E-cigarettes (tobacco heating systems)

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2024

The Ministry of Health of the Russian Federation told how vapes and e-cigarettes cause a new lung disease EVALI similar to coronavirus

The Russian Ministry of Health in August 2024 drew attention to the increase in lung disease associated with the use of e-cigarettes and vapes, and reported a new pulmonary disease called EVALI (Electronic Cigarette or Vaping Product Use Associated Lung Injury). This disease was first diagnosed in 2019 in the United States, but now raises serious concerns in Russia.

Information about the new disease appeared in the telegram channel of the Ministry of Health. EVALI is an acute pulmonary injury caused by the consumption of e-cigarettes and vapes. The disease first attracted attention during the peak of sales of these devices in the United States, when cases of respiratory diseases among adolescents and young people began to gain momentum. According to the data, as of August 2024, about 2,807 cases of EVALI were recorded in the United States, of which 68 were fatal. Experts believe that the real number of victims may be significantly higher, and their number will continue to grow.

The Ministry of Health of the Russian Federation reported that vapes and e-cigarettes can cause a new lung disease EVALI, similar to coronavirus

The symptoms of EVALI are largely similar to the signs of COVID-19 - fever, general weakness, cough and shortness of breath, as well as pathological changes in the lungs that can be detected using computed tomography. However, as emphasized in the Ministry of Health, unlike the coronavirus, EVALI is often manifested by disorders of the digestive system in the early stages, which makes it difficult to diagnose. At the moment (August 2024), there are no special studies that could reliably confirm or refute the presence of this disease.

There have been discussions about the dangers of vaping for a long time, and, as Lyudmila Zhelenina, professor of the Department of Childhood Diseases at St. Petersburg State Pediatric Medical University, noted, it can now be confidently argued that the use of electronic cigarettes and vapes harms health.

Rospotrebnadzor Vaping dries up lung tissue and the lining of the airways, making it easier for the infection to penetrate, the person added. Impaired gas exchange in the lungs leads to oxygen deficiency.^[1]

Kyrgyzstan banned the import and sale of vapes and electronic cigarettes

The Parliament of Kyrgyzstan passed a law prohibiting the import and sale of vapes and electronic cigarettes in the republic. The corresponding decision was made at a meeting of the Jogorku Kenesh on June 26, 2024. This step is aimed at limiting the spread of nicotine-containing products.

The main goal of the adopted amendments to the legislation is to protect the health and well-being of young citizens from the use of e-cigarettes. The initiative came from a group of MPs. Lawmakers have raised concerns about the growing popularity of vapes among young people.

Smoking vape

According to Interfax, administrative fines are provided for violating the ban on the use of electronic cigarettes. For individuals, the amount of the fine will be 10 thousand soms (about $115), for legal entities - 60 thousand soms (about $690). For the sale of electronic cigarettes, the fine is set at 65 thousand soms (about $745). These measures are intended to be a serious deterrent.

According to the agency, the most severe punishment is provided for the import of electronic cigarettes. Violators face a fine of 150 to 200 thousand soms (from $1.7 to 2.3 thousand) or imprisonment for a term of one to two years. Such tough sanctions are aimed at stopping the smuggling of these products.

The bill is aimed at ensuring the health of all citizens, protection against the use of electronic cigarettes, - said in a statement published on the website of the Kyrgyz parliament. The country's authorities emphasize the importance of preventing nicotine addiction.

It is worth noting that similar restrictions were previously introduced in neighboring Kazakhstan. There, the ban on the sale and distribution of electronic cigarettes, as well as flavors and liquids for vapes, was signed by the President of the Republic, Kassym-Jomart Tokayev. This indicates a regional trend towards tougher regulation.^[2]

E-cigarettes alter human DNA

On March 19, 2024, specialists from University College London in Britain and Innsbruck University in Austria released the results of a study suggesting that e-cigarettes change human DNA. Moreover, these changes are almost identical to those observed in tobacco smokers.

The paper analyzed the epigenetic effect of tobacco and e-cigarettes on DNA methylation - this is a modification of a DNA molecule without changing the DNA nucleotide sequence itself. More than 3,500 samples were taken for the study: the goal was to study the effect of smoking on cells that are directly exposed to smoke (for example, in the mouth), and those that are not directly exposed (in particular, in blood or cervical cells).

E-cigarettes have an impact on human DNA

Scientists note that epigenome refers to an additional layer of information that is superimposed on DNA. If you draw a parallel with a computer, then DNA can be compared with "hardware," and epigene - with "software," which allows you to determine how, where and when programs are used. Epigenome changes throughout a person's life, and various genetic and non-genetic factors can influence it, including aging, lifestyle, exposure to hormones, chemicals and environmental conditions.

The researchers established that epithelial cells in the mouth show significant epigenomic changes in smokers. Moreover, these changes are more pronounced in lung cancer or precancerous conditions - this confirms the idea that epigenetic changes associated with tobacco smoking provoke an acceleration of cell growth. Moreover, it has been established that people who have smoked less than 100 e-cigarettes in a lifetime show similar epigenomic changes. However, scientists admit, based on the data obtained, it cannot be said that electronic cigarettes cause cancer.^[3]

President of Kazakhstan signed a law banning sales of vapes in the country

On April 19, 2024, President of Kazakhstan Kassym-Jomart Tokayev signed the law "On Amendments and Additions to Some Legislative Acts of the Republic of Kazakhstan on Health Issues." The document, among other things, provides for the imposition of a ban on the sale of vapes in the country.

It is noted that the law is aimed at implementing the instructions of the head of state to introduce a system of legal and financial protection and increase the responsibility of medical workers, as well as to take systemic measures to prevent and combat the spread of nicotine-containing substances among young people. In particular, there is a ban on the sale, distribution of non-smoking tobacco products, vapes, flavors and liquids for them. In addition, it is forbidden to advertise such products.

Kassym-Jomart Tokayev signed the law "On Amendments and Additions to Certain Legislative Acts of the Republic of Kazakhstan on Health Issues"

The law provides for a number of measures aimed at supporting medical workers. Such employees are granted the right to receive priority places for their children in preschool organizations at the place of residence, protection from illegal interference and obstruction of professional activities, respect for the profession, military service in a medical specialty or deferral from conscription.

An acute shortage of medical specialists who arrived at work in the countryside for a period of at least five years will be made a one-time cash payment in a hundred times the minimum wage. In addition, professional liability insurance for medical workers is introduced. In order to exempt the provision of unnecessary reporting and information, the authorized health authority, in accordance with the new rules, will approve a list of documentation that is mandatory for filling out by medical professionals.^[4]

2023

The number of Russians smoking e-cigarettes in 5 years has grown 46 times

The number of Russians smoking e-cigarettes over 5 years has grown 46 times and reached 4.5 million people by the end of 2023. This is evidenced by the data of FinExpertiza analysts, which are formed on the basis of Rosstat statistics. The study was published on March 19, 2024.

According to experts, at the end of 2023, the share of consumers of vapes and tobacco heating systems among smokers in the Russian Federation amounted to 17.5% against 16.7% a year earlier. The share of e-cigarette lovers among the entire population of the country during this time increased from 3.6% to 3.7%.

Now every sixth Russian smoker uses electronic cigarettes, - comments the president of FinExpertiza Elena Trubnikova (her words are quoted on March 19, 2024). - And if at first these devices were used mainly by young people in megacities or smokers who want to gradually abandon their addiction, now the circle of consumers has expanded to older age groups. Often they see "electronics" not as an alternative, but as an addition to ordinary cigarettes.

The leaders in the popularity of vapes in 2023 were the Magadan region (41.8% among the smoking population), Moscow (33.5%) and the Astrakhan region (30.4%). Almost no one uses electronic cigarettes in Chechnya and Ingushetia - there the share of owners of such devices tends to zero: sales go almost exclusively in tourist places.

