Vaping vs. Smoking

Vaping and smoking are two alternative nicotine delivery methods. Vaping is often promoted, along with nicotine replacement therapy, as an alternative to cigarettes for people who are quitting smoking. Nicotine replacement therapies, unlike vaping devices, replace nicotine without drawing potentially harmful chemicals into your lungs.

Vaping is popular. Roughly 1 in every 20 Americans (10.8 million) use vaping devices, and one in three uses them daily.¹ According to the 2022 Gallup poll, 8% of U.S. adults say that they regularly or occasionally vape. One in four high school students uses vape products. 

Between 2014 and 2018, vaping use decreased from 3.7% to 3.2%. However, use in youth has skyrocketed. Cigarette smoking rates have fallen by 68% for adults and youth between 1965 and 2017. Over the last five years, cigarette smoking use has fallen by 23% among adults and 44% among youth.²

Understanding the differences between these two nicotine delivery methods is essential if you consider vaping a safer alternative to smoking.

What is Vaping? 

Cigarette smoking is a complex behavior. It involves holding a cigarette, bringing it to your mouth, pursing your lips, and inhaling smoke deeply into your lungs. The smoke contains nicotine, a compound that has physiologic effects.

Vaping simulates the behaviors associated with smoking, and, like cigarettes, vaping devices deliver nicotine into the lungs. Nicotine is very addictive. Whether you smoke cigarettes or use a vaping device, you are at risk of developing nicotine tolerance and dependence.

How Does Vaping Work?

Vaping uses an electronic nicotine delivery system (ENDS) to simulate cigarette smoking using aerosolized vapor instead of smoke. These devices are intended to simulate the physical movements associated with smoking cigarettes and with delivering chemicals to the lungs.

Vaping devices are made up of:

• A cartridge or reservoir to hold the liquid solution
• A heating element
• A power source
• A mouthpiece

Vaping devices use a heating element to vaporize liquids containing nicotine, such as glycerin, propylene glycol, and flavorings. Since the compounds are heated and not burned, they produce no smoke.

What Materials Are Used in Vaping Devices?

Researchers at Johns Hopkins analyzed the chemicals found in vaping aerosols and found nearly 2,000 chemicals in vaping solutions, most of which they could not identify. The researchers found six potentially harmful chemicals, including caffeine, three industrial chemicals, a pesticide, and two flavorings. Other researchers have identified unknown and harmful chemicals in vaping aerosols. They note that even vaping solutions marked as nicotine-free contain traces of nicotine.

Chemicals found in vaping solutions include:⁴

• Nicotine
• Nicotyrine
• Formaldehyde
• Acetaldehyde
• Glycidol
• Acrolein
• Acetol
• Diacetyl

Vaping solutions also contain flavorings, propylene glycol, vegetable glycerin, and other ingredients.⁵ Heavy metals such as nickel, tin, and lead have also been found in vaping aerosols.

What Is the Difference Between an E-Cigarette and a Vaporizer?

Types of electronic nicotine delivery systems include:

• Vapes
• Vaporizers
• Vape pens
• Hookah pens
• Electronic cigarettes
• E-cigars
• E-pipes

E-cigarettes have a battery, a heating coil, a reservoir for the e-liquid, and a mouthpiece. The heating coil and reservoir are inside the cartomizer, which contains a cartridge and atomizer. The cartridge is replaceable, and you can recharge the battery. E-cigarettes deliver a more standardized amount of nicotine and require a new cartridge when the previous one is depleted. The manufacturer determines flavor selections.

Vaporizers are larger and contain a reservoir, battery, and mouthpiece. Vaporizers give users more control over what they put into the reservoir and smoke. Many vaporizers accommodate both liquid and leafy substances.

Are there Health Risks Associated with Vaping?

Vaping is frequently considered to be a safer alternative to smoking cigarettes. While you are not inhaling the chemicals found in cigarette smoking, you are still inhaling chemicals when you vape, and there is not enough research to know exactly what chemicals you are inhaling and what their effects are on your lungs and body.

