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Vaping vs. Smoking: The Key Differences and Health Risks

5th Jul 2023

Doctor Breaking a CigaretteThe first vaping devices began to enter wide distribution in the United Kingdom about 15 years ago, which means that medical experts have had plenty of time to study vaping and determine what its potential health risks are. The research so far has produced extremely positive results – Public Health England estimates that vaping is about 95% less harmful than smoking.

It’s important to remember, though, that “less harmful” isn’t the same as “harmless.” Vaping does have potential health risks. Some of those risks are from the nicotine itself, and others stem from the things that make vaping distinct from other forms of nicotine consumption.

From the perspective of your health, quitting nicotine entirely is always the best thing that you can do – and it’s possible that switching to vaping could help you along that path. If you can’t stop using nicotine, though, there’s no doubt that vaping is the next best option – but it’s important to be aware of the potential risks.

This article will compare the differences and health risks of vaping vs. smoking.

How Do Vaping vs. Smoking Compare from a Health Standpoint?

The health differences between vaping and smoking stem from the fact that cigarettes and e-cigarettes deliver nicotine in extremely different ways. When you smoke a cigarette, you’re lighting tobacco on fire and inhaling the smoke. In addition to the nicotine contained within the smoke, you’re also inhaling tar and carbon monoxide because those are the products of combustion. You’re also inhaling tobacco-specific nitrosamines, which are known carcinogens that form during the process of curing tobacco. In all, cigarette smoke contains thousands of chemicals. Most of those chemicals are present in much lower concentrations – or not present at all – in e-cigarette vapour.

The reason why vaping doesn’t expose you to most of the harmful chemicals in cigarette smoke is because of how differently an e-cigarette operates compared to a conventional cigarette. When you vape, a metal heating coil turns a nicotine-infused liquid called e-liquid or vape juice into vapour. Because there’s no combustion, e-cigarette vapour contains no tar or carbon monoxide.

What Are the Health Risks of Smoking?

You’re already aware of the health risks of smoking, so we won’t spend too much time on that except to say that smoking kills about 76,000 people in the UK each year. Although nicotine is the reason why people use tobacco, it isn’t the primary thing that makes smoking harmful. Instead, the health risks of smoking primarily stem from the other compounds in cigarette smoke such as tar, carbon monoxide and tobacco-specific nitrosamines.

Smoking greatly increases your risk of cancer. In addition to accounting for about 70% of all lung cancer cases, smoking also increases the risk of cancer in the mouth, throat, stomach, bowels, liver and more. Smoking increases the risk of heart attack and stroke, and it also increases the chance that others around you will develop health problems due to the inhalation of second-hand smoke.

It’s possible, in fact, that we don’t even know the full extent to which smoking is harmful to health. Cigarette smoke contains thousands of chemicals, and it’s almost impossible to fully understand those chemicals’ complex interactions with the human body.

What Are the Health Risks of Vaping?

It’s widely believed that vaping is likely to be significantly less risky to health than smoking, but that doesn’t mean it’s completely safe; vaping has some of its own health risks as well. Some of those risks stem from the nicotine itself – we’ll discuss those risks separately – and some of the risks stem from the fact that vaping works very differently from other types of nicotine replacement products. We’ll explain some of those potential risks now.

Metal Particles

Virtually all vaping devices use metal wires or strips as their heating surfaces. The most common materials used for heating surfaces are stainless steel and Kanthal, which is an alloy of iron, chromium and aluminium. Because you’re inhaling vapour directly from the metal heating surface when you vape, a 2018 study concluded that vaping may lead to toxic metal inhalation. However, another study published in 2018 offered a conflicting view. According to that study, a normal daily amount of vaping doesn’t result in the inhalation of enough metal to exceed well-established safety limits.

In the UK, vaping products are required to undergo emissions testing before being introduced to the market. This includes testing the emissions for metal content.

Formaldehyde Production

When propylene glycol and vegetable glycerine are heated to very high temperatures, they can degrade and produce formaldehyde. Although the exact extent to which the potential formaldehyde production is harmful to health is unknown, formaldehyde is a known carcinogen. Another study published in 2015 refuted the findings of the first study, noting that the first study found formaldehyde only under high-voltage conditions that would have produced an unpleasant burnt flavour. Under those conditions, the user would immediately reduce the device’s power level. A third study published in 2018 contradicted the second study, though, finding that a vaping device can produce formaldehyde even at moderate power levels.

Vegetable Glycerine, Propylene Glycol and Other E-Liquid Flavours

Woman Struggling to Sleep

All of the ingredients in e-liquid – vegetable glycerine, propylene glycol and flavours – are food grade and safe for oral consumption. The fact that a given ingredient is safe to eat, though, doesn’t necessarily mean that it is safe to inhale. There are so many different ingredients used to flavour e-liquid that testing them all for long-term safety in inhalation could take decades if it ever happens at all. Until that happens, our knowledge of which e-liquid ingredients are safe to inhale will be incomplete. The emissions tests that are conducted on e-liquids do check for ingredients that are known to be unsafe for inhalation, such as diacetyl.

What Are the Health Risks of Nicotine?

In addition to the potential health risks of vaping described above, nicotine itself poses certain potential risks. Those risks are common to all products that contain nicotine, and they include:

  • Reduction in sleep quality and total sleep time.
  • Possible increased risk of heart attack or stroke, especially in those who already have poor cardiovascular health.
  • Risk of sickness in the event of an overdose.
  • Increased risk of stillbirth, miscarriage, low birth weight and birth defects in pregnant mothers.