The Harsh Truth About Vaping

Aaron S. Weinberg MD, MPhil
November 3, 2021
5 mins

In October 2021, the FDA (U.S. Food and Drug Administration) authorized a brand of tobacco-flavored electronic cigarettes for the U.S. market for the first time, citing their use as a tool that some cigarette smokers can use to reduce or quit smoking. But while vaping (another term for using e-cigarettes) has frequently been touted as a “healthier alternative” to smoking traditional cigarettes, it is not. Vaping is very hazardous to your health and can lead to serious illness and death.   

What Is Vaping?

Vaping, or the inhalation of vapor created by an e-cigarette or vape pen, has been gaining in popularity, especially among young people. E-cigarettes produce the vapor by heating a liquid, or “juice,” that frequently contains nicotine — the highly addictive drug in traditional tobacco cigarettes — along with flavorings and other chemicals that help to make the vapor. Users inhale this vapor into their lungs. (E-cigarettes can also be used to deliver marijuana and other drugs.) 

In addition to nicotine, the vapor from an e-cigarette or vape pen may contain many unknown chemicals (there is little regulation of vape-pen ingredients), many known harmful and cancer-causing chemicals, heavy metals such as nickel and lead, and flavoring such as diacetyl (which has been linked to serious lung disease). Often veiled in candy flavors or scents, vape juice is frequently designed to appeal to young adults and kids. 

What’s in a Vape?

Even if the aerosol you’re inhaling tastes and smells like cotton candy, it’s not nearly as innocent as that. Vape juice production is not regulated by any governing body, so producers are free to add whatever chemicals they see fit. Vape juice may be be tainted with poisonous substances.

No matter which type of vaping device is used, vaping is not safe. Some users of e-cigarettes (even short-term users) have developed a serious condition called “e-cigarette or vaping use-associated lung injury,” or EVALI. Certain ingredients in vape juice have been linked to EVALI, such as vitamin E acetate, THC, and nicotine. EVALI causes inflammation of the lungs; typical symptoms include shortness of breath, cough, chest pain, and coughing up blood. The condition can rapidly progress to respiratory failure, the need for mechanical ventilation (a breathing machine), and even death. (Many physicians who have spoken during investigations into deaths caused by EVALI claimed that the patients’ lungs looked like “crushed glass.”) 

If the FDA Authorized Marketing, Doesn’t That Make It Safe? 

According to Johns Hopkins Medicine, e-cigarettes are bad for your heart and lungs and just as addictive as traditional cigarettes. Some devices are even more addictive, as they deliver higher concentrations of nicotine than traditional cigarettes.  

In short, no, vaping is not safe. This recent FDA authorization sends a bad message to teens and young adults who do not smoke cigarettes, but who choose to partake in vaping only for recreational purposes. For a very select group of tobacco smokers looking to quit cigarettes, vaping devices may be effective — though the data is mixed. We ultimately know of the negative health consequences of vaping, and there may be safer alternatives. This new FDA authorization is not a broad endorsement of vaping and should not be taken as such. 

Vaping comes with serious risks. In addition to nicotine addiction (along with the normalization of tobacco use) and the potential for vaping-associated lung disease, vaping can also harm other parts of your cardiovascular system, like your heart and arteries. There is some research showing that vaping and cigarette use can increase your risk of heart attack and stroke. Vaping can cause periodontal disease, throat inflammation, cavities, and gingivitis. Vaping is also being linked to DNA dysfunction and disturbances in health on a cellular level, as well as altering brain development in people younger than 25. Furthermore, while some people may turn to vaping as a way to try and cope with their anxiety or depression, the high doses of nicotine in vaping have been linked to increased anxiety, depression,  impulsivity, and mood disorders.

We also don’t yet know about the potential long-term health consequences of vaping — which may start appearing only after decades have passed (similar to the way many kinds of cancer start to appear in cigarette smokers after many years have passed — and not just lung cancer: 40 percent of cancers in the U.S. may be linked to tobacco use). Nor do we fully understand the health effects of secondhand exposure. 

Who Is Vaping For? 

Vaping may sometimes be used as a tool for heavy smokers to stop smoking traditional cigarettes. Eventually, those heavy smokers would also be guided off of vaping. Vaping is not the goal. The goal is a nicotine-free life. Vaping should not be done recreationally by anyone. Many years ago, people thought smoking was a healthy choice. Research shows us that this was incorrect. We now see warning labels, commercials, and ads everywhere warning us of the dangers of smoking. Vaping doesn’t have to follow the same pattern. Using knowledge from the past, we can avoid ignorance and tragic health consequences. 

If you smoke cigarettes or e-cigarettes, quitting is one of the best steps you can take to protect your long-term health. If you or someone you know is trying to quit, make a virtual or in-person appointment with a Carbon Health primary care provider today, to discuss options and make a plan. 

Carbon Health’s medical content is reviewed and approved by healthcare professionals before it is published, but it is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Talk to your healthcare provider about questions you may have regarding your health or a medical condition, and before making changes to your healthcare routine.

Aaron S. Weinberg MD, MPhil

Aaron S. Weinberg, MD, MPhil, is Director of Program Development at Carbon Health and triple board-certified in Pulmonary, Critical Care, and Internal Medicine.