# Long-term effects of electronic cigarettes on brain health

> **NIH DA R01** · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2026 · $705,276

## Abstract

ABSTRACT
Electronic cigarettes (e-cigs) are being touted as safer alternatives to traditional cigarettes, which have well-
known harmful effects on the brain due to combustion-related inflammation and oxidative stress. Some
smokers report using e-cigs to help quit smoking and switch to exclusive e-cig use. However, nicotine itself, as
well as the other components of e-cig vapor, produce inflammation and oxidative stress, albeit to a lesser
extent than traditional cigarettes. The effects of long-term e-cig use on the brain are poorly understood.
Smoking cessation is associated with improvements in brain structure and function that correlate with quit
duration, suggesting a recovery from the harmful effects of smoking. But whether switching from cigarettes to
e-cigs results in comparable brain health is unknown. Most research on the health effects of e-cigs has been
on short-term effects and/or use in adolescents and young adults compared to healthy non-users. Adult
smokers are now the target of e-cig marketing and are being encouraged to make the switch to e-cigs.
Research on the long-term, relative safety of e-cigs in this population is desperately needed. Existing research
indicates smoking negatively affects brain measures, including gray matter volume (GMV), white matter
integrity (WMI), cerebral blood flow (CBF), and cognitive performance (CP). Evidence from ex-smokers
indicates that quitting smoking leads to positive changes in brain measures. Smoking and e-cigs also
negatively affect physiological measures, such as autonomic function and inflammation, which in turn affect the
brain. The key problem is to what extent abstinence from cigarette smoke, compared to abstinence from
chronic nicotine, affects brain and physiological health. An important biomarker of the heaviness and duration
of cigarette smoke exposure is DNA methylation of the AHRR CpG site, which we have shown correlates with
GMV, WMI, and CP among smokers and ex-smokers. We will investigate the re

## Key facts

- **NIH application ID:** 11360203
- **Project number:** 5R01DA061863-02
- **Recipient organization:** WAKE FOREST UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Merideth A. Addicott
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** DA
- **Fiscal year:** 2026
- **Award amount:** $705,276
- **Award type:** 5
- **Project period:** 2025-07-01T00:00:00 → 2030-03-31T00:00:00

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11360203

## Citation

> US National Institutes of Health, RePORTER application 11360203, Long-term effects of electronic cigarettes on brain health (5R01DA061863-02). Retrieved via AI Analytics 2026-07-04 from https://api.ai-analytics.org/grant/nih/11360203. Licensed CC0.

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