Ask the Doc: Is vaping worse than smoking cigarettes?

Vapes and e-cigarettes have only been around for less than 20 years, so we can’t be sure of the long-term health effects like we can with tobacco smoking. It took around 50 years to realise that tobacco smoking caused lung cancer. The short-term effects of vaping are dangerous enough though, and they suggest there will be long-term consequences.

Vaping and smoking are both bad for your health. Some of their effects on your heart, lungs, blood vessels and brain are the same and some are a bit different, but none of them are good. 

Modern vapes are just as effective at delivering nicotine into the bloodstream as cigarettes, so the effects of the drug when you take a puff are the same, including the addictive effect. This means that getting hooked on vaping might be just as likely as becoming addicted to cigarettes. The nicotine in vapes and cigarettes acts on the nervous system to increase heart rate, blood pressure and narrowing of blood vessels (vasospasm), which can reduce blood flow, cause abnormal heart rhythms and even cause sudden death.

Cigarettes and vapes are different when it comes to the other chemicals and particles that are inhaled. The levels of many damaging chemicals that are inhaled from vapes are lower than from cigarettes, but their levels are still high enough to cause concern. Vapes also contain chemicals not found in cigarette smoke, that come mainly from the fluid and thousands of different chemicals used to add flavour. An analysis of 65 common liquids used in vapes available in Australia found many contained carcinogenic and other harmful ingredients, including a group of chemicals called polycyclic aromatic hydrocarbons (PAHs), which have been linked to lung, bladder and gastrointestinal cancers. 

The vapour produced by vapes is created in the same way as the ‘smoke’ from smoke machines they use at concerts. Studies done long before the use of vapes show that the smoke from smoke machines causes coughing and irritation of the respiratory system, and over time reduces lung function.

Each vape on the market can contain different types of fluid and levels of nicotine and generate different ranges of temperature. Since 2021, all nicotine vaping products can only be purchased with a doctor’s prescription. So, if you’re using a vape without a prescription, that means it has not been regulated and you cannot know what you’re breathing in when you vape. A few years ago, there was a spate of sudden deaths and severe lung damage among vapers in the United States that was traced to a vitamin E compound in the fluid. You can’t be sure about the contamination of vapes with such poisonous substances.

Rising rates of vaping among young people, many of whom probably would not have smoked cigarettes, place them at risk of problems with brain development and thinking, mental health problems, worse asthma, inflammation of the airways and lungs, headaches, insomnia, weakness and chest pain. Vaping also makes it more likely that someone will smoke or use other drugs.

It does seem that vapes help people to stop smoking cigarettes and other tobacco products when compared to alternative ways of quitting, and on balance, vaping might cause less harm than smoking. However, it’s better to not do either.

Want help quitting? Visit quit.org.au