Nicotine is an addictive substance found in cigarette smoke, and it is also found in vaping solutions. The nicotine content in cigarettes is standardized. This is not necessarily the case in e-cigarettes and other vaping devices.

What Is Smoking? 

Cigarette smoking is the act of burning tobacco and inhaling the smoke. We all know the dangers of cigarette smoking, whether it is cigarettes, cigars, pipes, or exposure to secondhand smoke. Cigarette smoking causes more than 480,000 deaths each year in the United States.

What Materials Are Used in Cigarettes?

According to the American Lung Association, cigarettes contain about 600 ingredients. Many of which are harmful. When these ingredients are burned, they generate more than 7,000 chemicals, including nicotine. At least 69 of these chemicals are known to cause cancer.⁶

In addition to nicotine, some other chemicals found in tobacco smoke include:⁶

• Acetone
• Ammonia
• Arsenic
• Benzene
• Cadmium
• Formaldehyde
• Lead
• Naphthalene
• Methanol
• Tar

What Are the Short-Term Effects of Smoking?

Short-term effects of smoking and inhaling nicotine include:

• Bad breath
• Skin staining
• Fatigue
• Coughing
• Dulled sense of smell and taste
• Dizziness
• Nausea
• Headache
• Shortness of breath
• Increased blood pressure
• Increased heart rate

What Are the Long-Term Effects of Smoking?

According to the Centers for Disease Control and Prevention, long-term smoking increases your risk of many chronic diseases, including:

• Heart disease
• Stroke
• Lung cancer
• Chronic obstructive lung disease
• Tuberculosis
• Macular degeneration
• Cataracts
• Gum disease
• Impaired immune function
• Type 2 diabetes
• Cancers
• Asthma
• Osteoporosis

The good news is that once you stop smoking, you get immediate health benefits, and the benefits multiply the longer you are not smoking.

Comparing Vaping vs. Smoking 

The biggest difference between vaping and smoking is that nicotine, and other chemicals are burned/combusted when cigarette smoking, and they are heated and aerosolized when vaping. Smoking delivers nicotine to the lungs by burning tobacco. Vaping uses a heater to create a vapor.

Health Risks of Each Activity

Both vaping and smoking increase health risks, though the risks are thought to be less with vaping. This is because vaping aerosols contain fewer chemicals than burned tobacco. But we don’t necessarily know all the chemicals in vaping solutions, and we may find it more harmful than once thought.

In both vaping and smoking, nicotine, a highly addictive substance, is inhaled. Smoking and vaping can irritate the lungs and airways and increase your risk for lung disease.

Cost of the Products

Spending on vaping products varies from $10 per month to more than $250 per month, with a median spend of $50 to $75 per month. Men spend more than women. Spending does not seem to be age dependent. Vape shops are designed to encourage people to linger and enjoy custom-designed vaping solutions.

The median amount of money spent on cigarettes prior to vaping devices was $127.87.³

Regulation of the Products

The Food and Drug Administration is the primary regulatory body for tobacco products, cigarettes, e-cigarettes, and cigars. They regulate the manufacture, distribution, and marketing of these products.

“FDA regulates the manufacture, import, packaging, labeling, advertising, promotion, sale, and distribution of ENDS, including components and parts of ENDS but excluding accessories.”

Quitting Vaping or Smoking 

Whether you are inhaling nicotine through smoking or vaping, quitting is a great idea. Since nicotine is an addictive substance, quitting is hard but doable. It is helpful to develop a plan and a timeline for quitting smoking before you get started to maximize your chance of success.

Seeking Professional Help

Smoking cessation specialists are professionals who understand the challenges people face as they quit smoking. They are familiar with the wide range of smoking cessation treatment options and can help guide you as you develop your plan.

Avoiding Triggers

Smoking is a habit, and, like all habits, most people have triggers that make it more difficult to meet their smoking cessation goals.  

