Which Is Less Harmful Vaping or Smoking?
Smoking cigarettes is nothing new. Take a walk into your city and you’ll spot workers having a puff on their break, groups of teens sharing a light, and busy business people inhaling potentially harmful substances in between meetings. The Centre for Disease Control and Prevention (CDC) found that 30.8 million people smoked cigarettes in 2020. In other words, over 30 million people in America have a nicotine addiction.
But what’s the alternative? Vaping devices have become a popular alternative to cigarette smoking in recent years. Believe it or not, the idea for e-cigarettes dates as far back as 1927, and the first working e-cigarette was produced in 1963. Despite this, vape pens didn’t gain traction until pharmacist Hon Lik created the first commercially viable electronic cigarette in 2003. Millions of people use e-cigarettes to quit smoking, but at what cost?
E-cigarettes boomed in popularity in a relatively short period of time, especially among young people. The American Lung Association found that e-cigarette smoking among middle school students increased 1650% from 2011 to 2019.
We are just now seeing research that answers the question, is vaping bad for you? In the battle of vaping vs smoking, which is healthier? Is vaping really a better alternative, or are the health risks just as dire? Let’s find out.
Long-Term Effects of Smoking
Cigarette smoking has a long-term negative impact on aerobic and cardiovascular function. Cigarettes contain more than 7,000 chemicals, more than 250 of which are known to be dangerous. At least 69 of these chemicals can cause cancer. These cancer-causing chemicals include ammonia, carbon monoxide, and hydrogen cyanide.
When you smoke a cigarette, the chemicals burn and create volatile organic compounds including tar and carbon monoxide. Tar or carbon monoxide can have a devastating impact on your health on their own, but combined the results can be fatal.
Let’s take a look at tar. When you smoke, tar forms in your body. It looks like a sticky yellow or black substance. The substance sticks to your lungs and coats every surface that it touches, hindering its natural function. Over time, this causes lung disease and other pulmonary issues. It is a leading cause of chronic obstructive pulmonary disease (COPD) in smokers. This umbrella term includes emphysema and chronic bronchitis. Smoking is now a leading cause of COPD.
The health implications don’t stop there. Cigarette smoking also has a negative impact on the healthy function of the heart. The CDC found that smoking causes 1 in 4 fatal deaths from cardiovascular disease (CD). It might seem unfathomable, but CD is the leading cause of death in the United States. In fact, this disease kills more than 800,000 people a year.
So, how is smoking responsible for CD? When you smoke cigarette vapor, the harmful chemicals travel through your bloodstream and form a plaque on the inside of your arteries. This causes atherosclerosis, a condition that occurs when ‘fat, cholesterol, and other substances in the blood form plaque that builds up the walls of arteries.’ As a result, the arteries narrow, and ‘blood can no longer flow properly to various parts of the body.’
Atherosclerosis leads to CD, as well as strokes, peripheral arterial disease (PAD), abdominal aortic aneurysms, and far more unpleasant conditions and diseases. As we can see, the long-term effects of cigarette smoke are dire. Tobacco smokers can expect heart problems, lung problems, and general poor health.
Long-Term Effects of Vaping
Cigarettes and vape products both contain nicotine, but there is one key difference. Whereas cigarettes contain tobacco (which contains nicotine), vape juice just contains nicotine. Manufacturers extract nicotine from the tobacco plant, and thereby bypass thousands of harmful toxins. Vapers can get the same nicotine fix, but without the added side effects.
There is no doubt that vape pens contain fewer harmful chemicals than cigarettes, and that they are an ideal alternative for people who want to quit smoking. But what are the long-term effects of daily e-cigarette use?
Electronic nicotine delivery systems have not been around for long enough for us to get an accurate outline of the future impact, but we can make some assumptions based on recent research.
