examples to get you started. So read on to get inspired!

• 1. What You Need To Know About Persuasive Essay
• 2. Persuasive Essay Examples About Smoking
• 3. Argumentative Essay About Smoking Examples
• 4. Tips for Writing a Persuasive Essay About Smoking

What You Need To Know About Persuasive Essay

A persuasive essay is a type of writing that aims to convince its readers to take a certain stance or action. It often uses logical arguments and evidence to back up its argument in order to persuade readers.

It also utilizes rhetorical techniques such as ethos, pathos, and logos to make the argument more convincing. In other words, persuasive essays use facts and evidence as well as emotion to make their points.

A persuasive essay about smoking would use these techniques to convince its readers about any point about smoking. Check out an example below:

Simple persuasive essay about smoking

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Persuasive Essay Examples About Smoking

Smoking is one of the leading causes of preventable death in the world. It leads to adverse health effects, including lung cancer, heart disease, and damage to the respiratory tract. However, the number of people who smoke cigarettes has been on the rise globally.

A lot has been written on topics related to the effects of smoking. Reading essays about it can help you get an idea of what makes a good persuasive essay.

Here are some sample persuasive essays about smoking that you can use as inspiration for your own writing:

Persuasive speech on smoking outline

Persuasive essay about smoking should be banned

Persuasive essay about smoking pdf

Persuasive essay about smoking cannot relieve stress

Persuasive essay about smoking in public places

Speech about smoking is dangerous

Persuasive Essay About Smoking Introduction

Persuasive Essay About Stop Smoking

Short Persuasive Essay About Smoking

Stop Smoking Persuasive Speech

Check out some more persuasive essay examples on various other topics.

Argumentative Essay About Smoking Examples

An argumentative essay is a type of essay that uses facts and logical arguments to back up a point. It is similar to a persuasive essay but differs in that it utilizes more evidence than emotion.

If you’re looking to write an argumentative essay about smoking, here are some examples to get you started on the arguments of why you should not smoke.

Argumentative essay about smoking pdf

Argumentative essay about smoking in public places

Argumentative essay about smoking introduction

Check out the video below to find useful arguments against smoking:

Tips for Writing a Persuasive Essay About Smoking

You have read some examples of persuasive and argumentative essays about smoking. Now here are some tips that will help you craft a powerful essay on this topic.

Choose a Specific Angle

Select a particular perspective on the issue that you can use to form your argument. When talking about smoking, you can focus on any aspect such as the health risks, economic costs, or environmental impact.

Think about how you want to approach the topic. For instance, you could write about why smoking should be banned. 

Check out the list of persuasive essay topics to help you while you are thinking of an angle to choose!

Research the Facts

Before writing your essay, make sure to research the facts about smoking. This will give you reliable information to use in your arguments and evidence for why people should avoid smoking.

You can find and use credible data and information from reputable sources such as government websites, health organizations, and scientific studies. 

For instance, you should gather facts about health issues and negative effects of tobacco if arguing against smoking. Moreover, you should use and cite sources carefully.

Paper Due? Why Suffer? That's our Job!

Make an Outline

The next step is to create an outline for your essay. This will help you organize your thoughts and make sure that all the points in your essay flow together logically.

Your outline should include the introduction, body paragraphs, and conclusion. This will help ensure that your essay has a clear structure and argument.

Use Persuasive Language

When writing your essay, make sure to use persuasive language such as “it is necessary” or “people must be aware”. This will help you convey your message more effectively and emphasize the importance of your point.

Also, don’t forget to use rhetorical devices such as ethos, pathos, and logos to make your arguments more convincing. That is, you should incorporate emotion, personal experience, and logic into your arguments.

Introduce Opposing Arguments

Another important tip when writing a persuasive essay on smoking is to introduce opposing arguments. It will show that you are aware of the counterarguments and can provide evidence to refute them. This will help you strengthen your argument.

By doing this, your essay will come off as more balanced and objective, making it more convincing.

Finish Strong

Finally, make sure to finish your essay with a powerful conclusion. This will help you leave a lasting impression on your readers and reinforce the main points of your argument. You can end by summarizing the key points or giving some advice to the reader.

A powerful conclusion could either include food for thought or a call to action. So be sure to use persuasive language and make your conclusion strong.

To conclude,

By following these tips, you can write an effective and persuasive essay on smoking. Remember to research the facts, make an outline, and use persuasive language.

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Essay on Tobacco

Students are often asked to write an essay on Tobacco in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Tobacco

Tobacco: a dangerous plant.

Tobacco is a harmful plant that can cause serious health problems. It contains nicotine, a highly addictive substance that can damage the brain and body.

Health Risks of Tobacco

Smoking tobacco can lead to many health problems, including lung cancer, heart disease, and stroke. It can also cause respiratory problems, such as bronchitis and emphysema. Smoking can also damage the skin and teeth.

The Addictive Nature of Nicotine

Nicotine is a powerful addictive drug. It can be difficult to quit smoking once you start. Nicotine withdrawal can cause irritability, anxiety, and depression.

Secondhand Smoke

Secondhand smoke is the smoke from cigarettes, cigars, or pipes that is breathed in by people who are not smoking. Secondhand smoke can cause health problems in nonsmokers, including cancer, heart disease, and stroke.

Tobacco is a harmful substance that can cause serious health problems. Smoking tobacco can lead to cancer, heart disease, and stroke. It can also cause respiratory problems and damage the skin and teeth. Secondhand smoke can cause health problems in nonsmokers.

Also check:

• Speech on Tobacco

250 Words Essay on Tobacco

Tobacco: a harmful habit.

Tobacco is a plant that is grown for its leaves, which are dried and used to make cigarettes, cigars, and other tobacco products. Tobacco contains nicotine, a drug that is addictive and can have harmful effects on your health.

Smoking tobacco can cause many health problems, including cancer, heart disease, stroke, and lung disease. It can also increase your risk of developing gum disease, cataracts, and age-related macular degeneration. Smoking during pregnancy can also harm the baby.

Even if you don’t smoke, you can still be exposed to tobacco smoke from other people who smoke. This is called secondhand smoke, and it can also cause health problems, including cancer, heart disease, and stroke.

Quitting Tobacco

Quitting tobacco is one of the best things you can do for your health. There are many resources available to help you quit, including support groups, counseling, and medication.

Tobacco is a harmful substance that can have a negative impact on your health. If you smoke, quitting is the best way to protect your health and the health of those around you.

500 Words Essay on Tobacco

Tobacco: a plant with a dark side.

Tobacco is a plant that has been used for centuries by people all over the world. It is native to the Americas, but it is now grown in many countries around the world. Tobacco contains nicotine, which is a highly addictive drug. Nicotine is what makes cigarettes and other tobacco products so appealing.

The Dangers of Tobacco

Tobacco smoke contains over 7,000 chemicals, many of which are known carcinogens. This means that they can cause cancer. Smoking tobacco is the leading cause of preventable death in the United States. It is responsible for more deaths than car accidents, murders, and AIDS combined.

Tobacco smoke can also cause serious health problems, such as heart disease, stroke, and COPD (chronic obstructive pulmonary disease). COPD is a group of lung diseases that make it hard to breathe.

The History of Tobacco

Tobacco was first used by Native Americans for religious and ceremonial purposes. European explorers brought tobacco back to Europe in the 16th century, and it quickly became popular there. By the 19th century, tobacco was being smoked by people all over the world.

The Tobacco Industry

The tobacco industry is a powerful and profitable industry. It spends billions of dollars each year on advertising and lobbying. The tobacco industry has a long history of deceiving the public about the dangers of smoking.

The Fight Against Tobacco

There has been a growing movement to fight tobacco use in recent years. This movement has led to increased taxes on tobacco products, smoke-free laws, and public awareness campaigns. As a result of these efforts, smoking rates have declined in many countries.

Tobacco is a dangerous drug that can cause serious health problems. The tobacco industry has a long history of deceiving the public about the dangers of smoking. There is a growing movement to fight tobacco use, and smoking rates have declined in many countries as a result of these efforts.

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‘Eloquence and Oracle’: Tobacco in Eighteenth-Century Life and Literature

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• Andrew Russell 7  

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In a seventeenth-century play, tobacco argues for the superiority of its ‘divine breath’ in distilling eloquence and oracle upon the tongue. This essay argues that tobacco’s arrival on European shores is reflected in two distinctive eighteenth-century literary genres, namely ‘object’- or ‘it’-narratives and the ‘poetry of attention’. Such literary works reflect eighteenth-century interest in questions of ‘sentient matter’ and ‘material agency’ and the increasingly detailed examination of nature demanded by empirical science. Using concepts derived from material culture studies and Actor-Network Theory, and examples from the deep history and current landscapes of tobacco in lowland South America, this essay argues that tobacco’s transit from ‘New’ to ‘Old’ World brought with it some cognitive changes that may have had a hitherto unrecognized influence on Enlightenment life and literature.

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Latour and Literature

Introduction: Narrating the Nonhuman

Moving Beyond the Frame: Literature, Madness, and Vincent van Gogh in Manuel Rivas’s Os comedores de patacas

Human beings need breath to function, to speak, and to do many things that are essential to life. They also use breath to inhale products that are variously pleasurable or efficacious. One such product is tobacco. From its origins in the Americas, tobacco arrived on European shores in substantial quantities from the early seventeenth century onwards. While some was imbibed as snuff or chewing tobacco, the bulk was added, as smoke, to breath. What were the consequences of the high and intense levels of tobacco consumption, particularly among the male literati of the time, on human life and thought? Can we draw parallels between the influence of tobacco in the eighteenth century and its place in indigenous societies in lowland South America where its evolutionary and human histories are longest? To answer such questions I bring anthropology, science, and technology studies into communication with literature and the other creative arts, based on the assumption that the latter can reveal ‘those dimensions of personal and social life we may have little access to when using other research strategies’. 1 Using an interdisciplinary approach I argue through comparative analysis for the significance of tobacco as a hitherto unacknowledged agent in the development of the epoch we now call ‘the Enlightenment’.

Tobacco is an example of things which, for ethnographers, ‘may appear as material objects; as practices or concepts; as events, institutions or beliefs; as gifts, mana, traps, actants, spirits or dividuals; or as structures, perspectives, networks, systems or scales’. 2 Tobacco has multiple dimensions of ‘thingness’, through the multiple hybrid relationships it establishes with people. Lupton et al. use the example of ‘the swimmer, who while wearing the goggles, embodies the ability to swim differently, and the goggles, who when wearing the swimmer, acquire the ability to move’. 3 We can think similarly about, and reflect on, the relationship between people and tobacco. For example, the person who inhales tobacco smoke embodies an altered state of consciousness, while tobacco, incinerated and penetrating the lungs on the breath of the smoker, acquires the ability to increase the spread and reach of its species. 4 Geismar distinguishes between objects with impact (like falling meteorites) and objects with agency (which, to be effective, must be ‘entangled within social relations and indeed within our own humanity’). 5 Tobacco, I argue, is both—the agency it garners through hybrid relationships with people is matched by the impact/agency it develops in its own right. My essay is thus part of a broader framework, traversing both anthropology and literary studies, associated with notions such as actor-networks, ‘material agency’, and ‘thing power’. It invites us to think differently about tobacco, both temporally and spatially—to consider its arrival on European shores as a mere blip in time, and its transmogrification into cigarettes as an unseemly aberration of twentieth- (and now twenty-first-) century capitalism.

