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You’ve heard it a million times: Smoking kills. Thankfully, we’re at a point where not that many young people smoke traditional cigarettes anymore—only about 13 percent of 18- to 24-year-olds, according to the Centers for Disease Control and Prevention (CDC). However, e-cigarette use (e.g., juuling, vaping) is going up—a 2015 study published in the Journal of American College Health found that e-cig use was “exponentially” on the rise on college campuses.

So, can smoking—especially “vaping”—really be that bad for you?

Vaping and juuling are terms for using e-cigarettes, which are devices used for inhaling nicotine mixed with other chemicals. Rather than producing stinky tobacco smoke, they produce a vapor that often contains added smells and flavors. They are often thought to be much safer than cigarettes because they don’t contain tobacco. However, emerging research shows that they aren’t quite as safe as we’ve been led to believe.

Q: How does smoking regular cigarettes affect your health?

A:  All the evidence points to the fact that smoking cigarettes is bad for you—which shouldn’t be surprising, considering health officials have known—and talked about this—for years.

Because it bears repeating, smoking is the number one cause of preventable death and disease in the US, according to the CDC. Officials estimate it causes 480,000 deaths in the US each year—that’s one out of every five deaths. This is no surprise; smoking isn’t just bad for your lungs—it affects almost every organ in your body, the CDC says.

  • Smoking increases your risk of heart disease, respiratory problems, and cancer all over your body (not just in your lungs).
  • A cigarette habit can negatively affect fertility in both men and women.
  • Smoking hurts your bone health, making a season-ending break on the soccer field more likely.
  • Overall, smoking lowers your immune function, making it more likely that you’ll get hit with a nasty cold when you really need to cram for finals or are prepping for spring break.

Q: How bad is vaping, though, really?

A:  Despite vaping companies’ marketing claims, early research on the health effects of e-cigs says they’re not exactly a healthy choice. A 2018 study on the effects of e-cigs published in Vascular Medicine found that smokers who vaped a nicotine-containing liquid had elevated heart rates and high blood pressure for longer periods after vaping than those who smoked regular cigarettes.

The concerning thing here is that there’s not enough research yet on how vaping could affect you long-term. So, even though some studies suggest one vape session isn’t as bad as smoking one cigarette, we don’t know how vaping could affect your future health. There is also a ton of variation in what’s inside vaping liquids (e.g., most contain nicotine, but some don’t). We know from years of research that nicotine is harmful to our health, but we don’t know much about how the other chemicals found in vaping liquids could affect us.

So far, the more scientists study how vaping affects your health, the worse it looks—the FDA recently called the use of e-cigarettes among teens a health “epidemic” and announced it’ll be cracking down on retailers who sell e-cigs to people who are underage. (In most states, the legal smoking age is 18, though six states have raised the minimum age to 21.)

Other forms of tobacco are hard on your body, too. Hookah (shisha) causes the same diseases that regular cigarettes do, and an hour-long hookah session is equivalent to smoking 10 cigarettes, according to the CDC. Also, like cigarettes, hookah gives out harmful secondhand smoke.

Q: Is it that bad to have an occasional cigarette now and then?

A:  It’s tempting to think that all the really scary stats about smoking or cringeworthy stories in anti-smoking commercials will only happen if you smoke two packs a day for 30 years—like, there’s no way that could happen if you just have the occasional cigarette with friends, right?

It’s true that lighting up more often is definitely worse than the occasional cigarette. But even the latter can have pretty serious consequences. A 2014 report from the surgeon general examining the past 50 years of smoking found that just a few cigarettes a day increases your risk of heart disease.

If your friend offers you a cigarette or a drag from a vape pen, and you don’t want to smoke, saying no can be easier said than done. To gracefully decline, think about it beforehand and prep ways to say no. Try something like:

  • “No, thanks; I’m getting in shape for track.”
  • “My girlfriend/boyfriend hates the smell.”
  • “No, thanks; it really throws off my taste buds.”
  • “Thanks, but I don’t smoke.”

Above all, decline confidently (even if you don’t feel confident)—the more confident you sound, the more likely it is that people won’t make a big deal out of it.

Q: Does vaping and juuling make you more or less likely to smoke regular cigarettes?

A:  A lot of e-cig companies claim vaping is a great way to quit smoking—or keep yourself from getting addicted in the first place. But research suggests that’s probably not the case. In fact, vaping may make people more likely to start up a cigarette habit.

A 2017 study found that students who used e-cigarettes in the past month were seven times more likely to report that they’d smoked actual cigarettes when asked six months later. Another study published this year found that young people smoking e-cigs were more likely to start smoking regular cigarettes. According to the National Institutes of Health, there’s currently no conclusive evidence that vaping can help you quit smoking.

female vaping

Q: What’s the deal with secondhand and thirdhand smoke?

A:  Let’s start with regular cigarette smoke. When you or someone around you smokes, the toxic cloud spreads everywhere, infecting the air that people around you are breathing (aka secondhand smoke) and even polluting the surfaces around you (aka thirdhand smoke). Most notably, cigarette smoke smells. The smell gets in your hair and clothes and holds on, leaving you smelling like a dirty ashtray all day.

