Vaping causes lung damage due to the chemicals in the vape liquid, the chemicals created when the vape liquid is heated and the heavy metals from the vape heater that enter the aerosol/gas as you inhale. The good news is that the human body is an amazing creation and starts healing in less than 20 minutes after that final cigarette or vape.
Full Answer
Can vaping cause COPD?
There is only limited research that has looked at vaping and COPD. A small study published in 2016, reports that nicotine-containing vaping products trigger lung inflammation and lung tissue damage. COPD development is associated with these effects.
Can vaping cause pneumothorax?
In other words, pneumothorax caused by smoking (or, theoretically, by vaping) is the result of many years, or likely decades, of lung damage. Ammirata’s doctor would have known all that.
What are the substances that contribute to lung damage from vaping?
These substances include nicotine, flavorings, and other additives (e.g., solvents, oils, and propellants). It is these substances that contribute to lung damage from vaping. E-cigarettes usually have a mixture of nicotine, glycerin, propylene glycol, and flavorings.
How often does vaping cause lung trouble?
It’s not clear how often vaping might lead to lung trouble or who is at highest risk. For example, are lung problems more common among vapers who already have breathing problems (such as asthma) or who use marijuana? Is it more common among younger individuals?
What is the chemical that can damage your lungs?
What is a vape pen?
What happens if you inhale diacetyl?
What to do if your lung hurts?
What is the food additive used to deepen e-cigarette flavors?
Does vaping affect the lungs?
Is second hand vapor safe?
See 4 more
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How does vaping cause lung problems?
Vaping and Popcorn Lung Diacetyl is frequently added to flavored e-liquid to enhance the taste. Inhaling diacetyl causes inflammation and may lead to permanent scarring in the smallest branches of the airways — popcorn lung — which makes breathing difficult.
How does vaping affect older adults?
The majority of the cases have been younger adults, however, the risk is of complications or more severe cases is higher with older adults. It is said that vaping can increase the risk of heart attack and alter cancer related genes in mouth tissue.
Can vaping damage my lungs?
Lung disease: Vaping can make asthma and other existing lung diseases worse. Breathing in the harmful chemicals from vaping products can cause irreversible (cannot be cured) lung damage, lung disease and, in some cases, death.
How long until vaping causes lung damage?
Exposure for just three days was enough to incur sufficient damage to their lungs, setting the stage for long-term chronic lung damage.
Is vaping safe for elderly?
“Everyone, including older adults, should refrain from using all e-cigarettes and vape products,” says Brian King, deputy director for research translation of the Office on Smoking and Health at the Centers for Disease Control and Prevention (CDC).
Is vape worse than cigarettes?
1: Vaping is less harmful than smoking, but it's still not safe. E-cigarettes heat nicotine (extracted from tobacco), flavorings and other chemicals to create an aerosol that you inhale. Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic.
What are 5 negative effects of vaping?
The most commonly-reported adverse effects were throat/mouth irritation, headache, cough, and nausea, which tended to dissipate with continued use....Coughing, dry throat, headachescoughing.dry mouth and throat.shortness of breath.mouth and throat irritation.headaches.
What are the symptoms of vape lung?
EVALI may cause the following symptoms:Shortness of breath.Cough.Chest pain.Fever and chills.Diarrhea, nausea, vomiting, and abdominal pain.Rapid heartbeat.Rapid and shallow breathing.
How do I clean my lungs from vaping?
Ways to clear the lungsSteam therapy. Steam therapy, or steam inhalation, involves inhaling water vapor to open the airways and may also help to loosen mucus. ... Controlled coughing. ... Draining mucus from the lungs. ... Exercise. ... Green tea. ... Anti-inflammatory foods. ... Chest percussion.
How many vape puffs a day?
There is no specific number of puffs that can be considered safe. The biological factors and several modes are one of the factors that an acceptable daily intake of nicotine is based on.
Can a doctor tell if you vape?
Medical tests can detect nicotine in people's urine, blood, saliva, hair, and nails. Nicotine is the addictive substance in tobacco, cigarettes, and vapes or e-cigarettes.
How harmful is vaping?
The e-cigarette aerosol that users breathe from the device and exhale can contain harmful and potentially harmful substances, including: Nicotine. Ultrafine particles that can be inhaled deep into the lungs. Flavorings such as diacetyl, a chemical linked to a serious lung disease.
