The long term health effects of e-cigarettes is a subject that frequently crops up in the world of vaping due to the relatively short time that the devices have been around. However, Dr. Riccardo Polosa and researchers from the University of Catania have now taken a big step forward in neutralising these concerns thanks to a 3 and a half year study which shows no evidence of health concerns in long-term e-cigarette use among vapers who have never smoked.

This research is the first of its kind in the sense that this long-term research tracks people who have never smoked and therefore aimed to “disentangle responses driven by chronic exposure to EC (electronic cigarette) aerosol emissions from those related to previous smoking history”. 

 The study was made of participants who had never smoked but were vapers and participants who had never smoked or vaped. Baseline figures, quality control and results tracking was rigorous and used accurate equipment and methodology. These procedures were in place to track the following Health outcomes: blood pressure (BP), heart rate (HR), body weight, lung function, respiratory symptoms, as well as exhaled biomarkers of airway inflammation.

Dr. Riccardo Polosa


Due to the scarcity of available vapers who had never smoked, the sample size consisted of 9 vapers and 12 control subjects who had never smoked or vaped. This is a limitation of the study but ‘because of the small sample size, they were able to check all individual data sets one by one to detect signs of negative changes and found no such changes’.

 This is a very encouraging piece of research which was concluded by the lead author stating:

“we found no decrements in spirometric indices, development of respiratory symptoms, changes in markers of lung inflammation in exhaled air or findings of early lung damage on HRCT, when compared with a carefully matched group of never-smoking non-EC users.”

Due to the small sample size the subject needs further investigation as the conclusion also states:

“While the sample size was small, the results of this study may provide some preliminary evidence that long-term use of ECs is unlikely to raise significant health concerns in relatively young users. Further studies in a larger sample of EC users with and without a history of tobacco smoking are warranted.”

Man Blowing Vape Cloud

The Challenge of Finding “Never Smokers” who Vape

One of the key issues stated by the research group was that in Italy, just as in the UK, vapers that have never been smokers are a rare breed.  More than this, vapers that have never smoked tobacco are far less likely to continue to use e-cigarettes in the medium or long term, as nicotine delivered in e-cigarettes has been found to be far less addictive than had previously been assumed, and is not comparable with the addictiveness of traditional combustible cigarettes.

By the time the study finished, of the 16 original participants that were vaping “never smokers”, two were excluded from the study as they stopped vaping completely, and one because they began vaping only sporadically.  Another four did not come back for final testing at the end of the study.  Quite heart breaking for researchers that had worked so hard to find these “unicorns”.

More interestingly, of the 15 non-smokers in the reference group that was used for control in the study, one was lost from the study when they moved to another city, but two had to be removed from the study because they had started smoking tobacco.  This does not appear to have been the case for any of the vapers, who we sincerely hope will be “never smokers” for the rest of their lives.