Using e-cigarettes, referred to as vaping, works by heating a liquid to generate an aerosol that the user inhales. The liquid in the e-cigarette, called e-liquid, is usually made up of propylene glycol, glycerin, flavorings, water, and nicotine, although some users will substitute THC for nicotine. In practice, e-cigarette users tend to reach lower blood nicotine concentrations than tobacco smokers, although it is difficult to make a direct comparison because nicotine concentrations in e-cigarettes vary widely.
Another danger associated with e-cigarettes has to do with nicotine. Although the percentage of nicotine is much lower (0.3%–1.8%) than traditional tobacco products, one electronic cartridge (200–400 puffs) can equal the smoking of two to three packs of regular cigarettes. The dangerous effects of nicotine on gum tissue are well known. The literature suggests that nicotine affects gingival blood flow as it is a vasoconstrictor. It also affects cytokine production, neutrophil function, and other immune cell function. In addition, nicotine decreases connective tissue turnover. All of this results a much higher chance of developing gum disease and tooth loss.
Recently, a 24-year-old man from Texas was killed when his vape pen exploded, and part of the device wound up severing his jugular vein. Although these types of sensationalized deaths are rare with e-cigarettes and vaping pens (only two reported to date), the explosions of these pens are not. The problem lies within the vape pen and the lithium batteries overheating and exploding. These explosions are usually attributed to improper charging of the device or have been linked to a type of device called a mechanical mod that has no internal safety and can overheat and explode.
One report found that 195 of these adverse events occurred between the years of 2009 and 2016. However, Dennis Thombs, dean of the School of Public Health at UNT Health Science Center, published a study that concluded the number of vape explosions in the US were most likely underestimated. Thombs estimated that there were 2,035 e-cigarette explosions and burn injuries in the US between 2015 and 2017—more than 40 times the initial estimate by the US government. (8) These injuries are serious and often lead to disfigurement of oral soft tissue The bottom line is vaping can be just as dangerous, if not more dangerous, when compared with smoking. The problem is that vaping is thought to be a safer alternative to traditional tobacco products, and companies are adding flavoring products to attract younger generations. According to a 2013–2014 survey, 81% of current youth e-cigarette users cited the availability of appealing flavors as the primary reason for use.