Can vaping damage your lungs? What we do (and don’t) know

Robert H. Shmerling, MD

Faculty Editor, Harvard Health Publishing

The rising popularity of vaping has been dramatic, especially among teenagers. According to a recent study, about 37% of high school seniors reported vaping in 2018, up from 28% the year before. An estimated 2.1 million middle school and high school students reported using e-cigarettes in 2017; that number jumped to 3.6 million in 2018. Certainly, age restrictions — it’s illegal to sell e-cigarettes to anyone under 21 (18 or 19 in some states) — aren’t preventing use among teens and young adults. And nearly seven million adults 18 or older use e-cigarettes, according to a 2017 survey by the CDC.

E-cigarettes use a battery-powered device that heats a liquid to form vapors — or, more accurately, aerosol — that the user can inhale (thus “vaping”). These devices heat up various flavorings, nicotine, marijuana, or other potentially harmful substances. Nicotine is addictive, of course. And while that fact is prominently displayed in advertising, we know from experience with regular cigarettes that warnings don’t always work!

Recent reports link vaping to lung disease

You may have seen news reports of lung problems, including two deaths — one in Illinois and another in Oregon— linked to vaping. According to the CDC:

  • Nearly 200 e-cigarette users have developed severe lung disease in 22 states (and the numbers keep rising — a Washington Post story put the number at 354). Most cases were among teens and young adults.
  • Experts aren’t sure if vaping actually caused these lung problems, but believe the most likely culprit is a contaminant, not an infectious agent. Possibilities include chemical irritation, or allergic or immune reactions to various chemicals or other substances in the inhaled vapors.
  • Typically, symptoms have started gradually, with shortness of breath and/or chest pain before more severe breathing difficulty led to hospital admission.
  • The lung disease has not been linked to a specific brand or flavor of e-cigarette.
  • The FDA, CDC, and state health officials are investigating these cases to determine the specific cause(s) and how to prevent and treat them.

What we don’t know about vaping and lung disease

It’s not clear how often vaping might lead to lung trouble or who is at highest risk. For example, are lung problems more common among vapers who already have breathing problems (such as asthma) or who use marijuana? Is it more common among younger individuals? Does use of e-cigarettes cause the lung disease? Or is an added substance (such as marijuana) or another contaminant the culprit? Since the FDA does not actively regulate e-cigarettes, it’s particularly difficult to get answers.

Other health risks of vaping

The recent tragic and alarming cases of severe lung disease are clearly cause for concern. A number of other health effects are also worrisome:

  • Nicotine is highly addictive and can affect the developing brain, potentially harming teens and young adults. Even some “nicotine-free” e-cigarettes have been found to contain nicotine.
  • Some substances found in e-cigarette vapor have been linked to an increased risk of cancer.
  • Teens who vape are more likely to begin smoking cigarettes.
  • Explosions and burns have been reported with e-cigarettes while recharging the devices, due to defective batteries.
  • Accidental exposure to liquid from e-cigarettes has caused acute nicotine poisoning in children and adults.
  • Vaping during pregnancy could harm a developing fetus.

How vaping affects our overall health is uncertain.

But what about the benefits?

In addition to whatever enjoyment vaping brings, some evidence suggests vaping helps some people stop smoking. However, how it compares to a nicotine patch or other methods of smoking cessation is not clear. So far, the FDA has not approved vaping as a method of smoking cessation. And many smokers who vape continue to use both cigarettes and e-cigarettes.

The CDC’s position is that “E-cigarettes have the potential to benefit adult smokers who are not pregnant if used as a complete substitute for regular cigarettes and other smoked tobacco products.” Meanwhile, the FDA warns that vaping is “not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products.”

The true balance between the benefits and risks of vaping remains impossible to assess. We don’t always know what’s in e-cigarettes. The FDA does not regulate these products. And there is no information available about long-term health impact.

The bottom line

Perhaps vaping should be viewed as a “lesser of evils” for current cigarette smokers. Still, it’s clear that there is a lot about vaping we don’t know. One way we’ll learn more is by people reporting possible vaping-related health problems to the FDA — you can let them know if you’ve had such problems.

Until we know more, think twice about vaping. Federal and state authorities recommend avoiding all vaping until more is known. If you do decide to vape, avoid e-cigarettes bought “off the street” and stick with brand name e-cigarette products without modification (such as adding marijuana or other drugs).