Common triggers for smoking include:

• Stress
• Boredom
• Anxiety
• Excitement
• Loneliness
• Fighting
• Watching television
• Talking on the phone
• Waiting in line
• Taking a break
• Going to a bar or club
• Smelling cigarette smoke

When developing your smoking cessation plan, think carefully about the people, places, and circumstances that trigger you to reach reflexively for a cigarette or vaping device. If possible, identify ways you can avoid your triggers or at least mitigate their effects.

Keeping Track of Your Progress

Smoking cessation timelines are important because they help you break down your ultimate goal, to stop smoking, into manageable milestones. Tracking your progress toward achieving each milestone can help you stay motivated. Make a list of lifestyle or health improvements you intend to track as you work on smoking cessation.

Exploring Nicotine Replacement Products

Nicotine is addicting. It changes your brain chemistry. You develop a tolerance to its effect and need more and more of it to get the same effects.

Nicotine replacement products such as patches, gums, lozenges, and inhalers are intended to take the edge off your nicotine cravings. These products deliver a small amount of nicotine without the toxins in cigarettes and vaping. The most effective way to use NRTs is to combine a long-acting nicotine patch with a shorter-acting product such as a lozenge, gum, inhaler, or nasal spray and to plan to extend treatment over 12 weeks.⁷ Talk to a doctor online to learn about nicotine replacement therapies and to get an online prescription for products that are not available over-the-counter.

Utilizing Behavioral Therapy

Studies indicate that when cognitive-behavioral therapies are utilized in conjunction with drugs, they can effectively aid adult smokers in quitting. In an analysis of over 52 clinical studies and almost 20,000 patients, smoking cessation was more successful when using a combination of behavioral therapy and medications than with minimal support alone.⁸  Meet with a specialist online to get an online diagnosis and get started on a treatment plan, all from the comfort of your home.

Resources Available to Help You Quit

Whether you are vaping or smoking, plenty of resources are available to help you quit smoking. Some of your many options include online support groups, online doctors on call, telehealth services, and in-person counseling.

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References

1. Mohammadhassan Mirbolouk, Paniz Charkhchi, Sina Kianoush, et al. Prevalence and Distribution of E-Cigarette Use Among U.S. Adults: Behavioral Risk Factor Surveillance System, 2016. Ann Intern Med.2018;169:429-438. [Epub 28 August 2018]. doi:10.7326/M17-3440
2. American Lung Association. (n.d.) Overall Tobacco Trends. Accessed on April 11, 2023. https://www.lung.org/research/trends-in-lung-disease/tobacco-trends-brief/overall-tobacco-trends
3. Sears C, Hart J, Walker K, Lee A, Keith R, Ridner S. A Dollars and “Sense” Exploration of Vape Shop Spending and E-cigarette Use. Tob Prev Cessat. 2016;2(Suppl):9. doi: 10.18332/tpc/67435. Epub 2016 Dec 2. PMID: 28758154; PMCID: PMC5528165.
4. Sleiman M, Logue JM, Montesinos VN, Russell ML, Litter MI, Gundel LA, Destaillats H. Emissions from Electronic Cigarettes: Key Parameters Affecting the Release of Harmful Chemicals. Environ Sci Technol. 2016 Sep 6;50(17):9644-51. doi: 10.1021/acs.est.6b01741. Epub 2016 Jul 27. PMID: 27461870.
5. U.S. Food & Drug Administration. E-Cigarettes, Vapes, and other Electronic Nicotine Delivery Systems (ENDS). Updated 6/20/22. Accessed 4/11/23. https://www.fda.gov/tobacco-products/products-ingredients-components/e-cigarettes-vapes-and-other-electronic-nicotine-delivery-systems-ends
6. American Lung Association. What’s in a cigarette? Updated November 17, 2022. Accessed April 11, 2023.
7. Rigotti NA. Strategies to Help a Smoker Who Is Struggling to Quit. JAMA. 2012;308(15):1573–1580. doi:10.1001/jama.2012.13043
8. Stead LF, Koilpillai P, Fanshawe TR, Lancaster T. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev. 2016 Mar 24;3(3):CD008286. doi: 10.1002/14651858.CD008286.pub3. PMID: 27009521; PMCID: PMC10042551.