Is Vaping a Gateway to Substance Use?

Teens struggling with Medication-Assisted Treatment and it's repercussions

Vaping is a continually growing trend that many, even those that engage in it, know little about. For researchers, this practice presents concerns as to whether this seemingly “harmless” alternative to cigarette smoking is making people more vulnerable to addiction and addictive behaviors.

What is Vaping?

With all of this exposure in popular culture, you would think it is clear what exactly “vaping” is. However, most people report they don’t understand the mechanism with which they are putting unknown chemicals and nicotine into their bodies.

In vaping, the battery of an e-cigarette ignites a heating component that heats the contents of the e-liquid contained within. This e-liquid is composed of a combination of nicotine (a drug extracted from tobacco), flavorings, and other chemicals [1]. Heating these components creates an aerosol which is then inhaled into the lungs and exhaled [2].

This aerosol contains fine particles that are often mistaken for but are not water vapor [2].

The Truth About Vaping

People are beginning to look at vaping as a “healthier” alternative to smoking, but research shows this isn’t the case. One article aptly describes vaping as “less harmful than smoking but not safe [1].”

In essence, vaping does reduce the amount of tar build-up and carcinogen exposure that comes from cigarettes, but it still contains nicotine, a drug that is harmful in-and-of-itself.

Check out our friend and colleague – Brad Lamm – in his Quit Vaping book interview 

Director of Clinician Research at Johns Hopkins University, Michael Blaha, M.D., M.P.H., stated that “there’s almost no doubt that they expose you to fewer chemicals than traditional cigarettes [1].”

Even so, Blaha asserts that this does not make them “safe” by any means. Vaping still means putting nicotine into the body, and nicotine can cause health issues such as raising blood pressure, spiking adrenaline, and increasing the heart rate and likelihood of having a heart attack [1].

Key evidence to support this is that the fine particles in the aerosol mentioned above contain “varying amounts of toxic chemicals, which have been linked to cancer, as well as respiratory and heart diseases [2].”

As of January 2020, the Centers for Disease Control and Prevention (CDC) has confirmed 60 deaths in patients with an e-cigarette or vaping product use associated lung injury (EVALI) [1].

There is a caveat here, however, as most of these cases are associated with individuals that “modify their vaping devices or use black-market modified e-liquids [1].” These risks are also more associated with vaping liquids that contain tetrahydrocannabinol (THC), “the chemical responsible for most of marijuana’s mind-altering effects [1] [2].”

Additionally, worth considering is that vaping is relatively new. Therefore, researchers haven’t had the time to study long-term effects. As such, as we may learn of other health risks vaping presents as time passes.

Does This Trigger Addictive Behaviors?

A Vape Machine for Vaping MarijuanaAs previously mentioned, research into vaping is as relatively as new as the practice itself. However, due to the booming increase in e-cigarette purchases and vaping, researchers are conducting numerous studies to try to learn more about its impacts.

One concerning result that indicates vaping is more harmful than perceived shows that teens that never would have smoked cigarettes are now vaping [3].

Evidence to support this comes out of the University of Southern California (USC), who looked at rates of smoking to determine that “if teenagers who vape are using e-cigarettes instead of cigarettes, we would have expected to see the decline of smoking rates continue through 2014.”

However, what the study found instead was that there was a downward trend in cigarette from 1995 to 2004 but no further decrease in smoking rates in 2014 [3].

Essentially, cigarette use is decreasing, but smoking rates are increasing, indicating that teens are smoking fewer cigarettes, but more teens are smoking. Researchers believe that this opens teens to increased substance use, particularly because there is easier access to THC in e-cigarettes.

This easier access and route of administration of THC also concerns researchers that people will begin ingesting the drug without considering that it is still a drug.


[1] Blaha, M. J. (2020). 5 vaping facts you need to know. Johns Hopkins University Medicine. Retrieved from

[2] Richter, L. (2018). What is vaping? Center on Addiction. Retrieved from

[3] Kim, L. (2016). A 2016 USC study suggests that some teens who never would have smoked are now vaping. Keck Medicine of USC. Retrieved from

About the Author:

Margot Rittenhouse photoMargot Rittenhouse, MS, NCC, PLPC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on July 27, 2020
Reviewed & Approved by Jacquelyn Ekern, MS, LPC on July 27, 2020
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