An electronic cigarette (e-cigarette) is a device that heats liquid nicotine and flavorings so they can be inhaled. The use of e-cigarettes is often called “vaping,” because many people believe it produces a vapor. E-cigarettes create an aerosol composed of tiny particles, which is different from a true vapor.

E-cigarettes are known by many different names. This includes e-cigs, vapes, vape pens, electronic nicotine delivery systems (ENDS), alternative nicotine delivery systems (ANDS), e-hookahs, mods, vaporizers, and tank systems. E-cigarettes are also sometimes known by their brand names.

Vaping works by heating liquid inside a small device, which turns it into an aerosol that is then inhaled into the lungs. Unlike smoking, which burns tobacco, vaping heats liquid to release particles suspended in air. The aerosol contains nicotine, flavorings, and other chemicals. When inhaled from the mouthpiece, these particles travel down the throat and into the lungs.

E-cigarettes are available in many shapes and sizes. They can look like cigarettes, cigars, pipes, pens, and USB flash drives. Most types of e-cigarettes have:

• A cartridge, tank or pod that holds liquid (can be refillable).
• A heating element for turning the liquid into breathable particles (aerosol, commonly called “vapor”).
• A battery to power the heating element.
• A power or control button (some are activated by sensors when you inhale).
• A mouthpiece to breathe in the aerosol.

E-cigarettes don’t have tobacco, but many of them have nicotine, which comes from tobacco. E-cigarettes heat liquid to make an aerosol; cigarettes burn tobacco, which creates smoke. Because of this, the U.S. Food and Drug Administration (FDA) classifies them as “tobacco products.”

Electronic cigarettes (e-cigarettes) were developed as a smoking cessation tool and a safer alternative to traditional cigarettes for people unable or unwilling to quit nicotine. The intention was to help people who smoke to reduce nicotine intake without exposure to the harmful tar and toxins in tobacco smoke, thus, reducing smoking-related diseases and deaths. However, 21 years since Chinese pharmacist Hon Lik, first introduced the modern e-cigarettes in 2003, to help himself quit smoking cigarettes, this did not work. He is now a dual user, both smoking and vaping. We must question whether they have achieved their intended objectives or if they have inadvertently become a Trojan horse in public health, presenting unforeseen risks and challenges.

Patterns of use

Some groups of adults use e-cigarettes at a higher percentage than others. For example:

• More men than women report current e-cigarette use.
• A higher percentage of young adults (18–24 years old) use e-cigarettes compared to older adults, usage declines with age.
• Use is higher among adults with less education, lower incomes, or without health insurance.
• Adults who identify as lesbian, gay, or bisexual report higher rates of use compared to heterosexual adults.
• Adults experiencing serious psychological distress are more likely to use e-cigarettes.

In 2024, e-cigarettes were the most used tobacco product among middle and high school students in the United States:

1. 63 million (5.9%) students currently used e-cigarettes. This includes:
   3. 410,000 (3.5%) middle school students.
   4. 21 million (7.8%) high school students.
2. Among students who had ever used e-cigarettes, 43.6% reported current use.
3. Among students who currently used e-cigarettes:
   38. 4% used an e-cigarette on at least 20 of the last 30 days.
   39. 3% used an e-cigarette every day.
4. 6% used flavored e-cigarettes. Vapes come in a variety of youth-friendly flavors, including fruit, candy, mint, and menthol.
5. Among students who currently used e-cigarettes; 55.6% used disposable e-cigarettes, 15.6% used prefilled or refillable pods or cartridges, and 7.0% used tanks or mod systems.

Most middle and high school students who vape both want to quit and have attempted to do so. In 2020, 63.9% of students who were current e-cigarette users reported wanting to quit, and 67.4% reported that they had tried to quit within the past year.

