Clinical Impact of Vaping

The term 'vaping' refers to the use of electronic cigarettes or other devices to inhale a variety of heated and aerosolized substances. Vaping has been promoted as a less harmful and potentially oncogenic alternative to nicotine cigarettes, particularly to help heavy smokers quit. While vaping products do not produce the same carcinogenic substances-such as polycyclic aromatic hydrocarbons-generated by the combustion of tobacco, and while their fluids lack tobacco-related carcinogens like nitrosamines, it is now well established that they still generate harmful and potentially oncogenic byproducts. Several mechanisms have been proposed to explain the potential oncogenic effects of vaping fluids, including direct chemical action, epithelial-mesenchymal transition induction, redox stress, mitochondrial toxicity, and DNA damage. In addition to cancer risk, there have been reports of adverse effects on cardiovascular health, reproductive function, and non-oncologic lung injuries. These include exogenous lipoid pneumonia, diffuse alveolar hemorrhage with proven alveolar injury, and vaping-associated bronchiolitis obliterans. The aim of this review is to examine vaping devices, their potential role in lung carcinogenesis, vaping-associated lung injury, and other clinical implications, including impacts on cardiovascular, cerebrovascular, and respiratory diseases, and also pregnancy and fetus health.