Do Americans Understand the Real Risk of Vaping?

A 2015 NCI survey shows we’re losing the public information war

Vaper with Sunglasses

Frightening ignorance

Just one in twenty Americans (5.3 percent) understands that using vapor products is much less harmful than smoking. That shocking number comes from 2015 data collected by the National Cancer Institute’s Health Information National Trends Survey (HINTS).

Just as frightening, 37.5 percent think that vapor is either just as harmful, more harmful, or much more harmful. An honest 33.9 percent said they didn’t know enough to answer the question. Obviously, the number who really don’t know is much higher — since we know that both Public Health England and the Royal College of Physicians have estimated the risk at about five percent that of smoking cigarettes.

The question asked in the survey was, “Compared to smoking cigarettes, would you say that electronic cigarettes are…” and offered seven choices: much less harmful, less harmful, just as harmful, more harmful, much more harmful, I’ve never heard of electronic cigarettes, and I don’t know enough about these products.

It's getting worse

In 2013, 9.8 percent of respondents thought vaping was much less harmful. That’s almost a 50 percent drop in just two years — from an already shockingly low number. Since 2013, the number that believe vaping is much more harmful has climbed about 20 percent.

In 2015, just 25.9 percent of the US population believed e-cigarettes are either less harmful or much less harmful than combustible cigarettes. That number has dropped from 39.8 percent in 2013. The survey looked at a representative sample, then estimated the percentages for the whole population.

Poisoning the well


The campaign to paint e-cigarettes as risky or harmful has been a roaring success. Between calls for caution (“We just don’t know enough”) and outright fear-mongering (formaldehyde, popcorn lung), the zealots are winning the knowledge war. They can’t stand the idea of something that looks like smoking being a solution to the smoking problem, and they’re willing to poison the well of public information to keep the comfortable system they’re used to.

Meanwhile, the public doesn’t understand the truth, and smokers continue to get sick and die.

Jim McDonald
I spend most of my time studying the regulatory, legislative and scientific challenges to vaping, advocating for our right to exist, and talking with others who do the same. Consider me a source for information, and feel free to agree or disagree with anything I say. I love good coffee and sweet Michigan cherries. My childhood hero was Gordie Howe.
  • Michael Abrams

    I don’t see how handing vaping over to big tobacco and limiting us to cigalikes and closed systems will help anyone other than big tobacco, big pharm, and big govt, both in the US and abroad. I think those products will improve, but it will still be a loss of 7-8 years of progress, unless the grandfather date gets revised.

    Problem I have is that scientists may have been aware of healthier vapor alternatives for as long as there have been surgeon general warnings on tobacco.

  • Jeff Kendall

    People learn about this stuff from the news focusing on only the negative headlines and websites that specialize in clickbait based on some sort of heavily swayed science. Ecigs kill mice! After we gave them dieases that worsen with stress and respiratory issues.. The truth about ecigs will be known at some point, its just sad that for now people will keep dying

    • Steve Tobias

      You rarely see positive stuff on the news, they make major headlines based on facts that have not been substantiated properly. E-cigs don’t kill mice, the study was that nicotine adversely affected their brains, it did not kill them based on the published data I read. They did not publish the levels of nicotine they exposed to the brains of said mice nor the time period over which the study was conducted. This tells me that based upon available funding they conducted short term studies using levels of nicotine that we would never use, or in a way we would use it. Maybe they did this to suppose that nicotine does not leave the system and therefore the levels do increase in our systems with every use, whatever their apparent logic dictates we know that it’s bullsh!t to shift the facts to negatively impact upon the industry that has given us our health back….

      • Jeff Kendall

        Well said!

  • Brendan Hughes

    Maybe the trick is to stop refering non-cigerette looking devices as e-cigerettes. Paint a difference between vaping mods and a cigerette replica as sold in filling stations.

