Smoking vs. Vaping: Which is Worse?

From ads and articles to posters and product labels—tobacco warnings are everywhere.

In big, bold letters, they spell out words like “heart disease”, “stroke” and “lung cancer” to remind us of one undeniable truth: smoking is bad for our health.

But what about vaping? How much do we really know, and is it better or worse for us than consuming tobacco?

Like tobacco products, most e-cigarettes contain nicotine, an addictive ingredient that makes it much harder for users to quit. This means that people who vape can be exposed to other harmful chemicals found in the products for longer periods of time.

In addition to nicotine, the National Institutes of Health lists other ingredients found in e-cigarette vapor including propylene glycol, vegetable glycerin, Vitamin E acetate and flavoring agents intended to be eaten, not inhaled.

“No tobacco products, including e-cigarettes, are safe,” explains Dr. Kris McDonough, pulmonologist on staff at Silver Cross Hospital and co-medical director for the Midwest Institute for Lung at Silver Cross. “Nicotine has been shown to harm brain development, which continues until about age 25. If nicotine is used regularly during adolescence, it can damage the parts of the brain that control attention, learning, mood and impulse control. What’s more, adolescents who use nicotine may be at increased risk for future addiction to other drugs, and youth who vape may turn to cigarettes in the future.”

In August of 2024, Dr. McDonough created a short educational video about the dangers of smoking and vaping, especially in younger populations. “As many as 1 in 5 young adults between the ages of 18 to 24, vape, and as many as 1 in 10 do so daily,” he said. “This is not an innocuous issue”

The addictive nature of nicotine aside, youth with asthma and other respiratory conditions are especially at risk for complications from vaping.

So if the question is: smoking versus vaping: “Stay away from both,” Dr. McDonough concludes.