Vape salt nicotine causes fast addiction, doctor warns

Sales of vapes and electronic cigarettes, including tobacco heating systems, in Russia grew nearly ninefold from 2020 to 2024 — from 28 million to 245 million units. This is according to a study conducted last year by the monitoring company BusinesStat. According to Rosstat (Russian Federal State Statistics Service), in 2024 the number of Russians who smoke electronic devices increased by 19.8% (852,000 people) to 5.3 million people, meaning every fifth smoker over the age of 15.

Diana Kochneva, a pulmonologist at the multidisciplinary medical center CL DOCTOR, told 93.RU about the consequences of vaping for the body.

— Diana Yuryevna, people switched to vapes from cigarettes, largely buying into the advertising that they are safe for the lungs. But is that true?

— Claims about «safety for the lungs» are a marketing myth. Although vape aerosol does not contain the tar that forms from burning tobacco, its contents are still a foreign chemical cocktail entering the lungs.

The main dangers of electronic cigarettes for the lungs:

The main components (propylene glycol and glycerol) form an aerosol when heated, which irritates the bronchial and bronchiolar mucosa, causing chronic inflammation and cough.

Vaping can cause acute, severe lung injury (EVALI), often associated with impurities, such as vitamin E acetate in illegal or modified liquids. This severe condition may even require artificial ventilation.

Some studies show that components of vape aerosol disrupt the function of macrophages — key immune cells in the lungs, making the body more vulnerable to infections.

— What toxic compounds contained in vapes are poison for our body?

— Many toxic and harmful substances have been found in vape aerosol, many of which are formed precisely during the heating process:

Acrolein — a strong irritant that can irreversibly damage the lungs and contribute to the development of chronic obstructive pulmonary disease (COPD).

Formaldehyde — a known carcinogen. Its concentration can increase with severe overheating of the coil.

Diacetyl — a flavoring agent linked to «popcorn lung.»

Heavy metals: nickel, tin, chromium, manganese, lead, zinc. They can be released from the heating elements (coils) of the device itself. Inhaling toxic metals is dangerous for the lungs, kidneys, and nervous system.

Nicotine — a poison that causes strong addiction, increased blood pressure, and rapid heart rate. In the liquids, natural nicotine is replaced by synthetic (salt) nicotine. The chemical substitutes include nicotine sulfate. This substance was previously used in the agricultural industry as a pesticide to combat plant pests and diseases. However, its use was soon banned due to high toxicity. In the aerosol, salt nicotine is quickly absorbed into the blood and metabolized by the body, and is eliminated more slowly than tobacco nicotine. This means that with each subsequent puff, the smoker receives an even larger dose of highly toxic nicotine, and addiction in this case forms much faster.

— «Popcorn lung,» or scientifically, obliterative bronchiolitis. What is this disease? Can it be directly linked to vaping?

— Obliterative bronchiolitis (OB) is an irreversible lung disease where the smallest airways — the bronchioles — become inflamed and scarred, leading to progressive impairment of respiratory function.

OB was first described in workers at popcorn factories who inhaled large amounts of the flavoring agent diacetyl. Yes, «popcorn lung» is directly linked to vaping, since diacetyl is often used in e-cigarette liquids, especially with buttery, caramel, or dessert flavors. Inhaling this substance, even in small concentrations, can cause severe damage to the bronchioles.

The name «popcorn lung» comes from the characteristic popping sound of popcorn that a doctor hears when listening to the lungs with a stethoscope.

Symptoms: malaise, weakness, cough, shortness of breath, wheezing and crackles in the chest, chest pain. Treatment is long and complex.

— Why are vapes especially dangerous for teenagers and children?

— The danger of vaping for teenagers is many times higher for three reasons:

1. Nicotine disrupts the development of the brain«s prefrontal cortex (responsible for decision-making, impulse control, and attention), which continues until age 25. This can lead to long-term cognitive problems. Nicotine also depresses a child»s central nervous system, leading to apathy, decreased performance, concentration, memory, adaptability, and disruption of sleep patterns.

2. A teenager«s brain forms a physical dependence on nicotine much faster. Thanks to salt nicotine in popular vapes, a teenager can develop an addiction within a few weeks comparable to that of a long-term smoker.

