How does vaping affect the brain?
The nicotine in e-liquids is readily absorbed from the lungs into the bloodstream when a person vapes an e-cigarette. Upon entering the blood, nicotine stimulates the adrenal glands to release the hormone epinephrine (adrenaline). Epinephrine stimulates the central nervous system and increases blood pressure, breathing, and heart rate. As with most addictive substances, nicotine activates the brain’s reward circuits and also increases levels of a chemical messenger in the brain called dopamine, which reinforces rewarding behaviors. Pleasure caused by nicotine’s interaction with the reward circuit motivates some people to use nicotine again and again, despite risks to their health and well-being.
Health Effects for Teens
The teen years are critical for brain development, which continues into young adulthood. Young people who use nicotine products in any form, including e-cigarettes, are uniquely at risk for long-lasting effects. Because nicotine affects the development of the brain's reward system, continued nicotine vaping can not only lead to nicotine addiction, but it also can make other drugs such as cocaine and methamphetamine more pleasurable to a teen's developing brain. 1
Nicotine also affects the development of brain circuits that control attention and learning. Other risks include mood disorders and permanent problems with impulse control—failure to fight an urge or impulse that may harm oneself or others. 1
E-cigarette, or Vaping Product, Use Associated Lung Injury (EVALI)
In recent years, public health and medical professionals have encountered a novel concern known as E-Cigarette or Vape Associated Lung Injuries, otherwise known as EVALI. EVALI refers to damage to a vape user’s lungs that can result in symptoms such as shortness of breath, cough, chest pain, and rapid and shallow breathing.2 During the period of time between the summer of 2019 and February 2020, the CDC recorded over 2,800 hospitalizations due to EVALI along with 68 deaths caused by the condition. Researchers believe the cause of this outbreak may have been linked to the presence of vitamin E acetate, a synthetic form of vitamin E, in some THC-containing vaping products. However, available evidence cannot rule out the contribution of other chemicals of concern included in both THC and/ or non-THC vape products. Most of these EVALI cases reported obtaining their vape products from “informal sources” such as friends, family, dealers, or online sources, rather than commercial outlets.
Fortunately, EVALI cases are on the decline - due in part to increased public awareness of the dangers surrounding vapes. The CDC, the FDA, state and local health departments, and other clinical and public health partners continue monitoring cases of EVALI, but stress that people do not use THC-containing e-cigarette, or vaping products, particularly from informal sources like friends, family, or in-person or online dealers. The public health agencies also urge that both nicotine- and THC-containing vaping products should NEVER be used by youth or young adults.3
1 U.S. Department of Health, and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease, Prevention and Health Promotion, Office on Smoking and Health. E-Cigarette Use Among Youth And Young Adults: A Report of the Surgeon General — Executive Summary.; 2016 https://e-cigarettes.surgeongeneral.gov/documents/2016_SGR_Exec_Summ_508.pdf
2 E-cigarette, or vaping product, use associated lung injury (EVALI) [Internet]. Yale Medicine; 2022. Available from: https://www.yalemedicine.org/conditions/evali
3 Outbreak of lung injury associated with the use of e-cigarette, or vaping, products [Internet]. Centers for Disease Control and Prevention; 2021. Available from: https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html