Why youth vape

Most tobacco use, including vaping, starts and is established during adolescence. There are many factors associated with youth tobacco product use. These include:

1. Tobacco advertising that targets youth: In 2021, 7 out of 10 U.S. middle and high school students reported exposure to e-cigarette marketing. Most students reported seeing e-cigarette advertisements or promotions in retail settings. Students also reported seeing advertisements on the internet, television, streaming services, movies, or in print media. In addition, about three out of four students (74%) who used social media reported seeing e-cigarette–related posts or content.
2. Product accessibility: Some e-cigarettes cost less than regular cigarettes, which may also contribute to youth vaping.
3. Availability of flavored products: A study from 2013–2015 showed that most youth who use e-cigarettes first start with a flavored variety. Availability of flavored vapes is among the top 10 reasons youth report ever trying an e-cigarette. In 2024, nearly 9 out of 10 middle and high school students who currently used e-cigarettes reported using a flavored product, with the most commonly used flavors being fruit, candy, and mint.
4. d) Social influences: The most common reason U.S. middle and high school students give for trying an e-cigarette is that a friend used them. Youth also report vaping because they are curious about e-cigarettes or because a family member used them.

Youth often obtain the e-cigarettes from others. Among U.S. middle and high school students who used e-cigarettes in 2021:

• 3% got them from a friend.
• 1% bought the products themselves.
• 7% had someone else buy the products for them.
• 7% had someone offer the products to them.

Dual use of e-cigarettes: Many young people who vape also use other tobacco products, including cigarettes and cigars. This is called dual use. In 2024:

• Among U.S. students who currently use a tobacco product, more than one-third report using more than one type of product, including 6%of high school students and 38.9% of middle school students.

Cannabis content of e-cigarettes: E-cigarettes can also be used to deliver other substances, including cannabis. In 2016, nearly one out of three (30.6%) of U.S. middle and high school students who had ever used an e-cigarette reported using marijuana in the device.

Health risks of E-cigarettes

The term “vapor” might sound harmless. But the aerosol that comes out of an e-cigarette is not water vapor, and it can be harmful. The aerosol from an e-cigarette can contain nicotine and other substances that are addictive.

1. Nicotine content: The e-liquid in most e-cigarettes has nicotine, the same addictive chemical in regular cigarettes, cigars, hookah, and other tobacco products. But nicotine levels are not the same in all types of e-cigarettes. Sometimes, product labels do not list the true nicotine content. There are some e-cigarette brands that have been found to contain nicotine even though they claim to be nicotine-free.

Young people can start showing signs of nicotine addiction quickly, sometimes before the start of regular or daily use. Because the adolescent brain is still developing, it is uniquely susceptible to nicotine.

The nicotine content of e-cigarettes has increased over time. Many e-cigarettes contain nicotine salts. These allow people to consume high levels of nicotine without experiencing the harshness of freebase nicotine.

High-nicotine products dominate US e-cigarette unit sales. In March 2022, products with a nicotine strength of 5% or more made up 81% of total e-cigarette unit sales. In recent years, the price of high-nicotine products decreased or stayed the same while the price of low-nicotine products increased.

2. Cancer risk: E-cigarettes contain chemicals that can cause cancer (carcinogens), like acetaldehyde and formaldehyde but their long term effect on cancer development is not yet clear.
3. Heart and lung disease: E-cigarettes contain chemicals known to cause lung disease, such as acrolein, diacetyl and diethylene glycol. A Johns Hopkins Medicine-led analysis of medical information gathered on a diverse group of almost 250,000 people over four years has significantly clarified the link between the “exclusive” use of e-cigarettes and chronic obstructive pulmonary disease, as well as high blood pressure in a sub-group of adults 30 to 70 years of age.

E-cigarettes and other similar products have been linked to lung problems. Using them can increase your risk of breathing problems. This includes worsening asthma symptoms, more frequent bronchitis, and lung infections.

The nicotine in e-cigarettes also increases heart rate, raises blood pressure, and might irritate blood vessels.

4. Vitamin E acetate, linked to lung injury caused by vaping (EVALI): An outbreak of EVALI in late 2019 and early 2020 put thousands of people in the hospital. At least 68 people died. Since then, EVALI cases have been declining, but people who vape can still get EVALI. Among people hospitalized with severe EVALI, most were younger than 35 and used THC-containing vapes from informal sources, such as online sellers or family and friends. However, EVALI can occur in anyone who uses either nicotine or THC-containing vapes.

