Young people who use vapes face a higher risk of breathing problems, poor mental health and other medical issues, experts from the Royal College of Paediatrics and Child Health have warned.
A major review of 81 studies examining the health and social impacts of e-cigarettes on children and young people also found the devices may act as a "gateway" to smoking tobacco, rather than steering teenagers away from the habit.
Publishing their findings in the journal Archives of Disease in Childhood, researchers said the evidence was "concerning" and showed that while vaping is less harmful than smoking, it is far from harmless.
The review associated vaping in young people with respiratory issues including wheezing and coughing, alongside mental health conditions such as anxiety, depression and panic disorders. Researchers also identified links to sleep problems, eye conditions and oral health issues including inflammation, ulcers and dry mouth.
The Royal College of Paediatrics and Child Health is the professional body responsible for setting postgraduate training standards and advocating for child health across the United Kingdom. Archives of Disease in Childhood is an official peer-reviewed paediatric journal published by BMJ.
Maternal vaping risks and child development
Furthermore, the research team found concerning signs among babies whose mothers vaped during pregnancy. These included "more abnormal reflexes" and "lower motor maturity", which measures how developed a baby's movements and physical responses are, as well as lower weight gain in the womb.
"This comprehensive review highlights the emerging risks of vaping and e-cigarette use on [children and young people]," the authors wrote. RCPCH experts noted that while vaping is a relatively new phenomenon, a "clear and concerning picture is emerging."
Co-author Professor Will Carroll said: "Vaping should not be seen as a harmless part of growing up." Carroll added that the review established "clear links" between youngsters vaping and subsequently taking up cigarettes.
In clinical evaluation, infant motor maturity measures early neuromuscular development and reflex responses. Gestational exposure to inhaled aerosols and active compounds can affect systemic growth and physical development in infants.
Vaping statistics and nicotine mechanisms
Around 5.5 million people in the UK are thought to vape, with experts warning that colourful packaging and sweet-like flavours have helped entice youngsters. Polling by the charity Action on Smoking and Health indicates that around 19 per cent of 11 to 17-year-olds in Britain, representing almost a million youngsters, have tried vaping.
Last year, the number of people who vape in Britain overtook the number who smoke cigarettes for the first time. While both cigarettes and most vapes deliver nicotine, they work in very different ways. Cigarettes burn tobacco, releasing thousands of chemicals including tar and carbon monoxide, many of which cause cancer. Smoking causes more than 60 per cent of UK lung cancer cases and kills around 33,000 people annually.
By contrast, vapes use a battery-powered device to heat a liquid, usually containing nicotine, to produce an aerosol that is inhaled. They expose users to fewer harmful chemicals than cigarettes, making vaping substantially less harmful than smoking, but experts stress this does not make them harmless. NHS guidance states vaping is "less harmful than smoking" but adds it is "not completely harmless and we don't know yet what the long-term effects may be."
Action on Smoking and Health is a UK public health charity established by the Royal College of Physicians to educate the public on tobacco risks and reduce smoking-related harm. The National Health Service provides publicly funded healthcare in the UK. Nicotine is an addictive chemical compound that acts as a stimulant on the central nervous system.
Government crackdown and flavour restrictions
Ministers have responded to the findings with measures designed to curb the appeal of vapes to children, including restrictions on advertising, packaging and flavour marketing. In July, the Government announced plans for plain packaging and rules forcing manufacturers to replace enticing flavour names inspired by sweets, desserts and alcohol with simple descriptions such as "apple".
Professor Carroll welcomed the crackdown but urged ministers to restrict the flavours themselves rather than just their names. He said: "As paediatricians, we call on the Government to go further and limit the types of flavours available, as opposed to just their descriptions."
Action on Smoking and Health chief executive Hazel Cheeseman said vaping remains an important quitting aid for adult smokers, but called for "strong controls on marketing and promotion" to reduce youth vaping.
A Department of Health and Social Care spokesman said: "Children should never vape and this evidence shows just some of the risks associated. We have already banned single-use vapes and have legislated to ban advertising and sponsorship from next year too. We're also consulting on proposals to crack down on packaging that appeals to children."
The Department of Health and Social Care is the UK executive department responsible for national health policy, public healthcare funding and medical regulation in England.
