We now have over a decade’s worth of toxicological, clinical and behavioural data on vaping products. This rich and varied literature provides a strong scientific basis to determine vaping’s safety relative to smoking and its utility to a smoker looking for a better alternative. We have collected some of that data here.

  • Imperial College 2014
    Result: E-cigarettes are 96 percent less likely to cause damage than tobacco cigarettes.
  • Cochrane 2014
    Result: E-cigarettes appear to help smokers who are unable to quit completely reduce their cigarette consumption compared to placebo e-cigarettes and nicotine patches.
  • Public Health England 2015
    Result: E-cigarettes are around 95% safer than smoked tobacco and can help smokers quit smoking.
  • Royal Society for Public Health (RSPH) 2015 Result
    Result: Electronic cigarettes contain nicotine but not the harmful substances found in tobacco cigarettes.
  • Royal College of Physicians 2016
    Result: The health risk from long-term inhalation of vapor from e-cigarettes available today should be no more than 5% of the harm from tobacco smoke.
  • University of St. Andrews 2017
    Result: Optimal combinations of device settings, liquid composition and vapor behavior typically result in e-cigarette emissions with a much lower carcinogenic potency than tobacco smoke.
  • Tobacco Control 2018
    Result: 99.6 percent lower cancer risk- The lifetime risk of developing cancer with e-cigarettes is only 0.4 percent of the risk with tobacco cigarettes.
  • University of Dundee 2019
    Result: Those subjects who switched from tobacco cigarettes to e-cigarettes achieved significant improvements in vascular health in terms of endothelial function and arterial stiffness.
  • University of Lille 2020
    Result: E-cigarettes produce 98 percent less formaldehyde and 99.97 percent less carbonyl compounds compared to tobacco cigarettes.
  • Brown University Providence 2020
    Result: Exclusive use of e-cigarettes leads to a reduction in respiratory symptoms compared to smoking tobacco.
  • Int.J.Environ.Res. Public Health 2020 17
    Result: The use of a large number of e-cigarettes does not lead to an increased intake of metals.
  • UK COT 2020 Report
    Quote: ” In considering the comparison of E(N)NDS use with CC smoking, the Committee concluded that the relative risk of adverse health effects would be expected to be substantially lower from E(N)NDS.”
  • Cochrane Review 2020
    Result: E-cigarettes are 70 percent more effective at quitting smoking than nicotine replacement products.
  • Cancer Research UK 2021
    Quote: “All this evidence is why at Cancer Research UK, we recommend people who smoke consider using e-cigarettes as an option to help them quit.”
  • Mayo Clinic USA 2021
    Result: Smokers and vapers contract Covid-19 no more frequently than non-smokers and non-vapers.
  • FDA/CDC Study 2021
    Quote: ” Exclusive e-cigarette users have biomarker concentrations that are similar to those of former smokers who do not currently use tobacco.”
  • AJPM Study 2021 Results
    Result: There is no reliable evidence that e-cigarette use is associated with heart attack in users who have never smoked.
  • Polosa study August 2021
    Result: Former smokers who only use e-cigarettes have similar bronchial values ​​to never-smokers and former smokers.
  • French National Cancer Institute 2021
    Quote: “The electronic cigarette can be a tool to quit smoking. On its own, and not in conjunction with traditional cigarettes, it helps reduce the risks associated with smoking.”
  • University of Valencia 2021
    Quote: “Based on the studies carried out so far, it seems that e-cigarette consumption is less toxic than tobacco smoking.”
  • JAMA Network 2022
    Result: ” This national cohort study provides evidence on the potential harm reduction associated with transitioning from exclusive cigarette use or dual use to exclusive e-cigarette use.”
  • University of Washington 2022
    Result: “Smokers who opt to vape may have more opportunities for healthy engagement.”
  • Nicotine & Tobacco Research 2022
    Result: ” Exclusive use of e-cigarettes was largely not associated with functionally-important respiratory symptoms and risks associated with their use was significantly lower than for cigarettes.”

