E-cigarettes and smoking alternatives: are they less harmful?

profile picture of Elizabeth Rogers
Associate Clinical Director, Bupa Health Clinics
13 July 2021
Next review due July 2024

It’s well known that smoking cigarettes is bad for your health. But that doesn’t mean that quitting smoking is easy. There are lots of products available that claim to be better for you than traditional cigarettes.

But are they as healthy as we’re led to believe? In this article, I explore e-cigarettes and other smoking alternatives, including any risks and safety issues.

person with a vape in the garden

How does smoking affect your health?

Smoking increases your risk of developing many serious health problems. These include:

  • heart disease
  • lung disease
  • arthritis
  • poor bone health
  • different types of cancer (such as lung, throat, mouth, liver and stomach)

In fact, smoking is the biggest cause of preventable illness and early death in England.

What other options are there to smoking?

If you want to quit smoking, there are lots of products available to help you to manage your cravings and reduce withdrawal symptoms.


E-cigarettes are battery-powered devices that deliver nicotine as a vapour. There are different types of e-cigarettes available, including:

  • vape pens
  • cigalikes
  • tank systems
  • mods

E-cigarettes allow you to inhale nicotine as a water-based vapour instead of smoke. Using an e-cigarette is often referred to as ‘vaping’.


Smoking shisha involves using coal or charcoal to heat up flavoured tobacco. Tobacco is a plant. Its leaves are dried and fermented to go into tobacco products. Tobacco contains nicotine, which can lead to addiction. This is why so many people who use tobacco find it difficult to quit.

When tobacco is heated with a shisha, it produces smoke. The smoke bubbles through a bowl of water and is inhaled through a long tube with a mouthpiece. It’s common in Southeast Asian, Middle Eastern, and North African communities, and is becoming increasingly popular in the UK.

Smokeless tobacco

As the name suggests, smokeless tobacco products are not smoked. They’re designed to be chewed, sucked or directly inhaled. It’s often called spit tobacco, chewing tobacco or snuff.

Are smoking alternatives safe?


Research has shown that e-cigarettes can help you to quit smoking. E-cigarettes allow you to inhale nicotine (the addictive ingredient in cigarettes) without most of the harmful effects of smoking. The vapour contains no tar or carbon monoxide, which are harmful chemicals found in cigarettes.

Some of the harmful chemicals found in cigarettes (like metal particles and aldehydes) are still present in e-cigarette vapour. But they’re produced at much lower levels, meaning the risk to your health is also lower.

E-cigarettes are still a relatively new product, so the long-term impact they could have on your health isn’t known yet. But the UK has some of the strictest regulations for e-cigarettes in the world. This means that products must meet minimum safety and quality standards before you can buy them.

In the UK, e-cigarettes aren’t available on prescription. This means you’ll need to buy them online, or in a shop or pharmacy. Generally, they’re much cheaper than cigarettes, so you’re likely to save yourself some money too.


Smoking shisha isn’t a safer alternative to smoking cigarettes.

In an hour-long session, you can inhale the same amount of toxins as a cigarette smoker consuming over 100 cigarettes. Shisha is also addictive as it uses tobacco, which contains nicotine.

Smokeless tobacco

Smoking alternatives that use tobacco still carry a significant risk to your health.

Although these products aren’t smoked, they contain cancer-causing chemicals (such as arsenic, nickel and nitrite) as well as addictive nicotine.

Research has found that smokeless tobacco causes heart disease and several cancers, such as mouth, oesophageal and pancreatic cancers.

Are smoking alternatives better for you than smoking?

Smoking alternatives that use tobacco aren’t better for you than smoking cigarettes.

E-cigarettes offer a safer alternative to smoking, so you may want to try them to help you to quit smoking.

You’re more likely to stop smoking successfully if you get professional support. You can ask your GP or pharmacist for advice, access online support, or use your local Stop Smoking Service.

Are you interested in learning more about your health? Discover more about our range of health assessments.

profile picture of Elizabeth Rogers
Dr Elizabeth Rogers
Associate Clinical Director, Bupa Health Clinics

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