Is Long-Term Vaping Safer Than Long-Term Smoking?

Is long-term vaping safer than long-term smoking?

For a smoker, the evidence points one clear way. Vaping is widely accepted as substantially less harmful than smoking, though its long-term risks are still being studied and it is not risk free. So fully switching is a major step down in risk, while it is not the same as being harmless.

The honest position holds two things at once. Smoking is uniquely deadly, so moving away from it matters enormously, yet vapes are new enough that the very long-term picture is still coming into focus. This page sets out what the evidence shows, what remains unknown and what it means for you.

Let us look at what the evidence shows, what is still unclear and what it means in practice.

It is worth being clear about what the question is really asking. It is not whether vaping is good for you in the abstract, rather how it compares with smoking for someone who is going to use nicotine either way. Framed like that, the comparison becomes much more useful.

What the evidence shows

UK health bodies are broadly agreed on the comparison. Major reviews conclude that vaping poses a small fraction of the risk of smoking over the short to medium term, since there is no tobacco and no combustion, so vapers avoid the tar, carbon monoxide and many of the toxic chemicals in cigarette smoke.

• No combustion: vaping does not burn tobacco, so it produces no tar or carbon monoxide.
• Lower toxin levels: people who fully switch show much lower harmful toxins in the body.
• Expert consensus: reviews put vaping at a small fraction of smoking's risk so far.
• Smoking is uniquely deadly: it kills around one in two long-term smokers.

The scale of smoking's harm is the key backdrop. Smoking causes at least 16 cancers and there is no safe level, so for a smoker the gap between the two is very large, which is why UK bodies actively encourage smokers who will not stop nicotine altogether to switch completely to vaping instead.

The strongest part of the evidence comes from biomarker studies, which measure the actual levels of harmful substances in the body. These consistently show that people who switch fully from smoking to vaping carry far lower levels of key toxins, which is a direct, measurable sign of reduced exposure.

What is still unclear

The long-term picture genuinely needs more time. Vapes only became widespread in the mid 2010s, so there has not yet been long enough to measure their effects over decades the way there has with smoking, which means the very long-term risks of vaping remain uncertain rather than proven either way.

Reviews raise the possibility that long-term use could carry some respiratory or cardiovascular risk, while stressing this is likely far smaller than smoking's. There is also extra risk from illicit, non compliant vapes, which can contain unsafe metals and other substances. Buying regulated products and switching fully rather than using both keeps risk lowest.

None of this uncertainty changes the headline comparison, though. Even at the cautious end of the estimates, the long-term risk of vaping is expected to sit well below that of smoking. The unknown is the precise size of the gap over decades, not whether the gap is large.

What it means in practice

The takeaway depends on where you start. If you smoke, fully switching to vaping is a large reduction in risk, even allowing for the long-term unknowns, while if you do not smoke, taking up vaping adds risk for no benefit, which is exactly what the expert guidance reflects.

That guidance is often summed up in a single line from the Chief Medical Officer for England: if you smoke, vaping is much safer. If you do not smoke, do not vape. It captures both halves of the answer cleanly, neither overstating the risks of vaping nor pretending it is harmless.

• If you smoke: switching fully is a major step down in risk.
• If you have switched: aim not to use both, since dual use keeps smoking's harms.
• If you do not smoke: there is no health reason to start vaping.
• Whatever you do: use regulated products and consider stepping nicotine down.

Why dual use is the thing to avoid

One trap worth naming is dual use, meaning vaping while still smoking some cigarettes. Because so much of smoking's harm comes from the cigarettes themselves, cutting down without fully stopping keeps most of that risk in place, so the safety benefit only really lands when you switch over completely.

If you are part way through a switch, that is a normal stage rather than a failure, though the goal is to leave cigarettes behind entirely. A stop smoking service or pharmacist can help you bridge the gap, while stepping the nicotine strength down over time can make the final move away from cigarettes easier to hold.

If you want to dig deeper, see our explainer on whether vaping is better than smoking. It pairs well with our guide on whether vaping is bad for you and our look at whether vaping is regulated in the UK.

For the full set of guides, the vaping and health hub brings everything together in one place.

Frequently asked questions