From the Guidelines
Vaping is not a safer alternative to smoking, and both pose significant health risks, with the safest choice being to avoid both entirely. The most recent and highest quality study, published in 2025 in the journal Diabetes Care 1, highlights the risks associated with vaping, including nicotine dependence, cardiovascular issues, and respiratory problems. While vaping may be perceived as less harmful than smoking, the long-term effects of vaping remain unclear, and it is not recommended as a cessation tool or recreational activity, especially for individuals with diabetes.
Key Points to Consider
- Vaping can lead to nicotine dependence, especially in young people who might not otherwise use tobacco products 1.
- E-cigarettes deliver nicotine, which is highly addictive regardless of delivery method, and can cause lung damage, cardiovascular issues, and contain harmful chemicals despite having fewer toxins than cigarettes 1.
- The safest choice is to avoid both smoking and vaping entirely, and if you're a current smoker considering vaping to quit, consult with a healthcare provider about FDA-approved cessation methods like nicotine replacement therapy, which have proven safety and effectiveness records 1.
- Emerging data have demonstrated that electronic nicotine delivery systems have a positive effect on smoking cessation rates, but long-term health-related outcomes with use of these systems have not been evaluated, and additional clinical investigation is needed to establish their safety and efficacy for smoking cessation 1.
Recommendations for Smokers
- Quitting smoking and other forms of tobacco is important for reducing the risk of developing peripheral artery disease (PAD), the progression of established PAD, and the risk of limb-related events and death 1.
- Both pharmacological and behavioral-based strategies, alone or in combination, increase smoking cessation rates, and nicotine replacement therapy, bupropion, or varenicline can be effective options 1.
- Consult with a healthcare provider about FDA-approved cessation methods, which have proven safety and effectiveness records, rather than relying on vaping or e-cigarettes as a cessation tool 1.
From the Research
Comparison of Vaping and Smoking
- Vaping and smoking are both nicotine delivery methods, but they have different mechanisms and potential health effects 2, 3.
- Smoking is a well-established cause of lung cancer and other respiratory diseases, while the long-term effects of vaping are still being studied 2.
- Some studies suggest that vaping may be associated with an increased risk of lung cancer, although the evidence is not yet conclusive 2.
Health Effects of Vaping
- Vaping has been linked to respiratory health problems, including lung injury and chronic obstructive pulmonary disease (COPD) 3.
- The 2019 E-cigarette or Vaping Use-Associated Lung Injury (EVALI) outbreak highlighted the potential harms of vaping, particularly among young people 3.
- Vaping products often contain toxic chemicals, including heavy metals and carcinogens, which can be harmful to the lungs and other organs 2.
Smoking Cessation
- Nicotine replacement therapy (NRT) is a commonly used method for smoking cessation, and it has been shown to be effective in helping people quit smoking 4, 5.
- Vaping has been marketed as a potential tool for smoking cessation, but its effectiveness and safety for this purpose are still being debated 3.
- Some studies suggest that vaping may be helpful for smoking cessation, particularly among people who have tried other methods and failed 3.