E-cigarettes contain nicotine and other chemicals that may damage the esophagus. They may also cause or worsen the symptoms of gastroesophageal reflux disease (GERD).

However, research into this area is still in the early stages. The potential adverse health effects of vaping warrant further investigation by scientists.

This article discusses vaping and the harmful contents of electronic cigarettes, known as e-cigarettes. It also explores GERD and how vaping can affect its symptoms.

A person vaping.Share on Pinterest
Alexandra Troyan/EyeEm/Getty Images

Vaping is the word that some people use to describe using an e-cigarette. E-cigarettes produce an aerosol — a suspension of small solid particles or liquid droplets in the air — by heating a liquid containing nicotine and other chemicals. They come in many different shapes and sizes, resembling cigarettes, pens, USB sticks, or pipes.

E-cigarettes may contain several potentially harmful substances, including:

  • nicotine and other tobacco products
  • flavoring such as diacetyl, which research has linked to a serious lung disease
  • chemicals that may cause cancer
  • heavy metals
  • volatile organic compounds
  • ultrafine particles that a person may inhale deep into the lungs

In 2018, approximately 8.1 million adults in the United States used e-cigarettes. The Centers for Disease Control and Prevention (CDC) advise that e-cigarettes have the potential to benefit some adults who currently smoke and wish to stop.

However, the organization warns that people who do not smoke should not start vaping. Furthermore, e-cigarettes are unsafe for the following groups of people:

  • youth
  • young adults
  • pregnant adults

GERD is a chronic medical condition associated with acid reflux. The American College of Gastroenterology notes that acid reflux can lead to GERD.

When someone has GERD, gastric acid and bile flow from their stomach into their esophagus. An esophageal sphincter — a band of muscle that acts as a valve — usually prevents the stomach contents from moving into the esophagus. However, certain foods, lifestyle habits, and health conditions can weaken this barrier, causing GERD.

Doctors will monitor and treat GERD because it may lead to esophageal cancer. They may prescribe medications such as H2 receptor antagonists, known as H2 blockers, and proton pump inhibitors (PPIs). Additionally, they may advise someone to make changes to their diet and lifestyle.

Research indicates that GERD prevalence is significantly higher among people who smoke than among those who do not. Quitting smoking can improve GERD, as well as health-related quality of life.

An older study involving about 50,000 individuals found that close to 20% of those who smoked hookah had symptoms of GERD at least once a week.

The researchers of the study explain that smoking cigarettes reduces the lower esophageal sphincter pressure and the salivary secretion of bicarbonates. These effects may cause gastroesophageal reflux episodes.

Additionally, the study indicates that the puff volume in hookah smoking is several times bigger than in cigarette smoking, which may increase GERD symptoms.

However, because vaping is a relatively new phenomenon, there is little research about its effects on GERD.

One example is a 2021 case study. The study found that an individual whose GERD was under control presented with inflammation of the esophagus, called esophagitis, associated with vaping.

The authors suggest that vaping may cause mucosal injury, oxidative stress, and DNA damage. In addition, they note that the inconsistent regulation of e-cigarettes can result in people inhaling unknown chemicals and toxins.

Finally, they stress the need for further investigation into the link between GERD and vaping.

Other adverse effects of vaping

The CDC explains that because e-cigarettes are fairly new, scientists are still learning about their long-term health effects. However, this is what they know so far:

  • Most e-cigarettes contain nicotine. The dangers of nicotine include addiction, toxicity to developing fetuses, and impaired brain development in adolescents and young adults.
  • The adverse effects of other vaping chemicals may include lung damage and cancer.
  • Exploding defective e-cigarette batteries may cause serious injuries.
  • Poisoning can occur in children who swallow, breathe, or absorb vaping liquid.

In addition, the CDC notes that by February 2020, e-cigarette, or vaping, product use-associated lung injury (EVALI) had caused 2,807 deaths and hospital visits in the U.S.

The CDC adds that laboratory data show that vitamin E acetate, an additive in some tetrahydrocannabinol-containing e-cigarettes, is significantly related to the EVALI outbreak.

However, EVALI cases have declined due to more public awareness, fewer products containing vitamin E acetate, and law enforcement actions against illicit products.

The National Library of Medicine (NLM) explains that the severity of a person’s symptoms will determine what treatments doctors recommend. However, the options may include:

In addition, the NLM advises that the following lifestyle modifications may help relieve the symptoms of GERD:

  • weight loss, if a person has excess body weight
  • avoiding meals for at least 3 hours before bedtime
  • maintaining good sleep hygiene
  • elevating the head when lying down

Lifestyle changes are the primary treatment for GERD.

Below are some of the most common questions about vaping and GERD.

Can vaping cause gastrointestinal problems?

Research indicates that nicotine may affect the function of the gastrointestinal system. Smoking cigarettes or vaping may cause digestive issues, such as heartburn or GERD.

Does nicotine make GERD worse?

Nicotine can potentially make GERD symptoms worse. Therefore, people with GERD may wish to consider avoiding e-cigarettes or quitting smoking.

Can vaping affect the esophagus?

Some evidence suggests that vaping may cause inflammation of the esophagus and affect the valve that prevents stomach acid from flowing into the esophagus.

Although vaping is relatively new and studies are limited, some research suggests that it may worsen GERD symptoms. Nicotine and other chemicals in e-cigarettes may cause inflammation and affect the function of the valve that prevents stomach acid from rising into the esophagus.

Although vaping may help some people quit cigarettes, pregnant people, adolescents, and those who do not already smoke should avoid e-cigarettes.

A person should speak with a doctor if they are experiencing symptoms of GERD.