Vaping may help you quit smoking cigarettes — but that doesn't make it a safer alternative

• Vaping is not a safer alternative to smoking cigarettes.
• Though long-term research is still emerging, early evidence indicates that vaping can still damage the lungs and cause serious chronic lung diseases like bronchiolitis obliterans.
• In addition, some harmful vaping products can cause a deadly condition called E-Cigarette and Vaping Product Use-Associated Lung Injury (EVALI).
• This article was reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine.

When e-cigarettes first came on the market in the mid-2000s, they were touted as a safer alternative to traditional cigarettes, and even a way for tobacco users to quit smoking. However, vaping still causes serious health complications.

Here's what you need to know about how vaping compares to smoking and the health risks associated with e-cigarettes.

Is vaping better than smoking?

The assumption that vaping is less harmful than smoking is demonstrably false, says Osita Onugha, MD, thoracic surgeon and assistant professor of thoracic surgical oncology at John Wayne Cancer Institute at Providence Saint John's Health Center.

Because vaping is relatively new compared to traditional cigarettes, there are fewer studies and data available to show the long-term effects of vaping and how they compare to the risks associated with smoking, like cancer and heart disease, Onugha says.

But we do know vaping causes inflammation that can lead to lung damage, and e-cigarettes still contain nicotine, the same addictive drug in traditional cigarettes.

E-cigarettes are thought to be less carcinogenic, or less likely to cause cancer, because they contain fewer chemicals than regular cigarettes, according to the National Cancer Institute. But just because there are fewer chemicals doesn't make them any less harmful.

The chemicals in e-cigarettes are still capable of causing serious health complications, like lung disease and heart disease. It took decades to gather the data to show how harmful traditional cigarettes are, and it will take time to show the harmful effects of vaping as well.

"If you look at vaping, we have this early data suggesting there are health risks associated with e-cigarette use," Onugha says. "So would I be surprised if 20 years from now we demonstrate that prolonged e-cigarette use can cause cancer? No, I would not be surprised at all."

The US Food and Drug Administration (FDA) does not currently require safety testing of all the substances in e-cigarettes, says Jamie Garfield, MD, national spokesperson for the American Lung Association. Common substances found in e-cigarettes include:

• Acrolein, which can damage the lungs and is often used as a weed killer.
• Diacetyl, which helps enhance the flavor of e-cigarettes and has been linked to bronchiolitis obliterans, a serious chronic lung disease.

Studies demonstrating the long-term effects of vaping in humans are still emerging, but some animal studies have shown the potential for e-cigarettes to cause the same level of harm as traditional cigarettes. It's important to note that the results of animal studies cannot be extrapolated to humans.

A 2019 animal study exposed mice to e-cigarette vapor for four months — about a quarter of a mouse's lifespan. The mice did not develop complications typically associated with smoking, like emphysema, but did develop lung damage, causing inflammation that reduced the efficacy of the immune system.

Another 2019 study found that mice who had been exposed to e-cigarettes for 54 weeks had an increased risk of lung cancer and also displayed changes in bladder cells that could cause cancer.

While researchers are still unsure of the long-term health risks of vaping in humans, the early data indicates that vaping can cause serious lung injury and other health complications, Onugha says. E-cigarettes may contain fewer chemicals than traditional cigarettes, but that doesn't make them safer.

Does vaping help you quit smoking?

Vaping is harmful, but some studies have shown it is effective in helping people quit using regular cigarettes. A 2019 study, partially funded by the pharmaceutical companies Pfizer and Johnson and Johnson, found that people who used vaping as a way to quit smoking had a one-year quit rate of 18% compared to about 10% in the nicotine replacement therapy group.

However, while the subjects quit smoking regular cigarettes, 80% were still vaping a year later, while only 9% of people in the nicotine replacement group who quit smoking were still using a nicotine replacement.

"E-cigarettes have been marketed as a way to help people wean or stop cigarette smoking," Onugha says. "But essentially you're trading one problem for another."

While some tobacco users have successfully quit smoking and attribute that to vaping, e-cigarettes still contain nicotine, which is highly addictive, Garfield says. Some e-cigarette manufacturers claim their products have less nicotine than traditional cigarettes, but newer products are becoming more efficient at delivering nicotine to users.

If you're struggling to quit smoking, there are better ways to do it. These include:

• Behavioral counseling
• FDA-approved nicotine replacement therapy
• Prescription medications like Chantix
• A combination of counseling and medication

"It's very difficult to quit an addiction, and nicotine addiction is no different," Garfield says. "And a lot of times it has to be approached in a multi-faceted way."

Vaping is still bad for you

While the long-term effects of vaping in humans are still unknown, it's clear vaping harms the lungs and can lead to serious health complications, Garfield says.

In August 2019, health officials across the country noticed an outbreak of severe lung infections in otherwise healthy individuals. The Centers for Disease Control (CDC) named this condition E-Cigarette or Vaping Product Use-Associated Lung Injury or EVALI. Symptoms include:

• Shortness of breath
• Rapid heartbeat
• Shallow breathing
• Fever and chills
• Chest pain
• Nausea and vomiting

More than 2,000 people have been hospitalized for EVALI in the United States and dozens have died, according to the CDC. Laboratory data show a strong link between vitamin E acetate, a common additive in e-cigarettes, and the EVALI outbreak.

Vitamin E is commonly found in many foods, like vegetable oils, meats, and fruits, and is usually not harmful when ingested. However, when vitamin E is inhaled, it can interfere with normal lung functioning.

Bottom line

Some studies show that vaping can help people quit using regular cigarettes, but that doesn't make it a safer alternative. The long-term health complications of vaping are still unknown, but preliminary data show it damages the lungs and could lead to serious infections.

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