See what vaping is doing to your body and brain.21516171819202122232425262728
High dose nicotine vapes can not only addict you faster, they may put you at increased risk for cancer, heart disease, COPD, and stroke.2151617181920212223242526293031323334
What’s lurking inside?
Vapes come with way more baggage than you signed up for.


Toxic chemicals in vapes may increase your risk of cancer.
Vapes can contain cancer-causing chemicals like lead, arsenic, and formaldehyde.1234567891011121314 Even secondhand vape aerosol releases heavy metals like chromium, nickel, manganese, and lead, putting friends and family at risk.8505152535455555657


Nicotine and vaping wreak havoc on your health.
Your body and brain pay the price, sometimes forever.
Nicotine is a poison that can magnify depression and anxiety and permanently change the way connections form in the brain.273536373839 That’s not all: People who vape have higher risk of dying younger from stroke.25264041 Not exactly the vibe.
Is your college tobacco- and nicotine-free yet?
The California Youth Advocacy Network’s College Program partners with students and faculty to eliminate tobacco and nicotine harms in college communities.
Work with policymakers to create nicotine-free campuses.
Campuses Organized and United for Good Health (COUGH) is a statewide student-led coalition that promotes healthier California colleges through tobacco- and nicotine-free policy and advocacy work. Join the COUGH Student Leadership Board and help make a difference.
Outsmart nicotine with the EX Program and find a quit that sticks
Get free, 24/7 support through daily text messages full of tips and advice, a resource library with expert guidance, and access to an active community of quitters.

Get more facts

The harm caused by vaping nicotine affects:

Who we are
A California without Big Tobacco isn’t just possible – it’s already happening. Together, we’re undoing the tobacco industry’s epidemic. As a program of the California Department of Public Health, UNDO is one of the nation’s leading public health programs – fighting to end Big Tobacco’s deadly epidemic in California.
Learn more about the tobacco industry’s damage
- Aherrera A, Lin JJ, Chen R, et al. Metal Concentrations in E-Cigarette Aerosol Samples: A Comparison by Device Type and Flavor. Environ Health Perspect. 2023;131(12):127004. doi:10.1289/EHP11921
- Fowles J, Barreau T, Wu N. Cancer and Non-Cancer Risk Concerns from Metals in Electronic Cigarette Liquids and Aerosols. Int J Environ Res Public Health. 2020 Mar 24;17(6):2146. doi: 10.3390/ijerph17062146. PMID: 32213824; PMCID: PMC7142621.
- Liu Q, Huang C, Chris Le X. Arsenic species in electronic cigarettes: Determination and potential health risk. J Environ Sci (China). 2020;91:168-176. doi:10.1016/j.jes.2020.01.023
- National Cancer Institute. Arsenic. Updated December 5, 2022. Accessed March 25, 2025. https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/arsenic
- World Health Organization. Arsenic: Key facts. Updated December 7, 2022. Accessed March 25, 2025. https://www.who.int/news-room/fact-sheets/detail/arsenic
- Zhao S, Zhang X, Wang J, Lin J, Cao D, Zhu M. Carcinogenic and non-carcinogenic health risk assessment of organic compounds and heavy metals in electronic cigarettes. Sci Rep. 2023;13(1):16046. Published 2023 Sep 25. doi:10.1038/s41598-023-43112-y
- American Cancer Society. Known and probable human carcinogens. Updated August 1, 2024. Accessed March 25, 2025. https://www.cancer.org/cancer/risk-prevention/understanding-cancer-risk/known-and-probable-human-carcinogens.html
- Goniewicz ML, Knysak J, Gawron M, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. 2014;23(2):133-139. doi:10.1136/tobaccocontrol-2012-050859
- Hess CA, Olmedo P, Navas-Acien A, Goessler W, Cohen JE, Rule AM. E-cigarettes as a source of toxic and potentially carcinogenic metals. Environ Res. 2017;152:221-225. doi:10.1016/j.envres.2016.09.026
