Are E-Cigarettes Safer to Smoke?

By Sally Wadyka. Medically reviewed by Tom Iarocci, MD. May 7th 2016

Electronic cigarettes, more commonly called e-cigarettes, are battery-operated devices that contain a heating element. This allows users to inhale a water vapor (usually containing nicotine, flavors and other chemicals) instead of tobacco smoke. Some people refer to using an e-cigarette as vaporizing “or vaping” instead of smoking, because there is no real smoke involved.

Proponents of this new trend hail e-cigarettes as not only a safer alternative to smoking, but also as a technique to help regular cigarette smokers quit. But critics are raising safety concerns and questions about just how “healthy” e-cigarettes really are.

“The most important message to consumers is that, unfortunately, we don’t have all the answers right now,” says Michael Fiore, MD, MPH, professor of medicine and founder of the University of Wisconsin Center for Tobacco Research & Intervention. “These devices have only been around a couple of years so we don’t have research on their long-term effects.”

Potential Benefits of E-Cigarettes

One of the major hazards of smoking traditional cigarettes is that you’re inhaling carcinogenic tobacco smoke, which increases your risk of several types of cancer, including lung, mouth, throat and stomach cancers. That is why proponents of tobacco-free electronic cigarettes claim that these devices are a healthier alternative.

“The general consensus is that, because they don’t involve burning, they are safer than cigarettes,” says Fiore. “The real killer in tobacco cigarettes is the burning.”

With no smoke, using these devices in public (even in places that have banned smoking) won’t cause those around you to suffer from exposure to secondhand smoke. Plus, they won’t leave your home and clothing smelling like an ashtray.

Many manufacturers also market e-cigarettes as effective devices to help people quit smoking, even though the U.S. Food and Drug Administration has not approved any e-cigarettes currently on the market for that purpose.

The Dangers of Vaping

Just because you’re not inhaling tobacco smoke doesn’t necessarily mean e-cigarettes are safe to use. An FDA analysis of two brands of e-cigarettes found that the vapor not only contained nicotine but also traces of toxic chemicals, including carcinogens (or cancer-causing agents).

One recent study by researchers at the University of Athens in Greece found that airway resistance increased immediately after using an e-cigarette, an indicator that inhaling from these devices could harm the lungs (although it did not demonstrate whether or not they caused lasting effects with long-term use).

The FDA is calling for more research on these products, stating that they “have not been fully studied,” leaving consumers without good information about possible health risks or their effectiveness as smoking cessation devices. There is also concern from the American Lung Association, the Academic Pediatric Association and other groups about whether e-cigarettes are a so-called “gateway” that leads users to try smoking real cigarettes — not to mention getting more people addicted to nicotine.

“Adolescent brains are very sensitive to nicotine,” says Fiore. “The risk of lifelong addiction is much greater if people are exposed to nicotine as teens instead of later in life.”


The FDA’s Center for Tobacco Products has the authority to regulate e-cigarettes, but the agency has not yet revealed a plan to oversee these devices. Any manufacturers that make therapeutic or “quit smoking” claims are subject to FDA oversight, and currently, no e-cigarettes have been FDA-approved to help people quit smoking.

For now, experts urge caution when it comes to e-cigarettes. While they are most likely safer than smoking tobacco cigarettes, there are still too many unknowns to claim they are a totally safe alternative. The safest thing to do is to abstain from cigarettes — of any kind — altogether.  

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