E-Cigarettes, Vaping, and Tobacco: Scoping Review with ☸️SAIMSARA.

Name: SAIMSARA Evidence Object longevity::E_CIGS_VAPING_TOBACCO_PM
Creator: SAIMSARA
License: https://saimsara.com/license/

SAIMSARA

doi:10.62487/saimsara7a9d22b6

E-Cigarettes, Vaping, and Tobacco: Scoping Review with ☸️SAIMSARA.

Issue 2, Volume 1, 2026

Editorial note

• Last update: 2026-05-13 07:23:01

What is this paper about

E-cigarettes may reduce selected harms when they fully replace combustible tobacco, but this evidence map shows why they cannot be treated as harmless nicotine products. The full SAIMSARA evidence map gives human- and machine-readable access to 123 references, clarifying substitution benefits, dual-use risks, youth uptake, toxicology, vascular and airway effects, pregnancy signals, and regulatory implications.

Human-verified editorial review Verified by World ID proof-of-human. This editorial layer was submitted from a SAIMSARA account verified as a unique human.

Evidence preview · Did you know?

Realistic clinical-public-health scene showing an adult smoker switching from combustible cigarettes to vaping.

Substitution can change exposure

Did you know? In experienced e-cigarette users, 78% reported no tobacco use in the previous 30 days.

That is the harm-reduction signal: benefit appears strongest when vaping fully replaces combustible cigarettes.

Realistic youth public-health scene showing vaping products, social media influence, and tobacco-risk awareness.

The youth signal is not small

Did you know? Adolescent susceptibility to e-cigarettes was 36.6%, higher than cigarette susceptibility at 27.8%.

This makes e-cigarettes a possible nicotine entry point, not only a smoking-reduction tool.

Realistic regulatory-toxicology scene showing vaping devices, laboratory testing, and public-health oversight.

Not harmless vapor

Did you know? Long-term e-cig exposure in mice induced lung adenocarcinomas in 22.5% and bladder urothelial hyperplasia in 57.5%.

This is not direct human cancer proof, but it is a strong reason for long-term toxicology and regulatory caution.

Swipe sideways on mobile · full evidence map opens after unlock

Abstract:

Keywords:

Review Stats

Final search date and database lock: 2026-05-11 23:58:30 CEST

Plan: Pro (expanded craft tokens; source: PubMed)

Source: PubMed

Total Abstracts/Papers: 193

Downloaded Abstracts/Papers: 193

Included original and non-original Abstracts/Papers (all): 143

Included original Abstracts/Papers (Vote counting by direction of effect): 123

Reference Index (links used in paper): 123

Total participants/sample observations (topic deduplicated ΣN): 8769068

Get access to the full paper

Unlock the full evidence map

The full evidence review, including the Introduction, Methods, Results, Discussion, Conclusion, figures, and complete reference index, opens after purchase or sign-in. The Evidence Object JSON is a separate machine-readable evidence product: a concentrated synthesis of results, topic-level evidence, and discussion across original and non-original studies. It can be directly input into your LLM, agent, or RAG workflow.

Reference Index (123)

