Speaker's Highlight

• Don Sin University of British Columbia, St. Paul Hospital (Canada)
  Kenneth R. Chapman Toronto General Hospital Research Institute (Canada)
• Parameswaran Nair McMaster University (Canada)
  Carolyn Calfee UCSF (U.S.A.)
• Gregory P. Downey University of Colorado School of Medicine (U.S.A.)
  David A. Schwartz University of Colorado School of Medicine (U.S.A.)
• Neil Schluger Tuberculosis Control Branch, California Department of Public Health (U.S.A.)
  Nick Kim Critical Care & Sleep Medicine, University of California San Diego (U.S.A.)
• Nicola Hananiah Baylor College of Medicine (U.S.A.)
  Jae-Joon Yim Seoul National University College of Medicine (Republic of Korea)
• Koichiro Asano Tokai University School of Medicine (Japan)
  Diahn-Warng Perng Taipei Veterans General Hospital (Taiwan)
• Konstantinos Kostikas University of Ioannina (Greece)
  Karin Klooster University Medical Center Groningen (Kingdom of the Netherlands)

• How Vaping Affects Adolescent Respiratory Health

  Electronic cigarettes are often presented as a cleaner alternative to combustible tobacco, yet that comparison can obscure the risks for young people who have never smoked. Vaping devices heat a liquid into an aerosol containing nicotine, flavouring chemicals, solvents and, in some products, metals released from the heating coil. The aerosol is inhaled deeply into developing airways. Learn more about 組織弾性イメージングでみる筋硬度.

  For adolescents, the concern extends beyond immediate irritation. Lung growth, immune responses and breathing patterns are still maturing, while nicotine can affect attention, mood and dependence pathways. Frequent use may also make physical activity less comfortable and increase the likelihood of later tobacco use.

  Australia has seen rapid changes in vaping products, access rules and public attitudes. Teenagers in Sydney, Melbourne, Brisbane and other cities may encounter devices through social networks, informal sellers or friends, even though lawful supply is tightly controlled. Understanding the respiratory effects helps clinicians, families, schools and young people respond without relying on scare tactics.

  What The Aerosol Contains

  Vape aerosol is not simply water vapour. Depending on the device and liquid, it may contain nicotine, propylene glycol, vegetable glycerine, aldehydes formed by heating, flavour compounds and fine particles. Some tests have also identified nickel, chromium, lead and other contaminants, particularly when devices are damaged, poorly made or operated at high temperatures.

  The chemical mixture varies between brands, disposable products and refillable systems. Labels may be incomplete, and a product advertised as nicotine-free may contain nicotine. This uncertainty makes exposure difficult to measure and complicates respiratory assessment in adolescents who use several products or share devices.

  Effects On Developing Airways

  Short-term vaping can cause throat irritation, coughing, wheezing, chest tightness and breathlessness. These symptoms may be mistaken for a cold, exercise intolerance or poorly controlled asthma. Heated chemicals and particles can irritate airway lining cells, alter mucus clearance and promote inflammatory responses.

  Repeated exposure may contribute to more persistent respiratory symptoms, although the full lifetime effect is still being studied. Young people with asthma or allergies may be especially vulnerable because their airways already react strongly to smoke, pollution or viral infections. Vaping should not be treated as harmless simply because it produces less visible smoke than a cigarette.

  Nicotine, Dependence And Breathing

  Nicotine dependence can develop quickly during adolescence. A young person may begin vaping at parties or during school breaks, then progress to regular use to prevent cravings, irritability or difficulty concentrating. Withdrawal can create a cycle in which vaping feels like relief from discomfort that nicotine itself helped establish.

  Nicotine can also increase heart rate and sympathetic arousal, sensations that may be confused with anxiety or shortness of breath. When vaping is combined with energy drinks, cannabis or tobacco, the overall physiological burden becomes harder to interpret. A careful health history should ask about frequency, device type, nicotine strength and use during sport or overnight.