How harmful is vaping?
The e-cigarette aerosol that users breathe from the device and exhale can contain harmful and potentially harmful substances, including: Nicotine. Ultrafine particles that can be inhaled deep into the lungs. Flavorings such as diacetyl, a chemical linked to a serious lung disease.
What is the safest vape to use?
If you are looking for the safest vape kit then you might want to consider disposables or pod kits. These are often low powered and have safety cuts offs as well as other features to prevent them from overheating. Not only as disposables one of the safest vape kits, but they are also super easy to use.
What are popcorn lungs?
What is popcorn lung? Popcorn lung (bronchiolitis obliterans) is an uncommon type of lung disease, but it is not cancer. It's caused by a build-up of scar tissue in the lungs, which blocks the flow of air. A possible link has been suggested between the disease and a chemical called diacetyl.
What are the benefits of vape?
Benefits of vaping Vaping can help some people quit smoking. Vaping is usually cheaper than smoking. Vaping is not harmless, but it is much less harmful than smoking. Vaping is less harmful to those around you than smoking, as there's no current evidence that second-hand vapour is dangerous to others.
Does Vaping Cause Lung Cancer? - WebMD
SOURCES: American Lung Association: "COPD," "Popcorn Lung: A Dangerous Risk of Flavored E-Cigarettes." Cleveland Clinic: "Cigarettes, Cigars and Vaping: Which Habit Puts You Most at Risk?"
What is the e-cigarette vaping outbreak?
Lung injuries and a spate of deaths are the result of what's now called EVALI (e-cigarette, or vaping, product use-associated lung injury). (Getty Images) The outbreak has raised nationwide concern and questions about the effects of vaping on the lungs.
What are the symptoms of e-cigarettes?
If you've recently used e-cigarettes or other vaping devices, what could make you suspect that you might have EVALI? Shortness of breath and cough are primary symptoms. Some patients also have symptoms of gastric illness and even weight loss.
What are the symptoms of evali?
As CDC gleaned data from medical records, they found that patients eventually diagnosed with EVALI initially had some of the following symptoms: 1 Cough. 2 Chest pain. 3 Shortness of breath. 4 Abdominal pain. 5 Nausea. 6 Vomiting. 7 Diarrhea. 8 Fever. 9 Chills. 10 Weight loss.
How many young people use e-cigarettes?
About 1 in 5 young adults between ages 18 to 38 uses e-cigarettes either daily or recreationally, according to survey data released by the American Society of Clinical Oncology in September. Nearly 1 in 4 young adults believes that the products are harmless and not addictive, the ASCO survey found.
Which state has no e-cigarettes?
Alaska is the only state without a reported EVALI case. Scientists with the Centers for Disease Control and Prevention and the Food and Drug Administration are working to identify patterns that are common to EVALI patients and their vaping and e-cigarette use.
How old are people with evali?
As a group, those who died were older, with a median age of 53. However, young people have died, too. Overall, fatal cases have occurred in people ranging from 17 to 75 years old. It's not surprising that higher proportions of young people are affected by ...
Does vaping cause lung problems?
How Vaping Causes Serious Lung Disorders. More. Across the U.S., an epidemic of severe lung disease is affecting people who vape. Although vapers don't expect to end up in the intensive care unit with respiratory and gastrointestinal problems, that's been the experience for some. Lung injuries and a spate of deaths are the result ...
How many people have lung disease from e-cigarettes?
According to the CDC: Nearly 200 e-cigarette users have developed severe lung disease in 22 states (and the numbers keep rising — a Washington Post story put the number at 354). Most cases were among teens and young adults.
What are the symptoms of vapors?
Typically, symptoms have started gradually, with shortness of breath and/or chest pain before more severe breathing difficulty led to hospital admission.
What are the effects of smoking?
The recent tragic and alarming cases of severe lung disease are clearly cause for concern. A number of other health effects are also worrisome: 1 Nicotine is highly addictive and can affect the developing brain, potentially harming teens and young adults. Even some "nicotine-free" e-cigarettes have been found to contain nicotine. 2 Some substances found in e-cigarette vapor have been linked to an increased risk of cancer. 3 Teens who vape are more likely to begin smoking cigarettes. 4 Explosions and burns have been reported with e-cigarettes while recharging the devices, due to defective batteries. 5 Accidental exposure to liquid from e-cigarettes has caused acute nicotine poisoning in children and adults. 6 Vaping during pregnancy could harm a developing fetus.
