Is Vaping Worse than Smoking?

Sophie Wei
Sophie Wei12 Dec 2022

E-cigarettes, also known as vapes, are a type of device that heats a nicotine-containing liquid and vaporizes it. The vapor is inhaled and helps produce a similar effect to traditional cigarettes. Although e-cigarettes were initially introduced as a healthier alternative to traditional cigarettes, usage has recently surged to epidemic levels and has proven to pose a serious risk to public health. 

Consistent visits and check-ups with your primary care doctor can help prevent or catch any potential side effects of e-cigarette usage. A membership with Mira includes $5 virtual care appointments and affordable virtual and urgent care, lab testing, and prescription medications. Sign up for Mira today to help keep your health on track. 

Health Risks of E-Cigarettes and Vaping

Using e-cigarettes can lead to various health conditions. In adolescents especially, nicotine in e-cigarettes is not only highly addictive but can lead to issues with brain development, mental health, and cognition. Although more research is needed to determine if e-cigarette usage directly causes these issues, substantial evidence demonstrates an association between vape or e-cigarette usage and mood-related disorders such as depression, anxiety, and suicidal ideation.  

Nicotine is also harmful to fetal development, can raise the risk of birth defects, brain and lung development issues, and is associated with miscarriages. Nicotine is classified as a Pregnancy Category D drug by the FDA, which indicates clear evidence of risk to fetus development. 

Finally, vaping can also worsen certain pre-existing medical conditions. Lung-related illnesses such as chronic obstructive pulmonary disease (COPD) and asthma could be exacerbated by e-cigarette usage. The aerosol in e-cigarettes can irritate the lung airways, trigger asthma attacks, and contribute to long-term lung diseases.  

Toxic Ingredients in E-cigarettes

Although research might be lacking in the field of e-cigarette usage due to its novelty, there is a lot of evidence of the potentially harmful effects of the chemicals in these devices. Even though e-cigarettes lack the primary cancer-causing “tar” in traditional cigarettes, e-cigarettes are likely to have increased levels of heavy metals, nicotine, and chemical flavoring. 

The aerosol in e-cigarettes can include several harmful chemicals. The table below outlines some e-cigarette ingredients and their potential toxic effects on the human body.  

E-cigarette Ingredients and Side Effects

E-cigarette Ingredients Potential Toxic Effects 

Slow brain development

Mental health disorders

Fetal toxicity

Ultra-fine particles

Heart conditions (heart attack, stroke) 

Increased cancer risk 

Worsened COPD and asthma 

Diacetyl (flavoring)

Popcorn lung


Breathing problems 

Volatile organic compounds (i.e. Benzene) 


Increased cancer risk

Skin diseases 

Heavy metals (i.e. cadmium, lead, nickel, chromium) 

Kidney dysfunction

Gastrointestinal dysfunction

Birth defects 

Propylene glycol and glycerin

Dry mouth 

Dry throat 

Allergic reactions

Acrolein, formaldehyde 

Increased risk of cancer 

Heart conditions (heart attack, stroke) 

DNA damage 

Potential Long Term Effects of Using E-Cigarettes and Vapes

With e-cigarette use being a new trend, there is minimal data about long-term health effects. However, trends and associations with serious disease states have emerged and indicated a need for more awareness and concern about these products. 

Vaping or e-cigarette usage can lead to irreversible damage to your lungs. These include but are not limited to the following:  

  • Popcorn Lung is a serious illness where damaged lung tissue blocks proper airflow. The flavoring ingredients in vape liquid can cause popcorn lung.
  • Lipoid Pneumonia is a condition where fat buildup in the lungs leads to inflammation, which can cause chest pain and difficulty breathing. This condition is caused by the oil in e-cigarette liquid.
  • Spontaneous Pneumothorax is when the lung collapses, leading to severe chest pain. This condition has also been found to be associated with vaping.
  • EVALI, which stands for “e-cigarette or vaping product use associated lung injury,” includes many serious lung diseases that can occur from the use of vapes or e-cigarettes.

Furthermore, adolescent e-cigarette usage has been associated with an increased likelihood of transitioning to traditional cigarettes in adulthood. According to the literature, e-cigarettes users were six times more likely than non-users to start smoking cigarettes.

E-cigarette Trends and Marketing 

The addictive nature of E-cigarettes, in addition to their convenient size and appealing flavoring, has led to a rapid increase in youth e-cigarette usage in the past five years. According to the Annual National Youth Tobacco Survey, more than 2 million U.S youth currently use e-cigarettes. 

The average e-cigarette user has shifted from adults trying to quit traditional cigarettes to youth and adolescents who are vaping socially. For instance, adolescents ranging from 15-17 years of age are 16 times more likely to vape than adults aged 25-34. From 2011 to 2019, youth e-cigarette use rose by 1,800%. 