    • Steve Tobias

      I wholeheartedly agree, I hate the term “e-cigarette” with a passion because the name says it is still a cigarette when all vapers know different. We are not smoking, we are Vaping… Smoke contains countless chemicals (poisons) whereas vaper contains none. Actually exhaled air / smoke / vaper can be measured in VoC’s (volatile organic compounds, not all of which are harmful) a normal exhaled breath contains 18 VoC’s, an exhaled cigarette breath contains 88 VoC’s and an exhaled Vape breath contains 21 VoC’s. The evidence is clear and that evidence has been verified by university studies in the UK

  • Daniel Silets

    Here is how the media/governing is scaring us.

    A recent report has linked PokemonGo with an increased risk of the developing of a pregnancy in males. A study conducted at the National Research of Pokemon Observers noticed this disturbing trend amongst males who play PokemonGo. The NTPO says there is not enough data yet to determine this, but if one keeps playing the game and is a male, he is at risk. The “baby” will come out of the “Pegina” as a round yellow blob. This report has yet to be confirmed, but once it is, the government will look into banning all mobile phones that were produced before March 6th 1993 in an effort to stop the downloading of this PokemonGo, hopefully halting male pregnancies.

    For those who think this is crazy. This is what is happening to vapers. Complete nonsense! #vaping #healthierthanreported #greedygovernment

  • Ken Thorne

    I started Vaping in 2010 and went from smoking a pack of cigarettes a day to 0 in a week, these days I’ve learned how to mix my own juice which saves me duckets in cash. I went from using the CE4 an 5 pen type Vape’s to mod boxes all-in-one, just in 6 years we are blowing smoke far more but the cost of these products are costly. Cigarettes are $55.00 0r less for a carton, Vaping was reasonable when they first came out but are costly now, now that more and more people are turning to Vaping. Just like everything that’s new the government wants control, they want to shut it down like they did when the first electric car became available. I feel Vaping is 100% better than cigarettes and tobacco, as there are only 4-5 ingredients-water, (VG) vegetable glycerin, (PG) propylene glycol, flavoring made from candy making liquids consisting of natural flavor, PG, alcohol. No added artificial flavors and gluten free. Nicotine can be added or not, all these are food products. They say cigarettes can contain thousands of chemicals.

  • Murray_B

    It does not help anything when the people working in vaping shops don’t understand vaping. True story, I was in my local shop one day enjoying a coffee and having a puff when I overheard the owner of the shop talking to a customer. The customer was complaining that vaping was giving him a sore throat. The man was using an iStick 30 with a Nautilus mini glassomizer and 6 mg/ml fluid. He was vaping at 25 watts even though I knew that the Misthub safe vaping chart recommends 8 at the most. The owner of the shop recommended the customer keep his power set at 25 watts and switch to 3 mg/ml fluid.

    A couple of weeks later I saw the customer again in a smoking area puffing on a cigarette. I asked him how the vaping was going and he told me he quit vaping because it was making him sick and he switched back to cigarettes. That made me sad and I asked if he still had his vaping gear which he did. At that point I told him that I had been using a mini Nautilus with 14 mg/ml fluid @8 watts and a K1 with 20 mg/ml @5 watts without any problems. He said he would try vaping at lower power levels and I hope he was able to switch back to vaping.

    It seems that some of the least informed vapers work in the vaping shops.

    • Jim McDonald

      That’s an awful story. I hope he found his way back to vaping too.

      • Murray_B

        Thanks for responding, Jim, and I am always happy when someone manages to switch to vaping their nicotine but I have not run into that fellow since I advised him to turn the power down. The part that shocks me about all this is how the entire vaping industry seems to be pushing high-powered vaping when it is known that vaping at high power levels can burn the fluid and increase toxic emissions. When the famous NEJM letter was published the most powerful standard vaping power packs were rated for a maximum output power of 20 or 30 watts. Yesterday I saw a young woman using an iStick 100W unit and a young fellow with a 200W Sigelei unit! It is as if these large vaping companies wanted governments to regulate them.

        • Jim McDonald

          Most of the high-powered devices also emply temperature control, which prevents combustion within the atomizer. When combustion does occur (as in the experiment described in the NEJM letter), it creates a dry hit that no user could withstand. No one would continue vaping on a device that gave consistent dry hits.

