It’s an epidemic that any parent will be well aware of. Cheap, colourful and creating sickly-sweet flavoured puffs of steam, e-cigarettes, also known as vapes, are now a mainstay of the British teen experience.
Teachers despair of how to deal with students so addicted to nicotine that they have to leave class every 20 minutes – with some schools resorting to using metal-detector wands at the gates or even cutting down hedges where students try to hide.
One secondary school headteacher in Greater Manchester, desperate to stymie the problem, installed specialised vaping sensors in the toilets. The alarms, he said, went off more than 100 times on the first day.
Though vapes are illegal for under-18s, surveys show more than 1.1 million UK teenagers have used one, while one in ten say they do so frequently, a figure that has tripled in the past three years.
It’s a relatively new phenomenon. While first introduced in the early 2000s to help people give up tobacco smoking, e-cigarettes took off among young people in the late 2010s, when disposable vapes, available in a range of vibrant colours and flavours, appeared on shop shelves. Until now, the dangers have all been theoretical. Previous studies have suggested that there are no major health risks attached to vaping. Some scientists have even described it as ‘95 per cent safer than smoking cigarettes’.
However, experts speaking to The Mail on Sunday say there is a growing body of evidence that vaping is leaving young people with chronic health problems.
For some young Britons, it would seem that vaping has also become a gateway to cigarettes, despite being introduced to help adults stop smoking
Research has linked e-cigarette use to increased inflammation in the lungs, more frequent lung infections and greater chance of developing chronic obstructive pulmonary disease, or COPD, a condition that can trigger organ failure.
Medics have created a new term for the range of lung diseases they are seeing in A&Es – e-cigarette or vaping product use-associated injury, or EVALI.
More than half of patients diagnosed with it are admitted to the intensive care unit, and the diagnosis – which can encompass anything from fluid in the lungs to chronic scarring, known as popcorn lung – can be fatal.
Children are uniquely vulnerable as their lungs are still developing. They’re also more likely than adults to see neurological impacts from becoming dependent on nicotine, a highly addictive substance that can impair adolescent brain development. Youngsters who use vapes are more likely to develop depression, panic disorder and anxiety, and nearly twice as likely as non-users to have suicidal thoughts, research shows.
A report from the Royal College of Paediatrics and Child Health (RCPCH) suggests that for some young Britons, vaping has become a gateway to cigarettes.
Smoking rates in young people have long been on the decline, but more than one in five children aged 11 to 17 reported smoking a cigarette in 2025 – the highest in more than a decade.
In the short term, the damage is already clear. NHS data shows 164 children aged 19 and under were hospitalised for vaping-related illnesses in the past five years. A shocking 46 of them were under nine years old.
One case was Freddie Janman, 18, who was taken to A&E with low oxygen after a severe asthma attack triggered by vaping. Starting the habit at 12, Freddie estimates he spent thousands of pounds to vape daily over six years. At the time, he says, ‘you were weird if you didn’t vape’.
More than 1.1 million teenagers have used a vape, with medics creating a new term for the range of related lung diseases they are seeing in A&Es
But lung issues, say experts, are likely to be only the tip of the iceberg. ‘E-cigarettes have been shown to contain a range of harmful substances – including heavy metals, toxic chemicals and microplastics,’ says Professor Will Carroll, consultant paediatrician at Staffordshire Children’s Hospital at Royal Stoke.
‘We don’t know the long-term consequences of regularly inhaling a heated concoction of these into the lungs from childhood, but we have shown that these substances are known to cause inflammation, suppress the immune system and be carcinogenic, as well as being highly addictive.
‘We’re seeing the same tactics that occurred with the tobacco industry repeated – just wait 30 years until something terrible happens. Do we really want to repeat that experiment?’
Dr Aran Singanayagam, consultant of respiratory medicine at Guy’s and St Thomas’, agrees.
‘A lot of people we see in clinic with COPD started smoking back when the harms were really not known,’ he says.
‘They tell me it was what everyone did when they were younger – but they’re suffering for it now. The same might be true for young people who started vaping in the last few years. Children have become guinea pigs for the risks.’
So what do we know about the health impacts of e-cigarettes?
Studies show vaping is safer than smoking cigarettes, which is the leading cause of lung cancer – the nation’s deadliest cancer that kills 33,000 people a year.
But experts say the evidence isn’t quite so clear on how safe e-cigarettes are, questioning the claim that vaping is 95 per cent safer than smoking.
‘We definitely know that inhaling any noxious substance or toxin into the lungs is likely to induce harm,’ says Dr Singanayagam. ‘But there’s increasing evidence that vaping causes unique harm to the immune system of the lungs.
For Freddie Janman, above, it took a traumatic admission to hospital to realise the damage his vaping habit was doing to his health.
The musician from Woking had been using e-cigarettes since the age of 12, when friends from school introduced him to them. ‘At first, I remember it made me feel a bit sick,’ he says. ‘But I ended up getting one myself.
