Health Effects
Vaping can increase your exposure to chemicals that could harm your health (e.g., cause lung damage). Vaping can also expose you to nicotine, which is addictive. There are concerns about the appeal of vaping products among youth and their potential to promote tobacco use.
What is in a vaping product?
The e-liquids found in vaping products usually contain nicotine, propylene glycol, vegetable glycerin, and flavouring chemicals. When heated, these flavouring chemicals can react with other solvents in e-liquid to form harmful by-products. Some by-products include formaldehyde (a corpse preserver and carcinogen), acrolein (used to kill weeds), cadmium (a toxic metal), and benzene (found in car exhaust). Vape products also often contain heavy metals like nickel, tin, lead, and ultrafine particles that can be easily inhaled deep into the lungs.
There exist over 7,000 unique e-liquid flavors. Flavoring components are often not included in vaping products’ ingredient lists. Many brands label ingredients as “natural or artificial flavours” but do not specify the ingredients or chemicals involved. Examples of flavourings are:
- Saccharides, which are used to make sweet flavours and degrade to produce furans and aldehydes.
- Aldehyes, which cause irritation to the respiratory tract.
- Pulegone (cancer-causing) and eucalyptol, which were identified in the menthol flavour.
While safe to eat, it is uncertain if these chemicals are safe to breathe in.
Note:
The number of substances a person can be exposed to by vaping is affected by the type of vaping device they use, battery power, power and temperature settings of the device, the type of vaping liquid and amount of nicotine, user behaviour patterns, and user’s experience with vaping. Many chemical by-products produced by vaping devices are linked to negative health effects. We are still learning more about how vaping affects health. The long-term health impacts of vaping are unknown. However, there is enough evidence to justify efforts to prevent the use of vaping products by youth and non-smokers.
Is the nicotine in vaping products safe?
While nicotine is approved for use in nicotine replacement therapies, such as the patch or nicotine gum, there are risks linked to nicotine. Nicotine is a highly addictive substance. Vaping with nicotine could lead to nicotine addiction among users who would not have started using nicotine otherwise (e.g., smoking). Research shows that regular users of vaping products without a history of tobacco use are more likely to start smoking regularly than those who don’t regularly vape.
Children and youth are especially susceptible to the harmful effects of nicotine, including addiction. They may become dependent on nicotine with lower levels of exposure than adults. Exposure to nicotine during adolescence may cause reduced impulse control, lead to cognitive and behavioural problems, affect memory and concentration and is known to alter teen brain development. Vaping may predispose youth to addiction to nicotine and possibly other drugs.
How does vaping impact long-term health?
The long-term safety of inhaling many of the substances in vaping products is unknown and continues to be assessed. Existing evidence shows that some of the known health effects are:
- Nicotine Dependence: Nicotine containing e-liquids often have high concentrations of nicotine. Thus, vaping can lead to dependence and addiction, especially among youth. Youth require lower levels of exposure than adults to develop a nicotine addiction.
- Nicotine Poisoning: Nicotine poisoning refers to the toxicity resulting from consumption of nicotine products. Vape products often contain high levels of nicotine which can increase the risk of toxicity, especially among youth. There have been fatalities as well as non-fatal nicotine poisoning caused by children swallowing vaping liquid.
- Popcorn Lung: (bronchiolitis obliterans) A chronic disease caused by the chemical diacetyl (commonly found in microwave popcorn) that damages the small airways in the lungs.
- Lung Disease: Vaping can cause a wide range of respiratory conditions and complications such as lung injuries and infections as well as asthma exacerbation, bleeding in lungs, and difficulty breathing.
- Malfunction injuries: When vapes malfunction, they can cause flame/chemical burns.
When buying a container of vaping liquid with nicotine, look for one that has a child-resistant closure and a 'poison' hazard symbol. The closure and symbol are required by law.