In what follows, I first consider some significant features of the ‘deep history’ of tobacco in lowland South America—its role in constituting persons, changing perspectives, and generating dualisms. I then explore the possibility that the impact of tobacco in eighteenth-century European life was associated with similar manifestations of material agency, and how its entanglements with people can be discerned through the art and literature of the period. Finally I identify two eighteenth-century literary genres where tobacco’s influence may particularly reverberate, namely the popular object- or ‘it’-narratives of the time, and the less commonly recognized or celebrated ‘poetry of attention’. 6

A Deep History of Tobacco in Lowland South America

Tobacco constituting persons, shifting shapes, and changing perspectives.

Tobacco has a 10,000-year history of engagement with humanity in lowland South America. For the Muinane, Witoto, and Andoke, the self-styled ‘People of the Centre’ living along the Brazilian/Colombian border, tobacco actively constitutes persons, exemplified in an elder’s remark that ‘we all have the same hearts, made from the same tobacco’. 7 Among the Xié of Amazonia the newborn is a ‘little fish’: a creature fluid and vulnerable, in need of forming into a fully-fledged human being. 8 Tobacco smoke serves to cool, dry out, and firm up—to humanize the less than human. So great is this sense of tobacco constituting persons that among the People of the Centre differences that westerners might consider cultural are attributed to differences between their tobaccos. 9

In contrast to western notions of the ‘natural body’, regarded as a generally stable substrate for the range and diversity of multiple human cultures, for Amazonian peoples culture is the stable constant, a ‘soul essence’ that underpins and is shared with a multiplicity of natural forms of which humans are only one. The ‘chronically unstable’ 10 boundaries within and between the variety of human and non-human animals, plants, and objects require careful nurturing, and tobacco is a key component in this process. Another manifestation of Amazonian body instabilities is belief in the propensity of bodies to alter and transform, a property known as shape-shifting. 11 This shape-shifting may also occur when, through ingestion of prodigious quantities of tobacco, shamans become were-animals (particularly jaguars), combative heroes against opposing ‘spirits, sorcerers, sickness, and death’. 12 Tobacco, a mainstay of shamanic practice, is strongly implicated in this shape-shifting agenda. 13

Shape-shifting is not always an easy matter for Amerindians to deal with. ‘Metamorphosis is something that haunts the native imagination’, writes Vilaça about the Wari’ in the Rodonia region of Brazil. 14 A Wari’ story relates the luring of a child into the forest by her mother to pick fruit. One day the child realizes they have spent an inordinate amount of time away from home and notices a tail discreetly hidden between her mother’s legs. She cries out in alarm and the jaguar flees, leaving a trail of paw-prints. The anthropologist who recorded this story relates that one woman, telling her about this event, said that the girl’s true mother hereafter warned the girl always to distrust other people: ‘Whenever she went far from home, either with her mother or father, she should take along a brother or sister as company (in order, I assume, to secure her point of view)’. 15

This extends into what the anthropologist Eduardo Viveiros de Castro describes as ‘the conception, common to many peoples of the continent, according to which the world is inhabited by different sorts of subjects or persons, human and non-human, which apprehend reality from different points of view’. 16 So marked is this recognition of perspectives other than one’s own, and so profound its consequences, that Viveiros de Castro has coined the term ‘cosmological perspectivism’ to encompass it. Perspectivism leaves ‘indelible, though elusive, marks’. 17 A compelling example is a pattern of speech common to many lowland South American groups, reflected in phrases such as ‘ this is beautiful to me ’ , ‘ for him, the animal turned into a jaguar ’ , and ‘ to us, there appeared prey while we were making the canoe ’, as Stolz-Lima records in the Portuguese spoken by the Juruna of Brazil. 18

This grammatical relativization of ‘self’ and ‘non-self’ offers a constant perspectival reminder that, while this is how it was for me (or us), others might see things differently. The ability to shift perspective in this way is a recurrent trope in lowland South American folklore. I suggest there are discernible parallels in eighteenth-century Enlightenment life, literature, and the creative arts.

Tobacco Generates Dualisms

Tobacco’s ability to generate dualisms is exemplified by the structuralist paradigm of Claude Lévi-Strauss, which in turn derives from his claims about deep, fundamentally binary structures of the human mind. The myths analyzed by Lévi-Strauss in his four-volume Mythologiques come from across the Americas, and correspond with ‘the limits of tobacco distribution in the New World’. 19 Lévi-Strauss’s fundamental categorical premise, indeed what has been described as a core Amerindian cosmological concern, 20 is the opposition of nature and culture, whatever these two poles might contain in specific circumstances. Volume Two of Mythologiques ( From Honey to Ashes ) presents one such mythic system, one which, significantly enough, ‘revolves round the central theme of tobacco’. 21

Where they are acknowledged, the binaries inherent in much structural theory seem to fit the ethnographic data in North and South America surprisingly well. This is precisely the same hemisphere marked by what Wilbert calls an ubiquitous ‘tobacco ideology’ which, he suggests, indicates ‘the extraordinary power of this agent of diffusion’. 22 Could it be that tobacco constituting persons, bending perspectives, and possibly even generating the binary oppositions on which Lévi-Strauss was able to build his theories may have had something to do with the long-term relationship between plant and people in the region? I argue for its influence on the life and thought of the people living there over the millennia. Can similar influences be discerned in some of the intellectual changes that helped precipitate what we now call the ‘Enlightenment’?

Tobacco in Enlightenment Life and Thought

Various reasons have been posited to explain the emergence of the philosophical and cultural epoch known as the ‘Enlightenment’ in Europe. One element that I feel has been ignored or overlooked in such analyses is the arrival of tobacco on European shores. It is suggestive that the word Enlightenment is first recorded in the English language in 1621, at around the same time as tobacco was starting to make substantial inroads into European life. Given the impact and agency of tobacco, a case can be made for including this powerful substance as a significant but hitherto neglected component in the history of the period.

The Stupefying Pleasures and Material Sociality of Tobacco

At the turn of the seventeenth century, the average price of Spanish American tobacco in London was about £1.10s. per pound; labourers’ wages were about 8d. per day. However, consumption increased as the supply of tobacco from the nascent Virginian colonies started to grow from 1640 onwards. By the start of the eighteenth century, Davies estimates that tobacco imports into England totalled around 26 million pounds annually. Sixty per cent of this was re-exported to other parts of Europe, but the remaining 10.4 million pounds still permitted a generous one and a half pounds of tobacco per inhabitant per year—enough for twenty-five per cent of the adult population to enjoy a pipe and a half every day. 23 The Dutch were consuming tobacco in similar proportions. 24

Social spaces such as coffee houses constituted a growing ‘public sphere’ offering opportunities for people across classes to meet (and smoke) together. Tobacco in eighteenth-century Britain was deeply imbricated in whatever conversations took place in these settings. For Porter, ‘to be enlightened, a gentleman had to be sociable’. 25 This was also, he argued, an era marked by ‘a philosophy of expediency, a dedication to the art, science and duty of living well in the here and now’. 26 Such ‘materialistic worldliness’ was fostered in and by the ‘bubbling commercial atmosphere’ of eighteenth-century England. In such a world, people’s concerns were with ‘the here-and-now, in matters tangible, buyable, disposable’. Tobacco, sugar, and tea were ‘the first objects within capitalism that conveyed with their use the complex idea that one could become different by consuming differently…closely connected to England’s fundamental transformation from a hierarchical, status-based medieval society to a social-democratic, capitalist, and industrial society’. 27 The melding of human and non-human through consumption, the ‘constituting of persons’, was a prominent trope in the life and literature of eighteenth-century England. In the process, tobacco was recognized, as the character Tobacco itself states in the seventeenth-century play Wine, Beere, Ale and Tobacco: Contending for Superiority , as a substance whose ‘divine breath…doth distill eloquence and oracle upon the tongue’. 28 The capacity for eloquence and oracle was a significant contribution to the development of the ‘Enlightenment’.

Sahlins sees the pleasure principle as a fundamental part of the Enlightenment, when ‘self-pleasing came out of the shadow of its sinful ancestry to assume a moral position nearly 180 degrees removed. The individual’s singular attention to his own good turned out to be the basis of society rather than its nemesis—as well as the necessary condition of the greatest wealth of nations’. 29 Tobacco played an important role in helping ‘to frame a distinctively early modern culture in which the pursuit of pleasure was thereafter more public, routine, and unfettered’. 30

Israel is critical of those who would make too much of ‘new eighteenth-century social spaces and practices…in generating Enlightenment ideas’. 31 Yet if anything was uniting people from across the social classes, it was tobacco, ‘the Old Man’s Solace, and the Student’s Aid’, as a poem published in The London Medley in 1731 put it. 32 The ‘Convert to Tobacco’, in A Collection of Merry Poems published in 1736, describes tobacco offering contentment to the Welsh farmer trudging barefoot through the snow (‘With thee he warms his dripping Nose, / And scrubs, and puffs, and on he goes’), as well as to the ‘Justice grave’, who partners tobacco with ale to hold court at his table after dinner ‘Whilst sober whiff fills each Hiatus’. 33 ‘The Triumph of Tobacco over Sack and Ale’ similarly emphasizes the social communion tobacco engendered:

Verse Tobacco engages Both Sexes, all Ages,           The Poor as well as the Wealthy, From the Court to the Cottage, From Childhood to Dotage,           Both those that are sick and the healthy.

Snuff, later to become the sine qua non of distinction and refinement, was performing a similarly unifying role in Parisian society at this time. One commentator wrote:

at court as well as in the city: princes, lofty lords, and the people all take snuff. It ranks among the favourite occupations of the noblest ladies, and the middle-class women who imitate them in everything follow them in this activity as well. It is the passion of prelates, abbés, and even monks. Despite the papal prohibition, priests in Spain take snuff during the Mass. The snuffbox lies open before them on the altar. 35

Yet smoking remained the primary means of tobacco consumption. As Brook argues, ‘whenever tobacco showed up, a culture that did not smoke became a culture that did…Not all the original meanings of Native smoking made the jump to other cultures…but many did, including the notion that tobacco opened a door to the spiritual realm’. 36 The ways in which tobacco was consumed in eighteenth-century Europe, however, were very different from those of the twenty-first century. An amusing and somewhat moralistic account of ‘Sam Scot’s Smoaking Club’ in mid-eighteenth-century London describes its gentlemen members—a linen draper turned dancing-master, a city musician, an engraver, and a Scottish writer—as a group that ‘had acquired such an expeditious Way of consuming a Pipe of Tobacco, that when they were met together, they would make no more of smoaking a Pound in an hour’. 37 This is tobacco consumption of potentially shamanic proportions. Simon Schama describes the Dutch artist Adriaen Brouwer who, in the 1620s and 1630s, ‘took great care to record the expressions of deep inhalation or drowsy puffing peculiar to the serious pipe smoker. Some of their figures appear so stunned and insensate with smoke that it has been argued—speculatively—that their tobacco might have been spiked with some sort of opiate or narcotic’. 38 Such exotic speculations are unnecessary, however. The amount of tobacco being consumed was enough to generate the same kind of narcotic intoxication experienced by shamanic practitioners in lowland South America through the heavy ingestion of N. tabacum to this day. The stupefied silence frequently engendered was captured by a Russian historian who visited England in 1790:

I have dropped into a number of coffeehouses only to find twenty of thirty men sitting around in deep silence, reading newspapers, and drinking port. You are lucky if, in the course of ten minutes, you hear three words…‘Your health, gentlemen!’ 39

