Vaping Frequency in Teen Years Connected to Risk of Exposure to Toxic Lead, Uranium


These data suggest vaping poses potential threats to the development of the brain and organs, with teenagers being a predominant target due to surges in use.

E-cigarette smoking (vaping) in the early period of life could increase metal exposure risk, according to new findings, leading to potential brain and organ development harm.1

These conclusions were the results of new research led by Andrew Kochvar of the University of Nebraska Medical Center. Kochvar et al. noted that while there had been previously-identified positive associations between cigarettes and uranium levels, there had not been an objective assessment of exposure to metals among adolescents.2

“This study analysed a national probability sample of adolescents aged 13–17 years to assess metal exposure among adolescent e-cigarette users with two primary research questions: (1) Are metal concentration levels positively associated with the frequency of e-cigarette use? (2) Does the metal exposure vary by e-cigarette flavour type used?” Kochvar and colleagues wrote.

Background and Methods

The investigators collected their data during Wave 5 of the Population Assessment of Tobacco and Health (PATH) Study Youth Panel, taking place from December 2018 - November 2019 and using a nationally representative sample of subjects in the US who had not been institutionalized. Interviews were conducted and urine samples were collected for laboratory analyses, with the team looking at adolescent subjects from the Wave 4 youth interviews.1

The research team gathered a probability sample from 6 distinct groups based upon tobacco product utilization, including those labeled as never-users, current users, and subjects who had recently ceased to utilize tobacco products. Their study involved the use of a 4-stage stratified probability sampling design, with urine being evaluated for metals through the use of mass spectrometry.

The investigators linked survey data and subjects’ urine biomarker data through the implementation of de-identified personal IDs. Their biomarker sample was made up of 1607 individuals who were given assessments of urine biospecimens and survey interviews.

Following their exclusion of certain subjects due to various criteria such as nicotine replacement therapy utilization or high levels of creatinine, the team’s dataset would involve a total of 1545 participants. In order to account for possible confounders, the research team made further exclusions, leading to a final sample of 200 users of nicotine e-cigarette.

The investigators examined the urinary biomarkers for lead, cadmium, and uranium exposure. This was based on frequency of vaping and flavor type within the prior 30 days.


Among the participants, the investigators noted that the median age was 15.9 years and that 62.9% were female. They reported that 65 of the 200 e-cigarette users reported occasional utilization, 45 were shown to have intermittently done so, and 81 were shown to have frequent use.

In terms of the subjects’ preferences, the research team found that 33.0% of users preferred menthol/mint e-cigarette flavors, 49.8% fruit-based flavors, and 15.3% sweet flavors. The team added that the sweet flavor users were found to have higher uranium levels compared to those preferring menthol/mint (.009 compared to .005 ng/mg creatinine, P = .02).

In their evaluation of urine samples, the investigators reported that intermittent users (.21 ng/mg creatinine) as well as frequent users (.20 ng/mg creatinine) were noted as having higher levels of lead detected compared to those who vaped occasionally (.16 ng/mg creatinine). They also found that frequent vapers had elevated uranium levels found in their urine as opposed to occasional users (.009 compared to .005 ng/mg creatinine, P = .0004).

“E-cigarette use during adolescence may increase the likelihood of metal exposure, which could adversely affect brain and organ development,” they wrote. “These findings call for further research, vaping regulation, and targeted public health interventions to mitigate the potential harms of e-cigarette use, particularly among adolescents.”


  1. Kochvar A, Hao G, Dai HDBiomarkers of metal exposure in adolescent e-cigarette users: correlations with vaping frequency and flavouringTobacco Control Published Online First: 29 April 2024. doi: 10.1136/tc-2023-058554.
  2. Badea M , Luzardo OP , González-Antuña A , et al . Body burden of toxic metals and rare earth elements in non-smokers, cigarette smokers and electronic cigarette users. Environ Res 2018;166:269–75. doi:10.1016/j.envres.2018.06.007.
  3. Frequent teen vaping might boost risk of toxic lead and uranium exposure. BMJ. April 29, 2024. May 1, 2024.
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