The National Academies Press (NAP) found that ‘there is substantial evidence that heart rate increases shortly after nicotine intake from e-cigarettes.’ This increases the risk of heart attacks, as well as the chance of high blood pressure. High blood pressure is a common condition, but it shouldn’t be taken lightly. It increases the strain on blood vessels, brains, kidneys, and eyes.
Respiratory diseases are another big concern. A 2019 study found that vaping might cause damage to the lungs, increase the production of free radicals, weaken the immune system, and delay brain development in younger individuals.
The American Cancer Society encourages individuals to quit smoking and vaping entirely, warning that ‘without urgent and effective public health action, e-cigarettes will lead to a new generation of nicotine-addicted individuals.’
With all this research-backed evidence on the line, we have to wonder why individuals quit smoking and start using e-cigarettes instead. There is no doubt that e-cigarettes are less dangerous than tobacco products, but the outlook does not seem that much brighter.
Let’s look at some of the more nuanced aspects of smoking vs vaping.
Secondhand Vapor vs. Secondhand Smoke
Traditional cigarettes impact far more than just the individual. Burning tobacco releases carbon monoxide and other harmful substances into the atmosphere. Secondhand smoke causes more than 7,300 lung cancer deaths each year in the US among adults who don’t smoke. The same study from the CDC found that ‘even brief’ secondhand smoke inhalation can change cells in a way that sets cancer in motion.
This problem is not just linked to young adults, it even impacts toddlers and babies. Small children do not have fully developed respiratory systems, lungs, or hearts. Children who are exposed to the chemicals in tobacco cigarettes are at increased risk for severe asthma, respiratory symptoms, slowed lung growth, middle ear disease, and acute respiratory infections such as pneumonia and bronchitis. Even worse, secondhand smoke is a leading cause of sudden infant death syndrome (SIDS) in otherwise healthy infants.
Cigarette users can have a negative impact on their young children even if they open a window or smoke outside. Cigarette smoke sticks to clothes for up to five hours. The only way to truly eliminate the chance of your child inhaling secondhand smoke is to quit smoking.
Unlike conventional cigarettes, vape products do not contain or burn tobacco. Adult smokers can satisfy their nicotine dependence without exposing the people around them to all the harmful chemicals in tobacco.
Secondhand e-cigarette vapor is far less dangerous, but recent studies have found that it can cause some significant health problems. One thing to remember is that vaping aerosols can contain heavy metals and ultrafine particles. It is not uncommon for vapes to contain lead, nickel, and zinc. Even more concerning, they contain cancer-causing substances like benzene and diacetyl, which are heavily linked to popcorn lung.
Talat Islam and others found that exposure to secondhand aerosols from vape pens and other nicotine replacement products is associated with bronchitis symptoms and shortness of breath. This is especially common among young adults, though it also impacts adults who don’t vape or smoke.
Health Implications of Daily E-Cigarette Use
The health implications can be harrowing, especially for ex-smokers who think that they were making a better choice by switching to vaping. The good news is that vaping has not been proven to have as harsh an effect on your heart, lungs, and other vital organs as smoking. Still, if you want to continue vaping you need to understand the potential health risks.
Read our article on the top 10 side effects of vaping to learn more.
How Does Vaping Affect Your Heart?
Heart health is one of the main reasons why people quit smoking. They often switch to vaping, believing that it is a healthier alternative. Vaping is less harmful than smoking for your heart, but you still need to be aware of the consequences of inhaling harmful substances.
Albert D. Osei and others conducted a 2019 study that assessed data from a nationwide survey of 450,000 individuals. They found that there is no significant association between daily e-cigarette use and heart disease. In the same study, they found that individuals who used regular cigarettes, as well as e-cigarettes, were more likely to have heart disease.
Another study (which used the same national dataset as Albert D. Osei and others) found that daily e-cigarette use leads to an increased risk of angina, strokes, heart attacks, and heart disease. The research community is conflicted, but the consensus is that e-cigarette products have a negative impact on heart health.