Most buyers of electronic cigarettes live in Moscow - 791,000 people, or 17.7% of the total number of Russians buying such products (by the end of 2023). This is followed by the Moscow region by a significant margin - the region accounts for 6.2% of all Russian vapers, or 276,000 people and St. Petersburg (5.8%, or 259,000 people).^[5]

Russia introduces a 5% duty on the import of electronic cigarettes. This will add 1.5 billion rubles a year to the budget

The government subcommittee approved the initiative of the Ministry of Finance of the Russian Federation to introduce a 5% customs duty on the import of electronic cigarettes in Russia. This was reported to the government on December 13, 2023.

The decision is aimed at equalizing import duties on these products and on disposable electronic devices, the document says, excerpts from which are provided by RBC.

It also follows from it that the import of electronic cigarettes to Russia is carried out from friendly countries. By December 13, 2023, the duty on the import of reusable electronic cigarettes into Russia is 0%. The Accounts Chamber proposed raising the duty to 5% of the cost of cigarettes in October 2023. Then the department said that this measure would bring an additional 1.5 billion rubles to the budget, provided that the volume of imported products remains at the level of 2022.

The increase in duties will help the population maintain health and well-being, according to the conclusion of the Accounts Chamber for the draft federal budget for 2024-2026. Deputy Chairman of the State Duma Committee on Economic Policy Artem Kiryanov in early October 2023 said that an increase in excise taxes on vapes from 21 to 42 rubles will not bring additional profit to the budget, but will only increase the amount of products in the shadow market.

In Russia, according to the National Scientific Center of Competence (NNCC), as of October 2023, 28 legal manufacturers, 691 wholesale trade organizations and over 50 thousand stores were present in the market for electronic nicotine delivery systems, while the share of illegal nicotine-containing liquid on sale at the end of 2022 was about 93%.^[6]

The first system in Russia has been developed that "sniffs" the smell of electronic cigarettes and vapes. It will be installed in schools

At the end of November 2023, researchers from St. Petersburg State University of Aerospace Instrumentation (GUAP) announced the development of the first system in Russia that is capable of detecting the smell of electronic cigarettes and vapes in the premises. The device is planned to be used in schools and universities in order to reduce the number of smokers. Read more here.

E-cigarette smoking freezes immune cells

On September 6, 2023, British experts from the University of Birmingham released the results of a study according to which even moderate exposure to nicotine-free vapor from e-cigarettes suppresses the activity of immune cells.

Experts have found that vaping literally freezes neutrophils, which are part of the first line of defense of the immune system. In the usual state, neutrophils are very mobile cells capable of penetrating even those tissues that are inaccessible to other white blood cells. Smoking e-cigarettes, however, causes neutrophils to lose the ability to move to counter threats.

British researchers took blood samples from healthy donors who never smoked or vaped. Then, experts exposed neutrophils extracted from the blood to 40 puffs of unaromatized vape: this is estimated to correspond to low daily exposure. Half of the samples were exposed to nicotine-containing vapors, the rest to nicotine-free alternatives.

Tests showed neutrophils remained alive in both groups but were "stuck" in place, rendering them unable to perform their usual protective functions effectively. Moreover, it turned out that vapors of e-cigarette liquids that did not contain nicotine had the same negative consequences as vapors of nicotine-containing compositions.

Neutrophils exposed to e-cigarette vapors, whether containing nicotine or not, are said to show high concentrations of F-actin strands. And the accumulation of F-actin leads to the fact that immune cells lose mobility and, therefore, cannot provide effective protection for the body.^[7]

A complete ban on the sale of vapes with flavors in Russia has been approved

The Ministry of Health of the Russian Federation approved a ban on the sale of vapes with flavors. It will come into force in March 2024. This became known on August 22, 2023.

In particular, the sale of e-cigarettes with additives such as food flavors (including vanilla, spices, ginger, cinnamon), sweeteners, as well as energy-activating additives such as caffeine, guarana and taurine will be banned. The list also includes biologically active additives, amino acids and vitamins C and E. The final list will be published by the Ministry of Health by September 1, 2023, Izvestia writes.

Representatives of the Association of Retail Companies (ACORT) expressed concern about the possible consequences of such a ban, which include illegal trade, violation of quality standards and lower tax revenues. ACORT proposed to introduce a transition period of 12 months so that companies can avoid significant losses and sell off product balances.

In early August 2023, it was reported that the Union of Nicotine-Containing Products Industry Enterprises (SPINI, unites more than 50 legal entities and individuals) asked to exclude food flavors and salt nicotine from the list of substances and additives subject to prohibition, which, as previously considered by the Ministry of Health, increase nicotine dependence of the population. SPINI noted that this rule makes the sale and use of vapes virtually impossible.

The law on restrictions on the sale of vapes was adopted by the State Duma on April 11, 2023. Initially, the deputies wanted to ban the sale of liquids for vapes with flavors and additives, but the final version of the adopted law states that the government has the right to create a "list of substances and additives," with the addition of which the sale of vapes will become impossible. The authors of the law were State Duma Speaker Vyacheslav Volodin, as well as leaders and representatives of all factions - more than 400 deputies.^[8]

Ban on the sale of vapes in Kazakhstan

At the end of July 2023, it became known about the introduction of a ban on vapes, liquids and flavors for them in Kazakhstan.

The Government of the Republic of Kazakhstan decided to completely ban vapes, liquids and flavors to them. This was preceded by a lot of work by the Respublica party faction, state and public organizations, the official Telegram channel of the Respublica parliamentary party says.

Members of the interdepartmental commission almost unanimously (12 against two) voted to introduce a ban on the sale, import, export and production of electronic cigarettes, liquids and flavors to them, said the deputy of the Mazhilis (lower house of parliament) Nurgul Tau, author of the initiative, her words are quoted by the portal Orda.kz.

Earlier, she reported, citing data from the Ministry of Finance, that the market for electronic devices for nicotine consumption grew 300 times in Kazakhstan from 2020 to 2022. At the same time, the legality of the import of this product raises doubts, the deputy noted.

At the same time, not everyone agrees with the complete ban on the sale of electronic cigarettes in Kazakhstan. According to Tengri News, the head of the Kazakhstan Vaping Association Rinat Shamerzayev proposed tightening the conditions for their sale so that minors would not buy them. He noticed that an electronic cigarette costs eight times more than a pack of cigarettes.

As one of the possible solutions to this problem, businessmen propose to leave honest players on the market who sell goods sealed at the plant. Entrepreneurs believe that devices in inconspicuous packaging will not attract the attention of adolescents.

Nurgul Tau compared the situation with the spread of electronic cigarettes among schoolchildren and young people with an "epidemic" and indicated that the reasons for this were the uncontrolled sale of vapes and their affordability, no more than 2000 tenge (409 rubles).^[9]

U.S. e-cigarette sales rise 1.5-fold in 2 years at the expense of teens

In 2022, sales e-cigarettes United States in increased 1.5 times compared to 2020 due to the distribution of flavored devices among adolescents. This is evidenced by data from a study by the Centers for Disease Control and Prevention (CDCP), as well as organizations of the CDC Foundation and Truth Initiative. The statistics were released at the end of June 2023. More. here

The heated mixture contains 19 new chemicals that are not in the original composition. Many of them have toxic properties

Vapes, or e-cigarettes, are an electronic nicotine delivery system by heating and aerolizing them. The temperature in such a device can reach 350 ° C. The composition of the traditional filler includes propylene glycol, glycerin, nicotine, flavors.

According to Svetlana Chikina, Associate Professor of the Department of Pulmonology at the N.V. Sklifosovsky Sechenov University (May 2023), when the mixture in the device heats up, a chemical reaction occurs between the components and new chemicals are formed that are absent in the unheated mixture.

