Is Vaping Better for You Than Smoking?

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It’s not an exaggeration to say smoking has been one of modern history’s greatest threats to public health. Despite steady drops in tobacco use in the United States, cigarettes still cause nearly half a million deaths in the country every year. To put that into perspective, smoking has killed 10 times as many Americans as all U.S.-fought wars combined. It’s more deadly than HIV, alcohol, motor vehicle crashes, and illegal drugs. Cigarettes can wreak havoc on the body, which is why doctors and public health officials have been encouraging people to quit tobacco for years.

To reduce the harm to their health from cigarettes, some smokers have turned to electronic cigarettes (more commonly referred to as e-cigarettes, e-cigs, or vaping). These devices look and feel a lot like cigarettes and frequently contain nicotine, the addictive ingredient in tobacco products. All of that taken together can make the transition away from smoking a little smoother. But is vaping that much better for you than cigarettes?

Not much research exists on the long-term health effects of e-cigarettes compared to smoking. Vaping is a relatively new phenomenon compared to traditional tobacco products. What we do know is a mixed bag. E-cigarettes appear to be less harmful than smoking—a low bar considering how dangerous combustible cigarettes have proven to be—but they are far from safe.

In fact, e-cigarettes pose some of the same health concerns as smoking, including addiction, damage to your heart and lungs, and physical injuries.

Smoke Versus Vapor

Smoking and vaping both work by heating up substances that users inhale, but the two processes can have different effects on the body.

One of the reasons smoking is so dangerous is because it involves burning tobacco. When you light up, the combustion causes harmful chemicals to be formed—chemicals that you breathe in with every puff, along with any other harsh substances inserted into the cigarette during the manufacturing process.

Filters that catch some tar or tipping paper with ventilation holes are often added to cigarettes as a way to counteract some of these effects. Their inclusion, however, helps only somewhat and can backfire, as some people block the ventilation holes or inhale more deeply to compensate, and that can cause the chemicals to reach deeper into the lungs.

Rather than burning tobacco, e-cigarettes heat up liquids to produce vapor (thus the term “vaping”). The lack of combustion means fewer harsh chemicals are formed. The ones left, however, aren’t exactly safe.

Ingredients

Cigarettes often contain more 7,000 chemicals, at least 250 of which can be harmful to your health. E-cigs don’t have nearly as many toxic chemicals in them, and while this is undoubtedly a point in vaping’s favor, many of the potentially dangerous ingredients in cigarettes are found in e-cigs, too.

Harmful substances found in both electronic and traditional cigarettes include nicotine, heavy metals, formaldehyde, flavorants, and ultrafine particles.

Nicotine

Many vaping products include nicotine, the same addictive chemical found in cigarettes. Nicotine affects the reward centers of your brain (which can eventually lead to addiction), as well as a whole range of body systems, including your heart and lungs. 

It’s tough to compare just how much nicotine you take in while vaping as opposed to smoking, in large part because users vary in how deeply and how frequently they inhale. Some studies, however, show experienced e-cig users take in about as much nicotine as smokers do, suggesting e-cigs could be just as addictive (and therefore, just as hard to quit).

Another reason it’s hard to compare nicotine levels in smoking versus vaping is that different e-cig products have different concentrations of nicotine. For example, while some e-cig fluids don’t contain any nicotine at all, fluid cartridges used by JUUL (a popular vaping device, especially among teens and young adults) contain about as much nicotine as a pack of cigarettes. Just like with smoking, how long it takes for someone to get through a whole pod depends on how often and how intensely a person inhales.

Heavy Metals

In addition to chemicals, some vaping fluids and devices contain heavy metals like lead and nickel, which can be toxic when inhaled.

One study looking at toxic metal concentrations in vaping aerosol found nearly half of the samples they tested (48 percent) had levels of lead outside safety levels set by the Environmental Protection Agency. Concentrations of other metals in the aerosol, like nickel and manganese, also often exceeded safety standards.

While it’s likely these concentrations are lower than what you’d be exposed to in cigarettes, it’s difficult to compare the two because of the different ways smokers or e-cig users are exposed to them. Some researchers suspect that heating up the vaporizing coils in vape pens (which are often made of metals like nickel) can prompt some of the metals to get into the aerosol, resulting in higher toxic metal concentrations being inhaled than you’d find in the vape fluid alone.

Like with nicotine and other ingredients, concentrations can vary by puff, by device, and by manufacturer. Different vape pens can have different settings that affect the temperature of the coils. Likewise, waiting a while between puffs can give the coils a chance to cool down between uses, reducing the likelihood of metals getting into the aerosol.

Flavorants

A major difference between smoking and vaping is the introduction of flavoring chemicals. Some cigarette manufacturers add a limited number of flavors, like menthol, to their tobacco products to mask the taste of burning tobacco. But e-cigs take it to another level.

