False. As of August 8, 2016, all new nicotine products introduced into the market after February 15, 2007 must go through a premarket review by FDA. While PMTA enforcement did not begin until September 2019, vapor products have existed under some form of regulation at the state and local levels since 2009. If marketed as a smoking cessation or any other therapeutic product, nicotine falls under FDA’s jurisdiction over drugs and devices. The US District Court for the District of Columbia stated as much in its ruling against the FDA in 2010 when the agency attempted to stop e-cigarettes from being imported to the US as “unapproved drugs/devices.”

True. E-cigarettes and vapor products are a form of Tobacco Harm Reduction, designed as a safer alternative to smoking. When discussing the safety of vaping, the comparison must always be to cigarette smoking. Numerous studies show that people who vape are exposed to significantly lower levels of toxicants and carcinogens than people who smoke, thus making them safer than smoking. Safer does not mean 100% safe, but for people who smoke, the science tells us switching completely can be extremely beneficial.

False. A variety of studies conclude that vapor products do help people quit smoking. Most notable is a randomized controlled clinical trial published in the New England Journal of Medicine in 2019 which found that nicotine-containing vapor products were nearly twice as effective as traditional nicotine replacement therapies (like gums and patches) to help people quit smoking. Additionally, the highly respected Cochrane Library published an updated analysis of e-cigarettes for smoking cessation in 2020, which found moderate-certainty evidence that quit rates were higher for people using nicotine vapor products than with traditional nicotine replacement therapies. Cochrane’s conclusions were based on a meta-analysis of 50 different studies across 13 different countries.

False. The first commercially successful e-cigarette was invented by Chinese pharmacist Hon Lik in 2003 to help him quit smoking. Independent consumers and small businesses around the world, but especially in the United States, innovated and grew the product category out of sheer passion for a more effective cessation method. It wasn’t until 2012 that the first large tobacco company entered the vaping market. While it’s true that most every major tobacco company now has their own branded e-cigarette, these products were not created by tobacco companies to “hook future generations,” as many activists claim. Vapor products were invented by people who smoke, for themselves, because they were frustrated with the low success rates of traditional nicotine replacement products.

Possibly. Heavy metals have been detected in some vapor products at varying levels, some concerning, and some not. Researchers have theorized that metals found in some products could be from the coils used to heat the liquid, however some of the testing methods used in these studies have been called into question. Overheating the coils, failing to account for metals from testing equipment, and not excluding participants who were still smoking are all potential causes of abnormally high test results. 

While the presence of any level of heavy metals is certainly a concern, heavy metals are just one component contributing to the potential risks from cigarette smoke. The fact that vapor products still contain far lower levels of other carcinogens and toxins – and none of the carbon monoxide and harmful particulates – found in cigarette smoke should not be overlooked, as the overall benefits of switching to vaping still outweigh the risks of smoking. Ideally, regulation should allow manufacturers to develop products that would mitigate the risk of metals leaching into liquid.

False. This claim comes from a single defective study published in 2015 in the New England Journal of Medicine in which researchers improperly used e-cigarette devices by overheating them, and effectively “burning” the wicking material, instead of aerosolizing the liquid. This phenomenon, referred to as “dry hits” or “dry puffs,” is well known by people who use vapor products because of how harsh and intolerable the resulting vapor is. “Dry puffing” a vapor device is the only way to achieve these high levels of formaldehyde, but due to the extreme level of discomfort this is not a realistic usage scenario – the user immediately stops vaping when this happens, as it means something is wrong with the device.

This same experiment was reproduced in 2017 by researchers more familiar with how vaping devices should work, and with participation from people who vape. They found that achieving high formaldehyde levels was essentially impossible in a normal use scenario because people could not tolerate the accompanying level of discomfort and foul taste. When used properly and under normal conditions, a person’s exposure to formaldehyde from vaping is well within levels considered to be safe.