Scientists found 19 new chemicals in the heated mixture that are not in the original composition. Many of them have toxic properties. Flavors are also added, which contain heavy metals in large quantities - lithium, aluminum, iron, lead, tin.

"The risk of the disease triples if a person uses vape over five times a day. The consequences of such a habit are cough, chest pain, shortness of breath and even hemoptysis. There are data that confirm that vaping smokers more often form scarring on the lungs, constrict bronchioles (the smallest airways), develop heart attacks and strokes, "says Svetlana Chikina.

It is not yet known exactly how passive smoking of e-cigarettes affects the health of others. This issue is now being actively studied by scientists at Sechenov University.

British Ministry of Health will distribute a million electronic tobacco heating systems free of charge with the condition of quitting smoking within two years

In early 2023, it became known that the Ministry would health care Britain distribute one million free of charge electronic tobacco heating systems to help as many citizens as possible to abandon traditional cigarettes. The main goal is to reduce the number of smokers by 2030 to below 5% of the population. It is this threshold that is WHO considered sufficient to recognize the state as' smoke-free '. Read more here.

2022

Imports of e-cigarettes to Russia soared by 92.3%

The production of tobacco for heating in Russia in 2022 exceeded 400 million tons, which is 7.1% more than the previous year. The import of electronic smoking devices in comparison with these periods increased by 92.3% and amounted to more than 25 million units. Such data are provided in a study prepared by NeoAnalytics analysts.

According to them, in Russia the market for electronic cigarettes and tobacco heating systems is significantly increasing annually due to active sales. At the same time, the legal market for the sale of traditional cigarettes is increasing only due to the annual increase in excise taxes. At the end of 2022, negative dynamics was observed in the traditional cigarette market.

As for the import of tobacco for heating, imports for the year decreased by 58.2% and amounted to 368.7 tons. The main supplier country of heated tobacco in 2022 was China.

In general, market dynamics are optimistic against the background of such macroeconomic indicators as retail turnover and cash incomes of Russians and significantly exceed these indicators. This is especially felt in the last two years, the researchers said in their 2022 report.

According to RIA Novosti in the geoservice of GIS, "by the end of 2022, the number of stores selling electronic cigarettes in large cities of the Russian Federation increased by 75% compared to a year ago. In Moscow, over the same period, there were 2 times more such places - by 108%, up to 2668 stores.

Lev Grigoriev, President of the PAURRENS Association, believes that the main reason for the growth of e-cigarette outlets is the large number of illegal products on the market, which are sold at low prices, and the constantly growing consumer demand provides sellers with high profits.

At the end of 2022, we estimate the illegal e-cigarette market at about 80%, "he said in a conversation with the agency.[10]

$1.2 billion fine for selling e-cigarettes to children

On December 6, 2022, the American company Juul Labs, which produces e-cigarettes, announced that a settlement had been reached as part of a large-scale process related to the youth vaping epidemic. The amount of payments in favor of the plaintiffs will be at least $1.2 billion. Read more here.

E-cigarettes provoke arrhythmia

At the end of October 2022, long-term use of e-cigarettes, or vaping products, can significantly impair the functioning of the body's blood vessels, increasing the risk of developing cardiovascular diseases. The use of both e-cigarettes and conventional cigarettes can lead to even greater risk than the use of only one of these products. These findings come from two new studies supported by the National Heart, Lung and Blood Institute (NHLBI), part of the National Institutes of Health (NIH).

The results of the study, published Oct. 26, 2022, in the journal Arteriosclerosis, Thrombosis, and Vascular Biology, add to a growing body of evidence that long-term use of e-cigarettes can harm human health. Researchers have known for years that smoking tobacco can cause damage to blood vessels. However, the effects of e-cigarettes on cardiovascular health have not been sufficiently studied. Two new studies - one in humans, the other in rats - aim to make a difference.

MD Matthew Springer and colleagues took blood samples from a group of 120 volunteers, among them those who used e-cigarettes for a long time, who smoked cigarettes for a long time, and those who did not. Scientists have defined long-term e-cigarette use as smoking more than five times a week for more than three months, and long-term cigarette smoking as smoking more than five cigarettes a day. They then exposed each of the blood samples to lab-cultured human blood vessel (endothelial) cells and measured nitric oxide release on the molecules' ability to pass through a layer of cells to the other side. Too high permeability makes vessels leaky, which impairs their functioning and increases the risk of developing cardiovascular diseases.

The researchers found that the blood of participants who used e-cigarettes and those who smoked caused significantly greater reductions in nitric oxide production by blood vessel cells than that of those who did not use cigarettes. Notably, the blood of those who used e-cigarettes also caused greater permeability of blood vessel cells than that of both smokers and nonsmokers. The blood of those who used e-cigarettes also caused more hydrogen peroxide to be released by blood vessel cells than the blood of non-smokers. Each of these three factors may contribute to impaired blood vessel function in people using e-cigarettes, the researchers say.

In addition, Springer and colleagues found that e-cigarettes have harmful effects on the cardiovascular system that differ from tobacco smoke exposure. Specifically, they found that the blood of people who smoked cigarettes had higher levels of certain circulating biomarkers of cardiovascular risks, and the blood of people who used e-cigarettes had increased levels of other circulating biomarkers of cardiovascular risks.

In the second study, the scientists tried to find out if there were specific components of cigarette smoke or a pair of e-cigarettes that were responsible for damaging blood vessels. In rat studies, they exposed animals to a variety of substances found in tobacco smoke or e-cigarettes. Among them were nicotine, menthol, acrolein and acetaldehyde gases, as well as inert carbon nanoparticles, which are particles of smoke and vapors of e-cigarettes.

Using special blood flow measurements, the researchers demonstrated that blood vessel damage did not appear to be caused by a specific component of cigarette smoke or e-cigarette vapor. Instead, they said, it is caused by irritation of the airways, which triggers biological signals in the vagus nerve, which somehow leads to damage to blood vessels, possibly as a result of an inflammatory process. The vagus nerve is a long nerve running from the brain that connects the airways to the rest of the nervous system and plays a key role in heart rhythm, breathing and other functions. Scientists have shown that disconnecting this nerve in rats prevents blood vessel damage caused by tobacco smoke, demonstrating its key role in the process.

This finding has implications for efforts to regulate tobacco products and e-cigarettes, as it highlights how difficult it is to isolate any one ingredient in them responsible for damaging blood vessels.^[11]

Russian schoolboy smoked an e-cigarette and died

In the Novosibirsk region, a teenager died after smoking an electronic cigarette. This became known on September 12, 2022.

According to the Telegram channel Mash Siberia, the 15-year-old boy felt unwell after smoking an e-cigarette. The teenager fell and lost consciousness.

The young man was hospitalized in the intensive care unit. Doctors failed to save the teenager. He died a few hours later.

As Komsomolskaya Pravda clarifies, the incident occurred on Rogachev Street in Berdsk on September 9, 2022. According to the boy's acquaintances, after school, he went to visit his aunt on Berezovaya Street, where he met with a friend.

The boy, together with a friend, played mobile games on his phone, sitting on a concrete slab between houses on Rogachev Street in Berdsk, the Investigative Department of the Investigative Committee of the Russian Federation for the Novosibirsk Region reported. - After some time, the victim became sharply ill, and he fell from this plate. Eyewitnesses called an ambulance, the child was hospitalized in the hospital, but he died from his injuries.

According to the boy's acquaintances, who were contacted by the newspaper, the young man hit his head, he had a head injury and clinical death. During the night, his heart stopped twice, the doctors tried to save him, but could not - on the morning of September 10, 2022, he died. The boy was in eighth grade at No. 11 School.

Misha's stepfather goes to the hall, so they have weights and barbells at home. Misha also worked with him, - an acquaintance of the student told reporters. - At school he studied well and his family is very good.