Tobacco and Embodied Cognition

Nowhere was tobacco use more prominent than among the literati, as is brilliantly evoked in Isaac Hawkins Browne’s six satirical poems in praise of tobacco. Every one of them is written in the style of a different contemporary poet. For Browne, the ‘light from smoke’ upon which they all rely is tobacco. He sees tobacco as either a disreputable cousin to the classical Muses or the divine inspiration of the Christian tradition. ‘While offering a sublime heightening of perception and thoughts, the inspiration she [tobacco] offers is debased by fleshly cravings, foul-smelling fumes, and addiction’. 40 Oxfordshire poet John Philips, while revelling in the ability of inhaled tobacco to ‘suck new Life into my Soul’, likewise noted the inferiority of a ‘Muse from smoke’ to a classical Muse, since even as it elevates the mind, tobacco weakens the body. 41 Tobacco could also, though, be described as ‘Assistant Chief’ to ‘Country vicar’: ‘If text obscure perplex his Brain, / He scratches, thinks, but all in vain; / Till lighted Pipe’s prevailing Ray, / Like Phoebus , drives the Fog away’. 42 In some cases ‘to think and smoke tobacco’ 43 became a profoundly spiritual experience, described by one Scottish Secessionist minister as bringing the mind closer to God, with tobacco’s effects on the body likened to the Holy Spirit’s even more powerful action on the soul. Inspiration was also attributed to snuff, which was becoming recognized for its stimulant properties: when pulverized into ‘smart Rappee’ (a coarse snuff) it was said to invigorate ‘Sir Fopling’s Brain, if Brain there be’, giving him the ability to shine ‘in Dedications, Poems, Plays’. 44

Heretofore there has been little recognition or acknowledgement of the breadth and profundity of tobacco’s influence on the ‘embodied cognition’ of individuals who regularly subjected themselves to such high levels of nicotian stupefaction. One fundamental effect, I surmise, was the development of binary notions of ‘self’ and ‘non-self’ or ‘other’, a prerequisite, if one were needed, for the generation of individuality. The narcotic effect of tobacco can only encourage the formation of such relationships. Some scholars see these changes in terms of the Renaissance humanist idea of Man boldly stepping out from behind God’s shadow and becoming a unique, all-powerful entity. 45 For Riesman and co-authors, though, there are two distinct periods in the development of modern individualism: its fifteenth- and sixteenth-century emergence from older ‘tradition-directed’ social forms, and what they call an ‘inner-directed’ stage of intense individualism which they see as developing between the sixteenth and nineteenth centuries. This of course was precisely the period when tobacco was making such great inroads into Europe. 46 Martin points out significant regional variations between and within countries in the increasing production of ‘ego documents’ in the sixteenth and seventeenth centuries—variations he describes as ‘baffling’. 47 Although pre-tobacco late Medieval Italy was similarly full of people writing letters, diaries, memoirs, journals, and such like, 48 the eighteenth-century effulgence of ego documents took place predominantly in England and the maritime provinces of the Dutch Republic (Friesland, Zeeland, Holland), the two areas of Europe where tobacco use was particularly heavy at that time.

Both the ‘individual as expressive, self-reflective subject’ in Martin’s formulation of the performative type of selfhood, and the shades of cosmological perspectivism inherent in a self ‘increasingly conscious about the need to assume different roles in different contexts’, would have been encouraged by nicotian influences (see Table 13.1 ). However, as well as ‘self’ and ‘non-self’, other dualisms appear to have become prominent in European thought at a time corresponding with the arrival of tobacco.

Tobacco and the Scientific Separation of ‘Facts’ and ‘Values’

Francis Bacon, for example, was one of the new breed of seventeenth-century philosopher-scientists whose arguments exemplified the trend towards the bifurcation of ‘facts’ and ‘values’, ‘reality’ and ‘fantasy’. According to Bacon, ‘traditional’ modes of knowledge continually mixed up ‘the reality of the world with its configurations in the minds of men’. 49 The ‘cracks and deformities’ of the mind, he argued, prevented it reflecting ‘the genuine ray of things’. The only option, in Bacon’s view, was to ‘dissect the nature of this very world itself’. Withington highlights the ‘perennial tensions’ (dualisms all) that came into play as words such as ‘modern’, ‘society’, ‘company’, and ‘commonwealth’ sidled into use—all of them at much the same time as tobacco became a significant feature of the European intoxicant landscape. These include the tensions between received wisdom and personal experience; between reform and resistance; between public service and private profit; between the common good and its political organization; between idealism and power; between the social and the natural worlds. 50 We could add Bacon’s ‘reality’ and ‘imagination’ to this list.

For Bruno Latour, attempting to champion one binary and ignoring the other results in the development of an even stronger hybrid relationship between the two. Through these means, one half of the polarity comes to assume some of the attributes of the other, be it nature–culture, reality–imagination, object–subject or tobacco–people. This is because as soon as one tries to become ‘modern’ by splitting the world into binaries such as ‘nature’ and ‘culture’, so these hard-fought distinctions are breached and the things we would call things become people, and the people we call people become things. We can see this development in the extraordinary eruption of non-human ‘object’- or ‘it’-narratives on the eighteenth-century English literary scene which I shall now go on to explore. The ‘poetry of attention’ likewise is a genre in which I argue nicotian influences are strong.

‘It’-Narratives and the Poetry of Attention—Changing Perspectives?

Although there are isolated instances of objects being given the power of speech in earlier literary history, in eighteenth-century English literature things started vocalizing as never before. ‘Can the thing speak?’ the anthropologist Martin Holbraad asks with an avant-garde rhetorical flourish in 2011. 51 Well, in eighteenth-century English literature things were positively gabbling. The object- or ‘it’-narratives featuring a non-human voice were satirical pieces of prose, the protagonists and narrators of which were ‘mundane material objects such as banknotes, corkscrews, shoes, and coins that circulate through human society, commenting upon and damning it as they go’. 52 While we might associate such a genre today with literature for children, the initial audience was overwhelmingly adult. The genre’s popularity is exemplified by the fact that one of the first examples, Charles Johnstone’s Chrysal: Or the Adventures of a Guinea , went into a third edition within three years of its first publication in 1760. 53

These non-human ‘it’-narratives are a fascinating genre, particularly given the potential of tobacco to influence cosmological perspectivism and in the context of Latour’s remarks about modernity. The complex modern relationship that was developing between man and nature, the human and non-human, is reflected in the philosophical dissolution of ‘nature’ and ‘culture’ in Locke’s Essay Concerning Human Understanding , published in 1690. Using arguments reminiscent of Lucretius, Locke argues that we cannot determine whether thought occurs in our souls, or in ‘some systems of matter fitly disposed’, such as our brains. It is perhaps no coincidence, given this shift to more material connections, that James Arbuckle commented in 1719 on the likeness between the tobacco leaf and the human brain. 54 John Hill, cautioning against the immoderate use of snuff in 1761, argued that the nose offered a direct path to the brain, its nostrils ‘covered, in a manner, with branches of nerves: and these so thinly guarded from the air, that the brain itself may be said to lie almost naked there’. 55

The ‘sentient matter’ question, as it came to be known, revolved around whether sentience derived from a soul (as the immaterialists believed), or whether man was nothing more than matter whose thought occurred in and through the brain (as the so-called ‘free thinkers’, or materialists, argued). The immaterialists, attempting ‘to maintain the ontological privilege of humanism’, 56 could only accept matter as passive. An early lecture series endowed by the chemist Robert Boyle featured a sermon delivered by Richard Bentley entitled ‘Matter and Motion cannot Think: or, a confutation of atheism from the faculties of the soul’. Bentley aimed to reconcile science with the rational belief in God and was strongly opposed to the ‘vulgarly received notion of nature’ espoused by the materialists. ‘Sensation and Perception are not inherent in matter as such’, Bentley argued, ‘for if it were so; what monstrous absurdities would follow? Every Stock and Stone would be a percipient and rational creature’. 57

Locke’s views, rather than Bentley’s, seem to have been the imaginative touchstone for the surge in popularity of ‘it’-narratives. 284 published works are recorded between 1700 and 1900. 58 With them came terms and ideas which seem highly consonant with contemporary notions of non-human agency. Indeed the term ‘material agency’ was first used in William Jones’ essay First Principles of Natural Philosophy (1762) in a manner remarkably similar to how it is used by Science and Technology Studies scholars today. 59

A diverse range of things speak in object narratives, and they go to many places. Mobile objects are at an advantage. A banknote circulates ‘within the space of five pages from a milliner, to a bishop’s wife, to the bishop, to a bookseller, to a printer, to a pastry cook, and to a seller of dead dogs’. 60 Alternatively static places such as a Covent Garden pub or the Bank of England are invoked, but watch and comment on the human characters that pass by them. The rupee in Helenus Scott’s Adventures of a Rupee (1782) spends most of its time in a pawnbroker’s, the novel presenting a series of portraits of visitors to the shop, whose stories are told to the rupee by the spirits of gold. 61 Like the diverse explanations for the origins of Enlightenment, the explanations posited for the eruption of the ‘it’-narratives and their success with the reading public largely reflect the disciplinary interests of those who propose them. Lynch, for example, suggests they were an attempt to soften (through humanizing) the new market system ‘which made English men and women uneasy’. 62 According to Hudson, they were a means of placing the old aristocracy and the new mercantile classes on an equal footing, narratively speaking. 63 Less convincing is Flint’s argument that speaking objects reflect authors’ anxieties concerning the public exposure of their books. 64 However, as well as reflecting the impact of the growing class of nouveau riche , markets or books, ‘it’-narratives offer important creative explorations of some of the philosophical preoccupations arising from the Enlightenment, such as people’s increasing sense of separation from, and consequent objective interest in, the material world. This trend is predicated on an increasingly strong dissociation of the human from the non-human from the seventeenth century onwards. Insofar as tobacco is strongly implicated in the hybridization that ensued, tobacco is another explanation for the development of the ‘it’-narrative form.

Another example of tobacco’s influence in eighteenth-century literature is afforded by what one commentator calls ‘the poetry of attention’. Koehler identifies this as an emergent poetic genre marked by ‘a commitment in much of the period’s poetry to teaching readers how to attend closely’, a concern related ‘to a more widely recognized impulse in eighteenth-century poetry to describe details and to proliferate objects… to focus on the minute, the miscellaneous, the detailed, the domestic’. 65 This description is also apt for the still life paintings so popular in the Dutch Republic at the time. One wonders whether tobacco might have had an influence on this artistic form, since one of the well-documented cognitive effects of tobacco is as a stimulus barrier, enhancing attentiveness through screening out extraneous and distracting stimuli.

The fascination with the ordinary and everyday evinced by the poetry of attention stems from what Koehler calls a ‘methodical, experimental attentiveness’. The examples she uses are telling. ‘How does the world look from a cat’s vantage? What response does the ringing of a bell evoke from hungry sparrows? […] In these poems the ordinary is defamiliarized; it is particularized according to the perception of one attentive viewer.’ 66 Note the perspectivism reverberating in the notion of animals’ vantage points. As in the ‘it’-narrative form, there are smoky whiffs here of the cosmological perspectivism characteristic of lowland South American life and thought. Might the attention to detail and the perspectivism that accompanies it have been heightened by the prodigious consumption of tobacco? I suggest that the insinuation of tobacco into human affairs offers an explanation for the changes we can observe in literature and the arts in Europe at this time as a result of its embodied, cognitive effects. However the poetry of attention, unlike the ‘it’-narrative form, does not seem to have caught the imagination of those working in literary studies, possibly because of a disinclination among scholars to grapple with some of its psychological theories and overtones. Tobacco may serve to ‘fill the gaps’ with a material substance that helps explain the cognitive developments and perspectival shifts Koehler observes.

