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Healthy Body, Healthy You-th:

Effects of E-Cigarettes on the Body

Lesson 2

Last updated September 2026

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Overview of the harmful chemicals in e-cigarette aerosol
How e-cigarette use affects the heart, lungs, and other body parts
What is second and thirdhand smoke/aerosol

Topics

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C. Nicotine

B. Sugar

A. Water

D. Caffeine

Warm Up!

Which chemical in e-cigarettes can affect adolescent brain development?

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Effects

Nicotine

Causes changes in brain chemistry by stimulating the pleasure centers and altering normal brain function

Highly addictive substance

As nicotine levels in the brain decrease, the brain craves nicotine to experience pleasure and alleviate feelings of anxiety and stress (withdrawal).

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Cigarettes

E-Cigarettes

Contains tobacco, nicotine, and other harsh chemicals

Contains nicotine, aerosol, flavorants, and other harsh chemicals

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Why do you think some people your age might start using e-cigs?

Think & Write

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Are all of these considered

e-cigarettes?

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Heats the nicotine and other chemicals and turns it into an aerosol

Anatomy of an E-Cigarette

Heating Element (Coil)

Where the person breaths in the aerosol

The cloud the user inhales and exhales

E-cigarette aerosol

Mouthpiece

Battery

Powers the e-cigarette

Tank/Cartridge/Pod

Holds the ingredients, including nicotine, propylene glycol, vegetable glycerin, flavorants, and more

Talking points:

As we mentioned earlier, e-cigarettes can look different, but they work in similar ways.

Most e-cigarettes have the same basic parts: a mouthpiece, a pod or cartridge, a heating element sometimes called a coil, and a battery.

The mouthpiece is the part a person places in their mouth to inhale.

The pod, cartridge, or tank hold the e-liquid. Depending on the product, the liquid may contain nicotine, THC, flavorings, or other chemicals as we discussed in the other slide. Some products are marketed as nicotine-free, while others contain nicotine. All e-cigarettes are concerning as we will discuss.

The battery powers the device. When someone activates the e-cigarette, the battery sends power to the heating element (coil).

The coil heats the e-liquid inside the pod, cartridge, or tank.

When a person inhales through the mouthpiece, the device produces an aerosol that travels into the lungs.

Now that we understand how an e-cigarette works, let's take a closer look at what is in the aerosol and why inhaling it can harm the body.

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What is in the

e-cigarette aerosol?

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HAIR SPRAY

E-cigarettes do not just produce harmless water vapor!

E-cigarettes release a mix of harmful chemicals called an aerosol, not water vapor!

The aerosol pollutes the air with cancerous chemicals, heavy metals, & more.

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Acetone

Acrolein

Silver

Nickel

Tin

Sodium

Strontium

Barium

Aluminum

Chromium

Boron

Copper

Selenium

Arsenic

Nitrosamines

Polycyclic aromatic hydrocarbons

What’s In That Aerosol

Propylene glycol

Glycerin

Flavorings (many)

Nicotine

NNN

NNK

NAB

NAT

Ethylbenzene

Benzene

Xylene

Toluene

Acetaldehyde

Formaldehyde

Naphthalene

Styrene

Benzo(b)fluoranthene

Chlorobenzene

Crotonaldehyde

Propionaldehyde

Benzaldehyde

Valeric acid

Hexanal

Fluorine

Anthracene

Pyrene

Acenaphthylene

Acenapthene

Fluoranthene

Benz(a)anthracene

Chrysene

Retene

Benzo(a)pyrene

Indeno(1,2,3-cd)pyrene

Cadmium

Silicon

Lithium

Lead

Magnesium

Manganese

Potassium

Titanium

Zinc

Zirconium

Calcium

Iron

Sulfur

Vanadium

Cobalt

Rubidium

Benzo(ghi)perylene

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Diacetyl

(butter flavor)

Benzene

(gasoline)

Cadmium

(batteries)

Nickel

(cheap jewelry)

Nicotine

(tobacco)

N-Nitrosonornicotine

(pesticides)

Formaldehyde

(dead tissue preservative)

Lead

(car batteries)

Toluene

(paint thinner)

What’s in that E-Cig?