On September 12, 2022, the Investigative Committee announced that it had begun checking after the death of a 15-year-old teenager. What caused the death of the teenager and whether there is really an electronic cigarette in the case remains to be seen.^[12]

Juul to pay $438.5 million to sell e-cigarettes to children

On September 6, 2022, Juul Labs announced that the company had agreed to pay $438.5 million to settle a case brought by more than three dozen states over marketing and sales that those states believe triggered the U.S. teen vaping crisis. Read more here.

Ministry of Industry and Trade introduces mandatory labeling of electronic cigarettes

In August 2022, it became known about the decision of the Ministry of Industry and Trade to launch mandatory labeling of electronic cigarettes and liquids with nicotine content (ESDN) from November 1, 2022. The agency referred to numerous requests from "business communities and participants in the circulation of nicotine-containing products" for the early completion of the experiment and the early introduction of mandatory labeling. Read more here.

150 thousand dangerous electronic cigarettes seized in Moscow

In Moscow, the police seized 150 thousand life-threatening electronic cigarettes, the press service of the Ministry of Internal Affairs (MVD) reported on July 14, 2022.

Six people were detained, among them three foreigners. According to preliminary data, the attackers organized deliveries to the capital of large consignments of cigarettes without marking through East Asia. They forged quality certificates and sold them in stores and online.

As the check showed, the content of nicotine in these products greatly exceeds the norm, which is dangerous for consumers. The police, with the support of Rosgvardia employees, searched the places of residence of the group members and in the office and warehouse premises they use. During the search, forged documents and more than 600 million rubles were seized, as well as foreign currency, accounting documentation, draft records and other items of evidentiary importance.

It was previously established that the attackers organized an international channel for the supply of large consignments of unmarked electronic cigarettes to Moscow. Nicotine-containing products were imported into Russia from East Asia under the guise of small household appliances. To legalize the goods, the defendants made fake accompanying documents and quality certificates. In the future, cigarettes were supplied to trading enterprises and sold through online stores.

The products were sent for an expert study, the results of which showed an excess of nicotine content, which is dangerous to the life and health of consumers. A criminal case was initiated (part 2 of article 238 of the Criminal Code of the Russian Federation), the investigation continues by mid-July 2022. The issue of making a procedural decision against the detainees is being considered, a representative of the Ministry of Internal Affairs said.^[13]

Russian schoolboy's half face ripped apart after e-cigarette explodes

On June 27, 2022, it became known about the explosion of an electronic cigarette in the mouth of teenagers in the Moscow region. He was hospitalized in serious condition at the Research Institute of Emergency Pediatric Surgery and Traumatology in Moscow.

The incident occurred on the evening of June 26, 2022 in the Skhodni microdistrict in Khimki. The device exploded in the 13-year-old's mouth right while smoking. Shards tore his lip, nose, damaged his right hand and even his chest.

According to the Telegram channel Mash, a young man named Vadim was in the hospital. He said that he went to check his grandmother's mailbox and quite unexpectedly found a "dudel" in it. There were no notes or notes or instructions next to the e-cigarette. According to the victim, he only opened the lid, and the device exploded. How his lip, teeth and nose ruptured, the young man cannot explain. He has already had a nose operation, a few more in line, Mash said in a statement.

According to TASS, citing Olga Vradiy, a representative of the Main Investigation Department of the Investigative Committee for the Moscow Region, a criminal case has been initiated under Part 2 of Art. 238 of the Criminal Code of the Russian Federation (production, sale of goods and products or the provision of services that do not meet safety requirements). Investigators by June 27, 2022 are interrogating, establishing the place of sale of an electronic cigarette. The prosecutor's office of the Moscow region put the investigation under control.

E-cigarettes can explode for a variety of reasons. The most common is the inattention of the user, disregard for safety and the use of incorrect batteries. Experts also pay attention to problems with shrinkage. The batteries have a small plastic layer called heat shrinkage. If it has become unusable, it must be changed immediately. Otherwise, a short circuit and an explosion may occur.^[14]

US bans sale of Juul e-cigarettes

On June 23, 2022, it became known that the Food and Drug Administration (FDA) banned Juul Labs from selling all of its products in the United States. Read more here.

Mexico bans e-cigarette sales

In late May 2022, Mexican President Andres Manuel Lopez Obrador signed an executive order banning the sale of e-cigarettes, thus continuing the government's anti-vaping policy. As follows from the document, this decision was made to protect the health of the nation, especially children and adolescents of the country.

Mexico has already banned imports of these devices from October 2021. Even before that, consumer initiatives and other laws had been states used to discourage e-cigarette sales. Despite the decree passed, many Mexicans import and buy cartridges or vaping liquid from the grey market, as well as through Internet domestically.

In information health care Mexico, the design of an electronic cigarette provides an evaporator and a battery. The evaporator serves to heat the liquid and then convert it into steam. The principle of operation of the vape is only in its safety of design. If we consider cigarette smoke, then there is no doubt that smoke inevitably harms human health, since in addition to nicotine it includes many impurities, among which the following can be distinguished: carbon monoxide, gas resin, toxins, soot, heavy metals and various carcinogens.

Assistant Health Minister Hugo Lopez Gatell hit out at claims from industry officials that vaping is safer than smoking, calling their advertising activities a big lie. Gatell added that according to the Mexican government's own data, at least 5 million Mexicans have tried vaping at least once.

With the law passed, Mexico joined countries banning the sale or use of vaping products: Australia, Antigua and Barbuda,,,, Brunei Argentina Bangladesh Brazil Darussalam, Bhutan,,,, Vatican Venezuela East Timor,,,,,,,,,,,,,, Mexico,,,,,,, Egypt,, Gambia,, Hong Kong,, India,, Iran Cambodia Qatar Colombia Timor-Leste Kuwait Lebanon Mauritius Macau Malaysia Myanmar Nepal Nicaragua Oman Panama North Korea Seychelles Singapore,,,,,,,,,,,. Syria United States Surinam Thailand Turkmenistan Turkey Uganda Uruguay Chile Sri Lanka Ethiopia Jamaica Japan^[15]

Juul to pay $22.5 million for e-cigarette ads targeting minors

On April 13, 2022, it became known that Juul Labs would pay Washington $22.5 million to the state, and would also agree to a series of reforms to prevent the use and sale e-cigarettes of minors in accordance with a settlement announced by state Attorney General Bob Ferguson. More. here

2021

Which countries ban e-cigarettes

Illegal vape and e-cigarette market in Russia exceeded ₽23 billion

The illegal market for vapes and electronic cigarettes purchased via the Internet exceeded 23 billion rubles by the end of 2021. This was announced on December 29, 2021 by analysts of the Gorodissky IP Security service, which specializes in identifying and preventing the spread of illegal products on the Internet.

According to the study, in 2021, more than 46 million nicotine delivery systems (ESDN), vapes and electronic cigarettes were illegally sold in Runet, and the damage to the state budget from this gray market will amount to more than 4.2 billion rubles. Compared to 2020, illegal sales of electronic cigarettes in Russia have almost doubled.

The study reports that the main sales channels for illegal ESDNs are sites and social networks, the total audience of which may exceed 30 million users. In particular, analysts found 4.7 thousand communities and accounts in social networks that sell illegal products. At the same time, the largest audience of resources in VKontakte (77.1%) and Instagram (13.7%), and wholesale sales of illegal ESDNs are widespread in Telegram, experts found out.

Illegal online sales are a serious problem, but to a greater extent it concerns not disposable ESDNs, but liquids with nicotine for refueling open systems. Liquid pure nicotine is not officially imported into Russia, no such licenses have been issued, but there are enough proposals on the Web, "said Maxim Korolev, chairman of the board of the PAURRENS association (unites participants in the electronic nicotine systems market).

