Vaping vs. Smoking: Differences, Effects, and Risks

By Latifa deGraft-Johnson, MD
Medically reviewed checkmarkMedically reviewed
April 7, 2022

If you are trying to quite smoking cigarettes, and you’re considering vaping as a “safer” alternative, there are things you should know.

Vaping can be just as addictive as smoking, so it can be difficult to quit, even if being used as a smoking cessation tool.

Both vaping and cigarette smoking can be harmful, and can cause serious side effects.

Just as with a cigarette, a seemingly innocuous puff on a vape can rapidly turn into a habit, and eventually, an addiction.

In this article, I’ll explore more of the similarities and differences between smoking and vaping, including which age groups are using each.

I’ll talk about the health risks of both, about which is more harmful, and offer some strategies to help you quit. Finally, I’ll tell you when to see a doctor about symptoms associated with smoking and vaping.


While vaping has become more popular among consumers of all ages in recent years—around 6% of U.S. adults vape—it’s especially popular among young people.

In September 2021, the U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) released some unsettling findings from the 2021 National Youth Tobacco Survey (NYTS).

In 2020, researchers found that more than 3.6 million U.S. youth were vaping regularly.

This number decreased in 2021, believed to be reflective of underreporting due to the pandemic.

Students as young as middle school are vaping. Increasing numbers of teens and young adults are vaping and developing nicotine dependence.

Among young people who vape, 85% reported using flavored e-cigarettes such as menthol, mint, candy, and fruit flavors, with a majority of users admitting that the appealing flavors are the main reason for use.

It is unsafe for youth to use any form of nicotine, including cigarettes and vaping. Smoking in any form is an epidemic among our youth, and a public health crisis.

The CDC, FDA, and other private and public sector groups have implemented programs aimed at prevention and cessation to help minimize incidence of use in youth. 

Concerned about the health effects of vaping or smoking? Chat with a medical provider through K Health.

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Vaping vs. Smoking

The fundamental difference between smoking traditional cigarettes and vaping is smoke versus vapor.

Smoking delivers nicotine to your lungs by burning tobacco—the smoke is then inhaled.

Vaping uses a battery-operated heater to warm an e-liquid or “e-juice,” creating a vapor that is consumed.

Because both methods deliver nicotine to your lungs, they can lead to nicotine addiction and cause serious health complications.

E-liquids contain several ingredients, such as ultrafine particles, that can be harmful to your health.

Vaping long-term risks 

Vaping did not enter the US marketplace until 2007, so its long-term effects are still being studied. But this does not mean vaping is safe.

JUUL and other electronic cigarettes have been linked to serious health problems.

This includes lung deterioration and injuries, nicotine addiction and poisoning, and seizures. 

Vaping for a long period of time can put you at a greater risk of having a stroke or heart attack, and some studies show that it may accelerate the development of cancer.

In addition, nicotine and cannabis have been shown to affect brain development and mental health.

This is particularly concerning in young people and those who smoke or vape during pregnancy, as brain development begins in the womb, and continues through age 25. 

Some vape flavorings and additives have been associated with severe health problems.

Diacetyl, a popular flavoring, can lead to lung problems.

Vitamin E acetate, used as a thickening agent in e-cigarettes containing THC, has been tied to a dangerous lung disease called e-cigarette or vaping product use associated lung injury (EVALI).

EVALI causes shortness of breath, fever, and rapid heart rate.

Smoking long-term risks

Smoking conventional cigarettes is associated with long-term risks that can be severe and even fatal.

More than 16 million Americans suffer from a disease caused by smoking, and the habit can harm nearly every organ in your body.

Smoking is the leading cause of preventable death in the United States.

Smoking can cause irreparable damage to your lungs and lead to a multitude of health complications including cancer, diabetes, stroke, heart disease, vascular diseases, and lung diseases.

You are at an increased risk for developing chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis, if you smoke.

Smokers are also at a greater risk for tuberculosis, immune system complications including rheumatoid arthritis, and certain eye diseases. 

Which is More Harmful?

Neither is safe. Both cigarettes and e-cigarettes contain thousands of chemicals—in the case of vapes, thousands of these chemicals are still unknown.

Many of these are toxic chemicals and cause serious health conditions.

When you inhale from either a cigarette or e-cigarette, these toxic chemicals can damage not only your lungs, but are carried very quickly to the rest of your body.

Since we do not yet have long-term data, the effects of e-cigarettes are still being studied.