[1] Vapes, E-cigs, and Mods: What Do Young Adults Call E-cigarettes? — https://doi.org/10.1093/ntr/nty223
[2] Electronic cigarettes (e-cigs): views of aficionados and clinical/public health perspectives. — https://doi.org/10.1111/j.1742-1241.2011.02751.x
[3] Development of a standardized new cigarette smoke generating (SNCSG) system for the assessment of chemicals in the smoke of new cigarette types (heat-not-burn (HNB) tobacco and electronic cigarettes (E-Cigs)). — https://doi.org/10.1016/j.envres.2020.109413
[5] Reasons why dual users of e-cigarette and conventional tobacco initiate or maintain dual use. A systematic review. — https://doi.org/10.20882/adicciones.1995
[6] Usage Pattern and Nicotine Delivery during Ad Libitum Consumption of Pod E-Cigarettes and Heated Tobacco Products. — https://doi.org/10.3390/toxics11050434
[7] Conventional tobacco and electronic cigarettes differentially affect cardiovascular health in male and female mice. — https://doi.org/10.1152/ajpheart.00492.2025
[8] Exhaled Carbon Monoxide Levels in Forty Resistant to Cessation Male Smokers after Six Months of Full Switch to Electronic Cigarettes (e-Cigs) or to A Tobacco Heating Systems (THS). — https://doi.org/10.3390/ijerph16203916
[9] Young adults report increased pleasure from using e-cigarettes and smoking tobacco cigarettes when drinking alcohol. — https://doi.org/10.1016/j.addbeh.2019.01.011
[10] Examining cigarette, heated tobacco and e-cigarette market pricing and tax pass-through in Ukraine during the 2019-2022 tax reforms. — https://doi.org/10.1136/tc-2025-059290
[11] Nicotine aerosols diminish airway CFTR function and mucociliary clearance. — https://doi.org/10.1152/ajplung.00453.2021
[12] E-cigarette exposure augments murine abdominal aortic aneurysm development: role of Chil1. — https://doi.org/10.1093/cvr/cvac173
[15] Smoking habits, ETS exposure and knowledge of tobacco and e-cigarettes/HTPs among university students in Italy-a multicentre study. — https://doi.org/10.1186/s12889-026-26840-4
[16] Fetal Growth Following Electronic Cigarette Use in Pregnancy. — https://doi.org/10.3390/ijerph21091179
[17] Use and susceptibility of youth aged 13-15 years to cigarettes, e-cigarettes and heated tobacco products: results of the Global Youth Tobacco Survey 2022 in eight Italian regions. — https://doi.org/10.1093/eurpub/ckaf126
[18] Effects of electronic cigarette E-liquid and device wattage on vascular function. — https://doi.org/10.1016/j.taap.2023.116631
[19] Single-cell transcriptomics identifies altered neutrophil dynamics and accentuated T-cell cytotoxicity in tobacco-flavored e-cigarette-exposed mouse lungs. — https://doi.org/10.7554/elife.106380
[20] Tobacco and menthol flavored nicotine-free electronic cigarettes induced inflammation and dysregulated repair in lung fibroblast and epithelium. — https://doi.org/10.1186/s12931-023-02537-9
[21] Poor Perception and Knowledge of Electronic Cigarettes Among Adolescents and Their Parents. — https://doi.org/10.1097/pec.0000000000002339
[22] Regulating E-cigarettes in India: A conundrum for the global giant in tobacco production. — https://doi.org/10.1016/j.ijtb.2019.02.014
[23] Evaluation of Nicotine and the Components of e-Liquids Generated from e-Cigarette Aerosols. — https://doi.org/10.1093/jat/bky056
[24] The impact of e-cigarette exposure on different organ systems: A review of recent evidence and future perspectives. — https://doi.org/10.1016/j.jhazmat.2023.131828
[27] E-cigarette use and perceived health change: Better health through vaping? — https://doi.org/10.18332/tid/95218
[28] Harmful chemicals emitted from electronic cigarettes and potential deleterious effects in the oral cavity. — https://doi.org/10.18332/tid/116988
[29] JUUL and Combusted Cigarettes Comparably Impair Endothelial Function. — https://doi.org/10.18001/trs.6.1.4
[30] Nicotine Sensors for Wearable Battery-Free Monitoring of Vaping. — https://doi.org/10.1021/acssensors.1c01633
[31] A Review of Pulmonary Toxicity of Electronic Cigarettes in the Context of Smoking: A Focus on Inflammation. — https://doi.org/10.1158/1055-9965.epi-17-0358
