Vaping is a promising tool for helping people quit smoking. But is it any better than smoking? I am part of a research group that investigated this in a recent study. Here’s what we found.

Smoking remains the second-leading mortality risk factor in the world, mainly due to cancer, lung disease, and cardiovascular disease. Although the number of smokers is decreasing globally, the percentage of smokers in the adult population remains high (for example, it is about 14% in the UK and over 12% in the US).

It is therefore no surprise that promoting quitting smoking is considered a health priority for most Western countries. Nevertheless, traditional approaches (in the form of the use of medication such as nicotine replacement therapy or NRT and behavior support) are not often successful in the long term and have a high relapse rate, reaching a whopping 75% in some cases.

Unsurprisingly, alternatives are coming into the spotlight more and more. But it’s maybe not the alternative most people would expect.

In the UK, like in other countries, vaping has emerged as one of the most popular methods to support stopping smoking, surpassing nicotine replacement therapy in the form of chewing gum or patches (27% against 18%), although vaping remains very controversial.

Recent scientific work, most notably a Cochrane review ( which essentially draws conclusions by pulling data from dozens of publications and analyzing it together) suggests that quit-smoking success rates were higher with nicotine-containing e-cigarettes than with NRT, nicotine-free e-cigarettes, or behavioral support — which would make vaping an important tool in giving up on smoking.

But isn’t vaping bad in itself?

Our goal

An important question remains: what is the effect of vaping on our cardiovascular system? This is an important question, considering the extent of the damage that smoking does by injuring the inner lining of our small veins and arteries, making both the coronary and peripheral arteries dysfunctional, and increasing the risk of thrombosis.

Unlike the standard effects of aging that can be partially reversed by exercise and a healthy diet, smoking can cause severe damage to the heart and the rest of the cardiovascular system — and if vaping does something similar, then it wouldn’t really make sense to use it as a method to quit smoking. Also, it’s unclear if switching from smoking to vaping has a positive effect on the cardiovascular system. This is what we analyzed here.

Previous work on this area suggested that positive changes occur in the large arteries within 1 month, but the controversy on the cardiovascular effects of vaping on people with no previous smoking history dictated a need for a larger and longer study. 

Consequently, with the support of Heart Research UK, we conducted a scientific study to explore the short-, medium- and longer-term effects of vaping on the cardiovascular systems of smokers making an attempt to quit smoking.

Our findings

In our study, we had the support of almost 260 smokers who wanted to stop smoking and compared three of the most popular support tools to help smokers quit:

• nicotine-rich e-cigarettes;
• nicotine-free e-cigarettes;
• and nicotine replacement therapy.

The first important finding of our work was that positive effects on the small arteries and veins could be spotted even shortly after our participants stopped smoking. Quite interestingly, no major differences could be found between the three groups – in other words, all three were equally beneficial. These benefits were most pronounced in those who smoked more than 20 cigarettes per day, which does, in a way, suggest that the extent of the damage that traditional cigarettes do is so extensive, that even stopping them for a short while can have a positive impact on our body. 

This improvement in blood vessel health persisted both in the medium (3 months after stopping smoking) and longer-term (6 months after stopping) in all three groups, without any difference between the groups. The difference between the short- and the longer-term benefits was that in the longer term, those who stop smoking experience an improvement in the way that the smooth muscle cells of the veins work. This allows for more production and availability of nitric oxide in our bodies, which is important for the efficient delivery of oxygen and nutrients to our organs and tissues.

Considering that our work also suggests that quitting smoking, by using any of our tested methods, helps to improve the function of the inner vein lining (which also indirectly affects the production of nitric oxide in a positive manner), we can easily deduce that it is never really too late for someone to stop smoking, at least for their cardiovascular system!

More questions that need a response

Although we can now safely assume that vaping is indeed healthier than traditional smoking, particularly in relation to cardiovascular disease risk for those who wish to stop smoking, there are questions that require more scientific work to answer — especially as our work only looked at one aspect of vaping’s impact.

For example, we need to know what their effects are in regard to cancer, lung function, or cardiovascular disease risk, for those using them for a very long period of time.  Will it be the same for ex-smokers or those who have never smoked in their lives?  Do different brands have different effects? Which is the key element that makes them more or less harmful in the course of time? 

It seems that vaping is here to stay, and it seems to be less damaging that cigarette smoking. Exactly how healthy it is, though, remains to be seen. These are important questions and require caution to be answered.