In second-hand vaping, scientists smell the risk

Available in a tantalizing array of flavors, e-cigarettes have exploded in popularity since hitting the market about 15 years ago, especially among middle and high school students. But research indicates that e-cigarettes — even just around their use — may not be as “safe” as some people believe.

While the dangers of breathing in secondhand cigarette smoke are well understood, science continues to grow on how inhaling secondhand vapour, or aerosol, affects the body. And people may be underestimating the health risk, said Dr. Talat Islam, assistant research professor of population sciences and public health at the University of Southern California in Los Angeles.

Islam and his research colleagues found that exposure to second-hand e-cigarette aerosols is associated with an increased risk of bronchitis symptoms and shortness of breath in young adults, particularly those who do not smoke or vape themselves, the team reported last year in the journal Thorax.

“Aerosols from vaping contain heavy metals and ultrafine particles,” Islam said. “If someone else vapes in the same area, you breathe it in – those particles get into your lungs, where they can do damage.”

In addition to nicotine, aerosols contain heavy metals such as lead, nickel and zinc, carcinogens such as benzene and diacetyl, which has been linked to a condition dubbed “popcorn lung” in people who vape.

A 2021 study in New York, published in the journal Tobacco Control, found that using e-cigarettes increased the number of fine particles in the surrounding room. Exposure to fine particles, or microscopic particles capable of reaching deep into the lungs, can aggravate heart and lung disease and even lead to premature death.

E-cigarettes were the most common tobacco product used by US middle and high school students in 2021, according to a government study. And while about 1 in 4 college students between 2015 and 2017 were exposed to second-hand e-cigarette aerosols, that figure jumped to 1 in 3 college students in 2018, according to a 2019 study in JAMA Network Open.

“There is a general perception that vaping is not as harmful as smoking,” Islam said. “I think that’s why we see such high levels of second-hand exposure.”

By the time the health impacts are fully understood, it may be too late, said Dr. Ellen Boakye, postdoctoral fellow at the Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease in Baltimore.

“When people started smoking, the health effects weren’t known until years later, and that’s the same thing we see with e-cigarettes,” said Boakye, who is also a Tobacco member. American Heart Association Center for Regulatory Science.

“There is evidence to suggest that e-cigarette use is associated with respiratory conditions and cardiovascular disease,” she added. “As more evidence becomes available, we can see that this association is causal, both for e-cigarette use and for secondhand vapor exposure.”

Boakye said people should minimize their exposure to vaping, ideally by leaving the area. And she urged people who vape to quit, noting that more funding is needed for quit vaping programs.

“Some of the work we’re doing now shows that a lot of (young people) are trying to quit and they don’t have a lot of support,” she said, noting that most of the substitutes for nicotine are intended for adults. “I think that’s an area where a lot of attention should be placed.” For help quitting smoking, call 800-QUITNOW (784-8669), text “QUIT” to 47848, or visit

Whether it’s inhaling car exhaust, cigarette smoke or e-cigarette aerosols, experts say the message is the same. “We want to breathe this clean air,” Islam said. “Any time you add things there, we know it has an effect.”

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