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Mystery ingredients in e-cig liquids can pose major health risks

GEHA | March 4, 2021

People who vape might not know what they are inhaling.

When they were first introduced, electronic-cigarettes, or e-cigarettes, were marketed as a way to stop smoking. Thanks to research conducted in the years since then, we now know this is not only false, but that e-cigarettes may be more dangerous than we realized.

An e-cigarette generally has four parts. The cartridge (also called a reservoir or pod) holds the flavored liquid. When the smoker activates the e-cigarette, a small battery supplies energy to an atomizer, which heats the liquid. The smoker inhales the vaporized liquid through the mouthpiece.

One of the biggest concerns about smoking e-cigarettes, or vaping, is that the smoker is never really sure what is in that liquid. A 2019 study found that there are more nearly 8,000 different flavors of e-juice. What’s in the e-juice can depend on the flavor or manufacturer. Research has shown that e-juice typically contains a varying amount of several ingredients:

  • Nicotine, a highly addictive chemical that is toxic to fetuses and harms brain development.
  • Ultrafine particles and cancer-causing chemicals that can be inhaled deep into the lungs.
  • Flavorings, including diacetyl, a chemical linked to lung disease.
  • Heavy metals, including lead, tin and nickel.

In addition, heating the e-juice may generate more toxic compounds, such as formaldehyde. And while many of the flavorings in e-juice are the same as what may be found in some foods, inhaling them is different from digesting them. For example, cinnamon may be consumed without problems, but when it goes directly to the lungs and blood stream, cinnamon can cause serious harm.

Although e-cigarette vapors contain fewer toxic chemicals than traditional cigarettes, they are still far from safe. The best way to stop smoking is never to start. If you do use tobacco products, the U.S. Surgeon General recommends you stop.

GEHA can help

GEHA wants to be part of your tobacco cessation team. GEHA’s medical plans offer 100% coverage to help you quit smoking. No copays, coinsurance, deductibles, dollar limits or in-network or out-of-network differentiation. GEHA’s smoking cessation benefits include:

  • Up to four sessions of counseling for each attempt to quit, with two attempts to quit covered each year.
  • Both over-the-counter* (with a physician's prescription) and prescription drugs approved for smoking cessation.


*Nicotine gum is covered, but you must get a prescription from your doctor or receive the drugs as part of a plan-approved tobacco cessation program for it to be covered with no copays and coinsurance.

For more information, call GEHA Customer Care at 800.821.6136 or consult your GEHA Plan Brochure. For more information on the FEHB tobacco cessation benefit, visit OPM's Quit Smoking webpage.

“Vaping devices (electronic cigarettes) drug facts.”, National Institute on Drug Abuse, January, 2020.
“Evaluation of e-liquid toxicity using an open-source high-throughput screening assay.”, National Center for Biotechnology Information, 16 March, 2018.
“About electronic cigarettes (e-cigarettes).”, Centers for Disease Control and Prevention, 16 November, 2020.
“Three surprising risks from vaping.”, National Institute on Drug Abuse, 27 January, 2020.