Electronic cigarettes are devices that heat a nicotine-containing liquid to create vapor that is inhaled. They were introduced as an alternative to traditional cigarettes and are often marketed as a way to reduce exposure to harmful chemicals.
Research shows that electronic cigarettes still contain addictive nicotine and can release substances like formaldehyde and metals when heated. Their use has also been linked to EVALI, a lung injury associated with vitamin E acetate and other chemicals found in certain vaping products.
Electronic cigarettes can increase the risk of serious health problems and may require medical assessment if symptoms such as chest pain, shortness of breath, or persistent cough develop. A doctor may perform tests to rule out lung disease and recommend treatments such as oxygen therapy or medications when needed.
Are e-cigarettes bad for you?
Just like conventional cigarettes, e-cigarettes are harmful due to the nicotine they contain. Nicotine is one of the most addictive substances known, making it difficult to quit vaping or smoking.
In addition, nicotine is released into the air after exhaling, which puts people around smokers at risk. This is particularly concerning for pregnant women, as nicotine exposure can increase the risk of neurological malformations in the fetus.
Although e-cigarettes contain fewer toxic substances than regular cigarettes, they still contain carcinogenic compounds. The CDC reports that when an e-cigarette nicotine cartridge is heated to over 150ºC (over 300ºF), it releases ten times more formaldehyde than a regular cigarette. Formaldehyde is a known carcinogen. Other harmful metals can be released and inhaled from the liquid cartridge as well as from the device itself.
In addition, the chemical substances used to add flavor to e-cigarettes are not proven to be safe for long-term use.
EVALI: the vaping disease
An EVALI (E-cigarette or Vaping product use Associated Lung Injury) is a lung condition caused by e-cigarettes or vaping. It was identified for the first time in 2019.
This disease is related to the presence of vitamin E acetate, a harmful type of oil used in some e-cigarette cartridges. Some additionally contain THC, the psychoactive substance from cannabis, which also interferes with normal lung function.
An EVALI can cause symptoms similar to other lung diseases, like pneumonia or the flu, and can include:
- Shortness of breath
- Fever
- Coughing
- Nausea and vomiting
- Stomach pain
- Diarrhea
- Dizziness
- Palpitations
- Chest pain
- Fatigue
These symptoms may develop within a few days or over several weeks. If you notice any of these symptoms, you should see your doctor for assessment and treatment as necessary. Treatment often requires hospitalization for oxygen therapy and medication like steroids, antibiotics, or antivirals.
Do e-cigarettes increase risk for COVID-19?
A literature review published in the American Journal of Respiratory and Critical Care Medicine reported that e-cigarette use may increase susceptibility to COVID-19 [1]. The presence of nicotine in the liquid can damage the lungs, making them more vulnerable to infection.
In addition, the exhaled vapor can increase transmission rates of coronavirus in indoor environments where they are used [1].
Why Juul products are banned in the USA
Juul products were banned for sale and distribution in the United States in 2022. In addition to playing a disproportionate role in the rise in youth vaping, the FDA stated that Juul products contain insufficient and conflicting data regarding their toxicological profile.
Although the FDA confirmed that it does not have enough information to declare Juul products an immediate public health hazard, the agency expressed concerns about the health risks associated with vaping.
Can e-cigarettes be used to help quit smoking?
The American Thoracic Society reports that studies evaluating whether vaping helps replace cigarette use have had conflicting results, making this topic inconclusive. Some studies show a positive relationship between vaping and smoking cessation success, but many others show that smokers are unable to permanently replace traditional cigarettes with e-cigarettes. Therefore, e-cigarettes should not be used in the same way as other smoking cessation therapies, such as nicotine patches or gum.
Nicotine patches work by gradually decreasing the nicotine dose over time, which helps the body become less dependent on it. E-cigarettes release the same amount of nicotine each time, giving smokers the same hit with every inhalation. This makes it more difficult to quit smoking. It is also important to note that there is no legal nicotine limit for smoking products in the USA.
The WHO agrees with the ATS position and highlights that there are better, proven products available to support smoking cessation.
Additionally, e-cigarettes can lead to higher nicotine addiction, as the flavors used in these devices make them more appealing, especially to young users who may use e-cigarettes as a gateway to traditional tobacco products.