Health Impacts of E-Cigarettes: A Comprehensive Review of the Evidence and Public Health Implications
DOI:
https://doi.org/10.12775/QS.2025.41.60421Keywords
e-cigarettes, vaping, electronic, nicotine delivery systems, tobbaco harm reductionAbstract
Electronic cigarettes, also known as e-cigarettes or Electronic Nicotine Delivery Systems (ENDS), have quickly become a well-liked substitute for conventional tobacco products, especially among teenagers and young people. Despite being marketed as a smoking cessation assistance and harm reduction tool, their safety profile is still being investigated. The health implications of e-cigarette use on the respiratory, cardiovascular, and neurological systems, as well as possible carcinogenic consequences, are examined in this thorough literature analysis. Airway inflammation, elevated cardiovascular risk markers, mental health comorbidities, and biomarkers of DNA damage are only a few of the detrimental health impacts that are now supported by data. The long-term safety of vaping is still unknown, despite some research suggesting lower exposure to dangerous chemicals as compared to combustible tobacco. The necessity of balanced public health measures is emphasized, and global regulatory approaches are also covered. This review
concludes by highlighting the significance of prudent regulation and ongoing research to inform clinical and policy decisions on the use of e-cigarettes.
References
Birdsey J, Cornelius M, Jamal A, Park-Lee E, Cooper MR, Wang J, Sawdey MD, Cullen KA, Neff L. Tobacco Product Use Among U.S. Middle and High School Students - National Youth Tobacco Survey, 2023. MMWR Morb Mortal Wkly Rep. 2023 Nov 3;72(44):1173-1182. doi: 10.15585/mmwr.mm7244a1. PMID: 37917558; PMCID: PMC10629751.
Centers for Disease Control and Prevention (CDC). Health effects of e-cigarettes. Available from: https://www.cdc.gov/tobacco/e-cigarettes/health-effects.html
Münzel T, Daiber A, Hahad O. Are e-cigarettes dangerous or do they boost our health: no END(S) of the discussion in sight. Eur J Prev Cardiol. 2023 Apr;30(5):422–424. doi: 10.1093/eurjpc/zwac266
Hamann SL, Kungskulniti N, Charoenca N, Kasemsup V, Ruangkanchanasetr S, Jongkhajornpong P. Electronic Cigarette Harms: Aggregate Evidence Shows Damage to Biological Systems. Int J Environ Res Public Health. 2023 Sep 22;20(19):6808. doi: 10.3390/ijerph20196808. PMID: 37835078; PMCID: PMC10572885.
Honeycutt L, Huerne K, Miller A, Wennberg E, Filion KB, Grad R, Gershon AS, Ells C, Gore G, Benedetti A, Thombs B, Eisenberg MJ. A systematic review of the effects of e-cigarette use on lung function. NPJ Prim Care Respir Med. 2022 Oct 22;32(1):45. doi: 10.1038/s41533-022-00311-w. PMID: 36273009; PMCID: PMC9588082.
Wills TA, Soneji SS, Choi K, Jaspers I, Tam EK. E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies. Eur Respir J. 2021 Jan 21;57(1):1901815. doi: 10.1183/13993003.01815-2019. PMID: 33154031; PMCID: PMC7817920.
Bhatta DN, Glantz SA. Association of E-Cigarette Use With Respiratory Disease Among Adults: A Longitudinal Analysis. Am J Prev Med. 2020 Feb;58(2):182-190. doi: 10.1016/j.amepre.2019.07.028. Epub 2019 Dec 16. PMID: 31859175; PMCID: PMC6981012.
Smith ML, Gotway MB, Crotty Alexander LE, Hariri LP. Vaping-related lung injury. Virchows Arch. 2021 Jan;478(1):81-88. doi: 10.1007/s00428-020-02943-0. Epub 2020 Oct 27. PMID: 33106908; PMCID: PMC7590536.