These cases of severe lung disease among people who vape raise important questions about the safety of vaping. Perhaps we shouldn’t be surprised that lung problems might develop in people who vape: our lungs were meant to inhale clean air and nothing else. It took many years to recognize the damage cigarettes can cause. We could be on a similar path with vaping.

Follow me on Twitter @RobShmerling

Related Information: Quit Smoking for Good

Comments:

  1. Rey

    I first started age 14 with chewing tabacco while playin hockey with friends, loved it and chewed for 3 years, then i switched to smoking belmonts (pack a day) for 1 year which i hated and felt digusted until vapes started coming out in my local smoke shop. I bought a big 20w box mod kit for 80 bucks and ive been vaping ever since. I then bought a dripper and have been drip vaping huge clouds for the past 4 years. Ive been going through 1 bottle every week for 4 years aswell and i am active, healthy and feel way better then i did smoking cigarettes.

    I have noticed alot of young kids 13-14 vaping, its the newest, quickest, cleanest way to get a buzz so of course kids are going to be all over the new JUULs and these stupid little pen vapes. They are also vaping NIC SALTS which is basically a more concentrated version of nicotine, pure and crystallized; can get any young kid addicted extremely quickly.

    Vapes have been out for years now, and to hear a kid got a lung infection in just 7 months of vaping is clearly horseshit and a hoax. I am glad these articles and news have been revealed fake or not because it will sway the children off the vapes. I work at a wedding hall, and most of the young staff have thrown away their vapes from these fake stories.

    PS. vaping strong 5 years lovin it

  2. R Atkins

    I smoked 1 and 1/2 packs a day. I was always coughing and had wheezing. I purchased my first e cigarette after my doctor suggested it as an alternative , in October 2013. I have not had a tobacco cigarette since. My breathing has improved dramatically I no longer wheeze. It has changed my life, I really hope that people realize not everyone gets sick from vaping.

  3. Thomas Prevenslik

    E-cigarettes containing nicotine vapor are more dangerous than ordinary cigarettes burning tobacco. E-cigarette vapor contains nanoparticles from the heater coil that emit UV radiation that raises nicotine to a higher electronic state than burning tobacco. Immediate symptoms similar to nicotine poisoning have been reported, but the serious health problem is DNA damage that depending on the smoker’s immune system leads to decades later cancer. See paper on the web at nanoqed.org

  4. Kim

    In 2012 I quit smoking cigarettes by using e-cigs. I decided I wanted to quit and that was the way that seemed the most familiar. I slowly decreased the nicotine content 2% every two weeks from 18% until I was down to 0%. I “smoked” 0% nicotine for about 5 days and then just stopped. The physical addiction was gone. If you plan on replacing cigarettes for the rest of your life, this is still a gamble. They just haven’t been around long enough for long term studies so we can’t know what’s lurking. But I will tell you that I do not regret the way I quit and I thank my lucky stars that these were available at a time when I really needed them most. I hit 7 years nicotine free in May!

  5. Dr. Gady

    Great valuable information! You have covered everything on the lungs that everyone should know about it. I’ve subscribed to your email list so whenever you publish a new article, I will keep aware of that. Keep sharing such good stuff!.

  6. Kip Winter

    What effect does e cig oil have when inhaled into lungs?

    • Ben

      The juice used in Vaping is not an oil, it is propylene glycol, vegetable glycerin, and nicotine. It would take very large amount of these substances over many years to cause issues in your lungs. Which is why factory workers in the popcorn industry ended up with popcorn lung.

