# Molecular Health Effects of Electronic Cigarettes

**Authors:** Paweł Sutkowy, Igor Hadryś, Wiktor Gmys, Przemysław Grzempa, Aleksandra Sobieszczańska, Weronika Tuska, Karolina Błachnio, Alina Woźniak

PMC · DOI: 10.3390/biom16020264 · Biomolecules · 2026-02-07

## TL;DR

This paper reviews how e-cigarettes cause harmful health effects at the molecular level, despite being seen as a safer alternative to traditional cigarettes.

## Contribution

The paper provides a critical analysis of molecular mechanisms by which e-cigarette aerosols induce oxidative stress and inflammation.

## Key findings

- E-cigarette aerosols contain harmful compounds like aldehydes and heavy metals that cause oxidative stress.
- Exposure leads to mitochondrial dysfunction, DNA damage, and activation of redox-sensitive pathways like NF-κB and NRF2.
- These molecular changes may result in chronic inflammation and altered gene expression with prolonged use.

## Abstract

Electronic cigarettes (e-cigarettes) have emerged as a prevalent substitute for conventional cigarettes, garnering perceptions of being a safer option for health. Nicotine addicts use e-cigarettes to cease smoking. These products have also become common among young people because of their taste, smell, and attractive appearance. However, accumulating experimental and clinical evidence indicates that e-cigarette use is not risk-free. The inhalation of e-cigarette aerosols exposes users and their non-using peers to a complex mixture of chemical compounds, including aldehydes, heavy metals, and flavoring agents, many of which possess pro-oxidative and pro-inflammatory properties. This review summarizes and critically analyzes current evidence on the molecular and cellular mechanisms underlying the biological effects of e-cigarette aerosols. Particular attention is given to excessive production of reactive oxygen species, mitochondrial dysfunction, DNA damage, and the activation of redox-sensitive signaling pathways, including NF-κB and NRF2. These molecular alterations may trigger acute and, with prolonged exposure, chronic oxidative stress and inflammation, which in turn can affect gene expression, protein function, and metabolic pathways. While molecular and experimental studies often demonstrate adverse biological responses to e-cigarette aerosols, the translation of these findings into long-term clinical outcomes remains an area of ongoing investigation.

## Linked entities

- **Proteins:** NFKB1 (nuclear factor kappa B subunit 1), GABPA (GA binding protein transcription factor subunit alpha)
- **Chemicals:** aldehydes (PubChem CID 6449839)