  • Onassis Surgery Center 2016
    Result: Altogether, more than 6 million Europeans have quit tobacco with e-cigarettes. In Germany, the e-cigarette is the most widely used method for smoking cessation.
  • New England Journal of Medicine 2019
    Result: E-cigarettes are twice as successful in quitting smoking as nicotine replacement products.
  • NGO Action on Smoking and Health (ASH), 2019
    Result: 54 percent of the 3.6 million British vapers are now tobacco-free thanks to e-cigarettes.
  • Santé publique France 2019
    Result: According to the French health authority, 700,000 French people have quit smoking thanks to the e-cigarette.
  • Nicotine & Tobacco Research 2019
    Result: E-cigarettes effectively support quitting tobacco and reducing tobacco  consumption. 25 percent success rate for vapers after three months.
  • DEBRA Study 2020
    Quote: “The most commonly used form of support was the electronic cigarette (10.2 percent).”
  • Schweizer Suchthilfe Ost 2020
    Result: “Smokers who wanted to quit smoking have a success rate of 17.5 percent with the e-cigarette.”
  • University of Montreal 2020
    Result: Success rate in quitting smoking with e-cigarette: 21.9 percent.
  • School of Public Health (Michigan) 2020
    Quote: “357 (99%) yield positive estimates of life-years saved (LYS) due to vaping by 2100, from 143 000 to 65 million. Most scenarios result in millions of individuals quitting smoking due to vaping. On average, vaping-induced quitters gain an extra 1.2–2.0 years of life compared to smokers who quit without vaping.”
  • Medical University of Vienna 2020
    Quote: “EC users showed a 2.04 times higher proportion of abstinent smokers in comparison with participants solely receiving counseling.”
  • Nicotine Tobacco Research 2020
    Result: Smokers who used e-cigarettes daily were 2-4 times more likely to quit short-term and long-term than smokers who did not use e-cigarettes.
  • University Queensland 2021
    Quote: “Participants randomised to receive nicotine e-cigarettes were 49% more likely to remain abstinent from smoking than those who received NRTs.”
  • University of Virginia and Hershey 2021
    Result: E-cigarettes provide significant reductions in tobacco-related toxins, such as lower exhaled carbon monoxide levels.
  • University of Leuven, Belgium 2021
    Quote: “People who smoke and choose e-cigarettes in the context of smoking cessation treatment by tobacco counselors show similar if not higher smoking cessation rates compared to those choosing other evidence-based (or no) smoking cessation aids.”
  • University of Paris 2021
    Quote: “E-cigarette use was associated with smoking reduction and cessation attempt for individuals who have used it for less than one year and additional benefits are expected to occur with a longer duration of use.”
  • Queen Mary University London 2021
    Result: After six months, 19.1 percent of vapers were still smoke-free. In the NRT group, it was only 3.0 percent of the participants. Vaping can be 6x more successful in stopping tobacco than nicotine substitutes from the pharmacy.
  • ASH UK 2021
    Quote: “Nearly two thirds of current vapers are ex-smokers (64.6%), and the proportion continues to grow, while the proportion who also smoke (known as dual users) has fallen to 30.5% in 2021.”
  • Addictive Behaviors 2021 study Results
    Quote: ” Among adult daily cigarette smokers initially not planning to ever quit, subsequent daily e-cigarette use is associated with subsequent plans to quit smoking.”
  • Roswell-Park study 2021
    Result: 28% of smokers quit smoking if they used e-cigarettes daily.
  • Australian study 2021
    Quote: “Daily, but not occasional, e-cigarette users were more likely to quit or reduce smoking cigarettes than Australian smokers who did not use e-cigarettes.”
  • New Zealand Study 2022
    Quote: “This modeling suggests that ENDS liberalization results in an expected gain of 195 000 quality-adjusted life-years (QALYs) over the remainder of the NZ population’s lifespan.”

