Health effects of electronic cigarettes

Electronic cigarettes (ecigs) are much less harmful than cigarettes which burn,^[1] but worse than not smoking at all. Ecigs increase the risk of asthma and chronic obstructive pulmonary disease (COPD) compared to not using nicotine at all.^[2] Pregnant women vaping may increase the risk of their children suffering asthma and COPD,^[3] but is still safer than smoking.^[4] Vaping is associated with heart failure.^[5] Unregulated or modified ecigs or liquids may be more dangerous.^[6]

The public health community is divided over the use of these devices to reduce/prevent smoking.^[7] As of 2017 they were not approved by the US Centers for Disease Control and Prevention (CDC) as a smoking cessation product,^[8] and in 2020 became regulated as a tobacco product (despite not containing tobacco). However, a 2019 study reported that 10% of participants given nicotine via gum, mouth spray, patches, etc., quit smoking, while 18% of those given vaping kits quit. Among participants still smoking, vapers smoked less.^[9] A 2021 review by Public Health England (PHE) reported vaping to be around 95% less harmful than smoking.^[1] E-cigarettes are estimated to have preserved 677,000 life–years in the US alone from 2011 to 2019.^[10]

E-cigarette use (vaping) carries some level of health risks.^[8][11] Reported risks (compared to not smoking) include exposure to toxic chemicals, increased likelihood of respiratory and cardiovascular diseases, reduced lung function, reduced cardiac muscle function, increased inflammation,^[12][13] increased drug dependency, and damage to the central nervous system.^[14] Misuse, accidents, and product malfunction issues increase risks^[15] such as nicotine poisoning,^[16][17] contact with liquid nicotine,^[18] and fires.^[19]

Randomized controlled trials provide "high-certainty" evidence that e-cigarettes containing nicotine are more effective than nicotine replacement therapy for discontinuing tobacco smoking, and moderate‐certainty evidence that they are more effective than e-cigarettes free of nicotine.^{[20][note 1]}

Some of the most common but less serious adverse effects include abdominal pain, headache, blurry vision,^[21] throat and mouth irritation, vomiting, nausea, and coughing.^[22] Nicotine is addictive and harmful to fetuses, children, and young people.^[23] Passive e-cigarette vapor exposure may be harmful to children, but more studies are needed as of 2025.^[24]

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