Aarnav Grover

IR 1/10 GT
5/14/20
Annotated Source List

Blount, Benjamin C., et al. “Vitamin E Acetate in Bronchoalveolar-Lavage Fluid

Associated with EVALI.” New England Journal of Medicine, Dec. 2019.

In the search for the causative agents for the current national outbreak of e-
cigarette, or vaping products use-associated long injury (EVALI) multiple studies must
be conducted. the authors conducted an experiment in which Brocholaveor-lavage
(BAL) fluid was collected from 51 patients with EVALI. 16 States from 99 healthy
participants who were part of an ongoing study of smoking involving non-smokers’
exclusive use of e-cigarettes. with the BAL fluid, they reformed isotope dilution Mass
spectrometry to measure priority toxins including vitamin E acetate, plant oils, medium-
chain triglyceride oil, coconut oil, petroleum distillates, and dilute terpenes. 25 out of the
26th probable EVALI patience found vitamin E acetate in the BAL fluid obtained from
48 of 51 patients. no other priority toxins were found in the BAL fluid except for one
patient with coconut oil and limonene. 47 of 50 detected tetrahydrocannabinol (THC).
vitamin E acetate has been associated with EVALI in the extreme majority of 51 sample
patients across 16 States.
This article provides multiple in-depth data while being easy to
understand due to the author’s word choice. The authors are a group of PhDs, M.D.s, and
MPH’s. this allows wanting to infer that the data is credible. additionally, this was found
in The New England Journal of Medicine, an established credible publisher.

Baille, Kathrine. “The Dangers of Vaping.” Penn Today, Accessed 20 Oct. 2019.

The article starts by providing some startling statistics, 37% of 12 graders have reported
using e-cigarettes in the past year. E-cigarettes to be defined as handheld battery-powered
devices that burn vapors in aerosols that contain nicotine. That vapor is then held into the user’s
lungs. Even though E-cigarettes are seen as safer alternatives, there have been 8 deaths and 500
long injuries resulting from the use. This has lead to extreme criticism from the public, the CDC,
and the FDA. Smoking was heavily criticized, deemed as gross, but. Surprisingly, the use of e-
cigarettes is not socially considered smoking. This is a socially acceptable version of tobacco.
Students reported feeling using a JUUL, a certain type of e-cigarette. a JUUL is a sleek USB
shape e-cigarette. In addition to the socially acceptable designs, the appealing flavors bringing
many adolescents. these adolescents get hooked on nicotine and continue to vape. While
cigarette companies claim that they are intended to help users quit cigarettes, they have been
found to be addictive to younger consumers who do not use tobacco products.. the article closes
by providing information on programs to help the health of the community.
This article was very insightful on the issue, but the data was very inconsistent with other
sources. This article was written by a researcher with the aid of a scientist. This article was found
on Penn Today, and educational site, leading to the inference that this is a valid source. This
information can be very useful to my topic as it expands on ideas like flavoring and design.
 Chen, Rui, et al. “Assessment of Indoor Air Quality at an Electronic Cigarette (Vaping)
Convention.” Journal of Exposure Science & Environmental Epidemiology, vol. 28, no.
6, Nov. 2018, pp. 522–29..

The article begins by defining e-cigarettes, a battery-powered machine that delivers

aerosol with or without nicotine. 3.7% percent, 11.8 million, of adults use e-cigarettes, at least,
once a day while 2.4 million high school students use e-cigarettes daily. The trend of daily use is
predicted to rise due to ads, conventions, expos, and flavors. A recent study shows that e-
cigarettes release nicotine, particulate matter, formaldehyde, volatile organic compounds, VOCs,
tobacco-specific nitrosamines, TSNAs, aldehydes, and metals. Second-hand smoke from e-
cigarettes come from exhalation. This exhalation has been found to negatively impact indoor air
quality which, in turn, has advent health effects. The contents are associated with cardiovascular,
respiratory, and gastrointestinal disorders and DNA mutations. The authors review an
experiment; the experiments test the different concentrations of VOCs, CO 2, NO2, nicotine, and
particulate matter. This was conducted at the vaping convention at Maryland State Fairgrounds
in Timonium. The particulate matter was 12 times higher than the outdoor environment while the
VOC and CO2 were 2 times greater. On the other hand, NO2 concentration was three times less
than the outside area. The air nicotine as compared to the bar or nightclub.
Though this article was found on a commercial site, it was featured on PubMed, and
extension on NIH. This researcher found some contradicting evidence with other articles. The
article references other articles that have been extremely useful. This researcher plans on using
this knowledge by connecting it to the situation in schools and offices. Though the experiment
provided evidence, it was taken at a vaping convention. The workplace does not encourage the
use of an e-cigarette as much as a convention would. Henceforth, the data’s credibility is brought
into question.