- Proposition 65. Lead and Lead Components. Accessed March 25, 2025. https://www.p65warnings.ca.gov/fact-sheets/lead-and-lead-compounds
- Williams M, Bozhilov K, Ghai S, Talbot P. Elements including metals in the atomizer and aerosol of disposable electronic cigarettes and electronic hookahs. PLoS One. 2017;12(4):e0175430. Published 2017 Apr 17. doi:10.1371/journal.pone.0175430
- Kosmider L, Sobczak A, Fik M, et al. Carbonyl compounds in electronic cigarette vapors: effects of nicotine solvent and battery output voltage. Nicotine Tob Res. 2014;16(10):1319-1326. doi:10.1093/ntr/ntu078
- Salamanca, J.C., Meehan-Atrash, J., Vreeke, S. et al. E-cigarettes can emit formaldehyde at high levels under conditions that have been reported to be non-averse to users. Sci Rep 8, 7559 (2018). https://doi.org/10.1038/s41598-018-25907-6
- The National Institute for Occupational Safety and Health (NIOSH). Formaldehyde: evidence of carcinogenicity. Centers for Disease Control and Prevention. Updated June 6, 2014. Accessed March 25, 2025. https://www.cdc.gov/niosh/docs/81-111/default.html
- National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on the Review of the Health Effects of Electronic Nicotine Delivery Systems; Eaton DL, Kwan LY, Stratton K, editors. Public Health Consequences of E-Cigarettes. Washington (DC): National Academies Press (US); 2018 Jan 23. 10, Cancers. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507174/
- The Impact of E-Cigarettes on the Lung. American Lung Association. Published February 24, 2020. Updated May 31, 2023. Accessed August 15, 2023. https://www.lung.org/quit-smoking/e-cigarettes-vaping/impact-of-e-cigarettes-on-lung
- Bein K, Leikauf GD. Acrolein - a pulmonary hazard. Mol Nutr Food Res. 2011;55(9):1342-1360. doi:10.1002/mnfr.201100279
- Hikisz P, Jacenik D. The tobacco smoke component, acrolein, as a major culprit in lung diseases and respiratory cancers: molecular mechanisms of acrolein cytotoxic activity. Cells. 2023;12(6):879. doi:10.3390/cells12060879
- Bracken-Clarke D, Kapoor D, Baird AM, Buchanan PJ, Gately K, Cuffe S, Finn SP. Vaping and lung cancer - A review of current data and recommendations. Lung Cancer. 2021;153:11-20. doi: 10.1016/j.lungcan.2020.12.030.
- Shehata SA, Toraih EA, Ismail EA, Hagras AM, Elmorsy E, Fawzy MS. Vaping, Environmental Toxicants Exposure, and Lung Cancer Risk. Cancers (Basel). 2023;15(18):4525. Published 2023 Sep 12. doi:10.3390/cancers15184525 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10526315/
- Gotts JE, Jordt SE, McConnell R, Tarran R. What are the respiratory effects of e-cigarettes? BMJ. 2019;366:l5275. doi: 10.1136/bmj.l5275.
- Auschwitz E, Almeda J, Andl CD. Mechanisms of E-Cigarette Vape-Induced Epithelial Cell Damage. Cells. 2023;12(21):2552. doi: 10.3390/cells12212552.
- Tommasi S, Blumenfeld H, Besaratinia A. Vaping Dose, Device Type, and E-Liquid Flavor are Determinants of DNA Damage in Electronic Cigarette Users. Nicotine Tob Res. 2023;25(6):1145-1154. doi: 10.1093/ntr/ntad003.
- Shields PG, Berman M, Brasky TM, et al. A Review of Pulmonary Toxicity of Electronic Cigarettes in the Context of Smoking: A Focus on Inflammation. Cancer Epidemiol Biomarkers Prev. 2017;26(8):1175-1191. doi:10.1158/1055-9965.EPI-17-0358
- Patel U, Patel N, Khurana M, et al. Effect Comparison of E-Cigarette and Traditional Smoking and Association with Stroke—A Cross-Sectional Study of NHANES. Neurol Int.. 2022;14(2):441-452. doi:10.3390/neurolint14020037
- Poisson SN, Glidden D, Johnston SC, Fullerton HJ. Deaths from stroke in US young adults, 1989-2009. Neurology. 2014;83(23):2110-2115. doi:10.1212/WNL.0000000000001042
- U.S. Department of Health and Human Services. E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta, GA: 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; 2016.
