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#2 A website page from Johns Hopkins Medicine entitled "5 Vaping Facts You Need to Know "

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#2 A website page from Johns Hopkins Medicine entitled "5 Vaping Facts You Need to Know "

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Johns Hopkins Medicine. “5 Vaping Facts You Need to Know.” Johns Hopkins Medicine, 20 June 2024, www.hopkinsmedicine.org/health/wellness-and-prevention/5-truths-you-need-to-know-about-vaping.

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Mens Health Heart Health Know Your Heart Risks

Reviewed By:

If you have thought about trying to kick a smoking habit, you're not alone. Nearly 7 of 10 smokers say they want to stop. Quitting smoking is one of the best things you can do for your health - smoking harms nearly every organ in your body, including your heart. Nearly one-third of deaths from heart disease are the result of smoking and secondhand smoke.

You might be tempted to turn to electronic cigarettes (e-cigarettes, vape pens, and other nondisposable and disposable vaping devices) as a way to ease the transition from traditional cigarettes to not smoking at all. But is smoking e-cigarettes (also called vaping) better for you than using tobacco products? Can e-cigarettes help you to stop smoking once and for all? Michael Blaha, M.D., M.P.H., director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, shares health information about vaping.

1: Vaping is less harmful than smoking, but it's still not safe.

E-cigarettes heat nicotine (extracted from tobacco), flavorings and other chemicals to create an aerosol that you inhale. Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic. While we don't know exactly what chemicals are in e-cigarettes, Blaha says "There's almost no doubt that vaping exposes you to fewer toxic chemicals than smoking traditional cigarettes."

However, there has been an outbreak of lung injuries and deaths associated with vaping. In February 2020, the Centers for Disease Control and Prevention (CDC) confirmed 2,807 cases of e-cigarette or vaping use-associated lung injury (EVALI) and 68 deaths attributed to that condition.

"These cases appear to predominantly affect people who modify their vaping devices or use black market modified e-liquids. This is especially true for vaping products containing THC," explains Blaha.

The CDC has identified vitamin E acetate as a chemical of concern among people with EVALI. Vitamin E acetate is a thickening agent often used in THC vaping products, and it was found in all lung fluid samples of EVALI patients examined by the CDC.

The CDC recommends that people:

Do not use THC-containing e-cigarettes or vaping products.

Avoid using informal sources, such as friends, family or online dealers to obtain a vaping device.

Do not modify or add any substances to a vaping device that are not intended by the manufacturer.

Research from The Johns Hopkins University on vape ingredients published in October 2021 reveals thousands of chemical ingredients in vape products, most of which are not yet identified. Among those the team could identify were several potentially harmful substances, including caffeine, three chemicals never previously found in e-cigarettes, a pesticide and two flavorings linked with possible toxic effects and respiratory irritation.

2: Research suggests vaping is bad for your heart and lungs.

Nicotine is the primary agent in regular cigarettes and e-cigarettes, and it is highly addictive. It causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine is a toxic substance. It raises your blood pressure and spikes your adrenaline, which increases your heart rate and the likelihood of having a heart attack.

Is vaping bad for you? There are many unknowns about vaping, including what chemicals make up the vapor and how they affect physical health over the long term. "People need to understand that e-cigarettes are potentially dangerous to your health," says Blaha. "Emerging data suggests links to chronic lung disease and asthma, as well as associations between dual use of e-cigarettes and smoking with cardiovascular disease. You're exposing yourself to all kinds of chemicals that we don't yet understand and that are probably not safe."

3: Electronic cigarettes are just as addictive as traditional ones.

Both e-cigarettes and regular cigarettes contain nicotine, which research suggests may be as addictive as heroin and cocaine. What's worse, says Blaha, many e-cigarette users get even more nicotine than they would from a combustible tobacco product: Users can buy extra-strength cartridges, which have a higher concentration of nicotine, or increase the e-cigarette's voltage to get a greater hit of the substance.

Does Vaping Lead to Smoking?

4: Electronic cigarettes aren't the best smoking cessation tool.

Although they've been promoted as an aid to help you quit smoking, e-cigarettes have not received Food and Drug Administration approval as smoking cessation devices. A recent study found that most people who intended to use e-cigarettes to kick the nicotine habit ended up continuing to use traditional and e-cigarettes.

In light of the EVALI outbreak, the CDC advises people who use e-cigarettes for smoking cessation to weigh the risks and benefits and first consider use of other FDA-approved smoking cessation options.

5: A new generation is getting hooked on nicotine.

Among youth, e-cigarettes, especially the disposable kind, are more popular than any traditional tobacco product. According to the 2021 National Youth Tobacco Survey, more than 2 million U.S. middle and high school students reported using e-cigarettes in 2021, with more than 8 in 10 of those youth using flavored e-cigarettes.