Commissioner, Office of the. “Respiratory Illnesses Associated with Use of Vaping Products.”
U.S. Food and Drug Administration, FDA.

This article is used to provide information to the general public. Cannabinoids are often
added to the liquid cartridges; if they are introduced, they can aid the illness. The symptoms start
as breathing difficulty, shortness of breath, and/or chest pain and progress to gastrointestinal
illness including vomiting and diarrhea, and even death. The article repeats itself in saying that
the FDA and CDC are working as hard as they can to solve the issue. It has been found that the
patents were inhaling a surplus of cannabinoids and vitamin E, acetate.
The article is not very useful as it mainly provides other articles. The author is not
specified, but it is an F.D.A. article so the information must have a high degree of truth to them.
This article should not be recommended or used.

Czogala, Jan, et al. “Secondhand Exposure to Vapors From Electronic Cigarettes.”

Nicotine & Tobacco Research, vol. 16, no. 6, June 2014, pp. 655–62.
 The article opens by emphasizing the effects of second-hand smoke, SHS, and urgency.
Second-hand smoking, or passive smoking, is the result of healing toxic chemicals released from
cigarettes. even though many regulations have been passed, six hundred thousand deaths have
occurred globally. Second-hand smoke comes from a stream of smoke exhaled after each puff
and contains as much, if not more, toxic chemicals and carcinogens, A substance that promotes
the formation of cancer. The article shifts its focus to e-cigarettes. To differentiate a regular
cigarette, not allowed in most workplaces, from electronic cigarettes, The article analyzes
essential component, the battery, the heating element, and the cartridge. The battery powers the
heating element which in turn heats the liquid in the cartridge into a vapor form. this vapor is
inhaled by the user. In an ideal world, e-cigarettes would be invaluable to those addicted to
smoking because they have vapor instead of smoke which contains tar. As enticing as that seems,
liquid in the cartridge contains toxic compounds in heavy metals. While most would believe that
secondhand smoke would be eliminated by e-cigarettes due to the lack of sidestream vapor, e-
cigarette vapor is exhaled, releasing volatile compounds and nicotine into the air. With e-
cigarettes on the rise, would it sensible to expect an increase in second-hand smoke deaths. The
article again shifts into the experiment conducted to come up with data about secondhand smoke
from electronic cigarettes. In order to assess the concentration of toxic elements in the emissions,
the scientists measured the vapor from three different brands of electronic cigarettes (Colinss,
Dekang, Mild Marlboro) through an exposure chamber for 2 hours, consistently measuring the
nicotine concentration.through proper experimental procedures a e-cigarette, filled with 18
milligrams of cartridge, Was placed in a 39 m3 room with acrylic walls, tiled floor, With
regulated exhaust, ventilation system, and two fans. There were no windows, carpets, linings, or
curtains. To properly mimic the everyday e-cigarette use, an e-cigarette, with help from a smoke
machine, was puffing 70 ml of vapor for 1.8 seconds with 10-second intervals. To properly
represent all the different types of vaping behaviors, the scientists testing the intensity of
emission, the brands of e-cigarettes, and emission patterns. In another experiment, the scientists
asked five volunteers to vape for 5 minutes with 30-minute intervals and do the same for
cigarettes. Their environment was constantly checked for nicotine, aerosol, Carbon Monoxide,
and volatile components. The results showed a significant second-hand exposure to nicotine and
aerosol substances.
This article was a high-level article and was easy to understand. This article will be
invaluable to research as it provides numerous data and has several points that can be linked to
other arguments. For example, one can connect the nicotine emissions with the addictiveness of
e-cigarettes. The article’s word choice made it clear while conveying a complex message.

