An electronic cigarette is a battery-operated device that emits a vaporized solution to inhale. Usually, the solution contains nicotine. The aim is to provide the sensation of inhaling tobacco smoke, without the smoke.

These devices have various names, including e-cigarettes, e-hookahs, vaporizer cigarettes, vapes, and vape pens.

They come in a range of shapes. Some look like USB drives and others look like pens, for example.

Manufacturers market e-cigarettes as tools for quitting or cutting down on smoking, but the Food and Drug Administration (FDA) class them as tobacco products.

United States federal law does not allow the sale of tobacco products to people under the age of 21. However, a major concern about vaping is its attraction for young people.

Vaping is popular among teens. In fact, it is now the most popular form of tobacco use among young people in the U.S., according to the Centers for Disease Control and Prevention (CDC).

Below, learn what e-cigarettes contain, how they work, and what research indicates about their risks to health.

In 2019, experts linked vaping with the appearance of a severe lung disease now known as e-cigarette, or vaping, product use-associated lung injury, or EVALI. By February 2020, doctors had confirmed 2,807 cases and 68 deaths from this disease, according to the CDC. Investigations are ongoing.

e-cigarettes on a table that may or may not be a safe alternative to smokingShare on Pinterest
The nicotine in e-cigarettes may affect brain development in young people.

An e-cigarette is a device that may look like a cigarette, a cigar, a pipe, a pen, or a USB drive. The liquid inside may smell fruity, but it can have a high nicotine content.

JUUL devices, for example, look like USB drives. They appeared on the U.S. market in 2015 and are now the top-selling brand of e-cigarette in the country.

There is concern about young people using JUUL. Refills come in flavors such as cool cucumber, mango, and mint, which may seem natural and harmless, but a single JUUL refill contains as much nicotine as a pack of 20 cigarettes.

Most e-cigarettes are made up of the following parts:

The mouthpiece: This is a cartridge fixed to the end of a tube. Inside is a small plastic cup containing absorbent material soaked in a liquid solution.

The atomizer: This heats the liquid, causing it to vaporize so that a person can inhale it.

The battery: This powers the heating element.

The sensor: This activates the heater when the user sucks on the device.

The solution: E-liquid, or e-juice, contains a combination of nicotine, a base, which is usually propylene glycol, and flavoring.

When the user sucks on the mouthpiece, the heating element vaporizes the solution, which the person then “vapes,” or inhales. The nicotine content of the liquid can range from “very high” to zero.

Flavors vary widely, from “traditional” and menthol to watermelon and “lava flow.” Some e-cigarettes taste like traditional cigarettes and even mimic the tastes of specific brands.

Manufacturers claim that e-cigarettes bypass many of the health risks of tobacco smoking, providing a healthful alternative.

While these devices may help some people quit smoking, there is growing evidence that e-cigarettes can pose serious health risks, especially to people who do not smoke traditional cigarettes.

The CDC advise against vaping if people:

  • are children or young adults
  • are pregnant
  • have never smoked and are not trying to quit

Below are seven reasons why e-cigarettes can be harmful:

1. They usually contain nicotine

Most e-cigarettes contain nicotine, which is dangerous because it:

  • is habit-forming
  • affects brain development, which continues up to the age of about 25 years
  • can harm a fetus during pregnancy

2. They contain other toxins

The American Lung Association list a number of toxins, beyond nicotine, that appear in e-cigarettes. Among them are:

  • carcinogens, such as acetaldehyde and formaldehyde
  • acrolein, a weed killer that can lead to irreversible lung damage
  • benzene, a compound in car exhaust
  • diacetyl, a chemical linked to bronchiolitis, which is a health condition sometimes called “popcorn lung”
  • propylene glycol, used in antifreeze
  • hazardous metals, such as lead and cadmium
  • other minute particles that can enter the lungs

Many of these are also in traditional cigarettes.

3. Quitting smoking may be harder

People who switch from traditional cigarettes to e-products may put off getting medical help or trying proven tools that can help with quitting. This can delay or even prevent a person from quitting smoking.

A 2016 study found that people who use or have used e-cigarettes are less likely to stop smoking altogether.

4. They cause secondhand smoke

Vaping produces secondhand smoke. Since e-cigarettes often contain the same chemicals as traditional cigarettes, smoke produced by vaping may be toxic to people nearby.

5. They may not deter teen smoking

The marketing of e-cigarettes and their range of flavors can give the impression that vaping is not harmful.

This message can tempt people, including teens, to start vaping. However, vaping early on may increase the chances of smoking ordinary cigarettes later in life.

According to a 2017 study, teens who use e-cigarettes are more likely to smoke regular tobacco products later on, compared with their peers.

6. They can harm the brain

In young people, the use of nicotine can impact the reward system in the brain. In time, this can make the use of other drugs, such as cocaine, more pleasurable, according to the National Institute on Drug Abuse (NIDA).

In addition, nicotine use can affect areas of a young person’s brain that are responsible for attention and learning.

It may also increase the risk of developing mood disorders and problems with impulse control.

7. Experimental use may be more dangerous

Experimenting with different ways of using vaping materials may be additionally risky.

As an example, NIDA point to the practice of “dripping.” This involves inhaling solutions dripped directly onto the heater coil “to produce a stronger throat hit.” The specific risks of these practices are still unclear.

Scientists are still determining how harmful e-cigarettes can be. So far, it seems that the effects may range widely.

Results of lab-based studies, including some in animals, suggest that compounds called nitrosamines in e-cigarettes can damage DNA, according to 2018 research.

The team reported that lung cells were less able to repair themselves after exposure to e-cigarette smoke. The smoke also caused damage to the lungs and bladders of mice, indicating that it may increase the risks of developing lung and bladder cancer.

A 2019 study in mice found that vaping could increase the risk of heart disease.

Meanwhile, a study in 90 smokers, also published in 2019, found that vaping may be more addictive than smoking conventional cigarettes.

Moreover, a 2019 review of studies concluded that vaping is highly likely to:

  • expose users to toxic chemicals
  • increase the risk of nicotine addiction among young people
  • possibly increase the chances of people switching to traditional tobacco products

The researchers also noted a lack of evidence that vaping is an effective means of quitting smoking.

Current evidence indicates that using e-cigarettes is dangerous, especially for young people and people who have never smoked.

While they may help some people stop smoking, vaping products do not have FDA approval as a tool for quitting. E-cigarettes may even keep people from trying proven methods of quitting smoking.

Several states have imposed restrictions on the sale of e-cigarettes. There are also restrictions on liquids with flavors that may be more attractive to younger people.

Since the end of 2019, it is illegal to sell vaping products to people younger than 21 years.

E-cigarettes are nicotine-based products, and no nicotine use is safe. Until we know more, it is probably best to avoid these products whenever possible, including secondhand smoke.