          • Murray_B

            Thanks, Jim, but as I understand it the researchers doing the study that led to the NEJM letter detected significant formaldehyde emissions when using a CE4 clearomizer at 12 watts. There are a whole lot of devices out there without temperature control that can deliver 12 watts of power into a CE4 coil. The poor fellow with the sore throat was advised by the dealer to drive his Nautilus Mini at 25 watts with his iStick 30. That iStick model does not have temperature control.

            Allowable formaldehyde levels in the workplace have been restricted for decades and harmful levels may not be detectable by taste or smell. The best way to measure ambient formaldehyde is to use commercial formaldehyde meters which are more sensitive to formadehyde than human senses. The next best thing is to use a safe vaping power chart made by researchers using formaldehyde meters. Those charts are readily available and the one on the Misthub site indicates the poor fellow with the sore throat should have been vaping at less than 8 watts with his Nautilus Mini and not around 25. No wonder his throat was sore. About 5% of the population is sensitve to propylene glycol but closer to 100% is sensitive to formaldehyde if the concentration is high enough.

            Like I said before much of the vaping industry is acting like it wants to be regulated.

          • Jim McDonald

            My point was that in real life no one would use a CE4 at 12 watts *twice*. The resulting hideous dry hit would be unbearable. The products are capable of delivering it, but no vaper would use it that way.

          • Murray_B

            Well, Jim, I agree that no one would use a CE4 at 12 watts but that clearomizer may start to emit significant amounts of toxic combustion products at much lower power levels.

            There is little doubt that exposure limits for formadehyde can be exceeded before human senses can detect the substance. From EH&S Berkeley, “Cal/OSHA limits employees’ exposure to airborne concentrations of formaldehyde to an average of 0.75 ppm over an 8-hour workday. Formaldehyde’s odor threshold (the lowest concentration you can smell) is about 1 ppm.[…] olfactory fatigue can significantly raise the odor threshold concentration.”


            What I don’t understand is why almost the entire vaping industry seems to deny the potential for toxic emissions when the solution is to simply turn the power down. That poor fellow with the sore throat may have been suffering from too much formaldehyde in the vapour. He probably would not have had any problems if he was vaping 12 mg liquid @8W instead of 6 mg @25W.

    • Steve Tobias

      Good on you for following up with the misguided customer when you seen him return to smoking. Vape stores need to ensure they pass on good advice. Advice has a ripple effect and the bad advice gets passed on with the good. I hope he returned to Vaping and is well on the way to leaving cigarettes in the past.

  • Denise Mansi Koundry

    I smoked for 38 years, in the end almost 3packs a day. I had quit several times but always came back. I started vaping on the gas store models and quit the same week, I’ve moved on to much better models with great choices in liquids. It’s been a little more than 3 yrs and I’ll never go back. I know it’s safer and more healthy, I no longer even use nicotine. I’m back to walking and have lost 30 lbs. Keep the Government out of my life!

  • Steve Tobias

    I have been Vaping for 5 months after a 35+ year stint of allowing cigarettes to poison me and those around me. After 6 weeks of Vaping the “pen” style e-cigs I went whole hog and purchased a couple of mods and a few RTA’s, I am now totally hooked on DIY … Juices, Coils, Wicks whatever it takes I make it all and save a bloody fortune, even buying over 125 different flavour concentrates, not only is my pocket healthier but so am I, weeks after starting to Vape, my taste buds came alive, then my nostrils started asking wtf!!! I can smell??? Blood started circulating better after 4 months and there is no risk for anyone around me. Wake up people, Vaping is the bomb, it the future for health to any smoker….

  • Peter Ward

    After 34 years as a smoker and numerous attempts to stop using everything from cold turkey to Champix I finally quit 10 weeks ago with an e-cig, I now use a box mod and will NEVER go back to smoking. I’m consistently reducing my nicotine and will be on 0mg in a few weeks. I will continue to vape once I have eradicated nicotine from my life because I enjoy it, far more than I ever did smoking.

    • Jim McDonald

      Congratulations and thanks for sharing your story. I also tried to quickly reduce my nic when I quit, and discovered that for me vaping wasn’t as good without nicotine. But a lot of people are able to do what you’re doing without missing the nic like I did. Either way, glad you’re not smoking!