[32] Electronic Cigarettes for Curbing the Tobacco-Induced Burden of Noncommunicable Diseases: Evidence Revisited with Emphasis on Challenges in Sub-Saharan Africa. — https://doi.org/10.1155/2016/4894352
[33] Comparative in vitro toxicity profile of electronic and tobacco cigarettes, smokeless tobacco and nicotine replacement therapy products: e-liquids, extracts and collected aerosols. — https://doi.org/10.3390/ijerph111111325
[35] E-cigarettes and flavorings induce inflammatory and pro-senescence responses in oral epithelial cells and periodontal fibroblasts. — https://doi.org/10.18632/oncotarget.12857
[36] Latin America and the Caribbean Code Against Cancer 1st edition: Tobacco and nicotine-related products, secondhand smoke, and alcohol and cancer. — https://doi.org/10.1016/j.canep.2023.102413
[37] Tobacco control in Mexico: a decade of progress and challenges. — https://doi.org/10.21149/9360
[38] Chronic electronic cigarette use elicits molecular changes related to pulmonary pathogenesis. — https://doi.org/10.1016/j.taap.2020.115224
[39] E-Cigarette Aerosol Condensate Leads to Impaired Coronary Endothelial Cell Health and Restricted Angiogenesis. — https://doi.org/10.3390/ijms24076378
[40] Impact of Electronic Cigarettes on the Upper Aerodigestive Tract: A Comprehensive Review for Otolaryngology Providers. — https://doi.org/10.1002/oto2.25
[41] Transcriptomic responses in the blood and sputum of cigarette smokers compared to e-cigarette vapers. — https://doi.org/10.1186/s12931-023-02438-x
[43] The combination of propylene glycol and vegetable glycerin e-cigarette aerosols induces airway inflammation and mucus hyperconcentration. — https://doi.org/10.1038/s41598-024-52317-8
[45] Differential effects of traditional cigarette, electronic cigarette, and tobacco heating product on human vascular smooth muscle cell phenotypic switch: A comparative functional perspective. — https://doi.org/10.1016/j.atherosclerosis.2025.120412
[46] Ventilation and features of the lung environment dynamically alter modeled intrapulmonary aerosol exposure from inhaled electronic cigarettes. — https://doi.org/10.1038/s41598-024-81066-x
[47] Free Radical, Carbonyl, and Nicotine Levels Produced by Juul Electronic Cigarettes. — https://doi.org/10.1093/ntr/nty221
[48] Maternal e-cigarette use can disrupt postnatal blood-brain barrier (BBB) integrity and deteriorates motor, learning and memory function: influence of sex and age. — https://doi.org/10.1186/s12987-023-00416-5
[49] Lipid laden macrophages and electronic cigarettes in healthy adults. — https://doi.org/10.1016/j.ebiom.2020.102982
[50] Metabolomics Provides Novel Insights into the Potential Toxicity Associated with Heated Tobacco Products, Electronic Cigarettes, and Tobacco Cigarettes on Human Bronchial Epithelial BEAS-2B Cells. — https://doi.org/10.3390/toxics12020128
[51] Transcriptome characterization of human gingival mesenchymal and periodontal ligament stem cells in response to electronic-cigarettes. — https://doi.org/10.1016/j.envpol.2023.121307
[52] Real-Time Assessment of E-Cigarettes and Conventional Cigarettes Emissions: Aerosol Size Distributions, Mass and Number Concentrations. — https://doi.org/10.3390/toxics7030045
[53] New Insights From MRI and Cell Biology Into the Acute Vascular-Metabolic Implications of Electronic Cigarette Vaping. — https://doi.org/10.3389/fphys.2020.00492
[54] Nicotine or marijuana vaping exposure during pregnancy and altered immune responses in offspring. — https://doi.org/10.20517/jeea.2024.03
[55] Interplay between proteasome function and inflammatory responses in e-cig vapor condensate-challenged lung epithelial cells. — https://doi.org/10.1007/s00204-023-03504-5
[56] Regulation in the face of uncertainty: the evidence on electronic nicotine delivery systems (e-cigarettes). — https://doi.org/10.2147/rmhp.s62116
[57] A comparative toxicological evaluation of emerging nicotine analogs 6-methyl nicotine and nicotinamide: a scoping review. — https://doi.org/10.1007/s00204-025-03960-1
[58] JUUL e-liquid exposure elicits cytoplasmic Ca responses and leads to cytotoxicity in cultured airway epithelial cells. — https://doi.org/10.1016/j.toxlet.2020.11.017
