Hello, vapemallow community! Today, we’re taking a deep dive into the statement made by Public Health England (PHE) in 2015, and reaffirmed in 2018 during the “PHE’s Health Harms campaign”: “vaping is at least 95% safer than smoking.” This striking declaration has reverberated across the globe, yet many vapers may not know the scientific underpinnings that led to this conclusion. Let’s explore this pivotal statement and the journey leading up to it.

The Road to the Declaration: PHE’s Research and Reports

The genesis of this declaration dates back to 2014 when PHE commissioned a report1 to investigate the health impacts of vaping. Authored by John Britton and Ilze Bogdanovica from the UK Centre for Tobacco and Alcohol Studies at the University of Nottingham, the report was presented to PHE in 2015. After careful review, PHE concluded that the risks associated with vaping were “extremely low,” notably lower than those related to smoking, and that passive exposure to e-cigarette vapor also posed an “extremely low” risk.

Following this, PHE released its own report, which aligned with an international review’s findings. This review, conducted by a global team of experts, estimated the risks of vaping to be less than 5% of the risks of smoking. Another comprehensive review of relevant literature found that e-cigarette aerosol can contain some of the toxicants found in tobacco smoke but at much lower levels. PHE concluded that while the long-term health effects of e-cigarette use are unknown, they are likely to be much less harmful than cigarettes, if at all, to users or bystanders.

Tracing the Origins of the “95% Safer” Statement

To understand the birth of the “at least 95% safer” assertion, we must turn to another study conducted by an international expert panel convened by the Independent Scientific Committee on Drugs. This panel developed a multi-criteria decision analysis model to assess different types of harm associated with the use of nicotine-containing products.

The researchers scrutinized twelve products based on fourteen defined harm criteria, seven related to harm to users, and seven related to harm to bystanders. Each product was scored on each criterion for their average harm worldwide, with a scale where 100 represented the most harmful product on a given criterion, and zero represented no harm.

The study results indicated that ENDS (e-cigs) scored less than 5, signifying that these devices carry about 5% the risks of smoking. This provided the basis for the “vaping is at least 95% safer than smoking” declaration. Upon reviewing the relevant scientific literature, PHE agreed that the dangers associated with vaping may be “extremely low” compared to those associated with smoking.

The Issue of Formaldehydes and Acrolein

Interestingly, one of the earliest studies examining these emissions was a Japanese study reported in 2014 by the Japan Times. It found that one e-cigarette emitted formaldehyde levels 10 times higher than tobacco cigarettes. However, PHE clarified that these toxic emissions only occurred when the e-liquid was overheated, and the study has never been published.

In January 2015, another similar study was released. It discovered that when using a 3rd generation personal vaporizer at maximum power for 3 to 4 seconds, causing a dry hit, the rate of formaldehyde found in the aerosol was 5 to 15 times higher than a tobacco cigarette. PHE, in response, stressed that these results were obtained through testing on smoking machines, and no actual vaper would take such long puffs at such power. Furthermore, when vapers experience a dry hit, they instinctively spit out the vapor due to the unbearable taste, something that smoking machines don’t detect. Thus, while these toxic substances are present when e-liquid overheats, no vaper would inhale them repeatedly.

H2: Vaping, Dry Hits, and Emission Levels

Further confirming these findings was a study conducted by the renowned anti-smoking expert, Dr. Konstantinos Farsalinos. His research found that none of the vapers participating could vape under the same conditions as the smoking machines. All participants had to expel the vapor due to the dry hits produced. Moreover, under normal usage conditions, the levels of toxic compounds in the aerosol were either “absent or negligible”.

Likewise, with respect to acrolein, other scientists have shown that vapers have significantly lower levels of acrolein and crotonaldehyde in their urine than tobacco smokers. It’s crucial to remember that a vaporizer produces higher levels of formaldehyde than smoking only when used under poor and unrealistic conditions. In typical use, the vapor produced by an electronic cigarette contains “absent or negligible” levels of toxic compounds.