Decker, Stacey. “‘Juuling’ in Class? Yes, It’s Happening. Here’s What You Need to
Know.” Education Week - Teaching Now, Accessed 5 Jan. 2020.

The article begins by defining a JUUL, a type of e-cigarette defined to look like computer
thumb drives, making it hard for teachers to detect. JUUL’s come in many different flavors,
making them harder to detect and more enjoyable. The article links a video. The video begins
with a clip of the teacher holding a JUUL in confusion as to what it is and how it works. The
video jumps to a manager of a vape store explaining the JUUL as a pod and a battery. To vape,
put the pod in and vape away. Lots of high school kids would never smoke because of the anti-
tobacco ads, but they do not think of vaping as smoking or using nicotine. JUULing attracted
teens because of the flavors, the quick buzz, media influence, young celebrities, cheap, easy to
hide, and easy to obtain. They look like thumb drives and devices teachers. The signs of a
student JUULing is frequent or long trips to the bathroom, covering their face with their hands,
or putting their heads down. Educators have begun to spread advocacy by having seminars and
bringing parents into the discussion.
The article covers a very narrow part of e-cigarettes, JUULs. There is very little text, and
the majority of the information is in the video. The video’s audience is directed to concerned
teachers creating a bais. This article provides evidence of vaping in small areas like one stall and
a classroom.

“E-Cigarettes and Lung Health.” E-Cigarettes, American Lung Association, 20 Aug. 2019.

The article begins by defining e-cigarettes, a tobacco product that includes ENDS,
electronic nicotine delivery systems. While much is still unknown, the American Lung
Association has expressed concern. E-cigarettes vaporize a liquid that contains tobacco with
propylene glycol, many flavors, and coloring, but it also contains formaldehyde and acrolein,
chemicals that permanently damage the lung.. The ALA goes on to reinforce the notion that
young adults who actively participate in the use of e-cigarettes have a substantially higher risk of
smoking cigarettes. Studies have shown that even the base of the liquids, propylene glycol,
tremendously increases the user's exposure to toxicity. e-cigarette secondhand smoke has been
compared to car exhaust, as they contain compounds like benzene and heavy metals like nickel
tin and lead.
The article comes from a government sourced organization, the information must have
gone through several edits to confirm the credibility of the information. unfortunately is the
author is not specified, but it can be inferred with the reason that it is an elder of the American
Lung Association. This researcher would highly recommend is this article for a nuanced
understanding of electronic cigarettes.

“Formaldehyde and Cancer Risk.” National Cancer Institute, 10 June 2011.

The article begins by diffing formaldehyde, a colorless, flammable, strong-smelling

chemical that is used in building materials to make houses. It can be found in pressed-wood
products, such as particleboard, plywood, fiberboard, glues, adhesives, permanent-press fabrics,
paper product coating, and certain insulation materials. it is used in fungicide, germicide, and
disinfectant. This produced in small amounts by normal metabolic processes. Normal exposure
to formaldehyde includes less than 0.03 parts of formaldehyde per million parts of air. Common
exposure is from formaldehyde foam insulation, cigarette smoke, gas stoves, wood-burning
stoves, and kerosene heaters. Industrial workers and laboratory technicians may also be
addressed to exposure to inhaling formaldehyde. watery eyes; burning sensations in the eyes,
nose, and throat; coughing; wheezing; nausea; and skin irritation. Formaldehyde has been found
to cause nasal cancer in rats and could also cause cancer in humans. it is classified as a human
carcinogen. Formaldehyde increases the risk of leukemia and brain cancer as well as mortality
from myeloid leukemia, hematopoietic and lymphatic cancer, and brain tumors. the article Ends
by providing contact information in order to reach other professionals in the field.
While the article is informative and published by the National Cancer Institute, a
government agency, it is very dry in providing specific details on the effects of formaldehyde. it
allows researchers to build a base and familiarize themselves with the compound and some of its
effects. the article provides multiple references as well as multiple other government agencies,
proving its credibility. one can use this in their research by showing how the formaldehyde
released from an e-cigarette can have detrimental effects on the body.

