Vaping: The Hidden Risks Young People Aren’t Being Told About

It’s the newest epidemic among adolescents of the 21st century and it isn’t stopping any time soon. Walk through any school hallway, bus stop, or social media feed and I assure you the same message will be presented over and over again: “Vaping is safer than smoking.” It’s a claim that sounds reassuring as it is intended to target current smokers who are looking for a safer or better alternative for a habit that is already so difficult to break. But what we aren’t accounting for is how attractive this statement is for younger generations who may be inclined to buy nicotine products for the first time. From their perspective, if there is a safer version of the cigarette, it may be worth a try, since afterall, it’s safer, right? As it turns out, this may not be exactly the case. A major scientific review release in 2025 sends a very different warning: vaping is not the harmless trend it’s marketed to be and in fact, it may be quietly reshaping youth health in ways that will have long-lasting consequences. 

Researchers from the University of York and the London School of Hygiene & Tropical Medicine conducted the most comprehensive umbrella review ever published on vaping harms in young people. They analyzed 56 systematic reviews, covering hundreds of thousands of adolescents across multiple countries, to answer one urgent question: How does vaping actually affect young people’s bodies, behavior, and future health? The results are striking.

1. Vaping triples the likelihood of smoking cigarettes later in life

Although it may seem intuitive that inhaling nicotine at a young age could lead to cigarette use later on, many teens who vape insist that they would “never smoke”. But the data tell a very different story, revealing a pattern that contradicts what many young users believe about their own risk. One of the strongest and most consistent findings comes from 21 systematic reviews focused on smoking initiation. If a young person vapes, even just experimentally, they are about three times more likely to start smoking cigarettes later compared with peers who never vaped. This is a pattern held across countries, age groups, and study designs. Odds ratios ranged from 1.5 to 26.0, overwhelmingly pointing in the same direction: vaping opens the door to tobacco use, not away from it. This directly challenges the idea that vapes “prevent” smoking. Instead, the evidence supports what researchers call a gateway effect.

2. Links to alcohol, marijuana, and other substances

The review found vaping doesn’t just influence cigarette use, it also clusters with other risky behaviors. Young people who vape are 4.5 to 6.7 times more likely to drink alcohol or engage in binge drinking compared with those who don’t vape. They are also 2.7 to 6 times more likely to go on to use marijuana. In addition, one study found that adolescents who vape have more than double the odds of misusing stimulants such as Ritalin or Adderall. These findings raise an important point for youth prevention: vaping is rarely an isolated behavior. Instead, it often marks entry into broader patterns of substance use.

3. Real respiratory harm: asthma, coughing, lung injury

Across numerous studies, young people who vape were found to have 20–36% higher odds of being diagnosed with asthma, and those who already had asthma were 44% more likely to experience flare-ups compared with non-vapers. Research also shows consistent links between vaping and chronic coughing, wheezing, and bronchitis-like symptoms, suggesting that repeated exposure to vapor irritates and inflames the airways. The review further documented cases of EVALI, a severe, sometimes life-threatening lung injury, in adolescents as young as 13 years old, reinforcing that while these events may be uncommon, they are real and can occur in very young users.

4. Mental health concerns: depression and suicidality

Some of the most concerning findings relate to mental health. Studies included in the review showed that adolescents who vape report significantly higher levels of depressive symptoms, as well as greater likelihood of suicidal thoughts, planning, and attempts, with some odds ratios ranging from 2.2 to over 6. Although these results do not prove that vaping directly causes mental health struggles, they highlight a troubling pattern: young people who vape appear to be at elevated risk for serious psychological distress. This association, especially in the context of rising youth mental health challenges, underscores the need for greater attention and intervention.

5. Additional harms that often go unnoticed

Beyond respiratory and mental health impacts, the umbrella review identified several additional harms that are often overlooked in conversations about vaping. These include burn injuries caused by device malfunctions or explosions, which can affect the mouth, face, hands, or legs. Studies also report oral health problems, such as gum pain, cracked teeth, and persistent dry mouth among adolescent users. Other frequently reported symptoms include dizziness, headaches, and migraines, suggesting acute effects on the nervous system. For young men, vaping was also associated with lower sperm counts in at least one cross-sectional study, pointing toward potential reproductive consequences. While some of these findings come from smaller datasets, together they portray vaping as a product with far more wide-reaching risks than many youth recognize.

The biggest takeaway from this massive review is simple: Vaping is not harmless. It carries real physical, mental, and behavioral risks, especially for young people. These findings support stronger policies that limit youth access to vapes and call for clearer education that cuts through marketing myths. For teens and families, this research provides something even more important: a clearer understanding of the stakes behind what may seem like “just a puff.”

Written by: Omesh Persaud

Edited by: Albert Deluxe Citation

Golder S., Hartwell G., Barnett L.M., et al. Vaping and harm in young people: umbrella review. Tobacco Control, 2025.