Vaping vs Smoking: Long-Term Effects on Lungs, Positive Science?

1. Introduction to Nicotine, Cigarettes, Vaping, and Lungs

Nicotine is a highly addictive substance. It has the potential to be deadly at high doses. The scrutiny of nicotine began with a 2013 review that suggested humans may have survived higher doses than previously estimated. The review papers concluded that 500-1000 mg of ingested nicotine could potentially lead to fatal outcomes, equating to 6.5-13 mg/kg orally. Accidental ingestion of as little as 6 mg can be deadly for children. 6 mg solutions are quite common in e-liquid thus making its storage a significant safety measure to take in households. The amounts listed are for oral ingestion, these levels would barely result from cigarette smoking or vaping electronic cigarettes.

The above levels indicate that the lowest dose for adults is 50 mg of disposables (also labeled as 5%). Keep these symptoms in mind when vaping: nausea and vomiting, excessive salivation, abdominal pain, pallor, sweating, hypertension, tachycardia, ataxia, tremor, headache, dizziness, and muscle fasciculations are all common symptoms felt as a result of inhaling too much nicotine. 

Smoking cigarettes has long been known to negatively affect one’s heart and lungs. But what makes someone more at risk for heart attacks, blood clots, and strokes? Most at risk are people with acquired high blood pressure (hypertension), those with low levels of HDL cholesterol, high levels of LDL cholesterol or triglycerides, cigarette smokers, those under a lot of stress, those who consume too much alcohol, those leading a sedentary lifestyle, those weighing more than 30% over their ideal weight range, and people eating a diet higher in saturated fat. Of course, anyone can suffer from a heart attack—which is why it’s important to be mindful of any risk factors that apply to you and make lifestyle changes where possible to reduce them. For those addicted to smoking – vaping e-cigarettes is one harm-reduction method.

2. Ingredients in E-Liquids vs Toxic Chemicals of Cigarettes

Many people assume vape juice contains the same carcinogenic chemicals as cigarettes, but that isn’t the case. Unfortunately, like many other organizations, the American Lung Association has fallen victim to misinformation and is making claims regarding vape juice that aren’t accurate. Vape juice is comprised of four ingredients: propylene glycol, vegetable glycerin, flavorings, and nicotine; all of which are food-grade chemicals used for various products. The American Lung Association erroneously lists vape juice as containing formaldehyde, toluene, acetaldehyde, lead, and more; none of these in any way constitute vape juice. With vaping being a much healthier alternative to cigarettes with far fewer toxins and carcinogens it’s disheartening that this type of misinformation is out there.  Here is the list of chemicals the American Lung Association states are in e-cigarettes (with my corrections):

