Medical organizations continue to flood the media with false claims about e-cigarettes. Subsequent to the AMA president’s January screed (here), the organization released a lengthy scare piece, extracted below with my comments in red.
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By Sara Berg, MS , News Editor
May 30, 2025 | 8 Min Read
AMA News Wire
What doctors wish patients knew about e-cigarettes
May 29, 2025
Clouds of vapor, sweetened with the scent of candy or mint, drift through the air. But behind the flavored haze, hidden dangers linger. E-cigarettes, once marketed as a safer alternative to smoking, have found a stronghold among teens and adults alike.
“Hidden dangers linger” falsely implies that the article will expose them.
Yet physicians are sounding the alarm: vaping is far from harmless. What many patients don't realize is that even without the tar and smoke of traditional cigarettes, e-cigarettes carry serious risks to lung health, heart function and even brain development.
Experts are sounding the alarm that the claims of e-cigarette serious risks are devoid of evidence.
While vape use went down between 2023 and 2024, for the 11th year in a row, e-cigarettes have been the most commonly used tobacco product among middle- and high-school students. In 2024, about 2.25 million middle- and high-school students in the U.S. used at least one tobacco product, according to the Centers for Disease Control and Prevention.
This is confusing. If the writer claims that “vape use went down” for 11 years in a row, it’s not true. As the chart shows, vape use by Americans is booming. In 2023 43% of vapers were former smokers. All of this progress, despite false alarms by the AMA and their prohibitionist allies.
High school vaping took a 64% nose dive from its peak in 2019 until 2023 (here), but the prohibitionists want the public to believe that a crisis persists.
This is alarming because tobacco use during adolescence increases the risk of lifelong nicotine addiction and adverse health outcomes. That is why the AMA adopted policy [sic] to decrease youth access to e-cigarettes.
The AMA does not, in fact, believe that nicotine addiction must be lifelong. It tells smokers to quit with FDA-approved nicotine gum, patches and behavioral tips, which works for about 7% of them.
The AMA’s What Doctors Wish Patients Knew™ series gives physicians a platform to share what they want patients to understand about today’s health care headlines.
In this installment, Bilal Shahid Bangash, MD, a pulmonologist and critical care physician at Bayhealth, discusses what patients should know about vaping or e-cigarettes.
Dr. Bangash’s credibility as a vaping authority is questionable, as there is no record in PubMed of his having published anything.
Chemicals are also found in vapes
“These devices contain other chemicals in addition to nicotine. One of the most common ingredients is a chemical called propylene glycol, which is a common additive in food,” said Dr. Bangash, noting “it may also be used to make antifreeze, paint, solvents and artificial smoke.
Propylene glycol is so safe that it is routinely used in a large number of foods, and in topical, oral, inhaled and injected medicines (here). It has been used as artificial smoke and in airplane antifreeze solutions, again, because it is nontoxic. It is a solvent, but that only means that it mixes with water and a many other chemicals that make up everything we consume.
“Additionally, there are flavoring and other unknown chemicals and ingredients,” he added, noting “it is believed when the liquid heats up, it produces further toxic chemical release.”
This is true but misleading. Flavors and other vapor ingredients are present in minuscule quantities that are at vastly lower levels than the 7,000 chemicals formed when tobacco is burned.
Vaping affects your health
“There’s already proven evidence that youth or adolescents who use e-cigarettes are at an increased risk of short-term lung disease,” Dr. Bangash said. “Those patients who have asthma or chronic obstructive pulmonary disease may experience increased coughing, wheezing and flare-ups.”
This is a non sequitur, as Dr. Bangash fails to define “short-term lung disease” and then discusses “asthma or chronic obstructive pulmonary disease,” which aren’t short-term. Also, there is no “proven evidence” that vaping leads to “coughing, wheezing and flare-ups.”
“The same body of evidence also suggests long term complications including lung disease,” he said, noting “some e-cigarettes and vapes may contain higher nicotine quantities than a regular cigarette. Therefore, at times it is like smoking an entire pack of cigarettes in terms of nicotine consumption.
The quantity of nicotine per vape cartridge is irrelevant to this discussion. It is, of course, greater than that in a cigarette, or even a pack of cigarettes, because vape products deliver doses of nicotine over periods longer than the typical cigarette’s 10 puffs. Vape cartridges are designed to be used over the course of hours or days.
Your lungs are at risk
Vaping still puts your lung health at risk, said Dr. Bangash, noting “there’s evolving evidence of the impact of e-cigarettes on the lungs and the health risks associated with it.”
Earlier, the author asserted that the lung health risk was “proven evidence”; now it’s “evolving”. This dithering underscores the gross inaccuracy of Dr. Bangash’s argument.
Brain development is affected
“Unfortunately, e-cigarettes and vapes are predominantly seen within the youth,” said Dr. Bangash, noting “the brain is still developing until your early- to mid-20s.
“When nicotine is consumed during the period of brain development, it can lead to long-lasting effects because it dysregulates some of the neuronal circuits in the brain that affect control, attention, impulse and mood,” he added.
There is no scientific evidence to support the claim that nicotine causes harm to human brain development (discussed here). In fact, the 30 million adult current smokers and 56 million former smokers in the U.S., virtually all of whom started smoking when they were teenagers, show no brain “neuronal” dysfunction and there is no evidence that their brain development was harmed.
