In the United States, 4.5% of adults use electronic cigarettes (e-cigarettes) (also known as vaping), putting them at risk for serious harm to their health. Usage is highest among youth aged 18 to 24. Of this population, 11% vape.One
Smoking rates among high school and middle school students are at an all-time low. Instead, e-cigarettes, also known as vapes, pod mods and vape pens, are the most commonly used tobacco product, with more than one in four people using them daily and one in three using them in the last 30 days. Used for at least 20 days.2
Unlike traditional smoking, vaping does not involve burning tobacco, which leads many people to mistakenly believe it is less harmful to their health. However, vaping poses serious health risks to the brain, arteries, lungs, and more.
What is vaping and why is it dangerous?
Vaping refers to the act of inhaling and exhaling aerosol produced by an electronic cigarette or similar device. First-generation e-cigarettes (sometimes called “cig-a-likes”) were designed to look like traditional cigarettes. These devices are typically thin, small, and have a glowing tip that mimics the shape of a lit cigarette. They are typically disposable or feature replaceable cartridges that contain nicotine-containing liquid.
In contrast, newer versions of e-cigarettes, which resemble USB flash drives, represent a change in both design and technology.three These are often called “pod mods” and have a smaller, discrete, USB-like design that makes them easier to carry and use. Unlike first-generation cigarettes, pod mods typically come with prefilled or refillable pods and may include features such as temperature control and variable voltage.
A popular example of this style is Juul, which has become synonymous with the flash drive design of vaping devices. These newer devices are particularly attractive to younger users due to their sleek, discrete designs. All of these devices typically heat liquid containing nicotine, flavoring, and other chemicals (commonly called e-liquid or vape juice) to create a vapor that is inhaled.
A study by Johns Hopkins researchers found nearly 2,000 chemicals found in e-cigarettes, many of which have not been identified.4 Among those that can be identified are caffeine, three industrial chemicals including tributylphosphine oxide, a pesticide, and two fragrances that have the potential to cause toxic effects and irritation to the respiratory system.5
“When people vape, all they need to know is that they are inhaling a very complex mixture of chemicals. And for many of these compounds, they actually have no idea what they are.” Carsten Prasse is senior author and assistant professor of environmental health. Engineering teams from the Whiting School of Engineering and the Bloomberg School of Public Health said in a press release.
“I have a problem with the way vaping is marketed as being healthier than smoking cigarettes. I think we’re not at the point where we can say that yet.”6
Additionally, the average vape pod not only contains as much nicotine as 20 cigarettes;7 However, e-liquid mixtures dissolve in oil-based bases, creating additional risks. “We think that some of the vaporized components of the oil get deeper into the lungs and cause an inflammatory response,” says Johns Hopkins lung cancer specialist Dr. Stephen Broderick.8
How Vaping Affects the Brain
Vaping poses risks to your entire body, including your brain, which can negatively impact your neurological health. A study in rats examined the toxic effects of short-term e-cigarette exposure on brain function and inflammatory responses.9 Results suggest that both cigarette smoke and e-cigarette exposure may delay mice's ability to seek food rewards, leading to impaired olfactory and memory functions.
Additionally, rats exposed to e-cigarettes did not show memory improvement the next day, suggesting that rats exposed to e-cigarettes may have impaired memory function. Examination of the mice's brains revealed signs of inflammation, with both groups showing elevated levels of the inflammatory marker TNF-α.
The researchers concluded that e-cigarettes have a similar toxicity profile to cigarette smoke and may have negative effects on brain function. Early exposure to nicotine through e-cigarettes can cause long-term brain changes that affect attention processes, potentially leading to attention deficit hyperactivity disorder (ADHD).10 As noted in the Surgeon General's recommendations on youth use of e-cigarettes:11
“E-cigarette aerosols are not harmless. Most e-cigarettes contain nicotine, an addictive drug found in regular cigarettes, cigars and other tobacco products. Nicotine exposure during adolescence can harm brain development, which continues until about age 25. Nicotine exposure during adolescence can affect learning, memory, and attention. “Nicotine use during adolescence may increase a person’s risk of becoming addicted to other drugs in the future.”
E-cigarettes may cause heart problems
Vaping poses heart health risks and is linked to increased blood pressure and arterial stiffness.12 As arterial stiffness increases, the heart has to work harder to pump blood. This is because stiff arteries do not easily expand in response to blood flow. This can cause the heart muscle to thicken (hypertrophy) and eventually lead to heart failure.
In a study using health data from the National Institutes of Health, researchers followed 175,667 people with an average age of 52 for 45 months. People who used e-cigarettes at any point in their lives were 19% more likely to develop heart failure than those who never used them.13 Overall, increased arterial stiffness is a significant risk factor for cardiovascular morbidity and mortality, and vaping also makes you more likely to have a heart attack.