    • Eddie Olivo

      E-juice is not an oil.
      I was a smoker for 21 years. When my first-born daughter was about 8 years old, she had been after me for a while to quit smoking. I had tried quitting using the patch and gum, but with no success. I also did the dumb thing and started using smokeless tobacco snuff, otherwise known as Dip, with no success. Well, one day my brother had been speaking with me about vaping, so I did my own research. I looked it up on YouTube and started watching some vapers’ videos and also did some searching on the web as well to inform myself of this fairly new alternative to quit. Well, it’s been 8 years now since I last smoked a cigarette and I feel great. I’ve also had some praise from my doctor who couldn’t tell from my lung scans that I had been a smoker for 21 years. I just hope more people inform themselves before they decide to speak out on issues. I also thought I was living in a free country (USA) where as a grown adult we can make decisions to better ourselves healthy or otherwise. What I’m curious about is, with all these discussions of how vaping has become an epidemic with teens, why hasn’t coffee ever been an issue with teens? Isn’t caffeine a stimulant Correct me if I’m wrong, but isn’t it in the same class as nicotine in regards to being a stimulant? Please keep helping the upstanding citizens of this great country to have another alternative to quit smoking. After all, isn’t that what everyone wants; NO MORE SMOKING!! Let us as adults and taxpayers go through the trials and errors of this life changing alternative. And if parents are so bent then maybe it’s time for parents to start being their kids’ parents and NOT their friend and they will know what their kids are up to. We have seen a lot of news stories of bad vaping incidents. If the news stations want to give real news, why don’t they ever investigate what the person was vaping at the time of his or her incident. Was it a black-market e-juice, black-market THC wax or liquid? These questions and information are rarely said on the news. Another thing, why don’t they ever get a news story with someone that is very informed on the vaping topic to give out Facts of vaping instead of false information?

  7. Cynthia J. Gracie

    I quit smoking cigarettes (one pack a day habit) with the help of a very cheap vape pen that looks like a cigarette. I haven’t had a cigarette since October 22, 2018. I still use the vape pen every day but not with the frequency or time-of-day, i.e., first thing in the morning with coffee, as I did with cigarettes.

    I’ve been pondering why people are getting sick from vaping and I believe it may be because of the following:

    1) some of the batteries are so powerful that one “hit” of vapor is far more in quantity than anyone ever receives from smoking a cigarette. In other words, people are receiving far more vapor per hit. Evidence of this is the amount of vapor that surrounds people after they exhale — I seen this in news reports. That huge amount of vapor doesn’t dissipate as smoke does.

    2) people are inhaling the vapor like they would when one takes a hit off of a pot joint or pot pipe or a bong, i.e., they take a long hit of vapor that goes far more deeply into the lungs than it would with a cigarette (I’m not promoting smoking cigarettes at all);

    3) people who use vapor likely use pot too. A poll of vape users who smoke pot would be interesting; and

    4) because of #3, they are holding the vapor in their lungs as pot smokers do, instead of inhaling the vapor by immediately releasing it quickly from their lungs.

    I have had no side-effects from the e-cigarette I use, and I use it less and less as time goes on. I agree that flavored e-cigs should be banned.

    Hope this helps. I’ve given this a lot of thought. I’m 65 years old and smoke-free, finally. My husband died of lung cancer in 2016 from smoking and exposure to toxic chemicals. It’s a hard lesson to learn.

    All the best, Cynthia Gracie

    • Griffin

      hey I agree with everything you said except that you think that flavored e cigs should be banned, I completely disagree with this opinion, because flavored e cigs helped me get off cigs, the taste just wasn’t there with e cigs. the JUUL tobacco wasn’t good the blu tobacco wasn’t good, I used to smoke 2 packs a day, after switching to the mango juul pods I haven’t toutched a cig in 3 years, almost all of my friends smoked but once I introduced them to flavored vaping they almost all quit. This might help you, but I think that by banning flavored e cigs we are making alot of adults start smoking again.

    • Robert Pilon

      All of your thoughts don’t make sense it’s not any of those reasons. It’s contamination in the juice or coils that’s damaging peoples lungs. It has nothing to do with people smoking weed or not.

    • Ben

      There so many assumptions and wrong statements in your post, I can tell you have no experience with vaping whatsoever. There is no metric to support vapor goes deeper into your lungs, nor the statement that most vapers also smoke marijuana, and hold in vape longer as a result. You are part of the problem of people speaking on a subject with which they are uneducated, and therefore misrepresent and misconstrue fact from fiction.

    • Kathy

      Agree with you. Same thing with me. I am ex smoke for 51 years bad wheeze and hard time breathe I stop smoking and use e cig vapor with tobacco low nicotine much better. No more wheeze and breath are back normal. E-cig vapor are good for ex smoker. Flavoring are not good. They are more banned only flavoring.
      I am happy with tobacco vapor.

    • Eddie Olivo

      Inform yourself do not depend on the news or social media hype it will only scare u more.

