The Risks and Benefits of Vaping

There’s some good news when it comes to smoking and public health: Cigarette smoking has been steadily decreasing among US adults. An analysis published in the New England Journal of Medicine Evidence shows that about 1 in 10 Americans reported smoking cigarettes in 2024.

However, that number nearly doubles if you factor in the use of e-cigarettes, often called vapes, nicotine pouches and other non-cigarette products that contain nicotine. The use of those products is also increasing among younger adults, ages 18 to 25. The CDC reports that e-cigarettes or vapes are the most used tobacco product among youth in the United States. Data from the 2024 National Youth Tobacco Survey showed that 5.9% of middle and high school students used electronic cigarettes in the past 30 days.

Vaping refers to using a battery-operated device that allows the user to inhale a combination of nicotine, flavorants, propylene glycol, vegetable glycerin or glycerol and other chemicals in aerosol form. They may also contain cannabis concentrates like THC or CBD.

Nicotine pouches contain a powder that includes nicotine, flavorants and other ingredients. They are typically placed between the lips and gums, where nicotine is absorbed. Once used, the pouch is removed and thrown away. Even if they are marketed as containing synthetic nicotine or non-tobacco nicotine, there is little difference between the nicotine from tobacco plants and these versions.

“For people who do not smoke or use nicotine, using nicotine e-cigarettes is likely to cause nicotine dependence. In addition to nicotine, e-cigarettes include flavorants, propylene glycol, vegetable glycerin and other additives. We do not know the long-term impacts of these on human health, particularly in the lungs,” says Elly Leavens, PhD, assistant professor of population health at the University of Kansas Medical Center and a member of The University of Kansas Cancer Center’s Cancer Prevention and Control research program.

Leavens also explained that while nicotine is not carcinogenic, it is addictive.

“Nicotine alone causes dependence and temporarily increases heart rate and blood pressure,” she says.

Young adults and children can become addicted to nicotine quickly, even if they aren’t regularly using the products. It can affect their brain development, including negative effects on attention, learning, mood and impulse control, according to the CDC.

While vapes and nicotine pouches are less harmful to your health than cigarettes because smoke isn’t being inhaled, there are still risks. For people who do not currently use nicotine, the best course is to not start using any of these products.

 

However, vapes can be a tool to help cigarette smokers stop or at least reduce their overall risk. Leavens says that using e-cigarettes is less harmful than smoking. What’s more, vaping appears to be more effective than some other methods when it comes to quitting.

“There is evidence from randomized trials that nicotine e-cigarettes can help people quit smoking. A systematic Cochrane review that is regularly updated shows high certainty evidence that e-cigarettes are more effective for cessation relative to nicotine replacement therapies (NRT), such as gums, lozenges and nicotine patches. E-cigarettes seem to be about as effective for smoking cessation as some of our best available medications such as varenicline (or Chantix) and combination NRT (i.e., long- plus short-acting NRT),” says Dr. Leavens.

Leavens was the lead author on a paper published in JAMA that provides guidance to clinicians on how to use e-cigarettes to help adults quit smoking. Developed by the Harm Reduction Workgroup of the Society for Research on Nicotine and Tobacco, the paper has practical guidance for how clinicians can talk with patients about e cigarettes and incorporate them into a quit plan.

“Cigarette smoking causes about 30% of all cancer deaths in the United States, and most people want to quit but struggle to do so,” said Leavens. “Adding clear guidance on e‑cigarettes gives clinicians a practical tool that can help people move away from combustible tobacco and toward better health.”

However, it is very important to only use e-cigarettes that have been authorized by the FDA.

“These e-cigarettes have been through a rigorous review process, and their ingredients are well-characterized. If someone plans to use an e-cigarette for smoking cessation, it is critical that they choose an e-cigarette that has received FDA authorization,” says Dr. Leavens.

Patients at The University of Kansas Health System can also access smoking cessation help from UKanQuit. Anyone can contact the Kansas Tobacco Quitline for support.