For some smokers, vaping has become part of the journey towards quitting cigarettes, but is switching to the trendy option better for you? Here’s the breakdown:

So what is the difference between vaping and smoking?

A cigarette burns tobacco, producing smoke containing substances including carbon monoxide, tar and heavy metals. Vaping devices instead heat a liquid to create an aerosol that is inhaled. Vape liquids commonly contain propylene glycol, vegetable glycerine, flavourings and, in many products, nicotine.

The absence of cigarette smoke can make vaping seem like a comparatively benign habit. But “not smoking” should not be confused with “not exposing your body to potentially harmful substances”.

When does quitting become switching?

The distinction matters because giving up cigarettes is not simply a matter of removing tobacco from someone’s life. Smoking is often tied to routine and behaviour: the cigarette with the morning coffee, the break from work, the drive home, the social ritual or the response to stress.

Replacing the cigarette with a vape may change the mechanism through which nicotine is consumed without necessarily addressing those behavioural cues. Some smokers do successfully transition away from cigarettes using vaping products. Others continue vaping and remain dependent on nicotine. And some end up doing both.

This so-called “dual use” is particularly concerning because the person may believe they have taken a meaningful step towards reducing their risk while continuing to expose themselves to substances from both cigarettes and vaping products.

Is vaping safer than smoking?

The consequences of tobacco smoking have been documented over decades. Research into the long-term effects of vaping is still developing. What is already clear is that vaping is not simply the inhalation of harmless water vapour.

Certain vaping products have been associated with e-cigarette or vaping use-associated lung injury, known as EVALI. This is distinct from the condition popularly called “popcorn lung”, which involves damage to the small airways and has been associated with exposure to diacetyl, a flavouring chemical used in some vape liquids.

There are concerns beyond the lungs too. Vaping has been associated with cardiovascular effects, while researchers are also examining the potential consequences for oral health.

Does leaving smoking for vaping move you away from nicotine dependence?

For someone who has replaced cigarettes with vaping, that does not necessarily mean the attempt to quit has failed. But it may mean the journey is not finished.

And for someone using both cigarettes and vapes, the reassuring idea that they have “cut down” may disguise the fact that they remain exposed to harmful substances from both vaping and smoking.

Neither smoking nor vaping is without risk. Understanding what you are inhaling, why you continue to reach for it and what role nicotine plays in that behaviour may be a more constructive starting point than trying to decide which habit is the lesser evil.

Anyone concerned about smoking, vaping, nicotine dependence or respiratory symptoms should speak to their GP or a respiratory healthcare professional about their individual risks and appropriate support for quitting.

Content by Dr Riju Thomas, pulmonologist at Life Wilgeheuwel Hospital.

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