  • University of Catania 2017 (3.5 years)
    Result: Even in the case of heavy users of e-cigarettes, there is no evidence of incipient damage to the lungs and bronchi. No evidence of changes in subjects’ blood pressure or heart rate.
  • University College London 2017 (6 months)
    Result: Significantly lower levels of carcinogens and toxins in long-term EC users compared to smokers and dual users.
  • Roswell Park study 2018 (10 months)
    Result: E-cigarette users showed 10% to 98% significantly lower concentrations of tobacco-specific biomarkers compared to cigarette smokers.
  • Action on Smoking and Health 2020 (8 years)
    Result: Since the start of the measurement in 2012, the number of e-cigarette users in the UK has increased from around 700,000 to 3.6 million in 2019. 99.7 percent of vapers are ex-smokers.
  • Harvard Medical School 2020 (2 years)
    Result: Vaping can increase the likelihood of tobacco abstinence by 77 percent.
  • University of Catania 2020 (5 years)
    Result: The use of e-cigarettes can improve objective and subjective COPD outcomes and the improvements achieved can be maintained over the long term. Some of the damage caused by tobacco smoking in COPD patients can be mitigated in this way.
  • Long-term French study 2021 (2 years)
    Result: One-year use of e-cigarettes was associated with reduction in smoking and attempts to quit smoking. Additional benefits are expected to occur with longer periods of use.

  • Onassis Surgery Center 2013
    Quote: “The results of this survey indicate that EC liquid flavourings play a major role in the overall experience of dedicated users and support the hypothesis that they are important contributors in reducing or eliminating smoking consumption. This should be considered by the health authorities.”
  • University of Pittsburg 2015
    Result: In contrast to adult smokers, non-smoking adolescents have very little interest in e-cigarette flavors.
  • ZIS Hamburg 2016
    Result: The majority of adult users consume fruit liquids (81 percent). Around half of those switching to use liquids with menthol or sweet flavors (cakes, pastries, etc.).
  • Seattle Public Health Center 2016
    Quote: “The results suggest that flavours play an important role in e-cigarette preference and most likely use.”
  • Virginia Commonwealth University 2016
    Result: Reasons to use flavored e-liquids: Increased satisfaction and enjoyment, better taste than cigarettes, and variety of flavors.
  • Lexington-Department of Behavioral Science 2018
    Quote: ” Participants rated ‘good taste’ as the most important consideration when using and purchasing liquids.”
  • University of Graz 2019
    Result: Flavors do not cause damage to endothelium and vessels.
  • Public Health England 2020
    Result: A ban on flavorings could have adverse effects and unintended consequences for smokers using e-cigarettes to quit smoking. It should only be viewed with caution.
  • Yale School of Public Health 2020
    Result: Users of non-tobacco flavors are more likely to quit smoking than users of tobacco flavors.
  • Penn State University College 2020
    Result: If all non-tobacco flavors were banned, a) 9.7% would return to tobacco cigarettes; b) 19.2% find a way to get their flavored liquid or c) 32.8% mix their own liquids.
  • University of Michigan 2020
    Result: Flavors are a criterion for vaping for just 5 percent of young people. Much more decisive are social factors (two thirds).
  • ETHRA study 2020
    Results: For around 70 percent of the German respondents, flavors were important or even very important when switching from smoking to vaping. More than a quarter would start smoking again or smoke more if all flavors except tobacco were banned.
  • Yale School of Public Health 2021
    Result: The likelihood of smoking conventional cigarettes has doubled among high school students in the San Francisco school district compared to trends in districts without the ban.
  • Auckland, New Zealand 2021
    Result: 57% of respondents said they would circumvent a ban on popular e-liquid flavors by mixing their own e-liquid and/or buying e-liquid overseas or on the black market.”
  • George Washington University 2021
    Result: A third of respondents (33.2 percent) would switch to tobacco cigarettes if flavors were restricted. 39 percent would smoke again if e-cigarettes were completely banned.
