A growing body of evidence shows that nicotine vaping is markedly less harmful than smoking and helps adults reduce or eliminate their cigarette use. The fact that millions of people have transitioned from combustible tobacco to vapes is nothing short of a public health miracle—especially since it has occurred despite intense opposition from influential voices in the medical establishment.
Fortunately, the landscape of the debate appears to be changing as more leading public health experts endorse vaping as an effective quit-smoking tool. In February 2023, Nature Medicine, one of the most important medical journals in the world, published a bombshell opinion piece summarizing the case for vaping. The authors didn’t mince words:
“There is abundant evidence that e-cigarettes can help some individuals to quit smoking, so they should be more widely recommended as smoking cessation aids.”
What sort of abundant evidence did they have in mind? Extensive investigations conducted by the US National Academies of Sciences, Engineering, and Medicine, England’s Department of Health and Social Care and the highly esteemed Cochrane Collaboration, whose research reviews are considered the “gold standard” by doctors the world over. Each of these analyses “have concluded that e-cigarette use is likely to be much less harmful than smoking,” the Nature authors explained.
Anti-vaping activists employ a set of boilerplate responses when forced to confront this consensus. Perhaps vaping is less risky, they’ll concede, but it can still cause heart and lung damage. Even reputable health care providers like the Cleveland Clinic have been caught parroting this rhetoric. “Like inhaling cigarette smoke, vaping can cause coughing and chest pain or tightness,” the Clinic told its patients in a recent blog post. There’s also a real risk that non-smoking teenagers will develop a nicotine addiction if they start vaping, critics have claimed.
The Nature authors were quick to highlight the limits of these concerns. There is indeed some preliminary research on animals and isolated human cells suggesting that vape liquids and aerosols may have harmful pulmonary and cardiovascular effects. Again, though, this isn’t the whole story. The Nature piece noted that “it is difficult to extrapolate these effects to human exposures.”
When researchers examine the impacts of vaping on lung health in people, “switching from cigarettes to e-cigarettes reduces symptoms and improves lung function, indicating a reduction in harm.” The same conclusion applies to heart health, the researchers argued. “When smokers quit smoking and switch to e-cigarettes, endothelial function (an indicator of cardiovascular health) improves, indicating harm reduction.”
They also acknowledged that a small percentage of high school students reported vaping last year, but added that “most were current or former cigarette smokers, many presumably already addicted.” Nobody wants teenagers using nicotine from any source—full stop. We should nevertheless accept good news when we get it: e-cigarettes don’t appeal to non-smoking youth.
Nicotine vaping is a relatively recent innovation, so scientists will continue to investigate its health effects. Still, the authors concluded, e-cigarettes “serve as an important, less-hazardous alternative to continued smoking.” It’s time for more governments, public health groups, and health care professionals to “give greater consideration to the potential of e-cigarettes for increasing smoking cessation.”