How Does Vaping Affect Your Lungs?
E-cigarette users don’t inhale tobacco, which means that they don’t consume many of the carcinogens that cause cancer and other unpleasant diseases. The vapor that comes from e-cigarettes also doesn’t contain solid particles, which eliminates another evidence-backed concern.
Nicotine replacement products are nowhere near as bad for your lungs as cigarettes, but there are still some risks associated with vapor. As we’ve discussed, diacetyl is present in most vaping aerosols. It is linked to a condition called popcorn lung.
Popcorn lung (known medically as bronchiolitis obliterans) is caused by layers and layers of scar tissue in the lungs. The scar tissue blocks the airflow, which leads to respiratory problems. It is often mistaken for lung cancer.
Apart from that, there is not much research into the impact of vaping on lung health. Industry leaders speculate as to whether vegetable glycerin (VG) and propylene glycol (PG) have an impact on the lungs, but there is not enough research to be conclusive either way. One thing that we know for certain is that PG allergies are common. In fact, it is thought that 1 in 10 vapers are sensitive to PG. This sensitivity can reveal itself in any number of ways, including irritation in the throat and lungs.
Are Vape Flavors Bad for Your Lungs?
To answer the question ‘is vaping bad for you?’ we have to think about more than just the device. There is also question marks around e-liquid, an essential component of vaping.
The main questions are about diketones like diacetyl and acetyl propionyl. Diketones are flavoring chemicals, so it is no surprise that they are present in a lot of e-cigarettes. The main issue with diketones is that they cause popcorn lung, which we’ve already discussed.
In 2014, cardiologist Konstantinos Faraslinos labeled diketones as ‘avoidable risks’ and went on to recommend that ‘manufacturers and flavoring suppliers’ should ‘eliminate these hazards from the products without necessarily limiting the availability of sweet flavors.’ This gave manufacturers the push they needed to eliminate diketones from their products. Of course, not everyone followed this recommendation. Some manufacturers simply started publishing studies that showed the percentage of diketones in their e-liquids.
Some vape liquids still contain diketones, but all cigarettes contain diketones. In the battle of vaping vs smoking for lung health, vaping is winning. E-cigarette users are far less likely to experience lung problems than cigarette smokers.
How Does Vaping Affect Your Teeth and Gums?
Just like smoking, vaping can affect your teeth and gums.
There are several studies that delve into the impact of e-cigarette use on oral health. 90% of e-liquids contain PG, which is a known irritant. 10% of people are allergic (or have sensitivities) to PG. Redness, swelling, and itching are just some of the common symptoms. In relation to oral health, vapers might see patches on their tongue, red painful patches on the opening of their throat, and swollen gums.
In 2016, Isaac K. Sundar and others found that vaping causes gum inflammation, which is a leading cause of periodontal diseases. Gingivitis is one of the most well-known and mild periodontal diseases, but it can progress to gum disease in just 15 months.
Can Vaping Cause Cancer?
One of the main concerns linked to smoking traditional cigarettes is cancer. Smoking cessation programs focus on this possible outcome, and public health bodies highlight it in their marketing materials. But what about e-cigarettes?
Unfortunately, e-cigarettes have not been around for long enough for us to offer any conclusive statements. All we can do is share the sparse research that has been conducted over the last few years.
In the same 2018 study that we mentioned earlier, NAP found that ‘there is substantial evidence that some chemicals present in e-cigarette aerosols (e.g. formaldehyde, acrolein) are capable of causing DNA damage and mutagenesis.’ In other words, some e-cigarettes contain chemicals that can damage DNA and promote cell dysfunction. These two issues can lead to cancer, though there is no direct link just yet.
Do Vapes Contain Formaldehyde?
Formaldehyde is a naturally occurring organic compound that is colorless and flammable. You might have heard of formaldehyde in relation to the building sector. It is bulk-produced in industrial settings to create building materials like plywood and particleboard. It is even used as a preservative in mortuaries, as well as a central chemical in disinfectants and fungicide products.
