Last reviewed
Why e-cigarettes aren’t as safe as people think
E-cigarettes deliver high doses of nicotine and expose the lungs to chemicals and metals. Here’s what we know, and better ways to quit.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
✓ Medically reviewed by Earl Johns, MSN, PMHNP-BC
Photos are illustrative and don’t show actual patients.
E-cigarettes are often called vapes, which makes them sound harmless, like water vapor. They’re not. What you inhale is an aerosol of nicotine, flavorings and other chemicals, which is why we call them e-cigarettes.
Very high nicotine
Many e-cigarettes use nicotine salts, which deliver nicotine quickly and smoothly. Some pods or disposables contain about as much nicotine as a pack of cigarettes or more, which makes dependence develop fast.
What’s in the aerosol
The aerosol can contain fine particles, flavoring chemicals, and metals such as nickel and lead from the heating coil. Heating flavorings can create new chemicals whose long-term effects aren’t known.
Lung injury
In 2019, an outbreak of serious lung injury, called EVALI, sent thousands of people to the hospital. Most cases were linked to THC e-cigarettes containing vitamin E acetate, a reminder that unregulated products can carry hidden risks.
Mental health
Nicotine dependence can worsen anxiety and irritability between hits, and many people find themselves using e-cigarettes far more often than they ever smoked.
Less harmful isn’t harmless
For an adult who switches completely from cigarettes, e-cigarettes are likely less harmful than smoking. But many people end up using both, and the long-term risks are still unknown. FDA-approved quit medications are the safest proven way to stop.
A gentle next step
Wellthy Psychiatry offers judgment-free, LGBTQ+ affirming care by telehealth across California. A free 15-minute phone consult is an easy way to see if we’re a good fit.
This article is for general education and isn’t medical advice. If you’re in crisis, call or text 988, the Suicide & Crisis Lifeline, or call 911.
About the author
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner · UCSF-trained · Founder of Wellthy Psychiatry & Wellness
Earl provides LGBTQ+ and neurodivergent-affirming psychiatric care, blending medication management, therapy and whole-person approaches. His background includes inpatient psychiatry and community mental health at Glenn County Behavioral Health and Equity Health, a federally qualified health center. He sees clients in San Francisco and by telehealth across California.
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