• Nicotine is a powerful and potentially dangerous substance. Inhalation of nicotine has beneficial effects, however, absorption through the skin or ingestion can be poisonous. Therefore caution should always be used when in contact with nicotine.
• Propylene glycol is a common additive found in many food items. This ingredient works to keep foods moist, flavorful, and vibrant – from the sweet vanilla extract used for baking delicious treats to popular coloring agents which give our dishes their hues! It’s also been approved as an antifreeze alternative by The Environmental Protection Agency; while not safe for human or pet consumption, it can be utilized in such applications with far less risk of harm than other chemicals. In addition, propylene glycol may turn up in paint solvents – perfect if you’re looking to freshen up your walls and clean any residue that might have accumulated during vaping! Many fog machine liquid mixtures are made up of propylene or ethylene glycol, and for the best results, it’s important to use food-grade propylene. Make sure you know where your propylene glycol has come from before inhaling any artificial smoke/vapor!
• Chemical-based carcinogens, such as Acetaldehyde and Formaldehyde, increase the risk of cancer. Extensive research into e-cigarette aerosol reveals that it contains considerably lower levels of these toxins compared to tobacco smoke – confirming potential danger potencies for those using electronic cigarettes is <1% in comparison with traditional smoking. Furthermore, biomarker studies demonstrate a more favorable toxicity profile among e-cigarette users versus smokers. With research, I have found that this topic holds true. Though ALA does not confirm its statement, the evidence is there to explore!
• Acrolein is primarily used as an herbicide to kill weeds. Contrary to popular belief that weed killer and lung damage are related, biomarkers showed similar exposure levels between former smokers who use FDA-approved nicotine replacement therapies (NRTs) and vapers using e-cigarettes. This suggests Acrolein’s presence in vaping devices could fall within what has been deemed safe by the Food & Drug Administration for NRTs. Studies fail to support the American Lung Association’s claims, suggesting that further research be done in order to understand any related impact.
• Despite the public (and American Lung Associations‘) misconception, vaping does not increase the risk of developing bronchiolitis obliterans – or ‘popcorn lung’ as it is commonly known. Although in some cases diacetyl can be present in e-cigarette liquids, there have yet to be any confirmed cases involving users who commercially purchased these products since 2006. E-cigarettes remain a useful tool for those wishing to transition away from traditional cigarettes with lower health risks associated.
• Diethylene glycol (DEG) is a toxic chemical found in antifreeze and other products. It’s also used as humectants – agents that keep the tobacco cigarettes moist to make smoke gentler on throats but more easily inhaled. Although present in certain electronic cigarette refill bottles, it was below potentially dangerous levels. The American Lung Association does not list any evidence, so we research sources, not just hearsay drove from one website to another.
• Noting the online presence of misinformation regarding heavy metals in vaping, leading researchers Konstantinos Farsalinos and Brad Rodu have published a study finding that exposure to such emissions is minimal enough to be considered an insignificant health risk. In fact, even if unrealistically high levels of liquid were consumed regularly – which falls outside normal use parameters- total metal intake would still remain below the safety threshold. The American Lung Association continues to promote an unsubstantiated assertion.
• This study provides evidence that switching to e-cigarettes can drastically reduce smokers’ exposure to cadmium, a carcinogenic substance found in regular cigarettes. Further research suggests the potential for reduced lead (Pb) levels among users as well; though this finding is overshadowed by other external factors. Ultimately, these findings point towards electronic cigarette use being an effective way of reducing the risk of smoking traditional cigarettes and serving as a harm-reduction device regarding Cd exposure.
• The findings of this study on the volatile compound benzene in electronic cigarettes are interesting. At their recommended setting, no significant amounts were detected – however such levels increased substantially with higher wattage and longer puffs – reaching up to 24 μg/g. The Subtank revealed low-detection or undetectable levels at its extreme power settings. It’s interesting to note that while car exhaust is one known source of VOCs, indoor sources like e-cigarettes were not mentioned for potential harm caused by pollutants like Benzene (via the American Lung Association). The findings present us with a startling comparison: inhaled air containing up to 5000 μg/m3 of benzene compared to the ambient levels at 1 μg/m3. Taking into account the average number of breaths taken each day and assuming realistic vaping conditions, you would need to consume an astonishing amount of e-liquid in order for exposure levels of benzene similar to ambient air rates. In fact, Subtank users at 25 W with 5-second puffs must inhale 105 mL daily while EVOD users require 125 mL per day – both unthinkable amounts! See my opening paragraph in Is Vaping More Harmful Than Smoking Cigarettes?
• Pharmaceutical Grade Vegetable Glycerin (American Lung Association doesn’t even mention this ingredient) is a natural chemical derived from vegetable oils. It gives e-liquids a thick sensation and a smooth throat hit that makes sub-ohm vaping enjoyable without the harshness of Propylene Glycol. In addition to VG’s consistent performance in vapor production, it provides users with sweetness on each inhale – perfect for those looking to take their vape experience up another notch! VG is an increasingly popular suspending agent for nicotine and flavorings in e-liquids. Classified as “generally recognized as safe” by the FDA, VG has a very low toxicity profile when consumed according to the SIDS assessment report. It also rarely causes irritation of skin or eyes, making it suitable for human use – in line with its widespread application in food and medicine where ingestion is typically more common than inhalation. I personally mix to 60/40, which is a nice balance for both pods and tanks. Recently, there has been debate about the safety of Vegetable Glycerin for vaping. Despite warnings that it may cause lung irritation, its popularity among millions of vapers since 2009 speaks volumes and indicates a low-risk factor when used as intended.

