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Which is worse smoking or vaping?

1: Vaping is less harmful than smoking, but it's still not safe. E-cigarettes heat nicotine (extracted from tobacco), flavorings and other chemicals to create an aerosol that you inhale. Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic.

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If you have thought about trying to kick a smoking habit, you’re not alone. Nearly 7 of 10 smokers say they want to stop. Quitting smoking is one of the best things you can do for your health — smoking harms nearly every organ in your body, including your heart. Nearly one-third of deaths from heart disease are the result of smoking and secondhand smoke. You might be tempted to turn to electronic cigarettes (e-cigarettes, vape pens, and other nondisposable and disposable vaping devices) as a way to ease the transition from traditional cigarettes to not smoking at all. But is smoking e-cigarettes (also called vaping) better for you than using tobacco products? Can e-cigarettes help you to stop smoking once and for all? Michael Blaha, M.D., M.P.H., director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, shares health information about vaping.

1: Vaping is less harmful than smoking, but it’s still not safe.

E-cigarettes heat nicotine (extracted from tobacco), flavorings and other chemicals to create an aerosol that you inhale. Regular tobacco cigarettes contain 7,000 chemicals, many of which are toxic. While we don’t know exactly what chemicals are in e-cigarettes, Blaha says “There’s almost no doubt that vaping exposes you to fewer toxic chemicals than smoking traditional cigarettes.” However, there has been an outbreak of lung injuries and deaths associated with vaping. In February 2020, the Centers for Disease Control and Prevention (CDC) confirmed 2,807 cases of e-cigarette or vaping use-associated lung injury (EVALI) and 68 deaths attributed to that condition. “These cases appear to predominantly affect people who modify their vaping devices or use black market modified e-liquids. This is especially true for vaping products containing THC,” explains Blaha. The CDC has identified vitamin E acetate as a chemical of concern among people with EVALI. Vitamin E acetate is a thickening agent often used in THC vaping products, and it was found in all lung fluid samples of EVALI patients examined by the CDC.

The CDC recommends that people:

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Do not use THC-containing e-cigarettes or vaping products.

Avoid using informal sources, such as friends, family or online dealers to obtain a vaping device. Do not modify or add any substances to a vaping device that are not intended by the manufacturer. Research from The Johns Hopkins University on vape ingredients published in October 2021 reveals thousands of chemical ingredients in vape products, most of which are not yet identified. Among those the team could identify were several potentially harmful substances, including caffeine, three chemicals never previously found in e-cigarettes, a pesticide and two flavorings linked with possible toxic effects and respiratory irritation.

2: Research suggests vaping is bad for your heart and lungs.

Nicotine is the primary agent in regular cigarettes and e-cigarettes, and it is highly addictive. It causes you to crave a smoke and suffer withdrawal symptoms if you ignore the craving. Nicotine is a toxic substance. It raises your blood pressure and spikes your adrenaline, which increases your heart rate and the likelihood of having a heart attack. Is vaping bad for you? There are many unknowns about vaping, including what chemicals make up the vapor and how they affect physical health over the long term. “People need to understand that e-cigarettes are potentially dangerous to your health,” says Blaha. “Emerging data suggests links to chronic lung disease and asthma, as well as associations between dual use of e-cigarettes and smoking with cardiovascular disease. You’re exposing yourself to all kinds of chemicals that we don’t yet understand and that are probably not safe.”

3: Electronic cigarettes are just as addictive as traditional ones.

Both e-cigarettes and regular cigarettes contain nicotine, which research suggests may be as addictive as heroin and cocaine. What’s worse, says Blaha, many e-cigarette users get even more nicotine than they would from a combustible tobacco product: Users can buy extra-strength cartridges, which have a higher concentration of nicotine, or increase the e-cigarette’s voltage to get a greater hit of the substance.

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