Symptoms of EVALI included:

• Cough, trouble breathing, or chest pain
• Nausea, vomiting, or diarrhea
• Fatigue, fever, or weight loss

Some people had to be hospitalized, and some died from their illness. Some of these lung injuries were linked to products that were changed, including products that had vitamin E acetate. But there were also many EVALI cases that did not involve added vitamin E.

The number of EVALI cases has since dropped, but there are still people being diagnosed with EVALI. More studies are being done to look for other possible causes.

5. Heavy metals: E-cigarettes may contain heavy metals like nickel, tin, lead and cadmium which have been shown to have adverse health effects.
6. Tiny particles: E-cigarettes may contain tiny (ultrafine) particles that can get deep into your lungs passing the filtration system of the lungs.
7. Seizures: There have been reports of people having seizures after vaping. This has been reported most often in young people. These seizures are thought to be caused by nicotine, but more studies are being done.
8. Dental problems: Studies are also starting to show a link between e-cigarette use and damage to teeth and other oral tissues. This includes cavities in the teeth and irritation of gums and other membranes in the mouth.
9. Secondhand aerosol: E-cigarettes expose people to secondhand aerosol or vapor that can contain harmful chemicals. Scientists are still learning about the health effects of being exposed to secondhand e-cigarette aerosol. Secondhand aerosol can expose others to nicotine and possibly to other harmful chemicals.
10. Explosions: There have been reports of e-cigarettes exploding and causing serious injuries. The explosions are thought to be caused by faulty batteries or because the batteries were not handled as they should be.

Can e-cigarettes help people quit?

E-cigarettes are not approved by the FDA and European Medicines Agency as smoking cessation devices due to limited data on safety and effectiveness. This is because there is not enough research to show that they help people to stop using tobacco.

Recent research indicates that people who use both cigarettes and e-cigarettes have a higher risk of getting lung cancer than people who only use cigarettes. People should not use both products at the same time and are strongly encouraged to completely stop using all tobacco products.

Globally, regulation varies:

• 88 countries have no minimum purchase age.
• 74 countries lack regulations entirely.
• E-cigarettes are banned in about 35 countries.
• Others regulate them as consumer, pharmaceutical, or tobacco products.

Marketing frequently targets youth, with over 16,000 flavors, cartoon packaging, and sleek designs resembling toys or tech gadgets. Alarmingly, in many countries, e-cigarette use among adolescents exceeds adult use. Even brief exposure to vaping content on social media increases the likelihood of trying these products.

One of the greatest public health risks is that vaping could “re-normalize” smoking after decades of successful tobacco control. Smoking remains the leading preventable cause of death, killing more than 480,000 people annually in the United States alone.

Conclusion

Taken together, these findings show that no tobacco products, including e-cigarettes, are safe. Most e-cigarettes contain nicotine, a highly addictive substance that poses serious health risks, particularly for youth, pregnant women, and developing fetuses. In addition to nicotine, e-cigarette aerosol can contain harmful and potentially harmful substances, including cancer-causing chemicals and ultrafine particles that can be inhaled deep into the lungs. For these reasons, e-cigarettes should not be used by youth, young adults, or individuals who are pregnant. Moreover, e-cigarettes pose potential health risks not only to those who vape but also to others exposed to secondhand emissions, while placing an added burden on public health systems and government healthcare budgets. Compounding these concerns, the short- and long-term health effects of e-cigarette use remain unclear, and much is still unknown about their full impact on human health. Until more is understood, this evidence underscores the importance of prevention, education, and informed decision-making.

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“…all cultures are partial and benefit from the insights of others [resulting in a genuine global universalism that] can be arrived at only by means of an uncoerced and equal intercultural [or inter-civilizational] dialogue.” Bhikkhu Parekh

Whatever is ill and unjust does not feign amid a world social construction. The awareness and moral action of youth are malleable forces within societies, and these form through educational processes. Dialogue can additionally enrich the character of youth, encouraging them to participate effectively within society to affect the moral nature of humanity. Such constructive effort teaches youth the importance of a deliberative approach to dialog, helping them learn better to manage conflicts and differences. Although the ability to control the inner self and moral makeup of individuals is impossible, constructing a social norm of moral ethos is not. Emile Durkheim has related that hegemony lays the foundation for social norms. His tenets reveal that ruling ideologies derive a majority social consensus that reflects the popular sentiments of society.