Smoking cigarettes, cigars, and pipe tobacco all come from dried tobacco leaves (with additional flavorings), but the smoke from these products contains thousands of chemicals – including at least 70 known cancer-causing chemicals. Carcinogens such as hydrogen cyanide, formaldehyde, lead, arsenic, and ammonia are just some of those found in tobacco smoke. Moreover, cigarettes still carry other dangerous toxins and chemicals like radioactive elements like polonium-210, benzene, carbon monoxide, and TSNAs that could create long-term negative health effects when inhaled.

Cigarette smoke is a health hazard – composed of many dangerous substances, it has been scientifically linked to cancer, heart disease, and lung ailments. Even more alarming than the chemical additives used in cigarettes is that much of this danger comes from toxic chemicals contained within the burning tobacco itself. Due to these dangers, people should seriously consider switching from cigarettes and combustible tobacco to a safer alternative.

If you are curious about vaping versus cigarettes, consider the radioactive materials in tobacco leaves used to make them. These materials, such as potassium and carbon, come from the soil used to grow the tobacco and may differ depending on where it was grown. What is more concerning, however, is smokers inhale these carcinogenic materials when they light up. Not only does vaping provide a cleaner substance for inhalation with fewer toxins overall, but there is also no risk of this radiation entering into one’s body or increasing the chances of lung cancer. Vaping could very well be the smarter choice for any smoker looking to switch.

3. Is Vaping 95% Safer Than Cigarettes?

See Vaping is 95% safer than smoking. Fact or factoid? 

Vaping is promoted as being 95% safer than cigarettes, but this number doesn’t come from one particular source; instead, it comes from the observations of leading health organizations. One organization, The United States National Academies of Science, Engineering, and Medicine has done reviews of the scientific evidence available and determined that vape products are safer compared to smoking traditional cigarettes. While they didn’t give a direct percentage comparison, the 95% figure seems to be appropriate for vape users to understand what kind of relative risk there is when switching from cigarettes to vape products. Despite the unknowns concerning long-term vaping effects, it’s been nearly 15 years since people started using e-cigarettes. During this time period, significant health benefits due to cigarette replacement have become a reality for many users.

Considering vape vs cigarette, it is essential to explore the 95% figure of e-cigarettes producing fewer toxins. The gases and chemicals associated with regular cigarette smoke are practically eliminated with vaping as there is no tobacco burning or smoke inhaled. After testing vapers’ blood and urine in comparison to smokers’, results revealed the levels of toxins were often lower than those of nonsmokers, sometimes only 1% of what would usually be found in a smoker. This evidence helps when discussing vaping vs cigarettes – the choice is to vape if health is considered.

Vaping is seen as a healthier alternative to cigarettes, with reports of vape aerosol having fewer amounts of toxins than cigarette smoke. It’s been reported that switching to vaping can lead to vast improvements in your health, such as improved lung function, lower blood pressure, reductions in asthma and COPD symptoms, and others. Additionally, people have also reported feeling better health-wise when making the switch from cigarettes to vape products. While there is still some risk associated with vaping, it is estimated to be far less than the risk of smoking cigarettes. Therefore, if you’re a smoker looking for a healthier option that won’t impact your health as negatively as cigarettes do, consider making the switch from combustible tobacco to e-cigarettes.

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4. Which is Better for the Lungs, Vaping or Smoking?

Inhaling vape compared to a traditional cigarette has a distinct difference in how it affects the user’s lungs. Initially, vape was thought to be the cause of respiratory issues such as asthma and COPD by some researchers. However, in some studies, it has been shown that vape actually improved lung health after five years when compared to cigarette smokers. E-Cigarette users experienced little signs of wheezing, bronchitis, or other symptoms associated with asthma or COPD. It should be noted that these changes also occurred because users of vape have eliminated the carcinogens by removing elements like tar found in cigarettes.

Electronic cigarettes have been on the rise in recent years due to their purported health benefits over conventional cigarettes. However, understanding the long-term effects of vaping on those with chronic obstructive pulmonary disease (COPD) is still unexplored. A 5-year assessment was conducted in a group of COPD patients who either greatly reduced smoking or quit entirely by switching to electronic cigarettes, and the results revealed significant positive changes in respiratory parameters compared to continued use of cigarettes.

