Understanding the Hidden Health Risks of Vaping

By the numbers

Vaping and e-cigarette use is not without consequences

Facts and misconceptions about vaping

From misconceptions about vape emissions being just water vapor to the belief that vaping is safe during pregnancy, widespread assumptions are not necessarily supported by current scientific evidence. Explore below to discover what risks might be hiding behind each misconception.

Vape emissions are not just water vapor

Vape devices operate by heating e-liquid to high temperatures, causing the production of vape emissions. E-cigarette emissions include vapors (i.e., the gaseous phase in the emission), but most of the cloud produced (and that which is visible) is an aerosol. Aerosols encompass both naturally occurring substances like dust, fog, and smoke, as well as man-made substances like particulate air pollutants, sprays, and emissions from vape devices. E-liquids contain an array of chemicals. These chemicals are often not disclosed on the product label, even if ingredients are listed (which they may not be). A typical e-liquid contains propylene glycol and vegetable glycerin as the main ingredients, as well as nicotine, flavoring agents, and a variety of other potentially harmful substances.  

Vaping is not safe during pregnancy or breastfeeding

Vaping during pregnancy can cause adverse effects for the mother and the developing fetus. Some studies have found that vaping during pregnancy increases the risk of small-for-gestational-age birth compared to babies of women who do not vape. Heavy metals have been linked to an increased risk of abnormalities during fetal development. Additionally, exposure to a main metabolite of nicotine, cotinine, has been linked to behavioral and psychological impacts on children.   

Secondhand exposure to vaping when pregnant can also cause issues with unborn children, including the potential transfer of glycerol and heavy metals into cord blood.  

Those who are pregnant should discuss the impacts of vaping with their healthcare provider.

Secondhand vaping may harm those around you

The idea that vaping does not harm those nearby is a misconception. The exhaled vape emissions linger in the air and can be unknowingly inhaled by bystanders in secondhand vaping, a process akin to secondhand smoking. Secondhand vaping emissions can accumulate on clothes, hair, dust, and furniture, leading to thirdhand vaping exposure for bystanders of all ages, such as a toddler who touches vaping residue on furniture and ingests it due to hand-to-mouth behavior. These exposures are exacerbated in indoor spaces, especially if there is minimal ventilation. One study reported that increased secondhand vaping emissions are associated with a higher risk of wheezing, bronchitis-like symptoms, and asthma attacks in youth. Studies also suggest that thirdhand vaping impairs lung function and health. Non-users sharing a home with vape users had significant levels of certain associated chemicals in their saliva and urine compared to non-users in control homes, which indicates that individuals can be exposed to secondhand and thirdhand vaping emissions by living with ENDS users.  

Anyone interested in the impacts of vaping on bystanders and indoor environments should consider these factors: 

• Exhaled vape emissions linger in the air and impact the health of those around them. 
• Vaping impacts indoor air quality and bystanders in the same space through secondhand exposure. 
• Secondhand vaping emissions can accumulate on clothes, hair, dust, and furniture, leading to thirdhand vaping exposure by bystanders of all ages.

Vaping waste pollutes the environment

Single-use and rechargeable vape devices are increasingly popular. Federal guidelines prohibit manufacturers and users from throwing away this waste in household trash and mandate a disposal management system, which includes discarding these items in a household hazardous waste collection site. However, these standards are often disregarded, with a lack of collection sites in place, and users may not even know that throwing a vape device in the trash is prohibited. According to the Centers for Disease Control and Prevention (CDC), the number of vaping devices sold annually in the U.S., if lined up, would stretch over 7,000 miles—enough to span the continental U.S. twice. This scenario has resulted in a large and increasing amount of toxic and plastic waste from disposable vapes and pods going to landfills. Waste from each vape device contains unused e-liquid (which may contain nicotine), a battery (usually lithium), a metal heating coil, and a non-biodegradable plastic case. Lead and mercury from these devices can leach into soil and sand. Beyond chemical leaching, the non-biodegradable case and other parts, such as the nicotine pod, will end up in oceans and threaten ocean life; ocean conservancy and beach cleaning volunteers have reported a significant increase in vaping device waste, even as cigarette butt waste has declined. With the increased use and acceptability, vape waste could become the number one waste and litter item in the U.S., persisting in nature without decomposing. 

Anyone interested in vaping waste or its environmental effects should consider these factors: 

• Vape users should never dispose of device parts in the regular trash. 
• Vape device parts can contaminate the environment. 
• Leftover nicotine in a vape device can contaminate the environment. 
• Vape device parts should be disposed of at proper recycling centers. 

Source: UL 200D Guidance Document: Science Education and Research on Vaping and Interventions for Community Engagement (SERVICE).
This document was produced by a task force co-chaired by Christa Wright, Ph.D., Research Director within Chemical Insights and Jonathan Shannahan Ph.D.,
of Purdue University, under a grant from the National Institute of Dental and Craniofacial Research (project number 1R56DE031814-01) .