Discussions around e-cigarettes and other vaping devices tend to focus on nicotine, which is highly addictive and carries other health risks. But what about nicotine-free options? Many users believe that if they stick to these products, they would only be inhaling harmless water vapor. The truth is, the other chemicals found in e-cigarette liquid, flavorings and aerosols are not safe.
A large number of these chemicals have serious health consequences, including cancer, lung disease, and heart disease. A recent study found five cancer-causing toxins in the urine of 16-year-olds who inhaled e-cigarette vapor. If they also smoked cigarettes, the levels were even higher. Another study found that some e-cigarettes release formaldehyde, a possible carinogen, when heated and inhaled.
According to the U.S. Food and Drug Administration (FDA), inhalation of chemicals found in most flavored e-cigarettes that were examined in one study is associated with respiratory disease. Diacetyl, for example, is a chemical added to food to produce a buttery taste and is harmless when ingested this way. But when heated up and then inhaled, diacetyl has been linked to a respiratory disease called bronchiolitis obliterans, which is also known as “popcorn lung,” which first appeared in workers who inhaled artificial butter flavor in microwave popcorn processing facilities. Diacetyl and other chemical flavorings found in e-juice may be considered safe to ingest in small quantities, but are dangerous when inhaled deeply and repeatedly into the lungs.
Another study evaluated 40 e-cigarette refill liquids and found toxic levels regardless of nicotine content. The toxicity seemed to be associated with the number and concentration of chemicals used in the flavoring. Though the toxicity of e-liquids varied depending on brand and flavor, this and a number of other studies found that cinnamon flavored e-cigarettes have the greatest potential health risk.
Regardless of nicotine levels, there is good reason to be concerned about the effects of the toxic chemicals found in e-cigarettes. With or without nicotine, the evidence to date suggests that e-cigarettes and other vaping devices are not risk free.
Azure Thompson, DrPH
Associate Director of Policy Research and Analysis
Dr. Thompson's work focuses on tobacco use among young adults, women and racial/ethnic minorities. Her projects include the development of tobacco-related reports for general and policy audiences and research on tobacco use among young adults.