COPD, a condition characterized by inflammation and changes to the airways, has been linked to the smoking of cigarettes for many years. Quitting smoking is the only proven strategy that positively influences the outcome of COPD, as it can halt its progression and also reduce the risks of suffering from other related illnesses. Mortality rates associated with COPD indicate that abstaining from cigarette habits may be critical in ensuring better health. Discarding traditional tobacco consumption is an evidence-based option with widely acknowledged benefits, thus encouraging those struggling to quit smoking to take hold of e-cigarettes.

Smoking cessation is a critical priority for people with COPD, however, it comes with high failure rates among those trying to quit. Currently licensed therapies such as nicotine replacement therapy (NRT), bupropion, and varenicline show limited success in helping smokers with COPD break the habit on a sustained basis. These patients may find it difficult to stop smoking altogether and may require prolonged treatment and/or controlled levels of nicotine use to achieve abstinence.

Electronic cigarettes have been gaining traction among smokers as an alternative to reduce their cigarette consumption, save money, and still get the experience of smoking without the associated health risks. Unlike traditional cigarettes, e-cigarettes contain no tobacco and do not require combustion, which decreases the risk by reducing exposure to toxic chemicals emitted by burning material. Though not completely safe, laboratory testing has found that there are considerably lower amounts of harmful chemicals present in emissions from e-cigarette aerosols when compared to conventional cigarettes.

It is expected that swapping traditional cigarettes for electronic cigarettes will result in a decrease in toxic exposure, producing important health gains. It is believed that tobacco harm reduction strategies enabled by electronic cigarettes have the power to save more lives swiftly than ever before. Nonetheless, it remains uncertain how successful people are when switching from regular cigarettes to electronic cigarettes, as many users of e-cigarettes may not be able to completely stem their desire for conventional cigarettes.

This research found impressive long-term health benefits associated with using electronic cigarettes to aid in smoking cessation. Patients reported no negative effects, and objective analysis revealed fewer exacerbations each year and improved health status. These improvements were seen to last for three years under the same scientist’s observance, which points to a meaningful and long-standing improvement in physical well-being from vaping. Health effects in COPD smokers who switch to electronic cigarettes: a retrospective-prospective 3-year follow-up.

Data on chronic obstructive pulmonary disease patients from 2013-2019 were collected to understand how electronic cigarettes can impact COPD. Eligible COPD patients admitted to regular exposure to electronic cigarettes and were categorized according to those who reported consistent daily use for at least 12 months. This study provided detailed insight into how a smoke-free lifestyle can be adopted through the use of an alternative product. Electronic cigarette users showed the potential of vaping products as an effective method of harm reduction. At baseline, these individuals were not using e-cigs, and data was collected from age/sex-matched counterparts who did smoke conventional cigarettes during a specific time period. Most outpatients had no inclination to quit despite being offered advice at each contact point – making this analysis an indication of whether e-cigarettes are effective for people with chronic respiratory conditions. Drawing upon the approved data from ‘Policlinico-Vittorio Emanuele Hospitals’, this study conducted follow-up visits at strategic intervals of 12, 24, 48, and 60 months. With each participant providing informed consent prior to participation, researchers were able to piece together a comprehensive narrative.

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Severe exacerbations were defined as changes in a patient’s pulmonary symptoms that required antibiotics and/or oral corticosteroids from the primary care physician, emergency department attendance, or hospital admission. In these cases, nebulized therapy may have been used to improve the patient’s condition. Furthermore, the participants of this study were divided into two groups – quitters (single users) and dual users according to their conventional tobacco smoking habits. The quitters completely ceased their tobacco smoking but still used electronic cigarettes whereas dual users would alternate between electronic and conventional cigarettes.

5. Study Results, You Judge

With an initial enrollment of 48 individuals at baseline, 39 datasets were available for completion at 60 months for COPD patients. Of these 39 datasets, 33 belonged to male participants and 6 to female participants. From the electronic cigarette user group, four Patient datasets were excluded due to relapse or quitting vaping. Similarly, from the COPD smoker group, five patient datasets could not be included in the study due to varied reasons such as quitting smoking and developing a malignancy, etc. These exclusions have been taken into consideration while analyzing the results.

Vaping products were used by COPD patients, with a mix of devices and e-liquids being changed quite frequently during the 5-year span of the study. Initially, 9% of users were using standard refillable e-cigs at baseline; this progressed to 18% by the first wave. Although no further hardware details were recorded after the first wave, nicotine was tracked. Most users started with medium/high (12–18 mg/ml) nicotine strength but then gradually reduced over time; at 5-year follow-up, only 2 out of 20 users were still using medium/high nicotine strength while the remaining were on low (3–9 mg/ml ) nicotine strength e-liquids. This is how needs can lead to relative changes in habits over time.