Drummond, Christopher, et al. “Chronic Electronic Cigarette Vapor Inhalation Induces

Renal Injury and Functional Decline in Female Mice.” The FASEB Journal, vol. 31, no.
1_supplement, Apr. 2017, pp. 698.1-698.1.

Early clinical studies show that combustible cigarettes smoke, e-cigarette smoke,
increases renal and cardiac injury and the climb. It causes chronic kidney disease. Novel nicotine
Delivery devices like electronic cigarettes are used by over 10% of the population. Their aerosol
may introduce chemicals that result in renal injury. In order to determine if e-cigarette aerosol
inhalation is directly related to induced renal injury, the authors ran an experiment. the
experiment outlines 8-week old female mice inhaling e-cigarette aerosol containing 24mg/mL of
nicotine. 12 seconds of vapor exposure for every 60 seconds for 60 Minutes 5 days per week for
1-, 3-, and 6-months. after the exposure, the rats were then assessed for renal fibrosis,
glomerular filtration rate, and expression of the antibiotic micro RNAmiR-29b-3p versus are
expose controls. the mice observed showed a significant increase in renal fibrosis at the- three
and 6-month time points as assessed by the trichrome standing in these animals. the renal
function decline by 21% vs the control group.
This article was incredibly hard to find and very wordy. It was difficult to follow.
However, It contains vital information about the Second-Hand effects of e-cigarettes
because the mice were not vaping; they were, instead, exposed to the aerosol. This is vital as
it connects the nicotine, heavy metals, and other toxins to specific effects on the body.

Editorial Staff | June 6, 2017 (Last Updated: October 12. “Don't Be Fooled, E-Cig Aerosol Is
Not Harmless for Kids.” American Lung Association,

This image can be used as an eye-grabber and an introduction to my main topic. this
researcher is currently considering using this photo for their website. The image asks the
question of what is in a “vape” cloud? The image then shows an aerosol of white particles with
the words nicotine, formaldehyde, tobacco-specific nitrosamines, carcinogens, benzene, and
acetaldehyde. By using this design it conveys the message that listed chemicals are found in the
second-hand aerosol of e-cigarettes.
The researcher finds the image bland as it is black and white, but informative. The
design makes the message clear and catches interest in the topic.

Goldberg, Rachel L, and Janine K Cataldo. “Using an e-Cigarette Is Like Eating Tofu When
You Really Want Meat.” American Journal of Health Behavior, U.S. National Library of
Medicine, 1 Sept. 2018.
 The article starts by providing statistics that proved that the use of e-cigarettes is viewed
as less dangerous and acceptable. This viewpoint has been taken to the extreme in which a
person who has quit smoking would be four times as likely to be a daily user. The question
arises, are e-cigarettes effective and safe? one study found that e-cigarettes are less harmful and
decrease cessation rates, but only the odds of successful smoking cessation or 27% lower among
e-cigarettes users who did not use e-cigarettes. Even though e-cigarettes carry fewer carcinogens,
there are increased levels of ultrafine and toxic particles. Said particles have been found to cause
cardiovascular and lung disease. A review of the safety cigarettes found heavy metals and
volatile organic compounds at levels that were higher than conventional cigarettes, henceforth
the popularity of e-cigarettes does not indicate that cravings are fulfilled and the vapor is safe.
Reports have found that through marketing the internet and Society the benefits of e-cigarettes
do not include any of the health risks compared to smoking. While some have stated that e-
cigarettes help reduce withdrawal and avoid relapse, e-cigarettes have been found to lead to dual-
use and eventual relapse. A group of researchers conducted a study with 20 Californian e-
cigarettes users. The Criterion for participants is the use of e-cigarettes at least once a week for
the last 30 days and at least 24 years of age. The group had an average of 38 years old, 55%
female, 60% been using e-cigarettes for an average of 19 months, and had an average use of 24.8
days a month with each of the participants being two users, smoking both cigarettes and e-
cigarettes. The consensus was that e-cigarettes will help the sensation smoking, have a pleasant
smell call convenience, and believe that they are healthier. A surprising Factor was flavoring
which made e-cigarettes more attractive and led to believe that they would be more socially
acceptable for the pleasant smell. It was found that the e-cigarette store unable to satisfy users
lead to relapse. Additionally, the convenience allowed constant vaping and increase the
frequency of switching to a more powerful device, therefore tolerance is built up to increasing
doses of nicotine.
This article is very effective to a researcher because it provides consistent information
from prior studies and current research. This article has not conflicted with the other articles. It is
very effective in tying in marketing and viewed benefits what are their severe drawbacks in a
relatively unbiased manner. This article was found on a government site, NIH.