What are the chemicals in e-cigarettes?
E-cigarettes produce a number of dangerous chemicals including acetaldehyde, acrolein, and formaldehyde. These aldehydes can cause lung disease, as well as cardiovascular (heart) disease. Electronic cigarettes, or e-cigarettes, put nicotine into your lungs and bloodstream.
How many puffs can you have with vaping?
With vaping, you can have one or two puffs, be satisfied, and be done whenever you want. You are not committed. You might only need one puff, then maybe five minutes later you take another one. You won’t overdo because your brain will never have to justify it as an expense if you stop now. You just stop now.
How much ohm is toxic?
It is likely that the super-heating of e-liquids that takes place in an RBA run at less than 1 oh m will create some toxic materials.
What is the e-cigarette called?
The Centers for Disease Control and Prevention has created a web page with the latest information and recommendations about what is now being called EVALI (for e-cigarette, or vaping, product use associated lung injury).
What happens when you lose elasticity in your lungs?
COPD occurs when the tubes in the lungs lose their elasticity. This loss causes some air to remain in the lungs after exhaling.
Why are older adults more likely to have COPD?
Older adults are more likely to have COPD because symptoms typically develop over several years.
How many people quit smoking cold turkey?
Nicotine and smoking are addictive and quitting can be challenging. Only 4 to 7 percent of smokers successfully quit “cold turkey .” Other people need to plan how they will quit.
How many participants were in the study of e-cigarette smokers?
The study included 44 participants, a mixture of conventional cigarette smokers, e-cigarette users, and non-smokers. Researchers discovered proteins in the airways of e-cigarette smokers that are known to contribute to COPD. All smokers in the study showed markers of oxidative stress associated with lung disease.
What is a pulmonary function test?
Also known as a pulmonary function test, spirometry detects even early cases of COPD. It involves exhaling forcefully into a tube connected to a spirometer. The device measures how much and how quickly air is exhaled.
How to help someone with smoking cessation?
Build a support network: Ask family and friends for help and support. Join a smoking cessation support group or online forum.
When do COPD symptoms appear?
COPD symptoms may not appear until the lungs have experienced significant damage.
How many cases of lung injury from vaping?
The CDC is currently investigating serious lung illnesses from e-cigarettes. As of September 2019, there are over 500 cases of lung injury from 38 states and 1 U.S. territory. There is also confirmation of seven deaths from 6 states.
What is vaping cigarette?
Vaping refers to the use of battery-powered electronic cigarettes. The use of e-cigarettes helps with the ingestion of nicotine without the smoke and tar that you get from burning tobacco. These electronic devices use a battery to heat a liquid containing nicotine. The heat produces an aerosol that the user inhales.
What are E-Cigarettes?
E-cigarettes contain a battery, a heating element, a place to hold the liquid, and an inhaler piece. The device heats the liquid to produce an aerosol that is inhaled into the lungs by the user. These devices have the following common names:
What is the main ingredient in e-cigarettes?
Nicotine is the main product in e-cigarettes. Of recent, though, vaping other substances such as tetrahydrocannabinol (THC) has become more common. THC is one of the active ingredients found in cannabis (marijuana).
What are the chemicals in vaping?
The aerosol from vaping comes from heating the liquid containing various chemicals. These substances include nicotine, flavorings, and other additives (e.g., solvents, oils, and propellants). It is these substances that contribute to lung damage from vaping. Some of such dangerous compounds found in the aerosol are:
How many deaths from vaping in 2019?
Evidence of lung damage and recent deaths, however, raises questions on the safety of vaping. As of September 2019, there have been over 500 severe lung illnesses and seven confirmed deaths in the U.S. The recent episodes of lung damage and deaths are still under investigation.
Why are e-cigarettes good?
E-cigarettes were introduced to help people quit smoking cigarettes. It removes the lingering smell and chemical compounds found in cigarettes. Recent reports and studies have, however, shown that vaping has its downsides.
What can vapers do to fight these viral posts?
What can vapers do to fight these viral posts? Not much. Probably the best thing is to avoid giving them further exposure. Don’t respond, and definitely don’t share—not even with an explanation. Use screencaps if you want to reference the post.
