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The Dangers of Vaping Compared to Smoking
Wossen Gedib
Department of English, University of Maryland College Park
ENGL395: Writing for Health Professions
Prof. Schmidt
March 18, 2022
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Abstract
Cigarette smoking is known to be harmful for health and cause a variety of diseases, including
cancers. Recent developments in the tobacco space have led to the explosion of e-cigarettes, an
electronic nicotine delivery method that uses aerosols to create smoke instead of traditional
combustion. Although it’s been touted as a healthier version of cigarettes, there are still drawbacks
to e-cigarette use. This paper seeks to examine the effects of each on the body in both the short
and long term and determine which is better for the health of the user. Through the studies found,
vaping does seem to be a healthier alternative to smoking. However, there is still more research
that needs to be done on the long-term effects of e-cigarette use.
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The Dangers of Vaping Compared to Smoking Over the Short and Long Term
Over the past 20 years, smoking cigarettes has decreased sharply among teenagers.
According to the American Lung Association, only 8.8% of current youth smokers in 2017 used
traditional cigarettes compared to 36.4% in 1997 (American Lung Association, 2019). This is
partially attributable to anti-tobacco campaigns such as Truth. These campaigns targeted teenagers
and young adults through ads on popular television stations, radio networks, and billboards across
major cities. The campaign has been successful at lowering cigarette use among young Americans.
However, a new, potentially more addictive smoking form has come along in recent years - vaping.
Vaping is the term associated with using an e-cigarette to ingest nicotine. The modern e-cigarette
was developed in 2003 by Hon Lik as a way to curb his cigarette habit. From there, the product
grew in popularity in the US and Europe. Around 2006, major e-cigarette brands such as N’Joy
and BLU began selling their vapes in the Western hemisphere. As quickly as they rose, both
companies ended up either going out of business or shrinking significantly. However, a new vape
company founded in 2015 would forever change the e-cig landscape. JUUL took the vaping
industry by storm. From its variety of flavored cartridges to attention-drawing features such as
party mode, the company effectively made it “cool” to vape - this was proven with e-cigarettes
making up 20% of tobacco products used by high school students in 2018 compared to only 5% in
2013 (US Surgeon General, 2022). This explosion in vaping activity has led to questions about the
health effects of vaping and the impact it’s had on teenagers and young adults. This paper seeks to
examine the difference in health effects of smoking cigarettes compared to vaping and determine
which is safer.
Nicotine
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Before delving into the different effects that smoking and vaping have on the body, it’s
important to understand the role that nicotine plays in the body’s reaction. Nicotine is classified as
a stimulant - this means it speeds up the messages sent between the brain and the body. This causes
heightened levels of alertness, attentiveness, and energy in the user. In nicotine’s case, there are
also negative drawbacks. When ingested, “nicotine on direct application in humans causes
irritation and burning sensation in the mouth and throat, increased salivation, nausea, abdominal
pain, vomiting and diarrhea” (Mishra et al, 2015). The feeling of a rush that users get comes from
an “increase in pulse rate and blood pressure” (Mishra et al, 2015). It’s important to note that
nicotine is the addictive chemical that keeps smokers hooked. Once nicotine addiction begins, it
is extremely hard to quit. Unlike drugs such as marijuana or LSD, nicotine use causes physical
dependence - this means that the user experiences physical symptoms, including pain, nausea, and
fever, due to lowering the dosage or completely abstaining from using. This is what makes drugs
like nicotine extremely dangerous. In fact, “The US surgeon general (2010) has concluded nicotine
to be as addictive as cocaine or heroin” (Mishra et al, 2015). This is because nicotine increases the
transmission of dopamine, a neurotransmitter that’s responsible for the human feeling of pleasure.
Intake Methods
When cigarettes are consumed, the way to intake the nicotine within them is to light it on
fire and inhale. When cigarettes are lit, a process called combustion begins. According to Philip
Morris International (2019), a major cigarette producer, “Combustion is the process of burning a
substance in oxygen, producing heat and often light”. Combustion is how tobacco releases
nicotine, as it is found in the smoke resulting from the reaction. When this smoke is inhaled, the
smoke carries nicotine into the lungs. Small air sacs called alveoli absorb nicotine into the
bloodstream where it finally reaches the brain, giving users the relaxed buzz they’re looking for.
