New Seton Hall Study Links Vaping Flavors to Joint Damage

A new study led by Jessica Cottrell, Ph.D., associate professor and chair of the Department of Biological Sciences at Seton Hall University, reveals that electronic cigarette liquid flavor additives (ELFAs) can severely compromise cartilage cell viability, disrupt tissue metabolism and trigger inflammatory responses, even without nicotine.

Published in Frontiers in Bioscience-Landmark, the peer-reviewed study, titled "Chondrocyte Viability and Function is Impaired by E-Cigarette Liquid Flavor Additives," sheds new light on the systemic health risks associated with vaping beyond nicotine addiction, particularly among adolescents and young adults.

Student Mentorship at the Heart of Discovery

Reflecting Seton Hall’s commitment to high-impact undergraduate and graduate research, the study was co-authored by four Seton Hall student researchers: Anzor Said, Connor Jaedicke, Mahika Ganguly and Amy Awadalla.

Under Cottrell’s mentorship, the student team — which included three undergraduate students and one recently graduated master’s student — led laboratory investigations evaluating how common nicotine-free e-cigarette flavorings impact ATDC5 cells, which are specialized cells responsible for maintaining healthy cartilage tissue.

The study was supported by grants from STEM Connect Awards and the Independent Colleges and Universities of New Jersey (ICFNJ). These competitive awards support collaborative, faculty-led research initiatives that empower undergraduate and graduate students with hands-on, publication-caliber laboratory experience.

Key Research Findings

While previous e-cigarette research has focused mostly on lung damage and nicotine addiction, this study looked at how inhaled flavor chemicals travel through the body to impact joint health. The researchers found that popular vaping flavors — even without any nicotine — can severely damage and kill cartilage cells, the vital building blocks responsible for cushioning joints and keeping bones moving smoothly. Cinnamon and menthol flavors proved especially harmful, causing nearly all tested cartilage cells to die off at concentrations of 4% or higher.

In addition to directly killing these essential joint cells, the chemical flavorings disrupted the cells' ability to build and maintain healthy tissue. The study also revealed that these flavor additives triggered strong inflammatory reactions in the cells, switching on biological signals that accelerate tissue breakdown and cause swelling. Together, the findings show that everyday vaping flavorings can independently weaken joint health and damage cartilage over time.

"Our findings show that e-cigarette flavor additives are far from benign additives," said Cottrell. "Even without nicotine, these chemical agents alter metabolism, gene expression and inflammatory pathways, which underscores an urgent need to examine how vaping impacts broader musculoskeletal and tissue health."

For more information and the full study, read the open-access article in Frontiers in Bioscience-Landmark.

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