The Silence of Tobacco

Given the literary fashion for things, plants, and animals to tell stories from particular vantage points, the apparent lack of any extant ‘it’-narratives delivered by tobacco or its paraphernalia is paradoxical. Despite the acculturation of things (‘nature’) through narrative, tobacco, although an eminent candidate for such a task, appears to have remained steadfastly silent, rather than making its own voice heard, at least in prose. Perhaps the reason is a practical one. Unlike a coin of the realm (for example) tobacco is an inherently unreliable speaking object, since it is less likely to be passed from person to person than to go up in smoke (in the hands of a smoker) or, as became increasingly popular during the eighteenth century, to go up the nostril, as snuff. Nevertheless, a pipe, tobacco box, pouch, or snuff box would appear to be ideal objects to offer perspicacious observations in the manner so evidently enjoyed by readers of the ‘it’-narrative genre.

Tobacco’s ‘it’-narrative silence seems doubly surprising considering there was ample precedent for its appearance as a speaking character in at least two early seventeenth-century plays. Rather than its ‘eloquence and oracle’, championed in the Dutch play above, it is the power of tobacco that is emphasized in the 1604 play Lingua (attributed to Thomas Tomkis). In this play, tobacco is variously described as ‘God’, ‘King’, and ‘Emperor’. ‘The great God tobacco’ appears on stage in spectacular fashion. However, when it comes to its voice, the apparition speaks an incomprehensible language that only his sponsor ‘Olfactus’ (the sense of smell) is able to translate.

Following an eighteenth-century reprint of Lingua , 67 a gentleman styling himself ‘William Whif’ wrote to the editor of the Gentleman’s Magazine asking ‘can any of your correspondents make sense of Tobacco’s language, or suggest why he uses it? The editor [of the reprint] takes no notice of it’. 68 Whif’s query seems to epitomize the changing perspectives of the eighteenth compared to the seventeenth century. I think it unlikely a seventeenth-century audience would have seriously entertained the idea that tobacco really was speaking a potentially intelligible or translatable language, or would have accepted unquestioned the opinions of other characters, that this was an Antipodean language or the language of Arcadia whose people existed ‘before the Moone’. 69 William Whif’s views reflect the changes occasioned by the development of Enlightenment science and the accompanying belief that things (the language of a speaking plant, anthropomorphized as the ‘King of Tobacco’) need to be decoded or ‘described’ 70 rather than taken—as Tomkis surely intended us to do—at face value or as just a bit of amusing nonsense. No correspondents to the Gentleman’s Magazine attempted to answer Whif’s query—or if they did, the editor did not publish their responses.

A tobacco-related object does speak at least once in eighteenth-century English literature. It is a tobacco pipe which argues with a perfumed wig in a ‘poetic fable’ published by Christopher Smart in 1752. The wig, of the ‘flaunting French’ sort so popular in genteel society at the time, is critical of the tobacco pipe’s ‘barb’rous English! horrid Dutch!’ polluting breath. The pipe retorts:

Verse Know, puppy, I’m an English pipe, Deem’d worthy of each Briton’s gripe [grip], Who, with my cloud-compelling aid Help our plantations and our trade.

Tobacco has shifted from an exotic, monarchical presence to an everyday product, the consumption of which was fundamental to supporting the national interest. Just as tobacco served to facilitate shifting, multinatural perspectives in its lowland South American base, the ‘it-narrative’ encouraged a perspectival shift for eighteenth-century English readers from one ‘strictly oriented by the rank and gender of the narrator’ 72 to one in which the non-human was also allowed an authoritative narrative voice. Indeed, Hudson goes on to suggest the ‘it’-narrative was a necessary precursor to the frequently omniscient, ‘non-focalized’ narrative style of the nineteenth-century novel. From the perspective of historical, comparative anthropology, it seems likely that tobacco itself might have played a part in effecting such changes.

I have argued for the need to add tobacco, a hitherto unrecognized or taken for granted substance, to the list of elements we should consider in seeking to explain why the Enlightenment emerged where and when it did. The ‘eloquence and oracle’ offered by tobacco, I suggest, helped to promote some key intellectual and literary changes in the seventeenth and eighteenth centuries. Commonalities can be discerned between the long-term entanglement of tobacco and people in lowland South America and characteristics of certain new genres of English literature in the eighteenth century. Tobacco constitutes persons, changes perspectives, and generates dualisms. All these features have echoes in the literary outputs I have identified. They seem to me as much the result of the imbroglio with tobacco as of the other religious, political, and social changes that were taking place in England at the time. All were changes that helped attune people to the concepts and principles of the Enlightenment. The psychosocial trends and developments that I have suggested relate, at least in part, to the increased consumption of tobacco include an increased awareness of self/non-self, a sense of enhanced attentiveness, and the embodied cognitive ability to shift perspective and reflect on one’s own positionality. These, I have argued, can be clearly discerned in two eighteenth-century English literary genres, the ‘it’-narratives and the ‘poetry of attention’, both of them resonant with the ‘tobacco ideology’ associated with a much longer cultural history of tobacco use in lowland South America.

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Russell, A. (2021). ‘Eloquence and Oracle’: Tobacco in Eighteenth-Century Life and Literature. In: Fuller, D., Saunders, C., Macnaughton, J. (eds) The Life of Breath in Literature, Culture and Medicine. Palgrave Studies in Literature, Science and Medicine. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-74443-4_13

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National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General [Internet]. Atlanta (GA): Centers for Disease Control and Prevention (US); 2016.

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

Chapter 1 introduction, conclusions, and historical background relative to e-cigarettes.

• Introduction

Although conventional cigarette smoking has declined markedly over the past several decades among youth and young adults in the United States ( U.S. Department of Health and Human Services [USDHHS] 2012 ), there have been substantial increases in the use of emerging tobacco products among these populations in recent years ( Centers for Disease Control and Prevention [CDC] 2015c ). Among these increases has been a dramatic rise in electronic cigarette (e-cigarette) use among youth and young adults. It is crucial that the progress made in reducing cigarette smoking among youth and young adults not be compromised by the initiation and use of e-cigarettes. This Surgeon General’s report focuses on the history, epidemiology, and health effects of e-cigarette use among youth and young adults; the companies involved with marketing and promoting these products; and existing and proposed public health policies regarding the use of these products by youth and young adults.

E-cigarettes include a diverse group of devices that allow users to inhale an aerosol, which typically contains nicotine, flavorings, and other additives. E-cigarettes vary widely in design and appearance, but generally operate in a similar manner and are composed of similar components ( Figure 1.1 ). A key challenge for surveillance of the products and understanding their patterns of use is the diverse and nonstandard nomenclature for the devices ( Alexander et al. 2016 ). These devices are referred to, by the companies themselves, and by consumers, as “e-cigarettes,” “e-cigs,” “cigalikes,” “e-hookahs,” “mods,” “vape pens,” “vapes,” and “tank systems.” In this report, the term “e-cigarette” is used to represent all of the various products in this rapidly diversifying product category. The terms may differ by geographic region or simply by the prevailing preferences among young users. For example, some refer to all cigarette-shaped products as “e-cigarettes” or as “cigalikes,” and some may refer to the pen-style e-cigarettes as “hookah pens” or “vape pens” ( Richtel 2014 ; Lempert et al. 2016 ).

Diversity of e-cigarette products. Source: Photo by Mandie Mills, CDC.

This report focuses on research conducted among youth and young adults because of the implications of e-cigarette use in this population, particularly the potential for future public health problems. Understanding e-cigarette use among young persons is critical because previous research suggests that about 9 in 10 adult smokers first try conventional cigarettes during adolescence ( USDHHS 2012 ). Similarly, youth e-cigarette experimentation and use could also extend into adulthood; however, e-cigarette use in this population has not been examined in previous reports of the Surgeon General. The first Surgeon General’s report on the health consequences of smoking was published in 1964; of the subsequent reports, those published in 1994 and 2012 focused solely on youth and young adults ( USDHHS 1994 , 2012 ). More recently, the 2012 report documented the evidence regarding tobacco use among youth and young adults, concluding that declines in cigarette smoking had slowed and that decreases in the use of smokeless tobacco had stalled. That report also found that the tobacco industry’s advertising and promotional activities are causal to the onset of smoking in youth and young adults and the continuation of such use as adults ( USDHHS 2012 ). However, the 2012 report was prepared before e-cigarettes were as widely promoted and used in the United States as they are now. Therefore, this 2016 report documents the scientific literature on these new products and their marketing, within the context of youth and young adults. This report also looks to the future by examining the potential impact of e-cigarette use among youth and young adults, while also summarizing the research on current use, health consequences, and marketing as it applies to youth and young adults.

Evidence for this report was gathered from studies that included one or more of three age groups. We defined these age groups to be young adolescents (11–13 years of age), adolescents (14–17 years of age), and young adults (18–24 years of age). Some studies refer to the younger groups more generally as youth. Despite important issues related to e-cigarette use in adult populations, clinical and otherwise (e. g ., their potential for use in conventional smoking cessation), that literature will generally not be included in this report unless it also discusses youth and young adults ( Farsalinos and Polosa 2014 ; Franck et al. 2014 ; Grana et al. 2014 ).

Given the recency of the research that pertains to e-cigarettes, compared with the decades of research on cigarette smoking, the “precautionary principle” is used to guide actions to address e-cigarette use among youth and young adults. This principle supports intervention to avoid possible health risks when the potential risks remain uncertain and have been as yet partially undefined ( Bialous and Sarma 2014 ; Saitta et al. 2014 ; Hagopian et al. 2015 ). Still, the report underscores and draws its conclusions from the known health risks of e-cigarette use in this age group.

Organization of the Report

This chapter presents a brief introduction to this report and includes its major conclusions followed by the conclusions of the chapters, the historical background of e-cigarettes, descriptions of the products, a review of the marketing and promotional activities of e-cigarette companies, and the current status of regulations from the U.S. Food and Drug Administration ( FDA ). Chapter 2 (“Patterns of E-Cigarette Use Among U.S. Youth and Young Adults”) describes the epidemiology of e-cigarette use, including current use (i.e., past 30 day); ever use; co-occurrence of using e-cigarettes with other tobacco products, like cigarettes; and psychosocial factors associated with using e-cigarettes, relying on data from the most recent nationally representative studies available at the time this report was prepared. Chapter 3 (“Health Effects of E-Cigarette Use Among U.S. Youth and Young Adults”) documents the evidence related to the health effects of e-cigarette use, including those that are associated with direct aerosol inhalation by users, the indirect health effects of e-cigarette use, other non-aerosol health effects of e-cigarette use, and secondhand exposure to constituents of the aerosol. Chapter 4 (“Activities of the E-Cigarette Companies”) describes e-cigarette companies’ influences on e-cigarette use and considers manufacturing and price; the impact of price on sales and use; the rapid changes in the industry, particularly the e-cigarette companies; and the marketing and promotion of e-cigarettes. Chapter 5 (“E-Cigarette Policy and Practice Implications”) discusses the implications for policy and practice at the national, state, and local levels. The report ends with a Call to Action to stakeholders—including policymakers, public health practitioners and clinicians, researchers, and the public—to work to prevent harms from e-cigarette use and secondhand aerosol exposure among youth and young adults.

Preparation of this Report

This Surgeon General’s report was prepared by the Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC , which is part of USDHHS . The initial drafts of the chapters were written by 27 experts who were selected for their knowledge of the topics addressed. These contributions are summarized in five chapters that were evaluated by approximately 30 peer reviewers. After peer review, the entire manuscript was sent to more than 20 scientists and other experts, who examined it for its scientific integrity. After each review cycle, the drafts were revised by the report’s scientific editors on the basis of reviewers’ comments. Subsequently, the report was reviewed by various institutes and agencies within USDHHS.