After participation in the program, COPD exacerbations reduced from 2.3 at baseline to 1.1 after 4 years; whereas, there was no significant change in control groups over the same time period. Furthermore, post-bronchodilator FEV1 and FVC also significantly improved for those using electronic cigarettes compared to the baseline values at all follow-up visits with the exception of follow-up 2 which had a non-significant decline. The study revealed that those using electronic cigarettes scored significantly higher on spirometric assessments than the non-users. It appears that e-cigarette users had better lung capacity when compared to others.

In their study, after the longest clinical follow-up ever documented in this field, it is clear that the long-term health effects of reduced smoking via vaping are profoundly positive. Proven medical benefits of smoking cessation, such as slowing COPD progression and enhancing respiratory health, are further solidified by this research. The results indicate a shift away from smoking towards vaping may benefit COPD patients’ improving health.

The study presented a major finding, a reduction of up to 50% in COPD exacerbations, which are episodes of increased symptoms or deterioration and poor response to treatment, was observed. This magnitude is similar to that seen with pharmacological interventions and thus clinically significant for patients. Cigarette smoke exposure has been known to weaken airway immunity and increase the difficulty faced by persons struggling with COPD, so quitting can bring improvements in their condition.

Another interesting finding revealed that only 8.3% of patients from the COPD electronic cigarette user group relapsed back to smoking over the course of 5 years. This implies that vaping may be an effective relapse prevention tool, as it creates a similar experience to smoking in terms of rituals and physical and behavioral effects. Lower relapse rates with vaping have also been observed in smokers with schizophrenia, asthma, and hypertension when compared to conventional nicotine replacement therapies such as patches or chewing gum. Lowering relapse rates among smokers with COPD is important for success in quitting, as current smoking cessation programs have not proven highly effective. It appears that modern vaping devices offer a solution to help cigarette users achieve and maintain long-term smoking abstinence.

Studies concerning COPD and cigarettes are of value, as they enlighten physicians in charge of smoking patients with COPD and ultimately save lives. While the degree to which COPD patients may be resistant to quitting or reducing cigarettes is concerning, utilizing much less harmful alternatives may limit their suffering and reduce mortality rates caused by cigarette smoking. As such, health professionals should take all available options into consideration, including electronic cigarettes, when it comes to treating their patients. Doing so could potentially cut back on respiratory problems that may have otherwise been unavoidable due to ongoing exposure to tobacco smoke. These findings provide a valuable starting point for more comprehensive studies in order to gain clarity on how vaping could help those struggling with smoking cessation and/or reverse chronic health complications associated with this debilitating condition. Health professionals should take heed of these results when granting advice about tobacco alternatives, particularly if their patients are having difficulty quitting or don’t wish to.

6. Additional References: Vaping vs Smoking and Your Lungs

https://en.wikipedia.org/wiki/Nicotine_poisoning

https://www.hopkinsmedicine.org/health/conditions-and-diseases/heart-attack

https://vaping360.com/learn/vg-vs-pg/#:~:text=.-,VEGETABLE%20GLYCERIN%20%28VG%29

https://www.cancer.org/healthy/cancer-causes/tobacco-and-cancer/carcinogens-found-in-tobacco-products.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154473/

https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-update

https://www.sciencemediacentre.org/expert-reaction-to-nicotine-vaping-in-england-an-evidence-update-as-published-by-the-office-for-health-improvement-and-disparities-ohid-and-authored-by-scientists-at-kcl/

7. Conclusion

This article has discussed nicotine, cigarettes, vaping, and their effects on the lungs. It has explored the actual ingredients in e-liquids and compared them to the toxins that are released when smoking a cigarette. Furthermore, we have found evidence to suggest that electronic cigarettes can actually help improve lung ailments – something which could potentially save lives. With an abundance of reliable research sources from clinical trials to back this up, it is safe to say that the conclusion of this article is that vaping is better for your lungs than smoking. But what do you think about this? Share your thoughts and opinions in the comment section below!