[60] Pharmacokinetic differences in nicotine and nicotine salts mediate reinforcement-related behavior: an animal model study. — https://doi.org/10.3389/fnins.2023.1288102
[61] Comparison of the chemical composition of aerosols from heated tobacco products, electronic cigarettes and tobacco cigarettes and their toxic impacts on the human bronchial epithelial BEAS-2B cells. — https://doi.org/10.1016/j.jhazmat.2020.123417
[62] The Importance of Conditioned Stimuli in Cigarette and E-Cigarette Craving Reduction by E-Cigarettes. — https://doi.org/10.3390/ijerph14020193
[63] Biomarkers of Exposure Specific to E-vapor Products Based on Stable-Isotope Labeled Ingredients. — https://doi.org/10.1093/ntr/nty204
[64] The impact of tobacco smoking and electronic cigarette vaping on salivary biomarkers. A comparative study. — https://doi.org/10.1016/j.sdentj.2022.05.003
[65] Effect of Electronic Cigarette Use on the Urge-to-Cough Sensation. — https://doi.org/10.1093/ntr/ntw021
[66] Electronic Cigarette Vaping Did Not Enhance the Neural Process of Working Memory for Regular Cigarette Smokers. — https://doi.org/10.3389/fnhum.2022.817538
[67] Biomarkers of Exposure and Effect in the Lungs of Smokers, Nonsmokers, and Electronic Cigarette Users. — https://doi.org/10.1158/1055-9965.epi-19-1245
[68] Longitudinal transitions in adolescent polytobacco use across waves 1-4 of the Population Assessment of Tobacco and Health study. — https://doi.org/10.1111/add.16095
[69] The effects of electronic smoking on dental caries and proinflammatory markers: a systematic review and meta-analysis. — https://doi.org/10.3389/froh.2025.1569806
[70] Electronic cigarette solvents, pulmonary irritation, and endothelial dysfunction: role of acetaldehyde and formaldehyde. — https://doi.org/10.1152/ajpheart.00878.2020
[71] Abuse liability assessment of an electronic cigarette in combustible cigarette smokers. — https://doi.org/10.1037/pha0000261
[73] E-cig vapor condensate alters proteome and lipid profiles of membrane rafts: impact on inflammatory responses in A549 cells. — https://doi.org/10.1007/s10565-020-09573-x
[74] In vitro cytoxicity profile of e-cigarette liquid samples on primary human bronchial epithelial cells. — https://doi.org/10.1002/dta.3275
[75] Smoking Cessation and Electronic Cigarette Use among Head and Neck Cancer Patients. — https://doi.org/10.1177/0194599815613279
[76] Chronic exposure to e-cig aerosols during early development causes vascular dysfunction and offspring growth deficits. — https://doi.org/10.1016/j.trsl.2019.01.001
[78] Revisiting the Rise of Electronic Nicotine Delivery Systems Using Search Query Surveillance. — https://doi.org/10.1016/j.amepre.2015.12.008
[79] The Era of E-Cigarettes: A Cross-Sectional Study of Vaping Preferences, Reasons for Use and Withdrawal Symptoms Among Current E-Cigarette Users in the United Arab Emirates. — https://doi.org/10.1007/s10900-021-00967-4
[80] E-Liquid Containing a Mixture of Coconut, Vanilla, and Cookie Flavors Causes Cellular Senescence and Dysregulated Repair in Pulmonary Fibroblasts: Implications on Premature Aging. — https://doi.org/10.3389/fphys.2020.00924
[82] Chronic exposure to electronic cigarettes results in impaired cardiovascular function in mice. — https://doi.org/10.1152/japplphysiol.00713.2017
[83] E-cigarette Aerosol Condensate Enhances Metabolism of Benzo(a)pyrene to Genotoxic Products, and Induces CYP1A1 and CYP1B1, Likely by Activation of the Aryl Hydrocarbon Receptor. — https://doi.org/10.3390/ijerph16142468
[84] E-cigarette exposure during pregnancy impairs uterine artery blood flow and feto-placental function. — https://doi.org/10.1093/toxsci/kfaf161
[85] Status of home-based secondhand smoke exposure among children and its association with health risks in Japan. — https://doi.org/10.1016/j.pmedr.2023.102585
[86] A Method for Classifying User-Reported Electronic Cigarette Liquid Flavors. — https://doi.org/10.1093/ntr/ntw383
[87] Assessing Smoking Habits, Attitudes, Knowledge, and Needs among University Students at the University of Milan, Italy. — https://doi.org/10.3390/ijerph191912527
[88] Vapors produced by electronic cigarettes and e-juices with flavorings induce toxicity, oxidative stress, and inflammatory response in lung epithelial cells and in mouse lung. — https://doi.org/10.1371/journal.pone.0116732