Layden, Jennifer, et al., “Pulmonary Illness Related to E-Cigarette Use in Illinois and
Wisconsin — Preliminary Report.” Pulmonary Illness Related to E-Cigarette Use in
Illinois and Wisconsin — Preliminary Report, 16 Sept. 2019.

This article explains the harm in E-Cigarettes and the recent experiment that lead to this
conclusion. E-cigarettes were since 2007 to help people get over their smoking habits. During
2017 teens use, and abuse, skyrocketed to 20.8% while only 3.2% of adults used it. In July of
2019, the Wisconsin Department of Health Services and the Illinois Department of Public
Health, WDHS and IDPH, acquired many cases of pulmonary illness that had a possible link to
E-cigarettes. In order to confirm their hypothesis they took 53 individuals who were either
confirmed or probable cases. The results showed that those who use e-cigarettes consistently
show respiratory and gastrointestinal symptoms but no upper respiratory symptoms, show lower
than normal oxygen saturation, show tachycardia and tachypnea, show leukocytosis; increase in
white blood cells, show neutrophil predominance; reaction to infection or cancer, and show low
levels of potassium in their blood. E-cigarette vapors are harmful and Wisconsin and Illinois are
counting to fight this battle. Anyone who is not smoking should not start E-Cigarettes.
This article is extremely useful in an in-depth review of E-Cigarettes On a body. It is
written by 18 people with masters and Ph.D. level knowledge. This Article combined medicine
and drugs to continue to update society about modern-day medicine. This source is reliable as it
comes from a reliable publisher and was written by reliable authors.

Järup, Lars. “Hazards of Heavy Metal Contamination.” British Medical Bulletin, vol. 68,
no. 1, Dec. 2003, pp. 167–82.

The article begins by attempting to define a heavy metal, Metals with a specific density
of more than 5 g/cm cubed. Heavy metal health threats are associated with exposure to lead,
cadmium, mercury, and arsenic. Heavy metals have been used since the early ancient Rome's to
sweeten old wine, glaze ceramics, build pipes for transporting water, etc. Heavy metals can still
be found in many parts of Latin America. Heavy metals are emitted through a wide range of
pathways, including surface waters, soil, food, and atmospheric emissions. Cadmium occurs
naturally in ores with zinc, lead, and copper. It also appears in many fertilizers. Agriculture and
cigarette smoking is a major source of cadmium exposure. Smokers, on average, have a four to
five times higher blood cadmium concentration than others. Cadmium can cause acute
pulmonary effects. It may cause kidney damage, resulting in tubular dysfunction. As kidney
damage increases it may cause chronic renal failure and end-stage renal disease. Long-term
exposure may cause skeletal damage and cancer. Mercury has been used since prehistoric times
in cave paintings. Mercury is used today in thermometers, barometers, and instruments for
measuring blood pressure. The majority of the population is exposed to mercury via food, fish.
Mercury has been found to cause lung damage and Tremors, changes in personalities,
restlessness anxiety, sleep disturbance, and depression. Mercury can also cause kidney damage.
organic mercury has been found to damage the nervous system, constricting the visual field as
well as auditory symptoms. High doses may lead to death.The general population is exposed to
lead from air and food. In adults, inorganic lead does not penetrate the blood-brain barrier,
whereas it can penetrate in children. Symptoms of lead poisoning include headache, irritability,
abdominal pain, and damage to the nervous system. There are behavioral disturbances, learning
and concentration difficulties, and acute psychosis. There may big renal tubular damage from
long-term exposure. Arsenic is a metalloid occurring in rock, soil, water, and air. Arsenic is
taken mainly by the intake of food. Arsenic can lead to gastrointestinal symptoms, severe
disturbances of the cardiovascular and central nervous system, and eventually death.
This article provides a lot of specific details on the multiple types of Heavy Metals. Its
Specificity is incredibly useful in research. One can use it to connect the health effects of Heavy
Metals to the symptoms exhibited by the patents. It details made the article difficult to follow.
This article is very helpful for research.

