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E-Cigarettes

 

E-cigarettes are the most commonly used tobacco products among kids—and it's become a significant health concern.

Electronic cigarettes, or e-cigarettes, are tobacco products that have been sold in the U.S. for about a decade. They include e-pens, e-pipes, e-hookah, and e-cigars, known collectively as ENDS—electronic nicotine delivery systems. They're also sometimes called "vapes" or "vape pens." While much remains to be determined about the lasting health consequences of e-cigarettes, there’s evolving evidence about the health risks of e-cigarettes on the lungs—including irreversible lung damage and lung disease.

The American Lung Association is very concerned that we are at risk of losing another generation to tobacco-caused diseases as the result of e-cigarettes. The Lung Association remains extremely troubled about the rapid increase of youth using these products and has repeatedly called upon the Food and Drug Administration (FDA) to increase their oversight and scrutiny of these products to protect kids.

 

What's in an E-Cigarette?

 

E-cigarettes, vapes or vape pens use a battery to heat up a special liquid into an aerosol that users inhale. It's not just harmless water vapor.

The "e-juice" that fills e-cigarette cartridges usually contains nicotine (which is extracted from tobacco), propylene glycol, flavorings and other chemicals. Studies have found that even e-cigarettes claiming to be nicotine-free contain trace amounts of nicotine. Additionally, when the e-liquid heats up, more toxic chemicals are formed.

Because the Food and Drug Administration (FDA) has not begun its review of any e-cigarette or its ingredients, nor has FDA issued any standards on the products, e-cigarette composition and effects vary. What researchers do know is that these toxic chemicals and metals have all been found in e-cigarettes: 

  • Nicotine – a highly addictive substance that negatively affects adolescent brain development
  • Propylene glycol – a common additive in food; also used to make things like antifreeze, paint solvent, and artificial smoke in fog machines
  • Carcinogens- chemicals known to cause cancer, including acetaldehyde and formaldehyde
  • Acrolein – a herbicide primarily used to kill weeds, can cause irreversible lung damage
  • Diacetyl – a chemical linked to a lung disease called bronchiolitis obliterans aka "popcorn lung"
  • Diethylene glycol – a toxic chemical used in antifreeze that is linked to lung disease
  • Heavy metals such as nickel, tin, lead
  • Cadmium – a toxic metal found in traditional cigarettes that causes breathing problems and disease
  • Benzene – a volatile organic compound (VOC) found in car exhaust
  • Ultrafine particles that can be inhaled deep into the lungs

 

The Impact of E-Cigarettes on the Lung

 

E-cigarettes are a relatively new tobacco product that have been sold in the U.S. for about a decade The e-cigarettes currently in the U.S. marketplace have not been systemically reviewed by the Food and Drug Administration to determine their impact on lung health. While much remains to be determined about the lasting health consequences of these products, the American Lung Association is very troubled by the evolving evidence about the impact of e-cigarettes on the lungs.

The Inhalation of Harmful Chemicals Can Cause Irreversible Lung Damage and Lung Disease

In January 2018, the National Academies of Science, Engineering and Medicine released a consensus study report that reviewed over 800 different studies.

That report made clear: using e-cigarettes causes health risks. It concluded that e-cigarettes both contain and emit a number of potentially toxic substances. The Academies' report also states there is moderate evidence that youth who use e-cigarettes are at increased risk for cough and wheezing and an increase in asthma exacerbations.

  • A study from the University of North Carolina found that the two primary ingredients found in e-cigarettes—propylene glycol and vegetable glycerin—are toxic to cells and that the more ingredients in an e-liquid, the greater the toxicity.
  • E-cigarettes produce a number of dangerous chemicals including acetaldehyde, acrolein, and formaldehyde. These aldehydes can cause lung disease, as well as cardiovascular (heart) disease.
  • E-cigarettes also contain acrolein, a herbicide primarily used to kill weeds. It can cause acute lung injury and COPD and may cause asthma and lung cancer.4
  • Both the U.S. Surgeon General and the National Academies of Science, Engineering and Medicine have warned about the risks of inhaling secondhand e-cigarette emissions, which are created when an e-cigarette user exhales the chemical cocktail created by e-cigarettes.
  • In 2016, the Surgeon General concluded that secondhand emissions contain, "nicotine; ultrafine particles; flavorings such as diacetyl, a chemical linked to serious lung disease; volatile organic compounds such as benzene, which is found in car exhaust; and heavy metals, such as nickel, tin, and lead."
  • The Food and Drug Administration has not found any e-cigarette to be safe and effective in helping people who use tobacco products to quit. If people are ready to quit smoking and using other tobacco products for good, they should call 1-800-QUIT NOW or talk with their doctor about finding the best way to quit using proven methods and FDA-approved treatments and counseling.

