Tom puffed on his Aspire CF Sub Ohm. Suddenly, his eyes crossed, his hair stood up on end and steam started coming out of his ears.
In all seriousness, while many scientists believe that e-cigarettes are a great alternative for smokers who can't or don't want to quit nicotine, e-cigs are not perfect.
And when you make the switch you may experience some side effects.
Fortunately, these side effects have been well-studied, and the majority of them are mild and temporary. But it helps if you know what side effects are caused by e-cigarettes, and what to do about them.
The Side Effects of Vaping: What the Research Says
There are two main types of study that tell us about the side effects from vaping.
Firstly, when researchers survey vapers to ask about their experiences, preferences and habits, side effects are usually mentioned. Surveys led by Lynne Dawkins, Jean-Francios Etter and Konstantinos Farsalinos all fall into this category.
Researchers looking at whether e-cigs help smokers quit usually also ask questions about side effects, and there have been quite a few studies on this topic.
Riccardo Polosa and colleagues have conducted many studies along these lines, with examples here, here and here, and the randomized controlled trial led by Chris Bullen found out about side effects too.
So what did they all find?
The short version is that mild side effects like throat irritation and coughing were the most common, and they usually clear up over time. One of Riccardo Polosa’s studies on whether vaping helps smokers quit concluded that:
The use of e-Cigarette substantially decreased cigarette consumption without causing significant side effects in smokers not intending to quit.
Faraslinos et al in a survey of over 19,000 users found more side effects, but also reported they were mostly temporary:
A substantial proportion reported side effects, which were generally mild and in most cases partially or completely resolved after the initial period of EC use...health benefits are substantial, especially for those who completely substitute smoking with EC use
What Users Say
We asked vapers on social media what side effects they had experienced when switching to vaping.
Some people reported only positive side effects, while other people reported a cough:
— Dutch Steamboat (@allahcarte) March 7, 2015
On Google Plus some waxed lyrical over positive side effects:
But others complained of sensitive teeth, although this seemed to be only temporary:
On Facebook people complained of dry mouth, amongst other side effects:
Although some argued that e-cigs were not the cause of the problems:
What Are The Common Side Effects of Vaping?
From research and user reports, the most common side effects are the following:
This is especially common when you use an e-cigarette for the first time, especially if you are vaping with a powerful device. It has also been reported as a minor side effect in several studies.
In the research cited above, about 20 to 30 % of new vapers experience coughing at first. However, researchers consistently found that the problem cleared up for most of these people.
We’ve asked about this directly in two surveys.
One found that about 57 % of vapers coughed when they first started vaping, but only 7 % still did at the time of the survey. Our other survey asked about symptoms related to PG, and found that about 22 % of vapers reported coughing.
This survey found that only about 11 % of vapers consistently had symptoms, with about 44 % no longer having issues at the time of the survey, and about 45 % only having intermittent issues.
To minimise coughing when you vape see these tips.
Dehydration/Sore Throat/Dry Throat/Dry Nose
These are likely to be caused by the e-liquid ingredient propylene glycol. They can also be caused by nicotine.
In our survey on PG, 28 % of vapers experienced a sore or dry throat, results which are in line with published research on the topic.
PG and VG both draw in moisture from their environments, and this includes your mouth and throat when you vape. PG also contributes to “throat hit,” and if you’re sensitive to PG, this can make vaping very unpleasant.
These symptoms can also be caused by nicotine. Nicotine is the main ingredient that determines your throat hit, so if your nicotine level is too high, this could mean vaping gives you a dry throat.
However, as over 99% of vapers smoked before vaping, and are used to nicotine, it's unlikely this is the cause.
Headaches are another of the most common vaping side effects. Research such as Dr. Farsalinos’ large survey of consumers found that about 11 % of new vapers experience headaches.
Other studies suggest that while headaches are a problem at first, they become less common for long-term vapers. Our own survey of almost 1,000 vapers found that about 6 % experienced headaches after vaping PG-containing liquid.
Headaches could be a sign of too much nicotine, but the most likely culprit is dehydration. This is because of PG and VG’s moisture-collecting properties.
To combat this, make sure you drink plenty of water when you’re vaping.
This is the last common side effect from vaping.
According to Dr. Farsalinos’ survey, about 5 % of vapers had experienced dizziness after vaping. Other studies show that as many as 15 % of vapers have dizziness and nausea in the first month of vaping, but this becomes considerably less common after people have been vaping for a while.