How old is a person with pneumothorax?
Primary spontaneous pneumothorax “usually occurs in tall, thin males of 10 to 30 years old,” according to Shi-ping Luh of the Department of Surgery at St. Martin de Porres Hospital in Taiwan. Unless caused by a particular gene mutation, “researchers suggest that rapid growth of the chest during growth spurts may increase the likelihood of forming blebs,” says the NIH.
How many blebs are there in a pneumothorax?
Affected individuals may have one bleb to more than thirty blebs.”.
What is the name of the woman who smoked popcorn?
Last February on Twitter, a young Florida woman named Abbey claimed to have been diagnosed with “bronchiolitis obliterans (popcorn lungs).” It was retweeted 13,000 times and received more than 20,000 likes. There is no telling how many vapers went back to smoking after seeing her baseless claim.
Do people who smoke see the ads?
But that’s how it works. Like the FDA’s Real Cost commercials that are supposedly “micro-targeted” at adolescents who have never smoked, people who smoke see these posts too. And some of them believe what they read. Or, if they don’t exactly believe it, it adds one more lingering bit of doubt. By the way, some smokers are kids too, and they may be even more prone to believe misinformation coming from a peer.
Is smoking a risk factor for older people?
Long-term smoking ( not short-term juuling) is a risk factor among older victims, but that is a completely different kind of event than the more common primary event seen in tall, thin boys and young men. “Secondary spontaneous pneumothorax usually occurs in older people with underlying pulmonary disease, such as emphysema or asthma, acute or chronic infections, lung cancer, and congenital diseases including cystic fibrosis, catamenial pneumothorax, or lymphangioleiomyomatosis,” writes Dr. Luh. In other words, pneumothorax caused by smoking (or, theoretically, by vaping) is the result of many years, or likely decades, of lung damage.
How many people died from vaping?
In just the last few months, there have been roughly 1,300 deaths tied to vaping, with the Centers for Disease Control and Prevention estimating that around half of those cases were people over the age of 50.
What is the purpose of vaping?
Vaping involves an e-cigarette or “pen” heating up liquid that contains nicotine or THC compounds to produce an aerosol gas for inhalation. In the case of nicotine, additives such as propylene glycol or glycerol provide flavor.
Why are older people more likely to have lung problems?
The reason that consequences tend to be more severe in older adults is down to the wear and tear their bodies have experienced over time. Older e-cigarette users, for example, are likely to have started smoking cigarettes years earlier, meaning their lung function is already diminished and their chances of having lung or heart diseases is significantly higher.
Why do people die from e-cigarettes?
The deaths are tied to pulmonary injury, with most of the cases involving the use of e-cigarettes or vape pens as a delivery mechanism for THC, the psychoactive compound in marijuana.
Does vaping cause pneumonia?
Recent research suggests that vaping also increases the risk of contracting pneumonia by causing harmful bacteria to stick to the airways in the lungs, nose and throat. The research examined the effects of vaping on a molecule produced by cells present in our airways called PAFR (platelet-activating factor receptor).
Is vaping good for older adults?
3 minute read. It wasn’t long ago that marketing campaigns were touting vaping as a healthy alternative to smoking for older adults and longtime smokers. But as the recent uproar around young people vaping has highlighted health issues caused by the habit, reports of health complications for older adults have surfaced too.
Does vaping cause heart attacks?
It is said that vaping can increase the risk of heart attack and alter cancer related genes in mouth tissue.
How can vaping lead to a pulmonary embolism?
A pulmonary embolism is an obstruction of one of the pulmonary arteries of your lungs and can be fatal. These blockages are caused by clumps of material, most often blood clots, that travel to the lungs from other parts of the body. The creation of this barrier in the artery stops blood from flowing to that part of the lung, which can lead to a pulmonary infarction or death of the lung tissue.
What happened to Juul?
A 24-year-old Rochester man filed a lawsuit against JUUL in September 2019, after being diagnosed with pulmonary embolism that same March. He stated that JUUL falsely portrayed its product as a safe alternative to cigarettes, which prompted him to start using the device to help him quit chewing tobacco.
What causes a pulmonary infarction?
