To appraise and synthesise the evidence on short and longer term harms of vaping in young people.
KSR Evidence (systematic reviews); Medline, Embase, and PsycInfo (umbrella reviews); and reference screening.
Systematic and umbrella reviews evaluating any potential harms from e-cigarettes in young people.
Searches identified 56 reviews for inclusion from 384 unique articles. A consistent significant association between vaping and smoking initiation was found, supporting a causal relationship, with pooled ORs of 1.50-26.01 (21 systematic reviews), most of which suggested that young people using e-cigarettes are about three times more likely than those not using them to initiate smoking. Five systematic reviews demonstrated a substantial association between e-cigarettes and substance use, with pooled ORs of 2.72-6.04 for marijuana, 4.50-6.67 for alcohol and 4.51-6.73 for binge drinking. Asthma was the most common respiratory outcome, with consistent associations (ORs: 1.20-1.36 for diagnosis and 1.44 for exacerbation). Three systematic reviews found associations between vaping and suicidal outcomes, and six included investigation of injuries, predominantly documenting explosion incidents. Significant associations between vaping and other harmful outcomes included pneumonia, bronchitis, lower total sperm counts, dizziness, headaches, migraines and oral health harms, but this evidence was largely derived from limited surveys or case series/reports.
This study found that there were consistent associations between vaping and subsequent smoking, marijuana use, alcohol use, asthma, cough, injuries and mental health outcomes. The findings support the implementation of policy measures to restrict sales and marketing of e-cigarettes to young people.
PROSPERO CRD42024569728.
This research output has an Altmetric Attention Score of 1758. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 October 2026.
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#7,003
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Outputs from Tobacco Control
#1
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Outputs of similar age
#95
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Outputs of similar age from Tobacco Control
#1
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Altmetric has tracked 34,554,170 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,048 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 36.5. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 350,991 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 46 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 97% of its contemporaries.
