Vaping has been marketed as a safer alternative to traditional smoking and has found its way into mainstream culture with sleek devices, enticing flavors, and excellent advertising. E-cigarettes, also known as electronic cigarettes or vaping devices, are battery-powered and simulate smoking by heating a liquid (often called e-liquid or vape juice) to create an aerosol, which is then inhaled. Many physicians have raised the alarm that vaping is very likely to be just as (if not even more) dangerous than traditional smoking. 

Vaping devices usually still deliver nicotine, which is highly addictive and can have serious health consequences. The e-liquid itself contains various ingredients, including propylene glycol (PG), vegetable glycerin (VG), flavorings, and nicotine (though not always). PG and VG are solvents to create the vapor, while flavorings provide the taste. When heated, the coil vaporizes the e-liquid, turning it into an aerosol or vapor. The user then inhales this vapor through the mouthpiece and then exhales the vapor, mimicking the act of smoking. Heating these substances can produce harmful byproducts and toxic compounds that are inhaled directly into the lungs. The long-term effects of repeated exposure to these chemicals are still being studied, but there are concerns about their potential to cause cell damage and inflammation in the respiratory system.

Vaping and Health 

One of the most immediate and concerning health effects of vaping is its impact on the respiratory system. Red flags emerged a few years ago when hospitals began to see cases of EVALI, or “e-cigarette or vaping product use-associated lung injury.” It typically presents with symptoms such as cough, shortness of breath, chest pain, and fever, and can progress to severe respiratory distress requiring hospitalization. EVALI gained significant attention in recent years due to a spike in cases, particularly among young people using e-cigarettes. The exact cause of EVALI is not entirely understood but is believed to be related to the inhalation of the harmful substances found in vaping products, such as vitamin E acetate, THC, and other contaminants. These substances can cause inflammation and damage to the lungs, leading to the symptoms associated with EVALI.

The inhalation of vaporized chemicals, flavorings, and other additives can irritate the lungs and airways, leading to coughing, wheezing, shortness of breath, and chest tightness. The chemicals used or produced when the e-liquid is heated are likely to cause serious health effects. For example, formaldehyde is well known to cause lung and heart disease, diacetyl (a food additive to deepen flavors) is known to damage small passageways in the lungs, and acrolein, typically used as a weed killer, can also damage the lungs. Diacetyl is of particular interest as its side effects are well-documented in the case of popcorn factory workers. Constrictive bronchiolitis or bronchiolitis obliterans which is also known as “popcorn lung,” was first discovered in workers at microwave popcorn plants who had inhaled the chemical diacetyl. Constrictive bronchiolitis is a rare and chronic disease that typically worsens over time; thick scar tissue blocks the small airways of the lungs called bronchioles making it difficult to breathe and take in oxygen. 

Vaping has also been associated with an increased risk of respiratory infections, including pneumonia and bronchitis. Physicians at Johns Hopkins have noticed an uptick in the cases of lipoid pneumonia which is the result of inhaling oily substances in e-liquids. It develops when fatty acids (the building blocks of fat) enter the lungs. Physicians at Hopkins have also seen an increase in Primary Spontaneous Pneumothorax (Collapsed Lung) after vaping. This is most common in individuals who go through a rapid growth spurt, which can lead to small blisters in the lungs. Normally, these blisters are harmless, however, vaping has been associated with causing them to rupture. 

Overall, the inhalation of foreign substances and the weakening of the immune system due to nicotine exposure can make vapers more susceptible to bacterial and viral infections, posing a serious threat, especially during flu seasons or outbreaks. Emerging research also suggests that vaping may pose risks to cardiovascular health. Nicotine, even in the absence of tobacco smoke, can elevate heart rate and blood pressure, increasing the strain on the heart and blood vessels. Prolonged use of nicotine-containing vaping products may contribute to the development of heart disease, stroke, and other cardiovascular complications.

Addiction

Nicotine addiction is a significant concern associated with vaping. Many e-cigarettes and vaping products contain high levels of nicotine, making them very addictive, especially for young users whose brains are still developing. This addiction can lead to a lifelong struggle with substance dependence and withdrawal symptoms when attempting to quit. The CDC notes that nicotine can harm the adolescent brain which keeps developing until age 25. It damages the areas of our brain that are responsible for impulse control, learning, mood, and more. Nicotine can change the way the synapses are formed in the growing brain and increase the chance of addiction to other drugs or alcohol in young people. 

Vaping companies often target young people with enticing flavors and marketing strategies that glamorize vaping as a trendy and harmless activity. This has led to a surge in vaping among adolescents, with serious implications for their health and well-being. The accessibility and appeal of vaping products contribute to a growing epidemic of nicotine addiction among youth.

 Lack of Regulation

Unlike traditional tobacco products, vaping devices and e-cigarettes are not as heavily regulated. This lack of oversight means that consumers may be unaware of the ingredients and chemicals they inhale. Additionally, there have been cases of poorly manufactured vaping devices causing fires or explosions, highlighting the need for stricter regulations and safety standards in the industry. Dr. Edwin J. Ostrin, an Assistant Professor in the Department of Pulmonary Medicine, Division of Internal Medicine at The University of Texas MD Anderson Cancer Center said, “Anybody can make this stuff and can refill these e-cigarettes. We don’t know what sort of contaminants are in them, and there can be nasty stuff in there that can cause serious lung injury and body injury in general.”

Vaping also has environmental consequences that are often overlooked. The disposal of vaping devices, cartridges, and batteries contributes to electronic waste, which can leach harmful chemicals into the environment if not properly managed and recycled.

Vaping carries significant risks and dangers that cannot be ignored. The vaping industry’s practices and products warrant closer scrutiny and regulation. It’s crucial for individuals, especially young people, to be informed about the potential harms of vaping and to make informed decisions about their health and well-being.