To vape or not to vape – we break down the evidence

Clinical Fellow at Bupa UK
08 October 2018

As a lung doctor, my patients often ask me about the safety of vaping (using e-cigarettes). It’s a good and important question. Here I look behind the smokescreen and explain what effect e-cigarettes have on you, and also the people around you such as your children.

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Is vaping harmful?

All experts agree that not smoking is the safest option. But switching to vaping, or using vaping to help you quit, is much less harmful than continuing to smoke tobacco cigarettes.

Tobacco cigarettes produce smoke that contains thousands of chemicals (some of which are known to cause cancer). E-cigarettes produce vapour – and not smoke – through the heating of liquids that contain nicotine. Studies have found much lower levels of these chemicals in e-cigarettes compared to tobacco cigarettes. In fact, Public Health England say they’re 95 percent safer than tobacco cigarettes.

In the UK, we regulate e-cigarettes so lots of potentially harmful chemicals (like those found in some flavours used in other countries) have been banned from being added. We also control the volume and strength of refills which is important so you know just how much you’re using.

Your doctor can’t prescribe you e-cigarettes because they’re not “medically licenced”. This means that they haven’t been approved by the Medical and Healthcare products Regulatory Agency (MHRA) as a medicine. Because of this, your doctor can’t write you a prescription for e-cigarettes. They can prescribe other nicotine replacement therapies (NRT) though, such as patches, gums or inhalers. These are safe and there’s alot more long-term evidence about them as they have been around for longer.

Is it safe to vape around my family?

There can be significant negative health impacts on other people who breathe in tobacco smoke produced by your cigarette. This is called passive smoking. They get the same diseases as smokers, including lung and heart problems and cancer. Children are particularly vulnerable and are more likely to get asthma, allergies, chest and ear infections and even meningitis if they’re exposed to smoke. Because of this, it’s been against the law to smoke in a vehicle containing a young person since October 2015.

Vaping doesn’t produce smoke; so the risks of passive vaping are different. The vaping mist does contain low levels of chemicals, including nicotine, but these don’t go over acceptable environmental levels. Researchers are also looking at the impact of the vapour which settles on surfaces, such as your sofa or kitchen table, and whether there are any health consequences of this. At the moment, there has been no identified health risk of passive vaping.

There have been some incidents of poisoning with small children drinking e-liquids. So it’s important to make sure you store your e-cigarettes away from children as you would household cleaning products, to prevent accidents. There have also been a few cases of e-cigarettes catching fire or exploding; but this is much less common than fires caused by tobacco smoking.

Is it safe to vape when I’m pregnant?

Smoking tobacco is well known to contribute to cot death and underweight babies and it’s really important to try to quit if you are pregnant.

As there are fewer ingredients in e-cigarettes, and at much lower levels, scientists agree vaping, or using other nicotine replacement therapies, is safer than smoking during pregnancy. However, although there’s no evidence to suggest nicotine harms unborn babies, there is no evidence to confirm that it’s safe either.

Either way, the safest option for you and your baby is to stop smoking entirely.

Do e-cigarettes cause more tobacco smoking in teenagers?

Studies have shown that the reasons for young people experimenting with or using conventional cigarettes and e-cigarettes are very similar. Risk factors include drinking alcohol, energy drinks, poorer academic performance and having parents who smoke. Protective factors include taking part in extracurricular activities such as music or art. The strongest risk factor for using e-cigarettes was smoking conventional cigarettes.

Current evidence suggests that fewer young people are experimenting with using e-cigarettes and the use in those who’ve never smoked remains very low.

Most scientists think that e-cigarettes are reducing the use of conventional cigarettes. They also think that using e-cigarettes are lowering the greater negative healthcare impacts of tobacco cigarettes.




Here at Bupa we understand how important your family is. So with our family health insurance you can rest assured knowing that eligible treatment and support is available for your loved ones when they need it.

Dr Nicola Read
Clinical Fellow at Bupa UK

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