Vaping and Lung Health Concerns

In February 2015, a significant study was conducted, where mice were enclosed in a box and exposed to the aerosol of an electronic cigarette. The research concluded that vaping could cause lung inflammation and infection, and even cancer. However, PHE pointed out several issues with this study. Firstly, an e-cigarette should be viewed only as a tool to reduce the risks associated with smoking. Therefore, any study that seeks to highlight problems caused by vaping, must compare them with problems caused by smoking, which this study did not do.

The second issue was the stress level of the mice exposed to e-cigarette vapor, which was significantly higher than the control group. Stress is known to impact bacterial and viral responses, leading PHE to deem the results of this study unreliable.

Moreover, due to the mice’s confinement, they also “suffered from repeated nicotine poisonings.” The UK Department of Health explains that accelerated weight loss, reduced immunity, and early death of animals “were much more likely to result from prolonged stress and nicotine poisoning than from exposure to free radicals,” particularly given that free radicals in e-cig aerosol were at levels 1,000 times lower than in tobacco cigarettes10.

That same year, another study revealed similar results. However, the UK Department of Health pointed out that “once again, no comparison with smoking has been made”11.

The only symptoms currently reported when using a vape are local mouth irritation and dryness. Regarding the respiratory tract, research has shown improvement in the condition of smokers with asthma13. Another study found no significant effect on the human body following the use of an electronic cigarette for 1.5 years.

The takeaway here, vapemallow community, is that while there are always risks associated with any form of nicotine consumption, the consensus among experts seems to be that vaping poses significantly fewer health risks than traditional smoking. As always, stay informed and vape responsibly.


[1] Britton, J. and Bogdanovica, I., Electronic cigarettes: A report commissioned by Public Health England. London: Public Health England, 2014


[2] McNeill, A., Brose, L.S., Calder, R., Hitchman, S.C., Hajek, P., and McRobbie, H., E-cigarettes: an evidence update – A report commissioned by Public Health England, 2015


[3] Nutt, D. J., et al., Estimating the harms of nicotine-containing products using the MCDA approach.European addiction research, 2014. 20(5): p. 218-225


[4] Hajek, P., et al., Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit. Addiction, 2014. 109(11): p. 1801-1810


[5] Jensen, R. P., et al., Hidden Formaldehyde in E-Cigarette Aerosols. New England Journal of Medicine, 2015. 372(4): p. 392-394


[6] Farsalinos, C., E-cigarette aerosols generates high levels of formaldehyde only in β€˜dry puff’ conditions. Addiction, (in press)


[7] Hecht, S.S., et al., Evaluation of toxicant and carcinogen metabolites in the urine of e-cigarette users versus cigarette smokers. Nicotine & Tobacco Research, 2014: p. ntu218


[8] Sussan, T. E., et al., Exposure to Electronic Cigarettes Impairs Pulmonary Anti-Bacterial and Anti-Viral Defenses in a Mouse Model. PLoS One, 2015. 10(2): p. e0116861


[9] Lerner, C.A., et al., Vapors produced by electronic cigarettes and e-juices with flavorings induce toxicity, oxidative stress, and inflammatory response in lung epithelial cells and in mouse lung.PLoS One, 2015. 10: p. e0116732


[10] Hajek, P., et al., Electronic cigarettes: review of use, content, safety, effects on smokers and potential for harm and benefit. Addiction, 2014. 109(11): p. 1801-1810


[11] Polosa, R., et al., Effect of smoking abstinence and reduction in asthmatic smokers switching to electronic cigarettes: evidence for harm reversal. Int J Environ Res Public Health, 2014. 11(5): p. 4965-4977


[12] McRobbie, H., et al., Electronic cigarettes for smoking cessation and reduction.Cochrane Database Syst Rev, 2014. 12: p. CD010216


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