Vape juice comes in a variety of flavors, including candy, bubble gum, and children's cereal. Johns Hopkins cardiologist Michael Blaha, M.D., M.P.H., discusses vape flavors and other e-liquid ingredients and how they may affect health, especially in children and adolescents.

What is in vape juice?

Flavor is just one of the ingredients in e-liquid. Vape juices typically contain nicotine and many other additives and chemicals, and Blaha says the unpredictable variety of ingredients is a problem. Even the heating coil, which turns the liquid into an inhalable aerosol, releases new chemicals and trace metals that end up in the user's lungs.

"There are so many ingredients in e-liquids, and so far no one is taking responsibility for them," Blaha notes. He explains that while there may be production standards for commercial e-cigarette companies, standards for vape shops, unbranded online vendors, or "homemade" vape juice blends are less consistent.

"Vape juice can contain a variety of things that can be toxic," Blaha says. There can be flavorings, dyes, nicotine, THC (the ingredient in marijuana that causes a "high"), and other substances. "There are all kinds of concoctions," he says. "For example, there have been reports of people putting essential oils, multivitamins, or traces of medications in e-liquids."

Is vape juice safe?

Some of these additives found in e-liquids are dangerous - even deadly. For example, vitamin E acetate has been linked to EVALI, which stands for e-cigarette or vaping product use associated lung injury. This is a potentially deadly syndrome associated with vaping, and it was on the rise in 2019. Vitamin E acetate is safe to eat, but dangerous to inhale.

"There's no doubt about it," Blaha says. "Some of the chest X-rays of patients with EVALI show signs of oily chemical irritation of the lungs.

"So when it comes to inhaling vape juice, we don't know what's 'safe.' You may be able to eat something safely, but if you inhale it, there may be a harmful effect."

Blaha says there's little evidence that vape juice flavors themselves are dangerous to individual users. But there are unknowns - research suggests that flavors, when combined with other vape juice ingredients and heated, can create new compounds that may be harmful.

Inhaling harmful substances can affect more than just the lungs. Some vaping enthusiasts describe a phenomenon called vaper's tongue, which causes a sudden total or partial loss of taste.

More to read: Is Vegetable Glycerin Safe to Vape?

WHY DOES E-LIQUID USE PG AND VG?

Propylene glycol and vegetable glycerin are commonly used as additives in a number of different food products, including ice cream and biscuits. Both generally help preserve food and are used as a diluent in e-liquid to dilute the nicotine.

Unfortunately, there are a lot of articles online saying that e-liquid contains antifreeze, however, this mistake comes from a misunderstanding on the origin of propylene glycol. This synthetic organic compound has a very low toxicity, and it is generally confused with another ingredient found in antifreeze – ethylene glycol. Vegetable glycerin is often obtained from coconut oil or soya beans.

All of the ingredients in our liquid pods and e-liquids are stated clearly on the back of the packet. Always purchase vape products from a company you trust, such as blu, as this will ensure they are made and packaged in a protective environment and benefit from significant scientific research. We also would like to recommend the Crystal Bar Flavours such as the lemon and lime crystal bar, cherry ice crystal bar, and berry ice crystal bar from SKE Vape.