Electronic cigarettes are a tool to vape illicit drugs

Although the current data are scarce and fragmentary, the misuse of electronic cigarette devices (ENDSs) for smoking illicit drugs poses a serious emergent threat to public health. This review emphasises the use of ENDSs as new tools for smoking illicit drugs. A comprehensive search using the terms “illicit drugs”, “vape”, and “electronic cigarettes” was conducted in PubMed, web-based drug forums, chat sites and grey literature combined with theterms tobacco, nicotine, smoking, cigarettes, cannabis, marijuana, opiate, opioid, heroin, cocaine, synthetic opioids/cannabinoids, cathinones, LSD, dimethyltryptamine (DMT), 3,4 methylenedioxymethamphetamine (MDMA), methamphetamine (Meth), vape/vaping, e-liquid and addiction. Studies were included if they met the following criteria: 1) involved human participants (Female, male, intersex); 2) consumed any type of illicit drug using electronic cigarette; 3) all ages were taken into consideration. We used all combinations of search terms from each category for articles published between January 2013 and October 2023 a long period due to the fact that in the last years ENDS cigarettes have undergone improvements in their structure having the ability to regulate the evaporation temperature and facilitate the potential for use of these devices to ‘vape’ illicit drugs. In addition to nicotine, the main vaped drugs were cannabis, cocaine and new psychoactive substances (NPSs), which included synthetic cannabinoids, synthetic opioids, hallucinogens and stimulant drugs. An increase in the risk of overdose and death with the use of NPSs is reported. Further work is urgently needed for a better understanding on the effect of vaping illicit drugs in the population. It is confirmed that ENDSs are becoming popular devices among both young and older individuals, with a mean age of use of 46.26 ± 16.8 years, as a new way of taking illicit drugs.