  • Addictive Behaviors 2021
    Result: 82 percent of the users surveyed are against flavor bans. One in six would start smoking again. Less than a third (28.8 percent) would be satisfied with the flavors that would then still be available. Almost as many (28.3 percent) say they would get their flavors in a different way.
  • Prof. Mayer’s report on the importance of menthol 2022
    Quotes: “Menthol is not toxic when used normally in e-cigarettes. Its ban would reduce the attractiveness of vaping and in no way contribute to a reduction in smoking rates.”
    “In view of the scientific facts, the Federal Council rejected the ban on menthol as a flavoring substance in e-liquids, which the Federal Government had already considered in 2016, and instead proposed a maximum quantity regulation. The facts have not changed since then.”
    “There is no evidence of toxic or harmful effects of menthol. As a non-toxic substance, menthol is not listed under the EU’s CLP regulation and is considered safe by the FDA.”
  • University of Illinois 2022
    Result: “”Dual users who preferred sweet flavors were the most likely to quit smoking.”

  • ZIS Hamburg 2016
    Result: 99 percent of the vapers are former (91.5%) or dual users (7.5%). Only 1 percent are never smokers
  • DEBRA study 2018
    Result: In Germany, e-cigarettes are mainly used by current tobacco smokers (5.1%), to a lesser extent by ex-smokers (1.6%) and only by a very small number of never-smokers (0.3%). 
  • Alternative Drug Report 2019
    Quote: “Overall, statements on causal relationships in general and on the gateway hypothesis in particular could not be made on the basis of the current study situation to date.”
  • University College London 2020
    Result: Less than 1% of US youth who first use e-cigarettes went on to smoke.
  • Queensland Study 2021
    Quote: “Results show little evidence that e-cigarette use is increasing cigarette smoking among US youth.”
  • University of Michigan and of Alabama 2021
    Quote: “Among adolescent never cigarette smokers, those who had ever used e-cigarettes at baseline, compared with never e-cigarette users, exhibited modest or non-significant increases in subsequent past 12-month or past 30-day smoking when adjusting for behavioral risk factors.”
  • University College London 2022
    Quote: ” Prevalence of e-cigarette use among the youth population in England does not appear to be associated with substantial increases or decreases in the prevalence of smoking uptake.”

  • Federal Institute for Risk Assessment (BfR) 2020
    Result: Only 6 percent of Germans are aware that e-cigarettes are significantly less harmful than tobacco.
  • IFT Munich 2018
    Result: Only a third of citizens in Germany know that e-cigarettes are significantly less harmful than tobacco.
  • Panel discussion on the e-cigarette 2020
    Quote: “It would be better if one provided reasonable information and looked at what role the e-cigarette could have in smoking cessation compared to other methods that are clinically contained in the guidelines and are recommended there. ”
  • Position paper Stöver et al. 2020
    Quote: “Public information about this significant risk reduction is poor, especially among smokers.”
  • US study 2021
    Results: Adult cigarette smokers generally have misperceptions about the harms of nicotine and the relative risks of e-cigarettes.
  • Rutgers School of Public Health 2021
    Quote: ” Our findings demonstrate that question wording is important when measuring physician beliefs about nicotine. However, even after accounting for question version, misperceptions about the direct health effects of nicotine were common, and perceptions about nicotine varied by sex and specialty. Provider education about tobacco and nicotine should be prioritized in order to optimize patient–provider communications about tobacco use and cessation.”
  • Bristol University / University of Pennsylvania 2021
    Quote: ” These findings suggest that misinformation about e-cigarette harms may influence some adult smokers’ decisions to consider using e-cigarettes.”
  • Office for Health Improvement and Disparities UK 2022
    Quotes: “E-cigarettes are the most commonly used quit aid among smokers in England and there is growing evidence of their effectiveness. An updated Cochrane Review published in 2021 found that nicotine-containing e-cigarettes are around twice as effective in supporting smokers to quit as NRTs such as patches and gum.”  “Health and care professionals should provide to smokers on using e-cigarettes to quit.”