Understanding the risks of vaping

Compared to traditional cigarette smoking, vaping is still relatively new, having been introduced to consumers in the United States in 2006. But in recent years, the risks of vaping have become increasingly clear. While more research is needed, current evidence suggests that vaping raises the chances of developing lung disease, heart problems, and other serious health issues.

Here’s what to know about vaping and how it could affect your well-being.

What is vaping?

Vaping is the use of electronic cigarettes (or e-cigarettes) and similar handheld devices that heat and vaporize liquids so that they can be breathed into the lungs. In addition to tobacco, e-cigarettes can also be used to smoke marijuana.

There are hundreds of different e-cigarette brands sold to consumers. You might hear a variety of different terms—like e-cigs, vapes, vape pens, mods, and hookah pens—but they’re all e-cigarettes.

E-cigarettes come in different shapes and sizes. They can look like regular cigarettes, cigars, or pipes. Some look like pens or USB memory sticks and can even be charged on a laptop.

They can also come in different flavors, such as mint, menthol, strawberry, grape, and chocolate—and even “Unicorn Cakes” and “Smurf Sauce.” These may appeal more to young people and could make e-cigarettes appear less dangerous.

E-cigarette vapor may be different from the smoke produced by traditional cigarettes, but it’s important to understand that this vapor isn’t harmless. Like regular cigarettes, most e-cigarettes contain nicotine—a highly addictive chemical that can contribute to serious health issues. Some vaping products are free of nicotine, but they contain delta-9-tetrahydrocannabinol (THC, the primary mind-altering chemical in marijuana). Others have a mixture of both chemicals.

The liquid in e-cigarettes may contain other potentially dangerous chemicals, as well. These include:

• Glycerol and propylene glycol-based solutions, which may break down into cancer-causing agents when heated
• Acrolein, also used as a weed killer
• Volatile organic compounds, potentially harmful gases that can affect multiple body systems
• Metals like nickel and lead, which can accumulate and damage organs

The exact combination of ingredients varies according to brand and flavor, although package labels aren’t always accurate. In fact, some products that claim to be nicotine-free have been found to contain the substance.

Who uses e-cigarettes?

About 7 percent of U.S. adults used e-cigarettes in 2024, according to a Centers for Disease Control and Prevention (CDC) report. Researchers found e-cigarette use declined with age. Nearly 15 percent of adults 18 to 24 vaped, while only 1 percent of those ages 65 and older vaped.

Many adults who vape are current or former traditional cigarette smokers. When a person vapes and smokes at the same time, it’s called dual use. Dual users are generally at higher risk of health issues.

Meanwhile, e-cigarettes have become the most commonly used tobacco products among teens, despite age restrictions that state a person must be 21 years old to purchase these devices. The 2024 National Youth Tobacco Survey found that about 1.6 million middle and high school students used e-cigarettes, including 3.5 percent of middle school students and 7.8 percent of high schoolers.

What are the health risks of vaping?

Experts are still learning about the lasting effects of vaping. But there’s compelling evidence that using e-cigarettes is linked to several health problems, such as the following.

Chronic lung disease

E-cigarettes are tied to multiple chronic lung conditions. Research suggests that people who use them have a significantly higher risk of developing asthma and chronic obstructive pulmonary disease (COPD) compared to those who don’t vape. The risk is even higher for people who use e-cigarettes and smoke traditional cigarettes.

Evidence also suggests that vaping is associated with a greater lung cancer risk—again, especially for those who both vape and smoke. Dual users have a lung cancer risk that’s four times greater than people who only smoke traditional cigarettes, according to the American Cancer Society. It may be because some brands of e-cigarette contain a number of cancer-causing chemicals.

EVALI

In 2019 and early 2020, more than 2,800 emergency room visits and 68 deaths were linked to a condition known as e-cigarette (or vaping) product use-associated lung injury (EVALI). Officials tied the deaths to e-cigarettes that contained THC and an additive called vitamin E acetate (an oily chemical used for either thickening or diluting vaping fluid).

Enforcement and awareness helped to reduce deaths following the outbreak, but EVALI remains a threat for people who vape. Speak with a physician or other healthcare provider (HCP) if you notice coughing, shortness of breath, chest pain, digestive issues, rapid heartbeat, or fever.

Heart issues

A growing body of evidence suggests e-cigarettes may be just as bad for your heart as traditional cigarettes, due in large part to their nicotine content. Nicotine can affect cardiovascular (heart and blood pressure) health by:

• Increasing blood pressure
• Raising heart rate
• Causing blood vessels to narrow, reducing blood flow
• Leading the heart to work harder

Other chemicals in e-cigarettes may harm blood vessel function and can contribute to inflammation and oxidative stress (a potentially harmful imbalance of body chemicals), as well. Eventually, this may lead to issues such as heart attack, heart failure, and stroke.

Vaping may be especially harmful for younger hearts. A 2022 statement from the American Heart Association asserts that teenagers who vape for a prolonged period are likely at higher risk for cardiovascular disease as they grow older.

Mental health concerns

Teenagers often vape to deal with stress, anxiety, or sadness—and vaping can make those feelings worse, feeding into a vicious cycle. In fact, in the 2024 National Youth Tobacco Survey, teens who vaped were about twice as likely to have moderate-to-severe depression symptoms as teens who formerly vaped or never vaped.

Nicotine likely plays a significant role in these mental health issues, since it impairs sleep and can harm developing brains, affecting mood, concentration, learning, and behavior.

Pregnancy and childbirth complications

Vaping is unsafe during pregnancy. Nicotine and other chemicals can damage the fetal brain, lungs, and other developing organs. Using e-cigarettes and other vaping products is also linked to low birth weight and pre-term birth.

Can vaping help you quit smoking?

Cigarette smoking is the leading cause of preventable death in the U.S., causing nearly 500,000 deaths each year.

Some people try vaping to help reduce or quit smoking traditional cigarettes. And while some evidence suggests using e-cigarettes might be helpful, other research has found this approach doesn’t work for many people—and a significant number end up as dual users. In fact, since e-cigarettes contain high levels of addictive nicotine—sometimes even more than traditional cigarettes—vaping may make it even harder to quit smoking.

Several major health organizations urge caution. E-cigarettes are not approved by the U.S. Food & Drug Administration or supported by the American Lung Association or American Thoracic Society as a safe way to taper off traditional cigarette use. The U.S. Preventive Services Task Force (USPSTF) also says there isn't enough evidence to recommend e-cigarettes as part of a healthy quit plan and that more research is needed.

If you smoke or are already using e-cigarettes to try to stop smoking, ask your HCP about smoking cessation strategies that are shown to be safe and effective, and whether your insurance can help cover the costs. Your HCP can also work with you to develop strategies that would help you quit vaping.

What's the bottom line?

The fact is, e-cigarettes haven’t been around that long. Researchers may not fully understand the dangerous health effects of vaping for another 50 years—which may be particularly ominous for adults who started vaping and became addicted to nicotine when they were in middle school.

So, if you don’t smoke or vape, don’t start. Children, teens, and pregnant women should never smoke, vape, or use e-cigarette products.

And if you do choose to vape, be mindful about the warning signs of health issues. Visit your HCP right away if you develop suspicious, new, or severe symptoms potentially related to vaping, such as shortness of breath, chest pain, or fever.