Table of ContentsView AllTable of ContentsIncreased SymptomsRisk of Developing AsthmaRisk of Other Lung ConditionsVaping for Smoking CessationSide EffectsOther Ways to Quit
Table of ContentsView All
View All
Table of Contents
Increased Symptoms
Risk of Developing Asthma
Risk of Other Lung Conditions
Vaping for Smoking Cessation
Side Effects
Other Ways to Quit
When they were first introduced into the market,electronic cigarettes(also known as e-cigarettes) were branded as the “safe” alternative to traditional cigarettes. Because of this, many people withasthmawere encouraged to switch to e-cigarettes—that is, vape instead of smoke—under the presumption that the aerosolized vapors were less likely to trigger anasthma attack.
But studies now suggest that this may not be the case. There is, in fact, growing evidence that the use of e-cigarettes (vaping) can not only make asthma harder to control but may actually contribute to the development of the disease in those who don’t yet have it.
Verywell / Ellen Lindner
Increased Symptoms and Asthma Attacks
Most e-cigarette devices consist of a vaporization chamber, a nicotine cartridge with chemical flavorings, and a rechargeable battery. When inserted into the vaporization chamber, the chemicals inside the cartridge are heated and atomized into an inhalable mist.
This inhalable mist, according to the U.S. Surgeon General, contains a variety of volatile chemicals that can cause short- and long-term harm to the lungs. These include heavy metals (like tin, nickel, and lead) and oily substances that can become trapped in smaller airways.
Some of these compounds (like the flavoring diacetyl, used to create buttery flavors) not only incite lymphocytic inflammation—the type associated withallergic asthma—but can also cause the progressive hardening and narrowing of the airways, making it all the more difficult to breathe during an attack.
There has been more and more evidence that many of the chemicals in e-cigarettes may be even more likely to trigger an attack in certain people than those in regular cigarettes.
Altered Immune Response
Evidence also suggests that vaping can change the body’simmune responsein a way that increases a person’s vulnerability toasthma triggers.
According to a 2018 study in the journalThorax, aerosolized chemicals in e-cigarettes immobilize immune cells called alveolarmacrophagesthat the body uses to remove allergens, dust, and other asthma triggers from the lungs.
Secondhand Exposure
Why Does Vaping Hurt My Throat?
The exactcause of asthmaremains unknown, but the disease is believed to be the result of a combination of genetic and environmental risk factors. How (or if) vaping plays a role in the development of asthma is equally unclear.
With that said, there is epidemiologic evidence linking vaping to the onset of asthma symptoms in high schoolers. People in this age group remain the prime consumers of e-cigarettes in the United States.
According to research published inPreventive Medicine, use of e-cigarettes among high schoolers is associated with a 1.5-fold increased risk of asthma compared to high schoolers who have never vaped.
Furthermore, research from John Hopkins University found that non-smokers who vape have a higher risk of asthma, often developing the disease between the ages of 18 and 24.
While it is too early to suggest that e-cigarettes “cause” asthma, they appear to contribute to the risk and are now considered an independent risk factor for the development of the disease.
E-cigarettes pose several concerns when it comes to your health, especially your pulmonary health. And while these can affect any users and are of great concern, they especially do so if you have asthma given your already compromised airways and existing risk of certain complications, such aspneumonia.
For example, the aforementioned team of Johns Hopkins' researchers found that non-smokers who vape have an increased risk ofchronic obstructive pulmonary disease (COPD)—as much as 2.6 times higher—and tend to develop the disease between ages 30 and 34.
This suggests that the ongoing use of e-cigarettes can cause a cascade of respiratory illnesses over time and may even speed the development of COPD, a disease that typically affects people 45 and over.Of note, asthma itself is considered arisk factor for COPD.
While it is true that e-cigarette solutions contain ingredients that are generally regarded as safe in their inert form, the heating of these ingredients can cause changes in their consistency and increase their toxicity in the lungs.
