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CSE, which simplifies the exposure process by focusing on hydrophilic constituents, does not fully represent the complex mixture of chemicals and particulate matter found in whole cigarette smoke 17,18

Research from Nevadas Desert Research Institute (2016-2018) found that e-cig vapors contain significant amounts of cancer-causing chemicals and harmful aldehydes, posing health risks through both secondhand and thirdhand exposure

DA vapor exposure increased CD14 and IL1B gene expression, HA production and promoted mobilization of NHBECs Three of the most significantly upregulated GO pathways in response to DA exposure included Lipopolysaccharide (LPS) mediated signaling, Positive regulation of epithelial cell migration and Cellular response to mechanical stimulus

Sources: Data used to create this ranking were collected as of February 3, 2026 from the U.S