After six months, less than 4 % of vapers reported dizziness and nausea.
Most vaping side effects are caused by PG and VG, but this one is probably to do with nicotine.
The first sign you’ve had too much nicotine is dizziness or nausea, so if you have problems, the first thing to do is take a break from vaping. If the problem persists, you probably need to reduce your nicotine strength to avoid the problem in future.
Although not highlighted by research, we know some vapers have reported stomach aches after switching to vaping.
Again, this a potential symptom of having too much nicotine, so take a break from vaping if you experience it.
This usually appears to be temporary, likely clearing up as vapers find the right nicotine strength for their needs.
Via word of mouth we have heard that some people's asthma has been exacerbated by vaping.
However, some vapers claim that their asthma improved or even disappeared after switching to e-cigarettes. Research by Polosa et al into asthma seems to indicate that most smokers' asthma improves after switching to e-cigs.
Some vapers have found that after vaping an e-liquid for a long time they are unable to taste that flavour.
I've identified 10 possible causes of vaper's tongue, three of which could be related to vaping.
Check out The Dreaded Vaper’s Tongue: What is it, what causes it and how to cure it to learn more.
Quit Smoking v. Vaping Side Effects
Are you experiencing other side effects? It's possible they might not be caused by vaping, but stopping use of tobacco cigarettes.
For example, some new vapers have complained of mouth ulcers. But this is also a common side effect of stopping smoking. In fact, research by Robbie H et al found that 40% of people quitting smokers developed mouth ulcers.
Studies also suggest a significant increase in cold and flu-like symptoms after quitting smoking, including coughing, sore throats and headaches.
Generally, it’s hard to say whether your symptoms are caused by vaping or by quitting smoking, but the best advice is to try to address the issue and see what happens.
For instance, if you get headaches, make sure you stay hydrated and see if the problem clears up.
If you’re feeling nauseous, stop vaping for a while or use a lower-nicotine e-juice and see if you feel better. If the problems don’t clear up and you’ve recently quit, it could be more to do with quitting smoking than starting vaping.
For more common symptoms, click here.
Propylene glycol, which absorbs water, currently seems to be a cause of the most common side effects (dehydration, dry mouth and sore throat).
Fortunately, there's plenty vapers can do to counter its effects.
There are a number of things you can do:
- Drink plenty of water to combat dehydration and dry throat.
- Check with your suppliers to find out the proportion of VG/PG. By going for a heavier VG e-liquid you should be able to reduce the side effects.
- Go for a VG only e-liquid.
Going for a 100% VG e-juice is not ideal, as VG heavy e-liquid can clog clearomisers, put pressure on atomisers and delivers less throat hit - but it's got to be better than going back to smoking!
Our UK-made Halo e-liquid is currently transitioning from 60 % PG to 40 % VG, to 50pg-50vg, and works well in a variety of devices.
This should be high enough to prevent any PG-related symptoms, but since VG also absorbs moisture, it’s still important to drink plenty of water when you’re vaping.
What Are The Side Effects of Nicotine?
While nicotine can have some side effects, over 99% of vapers (according to studies by Action on Smoking and Health) are former or current smokers, and well used to nicotine.
Nicotine is well known as an addictive substance. However, electronic cigarettes deliver less nicotine than cigarettes, and other compounds that contribute to addiction in cigarettes are not present in electronic cigarettes, so it is quite possible that e-cigarettes are less addictive than tobacco cigarettes.
Recent research into dependence on electronic cigarettes provides direct evidence that they are less addictive than tobacco cigarettes.
Nicotine can lead to a temporary increase in blood pressure. However, there is controversy on whether it does this in the long term. Indeed, some studies have shown that smoking leads to a long term fall in blood pressure, and smoking cessation to an increase, while other studies have shown the opposite.
Remember, nicotine's not all bad. For more on nicotine, including some of the most positive effects, see 10 Facts All Vapers Should Know About Nicotine.
Contrary to popular opinion, nicotine doesn't cause cancer - that's caused by the inhalation of smoke.
There is some controversy on whether nicotine could speed up the development of cancer - some studies say it can, while others say it can't.
Other Side Effects of Nicotine
Other common side effects of nicotine include:
- Mouth Irritation
- Head Pain
- Increased Hunger (although nicotine is usually an appetite suppressor)
- Increased Production of Saliva
- Pain in the Jaw Area
- Throat Pain
Nicotine overdoses are rare in smokers and vapers. That's because nicotine users are known to self-titrate i.e. they take in the amount they need, and stop before taking too much.