Take coconut oil and the sweetener glycerol, two ingredients commonly used in vaping products, for example. Both are well-tolerated on the skin or in the digestive tract, but can cause inflammation when inhaled and accumulate in the airways as the thickened oils cling to tissues. Over time, this can lead to a rare respiratory condition called lipoid pneumonia (a form ofaspiration pneumonia).
Other ingredients like diacetyl can lead to an irreversible condition calledbronchiectasisin which the airways become permanently widened with an irregular wall.
Formaldehyde and benzene are two examples of majorcarcinogensfound in e-cigarette vapors that are linked not only tolung cancerbut other cancers such asleukemiaandbreast cancer.
Whether this willincrease the risk of cancerin later life is still unclear. Because vaping was only introduced to the U.S. market in 2007,it may be many years before scientists are able to fully evaluate the true long-term harms of e-cigarettes.
Arguably, though, the most harmful ingredients used in vaping are THC and vitamin E acetate. The Centers for Disease Control and Prevention (CDC) regard them as major causes of hospitalizations and deaths among e-cigarette users.
As of February 2020, 68 Americans have died and more than 2,800 have been hospitalized as a result of e-cigarette use. The majority were under the age of 35, 82% of whom used a THC-containing product.
The majority of people with e-cigarette-associated lung injury (EVALI) also had traces of vitamin E acetate in their lungs.
These factors not only increase the frequency and severity of asthma attacks but may increase the risk of COPD and other lung diseases in people who have never smoked.
Vaping should,in no way, be considered a “healthier” alternative to tobacco smoke—for those with asthma or without it. Since 2014, public health officials have noted an alarming spike in the number of e-cigarette-related illnesses in users as young as 17 and old as 75.
Furthermore, cigarette smoking is known to be a risk factor for the frequency and severity of acuteasthma symptoms. Not only are smokers less able to control the disease compared to non-smoking counterparts, but they are more likely to require hospitalization forsevere attacks.
Smoking cessation, while encouraged for everyone, is obviously something that is stressed for those with asthma for these reasons.
Some studies do suggest that when used as part of a combination approach with counseling and other cessation aids, such as Chantix (varenicline), e-cigarettes can be a very effective tool for quitting smoking.
When used on their own without medical oversight, however, the benefits are far less certain. And e-cigarettes do pose other health concerns that must be considered when weighing them against other cessation tools.
Side Effects of Vaping
However, in addition to the risks of developing or worsening pulmonary and other diseases, the fact that nicotine is addictive must be kept in mind.
Clearly, this poses a risk of a first-time addiction for those who vape but have never smoked. But studies have also shown that people who use e-cigarettes for smoking cessation tend to stay on the device longer than those who use other cessation aids.The nicotine dose in e-cigarettes is higher than in patches or gums, so the risk of a secondary addiction in those trying to quit smoking is increased.
In addition to this, there are other side effects that you should be aware of.
Even at low doses, vaping can also cause:
At high doses, vaping can cause potentially severe side effects, including:
Call 911 or seek emergency care if you use e-cigarettes and develop some or all of the following symptoms of ARDS:Severe shortness of breathLabored and rapid breathingExtreme tirednessDizziness or faintingNausea or vomitingBlurred visionConfusion
Call 911 or seek emergency care if you use e-cigarettes and develop some or all of the following symptoms of ARDS:
Safety of Vaping Marijuana vs. Smoking
Particularly if you have asthma, it’s recommended that you don’t smokeorvape. If you already smoke and still decide that you want to include e-cigarettes as part of your smoking cessation plan, do so under the care of a healthcare provider with clearly set goals.
Other effective smoking cessation aids that you may want to consider and discuss with your healthcare provider include:
You may find that many of the most effective cessation aids are available free of charge under theAffordable Care Act, even for multiple quit attempts.
Support groups and counseling are also invaluable tools that can improve your odds of quitting.
Best Aids to Help You Stop Smoking
A Word From Verywell
Vaping has become more than a fad with an estimated 11 million users in the United States. Due to the known and unknown that risks e-cigarettes pose, it is difficult to endorse their use or regard them as a “safer” alternative to smoking. This is especially true if you have asthma. In the end, the risks of vaping may well exceed the benefits.