- U.S. Department of Health and Human Services, Office of Surgeon General. (2018). Surgeon General’s advisory on e-cigarette use among youth. Retrieved from https://e-cigarettes.surgeongeneral.gov/documents/surgeon-generals-advisory-on-e-cigarette-use-among-youth-2018.pdf
- Campaign for Tobacco-Free Kids. High Nicotine E-Cigarettes are Addicting a New Generation of Youth. Accessed April 30, 2025. https://www.tobaccofreekids.org/us-resources/fact-sheet/juul-and-other-high-nicotine-e-cigarettes-are-addicting-a-new-generation-of-youth
- Tsai M, Byun MK, Shin J, Crotty Alexander LE. Effects of e-cigarettes and vaping devices on cardiac and pulmonary physiology. J Physiol. 2020 Nov;598(22):5039-5062. doi: 10.1113/JP279754. Epub 2020 Oct 12. PMID: 32975834.
- Berlowitz JB, Xie W, Harlow AF, Hamburg NM, Blaha MJ, Bhatnagar A, Benjamin EJ, Stokes AC. E-Cigarette Use and Risk of Cardiovascular Disease: A Longitudinal Analysis of the PATH Study (2013-2019). Circulation. 2022 May 17;145(20):1557-1559. doi: 10.1161/CIRCULATIONAHA.121.057369
- Abbasi J. The American Heart Association Takes on Vaping. JAMA. 2020 Jan 21;323(3):205-206. doi: 10.1001/jama.2019.20781. PMID: 31899479
- Wang Y, Zhu Y, Chen Z, Chen S, Fu G, Fu J. Association between electronic cigarettes use and whole blood cell among adults in the USA—a cross-sectional study of National Health and Nutrition Examination Survey analysis. Environ Sci Pollut Res Int.2022;29(59):88531-88539. doi:10.1007/s11356-022-21973-6
- Alzahrani, T., Pena, I., Temesgen, N., & Glantz, S. A. (2018). Association Between Electronic Cigarette Use and Myocardial Infarction. American Journal of Preventive Medicine, 55(4), 455–461.
- Becker TD, Arnold MK, Ro V, Martin L, Rice TR. Systematic Review of Electronic Cigarette Use (Vaping) and Mental Health Comorbidity Among Adolescents and Young Adults. Nicotine Tob Res. 2021 Feb 16;23(3):415-425. doi: 10.1093/ntr/ntaa171
- Kutlu MG, Gould TJ. Nicotine modulation of fear memories and anxiety: Implications for learning and anxiety disorders. Biochem Pharmacol. 2015;97(4):498-511. doi: 10.1016/j.bcp.2015.07.029.
- Benowitz NL. Nicotine addiction. N Engl J Med. 2010 Jun 17;362(24):2295-303. doi: 10.1056/NEJMra0809890.
- Lechner WV, Janssen T, Kahler CW, Audrain-McGovern J, Leventhal AM. Bi-directional associations of electronic and combustible cigarette use onset patterns with depressive symptoms in adolescents. Prev Med. 2017;96:73-78. doi: 10.1016/j.ypmed.2016.12.034.
- Hughes JR. Effects of abstinence from tobacco: Valid symptoms and time course. Nicotine Tob Res. 2007;9(3):315-327. doi:10.1080/14622200701188919.
