The NHS says vaping is less harmful than smoking. It even helps people who smoke switch to vapes. So why doesn't it say vaping is safe – or suggest anyone else tries it?
The answer comes down to one small but important word: than. Vaping is safer than smoking. That's a comparison, not a clean bill of health.
Key insight
"Safer" always means "safer than something". Stepping off a low wall is safer than jumping from a roof – but nobody would tell you to go jumping off walls for fun.
Why vaping is less harmful than smoking
Most of the damage from smoking comes from burning tobacco. Burning creates many harmful toxins that can cause cancer, lung disease, heart disease and stroke. Vapes heat a liquid instead, and most of the harmful chemicals in cigarette smoke, including tar and carbon monoxide, aren't in vape aerosol (NHS, n.d.b).
The most thorough review of the health evidence so far, commissioned by the government in England, concluded that in the short and medium term, vaping poses only "a small fraction of the risks of smoking" (Office for Health Improvement and Disparities, 2022).
That's why England's Chief Medical Officer summed it up like this: if you smoke, vaping is much safer; if you don't smoke, don't vape (Whitty, 2023).
Vaping sits between smoking and doing neither. Bar heights are for illustration only.
So why doesn't the NHS say vaping is safe?
Because the evidence doesn't support that. The NHS says vaping is not risk-free and is unlikely to be totally harmless (NHS, n.d.a). These are the harms we know about so far.
| Known harm | What the evidence says |
|---|---|
| Nicotine addiction | Vaping can lead to nicotine dependence, although the risk appears lower than with smoking (McNeill et al., 2022). Nicotine vapes contain the same addictive substance as cigarettes (NHS, n.d.b). |
| Side effects when starting | Some new users get throat and mouth irritation, headaches, a cough or feeling sick. These often improve with time (Cancer Research UK, 2026). |
| Chemicals in the vapour | As well as nicotine, vapes can contain some potentially harmful chemicals, but usually at far lower levels than cigarettes (Cancer Research UK, 2026). See the next section for what each one does. |
| Fires and burns | Vapes are still a fire risk, often from faulty or counterfeit products and unsafe charging (London Fire Brigade, n.d.). |
| Poisoning | E-liquid should be kept out of reach of children and pets (London Fire Brigade, n.d.). Poisonings can be serious but are rare (King's College London, 2022). |
| Illegal vapes | A 2019 lung injury outbreak in the United States was caused by contaminated illegal products, not legal UK vapes (Cancer Research UK, 2026). A 2021 check of disposable vapes in Scotland found many were over the legal nicotine limit (McNeill et al., 2022). |
| Unknown long-term effects | Most evidence covers the short and medium term, so we don't yet know the long-term effects (Office for Health Improvement and Disparities, 2022; Cancer Research UK, 2026). |
In other words, if you smoke, swapping to a vape is a big step down in risk. If you don't smoke, starting to vape is a step up in risk – with nothing to gain.
What the chemicals in vapes do to your body
A vape heats a liquid to make a vapour you breathe in (Cancer Research UK, 2026). Here's what research has found so far.
| Chemical | Known effects on the body |
|---|---|
| Nicotine | Briefly raises heart rate and makes arteries stiffer shortly after use (McNeill et al., 2022). It is addictive, but nicotine itself doesn't cause cancer (Cancer Research UK, 2026). |
| Base liquid (propylene glycol and vegetable glycerine) | In lab studies on cells, base liquids without added flavourings had little or no effect (McNeill et al., 2022). |
| Flavourings | Limited evidence from lab and animal studies suggests cinnamon flavouring (cinnamaldehyde) and buttery or creamy flavours may change how cells behave – though less than tobacco smoke does (McNeill et al., 2022). |
| Volatile organic compounds (potentially harmful gases) | Mostly much lower in people who vape than in people who smoke – for example, a marker of acrolein was 71% lower. A marker of acrylonitrile was over three times higher in people who vape than in non-users in one study (McNeill et al., 2022). |
| Metals | May come from device parts. Evidence is mixed, but most studies found higher levels of some metals in people who vape than in non-users (McNeill et al., 2022). |
| Tobacco-specific nitrosamines (some cause cancer) | Markers of these chemicals were 58% to 94% lower in people who vape than in people who smoke (McNeill et al., 2022). |
| Carbon monoxide | People who switch completely from smoking to vaping may see levels fall to those of non-users (McNeill et al., 2022). |
So what does this mean for the body? Studies have not found clear damage to lung function so far, though the evidence is limited. In a small study, people with the lung disease COPD who switched completely from smoking saw some breathing tests improve. One trial found switching from smoking improved how well blood vessels work after four weeks, and people who vape had lower blood pressure than people who smoke (McNeill et al., 2022).
