Smoking and vaping: which of the two is less harmful and how?

Tobacco and vaping devices contain nicotine which leads to addiction, which is why so many people who smoke or vape find it difficult to quit.

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?

Tobacco and vaping devices contain nicotine, an ingredient that can lead to addiction, which is why so many people who smoke or vape find it difficult to quit. Both tobacco and vaping devices contain other harmful chemicals; burning tobacco can create these chemicals and vaping devices turn chemicals and flavorings into mist that combines with synthetic nicotine.

In January 2018, the National Academies of Science, Engineering and Medicine released a consensus study report that reviewed over 800 different studies.

That report made clear: using e-cigarettes causes health risks. It concluded that e-cigarettes both contain and emit a number of potentially toxic substances. The Academies’ report also states there is moderate evidence that youth who use e-cigarettes are at increased risk for cough and wheezing and an increase in asthma exacerbations.

  • A study from the University of North Carolina found that the two primary ingredients found in e-cigarettes, propylene glycol and vegetable glycerin, are toxic to cells and that the more ingredients in an e-liquid, the greater the toxicity.
  • E-cigarettes produce a number of dangerous chemicals including acetaldehyde, acrolein, and formaldehyde. These aldehydes can cause lung disease, as well as cardiovascular (heart) disease.
  • E-cigarettes also contain acrolein, a herbicide primarily used to kill weeds. It can cause acute lung injury and COPD and may cause asthma and lung cancer.

Long-term effects of smoking

Smoking has many long-term adverse effects on the body. The CDC reports that smoking:

  • reduces sperm count
  • increases the risk of pregnancy loss or congenital disabilities
  • increases the risk of cataracts
  • impairs immune system function
  • increases general inflammation
  • can cause cancer in nearly any part of the body, including the lungs, kidneys, and stomach
  • triggers asthma attacks
  • causes blockages in the veins and arteries
  • increases the risk of a stroke

Long-term effects of vaping

Research generally accepts that while vaping can harm the lungs and other bodily systems, its impact is much less than tobacco smoking.

However, a 2019 study into the long-term health effects of vaping found that people using e-cigarettes had a higher risk of respiratory disease than people who never smoked.

Vaping may:

  • damage the lungs
  • release free radicals, which promote cancer development, into the body
  • weaken the immune system
  • delay brain development in fetuses, children, and teenagers

Some people also report sustaining burns when recharging e-cigarettes due to defective batteries leading to explosions.

Health services in the United Kingdom recommend that vaping can be an effective tool for quitting smoking. Additionally, in 2021, the Food and Drug Administration (FDA) permitted the marketing of three e-cigarette products, specifically citing their potential benefit in helping people quit smoking.

However, the CDC states that there is insufficient evidence to suggest vaping can help people quit smoking.

A 2021 study found that daily e-cigarette usage among tobacco smokers can increase the likelihood of quitting smoking by eightfold. Researchers assessed data from the 2014­–2019 Population Assessment of Tobacco and Health (PATH) study, focusing on smokers who were not planning to quit smoking at the start of the period.

At the end of the survey, 28% of smokers using e-cigarettes daily had ceased smoking tobacco altogether, while 45.5% had ceased smoking tobacco daily.

However, researchers found that only daily e-cigarette use had a statistically significant effect on smoking cessation rates.

Of the participants who were not using e-cigarettes, only 5.8% had quit smoking altogether by the end of the survey, while 9.9% had stopped smoking daily.

Meanwhile, people who were smoking e-cigarettes non-daily had a 3.1% rate of quitting smoking and a 10.2% rate of cutting down to non-daily tobacco smoking.

A 2019 randomized control study also found that daily e-cigarette use leads to an almost doubled rate of smoking abstinence than other nicotine-replacement products after one year.

Electronic cigarettes aren’t the best smoking cessation tool

Although they’ve been promoted as an aid to help you quit smoking, e-cigarettes have not received Food and Drug Administration approval as smoking cessation devices. A recent study found that most people who intended to use e-cigarettes to kick the nicotine habit ended up continuing to use traditional and e-cigarettes.

In light of the EVALI (a serious medical condition in which a person’s lungs become damaged from substances contained in e-cigarettes and vaping products) outbreak, the CDC advises people who use e-cigarettes for smoking cessation to weigh the risks and benefits and first consider use of other FDA-approved smoking cessation options.

Research from the CDC shows that vaping among youth has declined somewhat since 2020. Kids being stuck at home under their parents’ supervision during the COVID-19 pandemic could contribute to that trend.

But interpreting the data is tricky, since young people change their preferences often, and, when surveyed, may not consider using disposable products such as “puff bars” as vaping. The same CDC report says disposable e-cigarette use has increased 1,000% among high school students and 400% among middle school students since 2019.

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