Vape

My recent post titled “Nicotine” produced responses showing an interest in similar information about “vape”.

Below is a series of bottom-line findings from various papers on “vape” published from 2020 to current.

The papers examine topics such as:

the cellular effects of various vape ingredients,
the impacts of second and third-hand vape exposures in the ecology of vape shops,
gateway effects of vape on the prevalence onset of cigarette smoking,
harms of vape upon eyes,
harms of vape upon kinds of oral health,
oversight and regulation of the content of vapes;

and more.

In reading this material, I’m essentially stuck by how limited, preliminary, and early our knowledge is – compared to the widespread use of vape products.

“Myocardial function after infarction is significantly decreased after exposure to nicotine vape aerosol…

Comparable loss of contractile function was not observed in mice exposed to vape aerosol alone, highlighting the essential role of nicotine in loss of contractile function.

Increased vimentin immunoreactivity was observed in the vape alone group compared with control and vape nicotine.

The correlation between vaping, interstitial cell responses, and cardiac remodeling leading to impaired contractility warrants further investigation.

Public health experts seeking to reduce vaping‐related health risks should consider messaging that highlights the increased cardiovascular risk especially with nicotine‐containing aerosols.”

Francesco Petrella, Paola Faverio, Andrea Cara, Enrico Mario Cassina, Lidia Libretti, Sara Lo Torto, Emanuele Pirondini, Federico Raveglia, Francesca Spinelli, Antonio Tuoro, Elisa Perger, Fabrizio Luppi. Clinical Impact of Vaping. Toxics, 13, 6, (470). 2025. https://doi.org/10.3390/toxics13060470

“…exposure to thirdhand nicotine vape residue damages mice cells. The effects of non-nicotine vapes are inconclusive…

Thirdhand nicotine vape residue contributes to changes in some cells in mouse models but not others.

Further investigation is warranted to confirm or deny this impression.”

Stracci, Jazzlin & Ganesan, Alyssa & Pitogo, Prescious & Smith, Sheree. (2025). The Effects of Thirdhand Vape Residue from Nicotine and Non-Nicotine Vapes on Cells: A Systematic Review. International Journal of Environmental Research and Public Health. 22. 465. 10.3390/ijerph22040465.

“Vape shops are established to sell electronic cigarette (EC) devices, e-liquids or e-juices, and other related accessories.

EC use is prominent in vape shops and indoor EC use has been associated with elevated levels of nicotine and particulate matter (PM).

This study assessed health and safety conditions, practices, building characteristics, nicotine, and PM concentrations in vape shops during business hours.

Sixty-four vape shops were visited but only 15 vape shops consented to participate in this study.”

Toluwanimi M Oni, Balaji Sadhasivam, Evan L Floyd, Assessment of vape shop built environment: airborne nicotine, particulate matter, ventilation, hazard identification, workplace practices, and safety perceptions, Annals of Work Exposures and Health, 2025; https://doi.org/10.1093/annweh/wxaf018

“Whilst only a preliminary study, these results lay the foundation for future research to investigate the viability, precision, and standardisation that can be achieved with medicinal cannabis vape cartridges compared to vaporised and/or combusted flower.

Future research on medicinal cannabis vapes should focus on improving technique for inhalation and sampling to be able to develop dosing guidelines, and dose form testing, for reproducible precision and patient safety.”

Widdowson, Aaron & Benares, Mary & Farooqi, Toobah & Kinghorn, Russell & Sinclair, Justin. (2025). The Life of the Vape: Chemical Profile Characterisation Across the Life Cycle of Medicinal Cannabis Vape Cartridges. 10.20944/preprints202506.2083.v1.

“A singular day of passive E-vape administration was sufficient to induce damage and inflammation in mouse lung tissue.

This suggests that even moderate usage of e-cigarette or other vape products may constitute a risk for lung injury in humans as well.

Notably, the increased inflammation observed in the vegetable glycerin treatment group compared to the nicotine group emphasizes the harmful effects of all vaping products, including THC and flavored nicotine-free vaping devices.”