There are important limits. Most studies are short-term and involve people who used to smoke. Lab and animal studies also suggest vapour is not harmless for people who have never smoked (McNeill et al., 2022).
Why is vaping addictive?
The short answer is nicotine. Most vapes contain it, and it's the same addictive chemical found in cigarettes (Cancer Research UK, 2026).
Nicotine acts on the brain's reward system. It triggers the release of dopamine, a chemical messenger linked to pleasure, which teaches the brain to repeat whatever caused it (University of Chicago Medicine, 2000). Over time, your body gets used to having nicotine. When you stop, you may get withdrawal symptoms such as strong cravings, feeling irritable or low, trouble concentrating, feeling hungrier than usual and difficulty sleeping. A quick hit of nicotine from a vape eases the cravings (NHS, n.d.c) – which is how the cycle keeps going.
Some things can make vaping harder to give up:
| Factor | What the evidence says |
|---|---|
| Nicotine salts | A form of nicotine that is smoother to inhale and absorbed into the blood faster. About half of 16 to 19-year-olds who vaped used them (McNeill et al., 2022). |
| Higher nicotine strength | Higher strengths may make vaping more appealing and increase dependence (McNeill et al., 2022). |
| Experience | Over time, people learn to puff in a way that gives them more nicotine. Experienced vapers can reach nicotine levels similar to smoking (McNeill et al., 2022). |
| Flavours | Early evidence suggests flavours may work together with nicotine strength to make vapes more appealing (McNeill et al., 2022). |
The good news is that dependence on vaping generally appears to be lower than on smoking (McNeill et al., 2022). But it's still real. In one survey, just over half of 16 to 19-year-olds who currently vaped said they felt a little or very addicted, compared with 83% of those who currently smoked (McNeill et al., 2022).
Thinking of stopping vaping?
If you switched to vaping to stop smoking, the NHS advises only quitting vaping once you're confident you won't go back to cigarettes. Cutting down gradually, or switching to a nicotine replacement product such as a mouth spray, can help. And if you slip, going back to vaping is much better than smoking again (NHS, n.d.c).
What about the "95% safer" figure?
You may have seen claims that vaping is "95% less harmful" than smoking. That figure came from a 2015 review for Public Health England, which called it the "current best estimate" at the time (Public Health England, 2015). The more recent 2022 review describes the risk as a small fraction of smoking's (Office for Health Improvement and Disparities, 2022). Either way, less harmful doesn't mean harmless.
What the NHS advice means for you
| If you… | NHS advice |
|---|---|
| Smoke | Consider switching to a vape. You're roughly twice as likely to quit with a nicotine vape as with patches or gum, and your local Stop Smoking Service may offer a free starter pack (NHS, n.d.a). |
| Have switched from smoking to vaping | Stay smokefree first. When you're sure you won't go back, gradually cut down your nicotine strength and how often you vape (NHS, n.d.b). |
| Don't smoke | Don't start vaping (NHS, n.d.a). |
| Are under 18 | Never vape (NHS, n.d.b). |
Getting the most from a vape
Almost two-thirds of people who use a vape, with support from their local Stop Smoking Service, successfully quit smoking (NHS, n.d.b).
Why young people are a particular concern
In 2026, around 19% of 11 to 17-year-olds in Great Britain had tried vaping and 6% currently vaped (ASH, 2026a). Among adults, just 1.5% of people who have never smoked vape (ASH, 2026b), and only 8% of people who vape have never smoked (ASH, 2026c).
Interestingly, 62% of young people wrongly believe vaping is as harmful as, or more harmful than, smoking (ASH, 2026a). Clear, honest information matters in both directions: vapes shouldn't be seen as harmless, but smokers shouldn't be put off switching either. Repeated scare stories are one way "false facts" take hold – our guide Why your brain jumps to conclusions explains how.
The law is changing to protect children. Single-use vapes were banned from 1 June 2025 (GOV.UK, 2025). The Tobacco and Vapes Act became law on 29 April 2026. Once its rules take effect, it will ban advertising and sponsorship of vapes, and it gives the government powers to control their flavours and packaging (Royal College of Paediatrics and Child Health, 2026).
More from Zero Jargon Health
Read our other posts on stopping smoking, vaping to quit and nicotine replacement therapy.