“The Nicotine in E-Cigarettes Appears to Impair Mucus Clearance.”

EurekAlert!,Accessed 5 Nov. 2019.
 The article began by referencing an article in the American Thoracic Society's American
Journal of Respiratory and Critical Care Medicine, about how E-cigarette vapors cause Airway
Mucociliary Dysfunction Preferentially via TRPA1 Receptors. Airway Mucociliary Dysfunction
is the inability to move mucus, containing harmful substances, in the airways. TRPA1 is an ion
pump that signals the presence of irritants, so e-cigarette vapors have a greater possibility of
disrupting the flow of chemicals into TRPA1, resulting in the lack of movement of mucus. The
lack of movement dehydrates the mucus making it more sticky and viscous. Since the mucus is
not moving out pathogens, it allows for more disease to affect the user; young users were likely
to develop chronic bronchitis. Studies have shown that the nicotine blocks TRPA1, causing no
sensation of irritation.
Although the source says that the publisher is not responsible for the factuality of this
information, leading us to believe that it may not be credible, the original paper is indeed
credible. It provides experts in the field who could be this researcher’s advisor. The word choice
allows for the reader to understand the complex topics of receptors. This source shows examples
of damage at the cellular level.

“Nicotine Receptors On Kidneys May Speed Kidney Damage.” ScienceDaily. Accessed 6 Jan.
2020.

The article begins by stating that scientist have found nicotine receptors on kidney cells
that may link nicotine to accelerated kidney damage in cigarette smokers. At the American Heart
association's 60th annual fall Conference of the council for high blood pressure research, it
identifies nicotine as a component of cigarettes that damages the kidneys. Initially, it was
believed that nicotine was only responsible for the addictive effects, but it has been discovered
that I can have significant biological affect other tissues. the kidneys regulate the body's
excretion, reabsorption of water, and electrolytes. kidney disease is the most common cause of
secondary hypertension, high blood pressure, in cardiovascular disease is the major cause of
death for all people with chronic kidney disease. Total disruptions in kidney function can lead to
disease progression and may lead to kidney Researchers measure the level of scarring, fibrosis,
related to the exposure of nicotine.
All those this article does not directly talk about e-cigarettes, can be used to link nicotine
to renal damage. This aligns with most other research this source is provided by the American
Heart Association, a reliable organization. additionally, authors have a medical degree and a
Bachelor of Science. This information can lead to the inference that the data is reliable. this
article would be incredibly effective in research if you can connect nicotine to e-cigarettes.

Vaping Devices (Electronic Cigarettes). National Institute on Drug Abuse. Accessed 22

Jan. 2020.

