Originally marketed as a tool for smoking cessation, a study published in JAMA on 5 March 2025 has shown that not only is vaping ineffective in increasing smoking cessation, it is actually associated with reduced tobacco abstinence and prolonged nicotine dependence.
Research also indicates that youths who vape but have never smoked cigarettes are more likely to pick up tobacco smoking compared to youths who never vaped. Beyond being ineffective in helping smokers quit their habit, recent studies show vapes are also responsible for several negative health effects.
We hear from cardiologist Dr. Jeremy Chow and respiratory specialist Dr. Alvin Ng on the negative effects vaping leaves on your cardiovascular and pulmonary health.
Vaping works by using a heating coil in the device to heat the vape liquid into aerosol form to be inhaled. The vape liquid typically contains nicotine, flavourings, and glycerine, which produce the vapor. While both vaping and smoking involve inhaling nicotine, they differ in the method used, as cigarettes burn tobacco, which creates smoke, and vapes heat liquid into the aforementioned aerosol.
Some commonly found substances in vapes include cancer-causing compounds such as formaldehyde and benzene, as well as toxic metal nanoparticles like tin, lead, and nickel.
Certain compounds in vapes may be highlighted to be “food safe,” and this may mislead users to believe the products are safe to use and be inhaled. However, being “food safe” means that the compounds are safe for consumption, not inhalation. The process of heating the compounds may also alter their chemical structure from “safe” into something dangerous.
While standard vapes already carry significant risks, newer variants such as K-pods are proving to be even more dangerous
Vapes come in various forms, with one gaining popularity in recent months—K-pods. According to the Ministry of Health, the number of cases involving K-pods has nearly tripled in the first six months of 2025, rising to 28 cases from the 10 cases reported in 2024.
According to Dr. Alvin, K-pod gets its name from the use of ketamine in the vape liquid. However, currently the main drug found in K-pods is etomidate, a fast-acting anesthetic used in medical procedures.
“The contents of vapes are somewhat similar to cigarettes—both contain nicotine, tar, and other harmful substances that can affect long-term health,” Dr. Alvin elaborates. “K-pods are even more dangerous than regular vapes because, on top of nicotine and tar, they are laced with substances such as etomidate, and in some cases, even cannabis.”
As Dr. Alvin states, the danger with K-pods arises due to the fact that the use of etomidate in these procedures is often in carefully calculated doses and are injected intravenously into the patient instead of being inhaled through aerosols.
Doing so may have dangerous consequences for the user’s health, resulting in nausea and vomiting, changes to your breathing and blood pressure, seizures, psychosis, and uncontrollable muscle spasms which have given K-pods users the nickname of “zombies” for the zombie-like state they appear to be in. In severe cases, K-pods have also been linked to fatalities.
Vaping initially started out as a tool for smoking cessation among smokers. It was a device that carried nicotine to relieve the user’s urge to smoke while not carrying the harmful chemicals known to be in cigarettes.
However, the issue lies in the high concentration of nicotine present in vapes, and Dr. Chow has noted that sometimes the concentration of nicotine in vapes is as high, or even higher, than in conventional cigarettes. This is not only ineffective with cigarette cessation, but sometimes users might end up using both their vapes and cigarettes, giving them twice the dose of nicotine. This continual inhalation of nicotine will inevitably lead to health problems.
“You are going to get an increased heart rate and increased blood pressure; it’s going to cause your blood vessels to stiffen over time,” Dr. Chow shares. “And recent studies have shown that [vaping] can cause quite a fair bit of damage to your blood vessels.”
As Dr. Chow puts it, an increased heart rate and blood pressure are “drivers for causing cardiac events,” and the stiffening of your blood vessels can, over time, result in atherosclerosis and the development of plaques. Although more research has to be conducted on vaping for a more comprehensive analysis of its ill effects, doctors have been noticing acute changes in parameters relating to the heart health of their younger patients.
“We are concerned that young people are putting themselves at risk of heart attacks and strokes at a much earlier age,” Dr. Chow adds.
Aside from cardiovascular health effects, vapes are also known for having a negative pulmonary effect, with the term ‘e-cigarette or vaping product use-associated lung injury’ (EVALI) coined to address this issue.
According to a study published in 2021, it reports that vape users are more likely to report chronic respiratory symptoms in both adolescents and adults. A separate study conducted on South Californian high school students found that past and current vaping was associated with a nearly two-fold increase in the risk of chronic bronchitis symptoms.
Bronchiolitis obliterans (BO), otherwise more commonly known as “popcorn lungs,” is a rare condition that results from damage to the airways in the lungs. The primary culprit is diacetyl, a chemical often added to flavored vape liquid to enhance its taste. Inhaling diacetyl causes inflammation of the lungs and may lead to permanent scarring, making breathing difficult over time.
Dr. Alvin shared that there were several cases in 2019 where young patients ended up in the ICU with severe pneumonia.
“Their doctors tried to test whether it was due to bacteria or viruses, but they couldn't find a source,” Dr. Alvin said. “The only common factor they found was that they were all using vapes, and they postulated that they were inhaling substances into their lungs, which their lungs are sensitive to, and ended up developing an allergic type of pneumonia called E-cigarette or vaping use-associated Lung Injury (EVALI). The lung condition became very severe, with some patients requiring life support and others tragically passing away from severe pneumonia.”
All hope is not lost for vape users, as Dr. Chow shares that much like cigarette quitting, those who quit vaping will be able to see reversals in some of the damage caused to their body as a result of vaping.
“I think within 1-2 weeks, you will be able to see some changes. Some of these [changes], if you start and stop early, it will probably, hopefully, not be permanent,” Dr. Chow said.
Not all the benefits will be felt physically, as some research indicates that the relationship between cigarette smoking and depressive symptoms in youths may also be present in those who are choosing to quit vaping. Additional studies and research in time to come will be needed to more accurately assess the benefits of quitting vapes.
Although vaping was once marketed as the safer alternative, the evidence now paints a different picture. Quitting may feel daunting, but the body is resilient, and with the right support, recovery is possible and long-term health can be protected.
