Nicotine Vaping Linked to Reduced Fitness and Vascular Function in Young Adults

Young adults who used nicotine vapes daily and had never smoked combustible tobacco had lower vascular function and cardiorespiratory fitness than tobacco- and nicotine vape–naive peers, according to a cross-sectional study published in JAMA Cardiology.

The investigators noted that rising nicotine vape use among young adults who have never smoked raises concerns about early cardiovascular and respiratory effects in an otherwise low-risk population. The study assessed whether regular daily vaping was associated with altered vascular function and cardiorespiratory fitness in young adults without known cardiovascular disease or major risk factors.

The single-center, laboratory-based study, conducted between July 2023 and April 2025, included 58 young adults (mean age, 26 years; 52% female). Based on self-report and verification of smoking status, 17 participants exclusively used nicotine vapes, 19 used combustible cigarettes, and 22 were tobacco and nicotine vape naive. Primary outcomes were vascular function, assessed by flow-mediated dilation (FMD) and carotid artery reactivity (CAR), and cardiorespiratory fitness during maximal cardiopulmonary exercise testing. FMD and CAR were lower in both nicotine use groups than in the naive group. Mean FMD was 5.5% in the vaping group, 4.4% in the cigarette group, and 8.3% in the naive group; mean CAR was 0.6%, −1.4%, and 4.7%, respectively.

Peak oxygen uptake was lower in the vaping group than in the naive group but did not differ significantly between the cigarette and naive groups. Minute ventilation and cardiac output were lower in both nicotine use groups. Lung function and physical activity levels did not differ significantly across groups.

The authors concluded that regular daily nicotine vape use in young adults who have never smoked combustible tobacco was associated with lower vascular function and cardiorespiratory fitness. The study was cross-sectional and included 58 participants at a single center, and the investigators said longitudinal studies are needed to determine long-term clinical implications.

Source: Boidin M, Degens H, Junejo RT, et al. Vascular function and cardiorespiratory fitness in adults who use nicotine vapes. JAMA Cardiol. Published online October 21, 2026. doi:10.1001/jamacardio.2026.4626