Vaping vs. Smoking: The Real Health Risks You Need to Know

Cigarette smoking has been recognised as one of the most preventable causes of death worldwide, linked to millions of cases of cancer, heart disease, and respiratory illness each year.

In recent years, vaping has emerged as a perceived “safer” alternative, marketed as a harm-reduction tool for smokers.

A study presented at the 2024 European Respiratory Society (ERS) Congress by Manchester Metropolitan University found that young vapers, like young smokers, showed significantly reduced exercise capacity and oxygen intake compared to non-vapers.

Both groups also exhibited impaired blood vessel function, higher muscle fatigue, and greater breathlessness during strenuous activity, challenging the idea that vaping is harmless.

However, growing evidence shows that e-cigarettes are not without risks, especially for young people and non-smokers. 

1. Chemical Exposure and Toxicity

• Smoking releases over 7,000 chemicals, including tar, carbon monoxide, formaldehyde, benzene, and heavy metals, many of which are toxic or carcinogenic. It’s the leading cause of lung cancer, Chronic Obstructive Pulmonary Disease, heart disease, and other fatal illnesses.
  
• Vaping, while lacking many combustion-related toxins, still exposes users to dangerous substances like formaldehyde, volatile organic compounds (VOCs), diacetyl, acrolein, heavy metals, and ultrafine particles. In some tests, a mere 15 puffs could generate as much formaldehyde as a cigarette.

2. Respiratory and Cardiovascular Impact

• A Manchester Metropolitan University study found that both vapers and smokers showed significantly poorer performance in strenuous exercise tests, with lower peak power output and reduced oxygen capacity, signaling similar cardiovascular and respiratory harm.
  
• Vaping has also been linked to arterial wall dysfunction, elevated heart rate, increased blood pressure, higher stroke and heart attack risk, and vaping-associated lung injury, especially from illicit THC or tetrahydrocannabinol products.
  
• Longitudinal data shows e-cigarette use can raise the odds of developing chronic lung diseases, and when combined with smoking (“dual use”), risks multiply.
  

3. Addiction and Developmental Effects

• Both cigarettes and many e-cigarettes deliver high levels of nicotine: some vapes match the nicotine content of a whole pack of cigarettes.
  
• Nicotine is especially harmful to developing brains, leading to long-term cognitive, emotional, and behavioural impairment. Adolescents and young adults are particularly vulnerable.

4. Economic and Environmental Dimensions

• In countries like the UK, research indicates that vaping can significantly reduce personal spending and healthcare costs compared to smoking. A pack-a-day smoker might spend over £5,000 annually versus £600–£950 for a vaper.
  
• Environmentally, vaping, particularly disposable devices, creates growing e-waste and contributes to plastic and lithium pollution. Millions of units are discarded weekly, posing recycling challenges.
  

5. Public Health and Youth Considerations

• Vaping has helped some smokers quit and lowered smoking rates, but it’s also introduced nicotine to many youths who’d never smoked. By 2019, nearly 30% of high schoolers in the U.S. reported vaping.
  
• Calls for stronger regulation, such as the UK’s incoming ban on disposable vapes to protect children, signal growing concern over youth uptake.