What Are The Risks Of Vaping? Stoptober

Vaping is not risk-free, but according to the NHS, it poses a small fraction of the risks of smoking in the short and medium term. It is not, however, a risk-free habit, and it is not recommended for people who have never smoked or for anyone under 18.

Is vaping less harmful than smoking?

Yes – tobacco experts cited by the NHS conclude that "in the short and medium-term, vaping poses a small fraction of the risks of smoking," largely because vape aerosol does not contain tar or carbon monoxide, two of the most harmful elements in cigarette smoke. A 2022 GOV.UK evidence review found that people who switch completely from smoking to vaping show substantially lower exposure to the toxicants linked to cancer, lung disease, heart disease and stroke. That said, vape aerosol is not free of harmful substances, and switching is only a clear benefit for people who already smoke.

Vape aerosol compared with cigarette smoke:

• Does not contain: tar or carbon monoxide, two of the most harmful components of cigarette smoke
• Does contain: nicotine and some of the same chemicals found in cigarette smoke, but generally at much lower levels
• Relative risk: a small fraction of the risk of smoking for someone who already smokes, but not a risk-free choice for a non-smoker

It’s officially October, and with the start of the new month comes Public Health England’s (PHE) annual Stoptober campaign, challenging smokers to go cigarette-free for the month. Stoptober is a fantastic initiative and one that we fully support here at DCA.

With that in mind, our clinical team was recently asked to contribute to the growing debate around the use of e-cigarettes (or vaping) as an alternative to smoking.

According to a YouGov survey commissioned by Action on Smoking and Health (ASH), there are 2.9 million smokers in the UK currently using e-cigarettes, of which 1.5 million say they have completely stopped smoking tobacco as a result. The same research also suggests switching to e-cigarettes for 28-days results in smokers being five times more likely to quit for good.

While these stats are hugely impressive, they shouldn’t be read in isolation. We don't yet know the short, medium and long-term effects of vaping, given there are limited studies available and the effects have yet to be fully investigated; unlike cigarettes whose effects have been well researched and documented.

Vaping has, for example, received a lot of media attention recently due to stories emerging (mainly from the US) of ‘mysterious vaping illnesses’ and teenagers developing lung disease due to excessive use. But what are the myths and truths on this?

For starters, we know that vapes don't contain tar or carbon monoxide, two of the most harmful elements in tobacco smoke. But they do still contain some of the harmful carcinogens and chemicals found in tobacco smoke (albeit at much lower levels) which can have significant adverse health effects if consumed excessively.

Moreover, we know that use of the term ‘vape’ mischaracterises the products typically on offer, as it suggests water vapour is inhaled when actually, e-liquid is heated to create an aerosol that can cause liver and retinal damage.

We recognise these potential health risks but still don’t know the full extent of the potential damage. Therefore, more understanding of the short, medium and long-term effects of vaping is needed, so it's great to see the European Commission undertaking a detailed review; with a report on the potential risks set to be published by the end of 2020.

While vaping can be an effective tool for quitting smoking, the best way to stay ‘safe’ is, of course, to not smoke anything at all. But we do understand that addiction to nicotine isn't always that simple and that patients need smoking cessation support tailored specifically to them and their lifestyle.

If you have any concerns about smoking or e-cigarettes, or would like to quit but aren’t sure how, we recommend speaking to one of our clinicians.

Lung and respiratory risks

Vaping can irritate the airways, and heating propylene glycol and vegetable glycerine – the two main liquids in most e-liquids – can irritate cells in the lungs, according to Cancer Research UK and the CDC. The long-term respiratory risk of vaping is still being studied, since e-cigarettes haven’t been around long enough for definitive data.

Everyday respiratory symptoms some vapers notice include:

• Coughing or wheezing
• A dry or sore throat
• Aggravated asthma symptoms
• Shortness of breath on exertion

Heart and circulatory risks

Nicotine raises heart rate and blood pressure and triggers a spike in adrenaline, according to the CDC. Emerging research is also looking at links between vaping and arterial stiffness and broader cardiovascular strain, though this evidence base is still developing.

• Nicotine increases heart rate and blood pressure shortly after use
• It also causes a short-term spike in adrenaline
• Researchers are still studying possible longer-term effects on blood vessels and heart health

Nicotine addiction and withdrawal

Nicotine is highly addictive, and most vapes contain it. Importantly, nicotine itself does not cause cancer, lung disease or heart disease – according to the NHS, it’s the way nicotine is delivered, not the nicotine itself, that drives most smoking-related harm. Stopping vaping suddenly can still bring on withdrawal symptoms, which typically include:

• Cravings and irritability
• Difficulty concentrating
• Low mood or restlessness
• Increased appetite

If you’re finding it hard to cut down, a GP or stop-smoking adviser can talk through options tailored to you.

