Keywords
Adolescents
Respiratory health
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To evaluate the respiratory and systemic impacts of electronic cigarette use in adolescents and young adults, with emphasis on pathophysiological mechanisms and recent evidence. Literature review: The use of electronic cigarettes has increased among young people, exposing them to aerosols containing propylene glycol, glycerol, nicotine, formaldehyde, acrolein, heavy metals, and flavoring agents. These compounds can induce inflammation, oxidative stress, epithelial dysfunction, and lung injuries, detectable through methods such as the Lung Clearance Index, even when spirometry results are normal. Beyond the respiratory system, effects have been observed in the central nervous system, with neurotoxic potential and risk of dependence; in the cardiovascular system, with increased heart rate and blood pressure; and in the gastrointestinal system, with acute symptoms and chronic inflammation. Mechanisms such as chemical irritation, neutrophil infiltration, increased pro-inflammatory cytokines, and production of reactive oxygen species are implicated in pathogenesis. The use of nicotine salts and flavorings, such as diacetyl, increases the potential for dependence and the risk of diseases such as bronchiolitis obliterans and EVALI. Final considerations: Electronic cigarettes are considered a significant health risk, including potential carcinogenicity, justifying preventive and educational strategies mainly aimed at young people.
References
ALEXANDER LEC, et al. Identifying, tracking, and treating lung injury associated with e-cigarettes or vaping. The Lancet, 2019; 394(10214): 2041-2043.
BHAVE SY e CHADI N. E-cigarettes and vaping: a global risk for adolescents. Current Opinion in Pediatrics, 2021; 33(4): 378-383.
CAO DJ, et al. Review of health consequences of electronic cigarettes and the outbreak of electronic cigarette, or vaping, product use-associated lung injury. Journal of Medical Toxicology, 2020; 16: 295-310.
CHAFFEE BW, et al. E-cigarette use and adverse respiratory symptoms among adolescents and young adults in the United States. Preventive Medicine, 2021; 153: 106766.
CHAFFEE BW, et al. Electronic cigarettes and oral health. Journal of Dental Research, 2021; 100(9): 906-913.
CHONG-SILVA DC, et al. Electronic cigarettes: “wolves in sheep’s clothing”. Jornal de Pediatria, 2024; 101(2): 122-132.
HAMBERGER ES e HALPERN-FELSHER B. Vaping in adolescents: epidemiology and respiratory harm. Current Opinion in Pediatrics, 2020; 32: 378-383.
IZQUIERDO-CONDOY JS, et al. Direct health implications of e-cigarette use: a systematic scoping review with evidence assessment. Frontiers in Public Health, 2024; 12: 1427752.
LYZWINSKI LN, et al. Global youth vaping and respiratory health: epidemiology, interventions, and policies. NPJ Primary Care Respiratory Medicine, 2022; 32: 14.
MCALINDEN KD, et al. The rise of electronic nicotine delivery systems and the emergence of electronic-cigarette-driven disease. American Journal of Physiology – Lung Cellular and Molecular Physiology, 2020; 319: 585-595.
MCGRATH-MORROW SA, et al. The effects of nicotine on development. Pediatrics, 2020; 145(3): 20191346.
MUGHIS M, et al. Assessment of respiratory health implications of vaping: a systematic review of toxicity mechanisms and adverse effects of electronic nicotine delivery systems. Cureus, 2024; 16(9): 69236.
PARK JA, et al. Vaping and lung inflammation and injury. Annual Review of Physiology, 2022; 84: 611-629.
ROSE JJ, et al. Cardiopulmonary impact of electronic cigarettes and vaping products: a scientific statement from the American Heart Association. Circulation, 2023; 148: 703-728.
SEILER-RAMADAS R, et al. Health effects of electronic cigarette (e-cigarette) use on organ systems and its implications for public health. Wiener Klinische Wochenschrift, 2021; 133: 1020-1027.
STANOJEVIC S, et al. Association between e-cigarette exposure and ventilation homogeneity in young adults: a cross-sectional study. European Respiratory Journal, 2025; 65: 2401675.
TACKETT AP, et al. A prospective study of e-cigarette use and respiratory symptoms in adolescents and young adults. Thorax, 2024; 79: 163-168.
TARRAN R, et al. E-cigarettes and cardiopulmonary health. Function, 2021; 2(2): 4.
WILLS TA, et al. Current perspective on e-cigarette use and respiratory outcomes: mechanisms and messaging. Expert Review of Respiratory Medicine, 2024; 18(8): 597-609.
WILLS TA, et al. E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies. European Respiratory Journal, 2021; 57: 1901815.
WOLD LE, et al. Cardiopulmonary consequences of vaping in adolescents: a scientific statement from the American Heart Association. Circulation Research, 2022; 131: 70-82.