Every Picture Tells a Story: Smoking vs. Vaping       

By Chuck Dinerstein, MD, MBA — Dec 03, 2021
While all uses of tobacco are bad for your health, we have maintained that vaping is both a lesser evil and a pathway to cessation. A new study looks at the effects of vaping and smoking on mitochondria, the engines of our lives.
Image courtesy of vickygharat on Pixabay

The study looked at the expression of genes among exclusive users of e-cigarettes, smokers including dual users, and controls without any tobacco use. The dual users may muddy the waters, but you can apply as much salt as you will.

  • Both conventional and e-cigarette users showed differential gene expression than controls
  • Smokers had nearly 7.5 fold more changes in both up and down-regulation of genes than those using e-cigarettes.
  • Our mitochondria have 37 genes; e-cigarette users have alterations in 11 of those genes, smokers 32.
  • The overlap suggests that both products contain the same “stimulus” to these differential gene expressions, although the inclusion of dual users, as I mentioned, makes this finding less certain.
  • Signals to macrophages, part of our immune response, were the most impacted in vapers, mitochondrial energetics that power our lives, the most impacted in smokers.
  • For 80% of the differential gene expressions in vapers, it was dose-dependent, for smokers roughly a third.


“Lastly, we have shown accentuated transcriptomic effects in smokers relative to vapers, suggesting that smoking has greater and more pronounced adverse effects than vaping on biological systems.”


Smoking is bad, vaping a bit better, especially if it is the pathway to quitting. Never inhaling tobacco either from combustion or vaporization is best.


Source: A novel role for vaping in mitochondrial gene dysregulation and inflammation fundamental to disease development Scientific Reports DOI: 10.1038/s41598-021-01965-1


Chuck Dinerstein, MD, MBA

Director of Medicine

Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.

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