Scientific Basis of the Report

The statements and conclusions throughout this report are documented by the citation of studies published in the scientific literature. Publication lags have prevented an up-to-the-minute inclusion of all recently published articles and data. This overall report primarily cites peer-reviewed journal articles, including reviews that integrate findings from numerous studies and books that were published through December 2015. However, selected studies from 2016 have been added during the review process that provide further support for the conclusions in this report. When a cited study has been accepted for publication, but the publication has not yet occurred because of the delay between acceptance and final publication, the study is referred to as “in press.” This report also refers, on occasion, to unpublished research, such as presentations at a professional meeting, personal communications from a researcher, or information available in various media. These references are employed when acknowledged by the editors and reviewers as being from reliable sources, which add to the emerging literature on a topic.

• Major Conclusions
• E-cigarettes are a rapidly emerging and diversified product class. These devices typically deliver nicotine, flavorings, and other additives to users via an inhaled aerosol. These devices are referred to by a variety of names, including “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” and “tank systems.”
• E-cigarette use among youth and young adults has become a public health concern. In 2014, current use of e-cigarettes by young adults 18–24 years of age surpassed that of adults 25 years of age and older.
• E-cigarettes are now the most commonly used tobacco product among youth, surpassing conventional cigarettes in 2014. E-cigarette use is strongly associated with the use of other tobacco products among youth and young adults, including combustible tobacco products.
• The use of products containing nicotine poses dangers to youth, pregnant women, and fetuses. The use of products containing nicotine in any form among youth, including in e-cigarettes, is unsafe.
• E-cigarette aerosol is not harmless. It can contain harmful and potentially harmful constituents, including nicotine. Nicotine exposure during adolescence can cause addiction and can harm the developing adolescent brain.
• E-cigarettes are marketed by promoting flavors and using a wide variety of media channels and approaches that have been used in the past for marketing conventional tobacco products to youth and young adults.
• Action can be taken at the national, state, local, tribal, and territorial levels to address e-cigarette use among youth and young adults. Actions could include incorporating e-cigarettes into smokefree policies, preventing access to e-cigarettes by youth, price and tax policies, retail licensure, regulation of e-cigarette marketing likely to attract youth, and educational initiatives targeting youth and young adults.
• Chapter Conclusions

Chapter 1. Introduction, Conclusions, and Historical Background Relative to E-Cigarettes

• E-cigarettes are devices that typically deliver nicotine, flavorings, and other additives to users via an inhaled aerosol. These devices are referred to by a variety of names, including “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” and “tank systems.”
• E-cigarettes represent an evolution in a long history of tobacco products in the United States, including conventional cigarettes.
• In May 2016, the Food and Drug Administration issued the deeming rule, exercising its regulatory authority over e-cigarettes as a tobacco product.

Chapter 2. Patterns of E-Cigarette Use Among U.S. Youth and Young Adults

• Among middle and high school students, both ever and past-30-day e-cigarette use have more than tripled since 2011. Among young adults 18–24 years of age, ever e-cigarette use more than doubled from 2013 to 2014 following a period of relative stability from 2011 to 2013.
• The most recent data available show that the prevalence of past-30-day use of e-cigarettes is similar among high school students (16% in 2015, 13.4% in 2014) and young adults 18–24 years of age (13.6% in 2013–2014) compared to middle school students (5.3% in 2015, 3.9% in 2014) and adults 25 years of age and older (5.7% in 2013–2014).
• Exclusive, past-30-day use of e-cigarettes among 8th-, 10th-, and 12th-grade students (6.8%, 10.4%, and 10.4%, respectively) exceeded exclusive, past-30-day use of conventional cigarettes in 2015 (1.4%, 2.2%, and 5.3%, respectively). In contrast—in 2013–2014 among young adults 18–24 years of age—exclusive, past-30-day use of conventional cigarettes (9.6%) exceeded exclusive, past-30-day use of e-cigarettes (6.1%). For both age groups, dual use of these products is common.
• E-cigarette use is strongly associated with the use of other tobacco products among youth and young adults, particularly the use of combustible tobacco products. For example, in 2015, 58.8% of high school students who were current users of combustible tobacco products were also current users of e-cigarettes.
• Among youth—older students, Hispanics, and Whites are more likely to use e-cigarettes than younger students and Blacks. Among young adults—males, Hispanics, Whites, and those with lower levels of education are more likely to use e-cigarettes than females, Blacks, and those with higher levels of education.
• The most commonly cited reasons for using e-cigarettes among both youth and young adults are curiosity, flavoring/taste, and low perceived harm compared to other tobacco products. The use of e-cigarettes as an aid to quit conventional cigarettes is not reported as a primary reason for use among youth and young adults.
• Flavored e-cigarette use among young adult current users (18–24 years of age) exceeds that of older adult current users (25 years of age and older). Moreover, among youth who have ever tried an e-cigarette, a majority used a flavored product the first time they tried an e-cigarette.
• E-cigarette products can be used as a delivery system for cannabinoids and potentially for other illicit drugs. More specific surveillance measures are needed to assess the use of drugs other than nicotine in e-cigarettes.

Chapter 3. Health Effects of E-Cigarette Use Among U.S. Youth and Young Adults

• Nicotine exposure during adolescence can cause addiction and can harm the developing adolescent brain.
• Nicotine can cross the placenta and has known effects on fetal and postnatal development. Therefore, nicotine delivered by e-cigarettes during pregnancy can result in multiple adverse consequences, including sudden infant death syndrome, and could result in altered corpus callosum, deficits in auditory processing, and obesity.
• E-cigarettes can expose users to several chemicals, including nicotine, carbonyl compounds, and volatile organic compounds, known to have adverse health effects. The health effects and potentially harmful doses of heated and aerosolized constituents of e-cigarette liquids, including solvents, flavorants, and toxicants, are not completely understood.
• E-cigarette aerosol is not harmless “water vapor,” although it generally contains fewer toxicants than combustible tobacco products.
• Ingestion of e-cigarette liquids containing nicotine can cause acute toxicity and possibly death if the contents of refill cartridges or bottles containing nicotine are consumed.

Chapter 4. Activities of the E-Cigarette Companies

• The e-cigarette market has grown and changed rapidly, with notable increases in total sales of e-cigarette products, types of products, consolidation of companies, marketing expenses, and sales channels.
• Prices of e-cigarette products are inversely related to sales volume: as prices have declined, sales have sharply increased.
• E-cigarette products are marketed in a wide variety of channels that have broad reach among youth and young adults, including television, point-of-sale, magazines, promotional activities, radio, and the Internet.
• Themes in e-cigarette marketing, including sexual content and customer satisfaction, are parallel to themes and techniques that have been found to be appealing to youth and young adults in conventional cigarette advertising and promotion.

Chapter 5. E-Cigarette Policy and Practice Implications

• The dynamic nature of the e-cigarette landscape calls for expansion and enhancement of tobacco-related surveillance to include (a) tracking patterns of use in priority populations; (b) monitoring the characteristics of the retail market; (c) examining policies at the national, state, local, tribal, and territorial levels; (d) examining the channels and messaging for marketing e-cigarettes in order to more fully understand the impact future regulations could have; and (e) searching for sentinel health events in youth and young adult e-cigarette users, while longer-term health consequences are tracked.
• Strategic, comprehensive research is critical to identify and characterize the potential health risks from e-cigarette use, particularly among youth and young adults.
• The adoption of public health strategies that are precautionary to protect youth and young adults from adverse effects related to e-cigarettes is justified.
• A broad program of behavioral, communications, and educational research is crucial to assess how youth perceive e-cigarettes and associated marketing messages, and to determine what kinds of tobacco control communication strategies and channels are most effective.
• Health professionals represent an important channel for education about e-cigarettes, particularly for youth and young adults.
• Diverse actions, modeled after evidence-based tobacco control strategies, can be taken at the state, local, tribal, and territorial levels to address e-cigarette use among youth and young adults, including incorporating e-cigarettes into smoke-free policies; preventing the access of youth to e-cigarettes; price and tax policies; retail licensure; regulation of e-cigarette marketing that is likely to attract youth and young adults, to the extent feasible under the law; and educational initiatives targeting youth and young adults. Among others, research focused on policy, economics, and the e-cigarette industry will aid in the development and implementation of evidence-based strategies and best practices.
• Historical Background

Understanding the role of e-cigarettes requires understanding the long history of tobacco use in the United States, including the role of nicotine delivery, the multiple examples of “reduced-harm” products and associated health claims, and the impact of using tobacco products on the public’s health. Since the late nineteenth century, when the “modern” cigarette came into use, scientists and public health officials have linked cigarette smoking to a remarkable number of adverse effects, and it is now recognized as the primary cause of premature death in the United States ( USDHHS 2014 ). Correspondingly, for a century, manufacturers, scientists, entrepreneurs, and public health leaders have promoted or recommended product changes that might remove some of the harmful elements in cigarette smoke. E-cigarettes are among the latest products.

E-cigarettes are designed for users to inhale nicotine, flavorings, and other additives through an aerosol. The claims and marketing strategies employed by the e-cigarette companies, and the efforts made by others to develop scientific and regulatory tools to deal with these new products, both contribute to the current discourse on e-cigarettes. Many lessons for assessing the potential (and future) consequences of these products can be learned from examining the relevant experiences of the past century, especially the introduction of novel products (including e-cigarettes as well as other tobacco and nicotine products) and the claims of reduced exposure to toxins made by the industry and elsewhere.

Early Efforts to Modify Cigarettes

In the 1880s and 1890s, entrepreneurs promoted novel products that allegedly blocked nicotine and other constituents of conventional cigarettes believed to be poisonous. Dr. Scott’s Electric Cigarettes, advertised in Harper’s Weekly, claimed not only to light without matches but also to contain a cotton filter that “strains and eliminates the injurious qualities from the smoke,” including nicotine ( Harper’s Weekly 1887 ). Nicotine delivery was essential to the development of the modern cigarette in the twentieth century; early on, this substance was thought to be addicting and thus vital to retaining customers. In 1913, the Camel brand was a new kind of cigarette that introduced high-nicotine content by using burley tobacco, which was generally too harsh to inhale into the lungs, but was made more inhalable through the addition of casings (e. g ., sugars, licorice) ( Tindall 1992 ; Proctor 2011 ). In 1916, American Tobacco introduced its Lucky Strike blended cigarette, and in 1918 Liggett & Myers ( L &M) reformulated its Chesterfield brand to make it more palatable to users. As the market grew, advertisements for major brands routinely included health-related statements and testimonials from physicians. During the 1930s and 1940s, prominent advertising campaigns included claims like “Not a cough in a carload” (Old Gold) ( Federal Trade Commission [FTC] 1964 , p. LBA-5); “We removed from the tobacco harmful corrosive ACRIDS (pungent irritants) present in cigarettes manufactured in the old-fashioned way” (Lucky Strike) ( FTC 1964 , p. LBA-2); and “Smoking Camels stimulates the natural flow of digestive fluids … increases alkalinity” (Camel) ( FTC 1964 , p. LBA-1a). Thus, early modifications to the cigarette were made so that it was more palatable, had a higher nicotine delivery and uptake, and could be marketed as “safe” ( FTC 1964 ; Calfee 1985 ).

Filters, Tar Reduction, and Light and Low-Tar Cigarettes

The landmark 1964 Surgeon General’s report on smoking and health concluded that cigarette smoking contributed substantially to mortality from certain specific diseases, including lung cancer ( U.S. Department of Health, Education, and Welfare 1964 ). Although the 1964 report considered the topic, it found the evidence insufficient to assess the potential health benefits of cigarette filters. Cigarettes with filters became the norm by the 1960s, and marketing them with an overt message about harm reduction became the standard ( National Cancer Institute [NCI] 1996 ). However, the Surgeon General convened another group of experts on June 1, 1966, to review the evidence on the role played by the tar and nicotine content in health. The group concluded that “[t]he preponderance of scientific evidence strongly suggests that the lower the ‘tar’ and nicotine content of cigarette smoke, the less harmful are the effects” ( Horn 1966 , p. 16,168). Subsequent studies have repeatedly failed to demonstrate health benefits of smoking light and low-tar cigarettes versus full-flavor cigarettes ( Herning et al. 1981 ; Russell et al. 1982 ; Benowitz et al. 1983 , NCI 2001 ).

