E Cigarettes

Overview

E-cigarettes, also called vapes, e-cigs or vape pens, are battery-powered devices that heat a liquid into a mist you breathe in. Using one is often called vaping. The liquid usually contains nicotine (the addictive chemical found in tobacco), flavourings, and other ingredients. Unlike regular cigarettes, e-cigarettes do not burn tobacco, so you do not breathe in tar or the many harmful chemicals in cigarette smoke. That makes vaping much less harmful than smoking, but it is not harmless. The mist still contains chemicals, and the long-term effects are still being studied.

Yes. Vaping is very common around the world, and the UK has one of the highest rates in Europe. Millions of adults use e-cigarettes, and use among teenagers and young adults has risen sharply in recent years.

Vaping is mostly used by adults who smoke or used to smoke. It is also increasingly used by teenagers and young adults who have never smoked, which worries health experts. People who have never smoked get no benefit from vaping and take on the risks. If you have a heart or lung condition, are pregnant, or take regular medicines, it is worth talking to a doctor or pharmacist before starting.

Symptoms

Common symptoms

• A dry or tickly cough, especially in the first few weeks
• A sore, scratchy throat or hoarse voice
• Dry mouth or a dry cough at night
• Headache
• Feeling sick or light-headed
• A fast or fluttering heartbeat, caused by nicotine
• Wheezing or getting out of breath more easily, particularly with exercise
• Mouth ulcers or a sore tongue
• Nosebleeds (less common)
• Needing to vape more and more to get the same feeling — a sign of dependence

Symptoms in children

• Nicotine affects the developing brain, which can show up as mood swings, trouble concentrating, poor sleep and feeling more anxious
• Coughing, wheezing, a sore throat or shortness of breath
• Feeling sick, dizzy or having a headache after vaping
• Mouth ulcers or a sore mouth
• Accidental swallowing or spilling of e-liquid is a poisoning emergency — even a small amount of concentrated nicotine can seriously harm a small child. Keep all liquids locked away and out of reach
• Burns or injuries from faulty devices, batteries or chargers
• Wanting to vape soon after waking, or feeling irritable without it, which are signs of dependence

Symptoms in older adults

• Nicotine raises heart rate and blood pressure, which matters if you already have heart disease
• Dizziness or light-headedness, which can increase the risk of falls
• Dry mouth, which can affect teeth, gums and dentures
• Wheezing or breathlessness if you have asthma or a long-term lung condition
• Possible interactions between nicotine and some prescription medicines — worth checking with your pharmacist
• On the positive side, older adults who smoke often gain the most from switching to vaping, because they carry the highest risk from smoking

Causes

Main causes

• Nicotine — the main reason vaping feels habit-forming. It reaches the brain quickly and is highly addictive
• Carrier liquids such as propylene glycol and vegetable glycerine, which can irritate the airways and cause a dry throat or cough
• Flavourings — many are safe to eat but have not been tested for breathing in, and some may irritate the lungs
• Tiny metal particles from the heating coil, which can be breathed in
• Very high device temperatures, which can create other harmful chemicals — a burnt, dry taste is a warning sign
• Illegal or contaminated products, including cannabis vapes cut with vitamin E acetate, which has been linked to severe lung injury
• Social and behavioural reasons for starting: curiosity, peer pressure, sweet flavours, advertising, and the belief that vaping is harmless
• Wanting to quit smoking — a common and often successful reason for adults to start vaping

Risk factors

• Being a teenager or young adult — the developing brain is more easily hooked on nicotine
• Never having smoked — you get the risks with none of the smoking-related benefit
• Being pregnant, or living with a baby or young child
• Existing heart disease, asthma or a long-term lung condition
• Smoking and vaping at the same time (dual use), which keeps all the risks of smoking
• Buying unregulated, black-market or refillable products, or modifying your device
• Mental health conditions, where nicotine can affect mood, sleep and some medicines
• Living in a household with young children, who are at risk from e-liquid poisoning

When to see a doctor

See a doctor urgently if:

• You have chest pain, severe breathlessness or are coughing up blood — call your local emergency number
• You feel very unwell after using a vape, with vomiting, confusion, a racing heartbeat or a fit — call your local emergency number
• You have a fever with breathlessness or a cough that is quickly getting worse — seek same-day medical advice
• A child has swallowed or spilled e-liquid — call your local emergency number or poison service straight away
• You have a burn from a device that is blistered, deep or larger than a coin
• You have sudden swelling of the lips, face or throat — this is an emergency

Book a routine appointment if:

• You want help to stop smoking or stop vaping — a GP or stop-smoking service can offer support
• You have a cough, wheeze or breathlessness that has lasted more than a few weeks
• You notice palpitations, dizziness or headaches that you think may be linked to vaping
• You are pregnant and vaping, or pregnant and smoking and want to stop
• You are worried about how much you vape, or you feel anxious or low when you cannot vape
• You are due to have surgery or are starting a new medicine and want to talk about vaping
• You have children at home and want advice on storing devices and liquids safely

Diagnosis

There is no single test for problems linked to vaping. A doctor or nurse will usually start by asking about your symptoms and your vaping habits — what you use, how often, whether the liquid contains nicotine, where you buy it, and whether you also smoke. They will examine you, listening to your breathing and checking your heart rate and blood pressure. If anything seems unusual, they may arrange tests to look at your lungs and heart, or to rule out other causes such as an infection or asthma.

Tests that may be done

• A full history and physical examination, including listening to your chest
• Checking your oxygen level with a small clip on your finger
• Lung function tests, where you blow into a machine to measure how well your lungs work
• A chest X-ray or scan if you have ongoing cough, breathlessness or chest pain
• Blood tests to check for infection, inflammation or other causes
• An ECG (heart tracing) if you have palpitations or chest symptoms
• Allergy testing if a reaction is suspected
• A referral to a specialist lung or heart clinic if symptoms are unusual or do not settle

What to expect at your appointment

Appointments are usually quick and straightforward. Be honest about what you vape and how often — you will not be judged, and it helps your clinician give you the right advice. Most people need only a conversation and an examination. If tests are arranged, results often come back within a week or two, and your clinician will explain what they mean and what happens next. If you are ready to stop vaping or smoking, you can ask for a referral to a stop-smoking service at the same appointment.

Treatment

Treatment depends on why you are seeking help. If you have symptoms such as a cough or breathlessness, the focus is on finding the cause and treating it, and on whether vaping might be playing a part. If you want to stop vaping or stop smoking, the most effective approach is a combination of behavioural support and medicine to ease cravings — this is what stop-smoking services specialise in. Support works far better than willpower alone.

Self-care at home

• Decide what you actually want: to stop vaping completely, to cut down, or to switch away from cigarettes — write it down and set a date
• Buy from reputable, regulated shops and avoid black-market or modified devices
• Never modify a device or use the wrong charger, and never leave a charging device unattended
• Store e-liquids locked away and out of reach of children and pets
• Stay well hydrated — sipping water helps with a dry mouth and throat
• Notice your triggers (coffee, stress, breaks at work, alcohol) and plan something else to do instead
• Reduce gradually if stopping all at once feels too hard, and lower the nicotine strength step by step with advice
• Avoid vaping and smoking together — if you vape, aim for it to fully replace cigarettes
• Tell friends and family your plan so they can support you, and ask them not to vape around you if you are trying to stop
• Use a simple diary or phone app to track your progress — seeing it in black and white really does help

Medical treatments

Your GP, nurse or pharmacist can offer structured support, which may include one-to-one or group sessions, phone or app-based coaching, and medicines that reduce cravings and withdrawal symptoms. These include nicotine replacement products in various forms, and other prescription medicines that help with urges — your clinician will discuss which option suits you, taking your health, pregnancy status and other medicines into account. They will also help you set a realistic plan and adjust it if things get difficult. If your symptoms point to a lung or heart problem, treatment will be directed at that condition, and you may be referred to a specialist. No one will tell you off — the goal is simply to help you feel better.

When is surgery considered?

Surgery is not a treatment for vaping or nicotine dependence. However, if you vape or smoke, it is important to tell your surgical team well before an operation, as nicotine affects healing and anaesthesia, and they can give you specific advice for the weeks around your surgery.