The bottom line
The NHS message isn't mixed – it's precise. For people who smoke, vaping is a much safer option and a proven way to quit. For everyone else, it's an unnecessary risk. If you smoke and want help, contact your local Stop Smoking Service.
References
ASH (2026a) Use of vapes (e-cigarettes) among young people in Great Britain. Action on Smoking and Health. Available at: https://ash.org.uk/uploads/youth-vaping-fact-sheet-2026-FINAL.pdf (Accessed: 28 September 2026).
ASH (2026b) Use of vapes and other novel tobacco and nicotine products among adults in Great Britain. Action on Smoking and Health. Available at: https://ash.org.uk/resources/view/use-of-e-cigarettes-among-adults-in-great-britain (Accessed: 28 September 2026).
ASH (2026c) Vaping: what you need to know. Action on Smoking and Health. Available at: https://ash.org.uk/key-topics/vaping-what-you-need-to-know (Accessed: 28 September 2026).
Cancer Research UK (2026) Is vaping harmful? Last reviewed 20 April. Available at: https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/is-vaping-harmful (Accessed: 28 September 2026).
GOV.UK (2025) Single-use vapes banned from 1 June 2025. 31 May. Available at: https://www.gov.uk/government/news/single-use-vapes-banned-from-1-june-2025 (Accessed: 28 September 2026).
King's College London (2022) Nicotine vaping in England: an evidence update including health risks and perceptions [Presentation slides]. Science Media Centre briefing, September. Available at: https://www.kcl.ac.uk/ioppn/assets/pdfs/kings-nicotine-research-group-vaping-evidence-review-sept-22-smc-presentation.pdf (Accessed: 28 September 2026).
London Fire Brigade (n.d.) Vaping and e-cigarettes: know the fire risks. Available at: https://london-fire.gov.uk/safety/the-home/smoking/vaping-and-e-cigarettes (Accessed: 28 September 2026).
McNeill, A. et al. (2022) Nicotine vaping in England: 2022 evidence update summary. London: Office for Health Improvement and Disparities. Available at: https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-update/nicotine-vaping-in-england-2022-evidence-update-summary (Accessed: 28 September 2026).
NHS (n.d.a) Vaping to quit smoking. Better Health. Available at: https://www.nhs.uk/better-health/quit-smoking/ready-to-quit-smoking/vaping-to-quit-smoking/ (Accessed: 28 September 2026).
NHS (n.d.b) Vaping myths and the facts. Better Health. Available at: https://www.nhs.uk/better-health/quit-smoking/ready-to-quit-smoking/vaping-to-quit-smoking/vaping-myths-and-the-facts/ (Accessed: 28 September 2026).
NHS (n.d.c) How to quit vaping. Better Health. Available at: https://www.nhs.uk/better-health/quit-smoking/ready-to-quit-smoking/vaping-to-quit-smoking/how-to-quit-vaping/ (Accessed: 28 September 2026).
Office for Health Improvement and Disparities (2022) Nicotine vaping in England: 2022 evidence update main findings. GOV.UK. Available at: https://www.gov.uk/government/publications/nicotine-vaping-in-england-2022-evidence-update/nicotine-vaping-in-england-2022-evidence-update-main-findings (Accessed: 28 September 2026).
Public Health England (2015) E-cigarettes around 95% less harmful than tobacco estimates landmark review. GOV.UK, 19 August. Available at: https://www.gov.uk/government/news/e-cigarettes-around-95-less-harmful-than-tobacco-estimates-landmark-review (Accessed: 28 September 2026).
Royal College of Paediatrics and Child Health (2026) Creating a smokefree generation: Tobacco and Vapes Act. Available at: https://www.rcpch.ac.uk/work-we-do/public-affairs/smokefree-generation (Accessed: 28 September 2026).
University of Chicago Medicine (2000) Brief exposure to nicotine makes lasting mark on the brain. Available at: https://www.uchicagomedicine.org/forefront/news/brief-exposure-to-nicotine-makes-lasting-mark-on-the-brain (Accessed: 28 September 2026).
Whitty, C. (2023) Chief Medical Officer for England on vaping. GOV.UK. Available at: https://www.gov.uk/government/speeches/chief-medical-officer-for-england-on-vaping (Accessed: 28 September 2026).
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Important medical disclaimer
The content provided in this blog post is for educational and informational purposes only and does not constitute professional medical advice, diagnosis, or treatment. Always seek the advice of your GP, psychiatrist or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. Never start, stop or change a prescribed medicine without speaking to your prescriber first.
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