What is worse, cigarettes or vaping?

From the Guidelines

Cigarettes are generally considered worse than vaping, though neither is safe. Traditional cigarettes contain thousands of chemicals, including at least 70 known carcinogens, and produce tar and carbon monoxide which cause significant damage to the lungs and cardiovascular system 1. Vaping products typically contain fewer toxic chemicals and don't produce tar, but they still deliver nicotine (often in high concentrations) and contain potentially harmful substances like propylene glycol, vegetable glycerin, and various flavorings whose long-term effects aren't fully understood.

Key Differences and Risks

• Cigarettes have a well-established link to various cancers, heart disease, and other serious health conditions, with a significant body of evidence supporting their harmful effects 1.
• Vaping, while potentially less harmful than smoking, poses its own set of risks, including nicotine addiction, respiratory issues, and exposure to toxic substances, with its long-term health effects still being researched 1.
• The introduction of e-cigarettes has led to an increase in nicotine use among youth, which is a significant public health concern, as it can lead to addiction and other health problems 1.

Recommendations for Quitting

For those trying to quit smoking, evidence-based approaches include:

• Nicotine replacement therapies (patches, gum, lozenges)
• Prescription medications like varenicline (Chantix) or bupropion (Zyban)
• Behavioral counseling, which can significantly increase success rates when used properly 1.

Conclusion on Safety

While vaping may be less harmful for current smokers as a transitional tool toward quitting nicotine altogether, it's not risk-free and should not be started by non-smokers. The best health choice is to avoid both cigarettes and vaping products entirely. Given the potential risks and the lack of comprehensive long-term data on vaping's health effects, caution is advised, and smokers are encouraged to explore evidence-based cessation methods rather than switching to vaping without a clear plan to quit nicotine use altogether.

From the Research

Comparison of Cigarettes and Vaping

• Both cigarettes and vaping have been linked to various health risks, including cardiovascular and pulmonary disease 2, 3, 4, 5.
• Cigarette smoking is a well-established risk factor for many diseases, including cancer, chronic obstructive pulmonary disease, and heart disease 6.
• Vaping, on the other hand, has been associated with a range of health problems, including lung injury, nicotine addiction, and increased risk of COVID-19 2, 4, 5.
• While some studies suggest that e-cigarettes may be a safer alternative to traditional cigarettes, the evidence is not conclusive, and more research is needed to fully understand the risks and benefits of vaping 3, 5.

Health Risks of Cigarettes

• Cigarette smoking is the leading cause of preventable death worldwide, accounting for over 7 million deaths per year 6, 5.
• Smoking is linked to a range of health problems, including cancer, heart disease, and chronic obstructive pulmonary disease 6.
• Quitting smoking can significantly reduce the risk of these health problems, and smoking cessation treatments are highly effective 6.

Health Risks of Vaping

• Vaping has been linked to a range of health problems, including lung injury, nicotine addiction, and increased risk of COVID-19 2, 4, 5.
• The use of e-cigarettes has been associated with a range of acute and chronic health effects, including cardiovascular and pulmonary disease 2.
• The long-term health effects of vaping are not yet fully understood, and more research is needed to fully assess the risks and benefits of e-cigarettes 3, 5.

Regulatory Efforts

• Regulatory efforts are underway to reduce the risks associated with vaping, including restrictions on the sale and marketing of e-cigarettes 2, 4.
• Public health campaigns are also being implemented to educate the public about the risks of vaping and to prevent youth initiation of e-cigarette use 4.
• More research is needed to fully understand the risks and benefits of vaping and to inform regulatory efforts 3, 5.