Vaping can be addictive
E-cigarettes and vapes “all stem from nicotine, which is a highly addictive substance. When you vape nicotine, it does the same—it dysregulates activity in several parts of the brain,” Dr. Bangash said, noting “it can affect neuronal pathways.”
Nicotine is addictive; so is caffeine.
“The end result is, all of those changes in the brain make nicotine more desirable,” he added. “So, vaping can cause a similar pattern of addiction or sometimes even worse as compared to cigarettes.”
The scientific literature tells us that vaping is far safer than smoking, full stop.
Vaping not shown to help you quit
“No e-cigarettes or vapes have been found to be safe and effective by the” Food and Drug Administration (FDA) in helping smokers quit”, he emphasized.
Dr. Bangash should know that “safe and effective” are standards applied to medical interventions by the FDA.
"Another major misconception is that switching to e-cigarettes or vaping is a way to quit smoking traditional cigarettes,” said Dr. Bangash. “Using any other tobacco product or any other product that contains nicotine is not actually quitting.”
This is not a misconception. Population evidence that smokers are switching was published years ago (here and here). Two smoking cessation trials, published in the New England Journal of Medicine in 2019 and 2024 clearly demonstrate that vapor products help smokers quit.
Arguing that vaping is not “actually quitting” demonstrates Dr. Bangash’s real goal of nicotine abstinence.
Vape marketing confuses people
“A lot of vape companies want consumers to believe switching to other tobacco products, including vapes or e-cigarettes is a way to quit,” said Dr. Bangash. “However, it is not, and there are a lot of unproven health claims made by the e-cigarette or vape industry that is confusing people who actually want to quit smoking.
“This creates a lot of confusion for people who really want to quit typical cigarettes and they feel that going to e-cigarette will be a way to help, but that’s not exactly true,” he added.
My previous comment demonstrates that the utility of vaping as a stop-smoking mechanism has been proven.
Secondhand vape smoke not understood
Many people have questions about the effects of secondhand smoke from e-cigarettes and vape pens, which is “a good question” to ask, said Dr. Bangash. Unfortunately, “the long-term harm from secondhand vape smoke is not well understood.”
Vape smoke is not a thing. Dr. Bangash and the AMA should know better.
“However, the aerosol from vape smoke does contain nicotine, heavy metals and formaldehyde, which in the short term can cause bronchitis, asthma flares and worsening breathing over time,” he said.
These claims are baseless. Facts are available on heavy metals (here), formaldehyde (here, here and here) and false respiratory claims (here).
Parents: Set an example
“Parents are very powerful influences on their children and it is important to maintain an open dialogue early on and express to children that smokeless tobacco, e-cigarettes, vapes, all have dangers including nicotine and nicotine addiction,” said Dr. Bangash. “One of the common things kids will face is peer pressure, so as a parent, it’s important to prepare kids for situations in which they may face pressure from their peers to use a vaping device.”
“At the same time, the things we can do as parents is to set a good example, never smoke around kids and establish a smoke-free home,” he added. “So, whether it’s yourself, your friends, your relatives, whoever, if you do not smoke it sets a very positive example for kids.”
While parents should know about their children’s potentially dangerous activities, vaping should be prioritized relative to other prevalent risky teen behaviors, such as:
Do not always wear seat belt 40%
Current text/email while driving 36%
Current drink alcohol 23%
Seriously considered suicide past year 22%
Sexual intercourse past 3 months 21%
Didn’t wear condom 48%
Current marijuana use 16%
Bullied on school property past year 15%
Current ride with driver had been drinking 14%
Current binge drink 11%
Centers for Disease Control and Prevention. High School YRBS Online. https://nccd.cdc.gov/youthonline/App/Default.
Educational campaigns discourage vaping
“The FDA started a campaign called ‘The Real Cost,’” said Dr Bangash, “and the Truth Initiative started a campaign called ‘It’s Messing With Our Heads.’”
“These are educational campaigns that primarily target the youth and aims to prevent the youth from using vapes and preventing nicotine consumption in addition to other objectives as well,” he said.
While the FDA claims it’s PR campaign prevents youth e-cigarette initiation, it clearly dissuades adult smokers from using e-cigarettes to quit (here).
Have a quit plan
“The most important thing when planning to quit vaping or smoking cigarettes, is to have a quit plan,” Dr. Bangash said. “In order to help with the quit plan, talk to your doctor who can help develop a quit plan which can include medication and counseling.
“Together, the combination of medication and counseling has resulted in very high success rates of quitting for good,” he added. “There are also Quit Lines where patients can talk to trained “quit” coaches to help assist in this process and motivate patients to continue with their quit plan.”
Population estimates of quitting with FDA-approved methods are abysmal, and 480,000 American smokers don’t quit in time to avoid untimely death.
It is also important “to understand with vaping, just don’t switch. Quit tobacco for good,” Dr. Bangash said. “We know from all the evidence and data around cigarette smoking is that quitting smoking is the single best thing to improve overall health.”
“It’s important to not get confused by unproven claims made by tobacco and e-cigarette companies. Just quit smoking for good and if you need assistance or help, please talk to your doctor,” he added. “And as a parent, please take it upon yourselves to educate your children about the hazards of smoking and be a positive influence for your kids and establish a smoke-free home.”
The final word, paraphrasing Dr. Bangash: “It’s important to not get confused by unproven claims from medical professionals and organizations. Just quit smoking for good, which you can accomplish with or without nicotine abstinence. Educate your children about the hazards of smoking and be a positive influence for your kids and establish a smoke-free home.”