Risks for teenagers and young people

Nicotine can harm brain development, which continues until around age 25, according to the CDC. In younger people, this can affect attention, learning and mood, and can make future nicotine addiction more likely. Vaping is not intended for anyone who has never smoked, and it is illegal to sell vapes to anyone under 18 in the UK.

• Nicotine exposure in the teenage years may affect attention and learning
• It can also affect mood and increase the risk of future nicotine dependence
• Vaping is not recommended for non-smokers of any age, and is illegal to sell to under-18s in the UK

What is in vape aerosol? Chemicals and heavy metals

Vape aerosol is created by heating an e-liquid, and typically contains a mix of the following, usually at levels far lower than cigarette smoke, according to the CDC:

• Nicotine: the addictive substance in most vapes
• Propylene glycol and vegetable glycerine: the base liquids that carry the flavouring and nicotine
• Flavourings: chemicals used to create different vape flavours
• Trace heavy metals such as nickel, tin and lead: can leach from the heating coil in small amounts
• Aldehydes such as formaldehyde: can form when e-liquid is heated, generally at much lower levels than in cigarette smoke

Short-term side effects of vaping

New vapers, and people switching from smoking, sometimes notice mild side effects that usually ease with time, according to Cancer Research UK:

• Throat and mouth irritation
• Headache
• Cough
• Dry mouth or nausea
• "Vaper’s tongue" – a temporary dulling of taste some regular vapers notice

These often settle on their own, but it’s worth speaking to a stop-smoking adviser or GP if they persist.

Long-term effects of vaping: what we do and do not know

Vapes haven’t been around long enough for definitive long-term data, so sweeping claims in either direction aren’t reliable. Here’s a fair summary of where the evidence currently stands:

What we know:

• Switching completely from smoking to vaping substantially reduces exposure to many toxicants linked to smoking-related disease
• Vape aerosol contains far fewer harmful chemicals than the roughly 7,000 found in cigarette smoke

What we don’t know:

• The full long-term respiratory and cardiovascular effects of regular vaping over decades
• Whether today’s reduced-exposure findings translate into the same long-term risk reduction seen when people fully quit nicotine

Does vaping cause cancer?

There is no good evidence that vaping causes cancer, according to Cancer Research UK. Unlike cigarettes, vapes don’t contain tobacco, and the levels of cancer-causing chemicals in vape aerosol are far lower than in cigarette smoke. Long-term data is still limited, so this picture may be refined as more research is published, but current evidence does not support a link between vaping and cancer.

Is second-hand (passive) vaping harmful?

There is no good evidence that breathing in someone else’s vape aerosol is harmful, according to Cancer Research UK, and it is different from passive smoking, since vape aerosol contains no tobacco. Long-term effects of passive vaping are still not fully understood, so it’s sensible to take a few precautions:

• Avoid vaping around babies and young children
• Avoid vaping around people with asthma or other respiratory conditions
• Ventilate rooms where vaping has taken place, as a general precaution

Vaping myths: popcorn lung and EVALI

Myth: vaping causes "popcorn lung."

Fact: this isn’t supported by current evidence. Popcorn lung (bronchiolitis obliterans) was linked to diacetyl, a flavouring chemical used in some US industrial settings – diacetyl is banned as an ingredient in UK-regulated nicotine vapes, according to the NHS.

Myth: the US "vaping illness" outbreak (EVALI) shows vaping is dangerous.

Fact: EVALI was largely linked to illicit, unregulated THC vapes containing vitamin E acetate, mainly in the US, according to Cancer Research UK. There is no good evidence that legal, regulated e-cigarettes in the UK cause this kind of lung injury.

UK vaping regulation and when to speak to a GP

Legal nicotine vapes sold in the UK are regulated by the Medicines and Healthcare products Regulatory Authority (MHRA), according to ASH, and it is illegal to sell vapes to anyone under 18. The Tobacco and Vapes Act became law in 2026 and introduces further controls on vape marketing, packaging and flavours aimed at reducing their appeal to children.

See a GP if you have:

• A persistent cough
• Breathlessness
• Chest pain
• Or if you’d like tailored support to cut down or stop vaping or smoking

You can book an online GP appointment with Doctor Care Anywhere, or read our guide on how to book an appointment with a GP online for a step-by-step walkthrough.