Is vaping safer than smoking?
Published: 11 January 2019
Smoke-free and vape-free is the best option for heart health. If you don’t smoke, don’t start vaping. For people who already smoke tobacco, vaping may be a helpful stepping stone on the road to giving up. The ASH team explain why.
Vaping is on the rise in New Zealand. Latest Ministry of Health figures show that, in 2016, one in six Kiwis had tried it, however, regular users are largely current and former cigarette smokers.
Electronic cigarettes are now legally available to anyone over the age of 18, making vaping a viable option for people wishing to change from traditional cigarette smoking (smoking combustible tobacco) to a less harmful alternative.
But, as with any new trend, many questions still remain. For example, ‘How much less damaging is vaping to your health, compared with traditional smoking?’ ‘Are there still risks for your heart health?’ And, ‘Is vaping a helpful way to quit smoking altogether?’
We asked ASH (Action for Smokefree 2025) Programme Manager, Boyd Broughton, to answer some of these commonly asked questions.
What is vaping and how does it work?
Vaping is the act of inhaling vapour produced by a vapouriser, also called an electronic cigarette or e-cigarette.
The vapour is produced by heating an ‘e-liquid’, also sometimes called an e-juice. The e-liquid is turned into vapour (atomised) inside the vaping device.
E-liquid generally consists of three ingredients; propylene glycol (PG), vegetable glycerine (VG) and flavouring. E-liquid may also contain nicotine.
Is it the same as e-cigarettes?
Yes. Vaping is the term for the action of using e-cigarettes (which are also known as electronic cigarettes, e-cigs, vaporisers, vapes).
Is vaping dangerous to my heart health?
It is widely accepted that there is always a risk when anything is inhaled into the lungs and, ideally, people should strive to live a life free of regular cigarette smoking or vaping.
Although vaping is safer than traditional cigarette smoking, it still potentially poses some risks to heart health. So, if you’re a non-smoker, don’t start vaping.
There are potential health risks linked to some of the chemicals found in vaping products. Aside from nicotine, the main ingredients in vaping liquids are vegetable glycerine and propylene glycol, which are considered safe for use in many consumer products (e.g. inhaled medicines, kai, foods, cosmetics and sweeteners).
The long-term safety of inhaling some of the flavouring substances is unknown, due to the rapid growth in new flavours available, however, these continue to be monitored and assessed. Research is still being carried out to fully understand the long term risks posed by the ingredients in vaping liquids.
Is nicotine-free vaping safer for my heart health than vaping with nicotine?
The nicotine in vaping liquid poses relatively little danger to people without heart disease. However nicotine can raise your heart rate and blood pressure (making your heart work harder). An e-cigarette is less harmful than continuing to smoke, however the safest way to manage nicotine withdrawal if you have heart disease is to use nicotine replacement therapy such as patches or gum that provide nicotine in lower doses.
Many smokers want to know how much nicotine is in a cigarette compared with an e-cigarette, but drawing a direct comparison is impossible. While we know the average amount contained in a tobacco cigarette (8.4mg), the quantity of nicotine that is ingested varies hugely depending on how fast the cigarette is smoked, how deeply the smoker inhales, and the proportion of cigarette that is smoked. Similarly, different vaping devices and the way they are used can change the level of nicotine absorption for people who vape.
The upside of vaping is that you can control the quantity of nicotine in your e-cigarette and reduce it over time.
Is vaping safer than smoking?
There is no doubt that smokers who switch to vaping dramatically reduce the risk to their health.
A 2016 report from the Royal College of Physicians in the UK (an organisation of senior doctors) says, “…the hazard to health arising from long-term vapour inhalation from the e-cigarettes available today is unlikely to exceed 5% of the harm from smoking tobacco.”
More recently, Public Health England (PHE) an agency of the UK’s Department of Health and Social Care, has published a report (PDF) encouraging smokers to switch to vaping and supporting the use of e-cigarettes as a stop smoking tool.
However, there remains some debate about the level of improved safety, given there are still some unknowns regarding long-term use. Ongoing monitoring is needed to ensure that if any new risks emerge, recommendations to smokers and regulatory requirements are revised accordingly.
If you decide to switch to vaping, quit conventional smoking completely. Smoking even a small number of tobacco cigarettes increases your risk of heart disease. A 2018 study in the British Medical Journal found that people smoking just one tobacco cigarette per day had 1.7 to 2.2 times the risk of non-smokers of heart disease and stroke than non-smokers.
Why is vaping safer than traditional smoking?
The PHE estimate that e-cigarette use is around 95% less harmful than smoking combustible tobacco. This is based on the following:
- constituents of cigarette smoke that harm health – including carcinogens – are either absent in e-cigarette vapour or, if present, they are mostly at levels much below 5% of smoking doses (mostly below 1% and far below safety limits for occupational exposure)
- the main chemicals present in e-cigarettes only have not been associated with any serious risks.
Can vaping lead to smoking?
There is no evidence that vaping acts as a gateway to smoking and other drugs for non-smokers. While vaping has increased in popularity in New Zealand, regular use among adults is largely by current and ex-smokers.
The same goes for vaping among teenagers. The ASH Year 10 Snapshot Survey has been monitoring vaping in New Zealand 14- and 15-year-olds since 2014. Overall, fewer than 2% of students reported vaping daily. Of those students who had never smoked cigarettes, fewer than 1% reported vaping daily.
Will vaping help me quit smoking?
Vaping is one of many tools and strategies that can help people to stop smoking.
Evidence is limited on the effectiveness of vaping products, compared with Nicotine Replacement Therapy (NRT). Results from the limited trials that have been done to date which compared the two, using now outdated vaping devices, showed that vaping products were equally as good as nicotine patches in helping people stop smoking. New research in this area is expected to be published by the New Zealand Ministry of Health in the near future.
What about studies that say vaping increases the risk of heart attack?
Because almost all vapers are smokers, or recent ex-smokers, there is a correlation between people who vape and increased incidence of heart attack. However, it is very difficult to attribute this to vaping, rather than smoking history.
Vapers and dual users (people who smoke both traditional cigarettes and vape) will be more likely to have had a heart attack because they are current or ex-cigarette smokers. It is most likely that vapers who experienced heart attacks did so as a consequence of traditional smoking.
While e-cigarettes are not 100% harm free, they are substantially (up to 95%) less harmful than traditional smoking.
Is vaping cheaper than smoking?
Vaping is significantly cheaper than smoking traditional cigarettes, approximately a tenth of the cost - puff for puff.
So what’s the conclusion then?
In summary, smoke-free and vape-free is the best option for heart health. If you don’t smoke, don’t start vaping. However, for those who already smoke tobacco, vaping may be a helpful stepping stone on the road to giving up. Vaping is a safer and cheaper alternative.
While there are some unknowns that continue to be monitored and assessed for risk, vaping is a considerably less harmful alternative to traditional tobacco smoking.
Remember, if you decide to switch to vaping, it’s important to completely stop smoking conventional cigarettes – even one a day raises your risk of heart disease.
Vaping has the support of the Ministry of Health government-funded smoking cessation (stop smoking) services throughout New Zealand. It is also possible to access vaping products direct from retailers who have experience and expertise regarding their use, maintenance and other technical information.
Websites with further information regarding vaping or support to stop smoking include:
- Quitline website
- Action for Smokefree website
- Health Promotion Agency Vaping Facts
- Public Health England press release about e-cigarettes
- Ministry of Health vaping information (PDF)
- Public Health England authors’ note on e-cigarette evidence (PDF)