Even if you’re not smoking yourself, hanging around others when they do can be pretty bad for your body—secondhand smoke causes 41,000 deaths per year, according to the surgeon general. What’s so bad about it? Breathing in secondhand smoke can lead to serious cardiovascular and respiratory issues—even cancer—down the road. Even the occasional hangout with a smoker can be bad for your health—brief exposure to secondhand smoke can damage the lining of your blood vessels, according to the CDC. And thirdhand smoke still contains cancer-causing compounds, according to the Mayo Clinic. In other words, it’s best if you can avoid spending time around cigarette smoke as much as possible.

Early research suggests that breathing in the vapor from e-cigarettes isn’t much better. A 2017 study conducted by the American Chemical Society found that the vapor emitted by juuling contains toxins that can be irritating to the eyes and skin; formaldehyde (the smelly stuff used to preserve whatever you’re dissecting in biology), which is associated with cancer; and other chemicals that can cause respiratory problems.

There’s not a ton of research yet on whether vaping produces the same kind of thirdhand “smoke” risks as traditional cigarettes, but early evidence suggests it might. In a 2015 study, researchers from the Roswell Park Cancer Center examined the homes of e-cig users and found that vaping does leave behind a dangerous nicotine residue, though in much lower amounts than regular cigarettes.

Q: How expensive is smoking?

A:  The occasional cigarette might seem like it would at least be cheaper than getting your caffeine fix at Starbucks, but smoking is crazy expensive when you consider all the costs associated with it: An average pack of smokes costs $6.16—and also comes with $35 of health-related costs down the road, according to the American Cancer Society. Buying a pack a day adds up to over $2,000 per year—think of the amazing graduation trip you could take for that money instead.

The cost of vaping can vary widely. According to an analysis by NerdWallet, disposable e-cigarettes (which are the equivalent of 2.5 packs of cigarettes) can cost over $1,300 per year, while rechargeable e-cigarettes average out to $600 per year.

There’s a broader cost, too. The World Health Organization estimates smoking-related health costs pile up to $422 billion in just one year.

How much extra cash would you have without your habit?

Q: Is smoking bad for the environment?

A:  If you care about ditching plastic straws to save the sea turtles, you should also consider the environmental impact of smoking. Cigarette butts are the most common form of litter—4.5 trillion butts are thrown away every year, according to an estimate published in the British Medical Journal. This is a major problem, since cigarettes aren’t biodegradable, meaning the butts will be polluting the environment for years and years to come. The same study found that the toxic chemicals that leach out of just one cigarette butt are especially harmful for marine life—one butt was enough to kill freshwater fish in a one-liter tank.

E-cigarettes aren’t any better. A recent study from the European Commission found that chemicals in both the lithium ion batteries and the disposable cartridges found in e-cigs are toxic to the environment and can be potentially harmful to plants and animals.

Male vaping outside

Q: Do people actually think smoking looks cool?

A:  Smoking gives you bad breath, stains your teeth, and ages you (not in the good way—we’re talking wrinkles). Nevertheless, the stereotype that it’s “cool” persists for some. In actuality, 80 percent of students surveyed in a recent Student Health 101 poll said that smoking is never attractive.

Still, smoking definitely has a social component. A 2014 study of smokers in college found that smoking was related to social anxiety, especially for women. They found that those who used smoking as a social crutch to deal with awkwardness or anxiety in social situations were more likely to become dependent on nicotine.

If you find yourself itching for a smoke to soothe your social anxiety, there are healthier ways to cope, like dialectical behavioral therapy (DBT). DBT is a form of mindfulness that helps us understand our own stress triggers and develop effective self-soothing techniques.

Find DBT resources

Test: Do you have social anxiety?

Q: OK, so how do I quit?

A:  Trying to quit without a plan can leave you without a way to cope when you get cravings. You’re more likely to succeed with a structured approach (e.g., choosing a date to quit and asking friends and family to help keep you accountable), says Smokefree.gov, a governmental resource for all things tobacco-free.

Most importantly, if you want quitting to be a permanent lifestyle change, your strategy has to be sustainable. That doesn’t necessarily mean you have to ditch your friends or change everything about your life. Look for life changes that you can live with, check out former smokers’ strategies, make a list of things that are important to you, and try to keep doing them after quitting.

Tips from former smokers: CDC

  • Nicotine replacement therapy (e.g., gum) or prescription medications (e.g., bupropion) can help, according to the Cochrane Collaboration, which reviews medical studies. In studies, using one of these two substances helped 80 percent more people quit compared to a placebo.
  • Find stress-busting alternatives to “just one” cigarette or hit on the vape when you have a bad craving. Having just one is likely to lead to more, according to the Mayo Clinic.
  • Sign up for a text message, Twitter, or email program for regular quitting tips and support.

Get more resources at smokefree.gov

Want an app for that? Try quitSTART

Quit guide: American Cancer Society

Daily “quitspiration” 

Other methods: Do they work?

Free, personalized quitting support is available in every US state. This typically includes phone and online counseling and free medications (e.g., nicotine patches). Find free support in your state.

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