Vaping in childhood carries graver risks than previously understood, according to a major review spotlighted by Nature this week with poorer mental health and a gateway into conventional smoking among the headline findings.
The review, published in the Archives of Disease in Childhood by researchers at the Royal College of Paediatrics and Child Health (RCPCH), screened more than 14,000 published articles and synthesised evidence from 81 studies across eight health and social domains.
The mental-health finding
The physician-scientists behind the review say they were surprised by the extent of the mental-health signal. Depression, panic disorder, anhedonia and suicidal ideation were all more commonly reported in young people who vape with young e-cigarette users almost twice as likely as non-users to report suicidal thoughts, plans or attempts.
Early nicotine exposure may disrupt neurological development pathways during formative years, increasing vulnerability to conditions affecting psychological health, the authors suggest.
The gateway finding
“The most alarming finding,” in the authors’ words: vaping increases the likelihood that children will eventually take up conventional smoking. Long-term studies showed strong evidence that young people who vape are significantly more likely to go on to smoke cigarettes positioning e-cigarettes as a stepping stone that normalises nicotine consumption rather than a harmless alternative.
What else the review found
- Respiratory: consistent links with cough, wheeze, bronchitis symptoms and asthma exacerbations.
- Oral and dental: gingival inflammation, ulcers, dry mouth.
- Eyes, skin, sleep: itching, redness, allergic conditions and emerging sleep impacts.
- Pregnancy: higher rates of preterm birth and small-for-gestational-age birth weight in infants born to mothers who vaped.
An important nuance
A separate September 2026 systematic review of 25 studies found a two-way association between vaping and adolescent mental-health symptoms and stressed that “causation cannot be determined.” Mental-health struggles may drive some young people to vape as a coping mechanism, while vaping may worsen symptoms over time. The relationship likely runs in both directions.
Why it matters now
The findings land as governments weigh tighter youth protections including the UK’s flavour-name and display proposals closing for consultation today. For adults, the evidence base still supports vaping as less harmful than smoking (see how vaping compares to cigarettes); for children and non-smokers, the message from the science is unambiguous: don’t start.
Source: Nature