Nicotine-Free Vaping: What You Should Know

You know that nicotine is addictive. And smoking is harmful to your health. Maybe you’ve even heard that vaping isn’t a safe alternative.

But what about vaping something else, like caffeine, marijuana or essential oils? Or using a nicotine-free vape to quit smoking?

There’s a lot we still don’t know about zero-nicotine vaping. But pulmonologist Angela Wang, MD, says that, based on what we know now, “There’s no such thing as a safe vape.”

What ‘nicotine-free’ really means

Non-nicotine vapes are marketed as “healthy” because they don’t contain the stimulant (nicotine) that makes smoking and traditional vaping so addictive. But there’s a problem: There’s no way to be sure these products are actually nicotine-free.

“Even though a vape may be labeled that way, it’s really important to understand that these products aren’t regulated,” Dr. Wang states. “These products may end up containing detectable levels of nicotine — sometimes as high as regular e-cigarettes.”

It can happen because of mislabeling or cross-contamination during the production process. But sometimes, it’s just false advertising.

“The products saying ‘nicotine-free’ on the label are not trustworthy,” she adds.

And even if you could trust those labels, there are plenty of other concerning ingredients in vapes that make them dangerous.

What’s inside a non-nicotine vape?

Even if the e-cigarette market were strictly regulated, using zero-nicotine vapes would still be risky. That’s because you’d still be inhaling potentially dangerous carbon-based chemicals called volatile organic compounds.

To understand the risks involved in nicotine-free vaping, you need to understand how vape pens work.

When you vape, you’re inhaling a liquid that’s been heated up enough to become a vapor. The liquid the vapor’s made of is called a carrier or diluent. Dr. Wang reports that one of the most used carrier liquids is a chemical called propylene glycol.

“It’s often used in cosmetics,” she says. “But we don’t know what propylene glycol does to your lungs when you heat and aerosolize it.” Early research suggests that as it breaks down, it creates formaldehyde and acetaldehyde — two substances known to cause lung damage and cancer (carcinogens).

Dr. Wang adds that there could be hundreds of other chemicals in a single vape pod or cartridge. And most of them haven’t been tested for safety.

Other common ingredients include:

• Flavoring chemicals: These compounds are often used in food, cosmetics and medicine. They’re used to make vaping more enjoyable, but the science to date indicates they can also damage your cells. “Just because something’s edible doesn’t mean you should inhale it,” Dr. Wang states.
• Vegetable glycerin (glycerol): Like propylene glycol, vegetable glycerin is often used as a carrier liquid. It also produces formaldehyde and acetaldehyde when heated. The U.S. Food and Drug Administration (FDA) says glycerol is generally recognized as safe to eat, but studies suggest that breathing it in can damage your airway and liver and may increase your risk of cancer.
• “Wellness” ingredients like vitamins, herbs and CBD: Many of these additives are associated with health benefits in foods, supplements or topical products. But there’s scant evidence that inhaling them is safe or effective.
• Potential contaminants: Studies have found that some vapes contain other contaminants, like heavy metals and chemicals used in the manufacturing process.
• Nicotine alternatives: Some nicotine-free products contain other habit-forming chemical additives, like nixinamide or nixodine. These compounds simulate the feeling of smoking a tobacco product. If you use them, you risk trading one addiction for another.

Reasons people choose zero-nicotine vapes

Non-nicotine vapes are popular, in large part, because they’re marketed as a safe — and even healthy — alternative to tobacco products or traditional vapes. Some people use them to help overcome nicotine addiction.

“Smoking is a very complex behavior,” Dr. Wang recognizes. “And it’s true that some of it is just having something in your hand and putting it in your mouth.”

The approach makes sense in theory. But right now, that’s all it is: A theory.

“It’s really up in the air whether these products can actually help a person quit,” she continues. “But these products aren’t tested, and there’s no quality control. So, you may be inhaling nicotine, or another addictive or dangerous substance, without knowing it.”

The FDA isn’t convinced either. It hasn’t approved any of these products for use as smoking cessation aids.

Here are a few other reasons people buy these products:

• Recreational use: Some, especially teens, use non-nicotine vapes to satisfy curiosity, try a new sensory experience or fit in during social situations. Flavors can also make these products more appealing.
• Other substance use: It’s possible to use e-cigarettes to consume other substances, like marijuana, THC, methamphetamines and heroin.
• Perceived health benefits: Some zero-nicotine vapes are often marketed — without evidence — as beneficial to your health. “I’ve heard of people vaping herbs, vitamins, melatonin, even caffeine,” Dr. Wang notes.

Potential risks

Vaping can have serious negative impacts on both your lungs and your overall health.

“You’re inhaling volatile organic compounds that can damage airway cells,” Dr. Wang explains. “They’re absorbed into your bloodstream, which can lead to inflammation, oxidative stress and damage to blood vessels.”

Here are the potential risks that we already know about:

• EVALI: EVALI stands for e-cigarette- or vaping-use-associated lung injury. It’s a type of lung damage that’s unique to vaping. The inflammation can be very sudden and it’s usually severe enough to send you to the hospital. The damage can be permanent and, in rare cases, deadly.
• Burns: At the end of the day, vape pens are battery-operated heating elements. While rare, they can explode, causing thermal and chemical burns. If the unit stays intact but the vapor inside overheats, it can cause painful burns to your mouth and airways.
• Oral health problems: It’s not yet clear whether nicotine-free vaping increases your risk of oral cancer, but it is associated with dry mouth, gum irritation and other dental concerns.
• Allergies: The additives, flavorings and other chemical compounds in vape juice may prompt an allergic or sensitivity reaction in some people when inhaled.
• Airway issues: Airway irritation is a common side effect of vaping non-nicotine products. And people with asthma, COPD or another lung condition may find vaping makes it worse.

While you may not be inhaling tobacco or nicotine when you use this type of e-cigarette, concerns about heart disease and cancer remain.

“With smoking, it took decades to understand the damage it causes,” Dr. Wang says. “These vapes just haven’t been out that long.” Only with time and research will we truly understand how zero-nicotine vapes affect your health.

Until then, Dr. Wang stresses that the dangers of vaping are especially great for young people. That’s because your lungs stop developing after your teen years.

“If you damage these organs, in general, they’re not reparable,” she emphasizes.

Ultimately, the choice to use a nicotine-free vape, for any reason, is yours and yours alone. But to make an informed choice, you need to know about the risks involved.

There are other ways to be nicotine-free

If you’ve been trying to quit smoking or vaping without success, Dr. Wang wants you to know that there are lots of safe, evidence-based approaches you can try. Non-nicotine vaping just isn’t one of them.

If you’re ready to give nicotine the boot, consider asking a provider to connect you with a smoking cessation specialist or program. They can help you choose a strategy that works for who you are and how you live.