The creation of this barrier in the artery stops blood from flowing to that part of the lung, which can lead to a pulmonary infarction or death of the lung tissue. There are many factors that can influence blood clotting activity, including smoking and vaping.
Does smoking make blood clots?
Smoking can make your blood cells “sticker” and easier to clump together, as well as harming the lining of blood vessels which can make it easier for clots to form. Older individuals more commonly suffer from pulmonary embolisms, but vaping is changing that.
Is vaping harmful?
The Dangers of Vaping. It is now known that using e-cigarette products like JUUL can be just as detrimental as smoking traditional cigarettes, if not more. If you or a loved one experienced a pulmonary embolism after vaping, contact the accomplished attorneys at Kwartler Manus, LLC to schedule a consultation.
How can vaping lead to a collapsed lung?
A collapsed lung, also known as a pneumothorax, occurs when the lung is unable to inflate due to pressure created by air getting in the space between your lungs and chest. This can happen due to external trauma such as a bullet wound or internal trauma like ruptured air sacs or holes forming in the lung due to COPD.
How to contact a lawyer about a collapsed lung?
If you or someone you love have experienced a collapsed lung or other injury listed, reach out today online or by phone at (267) 214-8608 for a consultation to learn more about your legal rights and options. Categories.
Why did Juul sue?
This can happen due to external trauma such as a bullet wound or internal trauma like ruptured air sacs or holes forming in the lung due to COPD. An 18-year-old college student in Miami filed a lawsuit against JUUL in August 2019 after one of his lungs collapsed the previous month from using the brand’s e-cigarette.
Is vaping safer than smoking cigarettes?
Vaping has become increasingly popular in the last few years, partly because it has been marketed as a safer alternative to smoking cigarettes. However, numerous studies have shown that JUUL and other e-cigarettes can cause many of the same problems associated with traditional cigarettes, including a collapsed lung.
How many people use electronic cigarettes?
Approximately 20.8% of high school students and 4.8% of adults age 18–34 years currently use e-cigarettes (also known as electronic cigarettes) [ 10 ]. Electronic cigarettes (that is, vapes) are portable, battery-powered devices that heat a complex liquid mixture containing nicotine to produce a vapor that users inhale. Many devices rely on replaceable liquid “pods” that may contain propylene glycol, glycerol, benzoic acid, nicotine, and artificial flavors [ 11 ]. A recent study reported high nicotine concentrations of pods ranging from 21.8 mg/mL to 59.2 mg/mL. These pods have considerably higher levels of nicotine per puff than older generation electronic cigarettes [ 12 ]. The long-term adverse health effects due to vaping are not well known, but several case reports have associated vaping with adverse respiratory, cardiovascular, neurological, and gastrointestinal health effects [ 13, 14, 15, 16, 17 ]. Unfortunately, it remains unknown whether vaping is a risk factor for spontaneous pneumothorax. Here, we describe an 18-year-old man with recurrent spontaneous pneumothoraces within 2 weeks that were temporally correlated with vaping.
How long did it take for a Caucasian man to have a recurrent right sided spontaneous pneu?
An 18-year-old Caucasian man presented twice with recurrent right-sided spontaneous pneumothoraces within 2 weeks. He reported a history of vaping just prior to both episodes. Diagnostic testing was notable for a right-sided spontaneous pneumothorax on chest X-ray and computed tomography scan. His symptoms improved following insertion of a chest tube and drainage of air on each occasion. In the 2-week follow-up visit for the recurrent episode, he was asymptomatic and reported that he was no longer using electronic cigarettes.
What are the risk factors for spontaneous pneumothorax?
Risk factors that contribute to the development of spontaneous pneumothorax include tobacco smoking, age (adolescents and young adults), thin stature, and male sex. Furthermore, recurrent spontaneous pneumothoraces occurs in 20–60% of patients [ 5 ]. Age, gender, tobacco smoking habits, pneumothorax size, low body mass index (BMI), and treatment modality have been suggested to contribute to recurrent spontaneous pneumothoraces [ 4, 6 ]. Although cigarette smoking is a well-established risk factor for spontaneous pneumothorax [ 7, 8, 9 ], little is known about the contribution of electronic cigarettes to the development of spontaneous pneumothorax.
Is vaping a risk factor for pneumothorax?
