Silhouette of a person in a red ambient background

Welcome to Big Tobacco’s nicotine nightmare.

It’s paradise for the tobacco and nicotine industry. They make money off addicting you – never mind their vapes can contain cancer-causing chemicals like arsenic, lead, and formaldehyde.1234567891011121314151617

Vaping dangers

See what vaping is doing to your body and brain.

High dose nicotine vapes can not only addict you faster, they may put you at increased risk for cancer, heart disease, COPD, and stroke.12345678910111213141516171819202122232425262728

Tap to reveal the health harms
See what vaping is doing to your body and brain.
Nicotine permanently damages your brain and can increase anxiety, depression, and mood swings.1029303132333435
Vaping increases your risk of stroke, making you more likely to die of one at a younger age.262728363738
Vaping can irritate gum tissue and contribute to the development of gum disease – and can cause bad breath.394041424344454647
Vapes can contain arsenic, lead, and formaldehyde – cancer-causing chemicals.1234567891011121314151617
Vaping increases the risk of developing respiratory diseases, like chronic obstructive pulmonary disease (COPD), emphysema, and bronchitis.2324254849505152
People who vape daily are more likely to have had a heart attack than people who don’t use tobacco.53
Long-term vaping can damage blood vessels, increasing the risk for cardiovascular disease.20
Vapes can contain chemicals that have been linked to bladder cancer, like pyrene, naphthalene, and fluorene.5455
The truth about vaping

What’s lurking inside?

Vapes come with way more baggage than you signed up for.

A distorted portrait image of a young male
A black and white portrait of a young man
CHEMICALS

Would you like arsenic with that?13717

WAKE UP
CHEMICALS

Toxic chemicals in vapes may increase your risk of cancer.

Vapes can contain cancer-causing chemicals like lead, arsenic, and formaldehyde.1234567891011121314151617  Even secondhand vape aerosol can contain heavy metals like chromium, nickel, manganese, and lead, putting friends and family at risk.351556

Vapes are toxic in more ways than one
Photo with no alt text
A black and white portrait of a woman wearing a jean jacket
HARM

Nicotine and vaping wreak havoc on your health.

WAKE UP
HARM

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.1029303132333457585960 That’s not all: People who vape have a higher risk of dying younger from stroke.27363738 Not exactly the vibe.

See more ways that nicotine affects the brain

Vaping can increase the risk of deadly diseases.212348536162 Spread the word to help protect your friends and loved ones.

I caught my son trying to hit my vape. He’s like a little me. He does everything that I do. That was it. I had to quit.”

Isaiah — Los Angeles

Vaping makes me feel more anxious and like I’m always looking for something more.”

Gen Z Californian

As a kid I was told vaping was a safer alternative. I don’t believe it’s safer now.”

Gen Z Californian
MAKE A CHANGE

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.

Help your campus go tobacco- and nicotine-free
QUIT NICOTINE

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.

Quit now
Photo with no alt text
Photo with no alt text
Pop quiz

The harm caused by vaping nicotine affects:

Layla, Galia, Lizzy

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 our mission

Learn more about the tobacco industry’s damage

The tobacco industry currently spends billions each year on slick marketing tactics and political influence so they can profit off death and disease.6667
Learn more
Even for people who don’t use tobacco, there can be deadly consequences.68
Learn more
The industry calls kids their “replacement customers.”69 Big Tobacco sentences them to a lifetime of addiction and disease.
Learn more
This racist and unjust industry has strategically targeted certain communities with deadly products and manipulative messaging.70
Learn more
No one’s safe from the environmental damage and health risks from toxic tobacco waste and its plastic pollution.71727374757677
Learn more
  1. 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
  2. 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
  3. 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.
  4. 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
  5. 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
  6. 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
  7. 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
  8. National Cancer Institute. Arsenic. Updated December 5, 2022. Accessed March 25, 2025. https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/arsenic
  9. National Cancer Institute. Chemical and Environmental Exposures: Arsenic. Updated March 2024. Accessed March 25, 2025.
  10. National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General. Centers for Disease Control and Prevention (US). Published 2016. Accessed April 17, 2024. https://www.ncbi.nlm.nih.gov/books/NBK538680/pdf/Bookshelf_NBK538680.pdf
  11. 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
  12. Proposition 65. Lead and Lead Components. Accessed March 25, 2025. https://www.p65warnings.ca.gov/fact-sheets/lead-and-lead-compounds
  13. 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
  14. 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
  15. 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
  16. World Health Organization. Arsenic: Key facts. Updated December 7, 2022. Accessed March 25, 2025. https://www.who.int/news-room/fact-sheets/detail/arsenic
  17. 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
  18. 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
  19. Truth Initiative. Nicotine and the young brain. Published June, 2022. Accessed May 14, 2025. https://truthinitiative.org/sites/default/files/media/files/2022/06/Nicotine_Factsheet_FINAL_061722.pdf
  20. 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.
  21. Espinoza-Derout J, Shao XM, Lao CJ, et al. Electronic Cigarette Use and the Risk of Cardiovascular Diseases. Front Cardiovasc Med. 2022;9:879726. Published 2022 Apr 7. doi:10.3389/fcvm.2022.879726
  22. Zong H, Hu Z, Li W, et al. Electronic cigarettes and cardiovascular disease: epidemiological and biological links. Pflugers Arch. 2024;476(6):875-888. doi:10.1007/s00424-024-02925-0
  23. Antwi GO, Rhodes DL. Association between E-cigarette use and chronic obstructive pulmonary disease in non-asthmatic adults in the USA. J Public Health (Oxf). 2022;44(1):158-164. doi:10.1093/pubmed/fdaa229
  24. 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.
  25. Traboulsi H, Cherian M, Abou Rjeili M, et al. Inhalation Toxicology of Vaping Products and Implications for Pulmonary Health. Int J Mol Sci. 2020;21(10):3495. Published 2020 May 15. doi:10.3390/ijms21103495
  26. 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
  27. 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
  28. Shi J, Xiong L, Guo J, Yang Y. The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey. BMC Public Health. 2023;23(1):697. Published 2023 Apr 14. doi:10.1186/s12889-023-15371-x
  29. Goriounova NA, Mansvelder HD. Short- and long-term consequences of nicotine exposure during adolescence for prefrontal cortex neuronal network function. Cold Spring Harb Perspect Med. 2012;2(12):a012120. Published 2012 Dec 1. doi:10.1101/cshperspect.a012120
  30. 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.
  31. Picciotto MR, Brunzell DH, Caldarone BJ. Effect of nicotine and nicotinic receptors on anxiety and depression. Neuroreport. 2002;13(9):1097-1106. doi:10.1097/00001756-200207020-00006
  32. Zhao-Shea R, DeGroot S, Liu L, et al. Increased CRF Signalling in a Ventral Tegmental Area-Interpeduncular Nucleus-Medial Habenula Circuit Induces Anxiety during Nicotine Withdrawal. Nature News. 2015;Nat. Commun. 6:6770. doi: 10.1038/ncomms7770
  33. 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.
  34. Obisesan OH, Mirbolouk M, Osei AD, et al. Association Between e-Cigarette Use and Depression in the Behavioral Risk Factor Surveillance System, 2016-2017. JAMA Netw Open. 2019;2(12):e1916800. Published 2019 Dec 2. doi:10.1001/jamanetworkopen.2019.16800
  35. Etter JF, Ussher M, Hughes JR. A test of proposed new tobacco withdrawal symptoms. 2013;108:50-59. doi:10.1111/j.1360-0443.2012.03981.x
  36. 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
  37. 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
  38. Samson K. Higher Mortality for Young Stroke Survivors. Neurology Today. 2013;13(9):19-20. doi:https://doi.org/10.1097/01.nt.0000430536.58483.d2
  39. 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