[89] Toxicological Aspects Associated with Consumption from Electronic Nicotine Delivery System (ENDS): Focus on Heavy Metals Exposure and Cancer Risk. — https://doi.org/10.3390/ijms25052737
[90] A framework to investigate the impact of topography and product characteristics on electronic cigarette emissions. — https://doi.org/10.1371/journal.pone.0206341
[91] The effect of electronic cigarette and tobacco smoke exposure on COPD bronchial epithelial cell inflammatory responses. — https://doi.org/10.2147/copd.s157728
[92] Toward automated e-cigarette surveillance: Spotting e-cigarette proponents on Twitter. — https://doi.org/10.1016/j.jbi.2016.03.006
[93] Electronic-cigarette smoke induces lung adenocarcinoma and bladder urothelial hyperplasia in mice. — https://doi.org/10.1073/pnas.1911321116
[94] Effect of e-Cigarette Use on Cough Reflex Sensitivity. — https://doi.org/10.1378/chest.15-0817
[95] Comparative effects between electronic and cigarette smoke in human keratinocytes and epithelial lung cells. — https://doi.org/10.1016/j.tiv.2014.04.012
[96] Exosomal microRNAs are novel circulating biomarkers in cigarette, waterpipe smokers, E-cigarette users and dual smokers. — https://doi.org/10.1186/s12920-020-00748-3
[97] Vaping Exacerbates Coronavirus-Related Pulmonary Infection in a Murine Model. — https://doi.org/10.3389/fphys.2021.634839
[98] Inhalation of electronic cigarette aerosol induces reflex bronchoconstriction by activation of vagal bronchopulmonary C-fibers. — https://doi.org/10.1152/ajplung.00137.2018
[99] A Survey of Current Tobacco and Nicotine Product Users to Identify Barriers to Quitting Smoking in Germany. — https://doi.org/10.7759/cureus.82419
[100] Comparison of the in vivo genotoxicity of electronic and conventional cigarettes aerosols after subacute, subchronic and chronic exposures. — https://doi.org/10.1016/j.jhazmat.2021.127246
[101] Using twitter to examine smoking behavior and perceptions of emerging tobacco products. — https://doi.org/10.2196/jmir.2534
[103] Attitudes towards tobacco and nicotine control policies in Italy: insights from a 2024 national survey. — https://doi.org/10.1093/ntr/ntag041
[104] Effects of E-Cigarette (e-cig) Aerosols on Mutagenesis in Selected Organs in a C57 (BigBlue) Mouse Model. — https://doi.org/10.3390/ijerph21121693
[105] Proinflammatory cytokine levels and peri-implant parameters among cigarette smokers, individuals vaping electronic cigarettes, and non-smokers. — https://doi.org/10.1002/jper.18-0045
[106] Electronic cigarette vapour increases virulence and inflammatory potential of respiratory pathogens. — https://doi.org/10.1186/s12931-019-1206-8
[108] The Effect of Comparatively-Framed versus Similarity-Framed E-Cigarette and Snus Print Ads on Young Adults' Ad and Product Perceptions. — https://doi.org/10.18001/trs.2.3.2
[109] Free Radical Production and Characterization of Heat-Not-Burn Cigarettes in Comparison to Conventional and Electronic Cigarettes. — https://doi.org/10.1021/acs.chemrestox.0c00088
[110] Reasons for Using Electronic Cigarettes and Intentions to Quit Among Electronic Cigarette Users in Malaysia. — https://doi.org/10.1007/s10900-016-0196-4
[111] Effect of smoking abstinence and reduction in asthmatic smokers switching to electronic cigarettes: evidence for harm reversal. — https://doi.org/10.3390/ijerph110504965
[112] Increased sensitivity to Δ-THC-induced rewarding effects after seven-week exposure to electronic and tobacco cigarettes in mice. — https://doi.org/10.1016/j.euroneuro.2019.02.001
[113] A C. elegans model of electronic cigarette use: Physiological effects of e-liquids in nematodes. — https://doi.org/10.1186/s40360-015-0030-0
[114] Quit and smoking reduction rates in vape shop consumers: a prospective 12-month survey. — https://doi.org/10.3390/ijerph120403428
[115] Smoking and use of electronic cigarettes (vaping) in relation to preterm birth and small-for-gestational-age in a 2016 U.S. national sample. — https://doi.org/10.1016/j.ypmed.2020.106041
[116] Detection of Metal-Containing Particles in FDA-Authorized and New Disposable Electronic Cigarette Aerosols. — https://doi.org/10.1021/acs.est.5c08370
