Is vaping safe? Merriam-Webster defines safe as free from harm or risk. So, no, vaping is not safe. Neither is eating pretzels. Ask former President George W. Bush about that. Very few products or activities can ever offer guarantees of being “safe.”
But it’s understandable for concerned parents, curious observers, and skeptics to approach the topic of vaping from a perspective of “safety.” People often demand safety from things they’re unfamiliar with — even as they forget that they themselves engage in activities daily that are not safe.
But those things — like driving, for example — are familiar, and people are willing to accept some risk for the benefits they deliver. Concerns about absolute safety should lead to acceptance of the relative safety of vaping. That should come with education about the fairly low risks of vaping.
Let’s have a look at the common points of contention in vaping. From nicotine, to vape devices, to flavoring, to toxins.
The vast majority of chemical flavorings that give e-liquids their unique profiles were never intended to be inhaled. They’re food flavorings, commonly used by bakeries and candy makers. While they are usually viewed by the FDA as GRAS (generally recognized as safe), that’s a designation for ingestion. Honestly, there isn’t much information on how our lungs handle most flavorings.
Flavorings may irritate the lungs and upper airways, which causes brief and minor inflammation. But since vaping is such a new phenomenon, we just don’t know that chronic airway irritation won’t lead to more serious issues in the long term. Some flavorings are known to be especially powerful irritants. Benzaldehyde (used in cherry and almond flavorings) is among the flavors that has been researched and found to cause upper airway irritation.
But there is no evidence that inhaling food flavorings is risky either. For all we know, it could be completely safe. Additionally, there are lots of vapers who don’t use flavorings at all. So it’s possible to eliminate what little risk flavorings present, and still keep vaping.
One group of flavorings has been linked to serious lung damage, when inhaled in large quantities. Diketones are a family of chemicals that are usually used to impart a savory or buttery flavor in e-liquid. They include acetyl proprionyl, acetoin, and the famous diacetyl. (Check out our more detailed look at diketones and their dangers.)
Diacetyl made headlines around the country in the early 2000’s when workers at a Missouri microwave popcorn factory were diagnosed with an incurable lung condition called bronchiolitis obliterans after working with diacetyl used to flavor the popcorn. The condition was nicknamed popcorn lung.
However, vapers using e-liquids that contain diacetyl would probably be unable to ever inhale diketones in amounts comparable to what the popcorn workers experienced. Cigarettes contain diacetyl too, and considerably more than any e-liquid — in fact, hundreds of times more. So is it safe to inhale diacetyl? Possibly not, but your odds are better vaping it than smoking. Not all e-liquid contains diketones anyway. And, by the way, no smoker or vaper has been diagnosed with popcorn lung.
The nicotine in e-cigarettes is the same pharmaceutical nicotine used in nicotine inhalers, patches, gum and other nicotine replacement therapy (NRT) products. The difference is that with vaping the user can customize how much nicotine is taken in. Also, it’s more fun, and to a smoker it feels a lot like smoking.
Because of its association with smoking, nicotine has a bad reputation. But in reality it’s a fairly benign and mild stimulant, similar in effect to caffeine. It doesn’t cause cancer, and it doesn’t seem to cause other diseases either. Nicotine is probably safe for most people to use.
Like caffeine, it causes a temporary increase in heart rate and high blood pressure because it constricts the blood vessels when it’s absorbed. That might make vaping nicotine a poor choice for people with serious heart problems — but, as always, a better choice than smoking.
Nicotine is often described as being “as addictive as heroin,” but that is far from true. Smokers get a freebase blast of nicotine to the brain, combined with other substances that increase nic’s addictive potential. Other forms of consumption, like NRT or smokeless tobacco, release the drug slowly into the body. Vaping may be somewhere between the two, but is probably closer to the latter than the former.
One thing that is not debatable: nicotine is absolutely not safe for young children to drink. E-liquid should be kept in child-resistant bottles and locked away from curious kids.
A group of Portland State University researchers found that if you turn up the power on a vape to a level no human could tolerate, an inexpensive clearomizer would produce high levels of formaldehyde. Thinking they had struck anti-vaping gold, they rushed the information into a letter to the New England Journal of Medicine, which published it. The result? Headlines around the world like “E-cigarette vapor filled with cancer-causing chemicals, researchers say.”
“The conditions used to study the e-cigarette aerosol at the high voltage setting were unrealistic and under such conditions, a vaper would never be able to use the product,” wrote Dr. Michael Siegel, an M.D. and public health professor at Boston University. “This is because the wattage being used was so high that the vaporizer was overheated (for a conventional e-cigarette it would likely damage or burn the coils), creating a horrible taste which a vaper could not tolerate.”
Vapers call it a dry hit or dry puff. It happens by accident when an atomizer goes dry, or the wick can’t keep up with the vapor being produced. Measuring the toxins that result from it is a useless enterprise, since no one would ever inhale it for more than a split second.
There are other known toxins in e-cig vapor. But none of them are found in quantities likely to cause harm to the vaper. According to the Royal College of Physicians, “In normal conditions of use, toxin levels in inhaled e-cigarette vapour are probably well below prescribed threshold limit values for occupational exposure, in which case significant long-term harm is unlikely.”
We breathe and ingest toxins all the time — a fact often glossed over in the chemophobic articles and books popular these days. If they are found at low levels that the body can easily process, they don’t accumulate and cause health problems. There are a lot of studies on various vapor constituents that sound frightening, but there’s still no evidence of actual harm being caused. That doesn’t mean that some real threat may not be lurking, but the odds are against it.
As with any electronic device powered by lithium batteries, there is some small risk of a battery being defective, or the charging circuits malfunctioning. There are a lot more cell phone fires than there are vape explosions, but since non-smokers use phones too, the public isn’t as frightened of phones.
Most vaping battery accidents happen through careless handling of loose batteries, improper charging, or inexperienced vapers using mechanical mods meant for advanced hobbyists. With caution and an eye toward battery safety, there’s no reason vapers should have to worry much about their devices malfunctioning.
If you still want to ask if vaping is safe after understanding that it’s safer than smoking, we can explore some potential sources of risk. But remember, no one ever says that vaping — or anything — is “safe.” The best we can say is that it offers relative safety.
If you’re not already a smoker, there’s no reason to start vaping, especially if you have concerns about safety. The risks and benefits of vaping should always be considered in relation to the dangers of smoking. Vaping is nowhere near as risky as smoking. But it’s unlikely to be as safe as breathing clean air.
Those who have weighed all of the medical evidence have concluded that the potential of serious vaping risks is probably very low. Both the Royal College of Physicians and Public Health England suggest that doctors recommend vaping to smokers who are unable to quit by other means.
And that’s about the best we can offer. If there are major risks to vapers, they haven’t shown themselves yet, or been proven by science. If you’re not a smoker, why start inhaling anything into your healthy lungs? But if you are a smoker, the relative safety of vaping is the exact reason you should give vaping a chance.