Nicotine, Tobacco and Vaping

Nicotine is the dependence-forming drug in cigarettes, vapes and other nicotine products, while much of smoking’s severe disease burden comes from inhaling tobacco smoke. Vaping avoids combustion but is not harmless and can sustain powerful nicotine dependence.

Nicotine, smoking and vaping are closely connected, but they are not the same thing.

Nicotine is the drug that drives dependence in cigarettes, most vapes and many other nicotine products. It can affect attention, arousal, reward and learning, and repeated use can make withdrawal and craving part of everyday life.

Cigarette smoking adds another major source of harm: combustion. Burning tobacco creates a complex mixture of toxic chemicals, particles and gases that damage the lungs, blood vessels and other organs and contribute to cancer, cardiovascular disease and respiratory disease.

Vaping does not burn tobacco, so it generally exposes users to fewer combustion-related toxicants than cigarette smoking. That does not make vaping harmless. Vape aerosol can contain nicotine and other potentially harmful substances, and the long-term effects of newer products are still being studied.

For an adult who already smokes, completely replacing cigarettes with a regulated nicotine vape can reduce exposure to many toxic products of combustion. Continuing to smoke while also vaping does not remove the harms of cigarette smoke.

For someone who does not already use nicotine, particularly a young person, lower risk than smoking is not a reason to start vaping.

Nicotine dependence itself can also become difficult to change. Withdrawal, learned routines and the rapid relief produced by another dose can keep smoking or vaping going even when someone strongly wants to stop.

Full access is needed to read this Topic's articles.