Over the years, the tobacco industry used multiple methods to reduce the machine-tested yields of tar and nicotine in cigarettes as a way to claim “healthier” cigarettes. Beginning in the 1970s, tobacco companies advertised the tar and nicotine levels for their cigarettes, which encouraged smokers to believe, without substantiation, they could reduce their risk of exposure to these constituents ( Cummings et al. 2002 ; Pollay and Dewhirst 2002 ). In 1996, the FTC issued a statement that it would allow cigarette companies to include statements about tar and nicotine content in their advertising as long as they used a standardized machine-testing method ( Peeler 1996 ).

The Role of Nicotine and Nicotine Delivery

Although the public health community understood early on that nicotine was the primary psycho-active ingredient in cigarette smoke, before the 1980s, little was known about the importance of nicotine in the addiction process beyond what the cigarette manufacturers had learned from their own research. Some scientists warned that due to nicotine addiction, a reduction in nicotine yields, along with decreases in tar, could lead smokers to change their smoking behavior, such as by smoking a greater number of cigarettes to maintain their nicotine intake or changing their behavior in more subtle ways, such as varying the depth of inhalation or smoking more of the cigarette ( Jarvis et al. 2001 ; National Cancer Institute 2001 ; Thun and Burns 2001 ). Not until the 1970s and 1980s, as researchers studying other forms of drug abuse began to apply their research methods to cigarette smoking, did it become apparent that nicotine was similar in its addictive capability to other drugs of abuse, such as heroin and cocaine ( USDHHS 1981 , 1988 ). As described in the 1988 Surgeon General’s report and in subsequent research, symptoms associated with nicotine addiction include craving, withdrawal, and unconscious behaviors to ensure consistent intake of nicotine ( USDHHS 1988 ; al’Absi et al. 2002 ; Hughes 2007 ).

Although the tobacco industry has long understood the importance of nicotine to maintain long-term cigarette smokers through addiction, public health officials did not fully appreciate this in a broad sense until the 1988 Surgeon General’s report, The Health Consequences of Smoking: Nicotine Addiction ( USDHHS 1988 ).

FDA and Nicotine Regulation

In 1988 (and again in 1994), the Coalition on Smoking OR Health and other public-interest organizations petitioned FDA to classify low-tar and nicotine products as drugs and to classify Premier, the short-lived “smokeless cigarette product” from R.J. Reynolds, as an alternative nicotine-delivery system ( Stratton et al. 2001 ). The Coalition on Smoking OR Health cited indirect claims made through advertising and marketing as evidence of R. J. Reynolds’s intent to have the product used for the mitigation or prevention of disease ( Slade and Ballin 1993 ). Meanwhile, FDA launched an investigation into the practices of the tobacco industry, including the manipulation of nicotine delivery. FDA asserted its jurisdiction over cigarettes and smokeless tobacco and issued certain rules governing access to and promotion of these products ( Federal Register 1996 ). On March 21, 2000, the U.S. Supreme Court ruled 5-4 that Congress had not yet given FDA the necessary statutory authority to issue any rules pertaining to tobacco products ( Gottleib 2000 ; FDA v. Brown & Williamson Tobacco Corp. 2000 ). The subsequent debate over control of nicotine products, including their potential impact on youth, ultimately led to the passage of the 2009 Family Smoking Prevention and Tobacco Control Act, which gave FDA authority to regulate tobacco products. Thus, discussions about the introduction of novel nicotine-containing tobacco products in the market during the 1980s and 1990s helped shape the current regulation of tobacco and nicotine products.

New products introduced in the 1990s or later included modified tobacco cigarettes (e. g ., Advance, Omni); cigarette-like products, also called cigalikes (e.g., Eclipse, Accord); and smokeless tobacco products (e.g., Ariva, Exalt, Revel, snus). Advance, made by Brown and Williamson, was test-marketed with the slogan “All of the taste … Less of the toxins.” Vector launched a national advertising campaign for its Omni cigarette with the slogan “Reduced carcinogens. Premium taste.” In addition to the question of whether the claims were supported by sufficient evidence, scientists and tobacco control leaders raised concerns about the potential for adverse consequences associated with novel nicotine and tobacco products marketed for harm reduction, such as a reduction in cessation rates or increased experimentation by children ( Warner and Martin 2003 ; Joseph et al. 2004 ; Caraballo et al. 2006 ). Studies have shown that smokers are interested in trying novel “reduced-exposure” products and perceive them to have lower health risks, even when advertising messages do not make explicit health claims ( Hamilton et al. 2004 ; O’Connor et al. 2005 ; Caraballo et al. 2006 ; Choi et al. 2012 ; Pearson et al. 2012 ).

At FDA ’s request, the Institute of Medicine ( IOM [now the National Academy of Medicine]) convened a committee of experts to formulate scientific methods and standards by which potentially reduced-exposure products (PREPs), whether the purported reduction was pharmaceutical or tobacco related, could be assessed. The committee concluded that “[f]or many diseases attributable to tobacco use, reducing risk of disease by reducing exposure to tobacco toxicants is feasible” ( Stratton et al. 2001 , p. 232). However, it also cautioned that “PREPs have not yet been evaluated comprehensively enough (including for a sufficient time) to provide a scientific basis for concluding that they are associated with a reduced risk of dis ease compared to conventional tobacco use” ( Stratton et al. 2001 , p. 232). The committee added that “the major concern for public health is that tobacco users who might otherwise quit will use PREPs instead, or others may initiate smoking, feeling that PREPs are safe. That will lead to less harm reduction for a population (as well as less risk reduction for that individual) than would occur without the PREP , and possibly to an adverse effect on the population” ( Stratton et al. 2001 , p. 235). Subsequently, in 2006, Judge Kessler cited these findings in her decision which demanded the removal of light and low-tar labeling due to the misleading nature of these claims ( United States v. Philip Morris 2006 ).

• The E-Cigarette

Invention of the E-Cigarette

An early approximation of the current e-cigarette appeared in a U.S. patent application submitted in 1963 by Herbert A. Gilbert and was patented in August 1965 (U.S. Patent No. 3,200,819) ( Gilbert 1965 ). The application was for a “smokeless nontobacco cigarette,” with the aim of providing “a safe and harmless means for and method of smoking” by replacing burning tobacco and paper with heated, moist, flavored air. A battery-powered heating element would heat the flavor elements without combustion ( Gilbert 1965 ). The Favor cigarette, introduced in 1986, was another early noncombustible product promoted as an alternative nicotine-containing tobacco product ( United Press International 1986 ; Ling and Glantz 2005 ).

The first device in the recent innovation in e-cigarettes was developed in 2003 by the Chinese pharmacist Hon Lik, a former deputy director of the Institute of Chinese Medicine in Liaoning Province. Lik’s patent application described a kind of electronic atomizing cigarette ( Hon 2013 ). With support from Chinese investors, in 2004 the product was introduced on the Chinese market under the company name Ruyan ( Sanford and Goebel 2014 ). The product gained some attention among Chinese smokers early on as a potential cessation device or an alternative cigarette product.

The e-cigarette was part of the U.S. market by the mid-2000s, and by 2010 additional brands started to appear in the nation’s marketplace, including Ruyan and Janty ( Regan et al. 2013 ). Ruyan gained a U.S. patent for its product with the application stating that the product is “an electronic atomization cigarette that functions as substitutes (sic) for quitting smoking and cigarette substitutes.” (U.S. Patent No. 8,490,628 B2, 2013). In August 2013, Imperial Tobacco Group purchased the intellectual property behind the Ruyan e-cigarette for $75 million. As of 2014 an estimated 90% of the world’s production of e-cigarette technology and products came from mainland China, mainly Guangdong Province and Zhejiang Province ( Barboza 2014 ).

Sales of e-cigarettes in the United States have risen rapidly since 2007. Widespread advertising via television commercials and through print advertisements for popular brands, often featuring celebrities, has contributed to a large increase in e-cigarette use by both adults and youth since 2010 ( Felberbaum 2013 ; King et al. 2013 ; Regan et al. 2013 ). Additionally, marketing through social media, as well as other forms of Internet marketing, has been employed to market these devices ( Huang et al. 2014 ; Kim et al. 2014 ).

In 2013, an estimated 13.1 million middle school and high school students were aware of e-cigarettes ( Wang et al. 2014 ). According to data from the National Youth Tobacco Survey, in 2011 the prevalence of current e-cigarette use (defined as use during at least 1 day in the past 30 days) among high school students was 1.5%; prevalence increased dramatically, however, to 16% by 2015, surpassing the rate of conventional-cigarette use among high school students ( CDC 2016b ; see Chapter 2 ). This equates to 2.4 million high school students and 620,000 middle school students having used an e-cigarette at least one time in the past 30 days in 2015 ( CDC 2016b ).

These trends have led to substantial concern and discussion within public health communities, including state and national public health agencies, professional organizations, and school administrators and teachers. A primary concern is the potential for nicotine addiction among nonsmokers, especially youth and young adults, and that this exposure to nicotine among youth and young adults is harmful. The diversity and novelty of e-cigarette products on the market and ongoing product innovations make assessments of the biological effects of current e-cigarettes under actual conditions of use—such as their long-term harmfulness—difficult to measure. Unanswered questions remain about the risk profile of these devices, their potential use by young people as a first step to other nicotine products, and their total impact on public health. There are diverging opinions about the potential public health impact of these new products. Some public health scientists have highlighted the potential for alternative nicotine products to serve as a substitute for conventional cigarettes and thus a harm reduction tool ( Henningfield et al. 2003 ; Abrams 2014 ). Others have cautioned that the use of alternative nicotine products might become a bridge that may lead to greater tobacco product use—including dual- or multiple-product use—or initiate nicotine addiction among nonsmokers, especially youth ( Cobb et al. 2010 ; Wagener et al. 2012 ; Benowitz and Goniewicz 2013 ; Britton 2013 ; Chapman 2013 ; Etter 2013 ; USDHHS 2014 ). Current evidence is insufficient to reject either of these hypotheses.

E-Cigarette Products

Components and devices.

E-cigarette devices are composed of a battery, a reservoir for holding a solution that typically contains nicotine, a heating element or an atomizer, and a mouthpiece through which the user puffs ( Figure 1.2 ). The device heats a liquid solution (often called e-liquid or e-juice) into an aerosol that is inhaled by the user. E-liquid typically uses propylene glycol and/or glycerin as a solvent for the nicotine and flavoring chemicals

Parts of an e-cigarette device. Source: Photo by Mandie Mills, CDC.

Flavors and E-Cigarettes

The e-liquids in e-cigarettes are most often flavored; a study estimated that 7,700 unique flavors exist ( Zhu et al. 2014 ) and that most of them are fruit or candy flavors ( Figure 1.3 ). A content analysis of the products available via online retail websites documented that tobacco, mint, coffee, and fruit flavors were most common, followed by candy (e. g ., bubble gum), unique flavors (e.g., Belgian waffle), and alcoholic drink flavors (e.g., strawberry daiquiri) ( Grana and Ling 2014 ). Some retail stores are also manufacturers that create custom flavors, which increases the variety of flavors available.

Examples of e-liquid flavors. Source: Photo by Mandie Mills, CDC.