Living with this condition

Living with a vaping habit, or trying to stop, is mostly about routines. Cravings usually come in short waves that peak and then pass within a few minutes. Knowing this makes them easier to ride out. Keep your device out of easy reach, change the times and places you associate with vaping, and have something else ready to do instead, like chewing gum, a short walk, or a glass of water. If you are vaping to stay off cigarettes, that is a positive choice — just try to avoid slipping back to smoking, and plan with your clinician how and when you might come off vaping too.

Lifestyle tips

• Build a support network: a friend, family member or stop-smoking adviser you can text when a craving hits
• Cut back on alcohol at first if it loosens your resolve, and avoid places where people around you vape heavily
• Protect children: keep devices and liquids locked away and never vape in a car or room with children
• Look after your sleep — tiredness makes cravings and low mood harder to handle
• Keep up with dental check-ups, as vaping and nicotine can affect gums and mouth health
• If you have asthma or a lung condition, keep your inhalers and action plan up to date and see your nurse for regular reviews

Diet and exercise

Eating regular meals helps steady your mood and energy, which makes cravings easier to manage, and sipping water throughout the day soothes a dry throat and mouth. Nicotine can dull appetite, so if you are vaping a lot, make sure you are still eating properly. Movement is one of the best craving-busters: a brisk ten-minute walk can take the edge off an urge and also strengthens your heart and lungs. Build up gradually, especially if you have been breathless, and choose something you enjoy so you keep it up.

Mental health and emotional wellbeing

Nicotine is addictive, and it is common to feel anxious, irritable, low or foggy-headed when you cut down or stop. These feelings are usually temporary and ease over a few weeks, though they can feel intense at the time. Vaping can also become a way of coping with stress, so it helps to plan other ways to manage hard feelings, such as talking to someone, breathing exercises, or getting outside. If your mood is seriously affected, or you have thoughts of harming yourself, please reach out for help straight away: contact your local emergency number, your GP, or a crisis support line in your country. You do not have to cope alone, and support is available.

Prevention

Yes, in the sense that the safest choice is not to start vaping at all — especially if you have never smoked. If you are a parent or carer, talking calmly and early with young people about vaping, and keeping devices and liquids out of the house, makes a real difference. Adults who smoke should be encouraged to switch completely to vaping with professional support rather than to keep smoking, since that is a genuine health gain. Buying only regulated products, never modifying devices and following charging instructions reduce the risk of burns and injuries.

Vaccines

There is no vaccine against vaping harms. Staying up to date with the vaccines your local health service recommends — such as flu and pneumonia vaccines if you are eligible — helps protect your lungs from infections, which matters more if you already have a lung condition.

Screening programmes

There is no routine screening test for vaping. The most useful thing you can do is tell your doctor, nurse or pharmacist that you vape, particularly before surgery, during pregnancy, or if you have a long-term lung or heart condition. If you develop a cough, breathlessness or chest symptoms, get them checked rather than waiting.

Complications

If left untreated

• Nicotine dependence that becomes harder to break the longer it continues
• Worsening asthma, wheezing or a persistent cough
• Irritation of the mouth, throat and airways, and dental or gum problems
• Effects on the heart and blood vessels from nicotine, including raised heart rate and blood pressure
• Serious lung injury from contaminated or illegal products — this is rare but can be life-threatening and needs emergency care
• Burns and injuries from faulty, damaged or incorrectly charged devices
• Nicotine poisoning in young children from swallowed or spilled e-liquid
• For young people, effects on brain development, mood, concentration, sleep and learning
• If vaping replaces quitting smoking and you end up doing both, all the serious risks of smoking remain

Long-term outlook

The outlook is genuinely encouraging. Most people who set a quit date with proper support do succeed, even if it takes more than one attempt — each try teaches you something. If you switch from smoking to vaping, you have already removed most of the harm from tobacco smoke, and many people go on to stop vaping as well, tapering down over time. Your body starts repairing itself within days of stopping smoking, and breathing usually feels easier within weeks to months. Whatever stage you are at, help is available and it is never too late to make a change.

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