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An electronic cigarette, also known as an e-cigarette, personal vaporiser or PV, is an electronic inhaler that vaporises a liquid solution into an aerosol mist, simulating the act of tobacco smoking. Electronic cigarettes are no longer marketed as smoking cessation aids or tobacco replacement in most countries. There may be similarities between conventional and some electronic cigarettes in the physical design and the nicotine release, which may approximate the same amount of nicotine as a conventional cigarette. There are many electronic cigarettes that do not resemble conventional cigarettes at all.
The benefits and risks of electronic cigarette use are uncertain among health organizations and researchers. Limited controlled studies are available due to its recent invention. Laws vary widely concerning the use and sale of electronic cigarettes and accompanying liquid solutions, with pending legislation and ongoing debate.
Hon Lik, a Chinese pharmacist, is widely credited with the invention of the first generation electronic cigarette. In 2000, he came up with the idea of using a piezoelectric ultrasound-emitting element to vaporise a pressurized jet of liquid containing nicotine diluted in a propylene glycol solution. This design produces a smoke-like vapour that can be inhaled and provides a vehicle for nicotine delivery into the bloodstream via the lungs. He also proposed using propylene glycol to dilute nicotine and placing it in a disposable plastic cartridge which serves as a liquid reservoir and mouthpiece. These inventions are the basis of the present-day electronic cigarettes. Electronic Cigarettes Ecig
The device was first introduced to the Chinese domestic market in May 2004 as an aid for smoking cessation and replacement. The company that Hon Lik worked for, Golden Dragon Holdings, changed its name to Ruyan (如烟, literally “Resembling smoking”), and started exporting its products in 2005–2006 before receiving its first international patent in 2007.
The cartridge, a small plastic, glass or metal container with openings at each end, serves as both a liquid reservoir and mouthpiece. It allows the passage of liquid into the atomizer, and vapour from the atomizer to the user’s mouth, without any leakage of liquid into the mouth.
Most models utilise a plastic sponge to keep the liquid in place, but it is common to find a refillable tank that holds the liquid, with a separate tunnel connecting to the atomizer. When the liquid is depleted, users can refill it or replace with another ready filled cartridge. Some users forgo liquid reservoirs and drip liquid directly onto the atomizer in a method known as “dripping”. Electronic Cigarettes Ecig
A single cartridge can have the same number of puffs as 20 cigarettes. 
The atomizer contains a small heating coil that vaporizes the liquid, and generally consists of a simple filament and wicking metal mesh or silica wick to draw the liquid in. It is positioned in the center of the three components that make up the entire electronic cigarette cylinder: the cartridge attaches to one end, and the power unit to the other. The atomizer’s filament will lose efficiency over time due to a build-up of sediment, or it “burns out” entirely, requiring replacement. In some models, the cartridge and atomizer component are integrated into what is known as a cartomizer. Electronic Cigarettes Ecig
The term cartomizer describes the combination of atomizer and cartridge in the same unit. A cartomizer consists of a heating element surrounded by a poly-foam soaked in the liquid. This combination is mainly used in the devices that are manufactured to look like cigarettes, and is covered by Gamucci’s patent.
When the cartomizer has been used it can simply be disposed of and replaced with a new one. This is much easier than having to refill your cartridge and clean and replace the atomizer every now and then. Electronic Cigarettes Ecig
Most portable power contain a lithium-ion rechargeable battery which makes up the largest component of an electronic cigarette. The battery may contain an electronic airflow sensor: activation is triggered simply by drawing breath through the device. Other models come with a power switch, which must be held during operation. A LED to announce activation may also be equipped in the front of the power unit casing.
Batteries are usually charged via an AC outlet, car charger socket or USB. Some manufacturers also offer a cigarette pack-like portable charging case (PCC), which contains a larger battery to charge smaller batteries of individual e-cigarettes.
Liquid for producing vapour in electronic cigarettes, known as e-juice or e-liquid, is a solution of propylene glycol (PG) and/or vegetable glycerin (VG) and/or polyethylene glycol 400 (PEG400) mixed with concentrated flavors, and optionally, a variable percentage of a liquid nicotine concentrate.
The solution is often sold in a bottle or in disposable cartridges. Many manufacturers offer dozens of flavors which resemble the taste of regular tobacco, menthol, vanilla, coffee, cola and various fruits, but nicotine concentrations vary by manufacturer. The standard notation “mg/ml” is often used in labelling, sometimes shortened to a simple “mg” (milligram). Nicotine-free solutions are also common.
Most e-liquids do not contain beta-carboline alkaloids found in tobacco along with nicotine.
There are dozens of e-cigarette models which are sold online and in stores, all under hundreds of different brand names. Most electronic cigarette users initially purchase starter kits that contain a battery, USB charger and a selection of cartomizers (cartridges). Some kits also include a portable charging case (PCC).
