The risks of smoking are clear: cigarettes kill over half of their long-term users. The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing more than eight million people per year worldwide.
Experts agree that vaping is one of the most effective tools to help smokers quit. However, a recent study shows that most smokers wrongly believe that vaping is at least as harmful as smoking.
Here we round up five scientific studies that prove vaping is far less risky to health than smoking.
1. Nicotine vaping in England: 2022 evidence update - King’s College London, September 2022
King’s College researchers were one of the first groups in the world to study the use of vapes in 2015.
Their regular scientific reviews - which receive global attention - have identified not only that vaping helps tobacco smokers quit, but also that it is significantly less harmful than smoking.
The latest review, published in September 2022, revealed that vapers are “far less exposed” to toxicants that lead to cancer, lung disease and cardiovascular disease than smokers. It concluded that vaping carries “drastically lower” health risks than smoking.
The report, commissioned by the Office for Health Improvement and Disparities in the Department of Health and Social Care, is considered to be the most comprehensive of its kind to date.
It found that, while vaping is not risk free (particularly for people who have never smoked), it poses a “small fraction” of the health risks of smoking in the short to medium term.
“The levels of exposure to cancer-causing and other toxicants are drastically lower in people who vape compared with those who smoke,” said Dr Debbie Robson, a Senior Lecturer in Tobacco Harm Reduction King’s IoPPN and one of the report’s authors.
“Helping people switch from smoking to vaping should be considered a priority if the Government is to achieve a smoke-free 2030 in England.”
The landmark report examined studies of ‘biomarkers of exposure’ (measures of potentially harmful substance levels in the body) as well as ‘biomarkers of potential harm’ (measures of biological changes in the body) due to vaping and smoking.
The strongest evidence, and where there was the greatest volume of research, came from biomarkers of exposure. Levels of tobacco-specific nitrosamines, volatile organic compounds and other toxicants implicated in the main diseases caused by smoking were found at significantly lower levels in vapers.
Professor Ann McNeill, a professor of tobacco addiction at King’s IoPPN and the report’s lead author, said: “Smoking is uniquely deadly and will kill one in two regular sustained smokers, yet around two-thirds of adult smokers, who would really benefit from switching to vaping, don’t know that vaping is less harmful.”
She added that vaping is not completely risk free and therefore should not be taken up by people who don’t already smoke.
Dr Jeanelle DeGruchy, Deputy Chief Medical Officer for England said: “Every minute someone is admitted to hospital in England due to smoking. Every eight minutes someone dies a smoking-related death.
“This important study is the latest in a series which carefully pulls together the science on vaping to help reduce the damage from smoking.”
2. ‘No Smoke, Less Harm’ - Smoke Free Sweden
This landmark report - published in May 2024 - provides compelling evidence that nicotine use does NOT lead to tobacco-related disease.
The study shows that Sweden has dramatically lower rates of tobacco-related deaths and health issues than other European nations - despite similar levels of nicotine intake.
In Sweden, one in four adults use nicotine daily, the same as across Europe. However, the Scandinavian country reports a massive 41 per cent lower incidence of lung cancer and fewer than HALF the tobacco-related deaths of 24 out of 26 of its European peers.
This stark contrast is attributed to the widespread adoption of smoke-free nicotine products such as snus, nicotine pouches and vapes.
“This distinction between smoking and the use of smokeless products is crucial,” says Dr. Karl Fagerström, a public health expert and contributor to the report.
The study compares rates of nicotine usage and different tobacco-related diseases in Sweden against other countries. It finds categorically that nicotine use is not a factor in tobacco-related health issues.
“Despite widespread misperceptions, nicotine does not cause cancer and has minimal, if any, contribution to tobacco-related disease,” it says.
The report adds that “there will always be people who wish to consume nicotine, like those who consume caffeine” and enabling consumers to use nicotine in less risky ways will “save millions of lives.”
3. E-cigarettes and harm reduction: An evidence review - Royal College of Physicians
This report - published in April 2024 - looks at several themes, including the differences in health effects of vaping compared to smoking.
Researchers from the Royal College of Physicians in London carried out a thorough review of biomarkers of exposure to, and harm from, vapes.
They used data published between 2021 and 2022, comparing people who vape, people who smoke, people who do both, and people who do neither.
Some of the report’s key overall findings were that:
- Carbon monoxide levels are lower in vapers than smokers
- Levels of tobacco-specific nitrosamines, volatile organic
compounds and polycyclic-aromatic hydrocarbons - which can lead to cancers - are lower in vapers than in smokers. - Vaping nicotine is not associated with a high frequency of adverse health effects.
The report concluded that vapes are “an important tool to alleviate the burden of tobacco use” but that more should be done to reduce their appeal to young people and ‘never smokers.’
4. COPD smokers who switched to e-cigarettes: health outcomes at 5-year follow up - National Library of Medicine
This report looks at the long-term health effects of the use of vapes in patients in the US with chronic obstructive pulmonary disease (COPD).
COPD is the name for a group of lung conditions, brought on by cigarette smoking, that cause breathing difficulties.
The study of 39 patients found that those switching to vapes from cigarettes displayed “significant and constant improvements in lung function” over a five year period.
It concluded that the benefits of switching to vaping from smoking “may persist long term.”
The researchers added that vape use for quitting or reducing smoking may reduce “some of the harm resulting from tobacco smoking in COPD patients”.
5. The VESUVIUS study - British Heart Foundation
The VESUVIUS study is thought to be the largest to date investigating the impact of swapping from smoking to vaping on the heart and circulation.
It found that for chronic tobacco smokers, there were significant improvements in vascular function within a month of switching from a tobacco cigarette to an vape.
The trial, published in the Journal of the American College of Cardiology and carried out by the University of Dundee, also found that participants who stuck to the switch best saw the greatest benefit.
The researchers say that if the improvements were sustained over a long time, smokers switching to vaping could expect to see at least a 13 per cent drop in their risk of having a cardiovascular event, which includes heart attacks and strokes.
The British Heart Foundation’s Associate Medical Director Professor Jeremy Pearson, said: “Our hearts and blood vessels are the hidden victims of smoking. Every year in the UK, 20,000 people die from heart and circulatory disease caused by smoking cigarettes – that’s more than 50 people a day, or 2 deaths every hour. Stopping smoking is the single best thing you can do for your heart health.
“This study suggests that vaping may be less harmful to your blood vessels than smoking cigarettes. Within just one month of ditching tobacco for electronic cigarettes people’s blood vessel health had started to recover.”
He emphasised that vaping should not be taken up by people who don’t already smoke, but “could be a useful tool to help people to stop smoking completely.”