Although tobacco smoking is a well-documented risk factor for spontaneous pneumothorax, an association between electronic cigarette use (that is, vaping) and spontaneous pneumothorax has not been noted. We report a case of spontaneous pneumothoraces correlated with vaping.
Does smoking marijuana cause pneumothorax?
Although our patient reported no history of cigarettes or smokeless tobacco use, he did report a history of occasional marijuana use. Although a correlation has been made between marijuana and spontaneous pneumothorax, its causality remains undetermined as most studies were presented as case reports or small case series [ 35, 36, 37 ]. In a 2017 case-control study, daily cannabis smoking combined with tobacco use increased the risk of spontaneous pneumothorax compared to tobacco smoking alone in males [ 35 ]. It is possible that the combination of marijuana and vaping share similar effects and pathophysiology (that is, carbon monoxide burden and carcinogen additives) contributing to an elevated risk of spontaneous pneumothorax. In addition, marijuana smoking increases squamous metaplasia, airway lesions, goblet and basal cell hyperplasia, and cell disorganization [ 38 ]. Pre-existing changes to the airway due to marijuana use could further contribute to the susceptibility of spontaneous pneumothoraces in chronic electronic cigarette users.
Can electronic cigarettes cause pneumothorax?
We hypothesize that electronic cigarette use could potentially increase the risk of spontaneous pneumothorax through the action of both inhaled toxins and through physiologic mechanisms. In marijuana smokers, the increased risk of spontaneous pneumothorax is thought to be partially attributable to deep inhalation followed by a Valsalva maneuver during exhalation [ 25 ]. Repeated deep inhalation through a highly resistive device, such as a water pipe, creating a Muller maneuver, and generating large negative intrathoracic pressure, has also been proposed as a mechanism of spontaneous pneumothorax in marijuana smokers [ 26 ]. Given the airflow resistance of pod-based electronic cigarettes, such as the ones used by this patient, there is certainly potential for a vaping-related Muller maneuver driving spontaneous pneumothorax in this patient. In fact, airflow rates of vaping apparatuses vary from 20 to 102 mL/s [ 27 ].
Do vape pods contain nicotine?
Furthermore, vape liquid pods may contain numerous other compounds and are known to provide unreliable nicotine delivery that is often inconsistent with the labeling [ 29 ]. These liquid pods also contain propylene glycol, which has been shown to induce airway epithelial injury and deep airway inflammation [ 30 ].
What is the chemical that can damage your lungs?
Acrolein: Most often used as a weed killer, this chemical can also damage lungs.
What is a vape pen?
With vaping, a device (typically a vape pen or a mod — an enhanced vape pen — that may look like a flash drive) heats up a liquid ( called vape juice or e -liquid) until it turns into a vapor that you inhale. “Vaping is a delivery system similar to a nebulizer, which people with asthma or other lung conditions may be familiar with,” says Broderick. ...
What happens if you inhale diacetyl?
Diacetyl is frequently added to flavored e-liquid to enhance the taste. Inhaling diacetyl causes inflammation and may lead to permanent scarring in the smallest branches of the airways — popcorn lung — which makes breathing difficult. Popcorn lung has no lasting treatment. There are, however, treatments that manage BO symptoms, such as: 1 Coughing 2 Wheezing 3 Chest pain 4 Shortness of breath
What to do if your lung hurts?
What to Do If Your Lungs Hurt. If you smoke or vape, don’t brush off chest or lung pain as something that’s normal. If you have pain or other symptoms associated with breathing difficulties, such as shortness of breath and chronic cough, it’s important to see a doctor.
What is the food additive used to deepen e-cigarette flavors?
Diacetyl: This food additive, used to deepen e-cigarette flavors, is known to damage small passageways in the lungs.
Does vaping affect the lungs?
Instead of bathing lung tissue with a therapeutic mist, just as a nebulizer does, vaping coats lungs with potentially harmful chemicals. E-liquid concoctions usually include some mix of flavorings, aromatic additives and nicotine or THC (the chemical in marijuana that causes psychological effects), dissolved in an oily liquid base.
Is second hand vapor safe?
Secondhand Vapor Isn’t Safe Either. It’s a myth that secondhand emissions from e-cigarettes are harmless. Many people think the secondhand vapor is just water, but this couldn’t be farther from the truth. The vapor emitted when someone exhales contains a variety of dangerous substances, which may include: Nicotine.