Vaping and Smoking Pose Different Dangers
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Office of the U.S. Surgeon General.The facts on e-cigarette use among youth and young adults.
Occupational Safety and Health Administration (OSHA).Flavorings-related lung disease.
Scott A, Lugg ST, Aldridge K, et al.Pro-inflammatory effects of e-cigarette vapour condensate on human alveolar macrophages.Thorax.2018;73(12):1161-69. doi:10.1136/thoraxjnl-2018-211663
Bayly JE, Bernat D, Porter L, Choi K.Secondhand exposure to aerosols from electronic nicotine delivery systems and asthma exacerbations among youth with asthma.Chest.2019;155(1):88-93. doi:10.1016/j.chest.2018.10.005
Jenssen BP, Boykan R.Electronic cigarettes and youth in the United States: A call to action (at the local, national and global levels).Children (Basel).2019;6(2):30. doi:10.3390/children6020030
Schweitzer RJ, Wills TA, Tam E, Pagano I, Choi K.E-cigarette use and asthma in a multiethnic sample of adolescents.Prev Med. 2017;105:226-31. doi:10.1016/j.ypmed.2017.09.023
Cho JH, Paik SY.Association between electronic cigarette use and asthma among high school students in South Korea.PLoS ONE.2016;11(3):e0151022. doi:10.1371/journal.pone.0151022
Osei AD, Mirbolouk M, Orimoloye OA, et al.The association between e-cigarette use and asthma among never combustible cigarette smokers: behavioral risk factor surveillance system (BRFSS) 2016 & 2017.BMC Pulm Med. 2019;19(1):180. doi:10.1186/s12890-019-0950-3
Clapp PW, Peden DB, Jaspers I.E-cigarettes, vaping-related pulmonary illnesses, and asthma: A perspective from inhalation toxicologists.J Allergy Clin Immunol. 2020;145(1):97-9. doi:10.1016/j.jaci.2019.11.001
Farsalinos KE, Voudris V, Spyrou A, Poulas K.E-cigarettes emit very high formaldehyde levels only in conditions that are aversive to users: A replication study under verified realistic use conditions.Food Chem Toxicol. 2017;109(Pt 1):90-4. doi:10.1016/j.fct.2017.08.044
Swenberg JA, Moeller BC, Lu K, Rager JE, Fry R, Starr TB.Formaldehyde carcinogenicity research: 30 years and counting for mode of action, epidemiology, and cancer risk assessment.Toxicol Pathol.2013 Feb;41(2):181-9. doi:10.1177/0192623312466459
Hsu G, Sun JY, Zhu SH.Evolution of electronic cigarette brands from 2013-2014 to 2016-2017: Analysis of brand websites.J Med Internet Res. 2018;20(3):e80. doi:10.2196/jmir.8550
Centers for Disease Control and Prevention.Outbreak of lung injury associated with the use of e-cigarette, or gaping, products.
Centers for Disease Control and Prevention.Health effects of cigarette smoking.
Stapleton M, Howard-thompson A, George C, Hoover RM, Self TH.Smoking and asthma.J Am Board Fam Med.2011;24(3):313-22. doi:10.3122/jabfm.2011.03.100180
Valentine G, Sofuoglu M.Cognitive effects of nicotine: Recent progress.Curr Neuropharmacol.2018;16(4):403-4. doi:10.2174/1570159X15666171103152136
Meier E, Tackett AP, Wagener TL.Effectiveness of electronic aids for smoking cessation.Curr Cardiovasc Risk Rep. 2013;7(6):8. doi:10.1007/s12170-013-0343-8
Butt YM, Smith ML, Tazelaar HD, et al.Pathology of vaping-associated lung injury.N Engl J Med.2019;381:1780-1. doi:10.1056/NEJMc1913069
Blaha MJ, Ratchford EV.Electronic cigarettes.Vasc Med.2019;24(3):267-9. doi:10.1177/1358863X19837361
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