Toxicological Profile Of Electronic Cigarette Use: A Literature-Based Review

Year 2026, Volume: 7 Issue: 3, 60 - 65, 10.01.2026

Gamze Sultan Güler , Muhammed Semih Gedik , Muhammed Ali Güler , Nur Paksoy , Muhammed Alkaya

https://doi.org/10.51262/ejtox.1844579

Abstract

Electronic cigarettes (e-cigarettes) are rapidly expanding products marketed as alternatives to conventional tobacco products and are often promoted as being less harmful. However, current literature indicates that e-cigarettes may pose significant health risks due to their complex toxicological profile. E-cigarette aerosols contain a variety of toxic chemicals, including nicotine, propylene glycol, vegetable glycerin, carbonyl compounds (formaldehyde, acetaldehyde, acrolein), heavy metals, aromatic additives, and volatile organic compounds. Many of these substances are formed through termal degradation and have been associated with oxidative stress, inflammation, cellular toxicity, and genotoxic effects. These toxicants exert adverse effects on oral and dental tissues as well as the pulmonary and cardiovascular systems, and several exhibit potential carcinogenic properties. Nicotine is a highly addictive alkaloid with pronounced effects on cardiovascular stress, sympathetic nervous system activation, and reward pathways. Although nicotine concentrations in e-cigarettes are often reported to be lower than those in conventional cigarettes, exposure levels may vary substantially depending on device type and technical characteristics. Similarly, other toxic constituents are generally present at lower levels in e-cigarette aerosols; nevertheless, individual exposure may differ markedly according to device design, heating temperature, e-liquid composition, and user behavior. E-cigarette use has been potentially associated with various adverse health outcomes, including chronic bronchitis, asthma, chronic obstructive pulmonary disease (COPD), e-cigarette or vaping use-associated lung injury (EVALI), inflammatory and microbiome-related alterations in oral and dental tissues. Cardiovascular effects resemble those of conventional cigarette smoking and include endothelial dysfunction, atherosclerosis, elevated blood pressure, increased heart rate, and a heightened risk of cardiovascular disease. The widespread use of new-generation disposable devices, particularly among adolescent and young adults, underscores the importance of identifying long-term health risks. This narrative review systematically evaluates the toxicological effects of e-cigarettes, highlighting both acute and chronic health risks. Future long-term epidemiological studies are essential to accurately assess these risks and to inform evidence-based public health policies.

Keywords

Aerosol , E-Cigarette , EVALI , Nicotine , Toxicology

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