So, is there formaldehyde in your e-cigarette?
A 2016 study found that the average exposure to formaldehyde is approximately 1 microgram each day, and that vaping exposes e-cigarette users to an extra 0.8 micrograms. In contrast, tobacco products such as cigarettes expose the user to an extra 3.4 to 8.8 micrograms per cigarette.
Are There Ingredients That I Should Avoid?
Vaping exposes the user to hundreds of chemicals that they might be sensitive to. We’ve compiled a list of e-liquid ingredients that are known irritants.
- acetyl propionyl
- pentanedione (2,3-pentanedione)
- propylene oxide
Are There Other Ways to Minimize Side Effects?
If you don’t want to stop smoking completely, there are a few ways that you can minimize the health impact of smoking e-cigarettes.
Here are our top five tips for people who want to protect their overall health.
Ask for a List of Ingredients
One of the easiest ways to avoid unexpected health complications is to be aware of what you are consuming. E-liquids contain PG and VG as standard, but there could be lots of other chemicals in your favorite vape liquid.
We recommend calling your e-juice manufacturer and asking for a list of the ingredients in your liquid. If they can’t provide you with a clear list, they might not want you to know about some of the chemicals in their products. This is a clear sign to stay away from certain brands and manufacturers.
Avoid Flavored Vape Juices
A standard e-liquid contains PG, VG, nicotine, and flavorings, but you can buy liquids that don’t contain flavors.
These products might be less tasty, but they are also far less likely to cause you harm. It is not uncommon for e-cigarettes to contain dangerous flavoring chemicals. If you’re experiencing unwanted side effects from vaping, buy a flavorless e-liquid and see how you get along.
Lower Nicotine Intake or use Non-Nicotine Vapes
This is a no-brainer for people who are quitting smoking anyway. Any smoking cessation program will recommend tapering your nicotine consumption to reduce cravings. This practice has the added benefit of reducing the number of dangerous chemicals that you consume.
Even if you’re not quitting smoking, you can reap the benefits of consuming less nicotine. 20mg to 18mg of nicotine might seem like a big jump, but your body will soon become accustomed to the new amount. You never know, you might be decreasing your risk of heart disease and lung cancer!
Drink Plenty of Fluids
This is the easiest way to reduce the short-term unwanted effects of using e-cigarettes. Lots of new vapers struggle with dry mouth, which can present itself as a burning sensation or soreness, dry lips, halitosis, oral thrush, tooth decay, and even a decreased or altered sense of taste.
With all these unpleasant symptoms up for grabs, it is no surprise that most vapers keep a bottle of water nearby. Drink water straight after vaping and you should be able to avoid these symptoms.
Brush Your Teeth After Vaping
Sometimes the simplest answer is the most effective. Like traditional cigarettes, e-cigarettes can impact your teeth and gums. To minimize the chance of oral health issues, brush your teeth after vaping. This scrubs away bacteria before it can settle and cause havoc with your oral health.
So, is vaping bad for you?
The answer is yes, but dig a little deeper, and it’s not that simple. As we’ve discovered, e-cigarettes pose far fewer health risks than cigarettes, which have well-documented links to lung disease, heart disease, and other fatal conditions. Cigarettes have been popular for decades, with 3.5 billion cigarettes being sold in the US in 1901 alone! When we compare the popularity and history of cigarettes with e-cigarettes, there is no competition.
This leads us to a dilemma; are e-cigarettes better than cigarettes, or is there just more data available to researchers? We can tentatively assume that vapes are still less harmful because, unlike cigarettes, they don’t contain nicotine. That being said, the research into vaping is still in its infancy, so we expect to see more worrying studies coming out in the future.
Ultimately, your health is in your hands. If you want to protect yourself against dangerous chemicals, use some of the tips in our article in your day-to-day life.