These sentiments, however good or bad, however ignorant or educated, are maintained within the parameters of whatever is popular belief. If individuals submit to a holistic approach that analyzes an entire system of beliefs rather than its single components, then a common ground for dialogue transpires.   A holistic understanding of good maintained by a recognizable constitution of global ethos can perfect a new hegemony. A formative education, inclusive of dialogue, can reduce stereotypes that prevent humanity from establishing commonalities among nations, cultures, or religions. This construct empowers individuals to rise above typical hegemonic devices and manufacture a transformative awareness toward global tolerance.

Knowledge, a culmination of educational processes, establishes the means to confront the significant and real issues of divisiveness while encouraging dialogue as a venue toward a more peaceful and safer world (Carroll 2007: ii). Within a renewed civil society, a “golden generation” of morally educated individuals, founded within a diverse and tolerant world, can affect the fundamental change needed to rejuvenate thinking and action. As we inhabit a world of shrinking space, a lesson in responsibility teaches us that respect for cultures and religions is imperative. Enlightening the ingrained mindset of adults is often difficult, as change does not come easily. Increasing the analytical skills and the thinking ability of youth enables a better examination of issues according to an inclusive and tolerant worldview. Education, in this capacity, embraces youth wherever the opportunity is available.

Social values and character building programs in schools in the U.S. and other nations are ineffective if they are not inclusive or diverse enough to reflect the global perspectives of diverse populations, religions, and cultures. Mediation processes, peace negotiations, and character programs alone are not enough. There must be a plan to expose youth to the foundations of various faiths and their cultural practices and origins. This kind of education has much social value since today’s diverse populations inhabit educational systems calling for a need for these skills. This educational practice does not mandate the teaching of religion, although culture and religion mesh, but it does suggest religious understanding. Being tolerant does not mean accepting what someone does or does not believe, as long as their beliefs do not affect any other individual. This type of tolerance perpetuates ignorance. Schools have a deeper responsibility toward teaching tolerance and dialogue to students, to move them toward a new era of relationships. Active learning works by asking questions and receiving answers, and this leads to progress. It is also a religious, political, and economic tool to be used in analytical discussions and real life applications. Gaining such knowledge and skills make education a creative and malleable force geared for ethical thinking.

A new history, written after 9/11, reveals that religion can create a socio-political statement, whether the message reflects minority malevolent intent or the misconstrued message of the majority. Tremendous efforts to seek truth, understanding, and awareness for greater dialogue among the religions of the world, especially between Christianity and Islam, have arisen because of this. Scholars work to obtain a global ethos that maintains a universal understanding of right and wrong, including a comprehensive agenda to direct humanitarian efforts toward common goals. David Smock, Vice President of the U.S. Institute of Peace and director of the Religion and Peacemaking Program, states his imperative for religious understanding and its political and diplomatic influence. He explains:

No major religion has been exempt from complicity in violent conflict. Yet we need to beware of an almost universal propensity to oversimplify the role that religion plays in international affairs. Religion is not usually the sole or even primary cause of conflict. With so much emphasis on religion as a source of conflict, the role of religion as a force in peacemaking is usually overlooked. Religious leaders and institutions can mediate in conflict situations, serve as communication links between opposing sides, and organize interfaith dialogue (Rumi Forum, 2009).
This type of informative academic material enriches the knowledge of civil society and can help people learn to distinguish what constitutes mainstream beliefs from extremists of varied religious backgrounds and faiths. Such was the misconception prior and just after 9/11.
The educational vision held by Fethullah Gülen takes an inclusive and holistic approach to interfaith understanding that enables youth to understand and engage with other cultures and faiths; such an approach benefits all of civil society. Jill Carroll quotes Mr. Gülen saying that his idea involves not only schools, but families, communities, and media. All major components of society must align the effort of educating youth in all beneficial knowledge. All social institutions must cultivate or “educate” people’s innate capacities for higher [human awareness]… (Carroll 2007:74).