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Recipe of a Cigarette

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Flavors make products more appealing

Why flavors?

Flavors & Flavorants

Flavors are added to mask the harsh taste

Talking Points:

E-cigarettes also have flavors and flavoring chemicals, like cinnamaldehyde (cinnamon), vanillin (vanilla), menthol (a minty flavor), and others.

You can heat and eat these flavors, but if you heat them and then inhale the aerosol from them, that is where the concern is! In fact, flavors that have chemical characteristics similar to toxic chemicals found in cigarette smoke disrupts the lungs' antibacterial defense system!

Flavors and flavoring chemicals can also make tobacco / nicotine products more appealing, especially to people who may not like the harsh taste from tobacco flavors.

These flavors can make the experience seem smoother, more enjoyable, or less harsh. This can make it easier for someone who has never used these products to be interested in trying them.

When a product is designed to make something unpleasant feel more appealing, it can influence how someone perceives the product and its risks. This is one way the tobacco/nicotine industry tries to influence young people.

Let's take a closer look at one of these flavoring chemicals: menthol.

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Menthol

Menthol suppresses respiratory tract irritation thus more smoke can be inhaled facilitating nicotine addiction

Menthol in a cigarette inhibits nicotine metabolism and hence more nicotine in body

E-cig flavors like menthol, eugenol, and others have been shown to decrease nitric oxide production in endothelial cells

A popular mint flavoring added into cigarettes and e-cigarettes.

Talking Points:

Menthol is a chemical compound found naturally in peppermint plants, but it can also be synthetically made.

Menthol creates a cooling sensation and can change the way smoke or aerosol feels in the mouth, throat, and respiratory system.

This cooling effect can reduce some of the irritation caused by inhaling smoke or aerosol. When something feels less harsh or irritating, a person may be able to inhale more deeply or tolerate the product more easily.

Menthol can also affect how the body responds to nicotine. Research has found that menthol can slow the metabolism of nicotine in cigarettes, which can result in nicotine remaining in the body longer.

Research has also found that flavoring chemicals such as menthol and eugenol can affect nitric oxide production in endothelial cells. Nitric oxide plays an important role in healthy blood vessel function.

So menthol is not simply about making a product taste or feel better. It can change the way the product feels when inhaled and can affect how the body responds to nicotine and other chemicals.

Making a product feel smoother or less harsh can make it more appealing, but that doesn't mean the product is safer.

Now, let’s take a closer look at how the tobacco/nicotine industry has used messaging to make these products more appealing.

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Industry Manipulation

What messages have you heard?

Message/Belief

Where did this come from?

What questions should we ask?

Nicotine-free means safe.

social media, friends, packaging

What else is in the e-cig?

It tastes like candy, it’s not harmful.

It’s just water vapor.

?

Activity

Talking Points:

We just talked about how flavors can make cigarettes and e-cigarettes seem more appealing and can mask some of the harsh taste and irritation associated with tobacco/nicotine.

But making a product more appealing doesn't change what the product contains or how it can affect the body.

Industries don't just sell products. They also influence the way people think about those products.

Before we move on, let's think about some of the messages or beliefs people might hear about e-cigarettes.

(Tell students): With a partner, discuss:

-What is a message, belief, or assumption people might have about e-cigarettes?

-Where do people hear those messages?

-What information would someone need to know if the message is actually true?

(Examples to get students thinking if needed):

-"It's just water vapor."

-"Nicotine-free means safe."

-"If it tastes like candy, it can't be that harmful."

-"Everyone vapes."

-"It's safer than cigarettes, so it's healthy."

Being health literate means asking questions, looking for evidence, and thinking critically about information before accepting it as true.

Sometimes important health information is left out of a message. That's why it's important to look beyond the claim, consider what evidence supports it, and ask what information might be missing.

A message can make a product sound harmless or appealing, but what we have learned about the chemicals in cigarette smoke and e-cigarette aerosol can help us evaluate whether that message tells the whole story.

(Educator Note): If the activity is done to completion, it meets National Health Standard 3.8.4 Analyze the validity, reliability, and accessibility of health information, products, services, and other resources.

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There is no such thing as a “safe” vape!