Tobacco companies see a threat in the growth of the illegal ESDN market. The segment of disposable devices is as opaque as possible, which hits law-abiding manufacturers and legal retail, Oleg Barvin, director of legal affairs and external corporate relations of BAT in the Russia, Central Asia and Belarus subregion, told Kommersant. But Data Insight partner Boris Ovchinnikov believes that the potential legalization of online sales of electronic cigarettes in compliance with all legal requirements could be interesting for marketplaces and for online retail.^[16]

One in five men who smoke e-cigarettes have problems with potency

In mid-December 2021, the results of studies of the connection between e-cigarette use and erectile dysfunction appeared. As a result, it was revealed that one in five smokers of an e-cigarette revealed problems with potency. Read more here.

In 2 years, the number of points of sale of electronic cigarettes has doubled in Russia

By December 2021, there were 5.2 thousand vape shops in Russia - outlets for the sale of electronic smoking devices, including disposable evaporators. Of these, 1.1 thousand stores in Moscow, according to data from 2GIS and Yandex.Business.

In December 2020, there were 3.1 thousand stores in the Russian Federation with electronic smoking devices, primarily disposable, and a year earlier - 2.6 thousand. Thus, in two years the number of such objects has doubled, notes, Kommersant referring to statistics. 2GIS

According to Yandex.Business, since 2019, the number of points has grown from 1900 to 4200. The 2GIS assessment includes tobacco shops that also implement electronic smoking devices, and Yandex.Business took into account only stores without traditional tobacco.

DNA Realty CEO Anton Belykh confirms the trend. He noted that tenants who open vape shops willingly stand next to their competitors and are ready to take larger premises.

The source of the publication in one of the large chains selling electronic smoking devices claims that only legal products are presented in their assortment, but in general counterfeit products dominate the market, providing 80-90% of sales. 

Market participants believe that the spread of such stores is associated with an increase in sales of disposable electronic nicotine delivery vehicles (ESDN) among the population. Maxim Korolev, Chairman of the Board of the PAURRENS Association (unites participants in the electronic nicotine systems market ), notes that most of such products are imported into the Russian Federation illegally, and the excise tax is paid only for the device, but not for the liquid.

 In turn, Baisolt Khamzatov, First Vice President of the Anti-Counterfeit Association, previously estimated the market for disposable ESDNs    in the Russian Federation at 40.5 million units by the end of 2020  , and this year its volume may exceed 93.1 million units.^[17] 

US banned from selling Iqos

At the end of September 2021, the International Commission to trade USA (ITC) banned the import and sale of tobacco heating devices. As a result Altria Group Philip Morris , they will have to remove the products IQOS from the market, since it, according to the regulator, violates the patent rights of the American tobacco company R.J. Reynolds, the manufacturer of Newport cigarettes. More here

Belarus banned from selling Iqos

In early August 2021, it became known about the termination of the supply of Iqos tobacco heating systems to Belarus. The decision of the manufacturer - Philip Morris - is related to sanctions. Read more here.

E-cigarette maker Juul to pay $40 million to silence harm from them

At the end of June 2021, it became known that Juul would pay $40 million to keep the harm from e-cigarettes silent. The fine will be transferred in favor of the US state of North Carolina, said its Attorney General Josh Stein. Read more here.

Mishustin approved a plan for the implementation of the anti-tobacco concept

In early May 2021, Prime Minister Mikhail Mishustin approved a plan for the implementation of the anti-tobacco concept. The task of more than 20 measures is to prevent smoking, reduce demand for tobacco products, inform Russians about the dangers of nicotine and introduce corporate programs to promote health. Read more here.

2020

Introduction of digital labeling of e-cigarettes and smoking mixtures

On December 29, 2020, the Government of the Russian Federation published a decree on an experiment on labeling electronic cigarettes and smoking mixtures. It will begin on January 11, 2021 and will last until February 28, 2022. The initiative will affect nicotine-containing products, including tobacco and tobacco products intended for consumption by heating, and smoking mixtures for hookah that do not contain tobacco. Read more here.

5% of the tobacco market comes from sticks

According to Nielsen, in the first half of 2020, sales of sticks for tobacco heating devices in Russia increased by almost 200% compared to last year. Today, the share of the tobacco market occupied by tobacco sticks is already 5% of the total volume.

CT images of affected light smokers of e-cigarettes are shown

At the end of August 2020, scientists published the results of a vaping study with CT images of the affected lungs. It turned out that lung lesions associated with the use of electronic cigarettes (EVALI) have a special picture on CT in the form of obscurations like "frosted glass."

The results of the study will help clinicians diagnose the disease without prescribing a biopsy, scientists say, as well as choose potentially less invasive treatment options. In 2019, the first reports of EVALI cases were reported, characterized by smoking e-cigarettes for 90 days before the onset of symptoms, presence of characteristic infiltrates in the lungs (darkening on a contrast-free X-ray) and no signs of respiratory tract infection. Within six months of the first reports, an additional 3,000 EVALI cases were reported with 68 deaths.

The scientists studied chest CT patterns that may match the pathomorphological pattern of EVALI in 26 patients. They all met the criteria for this condition and underwent both CT and biopsy. The most common CT lesion among EVALI patients was multifocal or diffuse frosted-glass darkening in 96% of the study cohort. These changes were even more common than subacute hypersensitive pneumonitis or pneumonia.

We hope that now, having seen a diffuse darkening of the lungs in a young patient without clearly defined reasons, radiologists will be able to immediately consider the possibility of damage caused by vaping, "said study leader Dr. Michael Gotway. - Patients do not always immediately admit that they use e-cigarettes, but if the radiologist recognizes signs of abuse and informs the attending physician about this in time, he will be able to collect a more detailed history and prescribe appropriate treatment.[18]

Lil Solid e-cigarettes will appear on the Russian market

On August 18, 2020, KT&G announced its entry into the Russian e-cigarette market. The company has started selling the lil Solid tobacco heating device, which the manufacturer says can be used for 20 sessions on a full battery charge and four sessions in a row. Read more here.

The State Duma equated electronic cigarettes with ordinary

On July 22, 2020, the State Duma in the third final reading adopted a law equating electronic cigarettes with ordinary ones. In this regard, anti-tobacco legislation, including administrative fines, will be extended to vapes, hookahs and snus.

E-cigarettes will be subject to liability for involving minors in the use process, violating the ban on their use indoors, and demonstrating the consumption process in audio-visual works and in theatrical productions. Fines will be the same as in violation of anti-tobacco legislation.

According to the document, consuming any nicotine-containing products, including electronic cigarettes, will be prohibited in places where cigarettes cannot be smoked: cafes, restaurants, hospitals, clinics, hotels, etc. It will be subject to the same restrictions on sales and advertising that are provided for tobacco products. Price and tax measures aimed at reducing demand for tobacco products today will also become identical. The new law also establishes a ban on smoking in communal apartments.

As noted in the State Duma, the health protection committee receives many appeals from public organizations and individuals with a request to limit the consumption, advertising and sale of electronic smoking products, since these products are sold to minors and are consumed by schoolchildren, including inside the school.

(The law) will allow you to work ahead of the curve, preventing sellers of such products from finding loopholes in the legislation. At the same time, it is very important to take into account the medical component and leave nicotine mixtures on sale for people who quit smoking and, for example, sell them on prescription, "Boris Mendelevich, a member of the State Duma Committee on Health Protection, explained to RIA Novosti.[19]

In the United States, the sale of the electronic tobacco heating system IQOS Philip Morris in the status of tobacco products with a reduced risk is allowed

On July 7, 2020, the US Food and Drug Administration authorized the sale of the IQOS Philip Morris electronic tobacco heating system in the status of a reduced-risk tobacco product. This is a tobacco product that has received a resolution on "reduced exposure" (exposure modification orders), which allows the commercial promotion of a product containing a reduced level of harmful substances, providing a reduced effect of substances on the body or not containing harmful substances, while it is expected that the issuance of such a permit meets the goals of public health. Read more here.

