A single vape session can harm immune cells in the body

E-cigarette vapors can stress cells in ways that could promote disease, new data show

a white teenage girl blows a plume of vape smoke

Here’s yet another reason teens should not experiment with e-cigarettes. Just one vape session can create tissue-damaging free radicals, new data show.

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Vaped nicotine is now one of the most common drugs by used U.S. teens. Last year, nearly one in three high schoolers used e-cigarettes daily or almost daily. It’s easy to think that only people who vape regularly face any health risks. But a new study finds that a single vape session damages cells. And it causes the type of damage that underlies many long-term diseases.

Holly Middlekauff is a heart specialist at the University of California, Los Angeles. This doctor is interested in behaviors that can lead to heart trouble later in life. Vaping is among them. But there had been little research on the near-term health impacts of vaping.

So Middlekauff worked with a team that recruited 32 healthy young adults for a study. Most of these people were in their early to mid-20s. Within the group, about one-third had smoked conventional cigarettes for more than a year. Another third had used e-cigarettes — vaped — for at least a year. A third group had not used either nicotine product.

Each recruit came to the research lab on two separate days. On one day, the participant puffed on an e-cigarette. At the second visit, they puffed on an empty straw. (This was the control: They went through the same motions as vaping but didn’t inhale the chemicals.) The team randomly assigned which visit for each person would be a control or vaping session.

At each visit, the research team also collected blood samples. One was drawn right after someone arrived. Four hours after the vaping session was over, the scientists drew blood again.

The team extracted immune cells from the blood. The researchers then looked for signs of oxidative stress. “Oxidative stress refers to molecules that contain oxygen in a special form,” Middlekauff explains. Called free radicals, these molecules are unstable. “They react with, or even attack, other compounds,” she says. At times, that can be helpful. Free radicals can attack germs, for example.

“But if the oxidative stress becomes imbalanced or excessive, it can be harmful and attack proteins and fats that are part of our cells,” she notes. Over time, that damage can lead to all types of health problems. Free-radical damage, she points out, can lead to heart and lung disease, cancer, premature aging and diseases such as dementia.

People who had never smoked had low measures of oxidative stress before vaping. Long-term smokers and vapers had higher levels. After vaping, nonsmokers experienced high levels of free radicals in their immune cells. “Up to four times the levels [compared to] before vaping,” Middlekauff says. That didn’t happen after puffing on the empty straw.

Long-term users didn’t show a big increase in free radicals when they vaped. That’s probably because their starting levels were already high, the team reports in the August 9 JAMA Pediatrics.

The take home for teens

Last year, some 3.6 million U.S. middle- and high-school students vaped. Janet Woodcock is a doctor and acting commissioner of the U.S. Food and Drug Administration. She reported the number at a June 23 congressional hearing in Washington, D.C. She added that “almost 40 percent of high school students using e-cigarettes were using them on 20 or more days out of the month.”

The new findings by Middlekauff’s team now point to health impacts that anyone who even experiments with vaping can encounter. And though her study was done in adults, “the results would be expected to be the same in teenagers,” Middlekauff says. That’s why her team published its findings in a journal aimed at pediatricians. Indeed, she notes, teens are the biggest group that has been experimenting with vaping.

“This study shows that even a short vaping session might have long-term consequences,” says Lucy Popova. She is a tobacco and health researcher at Georgia State University in Atlanta. She was not involved with the study. “Teens are smart,” she says. “They make their own decisions. And studies like [this] give them information to base the decisions on.” Sharing such data is an important way “to counteract the ads and social-media information that often presents vapes as cool harmless products,” she says. Popova and Middlekauff both hope teens take note. “Even a little bit of vaping can lead to real, dramatic and unambiguous adverse effects on the body,” Middlekauff says.

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