 

Common Questions About E-Cigarettes

 

Below are answers to common questions about e-cigarettes, including health consequences, risks of secondhand emissions, kids and e-cigarettes and FDA oversight.

What Are E-Cigarettes?

Electronic cigarettes, or e-cigarettes, include e-pens, e-pipes, e-hookah, and e-cigars are known collectively as ENDS— electronic nicotine delivery systems. According to the FDA, e-cigarettes are devices that allow users to inhale an aerosol containing nicotine or other substances.

Unlike traditional cigarettes, e-cigarettes are generally battery-operated and use a heating element to heat e-liquid from a cartridge (usually refillable), releasing a chemical-filled aerosol.

What's in E-Cigarettes?

The main component of e-cigarettes is the e-liquid contained in cartridges or tanks. To create an e-liquid, nicotine is extracted from tobacco and mixed with a base (usually propylene glycol), and may also include flavorings, colorings and other chemicals (such as formaldehyde and acrolein, which can cause irreversible lung damage).

Are E-Cigarettes a Gateway to Youth Smoking?

The National Academies of Science, Engineering and Medicine concluded there is "substantial evidence" that if a youth or young adult uses an e-cigarette, they are at increased risk of using traditional cigarettes.

How Many Youth Use E-Cigarettes or Vape?

The 2024 National Youth Tobacco Survey found that more than 1.6 million middle and high school students currently use e-cigarettes, with more than 1 in 4 using them daily. Additional data, rates and trends can be found in the American Lung Association’s Tobacco Trends Brief.

What Are the Health Consequences of E-Cigarette Use?

A recent study from the University of North Carolina found that even in small doses, inhaling the two primary ingredients found in e-cigarettes—propylene glycol and vegetable glycerin—is likely to expose users to a high level of toxins and that the more ingredients a user is inhaling, the greater the toxicity.

The mid-to-long-term consequences of e-cigarettes are not yet known, as it's a new product and has been sold for less than a decade in the U.S. While much remains to be determined about these lasting health consequences of these products, we are very troubled by what we see so far. The inhalation of harmful chemicals can cause irreversible lung damage and lung diseases.

Can E-Cigarettes Help Smokers Quit?

The Food and Drug Administration has not found any e-cigarette to be safe and effective in helping smokers quit. If smokers are ready to quit smoking for good, they should call 1-800-QUITNOW or talk with their doctor about finding the best way to quit using proven methods and FDA-approved treatments and counseling.

How Can Smokers Quit Their Use of All Tobacco Products?

The American Lung Association believes everyone who uses tobacco products can quit using methods that are proven safe and effective by the FDA, including the seven FDA-approved medications and individual, phone (available by calling 1-800-QUITNOW and 1-800-LUNGUSA) and group counseling (such as the Lung Association's Freedom from Smoking® program).

The American Lung Association urges everyone to quit – don’t switch!

Are There Risks of Secondhand E-Cigarette Emissions?

In 2016, the Surgeon General concluded that secondhand emissions contain, "nicotine; ultrafine particles; flavorings such as diacetyl, a chemical linked to serious lung disease; volatile organic compounds such as benzene, which is found in car exhaust; and heavy metals, such as nickel, tin, and lead."

 

Links to E-Cigarette Resources

 

Below you'll find links to other websites, reports educational materials, toolkits and more information on e-cigarettes.

 

Don't Just Switch, Quit Tobacco For Good

 

We know that quitting smoking is the single best thing you can do to improve your health. Don’t get confused by unproven claims made by tobacco and e-cigarette companies: quit smoking for good.

What’s the Best Way to Quit for Good?

Despite what e-cigarette, vape and other tobacco product companies want you to believe, switching to use of any other tobacco product is not quitting. E-cigarettes are still tobacco products, and FDA has not approved any e-cigarette as a way to quit for good. In fact, the FDA must crack down on the unproven health claims made by the e-cigarette industry because it's confusing people who want to quit.

What Are the Facts About E-Cigarettes?

The Food and Drug Administration has not found any e-cigarette to be safe and effective in helping people quit. The fact is e-cigarettes are tobacco products too.

Though we still have a lot to learn about the health consequences of vaping, we are very troubled by what we’ve seen so far. E-cigarettes still produce a number of dangerous chemicals including acetaldehyde, acrolein, and formaldehyde. As we’ve recently seen on the news, the inhalation of harmful chemicals can cause irreversible lung damage, lung diseases —and even death.

What Should I Do Instead of Switching?

Talk to your healthcare provider about developing a quit plan that includes medication plus counseling. Together, this combination results in the highest rates of success in quitting for good.

Using quit medications that are proven safe and effective such as nicotine gum, patches, inhaler and lozenges and the non-nicotine medications buproprion (Zyban®) and varenicline (Chantix®) to help relieve physical symptoms of recovery. Learn more about these medications and whether your insurance plan may cover them.

 

 

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Most recent revision January 22, 2026 12:29:02 PM

 

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