This drastic increase in vaping and e-cigarette use can be mainly attributed to the following reasons:

  • Health Misconceptions
  • Flavoring
  • Social Media Marketing
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Health Misconceptions

E-cigarettes are widely marketed as a healthy and safe alternative to traditional cigarette usage. Although there is evidence to support that e-cigarettes are less harmful than traditional cigarettes, this does not mean that they are safe or healthy. 

Additionally, the tobacco industry’s history of marketing its products to people with mental health issues has fueled the misconception that cigarettes and nicotine are stress-relievers. This type of marketing has had a lasting impact, with over 50% of frequent users claiming they use tobacco products to cope with stress anxiety. On the other hand, nicotine usage and subsequent withdrawal actually lead to increased anxiety, depression, and stress. 


The 2009 Family Smoking Prevention and Tobacco Control Act placed major restrictions on tobacco marketing to children. For instance, tobacco products now require warning labels, a list of ingredients, and banned flavors in cigarettes. In 2019, the Trump Administration banned e-cigarette flavoring in cartridge-based cigarettes, except for flavored pods that are still sold at convenience stores. 

Even with these restrictions in place, companies such as JUUL are still successfully advertising their flavored products to youth. It was found that 43% of youth started using e-cigarettes directly because of flavoring, and nearly 85% of current users choose to use flavored e-cigarettes. 

Social Media Marketing

Social media and online advertising have been major avenues for e-cigarette and vape sales. Companies like JUUL, which currently dominate the e-cigarette market, targeted their products to appeal and align with youth culture. Although JUUL asserted that their product was meant for adult smokers only, their advertisements often depicted popular youth influencers and celebrities. 

Additionally, even though traditional cigarette advertisement is prohibited, social media advertising for vape products is largely unregulated. As such, JUUL frequently marketed its products across popular social media platforms until 2018, after they received public backlash. 

E-Cigarette and Vaping Frequently Asked Questions (FAQs)

Although research might be lacking in the field of e-cigarette usage due to its novelty, it is important to have a clear understanding of the potential risks of using e-cigarettes. Below are some answers to frequently asked questions about e-cigarettes that can help further your understanding of the topic.

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Are e-cigarettes less harmful than regular cigarettes? 

The aerosol from e-cigarettes is generally safer than traditional tobacco cigarettes. Specifically, e-cigarettes do not produce tar or carbon monoxide, which are two of the most harmful ingredients in traditional cigarette smoke. However, this does not mean that e-cigarettes are safe. Due to the unpredictable nature of e-cigarette ingredients, in addition to a profound lack of evidence and research, make sure to exercise caution if you choose to vape. 

Can e-cigarettes help adults quit traditional cigarettes? 

There is minimal evidence about whether or not e-cigarettes are a helpful agent in smoking cessation. E-cigarettes for smoking cessation are not FDA approved, and more research is necessary in this field. However, there are many other evidence-based methods and therapies to help you quit smoking, such as nicotine patches, inhalers, and other prescription medications like Varenicline.

If you are looking to quit smoking, make sure to talk to your primary care physician to develop an active quit-smoking plan. In addition to your primary care provider, there are several online resources to help you quit vaping. Below are some sites with helpful information and resources: 

What are the early warning signs for vaping-related diseases? 

Early signs of vaping-related illness include chest pain, difficulty breathing, fever, chills, cough, shortness of breath, nausea and vomiting, diarrhea, and weight loss. However, most of these symptoms are non-specific and might not always indicate a vaping-related illness. 

It is important to note that you are more at risk for vaping-related diseases if your vaping product contains Vitamin E acetate. This ingredient has been linked to EVALI (e-cigarette or vaping product use associated lung injury). If you are a consistent e-cigarette user and are experiencing these symptoms, make sure to get in contact with your primary care provider and schedule an appointment. 

Can vaping cause lung cancer? 

E-cigarettes have not been long enough to establish a direct relationship between e-cigarettes and increased cancer development. However, the ingredients in some e-cigarettes have been proven to increase cancer risk. Especially in people who have never smoked before, vaping can increase the risk of developing lung cancer in particular. 

Bottom Line 

The unpredictability and sudden popularity of e-cigarettes pose a serious risk to public health. Although generally safer than traditional tobacco cigarettes, vaping can lead to irreversible damage to your lungs and overall health. If you suspect that you might have a vaping-related illness, make sure to contact your doctor to prevent any serious complications. 

Mira can help you stay on top of your routine doctor visits and can help you manage or prevent any e-cigarette related symptoms or conditions. Starting at an average of $25 a month, you can receive access to low-cost primary and urgent care. Sign up for Mira today! 

Sophie Wei

Sophie is a 2024 Pharm D. candidate studying pharmacy at Rutgers University, New Brunswick. She has a passion for healthcare and writing and hopes to make meaningful contributions to healthcare transparency and accessibility. In her free time, she likes to take care of her houseplants, cook, and hang out with her cat.