A study presented at the 2019 American College of Cardiology Annual Scientific Sessions found that adult e-cigarette smokers had a significantly higher risk of heart disease and mental health problems compared to non-smokers, even after controlling for known risk factors such as body mass index (BMI). found to be high. High blood pressure. Compared to non-smokers, vapers:14
- You are 34% more likely to have a heart attack.
- You are 25% more likely to develop coronary artery disease.
- They are 55% more likely to experience depression or anxiety than non-smokers with the same risk factors.
Study author Dr. Mohinder Vindhyal, assistant professor of medicine at the University of Kansas Wichita School of Medicine, said in a press release:15
“If the risk of heart attack increases by up to 55% in e-cigarette users compared to non-smokers, I wouldn’t want any of my patients or family members vaping. “When we looked deeper, we found that no matter how often you used e-cigarettes – daily or over several days – you were still more likely to have a heart attack or coronary artery disease.”
E-cigarettes linked to permanent lung damage
The ultrafine particles contained in e-cigarette vapor can be inhaled deep into the lungs. They may also contain chemical fragrances such as diacetyl, which can damage the small passages in the lungs and has been linked to serious lung disease.
This damage and inflammation can cause permanent scarring, leading to bronchiolitis obliterans (also known as popcorn lung), which causes coughing, chest pain and difficulty breathing.16
Inhaling oily e-liquid from e-cigarettes can also cause lipoid pneumonia, a specific type of lung inflammation that occurs when fat or oil enters the lungs. “There is no good treatment for lipid pneumonia other than supportive care while the lung heals itself,” Broderick says.
“The most important thing you can do is figure out what the cause is and eliminate it, which in this case is vaping.” Vaping may also increase the risk of primary spontaneous pneumothorax or collapsed lung.17
Lung injury associated with e-cigarette or vaping use, known as EVALI, is also possible. This is a serious lung disease that occurs in people who use e-cigarettes and may be caused by vitamin E acetate and other compounds in the products.18 In 2020, there were at least 2,807 cases of EVALI in the United States, most requiring hospitalization and deaths reported.19
“At its core, EVALI is a serious disease that primarily affects the lungs and results in a significant number of hospitalizations and deaths in relatively young, healthy populations across the United States,” said Meghan Rebuli, assistant professor of pediatrics. The University of North Carolina School of Medicine said in a press release:20
Vaping Disrupts Your Immune System
E-cigarette use may jeopardize immune system function and should not be considered a “safe” form of smoking.21 “Vaping renders immune cells unable to fight threats,” the University of Birmingham warned in a press release.22 This effect was seen even with brief, low-level exposures, suggesting that even occasional e-cigarette users may be at risk.
This effect is associated with neutrophils, white blood cells that the immune system uses as its first line of defense.23 As they travel throughout the body, they trap and neutralize bacteria and other pathogens that can cause disease.
Neutrophils exposed to e-cigarette vapor had higher concentrations of microfilament F-actin, which resulted in decreased cell movement and function.24 Regular smoking is also known to affect neutrophils.
UK introduces bill to create first smoke-free generation
On March 20, 2024, the UK government introduced the Tobacco and Vapes Bill, which significantly restricted the sale and use of tobacco and vaping products, especially among young people. The bill makes it illegal to sell tobacco products to anyone born on or after January 1, 2009. The bill aims to effectively phase out smoking in future generations. According to the UK government:25
“We will create the first smoke-free generation, ensuring that cigarettes will no longer be legally sold to children under 15 this year. Since there is no safe age to start smoking, the selling age is raised by one year each year to prevent future generations from taking up smoking.
It was also announced that new features would be introduced to limit vape flavors and packaging to reduce their appeal to children. This power also allows the government to change the way vapes are displayed in stores.
In a bid to crack down on underage sales, the government will introduce quicker and simpler on-the-spot fines (fixed fines) of £100 for shops in England and Wales selling cigarettes and vapes to minors. Local authorities will reinvest 100% of the proceeds into enforcing this measure and other existing tobacco and vaping regulations. This builds on the maximum fine of £2,500 that courts can already impose.
Vaping alternatives, such as nicotine pouches, will also be made illegal as children increasingly turn to highly addictive alternatives.”
If you're a parent, engaging in open discussions about the risks and realities of vaping can be an effective way to educate your children and teens about the various health risks. People trying to quit smoking should not consider vaping a “safer” alternative. Electronic cigarettes typically contain nicotine and, like cigarettes, are designed to be used over and over again.
Participating in physical activity, such as walking, can help eliminate cravings and reduce the stress that often triggers smoking. Relaxation techniques such as yoga, meditation, and emotional freedom techniques may also help you manage stress and reduce the psychological urge to smoke.
