- ANSES says vaping’s health effects are not of equivalent severity to those caused by tobacco
- Risks from vaping remain lower than those associated with smoking
- No tumours identified in people who vape
- Exposure to key toxic compounds reduced by 80% to nearly 100% compared with cigarettes
France’s national health and safety agency ANSES has delivered one of the clearest statements yet from a major European health body that vaping is less harmful than smoking.
In its 700-page scientific assessment of vaping products, the agency concludes that while vaping is not risk-free, its effects are consistently less severe than those caused by combustible tobacco.
Not equivalent to smoking
“Current knowledge makes it possible to conclude that the effects associated with the use of electronic cigarettes are not of equivalent severity to those caused by tobacco,” ANSES says.
“Although electronic cigarettes lead to fewer harmful effects than tobacco smoke, their use is not without risks, which nevertheless remain lower than those associated with smoking.”
The agency highlights the absence of combustion as “a major advantage of vaping”, noting that this substantially reduces exposure to the toxic and carcinogenic substances that make smoking so deadly.
In other words, no smoke means dramatically fewer toxins.
Cardiovascular effects: lower risk, nicotine the driver
On heart health, ANSES finds that some short-term changes such as increases in blood pressure and heart rate are “probable” in the presence of nicotine.
These include “an increase in systolic and/or diastolic blood pressure and heart rate in the presence of nicotine” and “impairment of endothelial function in the presence of nicotine”.
Crucially, however, the agency stresses that the link between these physiological responses and long-term chronic disease “remains to be demonstrated”.
This means that while nicotine has measurable short-term effects, there is no evidence that vaping produces the same established cardiovascular disease burden as smoking, where the evidence is described as “established”.
Respiratory disease: weaker evidence than for smoking
For respiratory outcomes, there is a clear contrast with smoking. For asthma and bronchitis, the “weight of evidence” is judged as “insufficient”. For COPD, an association is described as “possible”, but the agency makes clear that the data are limited and often confounded by smoking history.
ANSES repeatedly emphasises the lack of long-term data and the methodological challenges of studying a relatively new product. That absence of evidence should not be confused with evidence of harm.
Importantly, when the agency compares vaping with smoking across major disease categories, the weight of evidence for smoking is “established”, while for vaping it is lower in every case.
Cancer: no tumours identified
Perhaps most significantly, ANSES states: “To date, no study conducted among electronic cigarette users has identified the development of tumours.”
The report does identify “the possible occurrence of biological changes compatible with the early stages of carcinogenesis”, including “genotoxic effects”, “mutagenic effects” and “epigenetic alterations”.
But it is clear that these findings “do not allow the prediction of cancer occurrence, nor the establishment of a causal link”.
Given that vaping has been widely used for little more than 15 years, ANSES stresses the need for long-term monitoring. However, the absence of identified tumours in users is a crucial finding in the harm reduction debate.
Pregnancy: caution, but based on animal data
On pregnancy, the agency concludes there are “possible harmful cardiovascular and respiratory effects for the offspring of pregnant women who vape”, based primarily on animal studies.
As with smoking, the safest option in pregnancy is nicotine abstinence. But this section does not undermine the core finding that vaping presents lower overall risks than combustible tobacco.
Quantitative risk: dramatically lower toxic exposure than smoking
ANSES also carried out a quantitative risk assessment of aldehydes, which are toxic compounds generated in emissions.
For cigarettes, the agency concludes that the risk linked to aldehyde exposure “can never be excluded”, even at very low levels of consumption.
For vaping, results are described as “more mixed”. Depending on the compound and exposure scenario, between five per cent and near 100 per cent of simulated exposure situations could not exclude risk.
The headline finding
Overall, ANSES said: “Vaping leads to a strong reduction in exposure to aldehydes in emissions: from 80 to nearly 100 per cent” compared with smoking.
That is an enormous reduction in exposure to some of the most harmful components of tobacco smoke. ANSES notes that while lower emissions do not automatically eliminate risk, the reduction is substantial and consistent.
A harm reduction message
Across cardiovascular, respiratory and cancer outcomes, ANSES concludes that the “weight of evidence” for harm from vaping is always lower than that for smoking.
It acknowledges uncertainties and calls for continued monitoring, but it also makes clear that vaping does not produce harms “of equivalent severity” to tobacco.
For smokers who cannot or will not quit nicotine entirely, that distinction matters.
The report is expected to guide future regulation in France. A second assessment this year will examine whether vaping products should be formally integrated into national smoking cessation policy.
Taken together, the findings reinforce what many public health experts have argued for years. While not harmless, vaping represents a substantially lower-risk alternative to smoking, and a powerful tool for harm reduction.
(All quotes are translated from the original French report.)