10.6 million people switched to smokeless smoking

According to Moira Gilchrist, vice president of scientific communications at Philip Morris International, during the Global Forum of Nicotine, which took place online in June 2020, tobacco companies are actively engaged in scientific research in order to replace cigarettes with alternatives as soon as possible, and in the future to rid the world of tobacco. According to her estimates, by the end of March 2020, 10.6 million people switched to smokeless tobacco products. "We are committed to at least 40 million people doing the same by 2025, which is 5 years from now.

Greek scientists: when switching to e-cigarettes, harm to the cardiovascular system of smokers decreases

At the end of April 2020, an article on the results of a study of the effect of electronic and conventional cigarettes on blood vessels and platelets of smokers was published in the journal Food and Chemical Toxicology. The authors were a group of Greek scientists from the Kapodistria National University of Athens, led by Ignatios Ikonomidis, MD.

At the same time, it is known that Greece is one of the most smoking countries in Europe. The proportion of adults smoking in Greece is comparable to that of Russia. In addition, Greece is the worst in Europe to comply with the ban on smoking in public places.

The study involved 40 adult volunteer smokers. One half of the participants had to continue smoking regular cigarettes for four months, the second half had to switch to electronic during the study. According to the authors of the study, all subjects were examined in advance and fully healthy. The results are moderately encouraging - when switching to e-cigarettes in 4 months, platelet function remained unchanged, while in subjects who smoked regular cigarettes, it continued to deteriorate. When switching to e-cigarettes, the stiffness of the walls of the arterial vessels and oxidative stress are also noticeably reduced.

The researchers point to the importance of the findings for the prevention of cardiovascular disease. The authors attribute the positive effect of the transition to e-cigarettes to carbon monoxide (CO). The study participants, who switched to using e-cigarettes for 4 months, significantly reduced the amount of exhaled carbon monoxide CO. Scientists suggest that smoking can potentially lead to chronic platelet dysfunction due to prolonged exposure to circulating CO in the body. However, when switching from conventional cigarettes to electronic cigarettes, further deterioration of platelet function is stopped, since in this case the amount of exhaled CO is significantly reduced. Therefore, in participants who used e-cigarettes, platelet function remained stable.

An important indicator in the study was the level of malonic dialdehyde (MDA). The level of this substance in the body is a marker for detecting various pathological changes (for example, coronary heart disease, psoriasis and others). Study participants who switched from traditional smoking to e-cigarette use by 4 months had a decrease in MDA, while those participants who continued to smoke traditional cigarettes still had an increase in MDA.

MDA is also a marker of another process - oxidative stress, which leads to a loss of elasticity of the arterial vessels. The process of accumulation of rigid collagen fibers in the walls of the arteries can lead to hypertension, kidney disease and stroke. A study by Greek scientists revealed that after 4 months, participants who used electronic cigarettes restored the elasticity of the walls of arterial vessels. In participants who smoked traditional cigarettes, the elasticity of the arterial vessels continued to decline.

An increase in the stiffness of the walls of large arteries is in turn associated with diseases such as atherosclerosis and other risk factors, as shown in epidemiological and clinical studies.

Thus, after analyzing all the results obtained, Greek scientists came to the conclusion that while maintaining the habit of traditional smoking, such important medical indicators as markers of platelet function and vascular elasticity continue to deteriorate, which entails the development of various cardiovascular diseases. In the same participants who also did not quit smoking, but switched to electronic methods of nicotine delivery, the above indicators have a positive trend.

The researchers stress that the effects of e-cigarettes on platelet function have not previously been the subject of clinical trials; known work was limited to experimental or in vitro studies. By the beginning of 2020, a certain amount of data has been accumulated, allowing us to carefully judge that e-cigarettes can be considered as a safer alternative to traditional tobacco smoking. For example, in countries such as Australia and the UK, electronic nicotine delivery systems are seen as a way to quit smoking.

An e-cigarette exploded in the mouth of a Russian teenager

At the end of January 2020, it became known about another case of an explosion of an electronic cigarette in Russia. The incident occurred with a 17-year-old teenager from the city of Atkarsk, Saratov region.

According to Versiya Saratov, on January 25, 2020, a young man was taken to the surgical department in serious condition, whose e-cigarette exploded right in his mouth. The blast wave was so powerful that it knocked out the guy's teeth and severely disfigured his face.

I found this e-cigarette. I don't even know what kind of firm she is. I decided to check how it works, after which an explosion occurred, - the schoolboy himself told the publication.

The victim was given medical assistance, they are trying to restore his jaw. In the future, the young man will be sent to Saratov to continue treatment.

The Ombudsman for the Rights of the Child in the Saratov Region Tatyana Zagorodnyaya posted on her Facebook page information that the Atkar student will need plastic surgery.

According to narcologist Roman Smolin, only a battery can explode in an electronic cigarette due to overheating.

This depends on the quality of the device itself, the cheaper or used the model is, the higher the risk. And from leaving, of course. Vapes need to be cleaned regularly. During smoking - or, as they say, "hovering" - a liquid forms that can leak to the battery and disable it, he said.

Smolin strongly recommended not using an electronic cigarette that overheats, as it is "a sure sign that the power source is junk - it can explode."

In September 2019, an electronic cigarette exploded in the hands of a 20-year-old resident of Perm while he was repairing the device. The problem was the battery pack. Due to the spark, clothes on the young man caught fire, he received 5% of the body burn.^[20]

E-cigarette maker Juul receives 2.6k health complaints

By mid-January 2020, maker e-cigarettes Juul Labs had received about 2,600 complaints about the adverse health effects of vaping. Customers cite issues such as burning sensation in the lungs, blisters on the lips and the development of vomiting. More. here

2019

E-cigarettes cause rare popcorn lung disease

At the end of December 2019, a clinical case report of a "popcorn" lung disease developed against the background of vaping was published in the Journal of the Canadian Medical Association.

Bronchiolitis obliterans, also known as "popcorn lung disease," is a chronic inflammatory lung disease that affects bronchioles and is characterized by persistent cough and shortness of breath. Previously, this disease was found only in workers in factories producing popcorn or ground coffee. This rare and life-threatening condition has been identified in a Canadian youth aged 17 after vaping flavoured liquids. The report details how the case differs from other types of vaping-related lung damage.

The patient worked in a fast food cafe and was not associated with the production of popcorn or coffee. He sought medical attention for a pronounced persistent cough, general malaise, nausea and shortness of breath, according to the report. The patient claimed that he did not drink alcohol or smoke regular cigarettes, but he actively used e-cigarettes for five months before going to the doctor. This case is considered the first circumstantial evidence linking this chronic lung disease to vaping.

This case of developing acute, life-threatening bronchiolitis, which in the future could lead to persistent chronic airway obstruction in a previously healthy young person, highlights the need for further research into vaping, as well as assessment of short-term and long-term risks, the researchers said.

Despite treatment, the symptoms persisted and the patient was eventually transferred to extracorporeal membrane oxygenation. After further assessment and treatment correction, the patient's condition improved and he was discharged home.^[21]

Medvedev equated e-cigarettes with ordinary

At the end of November 2019, the Prime Minister Russia Dmitry Medvedev signed a new anti-tobacco concept for the period up to 2035. She equates electronic nicotine delivery with conventional cigarettes.

Thus, e-cigarettes will not be able to buy consumers under the age of 18, and their smoking in public places will be regulated in the same way as in the case of ordinary tobacco.

In addition, advertising of e-cigarettes and vaporizers will be banned. At the same time, smoking rooms can be returned at airports, where it will be possible to smoke with both ordinary cigarettes and all types of electronic ones.

Smoking electronic and other cigarettes will continue to be prohibited in hospitals, cafes, schools, social security institutions, staircases, transport stops and some other places.