Tobacco/Nicotine Free ≠ Harm Free

*Real claims from a “wellness” vape brand!

Talking Points:

You may have seen products advertised as tobacco/nicotine-free or even as “vitamin vapes.”

Take a look at the example on the slide. What do you notice about the claims being made by the company?

(Take a few student responses).

While some of these products may not contain tobacco/nicotine, that doesn't mean they are harmless.

Like we learned earlier, regardless of what an e-cigarette contains, using it means inhaling a heated aerosol into the lungs.

Scientists are still studying the long-term health effects of many of these products, but plenty of science shows the aerosol is harmful in the short- and long-term.

So when we look past the product's name, flavor, or marketing claims, one important question remains: What happens to the lungs when we inhale this aerosol?

Let’s take a closer look at how inhaling smoke from cigarettes and aerosol from any e-cigarette regardless of whether it has nicotine, THC, vitamins, etc can affect the lungs.

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Destruction of Air Sacs

in the Lungs

No Fun in the Lungs

Inflammation and Irritation of the Airways

Weaker Immune Response to Infection

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Lungs & Vaping

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A Hit to the Heart

Risk for blood clotting

Stiff blood vessels

Talking Points:

In addition to affecting the lungs, cigarettes and e-cigarettes can also affect the heart and blood vessels.

Research has found that cigarette smoking can increase cardiovascular risk, and evidence continues to show that e-cigarette use can also affect the cardiovascular system.

The heart pumps blood through a complex network of blood vessels throughout the body. These blood vessels deliver oxygen and nutrients to organs and tissues.

Your cells need oxygen to survive and work properly.

Inhaling cigarette smoke or e-cigarette aerosol can affect blood vessels and how the cardiovascular system functions.

Some research has found that e-cigarette use can contribute to changes such as blood vessel stiffness, while cigarette smoking is well established as a major risk factor for cardiovascular disease.

Over time, changes to blood vessels and blood clotting can contribute to an increased risk of heart disease, heart attack, and other cardiovascular problems.

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Increased Acid Reflux

There is also evidence that using e-cigarettes can give you acid reflux, or heartburn.

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Cancer & E-Cigs

Emerging Research

Studies conducted on mice found that e-cigarette aerosol can cause cancer.

Chemicals found in e-cigarettes are known to be carcinogenic (cancer causing).

People who use e-cigs have similar amounts of DNA damage as people who smoke cigarettes.

Talking point:

While the direct link between cancer and e-cigarettes is still being studied, there is emerging research that connects the two.

Here is some emerging research on the topic:

1. Studies conducted on mice found that e-cigarette aerosol can cause cancer, particularly lung and bladder cancers.

2. As we discussed earlier in the lesson, there are certain chemicals in e-cigarettes that are known to cause cancer.

3. Studies in humans found that people who vape had the same amount of DNA damage as people who smoke cigarettes. This is concerning since DNA damage is a critical part of cancer development, and cigarettes have long been known to cause cancer. But, again, more research on this link is needed.

PEER-REVIEWED CITATIONS:

1.https://www.pnas.org/doi/abs/10.1073/pnas.1911321116

AND

https://pmc.ncbi.nlm.nih.gov/articles/PMC9222281/

2.https://europepmc.org/article/MED/40278584

3.https://academic.oup.com/ntr/article/25/6/1145/7035481?login=false

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Good News!

Risk goes down immediately after you stop smoking or using e-cigarettes!

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Nicotine

Secondhand Aerosol

Heavy Metals

Ultrafine Particles

Volatile Organic Compounds (VOCs)

Cancerous Chemicals

Talking Points:

Remember the video we watched earlier about e-cigarette aerosol? Well, secondhand smoke or aerosol is the cloud or plume released into the air when someone uses a cigarette or e-cigarette.

Common places for exposure to secondhand smoke or aerosol include parks, vehicles, and designated smoking areas.

Enclosed spaces, such as vehicles, can dramatically increase the concentration of these chemicals and increase exposure.

Harmful chemicals that can be released include nicotine, heavy metals, ultrafine particles that can travel deep into the lungs, cancer-causing chemicals, and volatile organic compounds, also known as VOCs.