Wohlars, Khazar, Favazza, Crawford, Huang, Lee-Wong, Promisloff, and Szema. (2025). Lung Tissue Inflammation in Mice Subjected to Passive E-Vape Administration of Vegetable Glycerin and Nicotine.

“The widespread use of tobacco has evolved with the popularity of vapes, especially among young people, despite the lack of clarity in warnings about their risks.

In addition to systemic, respiratory, and cardiovascular effects, vaping is associated with an increased risk of gingivitis and periodontal disease as well as reduced antioxidant capacity of saliva.

The sample size of all included studies was composed of 31,647 participants, (14,477 male and 17,170 female) with a mean of 35.016 ± 7.57 years of age…

…the use of vapes is associated with an increased risk of periodontitis and caries.

Although users experience more oral problems than non-smokers, these are less severe than those of traditional smokers.

The widespread prevalence, especially among young people, highlights the urgency of awareness campaigns to warn of risks and understand potential harm.”

Iacob, A. M., Escobedo Martínez, M. F., Barbeito Castro, E., Junquera Olay, S., Olay García, S., & Junquera Gutiérrez, L. M. (2024). Effects of Vape Use on Oral Health: A Review of the Literature. Medicina, 60(3), 365. https://doi.org/10.3390/medicina60030365

“The highest quality and most recent systematic review with meta-analysis that investigated tobacco cigarette initiation found that ever users of vapes had over three times the risk of ever cigarette use…

There was some evidence available to support an association between vaping and having asthma, increased rate of coughing, several domains of mental ill-health, marijuana use, alcohol use and binge drinking.

We found strong, high-quality evidence that a gateway effect exists between vaping among children and future cigarette smoking based on longitudinal evidence.

There was also evidence supporting a relationship between vaping and respiratory problems, other substance use, and poor mental health indicators.”

The effects of vaping on children and adolescent health: a review of systematic reviews Reynolds, Ciara Marie Edel et al.The Lancet, Volume 404, S87. 2024.

“Inhalation of CBD aerosol resulted in greater inflammatory changes, more severe lung damage and higher oxidative stress compared with nicotine.

CBD aerosol also showed higher toxicity to human cells compared with nicotine.

Vaping of CBD induces a potent inflammatory response and leads to more pathological changes associated with lung injury than vaping of nicotine.”

Bhat TA, Kalathil SG, Goniewicz ML, et al. Not all vaping is the same: differential pulmonary effects of vaping cannabidiol versus nicotine. Thorax. 2023; 78:922-932.

“These findings add to a growing body of studies that indicate a link between e-cigarette use, tobacco smoking, and unintended consequences in young adults.

More work is needed to better understand why there are such associations and whether these may be causal relationships.

ENDS (Electronic Nicotine Delivery Systems) and vaping research typically requires a validated construct survey instrument, recruitment of participants, and self-reported answers that assess various behaviors and attitudes.

There are 2 other articles in Respiratory Care that relate to smoking, vaping, and college students that are very good examples of survey methods.

Other research designs that examine ENDS and vaping from different aspects are needed, too. For example, the authors mention addiction counseling and mental health counseling and the need for increased accessibility in reaching college students.

Support groups who can advise and inform how to eliminate barriers to addiction counseling are needed.

Lastly, health promotion and interventions targeted to ENDS users and to those who are prone to relapse are needed in understanding addiction and stress on college campuses.

Addiction and stress relief were found to be significant predictors of increased vaping use. As such, the authors underscore the shift from social motivation for vaping to the addictive component of vaping in seeking stress relief.”

Lynda Goodfellow. Is Vaping a Gateway to Addiction and Stress? Respiratory Care 2023 68:11, 1609-1610

“The results of this survey suggest that most participants believe that vaping is neither better nor a safer alternative to cigarettes.

While the scientific evidence confirms this opinion, advertisement continues to portray vaping as a better and even a safer alternative to cigarettes.”