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The problem is that there are many other chemicals present in cigarette smoke than just nicotine in fact, the “burning process that releases the tobacco flavors and nicotine also produces over 6,000
chemicals, of which about 100 have been identified as causes or potential causes of smokingrelated diseases, such as lung cancer, cardiovascular disease, and emphysema” (Philip Morris
International, 2019). E-cigarettes, on the other hand, don’t use the traditional burning method to
create smoke. According to the US Surgeon General (2022), “E-cigarettes are devices that heat a
liquid into an aerosol that the user inhales”. Vapes use batteries to simulate the heat of lighting an
actual cigarette with a lighter or match. However, the main difference lies in the fact that actual
tobacco is not present in e-cigarettes. Instead, a nicotine solution is used. Typically, this mixture
is liquid nicotine, a base, and flavoring agents. This is where flavors such as mango, mint, and
other varieties distinguish e-cigarettes from regular cigarettes. Next, an atomizer disperses this
solution as a fine mist. It gets heated up by the battery and the user inhales it. The mist looks very
similar to the smoke clouds of cigarettes, although it’s usually a bit thicker.
Short Term Effects
The short-term effects of cigarettes in many ways resemble that of vaping. However, there
are key differences between the two. Coughing and shortness of breath associated with cigarettes
are a byproduct of the negative effect that cigarette smoke has on the lungs. According to a study
done by Ferrari and colleagues (2015), traditional cigarettes “induced statistically significant
increases in FeCO [fractional concentration in exhaled breath of Carbon oxide] in both smokers
and non-smokers” (p. 1). The presence of these chemicals in our breath means that they are
irritating our lungs and breathing passages through cigarette smoke being inhaled, leading to the
effects of coughing and shortness of breath. Because of this, “smoking a traditional cigarette
induced immediate bronchoconstriction” (Ferrari et al, 2015, p. 4). E-cigarettes, on the other hand,
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“had no immediate adverse effects after short-term use in non-smokers and a small effect…in
smokers” (Ferrari et al, 2015, p. 8). Some of the common ingredients in vapor such as “carbonyls,
volatile organic compounds (such as benzene and toluene), particles, trace metal elements
according to flavor bacterial endotoxins, and fungal glucans” (Christiani, 2020) contribute to the
irritation that the lungs undergo when vaping. With this being said, a study found that “e-Cig
solutions and condensed vapor disrupt the lung epithelial and endothelial barriers, associated with
rapid oxidative and nitroxidative stress and inflammation” (Schweitzer, 2015) in the short term.
Interestingly enough, the study found that when e-cigarettes don’t have nicotine in them, the vapor
still has the same negative effects on the lungs - this points to other substances in vapor causing
issues for the body. Smoking traditional cigarettes can also pose risks with regards to bacterial
infections - in fact, “invasive pneumococcal disease is associated with exposure to tobacco smoke”
(Miyashita, 2017). However, studies point to e-cigarettes being capable of causing the same issue.
When bacteria latch onto platelet-activating factor receptors (PAFR), they can begin infecting the
body. Within 5 minutes of using an e-cigarette, nasal PAFR was increased, leading to an increased
chance of contracting a pneumococcal disease (Miyashita, 2017).
In addition to causing problems in the lungs, both cigarettes and e-cigarettes can cause
issues with the heart. This is no surprise, as the lungs and heart play a key role in obtaining and
circulating oxygen around the body. If one of these is negatively impacted by cigarette smoke, the
other is sure to be as well.
The effects of cigarettes on the heart have been well documented. In the short-term,
“smoking causes an acute and transient decrease in vagal cardiac control” (Hayano et al, 1990).
To put this change in context, cigarettes cause “a sharp increase in blood pressure (6%) and heart
rate (14%)” (Kool et al, 1993). For cigarette smokers, this leads to “short-term increases in arterial
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wall stiffness that might be harmful to the artery and increase the risk for plaque rupture” (Kool et
al, 1993). This is part of the reason that smoking could lead to a heart attack, especially in those
who are already predisposed or have heart conditions. The stiffer your arteries become, the less
blood they can pump throughout your body. This means that you’ll have trouble performing
aerobically taxing tasks such as exercising directly after smoking cigarettes compared to if you
hadn’t smoked at all.
Another important factor in the difference between short-term use of cigarettes and ecigarettes are the immediate effects the cessation has on the body. As mentioned, e-cigarettes were
originally designed to wane smokers off of traditional cigarettes. From a cardiovascular standpoint,
e-cigarettes have shown benefits compared to smoking regular cigarettes for the heart. One study
found that “smokers who had quit three days ago showed clear improvements in different
indicators of cardiovascular risk” (Klonizakis). Moreover, the effects of e-cigarettes compared to
other stop-smoking aids were similar on the heart, as “improvement was the same for smokers
using…an e-cigarette” (Klonizakis et al, 2021). Withdrawal symptoms are something that most
smokers will have to deal with if they want to quit. E-cigarettes are one example of an alternative,
but that doesn’t make it the best for reducing cravings - “, after 12 h of smoking abstinence,
participants reported moderate cigarette craving at the start of each session. Five minutes of use of
each product resulted in significant decreases in cigarette craving, but smoking resulted in a
craving reduction of 44%, whereas vaping only resulted in a reduction of 26%” (Adriaens et al,
2018). This isn’t necessarily a bad thing - the purpose of vaping in this context is to wane the body
off of nicotine, so as long as the substitute (e-cigs in this case) is fulfilling this goal, then whether
or not the cravings are reduced is inconsequential.
