Myth or Fact: Is Vaping Really Safer Than Smoking? A Lung Expert Weighs In

E-cigarettes and nicotine pouches are often marketed as cleaner, safer alternatives to smoking. Many of the beliefs about these products don’t hold up, according to Amit “Bobby” Mahajan, M.D., FCCP, DAABIP, a national spokesperson for the American Lung Association and medical director of interventional pulmonology and the complex airways disease program at Inova Health System.

In a “Myth or Fact” video with The Educated Patient, Mahajan addressed common misconceptions about vaping and nicotine.

“No tar” doesn’t mean safe

One of the most common myths is that e-cigarettes are completely safe because they don’t contain tar. Mahajan said e-cigarettes still deliver significant amounts of nicotine, along with chemicals such as glycols and glycerin. Once heated and aerosolized, those chemicals can travel deep into the lungs.

He also pushed back on the idea that vaping produces harmless water vapor. While it may look like steam, it is an aerosol made of tiny particles of heated chemicals that can irritate and damage the lungs. That aerosol can affect people nearby as well, and residue can linger on clothing and furniture. This is a particular concern for people with asthma or emphysema.

Nicotine pouches are a growing concern for teens

Youth e-cigarette use has declined in recent years, but Mahajan said nicotine pouches are filling some of that gap. The pouches dissolve in the mouth, are absorbed through the gums, deliver nicotine quickly and are easy to hide. Many teens who use them also use other tobacco products.

Flavors such as fruit and mint are a major draw for young people, he said, and nicotine exposure during adolescence can affect brain development, including attention, learning and impulse control.

Not an approved way to quit

Mahajan also addressed the belief that switching from cigarettes to e-cigarettes ends nicotine addiction. It doesn’t, he said, since e-cigarettes still contain nicotine and some cartridges can deliver large doses. The Food and Drug Administration has not approved any e-cigarette as a smoking cessation aid.

People who want to quit smoking or vaping can talk with their health care provider about FDA-approved options, such as nicotine replacement therapy and prescription medications.