page_title: Safety of electronic cigarettes
section_title: Nicotine
hierarchical_section_title: Safety of electronic cigarettes / Toxicology / Nicotine
caption_attribution_description: English: Main side effects of nicotine (See Wikipedia:Nicotine). To discuss image, please see Talk:Human body diagrams List format Circulation: Increased clotting tendency&#91;1&#93; Atherosclerosis&#91;2&#93; Enlargement of the aorta&#91;2&#93; Lungs: Bronchospasm&#91;1&#93; Muscular: Tremor&#91;1&#93; Pain&#91;1&#93; Gastrointestinal: Nausea&#91;1&#93; Dry mouth&#91;1&#93; Dyspepsia&#91;1&#93; Diarrhea&#91;1&#93; Heartburn&#91;1&#93; Peptic ulcer&#91;2&#93; Metastasis&#91;3&#93; Joint pain&#91;1&#93; Central: Lightheadedness&#91;1&#93; Headache&#91;1&#93; Sleep disturbances&#91;1&#93; Abnormal dreams&#91;1&#93; Irritability&#91;1&#93; Dizziness&#91;1&#93; Risk of blood restriction&#91;2&#93; Heart: Increased or decreased heart rate&#91;1&#93; Increased blood pressure&#91;1&#93; Tachycardia&#91;1&#93; More (or less) arrhythmias&#91;1&#93; Coronary artery constriction&#91;1&#93; Coronary artery disease&#91;2&#93; Hormonal: High insulin&#91;1&#93; Insulin resistance&#91;1&#93; During pregnancy, risks to child later in life: Type 2 diabetes&#91;2&#93; Obesity&#91;2&#93; Hypertension&#91;2&#93; Neurobehavioral defects&#91;2&#93; Respiratory dysfunction&#91;2&#93; Infertility&#91;2&#93; Excluded are symptoms specific for a certain route of administration of nicotine, where other factors than the nicotine itself may be responsible. Excluded are also some very rare symptoms, and symptoms that are only seen together with another, relatively rare, condition. References ↑ a b c d e f g h i j k l m n o p q r s t u v w Nicotine Side Effects.&#32;Drugs.com. Retrieved on 2009. ↑ a b c d e f g h i j k &#32;(2014).&#32;"Electronic Cigarettes. A Position Statement of the Forum of International Respiratory Societies". American Journal of Respiratory and Critical Care Medicine&#32;190&#32;(6): 611–618. DOI:10.1164/rccm.201407-1198PP. PMID 25006874. ISSN 1073-449X. ↑ &#32;(2014).&#32;"Nicotine-Mediated Cell Proliferation and Tumor Progression in Smoking-Related Cancers". Molecular Cancer Research&#32;12&#32;(1): 14–23. DOI:10.1158/1541-7786.MCR-13-0541. PMID 24398389. PMC: 3915512. ISSN 1541-7786.
context_page_description: The use of electronic cigarettes carries health risks compared to not using any inhaled recreational drugs, especially for children, young adults, and pregnant women. The risk depends on the composition of electronic cigarette aerosol, which varies according to the contents of the liquid, the physical and electrical design of the device, and user behavior. As of 2019, the long-term risks of vaping are somewhat uncertain because studies have yet to be performed on the relatively new technology, though the long-term risks of some individual substances in vaping aerosols and tobacco smoke have been studied.
  When used to deliver nicotine, vaping avoids several carcinogens usually found in tobacco smoke produced by cigarettes and cigars, such as ash, tar, and carbon monoxide. E-cigarettes reduce lung function, reduce cardiac muscle function, and increase inflammation, but to a much lower extent than with traditional cigarettes. Some hazards occur with vaping but not with smoking.
context_section_description: Pregnant women, breastfeeding mothers, and the elderly are more sensitive to nicotine than other individuals. There are safety issues with the nicotine exposure from e-cigarettes, which may cause addiction and other adverse effects. Nicotine is regarded as a potentially lethal poison. Concerns exist that vaping can be harmful by exposing users to toxic levels of nicotine. At low amounts, it has a mild analgesic effect. At sufficiently high doses, nicotine may result in nausea, vomiting, diarrhea, salivation, bradyarrhythmia, and possibly seizures and hypoventilation. High doses can induce deleterious effects on the growth of osteoblasts. Higher-doses leads to loss of nicotinic receptor specificity and induces cholinergic toxicity. The highest-doses can lead to coma. However, at the low amount of nicotine provided by e-cigarettes fatal overdose from use is unlikely; in contrast, the potent amount of nicotine in e-cigarettes liquids may be toxic if it is accidentally ingested or absorbed via the skin. The health effects of nicotine in infants and children are unclear.
  E-cigarettes provide nicotine to the blood quicker than nicotine inhalers. The levels were above that of nicotine replacement product users. E-cigarettes seem to have a pharmacokinetic nicotine profile closer to nicotine replacement products than with traditional cigarettes. How efficiently different e-cigarettes give nicotine is unclear. Serum cotinine levels are comparable to that of traditional cigarettes, but are inharmonious and rely upon the user and the device. Blood nicotine levels raised more gradually and took more time to get to peak concentration with e-cigarettes than with traditional cigarettes. Vaping was found to have comparable levels of nicotine urinary metabolites to those who were tobacco and smokeless tobacco product users. Though, the oxidative nicotine metabolites were less in those who were vaping. Evidence indicates that some vaping products may deliver the same amount of nicotine as traditional cigarettes. There is fair evidence that chance and degree of dependence are less for e-cigarettes than traditional cigarettes, according to a 2018 National Academies of Sciences, Engineering, and Medicine report. It not clear the level of addictiveness of e-cigarettes, compared with traditional cigarettes, according to a 2018 PHE report. The report also stated "nicotine addictiveness depends on a number of factors including presence of other chemicals, speed of delivery, pH, rate of absorption, the dose, and other aspects of the nicotine delivery system, environment and behaviour." Users vaping without using nicotine exhibited symptoms of dependence, according to a 2015 study. E-cigarette packages and advertisements require health warnings under US law, stating "WARNING: This product contains nicotine. Nicotine is an addictive chemical."
caption: Possible side effects of nicotine.[205]
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