Is vaping safer than smoking long term?

According to the NHS and the UK government's 2022 expert review, yes, by a substantial margin in the short and medium term. The long-term picture is still being studied, but every UK health body agrees that vaping is far less harmful than smoking.

The short answer, from UK health authorities

In 2022, the Office for Health Improvement and Disparities (OHID) commissioned the most thorough review of vaping evidence done in the UK. It was conducted by researchers at King's College London and covered hundreds of studies.

“In the short and medium term, vaping poses a small fraction of the risks of smoking.”
UK Government 2022 Evidence Review

The NHS, Action on Smoking and Health (ASH) and Asthma + Lung UK all align with this position. Public Health England previously estimated vaping to be around 95% less harmful than smoking, a figure that newer reviews have broadly upheld.

Why vaping is substantially safer

The difference comes down to what your lungs are exposed to. Cigarettes burn. Vapes heat.

Cigarette smoke

Around 7,000 chemicals from burning tobacco
About 70 known carcinogens
Tar that coats and damages the lungs
Carbon monoxide reduces oxygen carrying
Heavy metals and radioactive particles

Vape aerosol

Far fewer chemicals overall
No combustion, no tar
No carbon monoxide
Some irritants present, much lower levels
UK products regulated under TPD

The 2022 review specifically measured biomarkers in the blood and urine of vapers and smokers. Levels of toxic and cancer-causing chemicals were dramatically lower in vapers, often by 90% or more.

What we still do not know

Honesty matters here. The phrase “in the short and medium term” in that government quote is doing real work. Vaping has only been widespread since around 2010. We do not yet have 30 or 40 years of data the way we do for smoking.

What is known

Exposure to known carcinogens, lung toxins and heart-disease-linked chemicals is much lower in vapers than in smokers.

What is likely

Long-term risks will be far lower than smoking, based on what causes smoking-related disease being largely absent.

What is unknown

Whether there are vape-specific long-term risks we have not yet identified. Studies tracking decades of daily vapers are still in progress.

Two different comparisons that matter

The honest answer depends on which comparison you are making. The science says different things to different audiences.

Smoker considering switching to vaping. The evidence is strong and consistent. Vaping is substantially safer. The NHS actively recommends it as a quit-smoking tool.
Vaper considering quitting nicotine entirely. Stopping is better than continuing. Vaping is not risk-free, just much less risky than smoking.
Non-smoker considering taking up vaping. Do not. There is no health upside to starting, and some unsettled long-term risk in picking it up.

The biggest misconception in the UK

Around two thirds of UK smokers wrongly believe vaping is as harmful as smoking or worse. King's College London researchers have flagged this as one of the biggest barriers to people switching.

The figure has actually been getting worse over time, not better. In 2014, 44% of smokers correctly believed vaping was less harmful than smoking. By 2025, that had dropped to under 19%.

This matters because misperception keeps people smoking. The professor leading the 2022 review said smoking will kill one in two regular sustained smokers, yet most smokers who would benefit from switching do not know vaping is less harmful.

What the long-term research is looking for

Studies currently running in the UK and Canada are tracking daily vapers over five to ten years. They are looking specifically at:

Lung function changes measured by FEV1, FVC and airway resistance over time.
Cardiovascular risk through blood pressure, heart rate variability and arterial stiffness.
Cancer biomarkers and any signs of cell changes in airway tissue.
Oral health including gum disease and dental wear patterns.
Mental health and sleep in long-term nicotine users.

Full results will take years to publish properly. The interim data so far has not shown anything that would change the current UK position.

Groups who should still be cautious

The safer-than-smoking message applies specifically to adult smokers and former smokers. The picture is different for these groups:

People who have never smoked, where the upside does not exist
Under-18s, where it is illegal to be sold to and lungs are still developing
Pregnant people, who the NHS recommends use NRT (gum, patches) rather than vaping
People with severe respiratory conditions like asthma or COPD, where any inhaled irritant may flare symptoms

The bottom line

UK health bodies agree

Vaping is substantially less harmful than smoking. NHS, OHID, ASH, Asthma + Lung UK and King's College London all say the same thing.

Long-term data is incomplete

Multi-decade studies are still running. The interim science has not changed the position. The chemicals that cause smoking-related disease are largely absent from vape aerosol.

It depends on who you are

If you smoke, switching is a clear win. If you have never smoked, the calculation is different and there is no health reason to start.

Part of our guide

Health Guidance

Clear, UK-focused answers to the health questions vapers actually ask. From side effects to long-term research.

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Is vaping safer than smoking long term?

The short answer, from UK health authorities

Why vaping is substantially safer

What we still do not know

Two different comparisons that matter

The biggest misconception in the UK

What the long-term research is looking for

Groups who should still be cautious

The bottom line

Health Guidance

Is vaping safer than smoking long term?

The short answer, from UK health authorities

Why vaping is substantially safer

What we still do not know

Two different comparisons that matter

The biggest misconception in the UK

What the long-term research is looking for

Groups who should still be cautious

The bottom line

Health Guidance