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When someone vapes, they inhale complex mixtures of known and unknown chemicals in the form of aerosols

5 3.5.2.1 Risk associated with smoking Smoking causes cancer of the pharynx and the larynx

Persistent hoarseness or voice changes lasting more than a few weeks can be an early warning sign of these conditions

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When caffeine is added to the equation, the likelihood (and severity) of adverse effects is multiplied, due most likely to the fact that PPA can produce dramatic increases in blood caffeine levels.14 Cases have been reported where individuals suffered manic psychosis after ingesting caffeine and PPA.15 The effects of the widely consumed drugs caffeine and phenylpropanolamine are mediated through activation of the central and sympathetic nervous systems

However, some individuals might not ever see any visible symptoms