The widespread availability and popularity of flavored e-cigarettes is a key concern regarding the potential public health implications of the products. The concern, among youth, is that the availability of e-cigarettes with sweet flavors will facilitate nicotine addiction and simulated smoking behavior—which will lead to the use of conventional tobacco products ( Kong et al. 2015 ; Krishnan-Sarin et al. 2015 ). Flavors have been used for decades to attract youth to tobacco products and to mask the flavor and harshness of tobacco ( USDHHS 2012 ). Industry documents show that tobacco companies marketed flavored little cigars and cigarillos to youth and to African Americans to facilitate their uptake of cigarettes ( Kostygina et al. 2014 ). Companies also intended flavored smokeless tobacco products to facilitate “graduation” to unflavored products that more easily deliver more nicotine to the user ( USDHHS 2012 ). Various studies have shown that youth are more likely than adults to choose flavored cigarettes and cigars ( CDC 2015b ). Concern over these findings led Congress to include a ban on characterizing flavors for cigarettes, other than tobacco or menthol, in the Tobacco Control Act. A similar concern exists about e-cigarettes, and this concern is supported by studies indicating that youth and young adults who have ever used e-cigarettes begin their use with sweet flavors rather than tobacco flavors ( Kong et al. 2015 ; Krishnan-Sarin et al. 2015 ). Notably, 81.5% of current youth e-cigarette users said they used e-cigarettes “because they come in flavors I like” ( Ambrose et al. 2015 ).

E-Cigarette Devices

First-generation e-cigarettes were often similar in size and shape to conventional cigarettes, with a design that also simulated a traditional cigarette in terms of the colors used (e. g ., a white body with tan mouthpiece). These devices were often called cigalikes, but there were other products designed to simulate a cigar or pipe. Other cigalikes were slightly longer or narrower than a cigarette; they may combine white with tan or may be black or colored brightly. These newer models use a cartridge design for the part of the device that holds the e-liquid, which is either prefilled with the liquid or empty and ready to be filled. The user then squeezes drops of the e-liquid onto a wick (or bit of cotton or polyfil) connected to the heating element and atomizer ( Figure 1.4 ). As e-cigarettes have become more popular, their designs have become more diverse, as have the types of venues where they are sold ( Noel et al. 2011 ; Zhu et al. 2014 ).

E-liquids being poured into an e-cigarette device. Source: Photo by Mandie Mills, CDC.

Second-generation devices include products that are shaped like pens, are comparatively larger and cylindrical, and are often referred to as “tank systems” in a nod to the transparent reservoir that holds larger amounts of e-liquid than previous cartridge-containing models. Third- and fourth-generation devices represent a diverse set of products and, aesthetically, constitute the greatest departure from the traditional cigarette shape, as many are square or rectangular and feature customizable and rebuildable atomizers and batteries. In addition, since the beginning of the availability of e-cigarettes and their component parts, users have been modifying the devices or building their own devices, which are often referred to as “mods.” The differences in design and engineering of the products are key factors in the size, distribution, and amount of aerosol particles and the variability in levels of chemicals and nicotine present in the e-liquid/aerosol and delivered to the user ( Brown and Cheng 2014 ).

E-Cigarette Product Components and Risks

One of the primary features of the more recent generation of devices is that they contain larger batteries and are capable of heating the liquid to a higher temperature, potentially releasing more nicotine, forming additional toxicants, and creating larger clouds of particulate matter ( Bhatnagar et al. 2014 ; Kosmider et al. 2014 ). For instance, one study demonstrated that, at high temperatures (150°C), exceedingly high levels of formaldehyde—a carcinogen (found to be 10 times higher than at ambient temperatures)—are present that are formed through the heating of the e-liquid solvents (propylene glycol and glycerin), although the level of tolerance of actual users to the taste of the aerosol heated to this temperature is debated ( Kosmider et al. 2014 ; CDC 2015a ; Flavor and Extract Manufacturers Association of the United States 2015 ; Pankow et al. 2015 ). There is also concern regarding the safety of inhaling e-cigarette flavorings. Although some manufacturers have claimed their flavorants are generally recognized as safe for food additives (i.e., to be used in preparing foods for eating), little is known about the long-term health effects of inhaling these substances into the lungs ( CDC 2015a ).

Many devices can be readily customized by their users, which is also leading to the concern that these devices are often being used to deliver drugs other than nicotine ( Brown and Cheng 2014 ). Most commonly reported in the news media, on blogs, and by user anecdote is the use of certain types of e-cigarette-related products for delivering different forms of marijuana ( Morean et al. 2015 ; Schauer et al. 2016 ). The tank systems, for example, have been used with liquid tetrahydrocannabinol ( THC ) or hash oil. Some personal vaporizer devices can be used with marijuana plant material or a concentrated resin form of marijuana called “wax.” One study describes the use, in Europe, of e-cigarette devices to smoke marijuana ( Etter 2015 ).

The various e-cigarette products, viewed as a group, lack standardization in terms of design, capacity for safely holding e-liquid, packaging of the e-liquid, and features designed to minimize hazards with use ( Yang et al. 2014 ). All of these design features may have implications for the health impact of e-cigarette use. Notably, from 2010 to 2014, calls to poison control centers in the United States about exposures related to e-cigarettes increased dramatically. According to the American Association of Poison Control Centers (2015) , 271 cases were reported in 2011, but 3,783 calls were reported in 2014. Among all calls, 51% involved exposure among children younger than 5 years of age ( CDC 2014 ). Most poisonings appear to have been caused by exposure to nicotine-containing liquid ( CDC 2014 ). The lack of a requirement for child-resistant packaging for e-liquid containers may have contributed to these poisonings. Since these data were released, one death in the United States has been confirmed in a child who drank e-liquid containing nicotine ( Mohney 2014 ). Additionally, serious adverse reactions, including at least two deaths, have been reported to FDA in cases that could be attributed to the use of e-cigarettes ( FDA 2013 ). This increase in poisonings prompted the Child Nicotine Poisoning Prevention Act of 2015 (2016) , which was enacted in January 2016. This law requires any container of liquid nicotine that is sold, manufactured, distributed, or imported into the United States to be placed in packaging that is difficult to open by children under 5 years of age.

Secondary risks are also of concern regarding e-cigarettes, including passive exposure to nicotine and other chemicals, and adverse events due to device malfunction. Nicotine is a neuroteratogen, and its use by pregnant women exposes a developing fetus to risks that are well documented in the 50th-anniversary Surgeon General’s report on smoking ( USDHHS 2014 ) and include impaired brain development ( England et al. 2015 ) and other serious consequences. Finally, another consequence of the lack of device regulation is the occurrence of battery failures and subsequent explosions. Explosions have typically occurred during charging, resulting in house and car fires, and sometimes causing injuries to those involved. From 2009 to late 2014, 25 incidents of explosions and fires involving e-cigarettes occurred in the United States ( Chen 2013 ; U.S. Fire Administration 2014 ; FDA 2013 ).

• E-Cigarette Companies

E-cigarette companies include manufacturers, wholesalers, importers, retailers, distributors, and some other groups that overlap with these entities ( Barboza 2014 ; Whelan 2015 ). Currently, most of the products are manufactured in Shenzhen, Guangdong Province, China ( Cobb et al. 2010 ; Grana et al. 2014 ; Zhu et al. 2014 ). One study placed the number of brands at 466 in January 2014 and found a net increase of 10.5 brands per month ( Zhu et al. 2014 ). All the major tobacco companies (e. g ., Reynolds American, Altria; Table 1.1 ) and many smaller, independent companies are now in the business. When e-cigarettes first entered the U.S. market, they were sold primarily by independent companies via the Internet and in shopping malls at kiosks where those interested could sample the products. A unique feature of the e-cigarette industry, compared to other tobacco and nicotine products, is the recruitment of visitors to their websites as “affiliates” or distributors to help market the products and, in turn, receive commissions on sales ( Grana and Ling 2014 ; Cobb et al. 2015 ). For example, some companies offer a way for users to earn a commission by advertising the products (e.g., a banner ad is placed on one’s website, and when someone clicks on the link and subsequently purchases a product, the website owner gets a percentage commission). Some companies also offer rewards programs for recruiting new customers or for brand loyalty, with web-site users earning points for free or reduced-price products ( Richardson et al. 2015 ).

Multinational tobacco companies with e-cigarette brands.

E-cigarettes are now in widespread national distribution through convenience stores, tobacco stores, pharmacies, “big box” retail chains such as Costco, online retailers, and shops devoted to e-cigarette products (often called “vape shops”) ( Giovenco et al. 2015 ; Public Health Law Center 2015 ). The “vape shops” offer a place to buy customizable devices and e-liquid solutions in many flavors and sometimes include a café or other elements that promote socializing, essentially making such places like a lounge. With the rapid increase in distribution and marketing in the industry, sales have increased rapidly and were projected to reach $2.5 billion in 2014 and $3.5 billion in 2015, including projections for retail and online channels, as well as “vape shops” ( Wells Fargo Securities 2015 ).

The advertising and marketing of e-cigarette products has engendered skepticism among public health professionals and legislators, who have noted many similarities to the advertising claims and promotional tactics used for decades by the tobacco industry to sell conventional tobacco products ( Campaign for Tobacco-Free Kids 2013 ; CDC 2016a ). Indeed, several of the e-cigarette marketing themes have been reprised from the most memorable cigarette advertising, including those focused on freedom, rebellion, and glamor ( Grana and Ling 2014 ). E-cigarette products are marketed with a variety of unsubstantiated health and cessation messages, with some websites featuring videos of endorsements by physicians (another reprisal of old tobacco industry advertising) ( Grana and Ling 2014 ; Zhu et al. 2014 ). Unlike conventional cigarettes, for which advertising has been prohibited from radio and television since 1971, e-cigarette products are advertised on both radio and television, with many ads featuring celebrities. E-cigarettes also are promoted through sports and music festival sponsorships, in contrast to conventional cigarettes and smokeless tobacco products, which have been prohibited from such sponsorships since the Master Settlement Agreement in 1998. E-cigarettes also appear as product placements in television shows and movies ( Grana et al. 2011 ; Grana and Ling 2014 ).

Another key avenue for e-cigarette promotion is social media, such as Twitter, Facebook, YouTube, and Instagram. As is true in the tobacco industry, the e-cigarette industry organizes users through advocacy groups ( Noel et al. 2011 ; Harris et al. 2014 ; Saitta et al. 2014 ; Caponnetto et al. 2015 ). The extensive marketing and advocacy through various channels broadens exposure to e-cigarette marketing messages and products; such activity may encourage nonsmokers, particularly youth and young adults, to perceive e-cigarette use as socially normative. The plethora of unregulated advertising is of particular concern, as exposure to advertising for tobacco products among youth is associated with cigarette smoking in a dose-response fashion ( USDHHS 2012 ).

• Federal Regulation of E-Cigarettes

A “Two-Pronged” Approach to Comprehensive Tobacco Control

Since the passage of the Tobacco Control Act in 2009, FDA has had the authority to regulate the manufacturing, distribution, and marketing of tobacco products sold in the United States. FDA had immediate jurisdiction over cigarettes, roll-your-own cigarette tobacco, and smokeless tobacco. In May 2016, FDA asserted jurisdiction over products that meet the statutory definition of a tobacco product, including e-cigarettes, except accessories of these products ( Federal Register 2016 ). That regulation is currently under litigation.

The IOM ’s 2007 report, Ending the Tobacco Problem: A Blueprint for the Nation, established a “two-pronged” strategy for comprehensive tobacco control: (1) full implementation of proven, traditional tobacco control measures such as clean indoor air laws, taxation, and countermarketing campaigns; and (2) “strong federal regulation of tobacco products and their marketing and distribution” ( Bonnie et al. 2007 , p. 1).

