Austin Air has been sounding the alarm on e-cigarettes for more than a decade. Now, new data—and a landmark Supreme Court decision—confirm what we warned about back in 2015: e-cigarette use is not without health risks, especially for youth and vulnerable populations.
A major study recently published in Nicotine & Tobacco Research delivered a sobering update: exclusive e-cigarette use is now significantly linked to chronic obstructive pulmonary disease (COPD) and, in adults aged 30–70, an increased risk of hypertension.1
This long-term analysis, led by Johns Hopkins Medicine and funded by the National Institutes of Health, tracked nearly 250,000 people as part of the All of Us Research Program.
While e-cigarettes may seem like a “safer” alternative to smoking, the long-term data tells a different story. The study confirmed:
- Exclusive e-cigarette users were more than twice as likely to develop COPD (Hazard Ratio: 2.29).
- In adults aged 30–70, e-cigarette use was linked to a 39% increased risk of hypertension.
- Dual users—those who use both e-cigarettes and traditional combustible cigarettes—showed the highest overall risk for cardiometabolic disease, including atherosclerosis and heart failure.
A Decade of Concern Confirmed
At Austin Air, we’ve been closely monitoring the rise of e-cigarettes since their early boom. Back in 2015, we published a detailed warning in our blog post, “The Hidden Dangers of E-Cigarettes.” We outlined about the lack of regulation, the untested chemicals, and the unknown risks of these devices, especially to indoor air quality. Our stance remains just as strong today:
“Despite a rapidly growing market and widespread popularity, there has not been any long-term research to establish if e-cigarettes are as safe as their supporters purport them to be… While you may not have realized that there is such a thing as ‘second-hand vapor,’ the same principles of second-hand smoke apply.” — Austin Air blog, January 29, 2015
We were among the first to point out that what’s exhaled from a vape pen may be odorless, but that doesn’t mean it’s harmless. At the time, early tests by the Food and Drug Administration (FDA) and independent researchers revealed dangerous substances like formaldehyde, diethylene glycol (antifreeze), tin, copper, aluminum, and volatile organic compounds (VOCs) in vape aerosols. Many of these particles are ultrafine, meaning they penetrate deep into the lungs—posing a clear risk to respiratory health.
But even back then, emerging research suggested that vaping might actually increase nicotine addiction, especially among dual users who continued to smoke cigarettes.
New Data, Same Concerns
The 2025 study builds on what scientists and public health advocates have long suspected but lacked longitudinal proof to confirm. In particular, the association with COPD is especially troubling. COPD is not reversible and often progressive, leading to reduced lung function, increased hospitalizations, and even premature death.
Though the study did not find a statistically significant connection between exclusive e-cigarette use and conditions like heart failure or type 2 diabetes (except in dual users), researchers emphasize this doesn’t mean the risk is absent. Instead, they caution that longer-term follow-up is urgently needed to capture the full picture.
“While in this short-term study there was no association between exclusive e-cigarette use and cardiovascular events, there was an association with incident COPD and possibly hypertension that will need to be closely watched,” said Dr. Michael Blaha, senior author and professor of cardiology at Johns Hopkins.
SCOTUS Sides With Science: Flavored Vapes Denied
In a unanimous ruling shortly after the study was published this spring, the U.S. Supreme Court upheld the FDA’s decision to ban flavored e-cigarette products from two major vape manufacturers: Triton Distribution and Vapetasia. The Court found that the FDA had properly denied applications for candy-, dessert-, and fruit-flavored vape liquids—like “Rainbow Road” and “Pineapple Express”—due to their overwhelming appeal to children and the public health risks they pose.
This decision reinforces the FDA’s authority under the Tobacco Control Act to deny market access to tobacco products—including e-liquids—that do not demonstrate a net public health benefit. It’s a decisive moment that underscores what Austin Air has been saying all along: these products are not safe, not proven to help people quit smoking, and not appropriate for young users.
The Air You Breathe Matters
Whether it’s tobacco smoke or vape aerosols, what’s exhaled into your home, school, or office air impacts everyone around you. Second-hand exposure to vape emissions may lack the visible smoke—but it doesn’t lack toxins or ultrafine particles.
While most people understand the risks of smoking and secondhand tobacco smoke, fewer realize that the vapor from electronic smoking devices (ESDs)—often mischaracterized as “harmless water vapor”—also poses serious health risks to bystanders. The aerosol exhaled by people using vapes contains a toxic cocktail of chemicals including nicotine, ultrafine particles, heavy metals, volatile organic compounds, and known carcinogens.
What’s in Secondhand Vape Aerosol?
Unlike smoke, vape aerosol is made up of ultra-fine droplets—smaller even than those in conventional cigarette smoke. These particles can linger in the air and be deeply inhaled, especially by children, older adults, and people with preexisting conditions like asthma or heart disease.2 Some key chemicals found in secondhand aerosol include:
- Nicotine (addictive and harmful to adolescent brain development)
- Formaldehyde and acetaldehyde (both carcinogenic)
- Heavy metals like lead, nickel, and chromium
- Ultrafine particles that reach deep into the lungs and bloodstream
- Propylene glycol and diacetyl, both known respiratory irritants
Even if you don’t vape, secondhand aerosol can affect your lungs, heart, and long-term health. Clean indoor air isn’t just a preference—it’s a necessity.
Austin Air’s medical-grade air purifiers are built to remove:
- Fine and ultrafine particulates
- Formaldehyde and VOCs
- Chemical fumes and gases
If someone in your home vapes—or if you’re worried about exposure at work or school—an Austin Air purifier is one of the best ways to protect your lungs, especially if you’re managing asthma, allergies, or COPD.
The Bottom Line
We now have science, regulatory action, and legal precedent working together to protect public health from the growing harms of vaping. But education is still essential. Many people continue to believe myths about e-cigarettes—and that misinformation can have lifelong consequences.
At Austin Air, we remain committed to clean air, clear science, and truthful public health education. We were here in 2015 warning of these dangers, and we’ll continue to be here as the evidence—and the policies—finally catch up.
REFERENCES
1 Erhabor J, Yao Z, Tasdighi E, et al. (2025 March 15). E-cigarette Use and Incident Cardiometabolic Conditions in the All of Us Research Program, Nicotine & Tobacco Research. doi: 10.1093/ntr/ntaf067.
2 Electronic smoking devices and secondhand aerosol fact sheet. (2025). American Nonsmokers’ Rights Foundation. https://no-smoke.org/electronic-smoking-devices-secondhand-aerosol/.
