Is Vaping Worse Than Smoking? 

Is vaping worse than smoking? Put another way, are vapes worse than cigarettes? These are important questions, as vaping has become a popular alternative to smoking, and the marketing is more targeted toward young people.  

Cigarettes and e-cigarettes, or vapes, contain nicotine, a highly addictive substance that makes it difficult for users to stop using it once they’ve started, resulting in a crash or withdrawal symptoms when that nicotine need is not met. 

This chemical compound also can interfere with brain development in those under age 25, affecting the parts of the brain that control learning, mood control, attention, and impulse control. In addition, it can be linked to substance use — and potentially substance abuse — issues. According to an analysis of multiple studies, published in JAMA Pediatrics, the odds of marijuana use are higher in youths who use e-cigarettes. 

To help explore the effects of vaping vs. smoking and the question “What’s worse, cigarettes or vapes?”, we spoke to Jennifer Acker, a certified master addiction counselor and clinical director at the Embark Behavioral Health outpatient clinic in Atlanta, Georgia

5 Signs Your Teen Is Vaping

If you’re concerned about your teenager, you can look for a few different signs your teen is vaping. They include: 

  1. Sweet-smelling residue: You may notice sweet smells in your home for small periods of time. 
  1. Empty cartridges and vape pens: You may find unusual cartridges or vape pens around your home. 
  1. Excessively drinking water: Vaping causes the mouth and throat to get dry more often than normal, so your teen may reach for water more often. 
  1. Lingering cough: Your teen may have a lingering cough that doesn’t seem to go away with medication or home remedies. 
  1. Batteries and chargers lying around: You may spot excessive batteries and chargers lying around your teen’s room or in their backpack or purse. 

Physical Health Dangers of Smoking 

To explore the question “Is vaping or smoking worse?”, it’s helpful to first consider how cigarettes affect the body. Research has shown that smoking can lead to physical health dangers with prolonged effects, such as cancer, which can be fatal. Other dangers include heart disease, asthma, and high blood pressure. 


According to Cancer Research UK, at least 70 chemicals found in cigarettes can cause cancer, as the chemicals can damage the parts of DNA that protect us from the disease — and the more cigarettes a person smokes a day, the higher their risk. 

Heart disease  

Smoking can lead to heart disease because of the chemicals that are released into the body. According to the Centers for Disease Control and Prevention, the chemicals in cigarette smoke can inflame the cells that line blood vessels and narrow those vessels, leading to coronary heart disease, which can be fatal. 


Asthma is a chronic lung disease that makes a person’s airways sensitive and reactive to specific triggers, depending on the person and the severity of their asthma. According to the Cleveland Clinic, tobacco smoke is a powerful trigger, and those who smoke while having asthma are known to have aggravated symptoms. 

High blood pressure  

Smoking is known to increase blood pressure each time a person has a cigarette. This is because when someone smokes, they activate their sympathetic nervous system, which triggers a person’s fight-or-flight response.  

Mental Health Dangers of Smoking 

When it comes to smoking and mental health, there are some dangers, and they can put stress and strain on your teen’s relationships and work or school life. 

The dangers include anxiety, stress, tension, and depression.  


Can nicotine cause anxiety? Since nicotine is a stimulant, and stimulants activate the central nervous system, it can create feelings of anxiety or being on edge because the central nervous system is in high gear, according to Acker.  


There is a relationship between stress and smoking. According to Acker, nicotine activates the pleasure pathway and the release of dopamine in the brain. The release can lead to an obsession with or dependence on nicotine, which can lead to a person becoming stressed about getting more of this addictive substance. 


Smokers may experience tension when preoccupied with getting more nicotine or finding time for another smoke break. They can also experience physical tension and discomfort from withdrawal symptoms. 


Can nicotine cause depression? There is a relationship between smoking and this serious mental health issue. 

“With any stimulant, there is a crash,” Acker said. “So, for someone who may be struggling with depression, that crash could lead into more depressive symptoms and perpetuate the cycle of needing more nicotine.”  

According to Acker, people can also turn to stimulants such as nicotine if they’re suffering with depression or depressive symptoms because they’ll help them feel good.  

Teen vaping and wondering if it’s bad for her health.
Teen vaping and wondering if it’s bad for her health.  

Physical Health Dangers of Vaping 

When exploring the question “What’s worse, vaping or smoking?”, it’s important to look at how vaping affects the body. Of note: Not everyone who uses vapes realizes they’re inhaling nicotine. According to the recent Truth Initiative study, 63% percent of JUUL users don’t know that these e-cigarettes have this substance in them. And, the study shared, one JUUL cartridge can contain as much nicotine as a whole pack of cigarettes. This can be a serious issue. 

“When we get into the higher concentrations of nicotine, we start to get into something we did not see with cigarettes, which is nicotine poisoning,” Acker said.  

As a result, vape users can develop several conditions with long-term consequences.  

Lung injuries/burns  

In 2019, the term EVALI was coined in response to a growing number of severe lung illness cases caused by e-cigarettes and vaping, according to the American Lung Association. EVALI stands for e-cigarette or vaping use-associated lung injury. The association shared that among the EVALI cases reported, 96% of patients required hospitalization, and some died. 

High blood pressure 

Can vaping cause high blood pressure? A study in the Journal of Hypertension found that vaping can be associated with a significant increase in blood pressure that lasts for about 30 minutes at a time. High blood pressure can be an issue because it increases the risk for heart attacks and strokes. 

Lung disease 

Vaping and lung disease has become a topic of interest for both researchers and concerned parents. For example, in a report in the New England Journal of Medicine that looked at pulmonary illnesses related to e-cigarette use, the authors noted that research has linked acute interstitial lung disease to vaping and e-cigarettes. This type of lung disease can involve scarring of the lungs, which can make it difficult to breathe. 