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With all of this in mind, it’s important to note that the negative effects of smoking come with
prolonged use over time. For this reason, it’s equally as important to take a look at the long-term
impacts of smoking traditional cigarettes compared to e-cigarettes.
Long Term Effects
Due to the effects that inhaling cigarette smoke has on the lungs in the short term, it’s no
surprise that they tend to be where most long-term problems are. As a smoker continues their habit,
diseases such as asthma, COPD, and lung cancer begin to develop. According to a study done with
adolescent smokers over 15 years, “cigarette smoking [was] associated with evidence of mild
airway obstruction and slowed growth of lung function” (Gold et al, 1996). Similarly, “E-cig users
were found to be intermediate between smokers and never-smokers for biomarkers of
inflammation and for gene methylation and expression, including known smoking-related
pathways” (Song et al, 2020). This increase of inflammation is what leads to many chronic issues,
including diseases such as COPD as well as smaller symptoms like coughing and wheezing. Gene
mutations are typically how cancers form and spread. In any case, researchers found that “e-cigs
are associated with less toxicity than cigarettes for smoking-related pathways” (Song et al, 2020).
This lends to the argument that e-cigarettes are healthier than regular cigarettes in the long term.
This could be because there are fewer known carcinogens present in vape juice compared to
cigarettes. The flavoring of cigarettes and e-cigarettes could also play a role in their effects on the
lungs. E-cigarettes are far more encompassing in this realm, as there are numerous flavors to
choose from. Some popular choices include mint, creme, and mango. However, “with regards to
the multitude of available flavors, some have demonstrated cytotoxicity” (Marques et al, 2021, p.
8). Certain compounds present within these flavorings, such as diacetyl, “assuming again 400 puffs
per cartridge and 40 mL per puff…could compromise normal lung function in the long-term”
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(Marques et al, 2021, p. 9). Cigarettes hold the advantage in this case, as “cigarette tobacco
flavoring ingredient does not meaningfully affect the inherent toxicity of cigarette smoke or the
human risks that attend smoking” (Heck, 2010).
The long-term effects of both cigarettes and e-cigs on the heart are just as important as they are for
the lungs. Since these systems are connected for oxygen absorption, negative effects would likely
affect both, not just one. Cigarettes have been known to cause heart issues in the long term, as
“long-term cigarette smoking has been associated with enhanced transcapillary leakage of albumin
and increased urinary albuminuria as indicators of vascular dysfunction” (Unverdorben et al,
2009). These are the underlying causes behind heart diseases such as coronary artery disease, high
blood pressure, and events such as heart attacks or strokes. This also translates to lower
performance in athletics, as “heavier smokers had lower TST measures of cardiorespiratory fitness
including peak exercise capacity” (Asthana et al, 2012). However, transitioning to e-cigarettes is
not a better alternative for the cardiovascular system. A recent meta-analysis found that switching
from regular cigarettes to e-cigarettes “does not appear to significantly lower odds of
cardiovascular outcomes” in the long term (Goniewicz et al, 2020). If this is the case, it may be
better for smokers who are struggling with heart problems to switch to alternative nicotine sources
instead of jumping to e-cigarettes.
When smokers do decide to switch, the question of long-term cessation and health
outcomes between cigarette smokers and vapers becomes vital to understand. There isn’t much
research out for the abstinence of e-cigarettes themselves - instead, there have been studies
showing that “E-cigarettes were more effective for smoking cessation than nicotine-replacement
therapy” (Hajek et al, 2019). This intuitively makes sense, as vaping uses the same intake method
as smoking and usually has a higher nicotine content. This increase in effectiveness was also
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coupled with increases in general health outlooks for smokers-turned-vapers, as “Smokers invited
to switch to electronic cigarettes who completely abstained from smoking showed steady
progressive improvements in their exhaled breath measurements and symptom scores”
(Campagna). This can be attributed to the lower amounts of known carcinogenic chemicals and
higher nicotine levels leading to fewer puffs for the same buzz. Altogether, vaping comes out
ahead in terms of long-term health compared to cigarettes.
Conclusion
In conclusion, multiple studies have found both cigarette smoking and e-cigarette smoking
to be dangerous for the health of users. Because of the lack of research done on the longer-term
effects of vaping, there’s still room for improvement on the effects of e-cigarette smoking and
abstinence on its own. With this being said, studies have shown that e-cigarettes are less deadly in
both the short and long term for smokers on both the lungs and heart. In addition, e-cigarettes
function better as smoking cessation aids than traditional nicotine replacement therapies.
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