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Vaping much less harmful to lungs than smoking, review confirms

Posted on August 7, 2019

A comprehensive review of the effects of vaping on the lungs has confirmed that vaping is much less harmful than smoking. The findings are in line with the advice from the British Lung Foundation and reflect the real-world experience of  millions of users.

The review by an international team led by Professor Riccardo Polosa was published this week in the journal Expert Review of Respiratory Medicine. The findings are important because the respiratory tract (throat, airways and lungs) is the primary target of any potential harm from vaping.

The findings are not surprising as the analysis of aerosol shows it has far fewer chemicals than cigarette smoke and those present are at much lower levels.

The review found that many studies are poorly designed and results can be misleading. Importantly, many cell and animal studies do not compare the effects of vaping to those of smoking and present findings which are hard to interpret. This has resulted in many sensational and deceptive media headlines.

Human studies

Human studies provide the most relevant data on the effects of vaping on the respiratory tract and confirm that vaping is unlikely to cause significant health concerns under normal use. Several studies have demonstrated benefits for smokers switching to vaping.

  • Improvements in symptoms (cough, phlegm, etc.)
  • In asthma, 'progressive significant improvement'
  • In COPD (emphysema), reduced symptoms, fewer infections, improved breathing and exercise capacity
  • No studies reported serious adverse events, which is consistent with the real world experience with vaping.

Cell and animal studies

The authors say that cell and animal studies 'are not robust indicators of the potential health risks of using e-cigarette' and have 'limited value'. The dosing and exposure to vapour often does not match normal vaping behaviour in humans. Furthermore, many studies do not compare the effects of vapour to smoking, so are hard to interpret.

Animal studies, mostly in rodents, shows that vaping can cause respiratory irritation, inflammation, oxidative stress and impairment of the immune defences. However, how these changes translate to humans is uncertain.

Studies which expose cells to aerosol have shown some potential effects but these are much less than from smoking when both vapour and smoke are compared.

Studies which expose cells to e-liquid (instead of vapour) are less useful. These studies 'do not represent exposures under normal conditions of use' and 'their relevance is questionable'.

A note of caution

The report acknowledges that very little is known about the long-term health effects of vaping. 'Only large long-range prospective studies of vapers who have never smoked can provide definitive data to demonstrate any potential impacts regular use of vaping products may have on long term health'.

For this reason, vaping is only recommended to adult smokers who are otherwise unable to quit. It is also recommended that vapers stop vaping once they are confident of not relapsing to smoking to avoid unnecessary risk.


Polosa R et al. The effect of e-cigarette aerosol emissions on respiratory health: a narrative review. Expert Review of Respiratory Medicine 2019

Posted by Colin Mendelsohn,

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4 Replies to “Vaping much less harmful to lungs than smoking, review confirms”


Now all you need to do is convince the boffins in Canberra, and those in State governments, that what they believe about vaping is wrong. Their opposition to this system of nicotine delivery proves they have no vested interest in the health of those who smoke tobacco products, nor do they actually want to help people quit smoking.
Yes, liquid nicotine is a Class 7 Poison, but the amounts of the substance used for mixing with e-juice for ingestion with an electronic 'vaping' device have long been considered by health professionals the world over to be Not Harmful. Certainly, chemical tests should be run on the vapor clouds exhaled by the user, to determine what toxins are present. Following those tests, a public education program should be commenced so as to inform the community about what exactly is in the 'average vape cloud', instead of dispersing false and misleading information via Fear Campaigns. Our civic leaders need to Educate, other than simply Legislate against a practice it incorrectly deems harmful.
Lastly, quick question to ponder…
Why is it across Australia tobacco products and vaping products are restricted for sale to those over the age of 18 years, and the sale of liquid nicotine is prohibited, yet anyone of any age can walk into any major chain supermarket and buy (*brand name here*) lozenges, gums and mouth sprays which contain nicotine?

Bill Richards

This echoes the real world experience of most vapers, some vapers do find that lower PG content is far less irritant than the higher PG e-liquids so 70VG30PG or even 80VG20PG is less harsh.
Many who vape higher VG liquids also reduce nicotine use even quitting using nicotine completely further reducing health risks

Dr Karen Counter

Yet another study confirming that vaping is much less harmful than smoking.
Of course we need more studies on any potential harmful effects of vaping, but as the "poisons" in vaping are about 1/100 that of smoking, (Prof Robert West, UK), and because it takes about 20 years for the 7000 odd poisons to start killing a smoker, we have loads of time to do all the necessary studies.

Why do we even need vaping ?

Well, because the 'government' is effectively killing smokers at the rate of 1 every 1/2 hour, 19,000 a year. How ? We have known for 40 years (BMJ, 5/4/1980, M.Russell) that the average plasma nicotine level of a smoker is 33ng/ml, (the level delivered by 3 and 1/4 21mg patches). Recently confirmed by an Argentinian study where 90% of smokers needed 3 patches to stop smoking, while 72% needed 4 patches. (BMJ Oct 2018, P Hajek, et al).

With their useless guideline "Use 1 patch and a few gums..", as well as the equally deadly PBS restriction where GP's can only prescribe one subsidised prescription for 28 x 21mg/24hr patches, with 2 repeats per year, the current "hard-core", dependant smokers cannot get anywhere near the amount of NRT that they need. Hence they need to continue to smoke or suffer a 1-2 hourly withdrawal, worse than stopping heroin..
Combined with essentially no smoking cessation clinics in Australia, unlike Britain which has hundreds of Stop Smoking Services scattered all over the UK, our smokers have been abandoned to disease and dying, even poverty,
The average number of attempts to stop smoking is over 30; it's not the smokers who aren't trying.
As we have failed in our duty of care to help them, how can we ethically stand back and deny them easy access to vaping, something substantially safer than smoking ?


a very sensible and balanced article. It's nice to read somethign about vaping that wasn't a scare campaign from a big tobacco corporation.

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