‘A dodgy corner shop would sell them to us. At one point it felt like you were the weird one if you didn’t vape.’
Eventually Freddie needed to vape as soon as he woke up. The disposable vapes he used were so tiny they were easy to hide from his parents.
At 18, Freddie suffered a severe asthma attack and was taken to A&E. There he was surprised to be checked into a ward for two weeks.
‘They told me I had severely low oxygen levels,’ he says.
‘I hadn’t realised it was that bad, but they told me I had probably been living with it for a couple of years.
‘Looking back, I was often breathless, and suffered so many chest infections over the years. I just didn’t connect it with the vaping.’
Since his hospitalisation, Freddie says he hasn’t touched a vape – and now uses his music, under the name FredStar, to warn other young people off the habit.
‘I thought vaping wouldn’t affect me,’ he says. ‘But it’s quite upsetting that people were knowingly selling them to children like me.’
‘Over time, this can predispose you to more frequent lung infections – whether viral or bacterial.’
In the long term, research shows chronic and long-lasting lung infections can cause irreversible structural and functional damage to the respiratory system – leading to life-threatening complications such as collapsed or bleeding lungs. In children, this damage can have particularly severe consequences.
‘This is when the lungs are developing. We know that when you smoke cigarettes in that critical phase, you have a much higher risk of later developing adverse health conditions, like COPD or even lung cancer,’ says Dr Singanayagam. ‘And the likelihood is that the same is true for vaping.’
At a conference last year, Norwegian cardiologist Professor Maja-Lisa Lochen made a similar warning. Because vaping causes the heart rate to increase and blood vessels to constrict, she explained, e-cigarette use can, over time, lead to high blood pressure, which increases the risk of developing an irregular heart rhythm, stroke and heart attack.
‘I worry vaping may be causing irreversible harm to children’s brains and hearts,’ she added.
Vaping can also have serious impacts on psychological health, says Prof Carroll. The lead researcher collating the RCPCH report, he says he was expecting to see that vaping in childhood was consistently associated with a cough, chest discomfort and wheezing. It also wasn’t particularly surprising it led to an increase in oral and dental disease – such as ulcers and dry mouth – as well as eye symptoms such as itching and redness.
But the research team was stunned, he says, by the extent to which vaping in young people was associated with poorer mental health. ‘We may have expected nicotine – which is a potent central nervous system stimulant – to have effects beyond the respiratory system. But to find that young e-cigarette users were almost twice as likely to have suicidal plans or attempts was very concerning,’ he says.
The link is probably due to nicotine causing the pleasure hormone dopamine to briefly spike in the brain, before dropping to below-baseline levels. The chemical also triggers the release of stress hormones, with frequent use leading to feelings of low mood and anxiety.
By increasing heart rate, blood pressure and alertness, vaping can also cause fragmented sleep, research shows, worsening existing poor mental health.
Perhaps the most concerning finding made by the report, says Prof Carroll, was ‘the strong evidence that vaping in children who have never smoked increases the likelihood of subsequent conventional cigarette smoking.’
They found that teenage e-cigarette users were typically two to 12 times more likely than non-users to start smoking later.
‘Vaping is a gateway into nicotine addiction,’ says Prof Carroll. ‘Patients I look after have severe asthma and are still using liquid vapes, which only makes it worse. They’re sensible people but they’re still vaping, because once you start it’s very hard to stop.’
And children are already seeing the devastating – and even deadly – consequences of addiction. The number of under-19s in England admitted to hospital for vaping-related issues more than quadrupled from 2021 to 2024, from 11 to 46.
Symptoms of the newly named EVALI typically include shortness of breath, chest pain, rapid heart rate and fever, but can suddenly worsen, potentially causing organ failure if left untreated. People under 35, research shows, are more likely to develop EVALI.
Additives in vapes are another major concern.
A University of Bristol study found that one in eight disposable vapes contained cannabis, while testing on vapes confiscated from students at the University of Worcestershire in 2023 revealed dangerous levels of lead, nickel and chromium.
‘We don’t have enough control over what’s going into these things,’ says Prof Carroll. ‘How secure are we that the liquid contains what it says it does? It’s not like medication – it’s a market that needs more regulation.’
Other experts are more hopeful for the future, however. Last year, disposable vapes were banned in the UK – a decision based on the logic that these cheap and easy-to-use products are appealing to young people.
The passing of the Tobacco and Vapes Act, which drove up the cost with a new tax from October 1– should further restrict young people’s access to e-cigarettes, says Dr Nicholas Hopkinson, professor of respiratory medicine at Imperial College London.
‘The Act will allow for more enforcement,’ he says. ‘The plan is to introduce retail licensing – and if you sell to underage buyers, that licence will be taken away.
‘Young people should be angry a multi-billion-pound industry tried to get them hooked as children on an addictive product, and, that we allowed that to happen.’
