Is Vaping Better Than Smoking?

The increase in e-cigarette use, particularly among young people, is a dangerous trend with real health risks. For many reasons, e-cigarettes should not be promoted as a safe alternative to smoking.

While fewer people are smoking or starting to smoke than ever before, many are using other forms of tobacco and electronic nicotine delivery systems. The increase in e-cigarette use (also called vaping) by kids and young people in recent years is a serious public health threat.

The battery-operated devices come in many forms and can look like conventional cigarettes, pens or even sleek tech gadgets. Users inhale and exhale a vapor-like aerosol. This way of taking in nicotine poses health risks to both users and non-users.

Many downsides and few potential upsides

E-cigarette promoters claim the devices can help people quit smoking. But much more evidence is needed to determine if they are an effective way to quit. Research suggests that users are more likely to continue smoking along with vaping, which is referred to as “dual use.”

The American Heart Association recommends proven methods to successfully quit smoking.

Many people think vaping is less harmful than smoking. While it’s true that e-cigarette aerosol doesn’t include all the contaminants in tobacco smoke, it still isn’t safe. Here are just a few of the reasons why:

• Most e-cigarettes deliver nicotine, which is highly addictive and can harm the developing brains of teens, kids and fetuses in women who vape while pregnant. Some types expose users to even more nicotine than traditional cigarettes.
  
  
• In addition to nicotine, e-cigarette vapor includes potentially harmful substances such as diacetyl (a chemical linked to a serious lung disease), cancer-causing chemicals, volatile organic compounds and heavy metals such as nickel, tin, and lead. Users breathe in these toxic contaminants, and non-users nearby risk secondhand exposure.
  
  
• The liquid used in e-cigarettes can be dangerous, even apart from its intended use. Children and adults have been poisoned by swallowing, breathing or absorbing the liquid through their skin or eyes.
  
  
• E-cigarettes have been linked to thousands of cases of serious lung injury, some resulting in death. While the exact cause is still not confirmed, the CDC recommends that people not use e-cigarettes.

E-cigarettes’ biggest threat to public health may be this: The increasing popularity of vaping may “re-normalize” smoking, which has declined for years. Reversing the hard-won gains in the global effort to curb smoking would be catastrophic. Smoking is still the leading preventable cause of death and is responsible for over 480,000 deaths in the U.S. each year.

A threat to kids and young people

Tobacco companies want to hook a new generation on nicotine and smoking.

• They spent more than $8.2 billion on aggressive marketing in 2019 alone. That’s more than $22 million each day and almost $1 million every hour!
  
  
• Nearly 76% of middle and high school students — that’s 3 out of 4 kids — were exposed to tobacco product advertising in 2021. And about 74% of students had seen e-cigarette-related posts and content through social media.
  
  
• E-cigarettes are the most common form of tobacco use by kids and teens. Over 2.1 million youth are currently using e-cigarettes, with a decline in use by high school students in the U.S. in 2022-2023.
  
  
• Many young people say they’ve tried e-cigarettes in part because of the appealing flavors. Among youth currently using e-cigarettes, almost 9 out of 10 use flavored ones.

More effort and research are needed

The U.S. Surgeon General called e-cigarette use among young people a “public health concern.” The American Heart Association shares that view. That’s why we advocate for stronger regulations that:

• Include e-cigarettes in smoke-free laws.
  
  
• Regulate and tax e-cigarettes in the same way as all other tobacco products.
  
  
• Remove all flavors, including menthol, which make these products more appealing to kids and young adults.
  
  
• Enforce the federal law that raised the minimum age for sale of tobacco products from 18 to 21 years.

The AHA supports maintaining the Food and Drug Administration’s regulatory authority over e-cigarettes along with other tobacco products.

What’s the bottom line?

• Kids, young adults and pregnant women should not use or be exposed to e-cigarettes.
  
  
• People trying to quit smoking or using tobacco products should try proven tobacco cessation therapies before considering using e-cigarettes, which have not been proven an effective method.
  
  
• People who do not currently smoke or use tobacco products should not use e-cigarettes.

The long-term health effects of e-cigarettes are not well understood yet. But the science clearly indicates vaping is not a safe or healthy alternative to smoking. We’ll continue to support research into the health consequences of this and other tobacco product trends that aim to appeal to a new generation of users.