Vaping: Are E-Cigarettes Any Safer than Traditional Tobacco Products?

Published June 5th, 2020 by Corey Riley
Fact Checked by

Cigarette smoking is the leading preventable cause of death in the United States causing nearly 1 in 5 deaths. Long-term effects of smoking cigarettes include increased risk of stroke, heart disease, and lung cancer. There have been significant efforts to reduce cigarette smoking; however, tobacco products have evolved to include smoke, smokeless, and electronic products.

Is Vaping Safer?

Vaping is the inhaling of a vapor created by an electronic cigarette (e-cigarette). Although e-cigarettes do not produce tobacco smoke, are they any safer?

E-cigarettes are battery-powered devices that heat up liquid containing nicotine, marijuana, flavoring and other additives. E-cigarettes deliver the solution in aerosol form. E-cigarette vapor is not harmless. Many of these vapors contain fine particles with varying amounts of toxic chemicals. E-cigarette vapors can contain harmful substances, including:

· Nicotine and/or marijuana

· Ultrafine particles that can be inhaled into the lungs

· Flavorings with chemicals

· Dangerous organic chemicals

· Cancer-causing chemicals

· Heavy metals including nickel, tin, and lead

E-cigarettes are known as e-cigs, e-hookahs, mods, vape pens, and JUULs.

JUUL is a type of e-cigarette with a slim design, shaped like a USB flash drive. The JUUL nicotine pods contain as much nicotine as a pack of 20 regular cigarettes.

Know the Risks

In 2015, the U.S. surgeon general reported that e-cigarette use in middle school and high school students had increased by 900%. In 2019, more than 5 million youth were using e-cigarettes. Many teens believe that vaping is less harmful than smoking, and most e-cigarettes come in fruit and candy flavors that appeal to kids. The lack of smoke, reduced odor, and small size is appealing to young adults.

Effects of nicotine on youth:

· Risk of addiction

· Harm to the developing adolescent brain

· Behavior risks

· Increased risk of lung disease

A 2018 report from the National Academy of Medicine found that young people who vape with nicotine are more likely to start smoking cigarettes in the future. The parts of the brain that are responsible for decision making and impulse control are still developing until age 25. Nicotine can cause harm to parts of the brain that control learning, memory, and attention.

Health Effects of Vaping

There has been an outbreak of lung injuries and deaths associated with vaping. As of February 18, 2020, the Centers for Disease Control and Prevention (CDC) confirmed a total of 2,808 hospitalized cases and 68 deaths in patients with e-cigarette, or vaping, product use associated lung injury (EVALI).

National and state data show THC-containing e-cigarettes are linked to most EVALI cases. The CDC has identified vitamin E acetate as a chemical of concern with EVALI. Vitamin E is a vitamin found in many foods and cosmetic products. Vitamin E acetate usually does not cause harm when ingested; however, when it is inhaled, it interferes with normal lung functioning. Vitamin E acetate is a thickening agent used in THC vaping products.

A recent study analyzed samples from 51 EVALI cases compared with 99 healthy individuals for vitamin E acetate, plant oils, MCT oil, coconut oil, petroleum distillates, and diluent terpenes. Vitamin E acetate was identified in fluid samples collected from the lungs in 48 of the 51 EVALI patients but not in the fluid obtained from the healthy individuals.  

Emerging data suggest links to chronic lung disease and asthma and associations between dual use of e-cigarettes and smoking with cardiovascular disease.

One study concluded the use of e-cigarettes was associated with increased risk of heart attack or heart disease. There is significant evidence that taking a puff from a nicotine e-cigarette triggers an increase in heart rate; however, vaping is thought to be less harmful to the heart than smoking cigarettes.

Fluid Flavor Matters!

A study tested more than 50 e-juice flavors and found that 92% of the flavors contained one of the three potentially harmful chemicals: diacetyl, acetyl propionyl, or acetoin. It is difficult to know which flavors are safer than others. Flavors that you might want to avoid are listed below.

Flavor Type


Dairy flavoring

Cheese, cream cheese, cheesecake, ice cream, ranch dressing

Brown flavoring

Cinnamon, clove, butterscotch, caramel, coffee, tea, toffee, chocolate, cocoa, maple, brown sugar, marshmallow, peanut butter, praline, hazelnut, almond

Fruit flavoring

Strawberry, pomegranate, lime and coconut, cranberry, raspberry, blueberry, pineapple, banana, apple, grape, pear, cider, tomato, jam

Alcohol flavoring

Brandy, rum, whisky, tequila, pina colada

Miscellaneous flavoring

Nutmeg, honey, graham cracker, vinegar, meat, camphor, cotton candy

Quit Vaping

One of the best things you can do to improve your health and add years to your life is to quit smoking, vaping, or using any form of tobacco. It’s not easy, but developing a plan makes it easier.

1.     Set a “Quit Day” and make a pledge to stop vaping. Make sure your supportive friends and family know about your quit day and will help you stick to it

2.     Choose your method (keep track on your calendar)

a.     Cold turkey

b.     Cut down the number of times you vape each day until you completely stop. By your quit day, stop smoking completely  

c.     Cut down the number of puffs you normally take each day and by your quit day, stop smoking completely 

3.     Talk with your doctor and decide if you can take medications or nicotine replacements to help you successfully quit  

4.     Make a plan for your quit day. Get rid of every vape, cigarette, lighter or any other tobacco product in your home, office, and car

The Bottom Line

Vaping is viewed as a lesser of two evils for current cigarette smokers; but there is still a lot we do not know about the long-term risks of vaping. The cases of severe lung disease among people who vape raise important questions about the safety of vaping.

Our lungs were meant to inhale clean air and it should not be a surprise that inhaling toxic chemicals damages our lungs. Youth and young adults should avoid vaping to decrease developmental risks. If vaping is used, avoid e-cigarettes bought off the street since it is not always know what is in e-cigarette liquid.