Other lung diseases linked to vaping include popcorn lung and asthma. 

Popcorn lung 

Does vaping cause popcorn lung? This rare condition, also known as bronchiolitis obliterans (BO), happens when there’s damage in the small airways of the lungs. According to Hopkins Medicine, when a person inhales diacetyl, a yellow liquid with a buttery flavor that’s often added to vape juice or e-liquids, they can experience inflammation and even permanent scarring in the lungs that makes breathing difficult. 


Is vaping bad for asthma? According to an article in the American Journal of Preventative Medicine, e-cigarette use is a risk factor for respiratory diseases — which include asthma. In a study in the journal Respirology, the authors reported that some studies have shown that e-cigarette smoking increases asthma symptoms and severity. 

Cardiovascular disease  

The risk for cardiovascular disease when vaping is unknown, according to Heart Journal, but vaping has been studied and linked to known risk factors such as inflammation and thrombosis, which is when a blood clot blocks a blood vessel. 

Mental Health Dangers of Vaping 

How can vaping affect your teen’s mental health? It can lead to the same issues as if they were smoking cigarettes or even worsen those issues because the nicotine concentration is higher when using vapes, and that could cause more serious effects, according to Acker.  


Can vaping cause anxiety? As is the case with smoking cigarettes, vaping can be an issue because nicotine is a stimulant and can create feelings of anxiety, as the central nervous system is in high gear.  


Vaping and depression were linked in a study published by JAMA Network. From 2016-2017, people who vaped were more likely to report a history of clinical diagnosis of depression. According to Acker, people will turn to stimulants, like nicotine, to feel good, and those struggling with depression or depressive symptoms will turn to a stimulant activity like vaping to give them temporary relief. 

Stress and tension 

Does vaping cause stress? According to Acker, one way to picture the amount of nicotine in e-cigarettes and traditional cigarettes is by comparing them to cups of coffee. She described cigarettes as one cup of coffee and vaping as six cups. The higher concentration of nicotine in vaping can help people develop a tolerance for nicotine much quicker. This can bring stress and tension when they’re trying to constantly keep their fix going. 

6 Ways To Help Your Teen Stop Vaping 

Teens vaping has become a concern, but you can help your child break this habit. According to Acker, the best place to start is understanding why your teen began vaping instead of shaming them into stopping. 

“The number one thing a parent can do when they’ve discovered their teen is vaping is to find out what the motivation for using was and how the teen can get that need met in a healthier way,” she said. 

1. Talk to your teen about vaping 

When it’s time to talk with teenagers about vaping, Acker suggested parents come alongside their teens and talk about the risks of using vapes. You can discuss the physical and mental health dangers listed above. 

2. Prepare your teen for withdrawals  

To help your teen deal with withdrawal when they stop vaping, Acker suggested you first familiarize yourself with what nicotine withdrawal symptoms look like. They include feeling hungrier, being irritable, and having a hard time sleeping. Then, when your teen is experiencing symptoms, you can explain that these are temporary and guide them toward activities that can distract or help them. For example, if a teen is feeling hungrier than usual, encourage them to eat healthy snacks rather than junk food, as proper nutrition is a vital part of recovering from withdrawal. 

3. Manage the triggers 

Identifying what triggers teenagers to vape can be a big step in how to help a teen struggling to quit vaping. Once you know why your child is engaging in this habit, you can help them create a plan to manage their triggers. This plan could include written reminders that they don’t have to vape in those situations and a list of activities they can do instead.  

4. Encourage your teen to practice mindfulness  

Mindfulness is a great way for your teen to be aware of their surroundings, triggers, and reasons for vaping. Acker suggested encouraging your teen to practice breathing exercises so they stay present and are aware of their cravings. 

5. Look into therapy for co-occurring issues  

“Looking into therapy goes back to understanding your teen’s motivations for vaping,” Acker said. “Vaping nicotine can be seen as a coping mechanism for depression, anxiety, or even an eating disorder.” Therapy can treat the co-occurring issues that vaping is masking.  

6. Be patient with them  

Patience is key to helping your teen stop vaping. Withdrawal symptoms will come, and family and friends involved in the quitting process will become irritated or frustrated with the process, but being patient and working together can help your child break this concerning habit.  

Vaping vs. Smoking Wrapup  

Teens vaping can be alarming to parents. After all, vapes contain nicotine, which is highly addictive. As you look to help your teenager, Acker suggested you come alongside them instead of at them to understand their world and the role vaping is playing in it. This will allow you to best support them in quitting. 

Regarding the question “Is vaping worse than smoking?”, while evidence points toward avoiding vapes because they contain chemicals, heavy metals, and water vapor that can harm the lungs, according to Acker, researchers are still investigating whether e-cigarettes are worse than standard cigarettes. 

“There’s been a lot of research done on the long-term health implication of smoking a cigarette, but we don’t know the long-term health implication of vaping e-cigarettes,” Acker said. 

Embark is the most trusted name in teen and young adult mental health treatment. We’re driven to find the help your family needs. If you’re looking for support, contact us today!   

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Embark Behavioral Health

Embark Behavioral Health is a leading network of outpatient centers and residential programs offering premier mental health treatment for preteens, teens, and young adults. Dedicated to its big mission of reversing the trends of teen and young adult anxiety, depression, and suicide by 2028, Embark offers a robust continuum of care with different levels of service and programming; has a deep legacy of over 25 years serving youths; works with families to adjust treatment in real time to improve results; treats the entire family using an evidence-supported approach; and offers the highest levels of quality care and safety standards. For more information about Embark or its treatment programs, including virtual services, intensive outpatient programs (IOPs), therapeutic day treatment programs, also known as partial hospitalization programs (PHPs), residential treatment, and outdoor therapy, visit