This first-of-its-kind study finds that vapers score worse on cognitive tests than cigarette smokers and non-vapers.
Although cigarette smoking has declined for decades in the U.S., electronic cigarettes, also called vapes, have gained popularity in recent years. Now, almost one in 20 Americans vape. Though tobacco companies marketed vapes as a tool to quit smoking, there is no evidence they help. In fact, some vaping cartridges even contain higher levels of nicotine than cigarettes and may be contaminated with toxic metals.
Since these products are relatively new, scientists are still figuring out how they affect the brain. Researchers at the 2024 annual meeting of the American Neurological Association presented a study linking vaping to cognitive impairment in college students, a first-of-its-kind finding.
The researchers recruited 405 Hispanic college students in Ecuador and collected information about their smoking and vaping habits. All the participants received a Montreal Cognitive Assessment (MoCA), which measures cognitive function. A score of 26 or above indicates normal cognitive function, while a score between 18 and 25 indicates mild cognitive impairment.
Students who didn’t smoke or vape had an average score of 26, cigarette smokers scored 25, those who vaped scored 24, and those who smoked and vaped scored 24. Students who vaped more scored worse on the MoCA.
“The repeated consumption of e-cigarettes by young people whose brains are still developing is a major concern,” lead author Linker Viñan Paucar, a medical student at the Catholic University of Santiago de Guayaquil, Ecuador, told Being Patient.
Vape ingredients and the brain
Although researchers haven’t previously studied the effects of vaping on cognitive function, there is plenty of data on nicotine and flavorants, the chemicals that add flavor to the vapes.
“Nicotine affects the brain reward processing networks and cognitive control center,” Wilfredo López-Ojeda, a neuroscientist at the U.S. Department of Veteran Affairs and associate professor at Wake Forest, told Being Patient. In both animal and human studies, nicotine causes impairments in cognition, memory, attention, impulse control, and higher-order cognitive tasks. These effects are most pronounced in youth and young adults whose brains are still developing.
Some of the flavorants, López-Ojeda explained, affect how the body processes nicotine, allowing higher levels to get to the brain. Though the Food and Drug Administration has approved flavorants for use in foods, they have not been tested for safety in vapes — and when they’re heated up and vaporized, they may turn into toxic or carcinogenic chemicals.
The convenience of vapes also makes it easier to get a high dose of nicotine and other flavorants. “Some of these pods allow consumers to inhale anything between 600 to 6,000 puffs, which is the equivalent of two packs to two cartons of conventional cigarettes,” said López-Ojeda.
There is also evidence that nicotine affects cognition later in life: A 2024 study published in Nature Communications found that smoking was associated with faster cognitive decline in middle-aged individuals. The authors of the study suggested nicotine might be to blame for damaging the cardiovascular system, leading to the narrowing of blood vessels and higher blood pressure and starving brain cells of oxygen and nutrients.
If you’re concerned about brain health, the best option is to avoid or quit cigarettes and vapes altogether.