The purpose of the concept is to reduce the prevalence of tobacco consumption and other nicotine-containing products, as well as to subsequently consider the possibility of phased withdrawal of tobacco and other nicotine-containing products from civilian circulation in the Russian Federation in order to achieve a maximum reduction in morbidity and mortality rates from diseases associated with tobacco consumption, the document says.

According to the plans of the authors of the initiative, by 2035 the share of adult smokers will decrease to 21%, children's - to 1%. Retail sales of cigarettes per person should also be reduced, which by the end of 2018 amounted to 1.6 thousand units. By 2035, the country should reach 1 thousand units.

The All-Russian Center for the Study of Public Opinion (VTsIOM) conducted a survey that showed that about a third of Russians (27%) consume e-cigarettes, vapes and devices for heating tobacco. More than half of smoking Russians - 59% - are convinced that the regulation of sales and consumption of conventional and electronic cigarettes should be different.^[22]

Proportion of smokers worldwide using e-cigarettes

The State Duma approved excise taxes on all electronic cigarettes

On September 19, 2019, the State Duma in the third reading adopted a law on excise taxes on all electronic cigarettes and vapes. From 2020, the excise tax on such devices will be 50 rubles, after which it will increase annually by 2 rubles.

The bill also increases the excise rate on liquids to 13 rubles in 2020 with an annual increase of 1 ruble.

On tobacco and tobacco products intended for consumption by heating, the rate will be 6040 rubles per kilogram in 2020. In 2021 and 2022, the cost will increase to 6282 rubles and 6534 rubles, respectively. 

Innovations will directly affect the price of devices. The state's anti-tobacco strategy implies a systematic reduction in e-cigarette smoking along with traditional tobacco products. This will be achieved, among other things, by raising prices. 

The introduction of a new excise tax could lead to e-cigarette smokers having to pay it twice - both for the device itself and for tobacco to it. According to experts, the initiative of deputies can motivate many smokers to return to "harmful" traditional cigarettes.^[23]

India ban

On September 18, 2019 India , it announced a ban on e-cigarettes, which are recognized in the country as harmful to the health of young people. Production, import, export, transportation, storage and advertising related to these products are prohibited, Finance and Corporate Affairs Minister Nirmala Sitaraman said.

This decision is made taking into account the impact that e-cigarettes have on today's youth, "she said.

Nirmala Sitharaman cited data that showed an increase in e-cigarette use among middle school students in the United States of 48.5%.

In the event of the first violation of the new law, the court may impose a prison sentence of up to one year and a fine of 100 thousand rupees ($1,404). The punishment for repeated violation increases to three years in prison and 500 thousand rupees of a fine.

By September 2019, India is home to 1.35 billion people, 106 million of whom are adults who smoke cigarettes, according to data from the World Health Organization. The country ranks second in the number of smokers after China.

More than 900 thousand people die from smoking-related diseases in India every year. At the same time, traditional cigarettes, unlike electronic cigarettes, are not prohibited in the country.

Vapes and e-cigarettes are not particularly popular in India. Their sales in the country at the end of 2018 amounted to about $57 million, and by 2022 this market may grow by 60% (data from Euromonitor International).

By 2019, the popularity of vapes has grown rapidly. From 2011 to 2018, the number of e-cigarette users in the world increased from 7 to 41 million people. According to Euromonitor, by 2021 this figure will grow to 55 million.

In September 2019, Indonesia's National Tobacco Products Control Commission said the government should ban e-cigarettes.^[24]

Flavored e-cigarettes began to be banned in the United States

In early September 2019, the authorities of the US state of Michigan banned the sale of all flavored e-cigarettes in the state. Thus, Michigan became the first state to impose a ban on these products, although the city of San Francisco has had similar restrictions since 2018.

Flavored e-cigarette products have attracted the attention of lawmakers for years. Over time, more researchers began to talk about addiction to flavored additives, and there was an increase in vaping among children and adolescents. A study published in 2018 found that chemicals in e-cigarette flavors react with other substances found in the liquid and lead to new products that can irritate the lungs. The Centers for Disease Control and Prevention continues to investigate mysterious lung diseases that affect people after using e-cigarettes. The origin of the disease is unclear, but a total of 215 cases are being investigated in 25 states, including Michigan.

The ban takes effect immediately and will remain in effect for the next six months while Michigan lawmakers work to impose more permanent restrictions. The ban covers all sales in the state, both online and in stores. The traders were given 30 days to carry out the order.

The ban, imposed in Michigan, covers all flavored e-cigarette supplements, including mint and menthol, making it more comprehensive than restrictions imposed in 2018 by U.S. regulators . According to their recommendations, the sale of most flavored products is prohibited in places where children and adolescents under 18 can purchase them. However, the ban did not restrict the sale of e-cigarettes with mint and menthol flavors.^[25]

Russian e-cigarette market predicts 400% growth

The volume of the Russian market for nicotine-containing products - electronic nicotine delivery systems, tobacco heating systems and vapes - in 2023 will grow by 411.1% compared to 2018 and reach $3.7 billion. This is expected at the consulting company Euromonitor International (data released in early September 2019).

According to experts, the relative novelty of the e-cigarette market and the growing interest in new types of smoking make it possible to increase sales of such devices by at least 30% annually. This is the fastest growing segment of the Russian tobacco market. However, its pace will decline as demand saturates: for 2019-2020, growth will be 41.6%, and in 2023, growth in the year will already be 32.5%.

By September 2019, most smokers in Russia prefer conventional cigarettes. However, government anti-smoking policies and the annual rise in excise taxes negatively affect the tobacco market. Euromonitor predicted a drop in sales of conventional cigarettes by 30.6% by 2023, although due to an increase in excise tax in monetary terms, the market will continue to grow slightly, by about 10% in five years.

The e-cigarette market could suffer if the state decides to regulate it on par with the traditional one. For example, brands such as IQOS, glo and Juul Labs will no longer be able to advertise and sell products over the Internet, analysts say.

Bans on the use of such products in public places may also be introduced. The likelihood of such an outcome, as RBC writes, is quite high, in particular, the Russian Ministry of Health stands for regulating the circulation of electronic cigarettes, vapes and tobacco heating systems along with ordinary cigarettes. In its new anti-tobacco concept, the ministry paid special attention to controlling the circulation of electronic nicotine delivery vehicles.^[26]

First e-cigarette death recorded

At the end of August 2019, the first official death was reported as a result of a disease caused by smoking e-cigarettes. It happened in Illinois, health care according to the State Department (IDPH).

According to the department, the patient died after a severe respiratory illness. It was caused by vaping.

The department clarified that in a few days the number of vaper patients with respiratory diseases doubled. A similar disease was diagnosed in 22 people aged 17 to 38 years.

In total, 94 cases of pulmonary disease among young e-cigarette users were recorded in the United States from June 28 to August 15, with 30 of them in Wisconsin.

Patients with complaints of shortness of breath, fatigue, chest pain, fever went to hospitals in a number of states - California, Wisconsin, Illinois, Indiana, Minnesota. The disease mainly affects young people. Some patients admitted that they smoked mixtures of their own making, including with the addition of cannabis.

Even if the cases look the same, it is unclear whether these cases have a common cause or are different diseases with similar symptoms, the IDPH said.

However, IDPH director Ngozi Ezike believes the disease, which is diagnosed in patients with complaints of chest pain or difficulty breathing, is linked to the use of e-cigarettes or vapes.

The department, seeing the seriousness of the situation, called the team of the Center for Disease Control and Prevention (CDC), experts arrived in the state and began to investigate cases.

Earlier in 2019, the head of the Food and Drug Administration (FDA), Scott Gottlieb, said vapes could be banned if the number of teenagers smoking increases in a year.^[27]

E-cigarettes harm vessels

At the end of August 2019, scientists from the University of Pennsylvania published the results of a study according to which e-cigarette smoking, also called vaping, can harm a blood vessel, even if the devices are completely devoid of nicotine.

