Electronic Cigarettes: Combating Misconceptions by Supporting Public Education

Electronic cigarettes, known more formally as electronic nicotine delivery systems (ENDS), have been growing in popularity in the United States over the last few years—especially among youth. While the rate of youth smoking traditional cigarettes continues to drop, the CDC reports that the national rate of ENDS/electronic cigarette use among high school students nearly tripled from 4.5% in 2013 to 13.4% in 2014. Largely unregulated, heavily marketed, and easily accessible, these products are enticing young people to try tobacco for the first time and threaten to reverse recent progress around youth smoking.

OLYMPUS DIGITAL CAMERAENDS/electronic cigarettes are battery-operated devices that heat a nicotine-containing liquid, creating an aerosol that the user inhales and breathes out, simulating the act of smoking. They come in many forms—both disposable and reusable. Some resemble cigarettes, cigars, or pipes; others appear more like fancy pens for discrete use. Their liquids are often flavored in ways that would appeal to young users—for example, cotton candy, black licorice, and green apple.

There are many public misconceptions around the health-risks of ENDS/electronic cigarettes. Many falsely believe that they are a safe alternative to smoking tobacco and that they can be used as quit-smoking aids. In reality, while ENDS/electronic cigarettes do not produce tobacco smoke, the inhaled and exhaled aerosol contains nicotine, carcinogenic chemicals, and ultrafine particles—all of which pose health risks to the user and secondhand bystanders. This aerosol is a far cry from what many tout as harmless water vapor. Furthermore, there is little scientific evidence to support the claim that ENDS/electronic cigarettes could help people quit smoking, and they are not approved cessation aids.


Other public health issues that extend beyond these misconceptions, include;

  • There have been many reports of young children being hospitalized for nicotine poisoning after ingesting the liquid designed for ENDS/electronic cigarettes. According to the American Association of Poison Control Centers, calls to poison control centers about liquid nicotine exposure have increased more than tenfold since 2011.
  • ENDS/electronic cigarettes can be used to discretely smoke marijuana and THC extract, making enforcement challenging—especially in school settings, where they bear a resemblance to common school supplies such as pens, and often emit little to no odor or smoke.

Over the last several months, the Rhode Island Prevention Resource Center (RIPRC), a JSI project funded by RI Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, has been working to support and promote local prevention providers and partners in Rhode Island who are educating and engaging their communities around ENDS/electronic cigarette use. In March, we interviewed Heidi Driscoll from the South Kingstown Partnership for Prevention and Dave Neill from the U.S. Attorney’s Office, Rhode Island District, featuring them in a provider profile that showcased their public outreach work. Concurrently, the RIPRC developed a factsheet that addressed the most common misconceptions around ENDS/electronic cigarettes and offered guidance on how to support prevention through law enforcement, media advocacy, youth education, and public policy efforts.


Learn more about the Developing a Prevention Resource Center in Rhode Island (RIPRC) Project.

Content Sources:

  • Drug Facts: Electronic Cigarettes. NIDA, 2014.
  • Questions and Answers on Electronic Cigarettes or ENDS. World Health Organization, 2013.  
  • E-Cigarettes Pose Risks. SAMHSA, 2014.  
  • Electronic Cigarettes Key Findings. CDC, 2014.
  • E-cigarette use triples among middle and high school students in just one year. CDC, 2015.