Included in FDA ’s broad authority are the restriction of marketing and sales to youth, requiring disclosure of ingredients and harmful and potentially harmful constituents, setting product standards (e. g ., requiring the reduction or elimination of ingredients or constituents), requiring premarket approval of new tobacco products and review of modified-risk tobacco products, and requiring health warnings. The standard for FDA to use many of its regulatory authorities is whether such an action is appropriate for the protection of public health ( Federal Food, Drug, and Cosmetic Act , § 907(a)(3)(A)). The public health standard in the Tobacco Control Act also requires FDA to consider the health impact of certain regulatory actions at both the individual and population levels, including their impact on nonusers, and on initiation and cessation ( Federal Food, Drug, and Cosmetic Act , § 907(a)(3)(B)).

Importantly, the Tobacco Control Act preserves the authority of state, local, tribal, and territorial governments to enact any policy “in addition to, or more stringent than” requirements established under the Tobacco Control Act “relating to or prohibiting the sale, distribution, possession, exposure to, access to, advertising and promotion of, or use of tobacco products by individuals of any age” ( Federal Food, Drug, and Cosmetic Act , § 916(a)(1)). This preservation of state and local authority ensures the continuation of more local-level, comprehensive tobacco control. However, the statute expressly preempts states and localities from establishing or continuing requirements that are different from or in addition to FDA requirements regarding standards for tobacco products, premarket review, adulteration, misbranding, labeling, registration, good manufacturing practices, or modified-risk tobacco products ( Federal Food, Drug, and Cosmetic Act , § 916(a)(2)(A)). But this express preemption provision does not apply to state and local authority to impose requirements relating to the “sale, distribution, possession, information reporting to the State, exposure to, access to, the advertising and promotion of, or use of, tobacco products by individuals of any age …” ( Federal Food, Drug, and Cosmetic Act , § 916(a)(2)(b)). The interaction of these complex provisions related to federal preemption of state law has been the subject of challenges by the tobacco industry to state and local laws. Thus far, courts have upheld certain local ordinances restricting the sale of flavored tobacco products ( National Association of Tobacco Outlets, Inc. v. City of Providence 2013 ; U.S. Smokeless Tobacco Manufacturing Co. v. City of New York 2013 ).

Legal Basis for Regulating E-Cigarettes as Tobacco Products

In the United States, e-cigarettes can be regulated either as products marketed for therapeutic purposes or as tobacco products. Since the advent of e-cigarettes in the United States around 2007, manufacturers have had the option to apply to FDA ’s Center for Drug Evaluation and Research ( CDER ) or Center for Devices and Radiological Health (CDRH) for approval to market e-cigarettes for therapeutic purposes; as of August 2016, no e-cigarette manufacturers have received approval through this avenue.

In 2008 and early 2009, FDA detained multiple shipments of e-cigarettes from overseas manufacturers and denied them entry into the United States on the grounds that e-cigarettes were unapproved drug-device combination products ( FDA 2011 ). Sottera, Inc., which now does business as NJOY, challenged that determination ( Smoking Everywhere, Inc. and Sottera, Inc., d/b/a NJOY v. U.S. Food and Drug Administration, et al. 2010 ; Bloomberg Business 2015 ). Between the filing of the lawsuit and a decision on the motion for preliminary injunction, Congress passed the Tobacco Control Act and the President signed it into law. The Tobacco Control Act defines the term “tobacco product,” in part, as any product, including component parts or accessories, “made or derived from tobacco” that is not a “drug,” “device,” or “combination product” as defined by the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321(rr)) ( Family Smoking Prevention and Tobacco Control Act 2009 , § 101(a)). The District Court subsequently granted a preliminary injunction relying on the Supreme Court’s decision in Brown and Williamson (1996) and the recently enacted Tobacco Control Act. FDA appealed the decision and the U.S. Court of Appeals for the D.C. Circuit held that e-cigarettes and, therefore, other products “made or derived from tobacco” are not drug/device combinations unless they are marketed for therapeutic purposes, but can be regulated by FDA as tobacco products under the Tobacco Control Act ( Sottera, Inc. v. Food & Drug Administration 2010 ).

On September 25, 2015, FDA proposed regulations to describe the circumstances in which a product made or derived from tobacco that is intended for human consumption will be subject to regulation as a drug, device, or a combination product. The comment period for this proposed regulation closed on November 24, 2015.

Most e-cigarettes marketed and sold in the United States today contain nicotine made or derived from tobacco. Although some e-cigarettes claim that they contain nicotine not derived from tobacco, or that they contain no nicotine at all ( Lempert et al. 2016 ), there may be reason to doubt some of these claims. Currently, synthetic nicotine and nicotine derived from genetically modified, nontobacco plants are cost-prohibitive for e-cigarette manufacturers, although technological advances could eventually increase the cost-effectiveness of using nicotine that was not derived from tobacco ( Lempert et al. 2016 ). The health effects of passive exposure to e-cigarettes with no nicotine, as well as their actual use and the extent of exposure to these products, have just begun to be studied ( Hall et al. 2014 ; Marini et al. 2014 ; Schweitzer et al. 2015 ) and some states and localities are taking steps to regulate e-cigarettes that do not contain nicotine or tobacco ( Lempert et al. 2016 ).

Deeming Rule

The Tobacco Control Act added a new chapter to the Federal Food, Drug, and Cosmetic Act , which provides FDA with authority over tobacco products. The new chapter applied immediately to all cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco; and the law included “any other tobacco products that the Secretary of Health and Human Services by regulation deems to be subject to this chapter” ( Federal Food, Drug, and Cosmetic Act , §901 (b)). Therefore, to regulate e-cigarettes as tobacco products, FDA was required to undertake a rulemaking process to extend its regulatory authority to include e-cigarettes.

• Prohibitions on adulterated and misbranded products;
• Required disclosure of existing health information, including lists of ingredients and documents on health effects;
• Required registration of manufacturers;
• Required disclosure of a list of all tobacco products, including information related to labeling and advertising;
• Premarket review of new tobacco products (i.e., those not on the market on February 15, 2007);
• Restrictions on products marketed with claims about modified risk.
• Minimum age restrictions to prevent sales to minors;
• Requirements to include a nicotine warning; and
• Prohibitions on vending machine sales, unless in a facility that never admits youth.

Future Regulatory Options

• Product standards, including restrictions on flavors;
• Restrictions on promotion, marketing, and advertising, and prohibitions on brand-name sponsorship of events;
• Minimum package sizes;
• Prohibitions on self-service displays;
• Child-resistant packaging and the inclusion of health warnings; and
• Regulation of nicotine levels in products.

Despite this broad authority, FDA is prohibited from certain regulatory actions, even if those actions may be appropriate for the protection of public health. Specifically, FDA generally cannot restrict tobacco use in public places, levy taxes on tobacco products, prohibit sales by a specific category of retail outlet (e. g ., pharmacies), completely eliminate nicotine in tobacco products, require prescriptions for tobacco products unless it is marketed for therapeutic purposes, or establish a federal minimum age of sale for tobacco products above 18 years of age. Thus, even if FDA fully exercises all of its existing authority over e-cigarettes, regulation will still need to be complemented at the state and local levels, including efforts previously shown to be effective for conventional tobacco products, such as comprehensive smokefree laws at the state and local levels, pricing strategies, raising the minimum age of sales to minors to 21, and high-impact countermarketing campaigns. In the current context of rising rates of use by youth, localities and states can also implement policies and programs that minimize the individual- and population-level harms of e-cigarettes (see Chapter 5 ).

This chapter presents the major conclusions of this Surgeon General’s report and the conclusions of each chapter. E-cigarettes are presented within their historical context, with an overview of the components of these devices and the types of products. In 2016, FDA announced its final rule to regulate e-cigarettes under the Family Smoking Prevention and Tobacco Control Act. The chapter outlines options for the regulation of e-cigarettes, particularly as they relate to youth and young adults, based on successful smoking policies. The need to protect youth and young adults from initiating or continuing the use of nicotine-containing products forms a strong basis for the need to regulate e-cigarettes at the local, state, and national levels in the future.

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Breaking news, cyndi lauper’s son faces boot from posh nyc pad for allegedly smoking weed, late-night screaming and thumping music: ‘unlivable’.

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Cyndi Lauper’s troubled son could get the boot from his luxury Manhattan digs for being the neighbor from hell with thumping music, late-night screaming and weed stench, court papers allege.

Declyn “Dex” Lauper-Thornton’s landlord lodged an eviction petition last month to try to boot the 26-year-old rapper from his $7,200-a-month apartment in a glassy high-rise building in the Financial District, according to the New York County Civil Court filing.

Lauper-Thornton — the only son of music icon Cyndi and her “Law & Order” TV actor hubby David Thornton — has allegedly violated a slew of lease rules since he moved into the posh one-bedroom pad with postcard views in October.

“I never had any problems with any of the neighbors before,” a former neighbor told The Post on Friday.

“Then a new tenant moved in … and immediately there was very loud music at the most bizarre times, like 3 a.m. or 7 a.m. — it felt like there was a nightclub right behind my wall,” the man said, referring to Lauper-Thornton’s apartment at the 19 Dutch St. building.

A source added that the day after a tenant confronted Lauper-Thornton about a particularly wild night, the former neighbor found a bullet in the hallway near his apartment — and decided to move out of his home shortly after.

Lauper-Thornton was previously arrested twice — for an illegal gun in Harlem in February and for alleged  possession of a stolen Mercedes in Hamilton Heights, Manhattan, in July 2022.

The night before his gun bust, the son of the “True Colors” and “Time After Time” singer walked into his building’s management office “holding a marijuana blunt and looking visually inebriated” to complain about being sent an email, court papers charge.

“If you don’t fix the email, I will come back with people and have everyone’s face broken,” Lauper-Thornton allegedly threatened. “I will break your legs. I have friends and an uncle that will f–k you up. Don’t play with me because I will bring someone with me and tear this whole place up.”

Other frightened tenants reported him to building management after hearing constant screaming coming from his apartment.

“The resident advised the yelling, shouting and/or screaming sounded very aggressive in nature and was filled with explicit language and threats of bodily harm,” the filing states.

Another reported that she is “scared for her safety because of the constant yelling and noise.”

A flurry of complaints have also piled up against Lauper-Thornton over the smell of cigarette and marijuana smoke allegedly wafting from his apartment — despite the building having a clear no-smoking policy.

His alleged antics had become so disruptive that one tenant claimed in court papers that their apartment was now “unlivable.”

The former neighbor said the noise wasn’t a one-off thing — by far.

“I would hear the disturbing music every other day. There were plenty of times when it was 2 a.m., 3 a.m. or 4 a.m.,” said the former neighbor, who didn’t want to be named.

“I had an important meeting one day, on a week day, but I was woken up at 3 a.m. the night before because the music was blasting. I could feel the bass. I put on a robe and went to confront the guy, in a nice way, and I had to bang on the door so loud because he just couldn’t hear.

“He tried to take the high road with me, saying ‘Oh, is this how you talk to people?’ I said, ‘Yes, at 3 a.m., I’m not going to be overly nice about it.’ So we had this conversation for 30 seconds. I left, and the music continued,” he added.

After residents started seeking concessions to make up for Lauper-Thornton’s alleged bad behavior, the landlord served him with eviction papers.

The building’s lawyer, Martin Meltzer, declined to comment when reached by The Post.

Lauper-Thornton’s attorney, Darryl Vernon, said, “We are talking about ways to resolve the situation.”

The claims come just months after Lauper-Thornton’s father coughed up $20,000 in cash to bail him out on the gun raps.

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