Vaping may raise cognitive impairment risk in young adults, study finds

By Vijay Kumar MalesuReviewed by Susha Cheriyedath, M.Sc.Apr 13 2026

A Thailand-based study found that young adults who used e-cigarettes were far more likely to screen as at risk for cognitive impairment, adding fresh concern to the debate over whether vaping is really a safer alternative.

Study: The impact of e-cigarette use on cognitive function, emotional intelligence, and dementia risk in adolescents and young adults. Image Credit: Hazem.m.kamal / Shutterstock

In a recent study published in the journal Scientific Reports, a group of researchers evaluated the association between e-cigarette use and cognitive impairment, emotional intelligence, and Attention-Deficit/Hyperactivity Disorder (ADHD) symptom tendency in young adults.

Neurocognitive Concerns Around Young Adult Vaping

What if a habit considered “safer than smoking” quietly affects how the brain thinks, feels, and remembers? The rising popularity of e-cigarettes, also known as electronic nicotine delivery systems (ENDS), in young people and adolescent populations has raised concern worldwide.

Nicotine exposure during critical developmental years can affect brain maturation, influencing attention, emotional regulation, and long-term cognitive health. 

Conditions such as ADHD and early cognitive impairment risk are particularly relevant in this age group. At present, there is limited and inconsistent research on the relationship between ENDS and these neurocognitive outcomes.

Further research is needed to provide clarity on these relationships and inform public health policies.

Thailand E-Cigarette Study Design

A cross-sectional analytical study was conducted between August 2023 and July 2024 in Lat Krabang District, Bangkok, Thailand. In the study, 232 participants, aged 18-25 years, were equally divided into e-cigarette users and non-smokers (n = 116 each). Systematic random sampling was used to select participants based on predefined inclusion and exclusion criteria to ensure comparability between groups.

Structured questionnaires and validated instruments were used to collect data from participants. The Adult ADHD Self-Report Scale (ASRS) Version 1.1 was used to determine ADHD symptom tendency.

Emotional intelligence was measured by a standardized test of the Emotional Quotient that assessed self-regulation, empathy, motivation, and interpersonal skills. The Montreal Cognitive Assessment (MoCA), a well-validated screening instrument for identifying early cognitive impairment, was used to assess cognitive function and risk of cognitive impairment.

Demographic data, substance use, and e-cigarette use were also recorded for this study. All statistical analyses were conducted using IBM SPSS version 29, and group differences were assessed using Pearson's Chi-square test.

Binary logistic regression analysis was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for dementia risk predictor variables, and statistically significant results were set at p < 0.05. Ethical approval and informed consent were attained before beginning data collection.

ADHD, Emotional Intelligence, and Cognitive Findings

The study included 232 young adults with a mean age of approximately 22 years. Most participants were students (53.9% female), among whom alcohol use was common, but drug use was low. Nearly half reported having a family member who smoked, indicating potential environmental exposure to nicotine-related behaviors.

The majority of e-cigarette consumers reported moderate use, meaning that most smoked one or fewer e-cigarette devices per day. Most began during late adolescence, often motivated by curiosity, perceived reduced harm, and social influences. Social and contextual influences played a role, with many participants using e-cigarettes on nights out or in social settings, emphasizing the importance of peer environments in perpetuating use patterns.

Analysis of ADHD symptom tendency showed that approximately 10-11% of participants showed symptoms consistent with ADHD. It was observed that e-cigarette users and non-smokers showed no significant difference in attention-related symptoms, and this suggests that, in this group, vaping was not strongly linked to attention-related issues.

Emotional intelligence levels were generally within the normal range, but both groups showed lower than expected levels of empathy, decision-making, interpersonal relationships, and emotional well-being.

Comparisons between e-cigarette users and non-smokers revealed no statistically significant associations across the “Good,” “Competent,” and “Well-Being” dimensions of emotional intelligence. Although minor differences were observed, these patterns likely reflect social or contextual influences rather than direct effects of e-cigarette use.

E-Cigarette Use and Cognitive Impairment Risk

The risk of developing dementia was significantly increased for those who used e-cigarettes. A substantially higher proportion of e-cigarette users (39.7%) were classified as at risk for cognitive impairment compared to non-smokers (0.9%) (p < 0.001).

A number of additional analyses confirmed these findings, including a logistic regression analysis that demonstrated that individuals who do not plan to stop using e-cigarettes in the next month were six times more likely to experience cognitive impairment (OR = 6.04).

Those who do not plan to stop using e-cigarettes in the next six months were four times more likely to experience cognitive impairment (OR = 4.15).

Vaping Prevention and Research Implications

This study shows that e-cigarette use is significantly associated with increased dementia risk in young adults, even in the absence of strong links to ADHD symptoms or emotional intelligence. Regular vaping, especially without trying to quit, is associated with greater cognitive vulnerability, even in young people.

These findings are critical, as early changes in cognition could affect brain health, work productivity, and quality of life. Even though it is believed by many that e-cigarettes provide an alternative means of consuming nicotine safely, the long-term effects of e-cigarettes may have neurocognitive implications, although this study cannot establish causation. 

Strategies designed to change public perception should focus on raising awareness of early intervention and prevention measures intended to help individuals who currently use e-cigarettes. There is also a need for longitudinal research to clarify this association and the mechanisms that may underlie it. 

The findings should also be interpreted cautiously because the study was cross-sectional, used MoCA as a screening tool rather than a diagnostic test, and was conducted in a single urban district in Thailand.