E-cigarettes vs. Combustible Cigarettes: A Harm Comparison
Electronic cigarettes are generally considered less harmful than traditional combustible cigarettes. This is primarily because e-cigarettes heat a liquid to create an aerosol (vapor), rather than burning tobacco. The combustion of tobacco releases thousands of chemicals, many of which are toxic and carcinogenic. By avoiding combustion, e-cigarette users are exposed to significantly lower levels of many of these harmful substances, such as tar and carbon monoxide.
Health Risks Associated with E-cigarette Use
Despite being a less harmful alternative to smoking, e-cigarettes are not risk-free. Their use carries several health concerns:

- Nicotine Addiction: Most e-cigarettes contain nicotine, a highly addictive substance. Nicotine can impair adolescent brain development, which continues into the early to mid-20s, and is harmful to fetuses during pregnancy. It also poses risks for individuals with pre-existing heart conditions.
- Harmful Aerosol Constituents: The aerosol produced by e-cigarettes is not merely water vapor. It can contain potentially harmful substances, including:
- Ultrafine particles that can penetrate deep into the lungs.
- Flavoring chemicals, some of which (like diacetyl) have been linked to serious lung disease.
- Volatile organic compounds (VOCs).
- Heavy metals such as nickel, tin, and lead, which can leach from the heating coil.
- Lung Damage: Inhaling e-cigarette aerosol can irritate the lungs and may lead to inflammation or damage. Cases of severe lung injury have been associated with vaping, particularly with products containing THC and vitamin E acetate, but risks from nicotine-only products are still being evaluated.
- Cardiovascular Effects: Nicotine acutely increases heart rate and blood pressure. While the long-term cardiovascular effects of vaping are still under investigation, these immediate impacts are a concern, especially for those with heart disease.
- Unknown Long-Term Effects: E-cigarettes are relatively new products, and the full extent of their long-term health consequences is not yet known. Comprehensive longitudinal studies are ongoing.
- Device Safety Issues: Though uncommon, defective e-cigarette batteries have been known to cause fires and explosions, leading to serious injuries.
- Risks to Specific Populations: The appeal of e-cigarettes, particularly flavored varieties, to young people who have never smoked is a significant public health concern. This can lead to nicotine addiction and expose them to the aforementioned health risks. Pregnant women should also avoid e-cigarettes.
Overall Safety Perspective
In summary, while switching completely from combustible tobacco cigarettes to e-cigarettes is likely to reduce exposure to many toxins and carcinogens associated with smoking, e-cigarettes are not safe. They deliver nicotine, an addictive drug, and other potentially harmful chemicals into the body. Therefore, non-smokers, children, adolescents, pregnant individuals, and adults who do not currently use tobacco products should not use e-cigarettes.