The article begins by defining vaping devices, battery-operated device that allows people
to inhale are so which typically contains nicotine, flavoring, and other chemicals. The most
common names for this are e-cigarettes, e-cigars, e-pipes, hookah pens, vape, vape pens, and
mods. E-pipes and E cigars resemble pipes and cigars, respectively. Mods are typically larger in
shape. Vape pens resemble many things including a pen, a cigarette, and a flash drive. e-
cigarettes consist of four different components, a cartridge containing a liquid that has nicotine
and chemicals, a heating element, a power source, and a mouthpiece. While vaping, a person
sucks on the mouthpiece, triggering the heating element to boil liquids. The liquids are released
in aerosol form into the person's lungs and are then exhaled. Vaping has been commonly
associated with teen use as research shows that many teens Vape. These teams do not even
realize that most vaping cartridges contain nicotine and assume Todd only contain flavoring.
These advertisements and flavors create the belief that they are safer than cigarettes that have
made them incredibly appealing to this age group. Additionally that you're very sealable as they
look like, the items. vaping might serve as an introduction for other products such as cigarettes,
marijuana, and more serious narcotics. Another risk is that they may begin smoking actual
cigarettes because of being addictive nicotine. The vaping releases nicotine into the bloodstream,
which causes the release of adrenaline. this causes the release of dopamine or the feel-good
hormone. This creates the addictiveness of nicotine in E-Cigarettes. E-cigarette use for teens
affects brain development causing long-lasting effects and can make other drugs such as cocaine
and methamphetamine more pleasurable to a teen's brain. vaping has been popular advertised
that helps quit smoking however there is no substantial data to back this claim.
This article creates a strong foundation for the researcher but does not contain much high-
level data or information. The publisher is a government agency, so the source and its data are
reliable. The word choice and sentence fluency come together to form an article that is easy to
follow.

Olmedo Pablo, et al. “Metal Concentrations in E-Cigarette Liquid and Aerosol Samples:
The Contribution of Metallic Coils.” Environmental Health Perspectives, vol. 126, no. 2,
p. 027010. Accessed 10 Jan. 2020.

The article begins by stating the recent status of the e-cigarette epidemic. It continues to
explain how heavy metals are introduced into the aerosol Vapor of e-cigarettes. Heavy metals or
introduced by the heating coil. This releases toxic chemicals including Chrome, nickel, and lead.
The authors conduct an experiment, in which they sample 56 e-cigarette devices from daily e-
cigarette users and cold samples from the refilling cartridge and remaining e-liquid. they then
extract the metals and measure them. The aerosols and liquids were found to have zinc, lead,
chromium, manganese, and nickel.
This article was very extensive and in-depth. They showcased all the intricacies of the
experiment including quality insurance. The article provided charts and informative graphics in
order to help simplify the complex topic and experiment. The article is excellent for research.
There are multiple authors, to reduce bias and elevate credibility.

Otto, M. Alexander. “Secondhand Vaping Aerosols Linked to Childhood Asthma

Exacerbations.” CHEST Physician, 10 Jan. 2019,

This image can be used as a visual example of my topic. This researcher is currently
considering using this photo for their website. The image shows one person vaping while another
stands near, inhaling the aerosol. By using this design it shows how people are exposed to
aerosol.
The researcher finds the image informative, however, it was taken in an outdoor setting
which is not the focus of the topic.
“Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping.” Centers for Disease
Control and Prevention, Centers for Disease Control and Prevention, 27 Sept. 2019.

The article begins by stating key facts about electronic cigarettes; e-cigarettes have a nicotine
delivery system, ENDS; e-cigarettes cheat a liquid capsule to produce an aerosol that is inhaled
by the user; using e-cigarettes is vaping; the liquid can contain tetrahydrocannabinol, THC;
cannabinoid, CBD. there are 805 cases and 12 deaths have been confirmed. 69% of the patients
are male, 62% of the patients are between the ages of 18 to 34, 22% are between 18 and 21, and
16% of the patients are under 18 years old. The latest news suggests that THC has played a large
role in the outbreak of this illness. Is the article is very clear in stating that youth, women who
are pregnant, and adults who do not currently use any tobacco products start vaping? This illness
is so widespread that only three states do not have any reported cases. Is the graph provided,
shows that in the recent outbreak hospital admission was prior to the date of symptom onset?
This article is from the Center for Disease Control, CDC, which is a government
organization, so the information is credible because it is being updated in the week prior to the
writing of the annotation. Unfortunately, the author was not specified but it can be inferred that it
was an editor for the CDC. This information is useful in building a basic understanding of
electronic cigarettes. There is no further information than the bare bones of e-cigarettes.