Kundu A, Feore A, Sanchez S, Abu-Zarour N, Sutton M, Sachdeva K, Seth S, Schwartz R, Chaiton M. Cardiovascular health effects of vaping e-cigarettes: a systematic review and meta-analysis. Heart. 2025 Feb 26:heartjnl-2024-325030. doi: 10.1136/heartjnl-2024-325030. Epub ahead of print. PMID: 40010935.
Yayan J, Franke KJ, Biancosino C, Rasche K. Comparative systematic review on the safety of e-cigarettes and conventional cigarettes. Food Chem Toxicol. 2024 Mar;185:114507. doi: 10.1016/j.fct.2024.114507. Epub 2024 Feb 6. PMID: 38331086.
Lee DN, Kim HM, Stevens EM. Association of Vaping Reasons with Stress, Anxiety, and Depression Among Young Adults Who Currently Vape. Subst Use Misuse. 2025;60(2):188–194.
Do EK, Tulsiani S, Koris K, Minter T, Hair EC. Depression, anxiety, stress, and current e-cigarette use: Results from the Truth Longitudinal Cohort of youth and young adults (2022-2023). J Affect Disord. 2024 Nov 15;365:628-633. doi: 10.1016/ j.jad.2024.08.127. Epub 2024 Aug 30. PMID: 39182517.
Becker TD, Arnold MK, Ro V, Martin L, Rice TR. Systematic Review of Electronic Cigarette Use (Vaping) and Mental Health Comorbidity Among Adolescents and Young Adults. Nicotine Tob Res. 2021 Feb 16;23(3):415-425. doi: 10.1093/ntr/ ntaa171. PMID: 32905589.
Kundu A, Sachdeva K, Feore A, et al. Evidence update on the cancer risk of vaping e-cigarettes: A systematic review. Tob Induc Dis. 2025;23(January):6. doi: 10.18332/tid/192934.
Tellez CS, Grimes MJ, Juri DE, Do K, Willink R, Dye WW, Wu G, Picchi MA, Belinsky SA. Flavored E-cigarette product aerosols induce transformation of human bronchial epithelial cells. Lung Cancer. 2023 May;179:107180. doi: 10.1016/ j.lungcan.2023.107180. Epub 2023 Mar 22. PMID: 36989612; PMCID: PMC10159902.
Yayan J, Franke KJ, Biancosino C, Rasche K. Comparative systematic review on the safety of e-cigarettes and conventional cigarettes. Food Chem Toxicol. 2024 Mar;185:114507. doi: 10.1016/j.fct.2024.114507. Epub 2024 Feb 6. PMID: 38331086.
Holt NM, Shiffman S, Black RA, et al. Comparison of biomarkers of exposure among US adult smokers, users of electronic nicotine delivery systems, dual users and nonusers, 2018–2019. Sci Rep. 2023;13:7297. doi: 10.1038/ s41598-023-34427-x.
Kamal NM, Shams NS. The impact of tobacco smoking and electronic cigarette vaping on salivary biomarkers. A comparative study. Saudi Dent J. 2022 Jul;34(5):404-409. doi: 10.1016/j.sdentj.2022.05.003. Epub 2022 May 20. PMID: 35814841; PMCID: PMC9263753.
World Health Organization. E-cigarettes are harmful to health. 2020. Available from: https://www.who.int/news/item/05-02-2020-e-cigarettes-are-harmful-to-health
Centers for Disease Control and Prevention. E-cigarettes and pregnancy. Available from: https://www.cdc.gov/maternal-infant-health/pregnancy-substance-abuse/e- cigarettes.html
Tackett AP, Hébert ET, Stevens EM, Wagener TL. E-cigarette regulation: a delicate balance for public health. Addiction. 2020 Dec;115(12):2197-2199. doi: 10.1111/ add.15092. Epub 2020 May 8. PMID: 32307739; PMCID: PMC7572541.
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