Vape vs Tobacco: ANSES Confirms Risk Reduction

After three years of work and the analysis of more than 2,500 scientific studies, the French Agency for Food, Environmental and Occupational Health & Safety (ANSES) has just published a major report on the toxicity of the e-cigarette.

A long-awaited report, especially when the majority of French people easily conflate vaping, tobacco, and too often confuse the dangers associated with each.

Yet its conclusions are clear, nuanced and scientifically robust.

No, vaping is not without risk.
But no, it is not equivalent to tobacco.

Read the full ANSES report (720 pages)

Let's take stock, simply.

An unprecedented scientific assessment

ANSES did not settle for a quick opinion.
Over three years, its experts reviewed 2,500 scientific publications, ultimately retaining 112 studies deemed sufficiently robust.

The researchers analyzed four main areas:

• The cardiovascular effects
• The respiratory effects
• The carcinogenic effects
• Effects on pregnant women and offspring

Each effect was classified according to a level of evidence:
established, probable, possible or insufficient: an essential distinction for understanding the report.

Vaping and tobacco: a clearly established difference in risks

First strong message of the report:

The risks associated with vaping are systematically lower than those of smoked tobacco.

Why?
Because the e-cigarette does not rely on combustion, the main source of toxic and carcinogenic substances in traditional cigarettes.

ANSES is very clear:

• The effects of tobacco are established, massive and well documented
• Those of vaping are weaker, often possible or probable, but never equivalent in severity

Putting vaping and cigarettes on the same level is scientifically false.

Cardiovascular effects: vigilance, especially linked to nicotine

In the short term

ANSES observes possible effects after short-term exposure:

• Increased heart rate
• Temporary rise in blood pressure
• Transient changes in blood vessel function

Effects attributed to nicotine, also observed with nicotine patches or gums.

In the long term

No study currently allows a causal link to be demonstrated between vaping and:

• Chronic hypertension
• Stroke
• Coronary heart disease

Experts clearly remind us:
no chronic cardiovascular disease has been formally attributed to the e-cigarette.

Respiratory effects: no evidence of chronic diseases

On respiratory conditions (asthma, bronchitis, COPD), ANSES adopts a cautious position:

• The data are insufficient to establish causality
• Studies are often too short
• The smoking history of vapers complicates the analysis

At this stage, no solid evidence allows us to assert that vaping causes chronic respiratory diseases.

Cancer: no cases observed after 15 years of vaping

This is a key point of the report.

No cancer has been observed in vapers, either in humans or in animal studies.

Some studies show early biological changes, but:

• They do not allow cancer to be predicted
• They establish no causal link
• The hindsight is still too limited (vaping has existed for around 15 years)

ANSES therefore calls for vigilance, without alarmism.

Pregnancy: quitting smoking remains the absolute priority

In pregnant women, the message is unambiguous:

• Quitting tobacco is essential
• Nicotine replacement therapies should be prioritized
• If quitting fails, the e-cigarette can be considered as an alternative, in a harm reduction logic

Effects observed on offspring are possible, mainly linked to nicotine, and derived from animal studies.
Here again, the risks exist, but remain lower than those of smoked tobacco.

Vaping vs tobacco: a massive reduction in toxic substances

ANSES also compared exposure to certain toxic aldehydes:

Result:

• Vaping reduces exposure to these substances by 80 to nearly 100% compared to cigarettes
• Tobacco exposes users almost systematically to risk levels
• Vaping greatly reduces this exposure, even if it is not zero

Less toxic does not mean harmless, but the difference is significant.

A completely mistaken public perception

This is one of the strongest findings of the report.

Today, the majority of French people believe that the e-cigarette is just as dangerous, if not more dangerous, than tobacco.

ANSES clearly states that this perception is false and recommends that public authorities better inform the population.

An implicit acknowledgment that current communication has failed.

The final message from ANSES (which we share)

• Vaping is not a product for non-smokers
• For smokers, it is a risk reduction tool
• Dual use (vaping + cigarette) should be avoided
• Vaping must be regulated, not demonized

As ANSES reminds us:

Less risky than tobacco does not mean risk-free.

But denying risk reduction means ignoring the reality of millions of smokers and a concrete lever for public health.