However, if you do over-do your vaping, you could experience some of the following symptoms:
- Fast Heartbeat
- Nausea or Vomiting
- Stomach pains
For a more complete list of poisoning symptoms, check out this list by the NHS.
Obviously, if you start to experience any of the above stop vaping immediately and have a lie down!
The good news is your body processes nicotine quickly, so these symptoms don't usually last long.
Unproven Side Effects of Vaping
Vaping and Lipid Pneumonia
Vaping has been linked to lipid pneumonia.
There was an isolated case in the UK where a vaper died of lipoid pneumonia, but there's two reasons to be sceptical:
1. A single isolated case of lipoid pneumonia in a population of several million vapers (almost all of whom have been smoking for years) does not prove that vaping was the cause.
2. Scientists such as Professor Polosa have pointed out the e-liquid used by the patient was glycerine based, and that it is impossible for these to cause lipoid pneumonia.
A lipid is a fat, so you’d have to vape fats or actual oils for vaping to cause lipoid pneumonia. Needless to say: don’t do that!
For more information, see our interview on vaping and Lipid Pneumonia with Professor Polosa.
Vaping and Popcorn Lung
For years a rumour has gone round that using e-cigs can cause popcorn lung. There's even a picture of someone in hospital who reputedly has popcorn lung from using e-cigs. (The claim has since been exposed by Snopes.)
We've discussed popcorn lung in depth here, but the low down is:
- popcorn lung has caused by the use of huge quantities of Diacetyl in popcorn factories
- Diacetyl is used in cigarettes, but is not known to cause popcorn lung
- Diacetly has been used in e-liquid in the past, but in quantities lower than in cigarettes
- UK and EU e-liquid is tested for diacetyl in UK 10ml e-liquid
UK Health Charity Cancer Research agrees, pointing out that there is no good evidence that diacetyl in e-liquid causes popcorn lung - and that in any case, diacetyl in e-liquid is banned in the EU.
Positive Side Effects of Vaping
Above: Results from a survey we conducted of users, asking how switching to ecigs had affected their lungs. Click here for the full results or here for more information on how e-cigs affect the lungs.
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<p><a href="https://www.ecigarettedirect.co.uk/ashtray-blog/2015/03/e-cigarette-side-effects.html"><img src="https://www.ecigarettedirect.co.uk/ashtray-blog/wp-content/uploads/2013/04/7.jpg" alt='Lung Capacity Switching Vaping' width='500px' border='0' /></a></p> <div>Courtesy of: <a href="https://www.ecigarettedirect.co.uk/ashtray-blog/2015/03/e-cigarette-side-effects.html">ECigaretteDirect</a></div>
Participants experienced significant benefits in physical status and improvements in pre-existing disease conditions (including respiratory disease such as asthma and chronic obstructive lung disease). Being a former smoker was independently associated with positive effects in health and improvements in disease conditions.
Of course, it's not all negative or smokers would not have switched to electronic cigarettes in their millions! Bear in mind that nearly all vapers surveyed are ex-smokers, and when it comes down to health effects you have to bear in mind it's really a matter of vaping vs. smoking. Here are some of the positive effects users have reported:
- Overall Better Physical Health
- Improved Breathing
- Improved Ability to Exercise (Stamina)
- Improved Sense of Smell
- Improved Sense of Smell
- Improved Sexual Performance
- Improved Endurance
- Improved Ability To Breathe
- Reduced Cough
- Improvements in Asthma & Other Diseases
Some of the reported improvements have been quantified via surveys. The following graph highlights some of the important benefits (there's just not room to get them all in), and is extrapolated from Farsalinos' survey.
While the next graph highlights changes in disease conditions after switching to e-cigs.
The results were even better for people who had switched 100% to using e-cigs.
In the following graph, you can also see there has been a substantial decrease in the number of people who had to take lung medication after switching to ecigs:
Read the results of Farsalinos' survey for the full data.
Is Vaping 100% Safe? No, But It's Better Than The Alternative
Is vaping safe?
Well, if you switch to electronic cigarettes, you may indeed experience some side effects. Most of the negative effects, though, are likely to be temporary and minor. And the scientists who are conducting research into e-cigarettes believe that they are likely to be far outweighed by the positive benefits of switching from smoking to vaping.