According to Blaha, there are three reasons e-cigarettes may be particularly enticing to young people. First, many teens believe vaping is less harmful than smoking. Second, e-cigarettes have a lower per-use cost than traditional cigarettes. Finally, youths and adults find the lack of smoke appealing. With no smell, e-cigarettes reduce some of the stigma of smoking.

"What I find most concerning about the rise of vaping is that people who would've never smoked otherwise, especially youth, are taking up the habit," says Blaha. "It's one thing if you convert from cigarette smoking to vaping. It's quite another thing to start up nicotine use with vaping. And, getting hooked on nicotine often leads to using traditional tobacco products down the road."

Research from the CDC shows that vaping among youth has declined somewhat since 2020. Kids being stuck at home under their parents' supervision during the COVID-19 pandemic could contribute to that trend.

But, Blaha says, interpreting the data is tricky, since young people change their preferences often, and, when surveyed, may not consider using disposable products such as "puff bars" as vaping. The same CDC report says disposable e-cigarette use has increased 1,000% among high school students and 400% among middle school students since 2019.

Vaping and the COVID-19 Pandemic

When the coronavirus pandemic first began, Blaha says, data show that e-cigarette sales went down, possibly because people were spending more time at home and avoiding stores and public areas.

But Blaha sees a trend that concerns him: rising rates of daily e-cigarette use among all vape users. "The number of people who vaped daily used to be 1 in 5, but now it's up quite a bit, which is concerning because it implies more nicotine addiction. I'm keeping a close eye on that."

Vaping, smoking and other lung irritants can compound the respiratory problems associated with COVID-19.

Want to quit smoking?

There's a strong link between smoking and cardiovascular disease, and between smoking and cancer. But the sooner you quit, the quicker your body can rebound and repair itself. Talk to your doctor about which smoking cessation program or tools would be best for you.

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Smoking electronic cigarettes is often considered safer than regular smoking. Learn facts about vaping and why you should rethink taking it up.

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A YouTube video from American Psychiatric Association

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A YouTube video from American Psychiatric Association

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American Psychiatric Association. “What Are the Harms of Vaping?” YouTube, 12 July 2023, www.youtube.com/watch?v=S3jtG1pi22M.

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A YouTube video from "Talking With Docs"

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A YouTube video from "Talking With Docs"

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"In Canada, there are actually 7000 flavors of vape juice. It's a 23 billion dollar market now in 2022. Expect it to rise to 390 billion in the next 10 years."

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Talking With Docs. “Vaping - Is It Really That Bad for You?” YouTube, 14 July 2023, www.youtube.com/watch?v=ng0iIz2EiQY.

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A YouTube video from UCLA School of Medicine

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A YouTube video from UCLA School of Medicine

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(David Geffen School of Medicine at UCLA)

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David Geffen School of Medicine at UCLA. “Electronic Cigarettes and Vaping.” YouTube, 23 Aug. 2017, www.youtube.com/watch?v=9dZS_Rniak0.

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#1 A website page from the American Lung Association Entitled  "Health risks of E-cigarettes"

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#1 A website page from the American Lung Association Entitled  "Health risks of E-cigarettes"

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While much remains to be determined about lastinghealth consequences, thereâ€™s evolving evidence about the health risks and impact of e-cigarettes on the lungs.

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#3 A website page from the Center for Disease Control entitled "Health Effects of Vaping"

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#3 A website page from the Center for Disease Control entitled "Health Effects of Vaping"

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(Center for Disease Control and Prevention)

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Center for Disease Control and Prevention. “Health Effects of Vaping.” CDC Smoking and Tobacco Use, 15 May 2024, www.cdc.gov/tobacco/e-cigarettes/health-effects.html.

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Overview

No tobacco products, including e-cigarettes, are safe.

E-cigarettes should not be used by youth, young adults, or people who are pregnant. E-cigarettes may have the potential to benefit adults who smoke and are not pregnant if used as a complete substitute for all smoked tobacco products.

Scientists still have a lot to learn about the short- and long-term health effects of using e-cigarettes.

Nicotine

Most e-cigarettes, or vapes, contain nicotine, which has known adverse health effects.

Nicotine poses unique dangers to youth because their brains are still developing.

Adolescents who use nicotine may be at increased risk for future addiction to other drugs.

Other potential harms of e-cigarettes

E-cigarette aerosol can contain substances that can be harmful or potentially harmful to the body. These include:

Nicotine, a highly addictive chemical that can harm adolescent brain development

Cancer-causing chemicals

Heavy metals such as nickel, tin, and lead

Tiny particles that can be inhaled deep into the lungs

Volatile organic compounds

Flavorings such as diacetyl, a chemical linked to a serious lung disease. Some flavorings used in e-cigarettes may be safe to eat but not to inhale because the lungs process substances differently than the gut.

