Over a decade ago, e-cigarettes entered the market, offering smokers a glimmer of hope in their efforts to quit traditional tobacco. Marketed as a cleaner and safer alternative, these devices quickly gained widespread popularity. Their sleek designs, enticing fruity flavors, and easy availability made them especially appealing to young people. However, mounting scientific evidence has begun to shatter this perception. Once hailed as a breakthrough in tobacco harm reduction, e-cigarettes are now increasingly linked to a range of serious health risks. Medical experts warn that what was initially seen as a cessation aid has rapidly evolved into a new and growing global public health concern.

According to the World Health Organisation (WHO), there is an alarming increase in use of e-cigarettes among children and young people, with rates exceeding adult use in many countries.

"E-cigarettes target children through social media and influencers, with at least 16 000 attractive flavours. Some of these products use cartoon characters and have sleek designs, which appeal to the younger generation. Some look like toys and games."

Nicotine, the primary ingredient in most e-cigarettes and traditional tobacco products, is a highly addictive substance that affects the brain’s reward system, making it extremely difficult for users to quit.

Dr. Rakesh Pandit, Senior Consultant & HOD- Internal Medicine, Aakash Healthcare explained, “Nicotine addiction develops quickly, especially in adolescents, because it triggers the release of dopamine which reinforces the urge to continue use. Over time, this not only fosters dependence but also increases the risk of transitioning to traditional smoking or other forms of substance abuse. . Vaping causes a serious condition called popcorn lung which is a form of chemical pneuminits. Medical research consistently supports this, showing that even occasional use can lead to long-term addiction."

"The prevalence of e-cigarette use among youth has escalated into a concerning epidemic, leading to the onset of nicotine addiction at an early age. Exposure to nicotine during adolescence can impair brain development, impacting attention, learning, and memory," warned Dr. Praveen Gupta, Principal Director &  Chief of Neurology.

Apart from their highly addictive nature, a common misconception surrounding e-cigarettes is that they are safe for regular use. However, health experts strongly refute this claim, warning that these devices contain a range of harmful chemicals that can seriously damage both the lungs and the cardiovascular system.

"E-cigarettes contain potentially harmful substances, like nicotine and ultrafine particles, which can directly go into the lungs. They also contain flavouring agents, like diacetyl, which is the chemical linked to serious lung diseases. They also contain volatile organic compounds, cancer-causing chemicals and heavy metals such as nickel, tin and lead. All these substances are very harmful," Dr. Sunil Rana, Associate Director and Head- Internal Medicine (Unit III), said Asian Hospital.

"Various studies have revealed that e-cigarettes contain numerous ingredients that pose serious health risks, particularly to the lungs and cardiovascular system. Among these are polyethylene glycol, vegetable glycerin, and a range of aromatic compounds such as aldehydes, acrolein, and formaldehyde—all of which are known to be harmful when inhaled. Acrolein, for instance, is a toxic chemical commonly used as a herbicide to kill weeds and even bees, and it has been linked to acute lung injury. Public perception often overlooks these dangerous substances due to absence of tobacco" said Dr Tanmay Kulkarni, Consultant - Cardiology from Jupiter Hospital.

According to experts, the primary components of most e-cigarette liquids—prophylene glycol and vegetable glycerin—are generally regarded as safe for ingestion in food products, but not for inhalation.

"When these substances are heated during vaping, they can decompose into harmful chemicals like formaldehyde and acrolein. These toxic byproducts are known to irritate and inflame lung tissue, potentially leading to chronic respiratory conditions such as bronchitis and exacerbating existing issues like asthma over time." added Dr. Sunil Rana.

"On the cardiovascular front, e-cigarettes frequently contain nicotine, a potent stimulant. Even in relatively small doses, nicotine can elevate heart rate and blood pressure, constrict blood vessels, and place additional strain on the heart—factors that significantly increase the risk of heart disease and other vascular complications." added Dr Tanmay Kulkarni.

 

 Lacking Regulatory Oversight

One of the most pressing concerns surrounding e-cigarettes is the glaring lack of regulatory oversight as these products remain overwhelmingly accessible despite partial or informal bans.

"With minimal checks on their composition, labeling, and marketing, many e-cigarette products reach consumers with undisclosed or inaccurately listed ingredients, inconsistent nicotine levels, and questionable safety standards. Without rigorous oversight, manufacturers can bypass safety standards, making it difficult for users to know what they are actually inhaling. This is a serious public health lapse that must be addressed before we see long-term consequences on a much larger scale.”

Medical experts urge stricter regulations and increased public awareness to combat this emerging public health concern.