In addition to the kits, there are disposable electronic cigarettes which were first invented and bought to market by the Gamucci brand in 2008. These feature a battery, atomizer, and cartridge all in one piece. Unlike the kits, the entire electronic cigarette is discarded when the cartridge becomes empty. Disposable electronic cigarettes are typically marketed to those new to the electronic cigarette market.
Proponents of electronic cigarettes often claim that electronic cigarettes deliver the experience of smoking while eliminating the smell and health risks associated with tobacco smoke. The base liquids – which includepropylene glycol (PG), vegetable glycerin (VG), and sometimes polyethylene glycol 400 (PEG400) – have been widely used as a food additive, as a base solution for personal care products such as toothpaste, and in medical devices such as asthma inhalers. However, the health effects of inhaling nicotine vapour into lungs are a subject of uncertainty.
The fact that e-cigarettes may resemble real tobacco cigarettes has been noted by both supporters and detractors. While e-cigarettes may give nicotine addicts more or less the same amount of nicotine as a conventional cigarette, they do not produce the same toxic smoke that can cause lung disease and cancer when inhaled over time. Since there are no products of combustion to be inhaled, no tobacco toxins are inhaled besides nicotine.
World Health Organization
The World Health Organization stated in September 2008 that no rigorous, peer-reviewed studies have been conducted showing that the electronic cigarette is a safe and effective nicotine replacement therapy. WHO does not discount the possibility that the electronic cigarette could be useful as a smoking cessation aid, but insisted that claims that electronic cigarettes can help smokers quit need to be backed up by clinical studies and toxicity analyses and operate within the proper regulatory framework.
In draft guidance on tobacco harm reduction the body responsible for drafting healthcare guidelines in England and Wales, NICE argues that there is limited evidence on the efficacy, safety and quality of other nicotine containing products such as electronic cigarettes. NICE also states that little is known about the extent to which electronic cigarettes deliver nicotine to the circulation. They recommend the usage of licensed nicotine replacement therapies as part of any quit attempt or tobacco harm reduction approach. The British Medical Association advises doctors not to recommend the use of electronic cigarettes as aids to smoking cessation or as a harm reduction approach. A summary of the BMA briefing states:
- e-cigarettes are not regulated as a tobacco product or as a medicine in the UK and there is no peer-reviewed evidence that they are a safe and effective nicotine replacement therapy
- the use of e-cigarettes may undermine smoking prevention and cessation by reinforcing the normalcy of cigarette use in public and workplaces
- health professionals should not recommend the use of e-cigarettes as smoking cessation aid or a lower risk option than continuing to smoke due to a lack of evidence of their safety and efficacy. Electronic Cigarettes Ecig
US Food and Drug Administration
In May 2009, the US Food and Drug Administration (USFDA) Division of Pharmaceutical Analysis tested 19 varieties of electronic cigarette cartridges produced by two vendors NJOY and Smoking Everywhere. Diethylene glycol, a poisonous and hygroscopic liquid, was detected in one of the cartridges manufactured by Smoking Everywhere . Tobacco-specific nitrosamines (TSNAs), known cancer-causing agents, were detected in all of the cartridges from one brand and two of the cartridges from the other brand[clarification needed]. Nicotine can also be traced in some claimed nicotine-free cartridges. Further concerns were raised over inconsistent amounts of nicotine delivered when drawing on the device. In some e-cigarettes, “Tobacco-specific impurities suspected of being harmful to humans—anabasine, myosmine, and β-nicotyrine—were detected in a majority of the samples tested.” It is not clear if these chemicals were detectable in exhaled vapour. 
In July 2009, the FDA publicly discouraged the use of electronic cigarettes and raised concerns that electronic cigarettes may be marketed to young people and lack appropriate health warnings.
The Electronic Cigarette Association criticized the FDA testing as too “narrow to reach any valid and reliable conclusions.” Exponent, Inc., commissioned by NJOY to review the FDA’s study in July 2009, objected to the FDA analysis of electronic cigarettes lacking comparisons to other FDA-approved nicotine replacement therapy products where similar levels of TSNA were detected. Exponent concluded that the FDA’s study did not support the claims of potential adverse health effects from the use of electronic cigarettes.
Furthermore, FDA methods “have been lambasted in journals” by some medical and health research experts who noted that potentially harmful chemicals were measured at “about one million times lower concentrations than are conceivably related to human health.”
Additionally, The Tobacco Products Scientific Advisory Committee of the FDA is alleged to have several members who maintain consulting relationships with various pharmaceutical companies who manufacture smoking cessation products. If these allegations are true, this might represent a potential conflict of interest.
