No, vaping is not as dangerous as smoking

“We don’t know the long-term effects!” is the standard excuse for clamping down on e-cigarettes. It is not an objection raised against iPhones, wi-fi or most other new technologies, although it was one of the slogans of the “vaccine hesitant” during the pandemic. 

So many years have passed without a vape-related death being documented that concerns about the “long-term” effects should be subsiding. The Chinese pharmacist Hon Lik invented the e-cigarette in 2003 and has been using them ever since. He is now in his mid-70s and still standing. For what it’s worth, I’ve been using them for 16 years and feel fine. It will obviously take several more decades for observational epidemiology to show what effect vaping for 50 years has on the human body, but observational epidemiology isn’t the only science in town. If the combustible cigarette were invented today, scientists would be able to tell immediately that it is very bad for your health. A similar toxicological assessment strongly suggests that vaping is much less bad for your health. Given the absence of smoke and the vastly reduced number of potential toxins and carcinogens, it would be truly remarkable if the risks were remotely similar.

It nevertheless remains possible that vaping carries a serious and unforeseen health risk that will only strike after a lifetime’s use. If you believe the tabloid press, this hidden peril was revealed this week. “Horror vaping health impact revealed in new study” (The Mirror), “Horror as vaping research reveals deadly effects “as bad as smokin’” (Daily Express) and “First vaping study suggests long-term use leads to these horrifying side effects” (Daily Record) were just some of the many headlines. The only problem was that there was no study. The research in question didn’t look at long-term effects and its findings do not show that vaping is “as bad as smoking” or anything close to it. 

The man responsible for what the Mirror described as a “bombshell new study into the long-term effects of vaping” is Dr Maxime Boidin, a senior lecturer in cardiac rehabilitation at Manchester Metropolitan University. Dr Boidin is not a man who is shy of the media. He has been tweeting about his e-cigarette research since June 2023, months before it even began. A sports scientist by training, he had never published anything about e-cigarettes before, and he still hasn’t, but he has appeared as an expert in a BBC3 documentary and on Good Morning Britain in addition to interviews with BBC 5Live, ITV and various newspapers. When he was interviewed by the Liverpool Echo last November, Boidin cheerfully tweeted the front page splash headlined ‘City Doc’s Warning to Vapers: Shock data shows damage “equal to smoking”’.

Boidin managed to get Sky News to publicise the launch of his vaping experiment back in October 2023. He was looking for twenty vapers, twenty smokers and twenty people who neither vaped nor smoked to undergo tests of their lung capacity and vascular health. When the BBC asked him what he expected his research to find, he said: “What I could expect is that those who doesn’t [sic] vape or smoke at all will have good blood vessels, good fitness. Those who smoke will have the worst fitness and blood vessel quality. I’m expecting that those who vape will be in the middle of it.” There was a whiff of the middle ground fallacy in this answer, but by the time he appeared on Good Morning Britain in April 2024, when his 18 month study still had a year to go, he was much more decisive. “The pilot data that we have at the moment are demonstrating that vaping is as harmful as smoking on the blood vessel around the neck, the blood vessel around the arm and even the exercise capacity,” he said. “So it’s not even better than smoking, it’s as harmful as smoking.”

That was what the media wanted to hear and he has been putting out the same message ever since. He got another bite of the cherry when his team presented some preliminary data on a poster at the European Respiratory Congress annual meeting last September and again on Monday when he told The Mirror that “the dangers for someone who keeps vaping are no different from smokers”. The rest of the media picked up on this interview and it even reached America where Professor Michael Siegel of the Tufts University School of Medicine said that it “shows how far certain researchers are willing to distort scientific rigour in order to condemn vaping.”

Neither of these findings remotely implies that vapers face the same risks of cancer, lung disease or heart disease as smokers

Indeed it does. Boidin’s claims appear to be nonsense. The “study” hasn’t been written, let alone peer-reviewed and published. The research hasn’t even been completed yet. And from what little we can tell from the information that has been drip-fed to the media, the methods used are completely inadequate to make any judgement about the health risks of vaping. Boidin’s team appears to have found evidence that vapers have more arterial stiffening and less lung capacity than people who do not use nicotine. That is not terribly surprising. Nicotine use causes arterial stiffening, but so does caffeine, stress, and high intensity training, and since the vast majority of vapers are former smokers, we would expect them to have less lung capacity than a lifelong non-smoker. Neither of these findings remotely implies that vapers face the same risks of cancer, lung disease or heart disease as smokers. A few people on exercise bikes at Manchester Polytechnic do not trump the wealth of evidence showing that vaping is vastly safer.

85 per cent of smokers wrongly believe that vaping is as bad or worse than smoking and this figure rises every year. It is an astonishing statistic until you consider how much hysteria has been spread for the last 15 years. As Clive Bates, the former director of Action on Smoking and Health, writes in a letter to Dr Boidin: “What you have done here ranks with the worst kind of misinformation of the tobacco industry of the 1970s and will likely have the same effect — more smoking, disease, and death.” 

Expect no remorse from the sports scientist. On Monday he bought a copy of the Mirror and proudly tweeted the full page article headlined “Vaping: The shocking truth”. Modern universities encourage academics to publish research that has an “impact”. Perhaps they shouldn’t.