Carcinogens, inflammatory substances, and particles from vapes irritate the lungs

Vape aerosol contains carcinogens, inflammatory substances, and particles that irritate the lungs. The marketing is aggressive, nicotine levels are high, and products are promoted to children as a “smoother” vaping experience where coughing and airway irritation are minimized. Healthy research participants using new nicotine products develop stiffer blood vessels, vascular damage, increased blood clot formation, and narrower airways. The effects are acute and significant, with long-term consequences including an increased risk of heart attack, stroke, and COPD. Sweden lacks effective laws regulating marketing on social media and has no ban on flavored vapes targeted at children.

E-cigarette use has reached epidemic proportions in many parts of the world, including Sweden.
– The largest increase is seen among children and adolescents, whose growing bodies are particularly vulnerable to the often high levels of nicotine found in e-cigarettes. According to the Swedish Council for Information on Alcohol and Other Drugs (CAN), usage among some youth groups has risen from just a few percent to over twenty percent within a few years. This increase is unparalleled in the history of various nicotine products, says Magnus Lundbäck, cardiologist at Danderyd Hospital.

Aggressive marketing and high nicotine levels
–  The rapid spread of e-cigarettes has been driven by a combination of aggressive marketing targeting young people, intensive product development, increasing nicotine content, and failed regulatory oversight. Despite this alarming trend, Sweden lacks effective laws regulating social media marketing and has yet to implement a ban on flavors appealing to children. The latest generation of e-cigarettes, known as "vapes," are allowed to taste like fruit, berries, as well as soda and candy flavors. Combined with the high nicotine content, these flavors have made the products highly attractive to children and adolescents. The industry has also become increasingly skilled at developing products that provide a "smoother" vaping experience, minimizing unwanted effects such as coughing and airway irritation, says Magnus Lundbäck, cardiologist at Danderyd Hospital.

Consequences – increased risk of heart attack, stroke, and COPD
The collective scientific investigation of e-cigarettes and alternative tobacco products lags far behind the industry's product development. The global spread of e-cigarettes is described by many as a large-scale experiment, with youth serving as the primary test subjects. When it comes to understanding e-cigarettes and other new nicotine products, it is worth remembering that it took decades of research to link cigarettes to the diseases we now know they cause. These are not rapid processes—cardiovascular and lung diseases develop over a long time. The health effects of new nicotine products flooding the market cannot yet be fully captured in large population studies.

–  One way to tackle the lack of conclusive population studies demonstrating adverse health effects is to conduct exposure studies where healthy participants use new nicotine products, and their physiological effects are measured. The results from such studies are hypothesis-driven and can predict future health impacts. In a series of studies, we have observed that participants exposed to e-cigarette vapor containing nicotine (but not without nicotine) exhibit several effects on the body's blood vessels and lungs. In these studies, we have seen that nicotine appears to cause stiffer blood vessels, vascular damage, increased blood clot formation, and narrower airways. These effects are acute and significant, following the same patterns observed after smoking conventional cigarettes. Therefore, we believe that the long-term consequences will include an increased risk of common diseases such as heart attack, stroke, and COPD, explains Magnus Lundbäck from Danderyd Hospital.