Michael Crager, Christine Azubuike, Margelid Baez, Janet Correa, Sydney Cosby, Kristina Ramirez, and Ruben D Restrepo. Is Vaping a Better Alternative to Cigarettes? An International Survey. Respiratory Care 2022 67:Suppl_10.

“Teens and young adults have seen the biggest uptake in use of vape pens, which have superseded conventional cigarettes as the preferred modality of nicotine consumption.

Relatively little is known…about the potential effects of chronic vaping on the respiratory system”

…the consequences of long term use remain unknown

…vaping is not without risk, and that further investigation is required to establish clear public policy guidance and regulation.”

Jonas A. Impact of vaping on respiratory health BMJ 2022; 378 :e065997 doi:10.1136/bmj-2021-065997

“Research discussing both the short-term and long-term effects of vaping on the eye is limited…

…nicotine and aldehydes warrant additional investigation and increased education about the detriment that electronic cigarettes may inflict on sensitive organs.

…electronic cigarettes may induce a disturbance in tear film stability, and vape flavorings may damage the lipid layer through peroxidation.

Corneal staining has been shown to appear following exposure to e-cigarette vapor, with nicotine and acrolein potentially inducing an inflammatory response in corneal epithelial cells.

In addition, nicotine has been shown to induce nystagmus, exert vasoconstrictive effects on ocular blood flow, and may interfere with retinal light-adapted vision.”

Martheswaran, T., Shmunes, M.H., Ronquillo, Y.C. et al. The impact of vaping on ocular health: a literature review. Int Ophthalmol 41, 2925–2932 (2021). https://doi.org/10.1007/s10792-021-01842-w

“Subjects who vaped had significantly higher heart rate, breathing frequency, and oral temperature, and significantly lower blood oxygenation levels…after vaping for 20 min.

Nonvaping subjects exposed to vapor had significantly higher oral temperature after 20 min of exposure.”

The Immediate Physiological Effects of E-Cigarette Use and Exposure to Secondhand E-Cigarette Vapor. Molly L McClelland, Channing S Sesoko, Douglas A MacDonald, Louis M Davis, and Steven C McClelland. Respiratory Care 2021 66:6, 943-950

“The impact of e-cigarette use on the inflammatory state and function of the lungs is not well understood.

…due to the multitude of different e-devices and the combination of chemicals within different aerosols generated, it is clear that use of e-cigarettes does alter the inflammatory state and function of the lungs with both acute and chronic use.

This is evidenced by the multitude of inflammatory lung diseases already tied to e-cigarette use, but the causal chemicals primarily remain at large.”

Jorge A Masso-Silva, Min Kwang Byun, Laura E Crotty Alexander. Acute and chronic effects of vaping electronic devices on lung physiology and inflammation. Current Opinion in Physiology, Volume 22, 2021,100447, ISSN 2468-8673, https://doi.org/10.1016/j.cophys.2021.06.001.

“Electronic cigarettes, also referred to as e-cigarettes or electronic nicotine delivery systems (ENDS), are devices that heat a liquid substance into an aerosol which the user inhales.

Typically, the liquid includes nicotine, flavoring, and a carrier fluid such as propylene glycol or vegetable glycerin.

When electronic cigarettes became widely available in the US market in 2007, they were intended for nicotine consumption, and briefly marketed as tobacco cessation tools.

Within certain subcultures of young adults, vaping quickly became popular.

A growing number of studies indicate that people are using these devices to inhale substances other than nicotine, referred to as ‘other substance use in e-cigarettes’…

Some of these other substances include synthetic cannabinoids, methamphetamine, 3-4-Methylenedioxymethamphetamine (MDMA) and other amphetamines, cocaine, and heroin.

…cannabis appears to be the most prevalent OSUE, as Jones et al report that 29% of college students vaped cannabis in their lifetime.

College students appear to vape cannabis at higher rates than young adults in general…

College students who use cannabis tend to both vape and use combustible methods, depending upon social and physical environment.

Typically, they underestimate the risks associated with cannabis use and vaping.