## Full-text entities

- **Genes:** REL (REL proto-oncogene, NF-kB subunit) [NCBI Gene 5966] {aka C-Rel, HIVEN86A, IMD92}, TP53 (tumor protein p53) [NCBI Gene 7157] {aka BCC7, BMFS5, LFS1, P53, TRP53}, CASP3 (caspase 3) [NCBI Gene 836] {aka CPP32, CPP32B, SCA-1}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, OGG1 (8-oxoguanine DNA glycosylase) [NCBI Gene 4968] {aka HMMH, HOGG1, MUTM, OGH1}, CXCL8 (C-X-C motif chemokine ligand 8) [NCBI Gene 3576] {aka GCP-1, GCP1, IL8, LECT, LUCT, LYNAP}, ERCC1 (ERCC excision repair 1, endonuclease non-catalytic subunit) [NCBI Gene 2067] {aka COFS4, RAD10, UV20}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, BAX (BCL2 associated X, apoptosis regulator) [NCBI Gene 581] {aka BCL2L4}, RAC1 (Rac family small GTPase 1) [NCBI Gene 5879] {aka MIG5, MRD48, Rac-1, TC-25, p21-Rac1}, PPP1R12A (protein phosphatase 1 regulatory subunit 12A) [NCBI Gene 4659] {aka GUBS, M130, MBS, MYPT1}, MYC (MYC proto-oncogene, bHLH transcription factor) [NCBI Gene 4609] {aka MRTL, MYCC, bHLHe39, c-Myc}, Ocln (occludin) [NCBI Gene 18260] {aka Ocl}, Cybb (cytochrome b-245, beta polypeptide) [NCBI Gene 13058] {aka CGD91-phox, Cgd, Cyd, Nox2, gp91-1, gp91phox}, IL10 (interleukin 10) [NCBI Gene 3586] {aka CSIF, GVHDS, IL-10, IL10A, TGIF}, MMP8 (matrix metallopeptidase 8) [NCBI Gene 4317] {aka CLG1, HNC, MMP-8, PMNL-CL}, Foxo3 (forkhead box O3) [NCBI Gene 56484] {aka 1110048B16Rik, 2010203A17Rik, FKHRL1, Fkhr2, Foxo3a}, RELB (RELB proto-oncogene, NF-kB subunit) [NCBI Gene 5971] {aka I-REL, IMD53, IREL, REL-B}, NFKBIA (NFKB inhibitor alpha) [NCBI Gene 4792] {aka EDAID2, IKBA, MAD-3, NFKBI}, HMOX1 (heme oxygenase 1) [NCBI Gene 3162] {aka HMOX1D, HO-1, HSP32, bK286B10}, RELA (RELA proto-oncogene, NF-kB subunit) [NCBI Gene 5970] {aka AIF3BL3, CMCU, NFKB3, p65}, CAT (catalase) [NCBI Gene 847], MLC1 (modulator of VRAC current 1) [NCBI Gene 23209] {aka LVM, MLC, VL}, NFE2L2 (NFE2 like bZIP transcription factor 2) [NCBI Gene 4780] {aka IMDDHH, NRF2, Nrf-2}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, MAPK1 (mitogen-activated protein kinase 1) [NCBI Gene 5594] {aka ERK, ERK-2, ERK2, ERT1, MAPK2, NS13}, NFKB2 (nuclear factor kappa B subunit 2) [NCBI Gene 4791] {aka CVID10, H2TF1, LYT-10, LYT10, NF-kB2, p100}, BCL2 (BCL2 apoptosis regulator) [NCBI Gene 596] {aka Bcl-2, PPP1R50}
- **Diseases:** oral squamous cell carcinoma (MESH:D000077195), squamous cell carcinoma (MESH:D002294), respiratory disorders (MESH:D012131), acute lung inflammation (MESH:D011014), COPD (MESH:D029424), Cancer (MESH:D009369), adenocarcinoma (MESH:D000230), Lung damage (MESH:D008171), endothelial dysfunction (MESH:D014652), diabetes (MESH:D003920), lung and nasopharyngeal cancer (MESH:D008175), allergic symptoms (MESH:D063926), neuroinflammation (MESH:D000090862), asthma (MESH:D001249), behavioral deficits (MESH:D019958), Inflammation (MESH:D007249), Nicotine addicts (MESH:D014029), injury to (MESH:D014947), mitochondrial dysfunction (MESH:D028361), dyslipidemia (MESH:D050171), respiratory diseases (MESH:D012140), atopic dermatitis (MESH:D003876), bronchiolitis (MESH:D001988), necrosis (MESH:D009336), cognitive impairment (MESH:D003072), allergy (MESH:D004342), interstitial pneumonia (MESH:D017563), COVID-19 (MESH:D000086382), allergic rhinitis (MESH:D065631), bronchitis (MESH:D001991), infection (MESH:D007239), insulin resistance (MESH:D007333), cytotoxicity (MESH:D064420), vascular dysfunction (MESH:D002561), carcinogenic (MESH:D011230)
