Switch to vaping ‘substantially reduces’ health risks in smokers, major study finds

The use of vaping products rather than smoking leads to a substantial reduction in exposure to toxicants that promote cancer, lung disease and cardiovascular disease, a UK government-commissioned study has found.

King’s College London, which undertook took the study, said their report represents the most comprehensive review of the risks of vaping to date. It found that, while vaping is not risk free (particularly for people who have never smoked), it poses a small fraction of the health risks of smoking in the short to medium term.

The independent report, titled Nicotine vaping in England: An evidence update including health risks and perceptions, has been commissioned by the Office for Health Improvement and Disparities in the Department of Health and Social Care.

The report reviewed many aspects of vaping, including who is vaping and what products, the effects on health (both absolute and compared with smoking) and public perceptions of harm. The authors examined studies of biomarkers of exposure (measures of potentially harmful substance levels in the body) as well as biomarkers of potential harm (measures of biological changes in the body) due to vaping or smoking.

The report says the strongest evidence, and where there was a greater volume of research, came from biomarkers of exposure. An exploration of the available studies found that levels of tobacco specific nitrosamines, volatile organic compounds and other toxicants implicated in the main diseases caused by smoking were found at significantly lower levels in vapers. Among vapers, overall levels of nicotine were lower or similar to smokers.

“The levels of exposure to cancer causing and other toxicants are drastically lower in people who vape compared with those who smoke. Helping people switch from smoking to vaping should be considered a priority if the government is to achieve a smoke-free 2030 in England,” commented Dr Debbie Robson, a senior lecturer in tobacco harm reduction at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College and one of the report’s authors.

When comparing biomarkers between people who vape and people who don’t smoke or vape, they were often similar, but in some cases there was higher exposure when vaping. The investigators therefore concluded that whilst less harmful than smoking, vaping is likely to sustain some risks particularly for people who have never smoked.

While the investigators are clear on the benefits of vaping vs smoking, they found that public perceptions are lagging behind. In 2021, only 34 per cent of adults who smoked accurately perceived that vaping was less harmful than smoking, while only 11 per cent of adult smokers knew that nicotine wasn’t the primary cause of the health risks connected to smoking tobacco.

“Smoking is uniquely deadly and will kill one in two regular sustained smokers, yet around two-thirds of adult smokers, who would really benefit from switching to vaping, don’t know that vaping is less harmful. However, the evidence we reviewed indicates that vaping is very unlikely to be risk-free. So we strongly discourage anyone who has never smoked from taking up vaping or smoking,” said Professor Ann McNeill, a professor of tobacco addiction at IoPPN and the report’s lead author.

Dr Jeanelle DeGruchy, deputy chief medical officer for England, added: “This important study is the latest in a series which carefully pulls together the science on vaping to help reduce the damage from smoking.

“Vaping is substantially less harmful than smoking so the message is clear, if the choice is between smoking and vaping, choose vaping. If the choice is between vaping and fresh air, choose fresh air. Quitting smoking is one of the best things you can do for your health, please give it a go this Stoptober.”