As e-cigarettes are fairly new to the market, there is little research on their long-term effects, but their recent popularity has sparked debates about their use and regulation—are they healthier than combustible tobacco, should they have the same restrictions in terms of age and public use, and are they a “gateway” to real tobacco for teen smokers? While a majority of the e-cigarette conversation focuses on whether they are better for you, the desire for healthy lungs is not the only factor contributing to these debates. The e-cigarette debates are the newest chapter in a long history of substance use regulation that is as much about social stigma as public health.

These debates are also influenced by social factors such as unemployment, youth populations, political battles for and against government regulation, and a much broader, but more subtle, process of stigmatization when cigarette smoking— which was once perfectly acceptable in society—slowly slides out of favor.
As smoking loses favor in public opinion, so do smokers. While these debates are about health on the surface, the underlying message to smokers is that they are deviant. Research has found that smoking, and substance use in general, occurs in higher numbers among lower income and minority groups, revealing much deeper power dynamics influencing smoking policy and the public image of smokers.


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