- Rutten-Jacobs LC, Arntz RM, Maaijwee NA, et al. Long-term mortality after stroke among adults aged 18 to 50 years. JAMA. 2013;309(11):1136-1144. doi:10.1001/jama.2013.842
- Cardenas HL, Evanoff NG, Fandl HK, et al. Endothelial-derived extracellular vesicles associated with electronic cigarette use impair cerebral microvascular cell function. J Appl Physiol (1985). 2023;135(2):271-278. doi:10.1152/japplphysiol.00243.2023
- Pushalkar S, Paul B, Li Q, et al. Electronic Cigarette Aerosol Modulates the Oral Microbiome and Increases Risk of Infection. iScience. 2020;23(3):100884. doi:10.1016/j.isci.2020.100884
- Johns Hopkins Medicine. Halitosis (Bad Breath). Published April 24, 2025. Accessed April 24, 2025. https://www.hopkinsmedicine.org/health/conditions-and-diseases/halitosis-bad-breath
- Sundar IK, Javed F, Romanos GE, Rahman I. E-cigarettes and flavorings induce inflammatory and pro-senescence responses in oral epithelial cells and periodontal fibroblasts. Oncotarget. 2016;7(47):77196-77204. doi:10.18632/oncotarget.12857
- Bhatta DN, Glantz SA. Association of E-Cigarette Use With Respiratory Disease Among Adults: A Longitudinal Analysis. Am J Prev Med. 2020;58(2):182-190. doi: 10.1016/j.amepre.2019.07.028.
- Osei, A.D., Mirbolouk, M., Orimoloye, O.A. et al. The association between e-cigarette use and asthma among never combustible cigarette smokers: behavioral risk factor surveillance system (BRFSS) 2016 & 2017. BMC Pulm Med 19, 180 (2019). https://doi.org/10.1186/s12890-019-0950-3
- Mohammadi L, Han DD, Xu F, et al. Chronic E-Cigarette Use Impairs Endothelial Function on the Physiological and Cellular Levels. Arterioscler Thromb Vasc Biol. 2022;42(11):1333-1350. doi: 10.1161/ATVBAHA.121.317749.
- Bjurlin MA, Matulewicz RS, Roberts TR, et al. Carcinogen biomarkers in the urine of electronic cigarette users and implications for the development of bladder cancer: a systematic review. Eur Urol Oncol. 2021;4(5):766-783. doi:10.1016/j.euo.2020.02.004
- Molony RD, Wu CH, Lee YF. E-liquid exposure induces bladder cancer cells to release extracellular vesicles that promote non-malignant urothelial cell transformation. Sci Rep. 2023;13(1):142. doi:10.1038/s41598-022-27165-z
- Gray N, Halstead M, Valentin-Blasini L, Watson C, Pappas RS. Toxic Metals in Liquid and Aerosol from Pod-Type Electronic Cigarettes. J Anal Toxicol. 2022;46(1):69-75. doi:10.1093/jat/bkaa185
- Lee MS, LeBouf RF, Son YS, Koutrakis P, Christiani DC. Nicotine, aerosol particles, carbonyls and volatile organic compounds in tobacco- and menthol-flavored e-cigarettes. Environ Health. 2017;16(1):42. Published 2017 Apr 27. doi:10.1186/s12940-017-0249-x
- Olmedo P, Goessler W, Tanda S, et al. Metal Concentrations in e-Cigarette Liquid and Aerosol Samples: The Contribution of Metallic Coils. Environ Health Perspect. 2018;126(2):027010. Published 2018 Feb 21. doi:10.1289/EHP2175
- Reilly SM, Cheng T, Feng C, Walters MJ. Harmful and Potentially Harmful Constituents in E-Liquids and Aerosols from Electronic Nicotine Delivery Systems (ENDS). Chem Res Toxicol. 2024;37(7):1155-1170. doi:10.1021/acs.chemrestox.4c00093
- Ruprecht AA, De Marco C, Saffari A, et al. Environmental pollution and emission factors of electronic cigarettes, heat-not-burn tobacco products, and conventional cigarettes. Aerosol Sci Tech. 2017; 51(6):674-684. https://doi.org/10.1080/02786826.2017.1300231
- State of California Environmental Protection Agency. Proposition 65 list of carcinogens or reproductive toxicants. Office of Environmental Health Hazard Assessment. Updated January 3, 2025. Accessed April 22, 2025. https://oehha.ca.gov/media/downloads/proposition-65/p65chemicalslist.pdf
- World Health Organization: International Agency for Research on Cancer (IARC). IARC monographs on the identification of carcinogenic hazards to humans. List of Classifications. Update April 16, 2025. Accessed April 22, 2025. https://monographs.iarc.who.int/list-of-classifications
- Zhao D, Navas-Acien A, Ilievski V, et al. Metal concentrations in electronic cigarette aerosol: Effect of open-system and closed-system devices and power settings. Environ Res. 2019;174:125-134. doi:10.1016/j.envres.2019.04.003
- Qasim H, Karim ZA, Rivera JO, Khasawneh FT, Alshbool FZ. Impact of Electronic Cigarettes on the Cardiovascular System. J Am Heart Assoc. 2017;6(9):e006353. Published 2017 Aug 30. doi:10.1161/JAHA.117.006353.