Additional research is needed to further examine the behaviors and attitudes surrounding cannabis vaping among college undergraduates, as well as the development of interventions specific to this demographic.”

Nicole McKenzie, Tavis Glassman, Joseph Dake, S. Maggie Maloney, and Ling Na. Factors That Influence Cannabis Vaping Habits of College Students. Respiratory Care 2021. 66:Suppl_10

“E-cigarettes” are a class of consumer devices designed to deliver drugs, primarily nicotine or marijuana oils, to the lung by vaporization.

Regulation of the devices in the United States is relatively minimal, and research on both epidemiology and potential toxicity has focused on nicotine devices.

In 2019, an outbreak of an acute respiratory illness in the United States was traced back to the contamination of e-cigarette fluids with vitamin E acetate, which had been used to disguise the dilution of marijuana oils.

The outbreak, termed ‘e-cigarette or vaping associated lung injury’ by the U.S. Centers for Disease Control, was characterized by pulmonary infiltrates and hypoxia, which usually required hospitalization and, often, admission to ICUs.

The syndrome sickened >2,600 people, mostly young men, and killed >50 people before it began to abate 6 months later.”

Nathan K Cobb and Jigna N Solanki. E-Cigarettes, Vaping Devices, and Acute Lung Injury. Respiratory Care 2020 65:5, 713-718

“The use of e-cigarettes, or ‘vaping,’ is exploding among the pediatric population.

Over 40% of high school seniors reporting use within the past year.

Adolescents are vulnerable to the risks of e-cigarettes, as they are targeted as new consumers with advertisements and flavoring compounds, and are not utilizing them as a means to smoking cessation.

The pulmonary risks of vaping are rapidly emerging, with the most immediately alarming being the condition electronic-cigarette/vaping associated lung injury (EVALI). Additionally, there have been more recent studies showing extrapulmonary effects including cardiovascular, immunologic and neuro-developmental effects.”

“…expanding epidemic”

Overbeek, D. L., Kass, A. P., Chiel, L. E., Boyer, E. W., & Casey, A. M. H. (2020). A review of toxic effects of electronic cigarettes/vaping in adolescents and young adults. Critical Reviews in Toxicology, 50(6), 531–538. https://doi.org/10.1080/10408444.2020.1794443

“E-cigarette aerosols are exceedingly different from conventional tobacco smoke, containing dozens of chemicals not found in cigarette smoke.

It is highly likely that chronic use of e-cigarettes will induce pathological changes in both the heart and lungs.

In terms of cardiac physiology, acute exposure to e-cigarette aerosols in human subjects led to increased blood pressure and heart rate, similar to traditional cigarettes.

Chronic exposure to e-cigarette aerosols using animal models caused increased arterial stiffness, vascular endothelial changes, increased angiogenesis, cardiorenal fibrosis and increased atherosclerotic plaque formation.

Pulmonary physiology is also affected by e-cigarette aerosol inhalation, with increased airway reactivity, airway obstruction, inflammation and emphysema.

Research thus far demonstrates that the heart and lung undergo numerous changes in response to e-cigarette use, and disease development will depend on how those changes combine with both environmental and genetic factors.

E-cigarettes have been advertised as a healthy alternative to cigarette smoking, and users are under the impression that vaping of e-cigarettes is harmless, but these claims that e-cigarettes are safer and healthier are not based on evidence.

Data from both humans and animal models are consistent in demonstrating that vaping of e-cigarettes causes health effects both similar to and disparate from those of cigarette smoking.

Further work is needed to define the long-term cardiopulmonary effects of e-cigarette use in humans.”

Tsai, M., Byun, M.K., Shin, J. and Crotty Alexander, L.E. (2020), Effects of e-cigarettes and vaping devices on cardiac and pulmonary physiology. J Physiol, 598: 5039-5062. https://doi.org/10.1113/JP279754

Prior to going tobacco-free (vape-free, etc.), some organizations go through various earlier attempts and stages of change at the level of the entire organization.

Some individuals: