When vapes started to become popular in the mid-2010s, the tiny cartridges carried big promises. They were presented as a healthier alternative to cigarettes and a path to quit smoking.
Now, researchers are coming to understand the hazards of vapes themselves. In a study from last month, for example, a team of scientists analyzed the mist from popular vapes and found such high levels of heavy metals that one researcher thought their machine had malfunctioned. Other studies have suggested that vaping can affect the heart, lungs and brain.
Experts said they were worried that vaping may become harder to study after the Trump administration shut down a unit focused on smoking and health. The government has also slashed funds for programs that help people stop vaping.
Data on the long-term health effects is limited, because vapes are relatively new and constantly evolving. Many people who use them are in their teens or 20s; it might take a while before further effects become apparent. Consumers also often use both cigarettes and vapes, which makes it difficult to isolate harms from vaping alone. Vaping is still less common than cigarette use among U.S. adults, 4.5 percent of whom said they vaped in 2021. Nearly 8 percent of high school students reported vaping in the last month in a 2024 survey.
Even so, “common sense tells you — your mom would tell you — that a superheated chemical inhaling right into your lungs isn’t going to be good,” said Dr. James H. Stein, a professor of cardiovascular medicine at the University of Wisconsin School of Medicine. Increasingly, research is pointing to the reality that while vapes do not contain the same dangerous chemicals as cigarettes, they come with their own harms.
Cardiovascular Concerns
A hit from a vape immediately stresses the cardiovascular system. Your heart rate rises and your blood vessels constrict, which can stiffen arteries in the heart over time. When you vape “all day long, over and over and over again — you’re basically walking around with high blood pressure,” Dr. Stein said. These effects could raise the risk of developing an irregular heart rhythm, stroke and even a heart attack.
When vapes heat liquids to higher temperatures, they can release larger amounts of harmful chemicals that can seep into the lungs, enter the bloodstream and flow to the heart, said Irfan Rahman, a researcher at the University of Rochester Medicine who studies nicotine products. The liquids in e-cigarettes can release known carcinogens, like formaldehyde and acetaldehyde, when heated. These and other chemicals can damage blood vessels, drive inflammation and contribute to cardiovascular disease risk.
When people quit vaping, they can also experience nicotine withdrawal that can increase heart rate and blood pressure, Dr. Stein added.
Lung Issues
Vaping causes inflammation in the airways and lungs that can become chronic, Dr. Stein said. It can also exacerbate asthma and symptoms of chronic obstructive pulmonary disease and can lead to a persistent cough and shortness of breath.
While we don’t know yet whether vapes cause cancer, which can take decades to develop, we know they can expose users to substances associated with increased cancer risk. Brett Poulin, an assistant professor of environmental toxicology at the University of California, Davis, tested three popular disposable vape brands and found that they released high levels of nickel and antimony, heavy metals linked to lung cancer. (Dr. Poulin’s team also found that vapes release large amounts of lead, a neurotoxin.)
Chemicals used in flavored vapes, especially disposable ones, can also damage cell membranes, which increases the risk of lung damage and cancer, as well as heart disease, Dr. Stein said.
In rare cases, patients have developed lung scarring and breathing issues known as “popcorn lung” after inhaling diacetyl, a compound in some flavored vapes. (Major vape brands currently say they do not use diacetyl.) In 2019, an outbreak of serious lung injuries, including 68 deaths, was linked to vapes that contained vitamin E acetate.
Oral Health
As with cigarettes, pouches and other products that contain nicotine, vapes limit blood flow to the gums, which makes them more vulnerable to disease and infection. Nicotine can also damage gum tissue, Dr. Rahman said.
Addiction
Dr. Pamela Ling, the director of the U.C.S.F. Center for Tobacco Control Research and Education, has worked with teens who sleep with vapes tucked under their pillows and reach for them first thing in the morning.
Research has shown that e-cigarettes are addictive. Dependence can be especially problematic for adolescents, whose brains are developing. There are still some support programs for quitting, and smoking cessation medications may offer relief. But it can also be an agonizing process, bringing on withdrawal symptoms like depression, anxiety and irritation.
Compounding those concerns: Even more addictive vapes that contain higher levels of nicotine are hitting the market.
Dr. Ling said it was now easy to find vapes that have 20,000 puffs of nicotine — an amount rivaling 100 packs of cigarettes.
“New products come out on the market faster than we can do science,” she said.
Dani Blum is a health reporter for The Times.
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