3. Flavorings and the «cool» image of vaping mask the danger and serve as a gateway to nicotine addiction for those who would never have started smoking regular cigarettes.

— How do vape liquids affect a child«s body?

— Flavorings cause severe allergic reactions. Nicotine-containing ones have a detrimental effect on the central nervous system, the endocrine system (disrupting the production of growth and development hormones), the reproductive system (lowering testosterone levels), and the entire body as a whole.

Cannabinoids cause acute intoxication. Even short-term cannabinoid intoxication in an adult can cause acute psychosis (depressed consciousness, delirium, hallucinations, suicidal thoughts and even actions). Cannabinoids are directly linked to the emergence of a number of mental illnesses, primarily schizophrenia.

It«s scary to imagine the irreparable harm these substances can cause to a child or teenager.

If parents notice their child is vaping, they must urgently consult a specialist.

— Who is strictly contraindicated from using vapes?

— Children and teenagers under 18. Pregnant and breastfeeding women, because nicotine is toxic to the fetus and infant. People who are non-smokers: vapes should not be a means «for fun.» Individuals with chronic lung diseases: COPD, asthma (vaping can provoke an exacerbation).

Vapes also should not be used by people with cardiovascular diseases: hypertension, after a heart attack or stroke, since nicotine increases the load on the heart.

— Besides the lungs, other organs suffer. What, for example, is the danger for the endocrine and reproductive systems?

— The main culprit of systemic harm is nicotine and, to a lesser extent, other toxins:

Endocrine system: Nicotine affects blood glucose levels, increases insulin resistance, and can worsen or provoke the development of type 2 diabetes. It also affects the function of the thyroid gland and adrenal glands.

Reproductive system: In men, nicotine worsens the quality and motility of sperm, lowers testosterone levels, and is a proven risk factor for erectile dysfunction due to vasoconstriction. In women, fertility worsens, and the risk of menstrual cycle disorders and complications during pregnancy increases.

— Are there symptoms that indicate the vape is already having a negative impact on the body?

— Yes, you may notice the following early signs:

Dry mouth, increased salivation (the effect of toxic metals). Chronic dry or wet cough, shortness of breath during exertion, constant throat irritation.

Cardiovascular system: Rapid heartbeat (tachycardia) at rest or after vaping, increased blood pressure.

Nervous system: Increased irritability, anxiety, sleep problems. This is related to the action of nicotine and withdrawal.

One can speak of addiction if a person cannot start the day without a vape, panics if the device runs out of battery, or increases the frequency of using electronic cigarettes.

— Electronic devices or traditional cigarettes: which is more dangerous?

— Comparing them is like choosing between two poisons. Cigarettes kill slowly and predictably through combustion products (tar, carbon monoxide), causing cancer and COPD. Their long-term harm is catastrophic and has been proven for decades.

Vapes kill in two ways:

1. Acute damage (EVALI, OB). These are potentially fatal, acute conditions not seen with cigarette smoking.

2. Nicotine addiction: An extremely high dose of nicotine and the risk of systemic vascular harm.

None of these products is safe. For a non-smoker, vapes are more dangerous, as they introduce them to nicotine addiction. For a long-term smoker, a complete switch to vapes may reduce the risk of lung cancer but increases the risks of acute lung injury and cardiovascular problems.

— By analogy with cigarettes — is passive vaping also dangerous?

— Certainly, passive exposure to vape aerosol (secondhand vaping) is dangerous, although differently than secondhand smoke. The aerosol contains nicotine, which settles on surfaces («thirdhand smoke») and is inhaled by others, especially children. The liquids contain formaldehyde, acrolein, and heavy metals, which are inhaled by bystanders.

Secondhand vaping can trigger asthma and bronchitis in children and harm their developing brains. It is strictly forbidden to use vapes in the presence of children, pregnant women, and people with chronic lung diseases.

— What needs to be done to quit smoking?

— For successful quitting (cigarettes or vapes), evidence-based medicine should be used:

1. Consultation with a pulmonologist, who will develop an individual plan.

2. Nicotine replacement therapy (NRT): patches, gum, inhalers. They provide pure, dosed nicotine without the toxins of aerosol and smoke.

3. Medication therapy — drugs that reduce cravings and withdrawal symptoms.