  8. Robbin Reinhart

    I quit smoking 9 years ago, and started vaping….I have never picked up a cigarette since then, I am almost 61 years old, started smoking at 19 years of age. I had tried every way possible to stop, with no results. 9 years ago I had a chest X-ray, it showed a small area of concern…/possible beginning stages of emphysema. That day I started trying different vapes ( not many available 9 years ago). A year after I quit smoking, and continued to vape, I had another chest X-ray…it was clear!! I buy my liquid from the same place, and I make sure it is made in the USA. And I never use flavored liquid.
    I no longer have that god awful smokers cough in the morning. And I feel great. ( I lost my mom at the age of 62, she died of emphysema in 1994).

  9. Ray

    These vaping related deaths are 99% linked to people using fake THC cartridges other known as dab carts. Illegal vendors or plugs would fill empty cartridges with a liquid that contains pesticides and many more deadly chemicals, but people don’t seem to care because they’re cheaper than normal carts and they still get them high. Don’t give up your life to these fake carts and make sure you know where your products are coming from. Juuls are not to blame

    • Jay

      this is the most facutal comment ive seen on here

    • Eddie Olivo

      I was a smoker for 21 years. When my first-born daughter was about 8 years old, she had been after me for a while to quit smoking. I had tried quitting using the patch and gum, but with no success. I also did the dumb thing and started using smokeless tobacco snuff, otherwise known as Dip, with no success. Well, one day my brother had been speaking with me about vaping, so I did my own research. I looked it up on YouTube and started watching some vapers’ videos and also did some searching on the web as well to inform myself of this fairly new alternative to quit. Well, it’s been 8 years now since I last smoked a cigarette and I feel great. I’ve also had some praise from my doctor who couldn’t tell from my lung scans that I had been a smoker for 21 years. I just hope more people inform themselves before they decide to speak out on issues. I also thought I was living in a free country (USA) where as a grown adult we can make decisions to better ourselves healthy or otherwise. What I’m curious about is, with all these discussions of how vaping has become an epidemic with teens, why hasn’t coffee ever been an issue with teens? Isn’t caffeine a stimulant Correct me if I’m wrong, but isn’t it in the same class as nicotine in regards to being a stimulant? Please keep helping the upstanding citizens of this great country to have another alternative to quit smoking. After all, isn’t that what everyone wants; NO MORE SMOKING!! Let us as adults and taxpayers go through the trials and errors of this life changing alternative. And if parents are so bent then maybe it’s time for parents to start being their kids’ parents and NOT their friend and they will know what their kids are up to. We have seen a lot of news stories of bad vaping incidents. If the news stations want to give real news, why don’t they ever investigate what the person was vaping at the time of his or her incident. Was it a black-market e-juice, black-market THC wax or liquid? These questions and information are rarely said on the news. Another thing, why don’t they ever get a news story with someone that is very informed on the vaping topic to give out Facts of vaping instead of false information?

  10. brian fox

    does lung health improve (like if you quit cigarettes) when you quit vaping or is the damage permanent?

  11. Aud

    The fda does regulate vape products

  12. Deepak Sharma

    The Inhalation of Harmful Chemicals Can Cause Irreversible Lung Damage and Lung Disease. … E-cigarettes produce a number of dangerous chemicals including acetaldehyde, acrolein, and formaldehyde. These aldehydes can cause lung disease, as well as cardiovascular (heart) disease. Electronic cigarettes, or e-cigarettes, put nicotine into your lungs and bloodstream. And they do it without the smoke and tar of a regular cigarette. But other harmful things can get into your body when you vape. … Also, some chemicals in e-cigarettes can irritate the airways in your lungs…(mygenericpharmacy)

    • daripper

      whether you are vaping a VG or PG based device does not matter. Though some users might find they prefer one over the other, both propylene glycol and vegetable glycerin can be considered safe components in any e-cigarette product. bascially that whats in vape juice products right. 2. Inhalation issues

      It is likely that the super-heating of e-liquids that takes place in an RBA run at less than 1 ohm will create some toxic materials.

      This is just plain logic and should not be seen as anything radically new: burning up refills creates some nasties and there is no way around that. It is likely that materials such as acrolein and aldehydes will be seen in measurable quantities, and some pyrolytic compounds may even be created.

      Inhalation of sub-ohm vapor is probably not the same as regular vapor and therefore may have additional risk. It is likely to create conditions where potential carcinogens (cancer-causing agents) will be seen in measurable amounts, and so there must be some elevation of risk, which will escalate as resistance goes down and heat goes up.

