What Are the Dangers of E-Cigarettes? Analysis of 5 Real Facts

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If you have considered trying to quit smoking, you are not alone. Nearly 10 out of 7 smokers express a desire to quit. 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 heart disease deaths result from smoking and secondhand smoke.

You may be thinking of turning to e-cigarettes (e-cigarettes, vape pens, and other non-disposable and disposable e-cigarette devices) as a way to ease the transition from traditional cigarettes to complete non-smoking. But is vaping (also known as e-cigarettes) better for you than using tobacco products? Can e-cigarettes help you quit smoking for good? Dr. Michael Blaha, Clinical Research Director at the Johns Hopkins Ciccarone Center for Heart Disease Prevention, shares health information about e-cigarettes.

1. E-cigarettes are less harmful than smoking but still not safe.

E-cigarettes heat nicotine (derived from tobacco), flavorings, and other chemicals to produce the aerosol you inhale. Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic. While we do not know exactly what chemicals are in e-cigarettes, Blaha states, "There is no doubt that e-cigarettes expose you to fewer toxic chemicals than traditional cigarettes."

However, lung injuries and deaths associated with e-cigarettes have already emerged. In February 2020, the Centers for Disease Control and Prevention (CDC) confirmed 807 cases of e-cigarette or vaping product use-associated lung injury (EVALI) and deaths attributed to the disease.

“These cases seem to primarily affect those who modify e-cigarette devices or use black market modified e-liquids. This is especially true for e-cigarette products containing tetrahydrocannabinol (THC),” Blaha explains.

The CDC has identified vitamin E acetate as a chemical of concern for EVALI patients. Vitamin E acetate is a thickening agent commonly used in THC e-cigarette products and has been found in all lung fluid samples from EVALI patients examined by the CDC.

The CDC advises people:

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

• Avoid obtaining e-cigarette devices from informal sources, such as friends, family, or online dealers.

• Do not modify or add any substances to e-cigarette devices that are not intended by the manufacturer.

A study published by Johns Hopkins University in 2021 on e-cigarette ingredients found that e-cigarette products contain thousands of chemical components, most of which are still unidentified. The substances that the research team could identify included several potentially harmful substances, including caffeine, three chemicals never before found in e-cigarettes, one pesticide, and two flavorings associated with potential toxicity and respiratory irritation.

2. Research shows that e-cigarettes are harmful to your heart and lungs.

Nicotine is the primary agent in both regular cigarettes and e-cigarettes, and it is highly addictive. Ignoring this craving can lead to a desire to smoke and withdrawal symptoms. Nicotine is a toxic substance. It raises your blood pressure and spikes your adrenaline, increasing your heart rate and the likelihood of a heart attack.

Are e-cigarettes harmful to you? There are many unknowns about e-cigarettes, including what chemicals make up the vapor and how they affect long-term physical health. "People need to understand that e-cigarettes pose potential dangers to your health," Blaha says. "New data indicate associations with chronic lung disease and asthma, as well as links between e-cigarettes and smoking and cardiovascular disease. You expose yourself to various chemicals that we still do not understand, which may not be safe.

3. E-cigarettes are as addictive as traditional cigarettes.

E-cigarettes and regular cigarettes both contain nicotine, and research shows that nicotine may be as addictive as heroin and cocaine. Blaha states that worse still, many e-cigarette users obtain more nicotine than they would from combustible tobacco products: users can purchase ultra-high nicotine cartridges or increase the voltage of their e-cigarettes for a bigger hit.

4. E-cigarettes are not the best smoking cessation tool.

Although e-cigarettes have been promoted as a smoking cessation aid, they have not been approved by the FDA as cessation devices. A recent study found that most people intending to use e-cigarettes to quit their nicotine habit ended up continuing to use both traditional and e-cigarettes.

In light of the EVALI outbreak, the CDC advises those using e-cigarettes to quit smoking to weigh the risks and benefits and to consider using other FDA-approved cessation options first.

5. A new generation is becoming addicted to nicotine.

Among young people, e-cigarettes, especially disposable ones, are more popular than any traditional tobacco products. According to the 2021 National Youth Tobacco Survey, over 2 million American middle school students reported using e-cigarettes, with eight out of ten teens using flavored e-cigarettes.

According to Blaha, e-cigarettes may be particularly appealing to young people for three reasons. First, many teenagers believe that e-cigarettes are less harmful than smoking. Second, the cost per use of e-cigarettes is lower than that of traditional cigarettes. Finally, young people and adults find the absence of smoke appealing. Without the odor, e-cigarettes reduce some of the stigma associated with smoking.

“What I find most concerning is that those who would not have smoked otherwise, especially young people, are developing this habit,” Blaha says. “Switching from smoking to e-cigarettes is one thing. Starting to use nicotine with e-cigarettes is another. Moreover, nicotine addiction often leads to the use of traditional tobacco products down the line.

CDC research indicates that since 2020, youth vaping has declined. During the COVID-19 pandemic, children being stuck at home under parental supervision may have contributed to this trend.

However, Blaha states that interpreting the data is tricky, as young people frequently change their preferences and may not consider using disposable products like "puff bars" as e-cigarettes when surveyed. The same CDC report states that since 2019, the use of disposable e-cigarettes among high school students has increased by 400%, and among middle school students by 2019%.

There is a close link between smoking and cardiovascular disease, as well as between smoking and cancer. However, the sooner you quit smoking, the faster your body can rebound and heal itself. Discuss with your doctor which smoking cessation plan or tool is best for you.