Educating youth and adults to understand the value of interfaith dialogue and tolerance is one route to greater global coexistence.
This education also affects all levels and functions of civil society. It is a collective yet individualized method of gaining human connection. A new era of world vision encompasses a diverse global society, and therefore, the worldview must acknowledge that the world’s systems inevitably fail, and individuals must respond.

This initiative rests at the threshold of a world without racism, without subjugation, and without divisiveness. Power, religion, and modernity accomplish more through understanding. A great gift to this world would be a higher existence on earth. A diverse yet inclusive world grants temperance as a foundation for building a better tomorrow.

Social education is a fundamental means for reconstructing existing hegemonic social norms. It also incorporates interfaith dialogue as a fundamental part of the social foundation. No society reaches its fullest potential without education, and Jill Carrol explains that “[Fethullah] Gülen sees education as the means by which people become the true beings God created them to be; thus, to become educated in life’s most important task” (Carroll 2007: 72). From her book, A Dialogue of Civilizations: Gülen’s Islamic Ideals and Humanistic Discourse, she also quotes Mr. Gülen saying:

The main duty and purpose of human life is to seek understanding. The effort of doing so, known as education, is a perfecting process through which we earn, in the spiritual, intellectual, and physical dimensions of our beings, the rank appointed for us as the perfect pattern of creation… perfecting our thinking, perceptions, and belief (Carroll 2007: 72).

There is much power in this educational theory, enough to sustain a global vision and move humans toward greater understanding. It merges religious and cultural commonalities despite differences.

Educational processes that support dialogue transcend normative social, religious, and cultural understandings and allow spiritual awareness to influence outcomes. Theologian Hans Küng stated during the opening presentation at the Exhibit on the World’s Religions at Santa Clara University that
The world’s religions are very, very different and have very different bases. It would be illusionary to think that you can just unify the religions. But, I hope for peace among the religions, and that is a very realistic hope. … There will be no peace among the nations without peace among the religions. There will be no peace among the religions without dialogue among the religions (Küng 2005).

His hope, too, is for a real community of nations – and that begins with peaceful coexistence and tolerance among faiths. This message stresses the need for a greater understanding and compassion among religions and encouragement for the world to recognize the valuable role of dialogue in the social educational system. To become ideally human is to incorporate the use of all that is human and use it to perfect the self through education of mind and spirit, whereby the soul recognizes the capacity to determine right action.

This educational empowerment assists global social change and is the beginning of a promising initiative to educate responsible global citizens. No better investment or place to start exists than with the youth of this world. Progress begins with a valuable investment in the youth of the world in hopes that they in turn manifest a new attitude that embraces dialogue, the tenets of a global ethos, good citizenship, and the will to strive for righteousness on behalf of humankind.

Recognizing that the great religions of the world have spiritual messages and visions that affirm ethical traditions is to realize that from these divergent paths, voices, languages, cultures, and heritages, we can find moral commonalities. The confirmation of an impassioned love for life and the divineness of mysteries unite humankind within an elevated existence. The acknowledgement and agreement of the existence of something beyond man’s earthly comprehension is encompassing. We can hope that educational programs will provide knowledge of diverse beliefs, faiths, and spiritual traditions and will one day nurture mutual understanding, respect, and cooperation among people.

Bibliography

Carroll, Jill B. 2007.   A Dialogue of Civilizations: Gülen’s Islamic Ideals and Humanistic Discourse. Somerset, NJ: The Light Publishing Company.

Küng, Hans. 2005. “The World’s Religions: Common Ethical Values”, presented at the opening of The Exhibit on the World’s Religions at Santa Clara University accessed on 5/16/2009 from http://www.scu.edu/ethics/practicing/focusareas/global_ethics/laughlin-lectures/kung-world-religions.html.

Smock, David. 2009. Religion in World Affairs: Its Role in Conflict and Peace. Rumi Forum, Georgetown University, Washington, D.C., presented June 18, 2009.

Futuwwa, defined as youth and chivalry, is really a composite of such virtues as generosity, munificence, modesty, chastity, trustworthiness, loyalty, mercifulness, knowledge, humility, and piety. It is a station on the path to God as well as a dimension of sainthood, and also signifies that altruism and helping others have become one’s second nature. It is an important, indispensable dimension of good conduct and a significant aspect of humanity.

