AS 2024 GOT UNDERWAY, many tobacco smokers who are concerned about the health effects of their habit resolved to find a way to quit. Many of these individuals may be tempted to switch to electronic cigarettes with the assumption that they’re not as hazardous as conventional cigarettes. But is e-cigarette use—a.k.a. vaping—truly a healthier alternative to smoking?
Perhaps the best answer to that question is, “It depends, but probably not.”
According to the Centers for Disease Control and Prevention (CDC), “E-cigarettes have the potential to benefit adult smokers who are not pregnant if used as a complete substitute for regular cigarettes and other smoked tobacco products.” They are not, however, “safe for youth, young adults, and pregnant women, as well as adults who do not currently use tobacco products.”
In other words, non-pregnant adults who already smoke tobacco and would otherwise continue to smoke tobacco might benefit if they completely substitute vaping for conventional smoking. Anyone who does not smoke or vape is urged to shun both habits.
The CDC is also dubious about the use of e-cigarettes as a smoking-cessation aid, noting that “scientists still have a lot to learn about whether e-cigarettes are effective in helping adults quit smoking” and advising smokers who want to quit that there are other FDA-approved, evidence-based smoking-cessation tools on the market that they should try first.
E-cigarette configurations vary considerably, with some resembling conventional cigarettes or other tobacco- smoking implements, and others resembling items like pens, USB sticks, or other objects. Whatever their specific design, e-cigarettes typically consist of a battery, a heating element, and a compartment to hold liquid, which is aerosolized and inhaled.
Though it might seem that inhaling vapor is relatively safe—and, indeed, early marketing of vaping devices suggested that they produce “harmless water vapor”—it’s important to understand that the liquids sold for these devices can contain a wide variety of potentially harmful chemicals and components.
High on the list of harmful chemicals present in vaping liquids is nicotine, which is not only very addictive but also harmful to developing fetuses and the still-developing brains of young people. What’s more, nicotine can raise your blood pressure, adrenaline level, and heart rate, thereby increasing the risk of heart attack. It can also be very difficult to determine how much actual nicotine is present in any given vaping liquid. In fact, some products marketed as “nicotine-free” have been found to contain nicotine.
Among the other harmful or potentially harmful substances that might be present in vaping liquids, the CDC lists ultrafine particles that can be inhaled deep into the lungs; flavoring such as diacetyl, a chemical linked to a serious lung disease; volatile organic compounds; cancer-causing chemicals; and heavy metals such as nickel, tin, and lead.
In recent years, there have also been headline-grabbing cases of lung illness related to vaping that resulted in ICU admissions and even deaths across the nation. Many, though not all, of these acute cases, appear to have involved the modification of vaping devices or the use of black-market liquids, especially those containing THC (the psychoactive component of marijuana) and vitamin E acetate. For this reason, the CDC advises against the use of THC-containing vaping products; acquiring vaping products from informal sources, such as friends, family, or online dealers; as well as the modification of vaping devices or addition of substances to a vaping device that are not intended by the manufacturer.
In light of the already-revealed health implications of vaping, the ambiguity of the components present in vaping liquids, and the fact that little is yet known about the longterm effects vaping has on health, it stands to reason that the CDC would discourage anyone from starting the habit. E-cigarette use may be safer than ongoing tobacco smoking, but it can’t be argued that it’s safe. Smokers looking to quit are well advised to try other smoking-cessation aids first and, if those aren’t effective, to evaluate the health costs and benefits of vaping carefully and in consultation with their physician before turning to e-cigarettes as a nicotine-step-down tool. ✲
