While many health organizations and professionals assume that vaping must have adverse effects on respiratory health, studies have actually shown that exclusive e-cigarette use, particularly among those with no prior smoking history, is associated with minimal respiratory symptoms such as cough or shortness of breath. More importantly, smokers who switch from smoking to vaping, including those who suffer from serious conditions such as COPD, consistently report improved respiratory symptoms. Hence experts in the field emphasize the importance of distinguishing between the effects of vaping and smoking, as conflating the two can misrepresent risks.

A recent study published in Nicotine and Tobacco Research reiterated that people who switch entirely from smoking to vaping experience notable improvements in respiratory symptoms like wheezing and coughing. Using data from the PATH study, which tracks tobacco use across the U.S., researchers categorized participants into four groups: those who quit nicotine entirely, those who switched exclusively to vaping, those who kept smoking cigarettes, and those who smoked while starting to vape.

In line with previous findings, the results indicated that participants who fully switched to vaping experienced a reduction in wheezing. The research team concluded that this indicates that partial transitions or dual use fail to provide the respiratory benefits associated with completely switching away from smoking.

Similarly, an international study under the VERITAS project has shed new light on the respiratory health of individuals who exclusively use e-cigarettes without a prior history of smoking. Published in Scientific Reports, and conducted by CoEHAR and global collaborators, this pioneering research addressed a critical research gap by focusing on vapers without smoking-related confounders, by comparing respiratory health between exclusive e-cigarette users and a control group who had never smoked or vaped. The results indicated that exclusive vapers without a smoking history did not exhibit significant clinical respiratory issues.

Vapers prefer flavoured disposable vapes

More specifically, indicated the results, among approximately 750 participants, 83.3% reported “rarely” or “never” experiencing respiratory issues such as coughing or shortness of breath. And while vapers scored slightly higher on the Respiratory Symptom Evaluation Scale (RSES), the difference was negligible and not clinically significant. Interestingly, disposable vapes were the most preferred device type, with fruit flavours being particularly popular. This latter finding should raise an alarm given the wave of bans on disposable devices and vape flavours, spreading across the globe.

Discussing the findings, CoEHAR founder Prof. Riccardo Polosa, reiterated the importance of distinguishing between cigarettes and the safer alternatives. “VERITAS provides the foundation for long-term research into vaping’s health impacts. This evidence is vital for forming science-based public health policies and differentiating vaping from smoking effects.”

While lead author Jeffrey Zamora highlighted why the findings of this particular study are significant. “The VERITAS project spans six diverse regions, offering real-world data on vaping habits, device preferences, and socio-cultural variations.” Moreover, by focusing on exclusive vapers, the study provided clarity in an area often clouded by conflated data, setting a benchmark for future investigations into the health impacts of vaping products.

Context is everything

Ultimately, all experts agree that evaluating the relationship between vaping and respiratory health, must be done in the context of the role of vaping as a harm reduction tool for smokers, seeking to quit or reduce risks. For these individuals, switching to vaping is a scientifically supported strategy to mitigate the damage caused by combustible tobacco.

Studies have consistently shown that vaping exposes users to significantly fewer toxicants than smoking, leading to measurable improvements in respiratory health for those who transition. Unlike continued smoking, which exacerbates respiratory conditions, vaping serves as a less harmful alternative. In this context, promoting vaping as a cessation aid aligns with public health objectives to reduce smoking-related disease and death.

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