American Association of Public Health Physicians
As of April 2010, The American Association of Public Health Physicians (AAPHP) supports electronic cigarettes sales to adults “because the possibility exists to save the lives of four million of the eight million current adult American smokers who will otherwise die of a tobacco-related illness over the next twenty years.” However, the AAPHP is against sales to minors. The AAPHP recommends that the FDA reclassify the electronic cigarette as a tobacco product (as opposed to a drug/device combination).
Boston University School of Public Health study
A study by researchers at the Boston University School of Public Health in 2010 concluded that electronic cigarettes were safer than real cigarettes and may aid in breaking the habit of smoking. Researchers said that while further studies on electronic cigarettes were needed, “few, if any, chemicals at levels detected in electronic cigarettes raise serious health concerns.” Electronic cigarettes were found to be “much safer” than traditional tobacco ones, and had a level of toxicity similar to existing nicotine replacements. Electronic Cigarettes Ecig
According to this report, the level of carcinogens in electronic cigarettes is up to 1,000 times lower than regular cigarettes, and early evidence shows that electronic cigarettes may help people to stop smoking by simulating a tobacco cigarette. Electronic Cigarettes Ecig
On 27 March 2009, Health Canada issued an advisory against electronic cigarettes. The advisory stated, “Although these electronic smoking products may be marketed as a safer alternative to conventional tobacco products and, in some cases, as an aid to quitting smoking, electronic smoking products may pose risks such as nicotine poisoning and addiction.” Canadian Customs now confiscate any parcel containing e-cigarettes with nicotine and notify the receiving party via a mail letter. The parcel is returned to the sender only at the request of the receiving party or otherwise destroyed. Electronic Cigarettes Ecig
Health New Zealand
In 2008, Dr. Murray Laugesen of Health New Zealand Ltd. published a report on the safety of Ruyan electronic cigarette cartridges. His study was funded by e-cigarette manufacturer Ruyan, but Laugesen claims that his research is independent. The presence of trace amounts of TSNAs in the cartridge solution was documented in the analysis. The results also indicated that the level of nicotine in the electronic cigarette cartridges was not different from the concentration of nicotine found in nicotine patches. John Britton, a lung specialist at the University of Nottingham, UK and chair of the Royal College of Physicians Tobacco Advisory Group, commented, “If the levels are as low as in nicotine replacement therapy, I don’t think there will be much of a problem.” The study’s detailed quantitative analysis concluded that carcinogens and toxicants are present only below harmful levels. It concluded: “Based on the manufacturer’s information, the composition of the cartridge liquid is not hazardous to health, if used as intended.” Electronic Cigarettes Ecig
Dr. Konstantinos Farsalinos of the Onassis Cardiac Surgery Center in Athens reported to the annual meeting of the European Society of Cardiology that a small short-term trial had shown significantly better cardiac performance of ecigarette users in comparison to tobacco smokers. Farsalinos warned that larger studies were required to measure the long-term health impact of ecigarettes, but expressed some optimism: “Considering the extreme hazards associated with cigarette smoking, currently available data suggest that electronic cigarettes are far less harmful and substituting tobacco with electronic cigarettes may be beneficial to health.” Another small study, also in Greece, reported earlier in 2012 the devices had little short-term impact on lung function. Electronic Cigarettes Ecig
A report from a UK Government advisory unit favoured the adoption of “smokeless nicotine cigarettes” over the traditional “quit or die” approach, believing this would save more lives.
While electronic cigarettes may deliver nicotine to the user in a manner similar to that of a nicotine inhaler, no electronic cigarette has yet been approved as a medicinal nicotine replacement therapy (NRT) product or subjected to the necessary clinical testing for such approval. Doubts have even been raised as to whether electronic cigarettes actually deliver any substantial amount of nicotine. Electronic Cigarettes Ecig
Research carried out at the University of East London on the effects of using an electronic cigarette to reduce cravings in regular tobacco smokers showed that there was no significant reported difference between smokers who inhaled vapour containing nicotine and those who inhaled a placebo vapour containing no nicotine. The report concluded that although electronic cigarettes can be effective in reducing nicotine-related withdrawal symptoms, the nicotine content does not appear to be of central importance, and other smoking related cues (such as taste or vapour resembling smoke) may account for the reduction in discomfort associated with tobacco abstinence in the short term.
In an online survey from November 2009 among 303 smokers, it was found that e-cigarette substitution for tobacco cigarettes resulted in reduced perceived health problems when compared to smoking conventional cigarettes (less cough, improved ability to exercise, improved sense of taste and smell). Electronic Cigarettes Ecig 
Trace amounts of ‘volatile organic compounds‘, namely formaldehyde, as well as traces of ketones, mercury and tetramethylpyrazine, have been found in electronic cigarette vapour, but the quantities are significantly smaller than the quantities found in tobacco smoke and do not pose a significant health risk. Electronic Cigarettes Ecig