Is a Harmful Level of Nicotine Exhaled When Vaping?

Check out this answer from Consensus:

While the levels of nicotine exhaled during vaping may not always reach harmful thresholds, the potential health risks, particularly respiratory issues, cannot be ignored. The evidence suggests that secondhand nicotine vape exposure can lead to adverse health effects, and the increase in indoor particulate matter due to vaping could pose additional risks. Therefore, it is crucial to consider these factors when evaluating the safety of vaping, especially in enclosed spaces.

The increasing popularity of e-cigarettes and vaping has raised concerns about the potential health risks associated with nicotine exposure, not only for users but also for bystanders. This article explores whether harmful levels of nicotine are exhaled when vaping, drawing on recent research findings.

Nicotine Exposure and Health Risks

Research has shown that nicotine exposure from vaping can have significant health impacts. A study investigating the effects of inhaled nicotine on bronchial epithelial cells found that nicotine exposure induces cellular apoptosis and senescence via reactive oxygen species (ROS) mediated autophagy impairment. This mechanism is a potential contributor to chronic obstructive pulmonary disease (COPD) and emphysema pathogenesis1. This suggests that the nicotine exhaled during vaping could potentially contribute to respiratory issues in bystanders.

Secondhand Nicotine Vape Exposure

The health effects of secondhand nicotine vape exposure have also been studied. A longitudinal study involving young adults found that exposure to secondhand nicotine vape was associated with increased risks of bronchitic symptoms and shortness of breath. The study controlled for various confounders, including active and passive exposure to tobacco or cannabis, and demographic characteristics. The findings indicated that secondhand nicotine vape exposure could lead to adverse respiratory health symptoms, particularly in non-smokers and non-vapers2.

Indoor Air Quality and Nicotine Levels

Another study examined the impact of vaping on indoor air quality and the composition of exhaled breath of bystanders. The study found that vaping significantly increased the indoor concentrations of particles smaller than 10 µm, 5 µm, and 1 µm. However, the increase in nicotine concentrations in the indoor air was relatively small compared to health regulatory thresholds. The study also noted that the particulate phase should be included in nicotine monitoring during vaping, as most differences in nicotine levels were recorded in the gas phase3.

Is a harmful level of nicotine exhaled when vaping?

Neal Benowitz, MD has answered Uncertain

An expert from University of California, San Francisco in Smoking, Pharmacology, Medicine

1. The amount of nicotine varies tremendously by the type of device and the behavior of the vaper. High power devices generate large amounts of aerosol, much of which may exhaled, such as in cloud chasing. Low power devices generate small amounts of aerosol, and very little is exhaled.
2. Nicotine that is exhaled quickly leaves particles and enters the environment as a gas, then deposits on surfaces. Nicotine can be found on surfaces in homes and business where people vape. Non-nicotine users who lives with vapers have measurable but low levels of cotinine (the main metabolite of nicotine) in their blood. 
3. Whether low levels of nicotine in the air or on surfaces causes human disease is unclear. Thirdhand tobacco smoke (THS) can aggravate allergies and respiratory conditions, but THS contains many other toxicants in addition to nicotine.

Is a harmful level of nicotine exhaled when vaping?

Paweł Kubica has answered Unlikely

An expert from Gdansk University of Technology in Analytical Chemistry

According to the:

J.N. Newton, M. Dockrell, T. Marczylo, Making sense of the latest evidence on electronic cigarettes, The Lancet, 391, 10121, p639-642

British Medical Association. E-cigarettes: balancing risks and opportunities. London: British Medical Association, 2017

“Passive exposure to EC aerosol is likely to pose a negligible health risk to bystanders”

It is unlikely to be harmful.

Is a harmful level of nicotine exhaled when vaping?

Mathieu C Morissette has answered Uncertain

An expert from Université Laval in Cell Biology

Very few data on this matter.

Vapers do exhale nicotine and it can remain in suspension in the room and be detected and quantified (PMID 30560536).

Variables affecting the amount of nicotine in the air are/can be severals: nicotine concentration in the e-liquid (from 0 to >30mg/ml); vaping intensity; room size; ventilation; distance between primary and secondary vaper; etc

Can it be harmfull? Acutely, very unlikely. However, chronic nicotine exposure does have adverse effects, especially in young individuals. We also have to consider that secondary vapers could, over time, develop low grade nicotine addiction that could make them more susceptible to start vaping or smoking. However, this remains a hypothesis.

Is a harmful level of nicotine exhaled when vaping?

Rebecca S Williams has answered Uncertain

An expert from University of North Carolina at Chapel Hill in Public Health, Cancer

There is insufficient research evidence to answer this question at this time, particularly in a general sense without context (number of people vaping, size of enclosed/unenclosed space, proximity to non-vaping people, how you define ‘harmful level of nicotine’, etc). I suspect that as more and more research on this topic is published, the evidence for secondhand e-cigarette vapor being a health risk to non-vapers will grow substantially.

Is a harmful level of nicotine exhaled when vaping?

Lynne Dawkins has answered Extremely Unlikely

An expert from London South Bank University in Addiction, Psychology, Public Health

Nicotine actually carries minimal health risks – it’s the thousands of other chemicals in tobacco smoke that are responsible for almost all the harms. There is clear evidence that second hand smoke is harmful but this is not because of the nicotine. In relation to e-cigarette vapour, in a recent evidence review of e-cigarettes commissioned by Public Health England (1) it was concluded that there is no evidence that e-cigarette vapour is harmful to bystanders. Detectable levels of nicotine have been found in e-cigarette vapour generated in the laboratory but these were 10 times lower than levels measured in tobacco smoke (3.32 μg /m3 compared with 31.6 μg /m3) (2). Moreover, under normal usage conditions, the user would inhale most of this vapour, so exhaled levels would be even lower. So, using an e-cigarette in an indoor environment may expose others to low levels of nicotine but this is unlikely to be harmful.

(1)https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/684963/Evidence_review_of_e-cigarettes_and_heated_tobacco_products_2018.pdf

(2) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565991/ 

Is a harmful level of nicotine exhaled when vaping?

Thanh-Huyen T Vu has answered Likely

An expert from Northwestern University School of Medicine in Cardiovascular Disease, Epidemiology

Although scientific evidence isn’t yet available on the health effects of the aerosol from e-cigarettes, we cannot say that the nicotine exhaled when vaping is not harmful.

The exhaled aerosol contains nicotine, and nicotine is a known health risk. Also, the exhaled aerosol contains many other chemicals that can cause health problems. Therefore there may be a negative health effect from inhaling the nicotine exhaled by vapers. We are working to develop scientific evidence on this question.