Daily nicotine vaping is associated with weaker blood vessel function and lower cardiorespiratory fitness in young adults who never smoked cigarettes, according to a new peer-reviewed study published in JAMA Cardiology on 21 October 2026.
The research, led by Maxime Boidin at Manchester Metropolitan University, examined 58 young adults (mean age 26, 52% female) recruited from Manchester universities between July 2023 and April 2025. The group included 17 exclusive daily nicotine vapers, 19 combustible cigarette smokers, and 22 people who were naive to both tobacco and vapes. Smoking and vaping status was biochemically verified.
What the researchers measured
The team assessed vascular health through two standard laboratory measures: flow-mediated dilation (FMD), which tests how well arteries widen when blood flow increases, and carotid artery reactivity (CAR), which measures how neck arteries respond to cold stimulation. They also measured peak oxygen uptake, a key marker of cardiorespiratory fitness.
The results were striking. Exclusive daily vapers showed markedly lower arterial function than the naive group, with mean FMD of 5.5% versus 8.3%, and mean CAR of just 0.6% versus 4.7%. Smokers showed similar impairments to vapers. Peak oxygen uptake was also lower in vapers than in the naive group.
| Measure | Vapers (n=17) | Smokers (n=19) | Naive group (n=22) |
|---|---|---|---|
| Flow-mediated dilation (FMD) | 5.5% | Impaired, similar to vapers | 8.3% |
| Carotid artery reactivity (CAR) | 0.6% | Impaired, similar to vapers | 4.7% |
| Peak oxygen uptake | Lower than naive group | Lower than naive group | Highest of the three groups |
Why this study matters now
The authors note that long-term vaping in England climbed from 1.3% in 2013 to 10.0% in 2023, with the rise most pronounced among younger adults. Because many of these younger users never smoked, questions about the cardiovascular effects of nicotine vaping in otherwise healthy lungs and hearts have become urgent. Previous research largely studied vapers who were former smokers, making it harder to separate vaping effects from a history of smoking. This study focused on young adults with no smoking history, which is a meaningful step.
What the study does not prove
Crucially, this was a cross-sectional study, so it shows an association, not causality. The authors explicitly say longitudinal studies are needed to determine the long-term clinical implications of these findings. The paper also acknowledges that nicotine vapes are used as smoking cessation tools in specific populations, and the authors position their findings within that wider harm-reduction context, where vaping is generally understood as less harmful compared with smoking.
This is general information, not medical advice. If you are considering switching products or quitting nicotine, speak to a qualified health professional.
Source: JAMA Cardiology.