Derived from fata’ (young man), futuwwa has become a symbol of rebellion against all evil and the endeavor for sincere servanthood to God; the following verse expresses this eloquently:

They were young men who had believed in their Lord, and We increased them in guidance. And We strengthened their hearts, when they rose up and declared: Our Lord is the Lord of the heavens and Earth; we will not call upon any god beside Him, or then we had spoken an outrage. (18:14)

The verse We have heard a youth talk of them (the idols); he is called Abraham (21:60) expresses the position and influence of one who has achieved perfect futuwwa in his or her community, one who has sought to guide humanity to truth. By contrast, the young men mentioned in the verses: With him there came into the prison two young men (12:36) and: (Joseph) told his young (servants) to put their merchandise (with which they had bartered) into their saddle-bags (12:62) were ordinary young men without chivalry.

As many people have written on or talked about futuwwa since the Age of Happiness, the concept has been defined in many ways: not despising the poor or being deceived by the rich and riches; being fair to everybody without expecting fairness in return; living one’s life as a pitiless enemy of one’s carnal self; being ever-considerate of others and living for them; smashing all idols or all that is idolized, and rebelling against falsehood so as to be wholly devoted to God Almighty; bearing whatever evil is done to oneself, but roaring when the rights of God are violated; feeling remorse for the rest of one’s life for committing the smallest of sins, but overlooking others’ sins, regardless of how large they are; seeing oneself as a poor, lowly servant while considering others as saintly; not resenting others while maintaining relations with those who resent you; being kind to those who hurt you; serving God and the people before everyone else, but putting others first when it is time to receive one’s rewards.

Some have summed up futuwwa in the four virtues mentioned by Haydar Karrar Ali, the fourth Caliph and cousin of the Prophet, upon him be peace and blessings. They are: forgiving when one is able to punish, preserving mildness and acting mildly and gently when one is angry, wishing one’s enemies well and doing good to them, and being considerate of others’ well-being and happiness first, even when one is needy.

Ali was one of the greatest representatives of futuwwa. When he was stabbed by Ibn Muljam while leading the morning prayer in the mosque, his children, who saw that their father was going to die, asked him what he wanted them to do to Ibn Muljam. He did not order his execution in retaliation. During a battle, Ali threw his enemy to the ground and then released him. When ‘Ali was about to kill this man, the latter spat in Ali’s face, which angered him. Fearing that his motive for killing the man was now confused and sullied, ‘Ali released him. He felt sincere grief when Zubayr ibn Awwam, a leading Companion and his enemy in the Battle of the Camel, was killed. Since he always considered others first, even when he was in need, he usually wore summer clothes in winter and trembled with cold (because he would give away his winter clothes). It was said about him that there could be no young, chivalrous man like Ali, and there could be no sword like Dhu al-Fiqar (Ali’s sword). Ali lived with the Prophet, upon him be peace and blessings, and was raised by him. He lived a perfectly honest, pure life without any stain, and embodied God’s answer to Prophet Moses, upon him be peace, about futuwwa: It means that you are able to return your self to Me as pure or untainted as you received it from Me.

The signs of a fata’ (young, chivalrous one) are that the individual, created with the potential to accept Divine Unity and Islam, is totally convinced of the Divine Unity; this urges him or her to live according to the requirements of this conviction; that, without being captivated by carnal or bodily desires, he or she lives a pure, spiritual life; and that he or she always seeks to please God in his or her deeds, thoughts, and feelings. One who cannot be saved from the temptations of the carnal self, Satan, appetites, love of the world, or attachment to the worldly life cannot climb upward to the peak of futuwwa.

Futuwwa is a treasure obtainable by climbing high beyond
All the “highest mountains of the world”;
What business have those who fall tired
Even on a smooth road with such a treasure?

Notes

1. Ibn al-Athir, Usd al-Ghaba, 4:118.
2. Shamsaddin Sivasi, Manaqib Jiharyar Guzin, 258.
3. Al-Haythami, Majma’ al-Zawa’id, 9:150.
4. Ibid., 9:122.
5. ‘Ali al-Qari, Al-Asrar al-Marfu’a fi akhbar al-Mawdu’a (Beirut, 1986), 367.