Smoking Cigarettes vs. Vaping: Health Impact Comparison

Smoking cigarettes is significantly more harmful than vaping, though vaping is not harmless and carries its own health risks. 1

Comparative Health Risks

Smoking combustible cigarettes negatively impacts nearly every organ of the body and reduces life expectancy by approximately 10 years compared to non-smokers 1
Smoking is the leading cause of preventable mortality and morbidity worldwide 1
Globally, smoking and exposure to secondhand smoke are responsible for roughly 1 in 5 (21%) of all deaths attributed to coronary heart disease 1
Smoking increases the risk of all types of cardiovascular disease including coronary heart disease, ischemic stroke, and peripheral arterial disease 1
The relative risk of myocardial infarction in smokers under 50 years is five-fold higher than in non-smokers 1

E-cigarettes contain and emit numerous potentially toxic substances beyond just nicotine, though exposure is highly variable based on product characteristics and usage patterns 1
Compared with combustible tobacco cigarettes, e-cigarette use likely poses less risk, but is not harmless 1
Growing evidence shows e-cigarettes and their constituents (nicotine, vaporizing solvents, particulate matter, metals, and flavorings) can have deleterious effects on the cardiovascular system, respiratory system, and brain 1
Vaping has been associated with cases of exogenous lipoid pneumonia, diffuse alveolar hemorrhage, and vaping-associated bronchiolitis obliterans 2

E-cigarette use among youth poses a clear threat to public health with dramatic increases in usage among young people in the United States 1
E-cigarette use is associated with increased odds of smoking combustible cigarettes among adolescents who had no previous intention of smoking conventional cigarettes 1
The introduction of high-nicotine delivery systems has transformed the e-cigarette landscape and increased addiction potential for young people 1

Many e-cigarette users also continue to smoke cigarettes, and dual use is not associated with higher rates of quitting 1
Recent research suggests that dual use of vaping and smoking may be associated with higher risk of lung cancer than smoking alone 3
The Forum of International Respiratory Societies recommends that individuals using e-cigarettes to quit smoking should avoid using both combustible and electronic cigarettes simultaneously 4

Evidence is limited regarding the efficacy of e-cigarettes as a smoking cessation aid 1
A 2020 Cochrane review found only moderate evidence that quit rates were higher among those using nicotine e-cigarettes compared with nicotine replacement therapy or non-nicotine e-cigarettes 1
E-cigarettes are not approved as smoking cessation aids by regulatory agencies, unlike standard nicotine replacement therapies 5

Pharmacotherapy plus counselling improves smoking cessation compared with either pharmacotherapy or counselling alone 1
Stopping smoking increases life expectancy at any age - those who quit at 30,40, or 50 years gain about 10,9, and 6 years of life expectancy, respectively, compared with continued smokers 1
The US Preventive Services Task Force recommends focusing on proven behavioral counseling and FDA-approved pharmacotherapy for smoking cessation rather than e-cigarettes 5

Healthcare providers should advise individuals to avoid both smoking and vaping for optimal health outcomes 4, 5
If patients are using e-cigarettes to quit smoking, they should be advised to avoid dual use and develop a plan to eventually quit e-cigarettes as well 4
Screening for tobacco, nicotine, and electronic cigarette use should be incorporated into routine healthcare visits 4
The benefits of smoking cessation on cardiovascular risk become apparent within 2-5 years after quitting 4

Many people incorrectly perceive e-cigarettes as harmless or significantly less harmful than traditional cigarettes 4
Long-term epidemiological studies of e-cigarettes are challenging because these products have evolved rapidly since their emergence 1
The claim that vaping is completely safe is not supported by current evidence, though it appears to be less harmful than combustible cigarettes 1, 6
Recent studies have raised concerns about potential long-term risks of vaping, including cardiovascular disease, chronic obstructive lung disease, and cancer 7