[118] Prevalence of cigarette smoking and secondhand smoke exposure in Italy in 2024. — https://doi.org/10.1177/03008916251378261
[119] Conventional and electronic cigarettes dysregulate the expression of iron transporters and detoxifying enzymes at the brain vascular endothelium: In vivo evidence of a gender-specific cellular response to chronic cigarette smoke exposure. — https://doi.org/10.1016/j.neulet.2018.05.045
[120] Nicotine delivery, tolerability and reduction of smoking urge in smokers following short-term use of one brand of electronic cigarettes. — https://doi.org/10.1186/s12889-015-2349-2
[121] Vaping effects on asthma: results from a web survey and clinical investigation. — https://doi.org/10.1007/s11739-019-02247-5
[122] Deregulation of Biologically Significant Genes and Associated Molecular Pathways in the Oral Epithelium of Electronic Cigarette Users. — https://doi.org/10.3390/ijms20030738
[123] Determination of Nicotine Content and Delivery in Disposable Electronic Cigarettes Available in the United States by Gas Chromatography-Mass Spectrometry. — https://doi.org/10.1093/ntr/ntv120
[124] A content analysis of the promotional strategies employed by e-cigarette brands on Twitter. — https://doi.org/10.1080/07359683.2019.1680121
[125] Effects of using electronic cigarettes on nicotine delivery and cardiovascular function in comparison with regular cigarettes. — https://doi.org/10.1016/j.yrtph.2014.11.004
[126] A comparison of nicotine dependence among exclusive E-cigarette and cigarette users in the PATH study. — https://doi.org/10.1016/j.ypmed.2017.04.001
[127] Prevalence and correlates of prior experimentation with e-cigarettes over conventional cigarettes among adolescents: Findings from the 2015 Korea Youth Risk Behaviour Web-based Survey. — https://doi.org/10.18332/tpc/112595
[128] Effects of nicotine versus placebo e-cigarette use on symptom relief during initial tobacco abstinence. — https://doi.org/10.1037/pha0000134
[129] [Formaldehyde in electronic cigarettes and in heat-not-burn products: let's make the point]. — https://doi.org/10.19191/ep18.5-6.p351.104
[130] Vaping: Impact of Improving Screening Questioning in Adolescent Population: A Quality Improvement Initiative. — https://doi.org/10.1097/pq9.0000000000000370
[131] Assessing electronic cigarette emissions: linking physico-chemical properties to product brand, e-liquid flavoring additives, operational voltage and user puffing patterns. — https://doi.org/10.1080/08958378.2018.1450462
[133] Environmental Electronic Vape Exposure from Four Different Generations of Electronic Cigarettes: Airborne Particulate Matter Levels. — https://doi.org/10.3390/ijerph15102172
[135] Effects of six weeks of electronic cigarette use on smoking rate, CO, cigarette dependence, and motivation to quit smoking: A pilot study. — https://doi.org/10.1016/j.addbeh.2018.01.012
[136] Development of a questionnaire for assessing dependence on electronic cigarettes among a large sample of ex-smoking E-cigarette users. — https://doi.org/10.1093/ntr/ntu204
[139] Effectiveness of the electronic cigarette: An eight-week Flemish study with six-month follow-up on smoking reduction, craving and experienced benefits and complaints. — https://doi.org/10.3390/ijerph111111220
[141] Emerging nicotine analog 6-methyl nicotine increases reactive oxygen species in aerosols and cytotoxicity in human bronchial epithelial cells. — https://doi.org/10.1016/j.toxlet.2025.01.007
[142] Health professionals in Flanders perceive the potential health risks of vaping as lower than those of smoking but do not recommend using e-cigarettes to their smoking patients. — https://doi.org/10.1186/s12954-016-0111-4
[143] Characterization of puff topography of a prototype electronic cigarette in adult exclusive cigarette smokers and adult exclusive electronic cigarette users. — https://doi.org/10.1016/j.yrtph.2018.07.019

E-Cigarettes, Vaping, and Tobacco: Scoping Review with ☸️SAIMSARA.

Longevity & Public Health

Issue 2, Volume 1, 2026

Substitution can change exposure

The youth signal is not small

Not harmless vapor

Get access to the full paper