To study the short-term effects of vaping, researchers performed MRI scans on 30 healthy, non-smoking adult volunteers before and after vaping a nicotine-free e-cigarette. Comparing the MRI data, the researchers concluded that even a single smoked e-cigarette reduced blood flow and impaired endothelial function in the femoral artery. Normally, the endothelium lining the vessels supports their function, and if damaged, the wall of the arteries thickens, scleroses and becomes fragile, which can lead to a stroke or heart attack.

Although e-cigarette liquid is considered relatively harmless, the evaporation process can turn some molecules - primarily propylene glycol and glycerol - into toxic substances, said the head of the study, Professor Felix W. Wehrli. Despite the lack of nicotine, vaping has a direct effect on blood vessels and could potentially lead to serious, if delayed, consequences.

Researchers noted that the diameter of the femoral artery after vaping grew by an average of 34%, resulting in a 17.5% reduction in peak blood flow and a 20% decrease in blood oxygen saturation. Until the results of long-term studies are obtained, it is difficult to argue for sure about the harmful effects of vaping. However, researchers suggest e-cigarettes could be much more dangerous than previously thought and urge young people to be wary of this popular entertainment.^[28]

In e-cigarettes appeared facial recognition system

In mid-August 2019, e-cigarette maker Juul Labs unveiled a product with a facial recognition system. Read more here.

San Francisco ban

On June 26, 2019, it became known about the ban on e-cigarettes and vapes in San Francisco. The Board of Supervisors unanimously approved this restriction.

The decree covers both the implementation of electronic and flavored cigarettes in regular stores and online sales with the delivery of goods to addresses in San Francisco. The punishment for violation of the decree includes an administrative fine of up to $1,000. The ban will come into force in early 2020.

Conventional cigarettes and other tobacco products, as well as medical marijuana, will remain legal in San Francisco.

According to Gizmodo, San Francisco is the headquarters of the world's largest e-cigarette manufacturer Juul Labs, so it is curious that it was this city that introduced a ban on the sale of such products - also the first in the United States. Juul does not see anything good in the restrictions.

A total ban would force former smokers who switched to vapour products to return to cigarettes. Also, the law will contribute to the development of the black market , "the company believes.

The ban on e-cigarettes was approved by San Francisco Mayor London Breed. She stated the following:

We must take action to protect the health of San Francisco's youth and to protect future generations of citizens from this harmful addiction.

In 2018, e-cigarettes were smoked by roughly 21% of American high school students, double the number a year earlier, according to a University of Michigan study.^[29] 

If the United States began to ban electronic cigarettes, then in Russia, on the contrary, they are given the "green light." On June 3, 2019, the head of the Federation Council Committee on Social Policy Valery Ryazansky said that the Russian government had approved a ban on smoking e-cigarettes, vapes and hookahs in public places.

Assessment of harm from smoking through tobacco heating systems

Manufacturers of tobacco sticks used as a tobacco source for tobacco heating systems (CHT) claim that the amount of harmful substances produced during combustion is reduced by 90-95%, due to the fact that the heating temperature is significantly lower than the combustion temperature - 350 ° in tobacco heating systems versus 800 ° in conventional cigarettes.

Tobacco used in CHT sticks is impregnated with glycerin and propylene glycol so that it, in turn, does not light up when heated and produces steam containing nicotine necessary for the smoker. Such a system involuntarily brings to mind a vape in which cotton wool contained in a heating element and consisting of a spiral is also impregnated with a liquid containing flavors, nicotine, glycerin and propylene glycol. During the heating of glycerol, acrolein begins to be produced - a substance belonging to the 1st hazard class and which is toxic to the human body, since it irritates the mucous membranes of the respiratory tract. It should also be noted that the substance belongs to the group of lacrimators - tear substances. However, when we are talking about vape, it should be understood that the spiral in it heats up to 200 °, while the needle heating tobacco in CHT reaches a temperature of 350 ° - at this temperature, the process of decomposition of glycerin begins and, accordingly, the production of acrolein occurs. The SNT with the new stick works for 6 minutes, after which the system is automatically turned off. During this time, the smoker tends to make as many puffs as possible, minimizing the interval between them. Also, do not forget that tobacco itself is quite toxic, since it contains carcinogens even in its natural form, "said Maxim Novikov, a pulmonologist at the Medicine JSC clinic, a member of the European Respiratory Society, in 2019.

The second unpleasant point associated with SMT smoking is the frequent lack of ability to properly clean the heating element on which the stick is applied. During smoking, it becomes heavily contaminated, and the narrow neck of the tobacco stick connector does not allow the user to clean it completely. With each smoking session, even taking into account the cleaning of the device, the volume of dirt accumulated increases, and the density of particles in the steam, which is produced during the heating of tobacco, grows. Consequently, the volume of inhaled carcinogens is growing, since the dirt remaining in the apparatus is a combustion product. However, in fairness, it should be noted that after 7-9 puffs, it falls.

As a result, it is difficult to say unequivocally how safe such a method of producing nicotine is for the health of a smoker, but it is obvious that it is much less harmful than smoking cigarettes.

Smoking vape and hookah threatens with tuberculosis

Smoking vape and hookah threatens serious infectious diseases, including tuberculosis and "popcorn lung disease." Oleg Kutushev, head of the Moscow Center for the Prevention and Treatment of Tobacco Addiction, warned about this in May 2019.

- There is no technical regulation of liquids in vapes and hookahs, which means that there is no confidence in the composition of the purchased products. Hookahs are not sanitized - the risk of developing tuberculosis and infectious diseases increases, - explained the narcologist in an interview with the Moscow agency.

Tobacco smoke contains seven thousand toxic substances, about 50 carcinogens and mutagens, heavy metals and even radioactive substances, Kutushev noted. According to him, these facts are undeniable, there are no safe breaths and exhalations of tobacco smoke.

Soaring using tobacco heating devices threatens the development of "popcorn lung disease," which affects the alveoli. At the same time, eight out of ten people after a year and a half smoking vapes switch to ordinary cigarettes.

2018: Ban in Hong Kong and 27 other countries

In 2018, tobacco heating systems are becoming one of the most popular ways to minimize the risk of smoking. A bizarre device, which is a mobile device, and available in various colors and forms, for many has become part of the image along with a fashionable smartphone.

In October 2018, Hong Kong authorities completely banned e-cigarettes following 27 other countries that imposed a similar ban on the recommendation of the World Health Organization (WHO). Sales and use restrictions apply to all electronic devices that use tobacco, including those that allow smokeless smoking. 

No doubt the tobacco industry is strong in lobbying. But we must do what is right for the health of young people, "said the head of the Hong Kong administration, Carrie Lam , adding that in 2018 she received about 3 thousand letters in support of the ban on e-cigarettes.

The Hong Kong government's decision to remove e-cigarettes from the market comes four months after authorities announced intentions to legislate regulation of the electronic smoking device market, including banning sales to minors and advertising. The Ministry of Health has advocated a complete ban on electronic evaporators with and without nicotine since 2016.

According to Lam, the active spread of e-cigarettes has created new risks  and health challenges: such devices are positioned as less harmful tobacco substitutes, but often lead to the smoking of ordinary cigarettes in young people.^[30]

The tobacco industry was upset by this decision of the authorities. As  Kristin Hu, a representative of the Coalition on Tobacco Affairs industry group, noted in an interview with the South China Morning Post, such a step will only lead to an increase in sales of illegal products on the black market and will not protect young people in any way.

We were disappointed by the decision of the government, which selectively and blindly accepted the views expressed by individual groups, and ignored the opinion of the industry and the scientific evidence of foreign research, she said.

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