E-cigarette aerosol generally contains fewer harmful chemicals than the deadly mix of 7,000 chemicals in smoke from cigarettes. However, this does not make e-cigarettes safe. Scientists are still learning about the immediate and long-term health effects of using e-cigarettes.

Dual use refers to the use of both e-cigarettes and regular cigarettes. Dual use is not an effective way to safeguard health. It may result in greater exposure to toxins and worse respiratory health outcomes than using either product alone.

Some people who use e-cigarettes have experienced seizures. Most reports to the Food and Drug Administration (FDA) have involved youth or young adults.

E-cigarettes can cause unintended injuries. Defective e-cigarette batteries have caused fires and explosions, some of which have resulted in serious injuries. Most explosions happened when the batteries were being charged.

Anyone can report health or safety issues with tobacco products, including e-cigarettes, through the FDA Safety Reporting Portal.

Health effects of vaping for pregnant people

The use of any tobacco product, including e-cigarettes, is not safe during pregnancy. Scientists are still learning about the health effects of vaping on pregnancy and pregnancy outcomes. Here's what we know now:

Nicotine is a health danger for pregnant people and is toxic to developing fetuses.

E-cigarette use during pregnancy has been associated with low birth weight and pre-term birth.

Nicotine addiction and withdrawal

Nicotine is the main addictive substance in tobacco products, including e-cigarettes. With repeated use, a person's brain gets used to having nicotine. This can make them think they need nicotine just to feel okay. This is part of nicotine addiction.

Signs of nicotine addiction include craving nicotine, being unable to stop using it, and developing a tolerance (needing to use more to feel the same). Nicotine addiction can also affect relationships with family and friends and performance in school, at work, or other activities.

When someone addicted to nicotine stops using it, their body and brain have to adjust. This can result in temporary symptoms of nicotine withdrawal which may include:

Feeling irritable, jumpy, restless, or anxious

Feeling sad or down

Having trouble sleeping

Having a hard time concentrating

Feeling hungry

Craving nicotine

Withdrawal symptoms fade over time as the brain gets used to not having nicotine.

Nicotine addiction and mental health

Nicotine addiction can harm mental health and be a source of stress. More research is needed to understand the connection between vaping and mental health, but studies show people who quit smoking cigarettes experience:

Lower levels of anxiety, depression, and stress

Improved positive mood and quality of life

Mental health is a growing concern among youth. Youth vaping and cigarette use are associated with mental health symptoms such as depression.

The most common reason middle and high school students give for currently using e-cigarettes is, "I am feeling anxious, stressed, or depressed." Nicotine addiction or withdrawal can contribute to these feelings or make them worse. Youth may use tobacco products to relieve their symptoms, which can lead to a cycle of nicotine addiction.

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Learn about how using e-cigarettes (vapes) can affect your physical and mental health.

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#3 A journal article from Journal of American College Health entitled "The association between vaping and health behaviors among undergraduate college students in the United States" 

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#3 A journal article from Journal of American College Health entitled "The association between vaping and health behaviors among undergraduate college students in the United States" 

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Wilson, Oliver W. A., et al. “The Association Between Vaping and Health Behaviors Among Undergraduate College Students in the United States.” Journal of American College Health, vol. 72, no. 5, May 2022, pp. 1360–64. https://doi.org/10.1080/07448481.2022.2076097.

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The association between vaping and health behaviors among undergraduate college students in the United States (1)

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#1 A journal article from BMC Public Health "Where there's smoke: there's fire"

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#1 A journal article from BMC Public Health "Where there's smoke: there's fire"

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Hwang, Josephine, et al. “Where There’s Smoke, There’s Fire: What Current and Future Providers Do and Do Not Know About Electronic Cigarettes.” BMC Public Health, vol. 20, no. 1, July 2020, pp. 1–11. https://doi.org/10.1186/s12889-020-09265-5.

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#2 A journal article from the Italian Journal of Pediatrics entitled "E-cigarettes and youth: an unresolved public health concern"

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#2 A journal article from the Italian Journal of Pediatrics entitled "E-cigarettes and youth: an unresolved public health concern"

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Virgil, Fabrizio, et al. “E-cigarettes and Youth: An Unresolved Public Health Concern.” The Italian Journal of Pediatrics/Italian Journal of Pediatrics, vol. 48, no. 1, June 2022, pp. 1-10.  https://doi.org/10.1186/s13052-022-01286-7.

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E-Cigarettes and Youth - Italian Journal Article