Is Vaping Better Than Smoking?

Vaping is a relatively new phenomenon, which means there isn't research on the long-term health effects of electronic cigarettes (commonly called e-cigarettes, e-cigs, or vaping) compared to smoking. Overall, 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.

E-cigarettes pose some of the same health concerns as smoking, including addiction and damage to your heart and lungs.

What Is Vaping?

Vaping and smoking both work by heating up substances that users inhale.

Most e-cigarettes work by using a battery to heat up coils. These coils vaporize liquids within a cartridge or reservoir (thus the term “vaping”) and produce an aerosol that's inhaled. The liquid often contains nicotine and other chemicals (used to help create the vapor) that then get inhaled into the lungs.

While it’s rare, batteries in e-cigs can sometimes malfunction, causing them to overheat or even explode without warning, which can cause skin injuries.

Smoking relies on flame to burn tobacco and produce smoke. 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 added to the cigarette during the manufacturing process.

The lack of combustion for e-cigs means fewer harsh chemicals are formed. The ones left, however, aren’t exactly safe.

Nicotine and Other Harmful Ingredients

E-cigs don’t have nearly as many toxic chemicals in them as cigarettes, and while this is undoubtedly a point in vaping’s favor, many of the potentially dangerous ingredients in cigarettes are in e-cigs, too.

Nicotine

Almost all 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. 

A CDC study estimates that 99% of e-cigs sold in the U.S. contain nicotine. Some vaping products marketed as containing no nicotine were even found to contain it in tested samples.

It can be tough to compare just how much nicotine you take in while vaping as opposed to smoking in part because different products have different concentrations.

Some e-cig fluids contain only traces of nicotine or no nicotine at all, while 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.

Some studies have shown that experienced e-cig users take in about as much nicotine as smokers, and there is even preliminary animal research that suggests JUULs may deliver five to eight times more nicotine than regular cigarettes. More research is needed, but this study suggests that some e-cigs may be even more addictive than cigarettes (and therefore, potentially harder to quit).

Heavy Metals

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

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 delivery methods. Researchers suspect that heating up the vaporizing coils (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 fluid alone.

Like with nicotine, concentrations can vary by puff, device, and 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

Flavoring chemicals used to be a big part of e-cigarettes. There were many flavored cartridges, including sweet flavors that appealed to teens. However, the Food and Drug Administration enacted a rule that required e-cigarette companies to cease manufacturing and selling flavored vaping products (excluding menthol and tobacco) by the end of January 2020.

Some cigarette manufacturers add a limited number of flavors, like menthol, to their tobacco products to mask the taste of burning tobacco.

What Does Vaping Do to Your Lungs?

One analysis found that regular e-cig users were nearly twice as likely as non-users to develop chronic obstructive pulmonary disease (COPD), a condition that includes chronic bronchitis and emphysema. This risk held up even when researchers took into account potential confounders like the use of other tobacco products or secondhand smoke.

Some of the biggest health concerns related to smoking have to do with lung diseases like COPD, and this research suggests vaping might be strongly linked to it, too.

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

Like cigarettes, e-cigs can also contain small pieces of debris that, when inhaled, can irritate your sensitive lung tissue. Burning tobacco creates more debris, but e-cigs have it, too. The deeper you inhale, the more damage these tiny particles can do.

EVALI

Some e-cigs, especially those that contain THC (an active compound in cannabis), may contain vitamin E acetate and other additives that may lead to serious lung inflammation and breathing difficulties known as EVALI (e-cigarette or vaping use-associated lung injury). EVALI has led to more than 2,800 hospitalizations and at least 68 deaths since it was identified in 2019. It's not well understood since it's so new, and the CDC continues to investigate it.

Does Vaping Cause Cancer? 

Most vaping products contain carcinogens (cancer-causing substances), however, there’s very little research regarding whether or not vaping could increase your chances of developing cancer.

The link between smoking and cancer is well known—with tobacco products like cigarettes being linked to a long list of cancers.

Long-Term Effects

Electronic cigarettes haven’t been around as long as cigarettes, and as a result, there’s still a lot we don’t know. Recent research does suggest that vaping may increase the chances of health conditions often experienced by smokers, including those related to the heart, lungs, brain, and immune system.

Immune System

Preliminary research on lung tissue samples suggests that vaping increases the production of inflammatory chemicals and disables vital immune cells in the lungs (alveolar macrophages) that help keep the lungs clear of harmful particles. These lab effects are similar to what is seen in smokers and those with chronic lung diseases, but more research is needed to better understand the potential dangers of vaping for the immune system and lungs.

Cardiovascular Issues

E-cigs contain fewer toxicants (substances that can cause damage to blood vessels and lead to heart disease or stroke) than cigarettes, but research indicates that using e-cigs could still lead to many of the same cardiovascular concerns.

An analysis published in 2020 found that e-cigarette users had a higher heart attack rate, and dual users (those who used both e-cigs and cigarettes) had an increased risk of stroke, heart attack, and heart disease.

Brain Development

Most vaping products contain nicotine, which is not only addictive but can harm brain development in adolescents and young adults. The risks include reductions in impulse control, deficits in attention and cognition, and development of mood disorders. Nicotine use in adolescents may also increase the risk of future drug addictions.

In addition, research suggests that e-cig users are more likely to suffer from depression, anxiety, and emotional problems.

Secondhand Vape

Studies show vaping emits harmful substances into the air, including nicotine and metals. But how exactly secondhand vaping compares to secondhand smoke is still unclear.

Some states have banned vaping in the same places where cigarettes are prohibited, but many still allow vaping in public spaces. Even with laws limiting their use, electronic cigarettes tend to be more discreet. Some devices look like a plain USB flash drive, which has led some students to even use them in schools, potentially exposing their classmates to the vapor.

We’ve known for a while that 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.

Vaping to Quit Smoking

To reduce the harm to their health from cigarettes, some smokers have turned to e-cigs. The devices can feel somewhat similar to cigarettes and contain the addictive nicotine without as many toxic chemicals. It can make the transition away from smoking a little smoother and offers a potential benefit.

It's important for vaping to only be used as a complete substitute so that lung issues aren't compounded. And, like cigarettes, they should be avoided during pregnancy (due to potential for birth defects and other risks).

A Word From Verywell

A lot more research on vaping is needed. What we do know 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. Picking up vaping could be extremely damaging to your health, especially if you’re under the age of 25.