A report highlights the growing and sustained use of vaping in France and warns of the risks

In a study based on an examination of nearly 3,000 scientific publications, international reports, and industry statements, experts from the French Agency for Food, Environmental and Occupational Health & Safety (ANSES) identified probable and possible health risks associated with vaping in the medium and long term.[1]. These include cardiovascular, respiratory, and carcinogenic effects, even in the absence of nicotine. Experts therefore recommend stricter regulation of vaping ingredients and components, stronger measures to prevent initiation among young people and non-smokers, and limiting vaping to smoking cessation purposes only, provided it is temporary, supervised by a healthcare professional, and accompanied by complete smoking cessation.

Vaping is becoming increasingly widespread and sustainable, including among non-smokers.

Initially presented as an alternative to tobacco, vaping has gradually become established in consumption practices in France. According to According to the Public Health France 2024 Barometer, 7.9% of adults aged 18-79 reported vaping, and 6.1% used it daily., that is more than 3 million people.

The use tends to be long-term and remains mainly linked to tobacco: more than half (59 %) of adult vapers have been using electronic cigarettes for two years or more, nearly two-thirds (65 %) of adult vapers continue to consume tobacco, and almost all (98 %) are smokers or former smokers.

However, the consumer profile differs among young people. For example, a third of vapers aged 13 to 17 have never smoked and started directly with electronic cigarettes.

The vaping market has diversified considerably, with a proliferation of devices, flavors, and practices such as "« do it yourself » (practiced by half of adult vapers), which allows users to make their own e-liquids by adjusting the ingredients and concentrations.

The main motivations cited by vapers are smoking cessation, lower cost compared to cigarettes, sensory pleasure, and, for pregnant women, a reduction in risks to the unborn baby compared to those associated with traditional tobacco use. Young people, for their part, are susceptible to marketing campaigns targeting them and are particularly drawn to the wide variety of flavors.

Possible health risks, including those without nicotine

The report's authors reiterate that, regarding the risks associated with tobacco, the health consequences, resulting from decades of research, are well-established. While there is less historical data on the risks associated with vaping, probable risks (high level of evidence, but not sufficient to be proven) and possible risks (limited level of evidence, but not proven) have already been identified.

From a cardiovascular standpoint, an increase in blood pressure and heart rate is cited as a likely effect when the products contain nicotine. From a respiratory standpoint, the potential development of effects such as COPD, a chronic respiratory disease, is particularly highlighted. Regarding carcinogenesis, the use of electronic cigarettes may also have a possible impact.

The same applies to the cardiovascular and respiratory development of the fetus in the event of in utero exposure, even when the products do not contain nicotine.

The specific assessment of the effects of vaping is made complex by the mixed usage patterns of consumers, the diversity and rapid evolution of products.

It should be noted that the authors did not include the effects of exposure to secondhand vaping in the scope of their study. ANSES recommends that future research be dedicated to this topic.

ANSES recommends better regulation of the ingredients and components of electronic cigarettes.

Although vaping relies on heating without combustion, it generates complex aerosols during the process, exposing users to toxic substances present in e-liquids. A total of 1,775 substances have been identified in these aerosols, and among them, 106 are of particular concern.

Anses has notably assessed the risks associated with several aldehydes (formaldehyde, acrolein, acetaldehyde, glyoxal, among others), known for their toxic and carcinogenic effects and systematically detected in the emissions of vaping products.

The Agency emphasizes that the absence of combustion does not eliminate these exposures and recommends strengthening consumer information on the risks associated with vaping practices. It calls for increased responsibility from manufacturers regarding the safety of devices and e-liquids. Finally, it recommends stricter regulation of ingredients, potentially including restrictions or bans.

Jérémie Pourchez, a toxicologist, advises using as few ingredients as possible, favoring "flavorless" products, and above all, avoiding mixing ingredients yourself to prevent interactions between products.[2].

According to Philippe Camus, professor of pulmonology at the University Hospital of Dijon, the health risks of electronic cigarettes cannot be reduced to simple individual misuse of ingredients not intended for e-liquids. He points out that« The link between electronic cigarettes and acute respiratory distress syndrome is strong. »", and that the argument of individual responsibility of the vaper, often put forward by manufacturers, does not explain this reality.

Preventing initiation of smoking among non-smokers and young people, and regulating its use for smokers.

In view of the identified risks, Anses recommends combating practices that encourage consumption and the trivialization of these products.

Among adolescents, consumption is largely influenced by the marketing practices of manufacturers targeting this population, particularly through appealing flavors and products. Furthermore, nicotine raises specific concerns regarding addiction and its effects on their development. Therefore, the Agency reiterates the importance of the effective enforcement of existing prohibitions concerning sales to minors, advertising, and promotion.

For Isabella Annesi-Maesano, research director at the National Institute of Health and Medical Research and professor of environmental epidemiology, there are enough warning signs, particularly concerning the risks of COPD or pulmonary fibrosis, to implement the precautionary principle.[3]. In an opinion piece in Le Monde, she argued for the inclusion of e-cigarettes in the extension of smoking bans to be implemented in the summer of 2025, given that more than 70% of 13-17 year old vapers have a smoker or vaper in their circle, according to an Anses survey included in the report.

For smokers, electronic cigarettes can be considered as a smoking cessation tool for certain categories of smokers. This use of electronic cigarettes should be considered as a second-line treatment option and should therefore be viewed as a "« transitional option »", to be associated with the support of a healthcare professional, and with a complete cessation of smoking.

Anses also points out that the effectiveness of electronic cigarettes in quitting smoking is not as well supported as that of scientifically approved cessation tools, such as Champix, a drug recognized as very effective in supporting smoking cessation, or nicotine replacement treatments (gums, patches, oral sprays, etc.).

Anses thus emphasizes the central role of doctors, tobacco specialists, nurses and pharmacists, and recommends strengthening their information and training on vaping products.

©Generation Without Tobacco

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[1]Health risk assessment related to vaping products. Collective expert report, ANSES, published in December 2025, accessed on February 4, 2026

[2]Apolline Le Romanser, Health risks, effectiveness in quitting smoking, danger for young people… The truth about vaping in 12 questions, Libération, published on February 4, 2026, accessed the same day

[3]Delphine Roucaute, Electronic cigarettes: lessons learned from the large-scale ANSES study on health risks, Le Monde, published on February 4, 2026, accessed the same day

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