      We can regard this as significantly more important than battery safety at this time: there are no reported incidents of exploding APVs or house fires caused by sub-ohm rigs self-destructing; but there are probably thousands of people inhaling materials that are simply not present in vapor from a regular clearo run at 2.5 ohms.

      Buttery flavors
      We have to add a specific note on butter/creamy flavors here. Diacetyl or a similar substitute is present in some flavors, and it is likely that many of this flavor group have exactly the same issues as diacetyl, since they are all fairly similar molecules. Because of the sheer volume of liquid consumed and the volume of vapor created by sub-ohming, all issues related to refill liquid safety are magnified.

      Until more information is available, our advice is that all butter/cream type flavors are avoided for sub-ohm use (inhalation of the butter-popcorn flavoring diacetyl can cause the irreversible degenerative lung disease (bronchiolitis obliterans, aka ‘popcorn lung’).

      This warning is not pure speculation:

      A research study has already indicated that the vapor created by high-power vaping contains more potentially toxic compounds.
      Dr Farsalinos’ recent study reports that a very high percentage of cream-type flavors contain diacetyl even when the vendor claims there is none present.”

      — Rolygate (ECF forum administrator)

      • Rhotard

        I’m reading some of this nonsense, posts, the plain truth is, every one of those cases are related to black market THC pods with vitamin e oil, vitamin e oil is not to be consumed, especially after a vape mod heats it up, I’ve been vaping for a few years, I’ve never had an issue, and it helped me quit smoking a pack of cigarettes a day, also I have never felt better. And if minors are vaping, it’s their parent responsibility to be involved in their kids lives.

  13. Brent

    I’m a 47yr old Caucasian male that’s never smoked. I ran track in Jr. High and then Cross-Country in all of my years through High School. I joined the Military and continued running then, and when I got out.
    Nov 17th of 2003 I had acquired aspiration pneumonia and the Doctors extracted 20oz. Of fluid out of my lungs leaving me with scarred tissue damage inside my lungs. Due to the fact that I still continued to jog was my only saving grace they told me, that had my lungs not have been in such good condition I surely would of died. After my 2 week stent in ICU I was told I would have asthma, one year later I was jogging 5 miles a day and threw away the inhaler and have never needed it since.
    I’ve picked up the vaping trend in hopes there would be some chemical relief I could find to help assist me with my anxiety. I’ve been doing that I’d say for maybe 6mo. Here recently I’ve noticed that I’ve acquired a cough not similar to the sound of “smokers cough”, but it’s something that came on out of the blue after 2 months of me quitting vaping. However I “graduated” from vaping to smoking CBD flower / Hemp.. That I found the CBD did in fact help to ease my anxiety. This went on for the two month period I had stopped vaping until now. That too I had stopped doing due to one morning of my coughing routines that lasted about 10min. I noticed I was short of breath. And as a prior runner that is a very unfamiliar and uncomfortable feeling. Now I’ve seen the news reports on the deaths from vaping and the fluid that is retained in a persons lungs and I’m quite concerned as to if this condition might present itself to either be an ongoing issue with me, or get worse?.. Should I worry, or will it subside now that I’m smoke free again?..
    it raises several questions and for me only time will tell.
    I hope any information I have provided will help assist in someone else’s health and well being. If there are any further questions you may have for me feel free to e-mail me, I will be happy to provide any needed information to help further along your case study.
    Brent

  14. Jaime Zazueta

    With all due respect:
    Why would group marijuana along with other real harmful substances?
    “These devices heat up various flavorings, nicotine, marijuana, or other potentially harmful substances.”
    “For example, are lung problems more common among vapers who already have breathing problems (such as asthma) or who use marijuana?”
    “Or is an added substance (such as marijuana) or another contaminant the culprit?”

    Now I have a couple real questions for you, Robert :
    Are you trying by any mean to indicate some close similarity between smoking cigarettes and vaping? You really think it comes even a little close in terms of harm as smoking cigarettes? Or are you simply trying to help big tobacco industry not to loose more profits?

    Why would you try to put Marijuana along with harmful substances Sir? Why is it that you think it’s bad or have some kind of hate/intolerance towards it? I highly recommend you that before you post these misleading kind of blogs, at least get to do some research on all the topics you just covered (maybe smoke a marijuana joint) and them rethink about what you will publish.