Raven, Kathleen. “Teen Vaping Linked to More Health Risks > Stories at Yale
Medicine.” Yale.

The article begins by referencing another article put out by the CDC, advising people to
avoid electronic cigarettes while officials investigate the outbreak of severe lung disease. While
some companies have announced their ingredients, including vitamin E acetate and THC
additives, there has not been any single identifying cause. Reciprocating the CDC’s response, e-
cigarettes should never be used by youth, young adults, or pregnant women. It has been found
that products that contain THC and modified substances or heavy contributors to these deadly
Cases of EVALI, e-cigarette or vaping products use-associated lung injury. Currently, there are
more than 5 million middle and high schoolers who are using e-cigarettes regularly. Vaping has
been described as a habit among middle and high school students. Vaping’s overarching issue is
the reception, harmless and cool. E-cigarettes us a system known as ENDS, containing a liquid,
heating element, and a battery. Vaping’s purpose is to move current smokers to remission, but it
has been found that it is not effective and leads to dual-use, use of both e-cigarette, and cigarette.
The pods have been fooled with flavorings to attract younger audiences, who have not have prior
experience of using tobacco products. These pods contain approximately 40 mg of nicotine, a
pack of cigarettes, which can be consumed anywhere from a week to a day. It is imperative that
people inform others about the dangers of vaping MD by-products. these byproducts, acetals, are
one of the major focuses of the upcoming studies.
This source was a repetition of the Center for Disease Controls. They cite their articles
and are very reliable. The article is difficult to follow. However, It is full of information that is
necessary for high-quality research. They reference multiple articles that further its quality in
research.

“Teens Using Vaping Devices in Record Numbers.” National Institutes of Health (NIH),
17 Dec. 2018.

The article begins by highlighting the dramatic increase of people using their vaping
devices in just a single year. 37.3% of 12 or ported vaping in the past year compared to 27.8% in
2017. This report comes with the annual results announced by the National Institute on drug
abuse. These alarming statistics can also be seen with other grades. Teens are attracted to the
marketable technology in flavoring a vaping device, but they fail to understand the overall health
effects on the development of their brain and the possible addiction. 25 percent of 12th graders
admitted to vaping solely because of the flavors. Teens, are unaware of the harmful chemicals
they are exposing themselves to. 2 out of 3 tenth graders say that E-cigarettes are easily obtained.
While smoking has dropped to a low of 3%, the e-cigarettes may lead to more smoking. 3.4% of
12th graders also report using high-level narcotics like heroin and Vicodin. 25% of 12th graders
reported using marijuana monthly and 5.8% report using it daily. These numbers are steadily
increasing. 17.5% of 12th graders report drinking alcohol.
This article was unhelpful. It contains a lot of information that is not needed for this
researcher. Additionally, it only focuses on one small group of people in high school. However,
it contains information about the decreased use of cigarettes and increased use of e-cigarettes can
be tied in with the fact that e-cigarettes can lead to dual-use. The language of the article helped
simplify the data. This would be moderately useful for background research on highschool drug
activities.

“Teen Vaping Soared In 2018.” NPR.Org, Accessed 23 Oct. 2019.

The article opens with disturbing news about kids vaping nicotine, vaping jumped
dramatically again among high school students and looks to continue in the future. The graphic
provided shows that 20.9% of 12th graders vaped, 16.1% of 10th graders vaped, and 6.1% of 8th
graders who vaped. There was a startling jump of nearly 10 percentage 12th graders vaping.
when considering all the data it means approximately 1.3 million more adolescents are vaping.
E-cigarette aerosol may be laced with potent drugs and chemicals which contradict the social
views of them being harmless. The aerosol cans high levels of nicotine raising fears about the
developing brains of teens. Additionally, flavoring has pulled out of lessons as the flavors mask
the high levels of nicotine.
this article was very brief and low level. Outdated data, and even though it was published
through an organization, it would be in a researcher’s best interest to not use this article. It
focused too much on one thing and transitioned abruptly.