  Vaping And Asthma In Australia

  Asthma is common in Australia, and symptoms can be triggered by viral illness, pollen, dust, smoke and air pollution. For an adolescent who uses a reliever inhaler before sport, vaping may add another source of airway irritation. It can also make it harder to identify whether worsening control reflects poor adherence, environmental exposure or a new respiratory problem.

  Australian clinicians should ask about vaping in the same matter-of-fact way as smoking. This is relevant in urban areas affected by traffic pollution and in communities exposed to bushfire smoke, including around Canberra, regional New South Wales and parts of Victoria. A young person with wheeze, chest pain, persistent cough or reduced exercise tolerance needs an assessment rather than assumptions about the cause.

  Exercise, Sleep And Daily Function

  Breathing discomfort can affect running, swimming, football and other activities that are central to adolescent life. Some users report coughing after vaping or needing longer to recover after exertion. Nicotine may also delay sleep or cause overnight cravings, while poor sleep can worsen concentration, mood and perceived breathlessness during the day.

  Respiratory muscle performance is one part of understanding exercise limitation, alongside lung function and cardiovascular fitness. In selected research settings, clinicians may use elasticity imaging methods to examine tissue properties, although such techniques do not diagnose vaping-related injury by themselves. Standard evaluation remains based on history, examination and appropriate pulmonary testing.

  The Australian Regulatory Setting

  Australia’s vaping market is shaped by federal and state rules that restrict lawful supply to therapeutic channels and impose product standards. Recent reforms have focused on pharmacy supply, limits on flavours and packaging, and controls on importation and advertising. The details and enforcement arrangements can change, so families should check current information from Australian health authorities rather than rely on social media claims.

  In practice, adolescents may still see disposable vapes promoted through informal online networks, convenience-store contacts or peer-to-peer sales. Products that are colourful, sweet-flavoured or designed to resemble highlighters and USB devices can be particularly attractive around schools and public transport routes. Legal restrictions reduce access but do not remove the need for prevention, screening and confidential support.

  Recognising Harm And Providing Care

  Warning signs include a new or worsening cough, wheeze, chest pain, shortness of breath, fever, vomiting or marked fatigue after vaping. Sudden breathing difficulty, bluish lips, confusion or severe chest pain requires urgent medical attention. A clinician may consider spirometry, oxygen assessment, imaging or other investigations according to the symptoms and history.

  Effective conversations should be direct and non-judgemental. Asking what the device contains, how often it is used and whether it is shared can reveal exposure more accurately than asking only whether the adolescent “smokes.” Support may include nicotine-dependence treatment, behavioural counselling, asthma management, family involvement and referral to youth-friendly services.

  Prevention Through Health Literacy

  Schools and sports clubs can explain that aerosol exposure has biological effects without overstating uncertain long-term findings. Lessons are more useful when they cover marketing tactics, nicotine dependence, breathing during exercise and the difference between regulated therapeutic products and illicit disposables. Parents can set clear boundaries while keeping communication open enough for a young person to disclose symptoms or dependence.

  Public health messages should also reflect local habits. Young Australians may encounter vaping at music events, shopping centres, beaches, parties and after-school gatherings, while stress, social belonging and curiosity can all influence use. Prevention works best when it combines accurate information with accessible cessation support rather than relying solely on punishment.

  For families and clinicians, the practical approach is simple: ask about vaping routinely, treat respiratory symptoms seriously, protect asthma control, and help adolescents stop before occasional use becomes dependence. A device that produces little visible smoke can still expose developing lungs to irritants, nicotine and uncertain contaminants.

  Richard Russell Nuffield Department of Clinical Medicine, University of Oxford (United Kingdom)
• Mona Bafadhel King’s College London (United Kingdom)
  David Jackson Guy’s and St Thomas’ Hospital, King’s College London (United Kingdom)
• James Chalmers University of Dundee (United Kingdom)
  David Price University of Aberdeen (United Kingdom)