What does scientific research say about e-cigarettes?

'Vapes' carry some health risks, but are likely much safer than smoking

Close up on a man exhaling vapor from an electronic cigarette
Close up on a man exhaling vapor from an electronic cigarette

State and federal policymakers are considering increased taxes and restrictions on e-cigarettes and vaporizers, calling teen use of the devices a public health epidemic.

E-cigarettes have been the subject of many research studies since they became widely available more than a decade ago. Here are a few of the most recent findings.

• Use of e-cigarettes among American teenagers has increased significantly in recent years, while use of other substances has remained stable.

University of Michigan “Monitoring the Future” survey, 2018: “Increases in adolescent vaping from 2017 to 2018 were the largest ever recorded in the past 43 years for any adolescent substance use outcome in the U.S. The percentage of 12th grade students who reported vaping nicotine in the past 30 days nearly doubled, rising from 11% to 21%.”

• Some young people who otherwise likely would not consume nicotine may be trying e-cigarettes.

Center for Tobacco Control Research and Education, 2018: “Young people who deem [e-cigarettes] as a ‘safe’ option, and may otherwise have never experimented with tobacco, could be at risk of later tobacco use.”

• E-cigarettes users are exposed to measurable levels of some toxicants found in tobacco, but generally at lower levels than smokers.


Journal of the American Medical Association, 2018: “Exclusive use of e-cigarettes appears to result in measurable exposure to known tobacco-related toxicants, generally at lower levels than cigarette smoking. Toxicant exposure is greatest among dual users, and frequency of combustible cigarette use is positively correlated with tobacco toxicant concentration.”

• The long-term health effects of e-cigarettes are not fully understood, but they are likely safer than traditional cigarettes.

Royal College of Physicians (United Kingdom), 2017: “[T]he possibility of some harm from long-term e-cigarette use cannot be dismissed due to inhalation of ingredients other than nicotine, but is likely to be very small, and substantially smaller than that arising from tobacco smoking.”

National Academies of Sciences, 2018: “While there is uncertainty about the relative harm of e-cigarettes compared to combustible tobacco and their effect on smoking initiation and cessation, the available evidence suggests that e-cigarettes are likely to be substantially less harmful than combustible tobacco.”

• In one study, e-cigarettes were nearly twice as effective as traditional smoking cessation tools to quit smoking.

New England Journal of Medicine, 2019: “E-cigarettes were more effective for smoking cessation than nicotine-replacement therapy, when both products were accompanied by behavioral support.”

• The potential of e-cigarettes to promote smoking cessation among adults might outweigh the risks associated with young people’s use of e-cigarettes.

Nicotine & Tobacco Research, 2018: “Our analysis strongly suggests that the upside health benefit associated with e-cigarettes, in terms of their potential to increase adult smoking cessation, exceeds their downside risk to health as a result of their possibly increasing the number of youthful smoking initiators.”

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