Vaping as a Way to Quit Smoking
Evidence shows that the aerosol produced by a vaping device has toxic effects on blood vessels and the cells that line the mouth, nose, and lungs. Vaping is also associated with increased blood pressure and respiratory injury. Most users of vaping devices want to quit, but the nicotine in these devices is addictive. For these health reasons and other factors, those who smoke in Canada and are trying to quit should consider using medically approved nicotine replacement therapies (NRT) and/or counselling. Strong evidence shows that NRTs are effective tools for quitting or cutting back on nicotine usage.
If you are unable to quit smoking through other methods and considering using vaping devices to quit smoking, remember that vaping is not without its harms. While less harmful than smoking, vaping is not harmless. It is still a nicotine delivery device and you may be risking replacing one nicotine addiction with another. It is also important to understand that using vaping devices and regular cigarettes together (dual use) can have more adverse effects than smoking or vaping alone. Daily dual use may increase your risk of a heart attack by over five times more than if you did not combine the use of vaping devices and regular cigarettes. The best way to improve your health is to stop smoking and vaping altogether. Quit programs and medically approved cessation aids are the best tools for achieving your goals.
Nicotine Withdrawal
No matter whether nicotine is consumed through smoking or vaping, nicotine is the chemical responsible for addiction. Nicotine withdrawal is the set of physical and psychological symptoms felt as nicotine wears off. These symptoms are temporary and are often signs of your body healing. For more information on nicotine withdrawal, visit our Health Effects page.
Second-hand Vapour
Vaping devices do not just emit “harmless water vapour.” Second-hand aerosol (incorrectly called vapour by the industry) from these devices contains nicotine, ultrafine particles, and low levels of toxins that are known to cause cancer.
Second-hand aerosol is made up of a high concentration of ultrafine particles, and the particle concentration is higher than in conventional tobacco cigarette smoke. Exposure to fine and ultrafine particles may exacerbate respiratory ailments like asthma, and constrict arteries which could trigger a heart attack.
The health effects of exposure to second-hand vapour are still unknown. There is some evidence that use of vaping devices increases the level of nicotine and other chemicals on indoor surfaces.
Device Malfunctions
Vaping devices are regulated under the Canada Consumer Product Safety Act. Although uncommon, another risk to consider involves defective batteries or defective vaping products that have caused fires and explosions.
If you notice a safety problem with a vaping device or vaping liquid, you can report the problem to the manufacturer or retailer, or using Health Canada’s online consumer product safety reporting page.
Batteries and Vaping Devices
Lithium-ion batteries and vaping devices can pose a hazard if they are not properly used, stored, carried or charged.
Visit the Health Canada website for tips to prevent injuries from batteries and vaping devices.
Vaping and Pregnancy
While vaping products contain fewer harmful chemicals than cigarettes, they may still contain nicotine. Talk to your health care provider about your options for quitting nicotine during pregnancy.
References
- American Nonsmokers’ Rights Foundation (2022). Electronic Smoking Devices and Secondhand Aerosol - no-smoke.org. American Nonsmokers’ Rights Foundation. https://no-smoke.org/electronic-smoking-devices-secondhand-aerosol/
- About Electronic Cigarettes (E-cigarettes). (2021). Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/basic_information/e-cigarettes/about-e-cigarettes.html
- Coleman, B. N., Rostron, B., et al. (2017). Electronic cigarette use among US adults in the Population Assessment of Tobacco and Health (PATH) Study, 2013-2014. Tobacco control, 26(e2), e117–e126. https://doi.org/10.1136/tobaccocontrol-2016-053462
- Dai, H., & Hao, J. (2016). Flavored Electronic Cigarette Use and Smoking Among Youth. Pediatrics, 138(6), e20162513. https://doi.org/10.1542/peds.2016-2513
- Health Canada. (2018). Risks of vaping. Canada.ca. https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping/…
- Heart And Stroke. (2020). Smoking and tobacco. Heart and Stroke Foundation of Canada. https://www.heartandstroke.ca/heart-disease/risk-and-prevention/lifestyle-risk-factors/smoking-and-tobacco
- National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee on the Review of the Health Effects of Electronic Nicotine Delivery Systems, Eaton, D. L., Kwan, L. Y., & Stratton, K. (2018, January 23). Toxicology of E-Cigarette Constituents. Nih.gov; National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK507184/