What are the risks of electronic cigarette (e-cigarette) use?

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Last updated: April 13, 2025View editorial policy

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From the Guidelines

Vaping carries significant health risks and should be avoided. The primary risks include nicotine addiction, which is particularly concerning for adolescents as it can harm brain development 1. Vaping can cause serious lung damage, including a condition called EVALI (e-cigarette or vaping product use-associated lung injury), which has led to hospitalizations and deaths. Users may experience respiratory issues like coughing, shortness of breath, and chest pain. The aerosol contains harmful substances including formaldehyde, acrolein, and metal particles that can damage lung tissue and potentially cause cancer with long-term use 1.

Some of the key health risks associated with vaping include:

  • Nicotine addiction
  • Serious lung damage, including EVALI
  • Respiratory issues, such as coughing and shortness of breath
  • Cancer risk with long-term use
  • Defective batteries in vaping devices can cause explosions resulting in serious injuries

It is essential to advise individuals with diabetes to avoid vaping and using e-cigarettes, either as a way to stop smoking combustible cigarettes or as a recreational drug 1. If people are using e-cigarettes to quit, they should be advised to avoid using both combustible and electronic cigarettes, and if using only e-cigarettes, they should be advised to have a plan to quit these also 1. The use of electronic cigarettes (e-cigarettes) should be discouraged because they are not harm-free, and evidence from several studies indicates that acute inhalation of e-cigarettes leads to negative changes in vascular endothelial function 1.

Overall, while vaping may be less harmful than smoking traditional cigarettes, it is not safe, especially for non-smokers, pregnant women, and young people 1. Anyone experiencing breathing difficulties after vaping should seek immediate medical attention. The most recent and highest quality study recommends avoiding vaping and using e-cigarettes due to the significant health risks associated with their use 1.

From the Research

Risks of Vaping

  • The risks of vaping are not fully understood, but studies have shown that it can have negative effects on respiratory health 2, 3.
  • The 2019 E-cigarette or Vaping Use-Associated Lung Injury (EVALI) outbreak highlighted the potential harms of vaping, and the consequences of long-term use remain unknown 2.
  • Vaping has been linked to pulmonary risks, including electronic-cigarette/vaping associated lung injury (EVALI), as well as extrapulmonary effects such as cardiovascular, immunologic, and neuro-developmental effects 3.
  • The use of e-cigarettes, or "vaping," is prolific among youth, with over 40% of high school seniors reporting use within the past year, and adolescents are vulnerable to the risks of e-cigarettes 3.
  • Public health efforts are urgently needed to decrease or eliminate new e-cigarette initiation, and support should be established to assist current e-cigarette users with cessation 3.

Comparison to Smoking Cessation Methods

  • Nicotine e-cigarettes have been shown to be effective for smoking cessation, with high-certainty evidence that they are associated with higher quit rates than control 4.
  • Varenicline and cytisine are also effective for smoking cessation, with high-certainty evidence that they are associated with higher quit rates than control 4.
  • Combination nicotine replacement therapy (NRT) has been shown to be effective for smoking cessation, with an additive effect that is comparable to nicotine e-cigarettes, varenicline, and cytisine 4.
  • Bupropion may slightly increase rates of serious adverse events (SAEs), although the certainty of this evidence is moderate 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Impact of vaping on respiratory health.

BMJ (Clinical research ed.), 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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