Pick your poison: The truth about vaping, smoking, and quitting for good

Smoking remains one of the leading causes of preventable deaths worldwide, contributing to various chronic diseases such as cancer, cardiovascular disease, and respiratory disorders. Smoking cessation is crucial for reducing morbidity and mortality, improving overall health, and lowering healthcare costs. However, quitting smoking is challenging due to nicotine dependence, and various cessation methods, including pharmacotherapy, behavioral therapy, and nicotine replacement therapy (NRT), have been developed to assist smokers.

Electronic cigarettes (e-cigarettes) (vaping) have emerged as a potential harm reduction tool, offering an alternative to combustible cigarettes by delivering nicotine in a less harmful manner. However, recent research suggests that e-cigarettes may pose significant health risks, potentially comparable to or even exceeding those of traditional smoking (Boidin, 2025). This article explores the benefits of smoking cessation, the role of e-cigarettes in smoking cessation therapy, and the potential harms associated with e-cigarette use. 

Benefits of Smoking Cessation

Health Benefits

Smoking cessation has immediate and long-term health benefits. Within minutes of quitting, blood pressure and heart rate begin to normalize (Benowitz, 2010). Within weeks, lung function and circulation improve, reducing the risk of heart attacks and strokes (USDHHS, 2020). Over the long term, quitting smoking decreases the risk of developing lung cancer, chronic obstructive pulmonary disease (COPD), and cardiovascular diseases (Jha et al., 2013).

Economic and Social Impact

Smoking-related illnesses contribute to substantial healthcare costs and lost productivity. Smoking cessation reduces medical expenses related to treating smoking-related diseases, leading to lower healthcare system burdens (CDC, 2021).

Behavioral and Psychological Aspects of E-Cigarette Use

One reason smokers find it difficult to quit is the behavioral reinforcement associated with smoking. E-cigarettes provide a similar hand-to-mouth action, throat hit, and inhalation experience, which may help reduce cravings and withdrawal symptoms (Etter & Bullen, 2014).

The fight against smoking’s toll hinges on cessation, a proven lifeline that slashes disease risk and eases economic strain, yet remains elusive for many gripped by nicotine’s pull. E-cigarettes, once heralded as a bridge to quitting, dangle a promise shadowed by doubt—new evidence hints their risks may rival or outstrip those of the cigarettes they aim to replace (Boidin, 2025). As science grapples with their dual nature, the stakes stay clear: every quit attempt, with or without vaping, is a step toward reclaiming health from a preventable scourge. The question lingers—will this tool lighten the burden, or merely shift it?

Hillel Isseroff, MD

Assistant Professor of Medicine New York University Grossman School of Medicine

Diplomate American Board of Internal Medicine

Diplomate American Board of Obesity Medicine

Diplomate American Board of Pain Medicine

Email: Hisseroff@gmail.com