You can now buy (or make) a wide range of flavored cartridges to use in vaping devices, including sweet flavors like chocolate or cherry. The ability to try a never-ending variety of flavors is a major part of the appeal among teens and young adults, and there are a lot of misconceptions about vape fluid safety, which could encourage more young people to take up vaping. One study, for example, found that teens were more interested in trying fruit-flavored e-cigarettes than tobacco-flavored ones, in part because they incorrectly believed them to be less harmful.

In addition to enticing more teens to take up vaping, some of the flavoring chemicals used in vaping products have known health risks, most notably diacetyl. Used to create rich flavors like butterscotch, caramel, or piña colada, diacetyl has been linked to lung diseases and other respiratory issues like bronchiolitis obliterans (or “popcorn lung”). 

Ultrafine Particles

Like cigarettes, e-cigarettes can also contain small pieces of debris that, when inhaled, can irritate your sensitive lung tissue. Burning tobacco creates more debris, but e-cigarettes have it, too. The deeper you inhale, the more damage these tiny particles can do. The very small size of ultrafine particles in both cigarette smoke and e-cig aerosol allows them to enter the body more easily than larger particles and thus can create poorly-understood health risks like an elevated chance of heart attack.

Injuries

In addition to long-term health risks of smoking, cigarettes can cause injuries like burns or unintentional fires—so can e-cigarettes. Unlike tobacco cigarettes, vaping devices don’t rely on a flame to function. Instead, they use batteries to heat coils and produce an aerosol. While it’s rare, these batteries can malfunction, causing the vape pens to overheat or even explode without warning. Because these devices are often kept in pockets or purses close to the body, they can cause serious damage to the face, hands, and thighs.

Long-Term Health Risks 

Electronic cigarettes haven’t been around as long as tobacco cigarettes have been, and as a result, there’s still a lot we don’t know about how their use can affect someone’s health long-term. Recent research suggests, however, that vaping could increase the chances of health conditions often experienced by smokers, including cancer, stroke, and respiratory problems. 

Cancers

While the link between smoking and cancer is well known—with tobacco products like cigarettes being linked to a long list of cancers—there’s very little research regarding whether vaping could increase your chances of developing cancer. Some vaping products contain possible carcinogens (cancer-causing substances) but in much smaller amounts than traditional cigarettes, and it’s unclear whether the presence of these substances will lead to more cancer cases in the future.

Cardiovascular Issues

One of the systems hit hardest by smoking is the cardiovascular system. Toxicants found in cigarettes can cause damage to blood vessels and lead to serious cardiovascular conditions like heart disease and stroke.

Vaping has fewer of these toxicants, but research indicates that using e-cigs could still lead to many of the same heart health concerns as smoking. An analysis published in 2019 found that e-cigarette users had an increased risk of stroke, heart attack, and heart disease. Another analysis found e-cig users were nearly twice as likely to have a heart attack, only slightly below the risk seen in daily smokers. In much of the research, the chances of cardiovascular issues were stacked on top of any risk individuals also had from smoking, as many e-cig users also smoke.

Respiratory Problems

Some of the biggest health concerns related to smoking have to do with lung diseases like chronic obstructive pulmonary disease (COPD), a condition that includes chronic bronchitis and emphysema. Using cigarettes is strongly linked to developing the disease, and research shows vaping might, too. An analysis published in 2018 found regular e-cig users were nearly twice as likely as non-users to develop COPD, even when they took into account potential confounders like the use of other tobacco products or secondhand smoke.

Even in cases where e-cig users don’t develop serious conditions, they can still experience breathing issues. In one study, e-cigs users reported troubles breathing or chest pain at rates similar to those who just used cigarettes.

Secondhand Exposure

We’ve known for a while that smoking doesn’t just affect smokers. Secondhand smoke can expose people to many of the same harmful chemicals found in cigarettes. An estimated 41,000 people die every year in the United States due to secondhand smoke. It kills more people than motor vehicle crashes, which is why laws have been put into effect banning smoking in many public spaces, including bars and restaurants.

Fewer laws exist restricting vaping. Some states have banned electronic cigarette use in the same places where cigarettes are prohibited, but many still allow vaping in a wide range of public spaces. Even with laws limiting their use, electronic cigarettes tend to be more discreet than traditional cigarettes, making it easier to use them without detection. Some devices look like a plain USB flash drive, allowing some students to even use them in schools and potentially expose their classmates to the vapor.

Studies show vaping emits harmful substances into the air, including nicotine and metals. How much harm secondhand vaping can cause, however, is still unclear especially as it compares to the known danger of cigarette smoke.

A Word from Verywell

Smoking is inarguably terrible for your health, and smokers should do what they can to quit tobacco products completely if at all possible. It may be helpful to find a tobacco cessation program that works for you.

A lot more research is needed on the long-term health effects of vaping as well. What we do know so far, however, is that while vaping doesn’t expose you to the same number of dangerous chemicals as you would get from smoking, it could still carry substantial health risks. So even if you don’t currently smoke, picking up vaping could be extremely damaging to your health, especially if you’re under the age of 25.

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