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NC Department of Health and Human Services
NC DPH: Chronic Disease and Injury Section
N.C. Public Health Home

Tobacco Prevention and Control Branch

Electronic Cigarettes / E-Cigarettes

According to the U.S. Centers for Disease Control and Prevention, e-cigarettes are one of a class of tobacco products which are battery-powered devices that provide doses of nicotine and other additives to the user in an aerosol, often referred to as vapor. There are many types of these products available in the United States, including e-cigarettes, e-hookahs, hookah pens, vape pens, e-cigars and others. Some are disposable, single-use varieties, while others can be refilled and/or recharged for repeated use.

Nicotine is highly addictive, and poses health risks, particularly for young people. Pregnant women can transfer nicotine to their developing fetus, which can be toxic. The evidence is also suggestive that nicotine exposure during adolescence may have lasting adverse consequences for brain development.

The U.S. Food and Drug Administration (FDA) has issued a rule to regulate the sale and manufacture of e-cigarettes (and some other tobacco products), which will go into effect on August 8, 2016. North Carolina – along with some other states and local governments – has decided to extend its tobacco sale to minor laws to include e-cigarettes. North Carolina has also placed a tax on the consumable nicotine solution used in e-cigarettes (often called e-juice).

While new studies are forthcoming on e-cigarettes, significant questions remain regarding their safety and impact on the patterns of traditional tobacco use. Some studies have shown potentially harmful ingredients and other concerns. So far, studies on the safety and health impact of these products and their use as a tobacco cessation aid, have had mixed results.

While cigarettes clearly pose the more significant health risk, e-cigarettes may contribute to an increase in young people becoming addicted to nicotine with e-cigarettes as a gateway drug leading to nicotine addiction; dual use of e-cigarettes, traditional cigarettes, and other tobacco products; delay in tobacco cessation; and an increase in relapse.

The use of e-cigarettes by North Carolina high school students increased 888 percent (PDF, 511 KB) from 2011 to 2015, and similar patterns are seen nationally and in other states. The unregulated marketing and literally thousands of flavors of these products may make them appealing to underage youth. One national study published in the journal Tobacco Control shows that the number of non-smoking teens who tried e-cigarettes tripled from 2011 to 2013.

There is also concern that secondhand exposure to the secondhand aerosol (vapor) from electronic cigarettes may pose a health hazard to others (PDF, 338 KB).

Regulating the Sale of E-Liquid Containers

Effective December 1, 2015, a new state law prohibits the sale of e-liquid containers without child-resistant packaging and requires a label for any e-liquid container that contains nicotine. The law creates a new Class A1 misdemeanor for a violation. Also, any person, firm, or corporation that violates the provisions of this law shall be liable in damages to any person injured as a result of the violation. See a copy of the law.