- OpenSecrets. Industry Profile: Tobacco. Opensecrets.org. https://www.opensecrets.org/federal-lobbying/industries/summary?cycle=2021&id=A02. Accessed March 16, 2022.
- Federal Trade Commission. Federal Trade Commission Cigarette Report for 2020. Washington, D.C.: Federal Trade Commission. October, 2021. Accessed July 10, 2024. https://www.ftc.gov/reports/federal-trade-commission-cigarette-report-2020-smokeless-tobacco-report-2020
- U.S. Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: a report of the surgeon general. Office of Smoking and Health, Centers for Disease Control and Prevention. Published 2006. Accessed July 10, 2024. https://ww2.arb.ca.gov/sites/default/files/classic/research/apr/reports/l4000a.pdf
- UCSF Industry Documents Library. Younger adult smokers: strategies and opportunities. R.J. Reynolds Tobacco Company. Published February 29, 1984. Accessed July 10, 2024. https://www.industrydocuments.ucsf.edu/docs/rkvk0045
- Anderson SJ. Marketing of menthol cigarettes and consumer perceptions: a review of tobacco industry documents. Tob Control. 2011;20(Suppl_2):ii20-ii28. doi:10.1136/tc.2010.041939.
- Belzagui F, Buscio V, Gutiérrez-Bouzán C, Vilaseca M. Cigarette butts as a microfiber source with a microplastic level of concern. Science of The Total Environment. 2021;762:144165. doi:10.1016/j.scitotenv.2020.144165.
- Break Free From Plastic. Branded Vol. III Demanding corporate accountability for plastic pollution. Brand Audit 2020. Published 2020. Accessed July 10, 2024. https://brandaudit.breakfreefromplastic.org/wp-content/uploads/2023/01/BFFP-Brand-Audit-Report-2020.pdf.
- Poma A, Vecchiotti G, Colafarina S, et al. In Vitro Genotoxicity of Polystyrene Nanoparticles on the Human Fibroblast Hs27 Cell Line. Nanomaterials (Basel). 2019;9(9):1299. Published 2019 Sep 11. doi:10.3390/nano9091299.
- Zarus GM, Muianga C, Hunter CM, Pappas RS. A review of data for quantifying human exposures to micro and nanoplastics and potential health risks. Sci Total Environ. 2021;756:144010. doi:10.1016/j.scitotenv.2020.144010.
- Jacob H, Besson M, Swarzenski PW, Lecchini D, Metian M. Effects of Virgin Micro- and Nanoplastics on Fish: Trends, Meta-Analysis, and Perspectives. Environ Sci Technol. 2020;54(8):4733-4745. doi:10.1021/acs.est.9b05995
- Ziv-Gal A, Flaws JA. Evidence for bisphenol A-induced female infertility: a review (2007-2016). Fertil Steril. 2016;106(4):827-856. doi:10.1016/j.fertnstert.2016.06.027.
- Campanale C, Massarelli C, Savino I, Locaputo V, Uricchio VF. A Detailed Review Study on Potential Effects of Microplastics and Additives of Concern on Human Health. Int J Environ Res Public Health. 2020;17(4):1212. doi:10.3390/ijerph17041212.
Follow us
See what we’re up to on social for updates, resources, and more.