- **Chemicals:** chrysene (MESH:C031180), 4-hydroxynonenal (MESH:C027576), Sn (MESH:D014001), Cu (MESH:D003300), 3-hexen-1-ol (MESH:C051918), naphthalene (MESH:C031721), PAHs (MESH:D011084), Aldehyde (MESH:D000447), ceramides (MESH:D002518), hydroxyl radical (MESH:D017665), NO (MESH:D009569), VOC (MESH:D055549), polycyclic hydrocarbons (MESH:D006844), e (MESH:D004540), Sb (MESH:D000965), Fe (MESH:D007501), benzyl alcohol (MESH:D019905), cinnamaldehyde (MESH:C012843), vanillin (MESH:C100058), methyl-cyclopentenolone (MESH:C471838), benzaldehyde (MESH:C032175), Ni (MESH:D009532), menthol (MESH:D008610), benz[a]anthracene (MESH:C030935), eucalyptol (MESH:D000077591), benzo[a]pyrene (MESH:D001564), benzo[b]fluoranthene (MESH:C006703), isoamyl acetate (MESH:C020377), Metals (MESH:D008670), acetoin (MESH:D000093), Zn (MESH:D015032), phosphate (MESH:D010710), bepridil (MESH:D015764), Arsenic (MESH:D001151), macitentan (MESH:C533860), acetaldehyde (MESH:D000079), Mo (MESH:D008982), Cd (MESH:D002104), alcohol (MESH:D000438), Pb (MESH:D007854), benzopyrene (MESH:D001580), ROS (MESH:D017382), Heavy metal (MESH:D019216), diacetyl (MESH:D003931), Ba (MESH:D001464), eugenol (MESH:D005054), Formaldehyde (MESH:D005557), Mn (MESH:D008345), glucose (MESH:D005947), acetol (MESH:C004433), Co (MESH:D003035), glyoxal (MESH:D006037), dibenz[a,h]anthracene (MESH:C026486), GSH (MESH:D005978), methylglyoxal (MESH:D011765), alpha-tocopherol (MESH:D024502), OH (MESH:C031356), Cr (MESH:D002857), thiol (MESH:D013438), malondialdehyde (MESH:D008315)
- **Species:** Cinnamomum verum (Ceylon cinnamon, species) [taxon 128608], Nicotiana tabacum (American tobacco, species) [taxon 4097], Severe acute respiratory syndrome coronavirus 2 (no rank) [taxon 2697049], Mus musculus (house mouse, species) [taxon 10090], Staphylococcus aureus (species) [taxon 1280], Rattus norvegicus (brown rat, species) [taxon 10116], Homo sapiens (human, species) [taxon 9606]
- **Cell lines:** BEAS-2B — Homo sapiens (Human), Transformed cell line (CVCL_0168), RAW 264.7 — Mus musculus (Mouse), Mouse leukemia, Cancer cell line (CVCL_0493), HEK293T — Homo sapiens (Human), Transformed cell line (CVCL_0063), HFL-1 — Homo sapiens (Human), Finite cell line (CVCL_0298), A549 — Homo sapiens (Human), Lung adenocarcinoma, Cancer cell line (CVCL_0023), UM-SCC-1 — Homo sapiens (Human), Floor of mouth squamous cell carcinoma, Cancer cell line (CVCL_7707), U937 — Homo sapiens (Human), Adult acute monocytic leukemia, Cancer cell line (CVCL_0007), MM6 — Homo sapiens (Human), Adult acute monocytic leukemia, Cancer cell line (CVCL_1426), H292 — Homo sapiens (Human), Lung mucoepidermoid carcinoma, Cancer cell line (CVCL_0455), EA.hy 926 — Homo sapiens (Human), Hybrid cell line (CVCL_3901), POE9n — Homo sapiens (Human), Oral epithelial dysplasia, Finite cell line (CVCL_L237), C57BL/6 — Mus musculus (Mouse), Transformed cell line (CVCL_C0MU), THP-1 — Homo sapiens (Human), Childhood acute monocytic leukemia, Cancer cell line (CVCL_0006)

## Full text

_Full body text omitted from this summary view._ Fetch the complete paper as Markdown: https://tomesphere.com/paper/PMC12938798/full.md

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12938798/full.md

## References

121 references — full list in the complete paper: https://tomesphere.com/paper/PMC12938798/full.md

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Source: https://tomesphere.com/paper/PMC12938798