Asthma is generally thought to be caused and influenced by multiple inherent ( and environmental factors (e.g., genetics, allergies, tobacco smoke, respiratory infections), so it is unlikely that vaping in the absence of other predispositions or environmental influencers is sufficient to cause asthma. However, multiple studies confirmed that vaping significantly worsens symptoms in people with asthma, including teenagers. Unfortunately, a recent study found that young people with asthma are more likely to vape than those without asthma.

Health Effects of Teen Vaping

Teen vaping increased at an alarming rate in recent years. According to the CDC, between 2017 and 2018, vaping increased by 78% among teens, with over 20% of high school students reporting use. The vaping industry has long claimed that e-cigarettes and vape pens are not only safer than conventional cigarettes, but that they can protect people from the risks of conventional cigarette smoke and reduce exposure to nicotine.

However, a growing body of literature indicates that these claims are unfounded. Teens often repeat claims that vaping reduces use of the conventional cigarettes, but this implies past cigarette use. Use of conventional cigarettes among teens is at an all-time low, so they do not reap this alleged benefit. Moreover, even nicotine-free vaping among teens is significantly associated with future nicotine use.

Nicotine-free vaping liquids are popular among teenagers, but several recent studies have identified substantial dangers associated with vaping liquids. Some vape pens have been found to contain carcinogenic heavy metals and chemicals. Even nicotine-free flavored vape liquids are associated with negative health outcomes. For example, the majority of flavored liquids contain diacetyl and acetyl propionyl. Inhalation of either of these chemicals is significantly linked to the development of very serious respiratory conditions that have lifelong repercussions. Even seemingly innocuous flavor carrying liquids like propylene glycol and vegetable glycerin have been shown to be irritating to lung tissue when vaporized particles are inhaled. This has particular implications for asthma, as propylene glycol is known to trigger asthma symptoms.

How Vaping Triggers Asthma Symptoms in Teens

It is widely recognized that the inhalation of foreign agents can exacerbate asthma symptoms, and vaping is no exception. Vaping is known to trigger asthma-like symptoms in both asthmatics and non-asthmatics, including labored breathing, coughing, chest tightness, and wheezing, likely as a direct result of inhaling vaporization products like propylene glycol, formaldehyde, acetaldehyde and volatile organic compounds. Regular vaping increases mucus formation in the airways and impairs immune responses to bacteria and viruses in asthmatics.

Secondhand Vaping and Asthma

A 2019 study evaluated the relationship between asthma and secondhand exposure to vape aerosol among teenagers and found that youth who were exposed to secondhand vape smoke had increased odds of experiencing a future asthma attack. However, this study is among the first to evaluate the link between secondhand vaping products and asthma, and more research needs to be done before conclusive statements can be made about the relationship between secondhand vaping and asthma. Of note, e-cigarettes have been shown to reduce indoor air quality, which may trigger asthma symptoms.

Links Between Teen Vaping and Asthma

Although data on the link between vaping and asthma are currently limited, a recent review clearly described potential risks associated with vaping and asthma, including inhalation of known respiratory intoxicants, impaired immune function, and persistent inflammation and mucus generation. Surprisingly, nicotine may actually reduce asthma-related inflammation, but this can increase susceptibility to viral and bacterial infections, which are major asthma triggers — not to mention that nicotine is an incredibly dangerous and powerfully addictive chemical that, when used by teens, leads to profound and long-lasting adverse effects on brain development.

Although it is too early to claim that vaping definitively causes asthma, circumstantial evidence supports a link. Moreover, vaping produces several chemicals that are known to exacerbate asthma symptoms and trigger attacks. The best way to avoid vaping-induced asthma is to not vape and avoid secondhand aerosol.