  40. American Society for Microbiology. Evidence grows for vaping's role in gum disease. Published February 22, 2022. Accessed May 8, 2025. https://asm.org/press-releases/2022/feb-2022/evidence-grows-for-vaping-s-role-in-gum-disease#%3A~%3Atext=Washington%2C%20DC%20%E2%80%93%20February%2022%2C%2Clong%2Dterm%20consequences%20of%20vaping
  41. 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
  42. Thomas SC, Xu F, Pushalkar S, et al. Electronic Cigarette Use Promotes a Unique Periodontal Microbiome. mBio. 2022;13(1):e0007522. doi:10.1128/mbio.00075-22
  43. Xu F, Aboseria E, Janal MN, et al. Comparative Effects of E-Cigarette Aerosol on Periodontium of Periodontitis Patients. Front Oral Health. 2021;2:729144. Published 2021 Sep 7. doi:10.3389/froh.2021.729144
  44. Guo X, Hou L, Peng X, Tang F. The prevalence of xerostomia among e-cigarette or combustible tobacco users: A systematic review and meta-analysis [published correction appears in Tob Induc Dis. 2023 Mar 27;21:46. doi: 10.18332/tid/161989.]. Tob Induc Dis. 2023;21:22. Published 2023 Feb 9. doi:10.18332/tid/156676
  45. 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
  46. Mayo Clinic. Bad breath: symptoms and causes. Updated December 21, 2023. Accessed May 14, 2025. https://www.mayoclinic.org/diseases-conditions/bad-breath/symptoms-causes/syc-20350922
  47. Soule EK, Bode KM, Desrosiers AC, Guy M, Breland A, Fagan P. User-Perceived Negative Respiratory Symptoms Associated with Electronic Cigarette Use. Nicotine Tob Res. 2020 Dec 15;22(Suppl 1):S45-S53. doi: 10.1093/ntr/ntaa179.
  48. 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.
  49. Ghosh A, Coakley RD, Ghio AJ, et al. Chronic E-Cigarette Use Increases Neutrophil Elastase and Matrix Metalloprotease Levels in the Lung. Am J Respir Crit Care Med. 2019;200(11):1392-1401. doi:10.1164/rccm.201903-0615OC
  50. Osei AD, Mirbolouk M, Orimoloye OA, et al. Association Between E-Cigarette Use and Chronic Obstructive Pulmonary Disease by Smoking Status: Behavioral Risk Factor Surveillance System 2016 and 2017. Am J Prev Med. 2020;58(3):336-342. doi:10.1016/j.amepre.2019.10.014
  51. Chaffee BW, Barrington-Trimis J, Liu F, et al. E-cigarette use and adverse respiratory symptoms among adolescents and Young adults in the United States. Prev Med. 2021;153:106766. doi:10.1016/j.ypmed.2021.106766
  52. Mukerjee R, Hirschtick JL, Arciniega LZ, et al. ENDS, Cigarettes, and Respiratory Illness: Longitudinal Associations Among U.S. Youth. Am J Prev Med. 2024;66(5):789-796. doi:10.1016/j.amepre.2023.12.005
  53. Alzahrani T, Pena I, Temesgen N, Glantz SA. Association Between Electronic Cigarette Use and Myocardial Infarction [published correction appears in Am J Prev Med. 2019 Oct;57(4):579-584. doi: 10.1016/j.amepre.2019.08.003.]. Am J Prev Med. 2018;55(4):455-461. doi:10.1016/j.amepre.2018.05.004
  54. 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
  55. 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
  56. Li L, Lin Y, Xia T, Zhu Y. Effects of Electronic Cigarettes on Indoor Air Quality and Health. Annu Rev Public Health. 2020;41:363-380. doi: 10.1146/annurev-publhealth-040119-094043.
  57. Abreu-Villaça Y, Seidler FJ, Tate CA, Slotkin TA. Nicotine is a neurotoxin in the adolescent brain: critical periods, patterns of exposure, regional selectivity, and dose thresholds for macromolecular alterations. Brain Res. 2003;979(1-2):114-128. doi:10.1016/s0006-8993(03)02885-3
  58. Levin ED. Neurotoxicology of nicotine and tobacco. In: Advances in Neurotoxicology. Vol 8. Elsevier; 2022:93-103. doi:10.1016/bs.ant.2022.06.003
  59. Mishra A, Chaturvedi P, Datta S, Sinukumar S, Joshi P, Garg A. Harmful effects of nicotine. Indian J Med Paediatr Oncol. 2015;36(1):24-31. doi:10.4103/0971-5851.151771
  60. Yuan M, Cross SJ, Loughlin SE, Leslie FM. Nicotine and the adolescent brain. J Physiol. 2015;593(16):3397-3412. doi:10.1113/JP270492
  61. Harvard Health Publishing. Popcorn lung: what is it, and who is at risk? Published January 2, 2024. Accessed May 14, 2025. https://www.health.harvard.edu/diseases-and-conditions/popcorn-lung-what-is-it-and-who-is-at-risk
  62. Sahu R, Shah K, Malviya R, Paliwal D, Sagar S, Singh S, Prajapati BG, Bhattacharya S. E-Cigarettes and Associated Health Risks: An Update on Cancer Potential. Adv Respir Med. 2023;91(6):516-531. doi: 10.3390/arm91060038.
  63. National Cancer Institute. Cancer-causing substances: nickel compounds. Updated December 8, 2022. Accessed May 15, 2025. https://www.cancer.gov/about-cancer/causes-prevention/risk/substances/nickel
  64. 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/
  65. Cho JH, Paik SY. Association between Electronic Cigarette Use and Asthma among High School Students in South Korea. PLoS One. 2016;11(3):e0151022. Published 2016 Mar 4. doi:10.1371/journal.pone.0151022
  66. OpenSecrets. Industry Profile: Tobacco. Opensecrets.org. https://www.opensecrets.org/federal-lobbying/industries/summary?cycle=2021&id=A02. Accessed March 16, 2022.
  67. 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
  68. 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
  69. 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
  70. 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.
  71. 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.
  72. 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.
  73. 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.
  74. 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.
  75. 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
  76. 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.
  77. 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.