Electronic cigarettes expose users to several documented health risks despite common misconceptions about their safety.
Key Health Concerns
- Nicotine Addiction: Most e-cigarettes contain highly addictive nicotine, leading to dependence and potential gateway use to other tobacco products, especially harmful for adolescent brain development.
- Toxic Aerosol Exposure: Inhaled aerosol carries ultrafine particles, volatile organic compounds (VOCs), heavy metals (nickel, lead), and carcinogens like formaldehyde and acetaldehyde generated during heating.
- Lung Injury Risk: E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI) causes severe respiratory distress. Vitamin E acetate in THC-containing cartridges is strongly linked, though other additives also pose risks.
- Cardiovascular Stress: Nicotine significantly elevates heart rate and blood pressure, increasing long-term risks of hypertension, arrhythmias, and atherosclerosis.
- Respiratory Irritation: Propylene glycol and vegetable glycerin base liquids can irritate the eyes, throat, and airways, exacerbating asthma and chronic lung disease.
Specific Vulnerabilities
Youth and Adolescents: Nicotine harms developing brains, impacting cognition and impulse control. Flavorings appeal to youth, increasing initiation risk.

Pregnant Women: Nicotine exposure can impair fetal brain and lung development, causing preterm birth and low birth weight.
Non-Smokers: Use introduces health risks and potential nicotine addiction where none existed previously.
Long-Term Uncertainty
While long-term research is ongoing, acute harms and chemical exposure confirm e-cigarettes are not safe alternatives to traditional cigarettes. Complete cessation of all tobacco products offers the greatest health benefit.