VAPES VERSUS SMOKES.

Since e-cigarettes became more widespread, debates have raged about whether vapes are better for you than lighting up a more traditional cigarette.

Micheál Martin isn’t a fan of smoking either way, and earlier this month, he suggested that inhaling nicotine electronically is almost as bad as doing it the more old-fashioned way.

But is that true? Is there any evidence to support the claim that the use of e-cigarettes is nearly as harmful as smoking traditional cigarettes?

The Claim

Micheál Martin said this month that vapes are “nearly worse” than cigarettes.

Speaking at the end of the Fianna Fáil think-in in Tullamore, Co Offaly 8 September, the Taoiseach described vapes as the “revenge of Big Tobacco” and said the government should deal with them in a “stronger way”.

He said:

“Vapes are nearly worse than cigarettes. In many instances, we don’t know what’s in them. They’re damaging to lungs and these are serious issues for society.”

Martin also cited advice from former chief medical officer of the United States, Dr Anthony Fauci, and unspecified “others” to bolster his claim.

Micheál Martin, who as health minister introduced the smoking ban in Ireland in 2003 Alamy Stock Photo Alamy Stock Photo

The Evidence

Before we begin, there’s an important behavioural pattern to take account of.

Although smoking is one thing and vaping is another, a lot of people who vape also smoke (or used to smoke), which can complicate the results of studies on the harms caused by each.

Last year’s Healthy Ireland Survey, conducted by polling company Ipsos B&A among a nationally representative sample of people, found that just 17% of people who vape have never smoked.

The studies quoted in this article take account of this, but it’s still worth mentioning that there’s a high crossover between both habits.

In search of evidence for Martin’s claim, we first asked the Department of An Taoiseach and Fianna Fáil what he was basing his comments on, but received no reply by the time of publication.

Our next port of call was to ask the Health Service Executive what its position is. On its website, it says that ”compared to cigarettes, vaping may be less harmful” and that vaping delivers nicotine “with fewer toxins than cigarettes”.

Note that this advice is phrased as a possibility, rather than definitive; the same page still says that “we are still learning about the long-term risks of vaping”.

And it doesn’t exactly say that vaping is harmless either: in fact, the health service lists a number of negative health effects associated with e-cigarette use, including damage to the heart, lungs and blood vessels and exposure to toxins.

We also asked the Royal College of Physicians in Ireland if they could provide any advice or an expert voice whom we could ask.

The group did not explicitly say whether e-cigarettes were safer than smoking, but directed us to two policy papers which emphasised that they should not be used to stop smoking.

The papers also said that children who vape are more likely to start smoking, and called for legislation to further regulate vapes.

There isn’t much other Irish evidence available, but other international bodies and academics have carried out studies of their own.

Two of the biggest studies carried out on vaping versus smoking have been carried out in the United Kingdom.

A 2022 review commissioned by the Office for Health Improvement and Disparities (OHID), concluded that while vaping is not risk-free, it is substantially less harmful than smoking tobacco in the short to medium-term.

Its authors looked at studies of what are known as “biomarkers of exposure” (which measure potentially harmful substance levels in the body) and “biomarkers of potential harm” (which measure biological changes to the body) due to vaping and smoking.

They found that levels of nitrosamines – the chemical compounds that are classified as probable human carcinogens – specific to tobacco, as well as other toxicants related to tobacco smoking, were found at much lower levels in people who vape.

The second study, published in 2024 by the Royal College of Physicians in London, also reviewed similar biomarkers of exposure and of potential harm in vapers and smokers.

It noted that there is “clear evidence that e-cigarettes cause less harm to health than combustible tobacco” and that vaping nicotine “is not associated with a high frequency of adverse health effects”.

However, it did stress that there were some mixed results, and that research on the health effects of vaping is limited by small sample sizes and a lack of evidence around the long-term risks of vaping.

