Impacts of vaping on children and young people: a systematic review.

OBJECTIVE: This systematic review aims to identify the health and social impacts of vaping in children and young people (CYP). METHODS: A continuous review of published literature was conducted from database inception to September 2025. We screened 14 026 articles and assessed 325 full-text articles for eligibility. Primary research studies involving CYP aged 0-19 years reporting health or social outcomes associated with vaping were included. 81 studies met inclusion criteria with data extracted across eight broad domains. PROSPERO (CRD42024614659). RESULTS: Sample sizes ranged from 83 to 2 16 056 CYP aged 12 to 19 years. Some studies included younger children (eg, <5 years or neonatal/infant outcomes following in-utero exposure). Vaping was associated with evidence of harm across eight domains: respiratory health, mental health, cigarette smoking initiation, oral and dental health, allergies, sleep, ocular symptoms and perinatal outcomes for babies exposed in utero. The most consistent associations for harm were reported in large cross-sectional studies of cough, wheeze, bronchitic symptoms, anxiety, depression and panic disorder. Limited age-stratified analyses from high-quality studies showed that associations for smoking initiation, smoking transition and mental symptoms may be stronger in younger adolescents. CONCLUSIONS: Vaping has significant short and medium-term adverse health consequences for CYP. As a relatively new phenomenon, the longer-term consequences are unknown; nonetheless, current evidence indicates a stronger legal framework is required in the UK and elsewhere to protect CYP from harm. PROSPERO REGISTRATION NUMBER: CRD42024614659.