Information for Parents: What Are the Risks of Vaping?

Although they entered the market as a "healthy" alternative to quit smoking, vapers have become a health hazard, especially for adolescents and young adults.

Written and verified by the doctor Maryel Alvarado Nieto.

Last update: 01 June, 2023

Electronic cigarettes entered the market at the beginning of the 21st century as a substitute for conventional cigarettes. Although, in theory, they represented a healthier alternative for smokers, the reality was far from being so. In recent years, there’s been an increase in the use of electronic nicotine delivery devices by adolescents who had no history of smoking. Thus, it’s important to talk about the risks of vaping in young people.

Marketing has been one of the driving forces behind electronic nicotine delivery systems (ENDS) as a less harmful resource for health than conventional cigarettes. However, there is now lots of studies that debunks this myth. In addition, there are other smoke-substitute options that have proven useful for smoking cessation.

What is vaping?

Currently, SEANs, or e-cigarettes are available in various models. These devices have a resistance system activated by a battery.

The function of this resistance is to heat a liquid, which is contained in a tank or cartridge, thus allowing the formation of an aerosol. The composition of the liquid depends on both the manufacturer and the type of vape, but may contain some of the following substances:

• Oils
• Nicotine
• Glycerin
• Glycerol
• Ethylene glycol
• Ethyl alcohol
• Flavorings
• Propylene glycol
• Flavorings
• Solvents
• Tetrahydrocannabinol (THC)

Actually, the term vapor is incorrect, as it isn’t the form in which the final product the consumer is exposed to is found. However, the word vapers is in common use to denote both the device and the individuals who use it.

This reflects only an attempt to emphasize that with e-cigarettes there is no smoke production. However, the consumer is inhaling substances harmful to your health through the mouthpiece of the device.

The risk of lung damage from the use of vapers

Since their launch on the international market, there have been controversies regarding NREDs. Those who defend them start from the idea that they constitute an alternative to conventional cigarettes, seeing their usefulness in quitting smoking as a harm control therapy.

On the other hand, those who oppose their use warn that vapers are frequently used by people who were not smokers in the first place, representing a risk to their health.

In 2009, the US Centers for Disease Control and Prevention (CDC) supported the latter group by issuing an alert on the use of NEDs. The publication contained information on multiple cases of severe acute respiratory illness in young patients, the main association of which was the use of vapers. For this reason, the cases were proposed to be defined as EVALI (e-cigarette or vaping-associated lung injury).

Lung disease associated with e-cigarette use

Of the 2807 cases reported in the United States (as of February 2020), the median age was around 19 years old, although it included people between 16 and 53 years old. Patients who sought medical help had at least 6 days of respiratory symptomatology, in which dyspnea (choking sensation or difficulty breathing) predominated.

They also manifested some of the following symptoms:

• Fever
• Dry cough
• Chest pain
• Tachycardia
• Chills
• Hemoptysis (bleeding cough)
• Gastrointestinal symptoms, such as nausea and vomiting

Almost all the patients required at least one day of hospital admission, although there were cases that required up to 25 days in the hospital. Likewise, 52% of the hospitalized patients had to be admitted to the intensive care unit (ICU), requiring ventilatory support, both noninvasive and invasive.

Deaths accounted for about 2% of the cases.

Scientific societies have urged the introduction of regulations on vaping devices in order to reduce access to them. On the other hand, although all the patients studied showed various alterations in the diagnostic images, it hasn’t been possible to establish which substances are involved in these changes, so further research is needed.

Cardiovascular risks from vaping

An association has been established between the use of electronic cigarettes and oxidative stress. This leads to an increased risk of developing atherosclerosis in patients using vapers, due to increased levels of LDL or bad cholesterol.

Similarly, both conventional cigarettes and e-cigarettes are involved in platelet aggregation. Therefore, the use of DELN is considered a risk factor for cardio and cerebrovascular pathologies.

It’s estimated that the risk of acute myocardial infarction could even be seven times higher in those who, in addition to e-cigarettes, are also exposed to tobacco smoke. These consumers are referred to as dual smokers. However, there is no clear evidence in this regard.

The effects of e-cigarettes on oral health

Although there is little information on the effects of vapers on the oral cavity, these should not be underestimated. The oral mucosa is the first point of contact between the substances present in the aerosol and the organism.

Periodontal conditions are the main risk to which DELN users are exposed, which is secondary to the inflammatory process triggered by vapor compounds. Opportunistic infections, especially Candida albicans, are of great importance in this group of patients.

Other risks of vaping

The long-term effects of SEANs on the various tissues of the body have not been established. However, this has not stopped scientists from trying to discover them.

In a study on rats in Italy, it was found that exposure to nicotine-free aerosol from a low-voltage vape produced a decrease in testicular volume in these animals.

The risk of burns and injuries from vaper use

Although not as common, vapers are no strangers to accidents. These can range from minor burns to trauma as severe as loss of teeth and facial fractures.

Since they are electronic devices, e-cigarettes are vulnerable to manufacturing defects and malfunctions. Errors that have been associated with accidents with SEANs include the following:

• Poor quality of materials used
• Modifications of parts by users
• Poor quality control in manufacturing
• Incorporation of large batteries to increase service life

The risks of vaping and the development of addictions

Finally, it’s understood that the use of vapers by adolescents and young adults can serve as a gateway to the consumption of other addictive substances, such as nicotine itself. Paradoxically, the main risk to which they are exposed is conventional cigarette smoking, a habit that, in theory, is being combated.

Do vapers carry a risk of cancer in adolescents?

At present, there’s no clear evidence linking e-cigarettes to an increased risk of developing cancer. This is thought to be because vapers have only been on the market for a short time and the processes involved in carcinogenesis are slow and complex.

However, it has been observed that rodents repeatedly exposed to aerosols from these devices show damage to the genetic material and mechanisms involved in DNA repair. Therefore, the recommendation is one of caution, since we do know that the device provides oncogenic substances.