A third and more recent study from the United States sways the other way. That paper, by the National Library of Medicine, was published earlier this year and cited a number of previous studies – including the RCP mentioned above – that suggest e-cigarettes are less harmful than traditional cigarettes.

It concludes that there is a growing body of literature that suggests vapes are “associated with disease outcomes indistinguishable from or approaching” regular smoking.

It’s not quite the same as “nearly worse” than smoking, as Micheál Martin suggested – but it’s certainly closer than previous studies suggested.

The results of the 2026 paper are a bit more nuanced than that headline conclusion.

In direct vaping-versus-smoking comparisons, it found only one instance where the negative outcome between the two was directly comparable: the risk of metabolic dysfunction.

Other instances found in favour of vaping, including the risk of oral disease (0.89 times as likely compared to smoking), asthma (0.84 times as likely), cardiovascular disease (0.76 times as likely), stroke (0.62 times as likely), and COPD (0.55 times as likely).

The paper therefore didn’t establish that vaping is generally or “nearly” more dangerous than smoking. There were a handful of statistically similar risks, but for several outcomes, vaping was found to carry significantly lower risks.

To complicate matters, roughly three-quarters of the estimates were from cross-sectional studies in which researchers tried to infer what caused a disease, or tried to disentangle a person’s previous history of cigarette smoking.

What experts say

In addition to the studies above, The Journal spoke to experts to ask about Martin’s claim comparing the dangers of vaping to smoking.

We asked the HSE and the RCPI for Irish experts who could speak about this, but none were available before publication.

However, we spoke to three international experts who have been involved in high-profile studies into the effects of vaping and smoking.

Dr Nicola Lindson, an associate professor at the University of Oxford whose research focuses on tobacco addiction and smoking cessation interventions, said that the “breadth of the evidence gives confidence” that vaping is not as harmful as smoking.

She explained how the nature of smoking cigarettes itself contributes to this.

“We know that one of the reasons smoking is so harmful is the combustion process inherent in smoking tobacco which generates many of the harmful chemicals,” Lindson said.

“There is no combustion involved in vaping.”

However, she also pointed out that there were still harms associated with vaping, which could be hard to judge given the number of people who vape and smoke, and that some health effects of vaping may not emerge for many years.

“We cannot say that we are confident about all effects of vaping without long-term and unconfounded data,” Lindson added.

We also contacted Dr Jamie Hartmann-Boyce, an associate professor at the University of Massachusetts and an expert in evidence-based medicine and health policy, particularly in tobacco control, e-cigarettes and diabetes.

She said that current scientific evidence shows that vaping e-cigarettes is “considerably less harmful” than smoking, though she added that it is not risk-free.

Hartmann-Boyce explained that there are variations in vapes (such as flavour and device type) that may impact their risk profile, making it hard to say the percentage to which they are less risky than cigarettes overall.

But she also said that misperceptions of the harms of vaping could stop people from switching from smoking, which could in turn reduce health risks to smokers and the people around them who may be being exposed to secondhand smoke.

“It’s really important to remember that, as a consumer product, cigarettes are uniquely deadly,” she said.

“It is estimated that they kill one in two people who [become lifelong smokers].

“It is too early to make any firm statements about the absolute risks of vaping, but the evidence we have so far shows that regulated, nicotine-containing e-cigarettes are considerably less harmful than smoking – which isn’t hard to achieve given how deadly cigarettes are.”

Finally, we also spoke to Prof Stanton Glantz, a tobacco control advocate and founding director of the University of California’s Centre for Tobacco Control Research and Education, who was involved in the National Library of Medicine study cited above.

He largely agreed with the Taoiseach’s claim and said vaping “does cause some of the same diseases as smoking” and that “overall, sole vaping is nearly as harmful as smoking” and that dual use (along with cigarettes) is “much worse”.

However, Glantz also said that the use of e-cigarettes on their own was not as harmful as smoking.

“E-cig use by itself is nearly as damaging or as damaging than smoking, but not more damaging,” he said.