    These kind of blogs just make Health Harvard “Edu” loose way a lot of credibility and in other cases can make people about it (like me). I really think you can do much better than that.

    This world needs much more publishings based on real facts and much less of blogs with a lot of misleading statements with signs of manipulation attempts.

    For your comprenhension and time, thanks.

  15. Wesley John Paul

    First, do we need a government agency telling us what to do, what risks, our choice of pleasures? No. Allow, facilitate and educate on the choices. But NEVER make then for us. Personal choice is so controlled I reckon Harvard should be testing that portion of a mind that makes choice. To observe its perhaps diminished state

  16. MA

    A smoker let me know that vaping isn’t going to help with cessation, as you don’t know when to stop – you puff all day anytime you can; and at least with a cigarette it’s lit, burns out, and is done for that moment.

    • RabidBeazt

      One smoker told you that? You didn’t bother asking maybe multiple smokers before forming an opinion? You yourself are not a smoker? Has this smoker even ever vaped?

      I find people like you to be incredibly fascinating.

      I am a smoker. I began smoking at the (then legal) age of 18. Went all through my childhood not having one puff. My mother was a 2-pack-a-day smoker (she died several years ago to cervical cancer caused by HPV). I hated her smoking when I was growing up. Hid her cigarettes. Crushed them. Flushed them. Pretty sure I put some down the garbage disposal. Then I went to college. Got severely homesick and bought a pack of Parliaments (she smoked Winston, I had friends that smoked Parliments). Moved to Marlboro lights, Pall Mall, American Spirit, then to rolling my own to attempt to cut down on the pack-ish I was smoking a day. A friend’s brother was visiting from France a couple of years ago and sitting outside, ripping butts, laughing, crying, and getting drunk on rum and whiskey, we made a pact that the three of us would quit at the same time. They’re in their 50s, me my early 30s. In Late January, he bought a vape device in Strasbourg. Two weeks later, when he spoke to my friend (his sister), he told her about it. She bought one the next day. She told me a week later and a couple of days later, I bought one. None of us have bought a pack/pouch of cigarettes/tobacco since.

      I knew one other person who vaped. A long time smoker and friend who frequented the same bar I did. I asked her over a year ago about it. She stopped using it some time later and went back to cigarettes. I found out after I started vaping that she only smoked at the bar—because a few of the other regulars were teasing her about vaping instead of smoking. I got a similar response, but said screw you. Within 6 months, 9 other smokers and regulars at that bar made the switch. Not because I or my friend talked about it or pushed it, because they asked questions and actually did research. One went back to cigarettes. The others have reported improved breathing and lung capacity, no more smokers cough, and no more phlegm in the morning. They also said they effectively “smoke” less. Because although you light a cigarette, it burns out, and is “done”, you are standing there, committed to smoking the whole cigarette (and then maybe another). With vaping, you can have one or two puffs, be satisfied, and be done whenever you want. You are not committed. You might only need one puff, then maybe five minutes later you take another one. You won’t overdo because your brain will never have to justify it as an expense if you stop now. You just stop now.

      I’ve recently moved 2,000 miles away to be near the only “family” I have left, my mother’s ex-husband. My vape, of course, came with me. He has been a smoker for a very long time, like many older people in the medical profession. He’s a neurosurgeon. He’s asked me about switching and is considering doing it himself.

      Of the 12 other people I know very personally who have made the switch, 9 are very happy they did. One complained that it, “Just wasn’t the same”. All smokers. All in their 40s, 50s, and 60s. I’ve also had the luxury of asking numerous other people, outside of restaurants, bars, venues, in vape shops, walking down the street. They all had similar stories of switching and seeing benefits.

      As far as the “vaping doesn’t help with cessation” “argument”, it helps some people. But things like patches and gum don’t really help with cessation either. Sure, like vaping, there are many people who succeed in never using any form of nicotine. There are also people who have been on patches and chewing gum for 10+ years. I know a number of those people as well. The only reason these “cessation” methods are deemed acceptable is because of big Pharma and their grip on the FDA’s you-know-what. And the lemmings follow… which is of course an insult to lemmings, because they don’t actually behave in that manner—they’re too smart.

    • R Atkins

      I personally have found I use less nicotine now that I vape. 1 ml of e juice will lasts me over a day. I go can hours without vaping, not like my cigarettes.

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