The FDA has not approved of any vaping device as a tool for tobacco cessation.

More research is needed in order for them to make a statement in this regard.

Precautions to Keep in Mind 

Due to the outbreak of EVALI, the CDC warns that vaping products containing THC are particularly dangerous due to the use of vitamin E acetate for thickening.

This chemical has been prevalent in all lung fluid samples of EVALI patients examined by the CDC.

Quitting Vaping vs. Quitting Smoking

For many smokers who are trying to quit, vaping may be an enticing choice—it is marketed to be “safer,” with fewer chemicals.

Vaping is not a safe substitution.

The number of toxins in vape products is being investigated by the FDA, but is still considered to be significant.

For many, vaping can turn into a habit where you both smoke and vape, exponentially increasing nicotine consumption and exposure to unknown chemicals.

Which is more addictive?

Studies show that both vaping and cigarette smoking can be addictive, and is dependent on many different factors, including age, social-economic factors, and others.

In some cases, vaping can be more addicting among the youth with peer pressure, flavors, frequency of use, and perception of safety, because it doesn’t produce the smell of a cigarette, people may be vaping in their home more frequently, and therefore, increase habit and addiction potential. 

Doses of nicotine are unregulated in each inhalation, and therefore, the amount of nicotine varies.

Over time, you may find your nicotine intake and requirement increases.

If you do vape, please consider what e-cigarette you are purchasing, as some have extra-strength cartridges which can increase your nicotine intake.

Because nicotine is highly addictive, it can make both smoking and vaping very difficult to quit.

Expect the first few days of quitting to be challenging as your body enters nicotine withdrawal.

If you are trying to quit either habit, consider the following:

  • Know what symptoms to expect: And choose a time when you are best able to manage those symptoms.
  • Have a quit plan: Your healthcare provider can help with this.
  • Avoid triggers: This may include certain daily routines, alcohol, and other smokers.
  • Replace the activity of smoking with something else: When you have the craving, consider going for a run, walk, or eating something healthy.
  • Utilize free resources: This includes joining groups to help you stay on track.
  • Be patient with yourself.
  • Reward yourself for staying on plan.

Quitting is not easy.

If you relapse, think about what triggered you to start again.

Try to avoid this trigger when you stop smoking or vaping again.

Concerned about the health effects of vaping or smoking? Chat with a medical provider through K Health.

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When to See a Doctor 

If you vape, you put yourself at risk of EVALI.

The symptoms of EVALI are quite similar to the flu and other illnesses, which make it difficult to diagnose.

Visit your healthcare provider right away if you have any of the following symptoms and are a regular vape consumer:

Smokers tend to have clearer signs that something might be wrong.

Visit your doctor if you smoke regularly and have any of the following symptoms:

  • Persistent cough that lasts longer than 2-3 weeks 
  • Colorless, blood-tinged, white, or yellow-green phlegm
  • Shortness of breath 
  • Wheezing, or a raspy sound when breathing
  • Chest pain
  • Sore throat

Visit your doctor if you start exhibiting symptoms you suspect may be attributed to smoking.

Your doctor will do a physical examination and treat you accordingly.

In some cases, they may prescribe medications to help you quit smoking.

How K Health Can Help

Are you looking for help to quit smoking or vaping? Speaking to a doctor can help you make an effective quit plan.

Did you know you can get affordable primary care with the K Health app? Download K Health to check your symptoms, explore conditions and treatments, and if needed text with a provider in minutes. K Health’s AI-powered app is based on 20 years of clinical data.

Frequently Asked Questions

Is it better to vape or smoke?
Both contain thousands of chemicals, which are extremely harmful and can lead to serious health conditions. As we do not have data on long-term consequences of vaping, more research is still needed in order to truly compare risks and benefits of using vaping as a smoking cessation tool.
What are 5 negative effects of vaping?
Vaping can cause long-term irreparable lung damage. It can also impact your brain’s development. When you vape, you consume thousands of unknown chemicals. Additives in vape juice can cause you to become addicted. And many people can be influenced by the media and marketing due to enticing artificial flavors.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Latifa deGraft-Johnson, MD

Dr. Latifa deGraft-Johnson is a board-certified family medicine physician with 20 years of experience. She received her bachelor's degree from St. Louis University, her medical degree from Ross University, and completed her family medicine residency at the University of Florida. Her passion is in preventative medicine and empowering her patients with knowledge.