Healthy Life

A Mediclinic expert explains why vaping is bad for your overall health, and why teens need to be particularly aware of the risks involved in smoking e-cigarettes.

Is vaping less harmful than smoking for teens?

There is nothing healthy or risk-free about any kind of smoking – e-cigarettes included. Vaping remains a very dangerous and addictive habit due to the inhalation of potentially dangerous oils, chemicals, and nicotine the e-liquid contains. E-cigarette users are exposed to a host of toxins and harmful substances in the vapours they inhale.

“We are still finding out about the long-term health impact of vaping, as it is only within the past decade that it has become so popular,” says Dr Marisna Venter, an emergency GP at Mediclinic Hermanus. “Many people wrongly consider vaping to be safer than smoking and feel it’s okay to vape more often. But we still don’t know the exact contents of vaping liquid and/or their effects.”

In 2021, researchers at Johns Hopkins University in Baltimore, USA, found that tobacco smoke contained ±5 000 chemicals, while vape aerosols contained nearly 2 000 mostly unidentified chemicals. Like traditional cigarette smoke, e-cigarette vapour contains known harmful toxicants such as formaldehyde (used to embalm dead bodies) and the heavy metals cadmium and lead. E-vapour also contains substances not found in tobacco smoke.

Even though some flavourings used in e-juice are approved as “food grade”, an Australian study conducted in 2023 found that heating and inhaling these oils leads to a very different type of exposure. Benzaldehyde, an almond flavouring, for example, impairs the immune function of lung cells when inhaled, potentially reducing the user’s ability to deal with other inhaled toxins, or respiratory infections.

Why vape use is increasing among teens and youth

The dangers of vaping also relate to its accessibility. Dr Venter believes that because vaping is less obtrusive than cigarette smoking, and e-cigarettes can be hidden away easily in a pocket, users tend to smoke more.

“People take chances with vaping. I have even seen people using their e-cigarettes on flights because it is not as obvious as smoking cigarettes and is a very lightweight device,” she says. An important concern about vaping is that while established cigarette smokers may use it to wean themselves off tobacco, it also introduces non-smoking youth to nicotine. The sweet and fruity flavours included in vaping liquids are a lure for teens, as are disposable vapes. Many e-cigarette brands target teens directly with bright colours and appealing designs.

What makes vaping particularly dangerous among teens is that it’s in their nature to experiment, and they modify the e-cigarette devices so they can breathe into their lungs all kinds of substances; not just tobacco and flavoured oils, but also THC oil (THC is the ingredient in cannabis that makes you feel high).

How does vaping affect teen lungs?

Vaping, as with traditional tobacco smoking, is known to cause several health problems, including chronic obstructive pulmonary disease (COPD), an inflammatory lung disease that causes obstructed airflow to the lungs with symptoms of coughing and shortness of breath.

“A major problem with the oil base used in e-cigarettes, especially the devices that users modify to use with additives like THC, is the carrier oil vitamin E acetate, a condensing agent linked to e-cigarette use-associated lung injury (EVALI), commonly known as ‘popcorn lungs’,” warns Dr Venter.

Burning vitamin E acetate in a vaping device has been shown to produce a highly noxious gas called ketene, which if inhaled can cause severe lung damage in low concentrations and death in high concentrations.

EVALI, also known by the medical term bronchiolitis obliterans, is a potentially fatal syndrome associated with vaping. This lung disease is caused by a build-up of scar tissue/thickening in the lungs, which blocks the flow of air to and from the lungs and leads to permanent lung damage. The term ‘popcorn lungs’ emerged when researchers first identified the disease among workers in a factory making microwave popcorn that used diacetyl. This chemical has now been removed from microwave popcorn products but is still widely used as a flavouring agent in e-juices for e-cigarettes.

Ironically, the effect of diacetyl on the alveoli – the tiny air sacs in the lungs where the exchange of oxygen and carbon dioxide takes place – resembles the popping of corn, says Dr Venter. Once this happens, the alveoli do not recover, leading to permanent lung damage.

The warning signs of vaping are clear

In recognition of the health dangers posed by vaping and to reduce e-cigarette use among youth, Australia, New Zealand the United Kingdom on 1 January 2024 jointly banned single-use, disposable vape products, a blessing to the environment as well. Since 2021, Australians have required a prescription to lawfully access nicotine-containing vape products to wean themselves off traditional tobacco smoking.

South Africa, however, has yet to legislate this sector and anyone aged 18 or over can legally buy e-cigarettes. A study in 2024 by the Medical Research Council found that 26.3% of university students across South Africa vaped and that these students were highly exposed to e-cigarette marketing.

“Vaping is not safe. We don’t know enough about the long-term effects of vaping. We know about EVALI, and the inflammation caused to the lungs, but anything you inhale into your lungs that is not clean air is potentially harmful to your airways,” warns Dr Venter. “Remember that when you vape it’s not just water vapour you’re breathing in. There are still chemicals in e-juice and nicotine that make it very addictive and very dangerous.”

Does your teen need more information about the dangers of vaping? Find a GP who can help at your closest Mediclinic.