Vaping reduces fitness and blood vessel function in young adults

Young people who vape or smoke cigarettes have reduced blood vessel functionality, breathing efficiency and exercise capacity compared to those who have never smoked or vaped, according to a study published today in ERJ Open Research.

Dr. Azmy Faisal, the lead author of the study from the Manchester Metropolitan University, United Kingdom, explains: "In active, healthy young adults with normal lungs, both vapes and tobacco smoking led to worsened exercise capacity, shortness of breath, and intense leg fatigue.

"Like smoking, our research indicates that vaping can lead to harmful changes to the blood vessels, lung efficiency during exercise and approximately a 15% reduction in fitness compared to those who have never smoked or vaped."

The study examined 75 people aged 18-30, a third had never smoked or vaped, a third were smokers but had never used vapes, and a third were vapers for approximately 3 years but had never smoked. All participants had normal resting lung function and similar lifestyles, including caffeine and alcohol consumption, and physical activity levels.

Each volunteer took part in an incremental cycle exercise test whilst having their heart, breathing and blood lactate responses measured at increasing difficulty until they reached their maximum. Ultrasound scans and blood tests were also done to look how well their arteries were functioning. Test results found that at their peak exercise ability, the vaping and smoking groups had significantly lower exercise capacity and oxygen uptake by approximately 15%. The lungs ability to blow out carbon dioxide was diminished and lactic acid built up quicker in vapers and smokers at all levels of exercise before they reached their maximum, resulting in increased breathlessness and leg discomfort compared to the group who had never smoked or vaped. Ultrasounds scans and blood samples showed signs of inflammation in the blood vessels. Researchers say these results suggest similar effects of vaping and smoking in young people.

These findings provide critical information for the general public, healthcare providers, and regulatory authorities regarding potential early risks associated with vape use, particularly for the growing number of young adults who have never smoked but choose to use these products. Additionally, our study supports the UK's Tobacco and Vapes Act 2026, which prohibits vaping for individuals under 18 and aims to reduce vaping among young adults in the future."

Dr. Azmy Faisal, lead author of the study, Manchester Metropolitan University

The team are now planning to conduct a series of MRI studies to better understand the changes within the heart, lungs and skeletal muscles associated with vaping, particularly the underlying mechanisms which lead to lower levels of fitness.

Dr Stamatoula Tsikrika from the European Respiratory Society's expert group on tobacco, smoking control and health education, based at Sotiria Hospital, Athens, Greece, who was not involved in the research, said: "More and more young people who have never smoked are using vapes. As the popularity of vaping continues to rise, so too do concerns that it is becoming normalised behaviour, functioning as a gateway to nicotine addiction and introducing serious health risks.

"Vapes may contain lower levels of cancer-causing substances, but they can still trigger genetic changes such as DNA damage and inflammation, which are linked to increased lung cancer risk. For people who have never smoked, and are therefore not using vapes as a cessation method, the health consequences of vaping are becoming harder for policymakers and the tobacco industry to justify."

Dr Tsikrika also commented on the Tobacco and Vapes Bill, passed in the United Kingdom earlier this year: "Ninety-four per cent of smokers start before they are 25 and 22% of 15-16 year olds in Europe are reported to use vapes, by establishing a generational sales ban on nicotine products, the UK has taken a monumental leap towards protecting the health of young people."