Secondhand smoke and aerosol can also be harmful to loved ones, including family, friends, and pets.

Exposure to secondhand smoke or aerosol can lead to respiratory infections and can cause someone's asthma to worsen, among other health problems.

(Educator note): Students may have loved ones who use tobacco/nicotine products and may worry about their health or their own exposure. Affirm that these concerns are valid, and respond to personal disclosures privately and respectfully, connecting students with the school counselor or other support as needed.

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Thirdhand Aerosol

Talking Points:

It is also important to know that exposure to the chemicals in e-cigs doesn’t necessarily end when the aerosol is no longer visible in the air.

Thirdhand smoke or aerosol is the mixture of chemicals and particles from cigarette smoke or e-cigarette aerosol that linger even after the plume disappears.

This residue can remain on surfaces, in carpets, and in dust, and even on toys.

People and animals can be exposed to these chemicals. Pets and children are especially vulnerable to the thirdhand smoke and aerosol exposure because they spend more time close to floors and surfaces, frequently put their hands or objects in their mouths, and have developing bodies.

If you live in a home where tobacco/nicotine products are used, avoiding the smoke or aerosol and spending time in well-ventilated or outdoor spaces can help reduce your exposure. You can also talk to a trusted adult at school if you are concerned about exposure at home.

Now that we’ve learned how cigarette smoking and e-cigarette use can affect ourselves and others, let’s look at ways you can stay true to you and affirm your decisions.

(Educator note): Students may have loved ones who use tobacco/nicotine products and may worry about their health or their own exposure. Affirm that these concerns are valid, and respond to personal disclosures privately and respectfully, connecting students with the school counselor or other support as needed.

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I just found a blueberry

e-cigarette. I'm thinking about trying it after school. Who wants to join?

What Would You Say?

Name one health effect you learned about today.
Explain why you would choose not to use the e-cigarette.
Write a respectful refusal.

In your response:

Talking Points:

Using the strategies we saw in the video, let's practice refusal skills.

Imagine you are in this situation. A student tells you they found an e-cigarette and wants to try it after school. What could you say?

Your response needs to do three things: identify something you learned about the health effects, use that information to explain your choice, and practice a clear refusal skill.

Give students 2–3 minutes to write their responses.

Then have students practice their responses with a partner. One student reads the scenario, and the other gives their response. Switch roles.

Afterward, ask for a few volunteers to share different ways they responded.

(Educator Note): If the activity is done to completion, it meets National Health Standard 4.8.5 Use refusal skills and strategies in a variety of situations.

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What is one fact about e-cigarettes and the young adolescent body that you think is important for other students to know?

Wrap up!

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Resources

For questions about quitting tobacco/nicotine:

Kick-It California, text “Quit Smoking” or “Quit Vaping” to 66819

For crisis support:

California Youth Crisis Line 1-800-843-5200
988 Suicide & Crisis Lifeline

Speak with a trusted adult:

You can also talk with a counselor, nurse, trusted educator, caregiver, or health provider

Talking Points:

(Review of resources from Lesson 1)

(Educator Note): Please feel free to edit or include resources that are relevant to your school and/or community.

These resources are here to support young people when they need help, information, or someone to talk to.

They can provide guidance, connect you to support, and help you make safer choices.

When you contact Kick It California, a real person answers, and it is free and confidential.

When you text or call 988, someone will respond within minutes, listen without judgement, and help you figure out your next step.

Often, the first person someone reaches out to isn’t a hotline or a website—it’s a person they trust. One important support is a trusted adult. This could be a parent/caregiver, coach, teacher, counselor, or another adult you trust.

Sometimes these resources are used in big situations, and sometimes they’re used just to ask questions or get advice. You do not have to wait until a situation feels extreme to ask for help.

References:

https://kickitca.org/

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E-cigarettes are NOT just harmless flavored water vapor. They produce an aerosol full of harmful chemicals and other constituents.

E-cigarette aerosol can damage the lungs and heart, which can lead to health issues.

There is no such thing as a safe e-cigarette/vape.

Going smoke or vape-free let’s the body begin to heal, and some risks drop right away.

Key Takeaways

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Let’s Play Kahoot!