Vape.ch E-Cigarette Guide
The Most Important Studies on E-Cigarettes at a Glance
What do Cochrane, NASEM, British reviews, the WHO and Swiss specialist bodies really say about e-cigarettes, smoking cessation, risks and youth use?
E-cigarette studies Smoking cessation Harm reduction Switzerland
In short
Nicotine-containing e-cigarettes can help smokers stop smoking.
Compared with tobacco cigarettes, vaping is considered significantly less harmful, but not harmless.
For young people and non-smokers, vaping is not a sensible starting point.
Studies on e-cigarettes often seem contradictory because they examine different questions: smoking cessation, pollutant exposure, long-term risks, youth use or public health. This overview separates the most important study groups and classifies them for adult readers in Switzerland.
Quick answer
If you do not smoke, you should not start vaping. E-cigarettes are intended only for adult smokers and are intended for people aged 18 and over in Switzerland.
Smoking cessation
There is good evidence that nicotine-containing e-cigarettes help many smokers quit better than conventional nicotine replacement products.
Risk
Compared with tobacco cigarettes, vaping is considered likely to be significantly less harmful – but it is clear: not harmless.
Young people
International organisations are sounding the alarm, mainly because of sharply rising use among young people.
Switzerland
Smoking is declining slightly, vaping has arrived in everyday life; specialist bodies see opportunities for smokers but warn against youth use.
Why do studies on e-cigarettes seem so contradictory?
If you google e-cigarettes, you will find headlines ranging from «95% less harmful» to «massive health risks». The reason: there are very different research questions.
Do e-cigarettes help with smoking cessation?
How harmful is the aerosol compared with tobacco smoke?
What happens at population level, especially among young people?
Studies from 2014 examine different products than studies from 2024.
Long-term data over decades naturally does not yet exist.
That is why it makes sense to look at the most important study groups separately.
1. Studies on smoking cessation effectiveness
1.1 Cochrane reviews: gold standard for smoking cessation data
The Cochrane Collaboration regularly evaluates high-quality studies on smoking cessation with e-cigarettes. The current evaluations reach clear core conclusions.
More smoking cessation success
Nicotine-containing e-cigarettes help more smokers stop smoking long term than nicotine replacement products, nicotine-free e-cigarettes or counselling alone.
Long-term abstinence
In a large analysis, long-term abstinence was roughly 14 out of 100 smokers with e-cigarettes compared with around 6 out of 100 without effective aids.
1.2 What does this mean for you?
If you smoke heavily and have already made several quit attempts, current data suggests that e-cigarettes are among the most effective available smoking cessation aids – provided you switch completely and do not continue smoking in parallel.
They are not a miracle solution, but they can increase your chance of really getting away from tobacco cigarettes.
2. Studies on health risks and pollutant exposure
2.1 National Academies: «Public Health Consequences of E-Cigarettes»
A very influential report comes from the National Academies of Sciences, Engineering, and Medicine (NASEM, 2018). The most important statements:
High certainty: E-cigarettes release significantly fewer and usually lower amounts of toxic substances than tobacco cigarettes.
Moderate certainty: E-cigarettes can have short-term effects on the cardiovascular system and airways.
Still unclear: Long-term risks over many years, such as cancer risk, have not yet been sufficiently researched.
2.2 British reviews
Several large reviews from the United Kingdom, including by Public Health England, OHID and the Royal College of Physicians, point in a similar direction.
Compared with tobacco cigarettes, the risk is probably significantly lower, mainly because there is no combustion process and far fewer combustion products such as tar and carbon monoxide are produced.
Nevertheless, there is exposure to nicotine, fine particles and various chemicals. E-cigarettes are not recommended for non-smokers or young people.
2.3 What do the findings from England say?
England is often cited in the discussion about e-cigarettes because British health bodies have for years classified vaping for adult smokers as a possible support for smoking cessation. The central message is not that vaping is harmless, but that for adult smokers it is less harmful than continuing to smoke if tobacco cigarettes are fully replaced.
The 2022 English evidence review concluded that nicotine vaping poses only a small fraction of the risks of smoking in the short to medium term. At the same time, it clearly emphasised that vaping is not risk-free and is not intended for children, young people or non-smokers.
For Switzerland, this does not mean automatically adopting British policy. The classification is still relevant because it explains the difference between tobacco combustion and e-cigarette aerosol. Smoking produces tar, carbon monoxide and numerous toxic combustion products. Vaping does not burn tobacco, but nicotine, PG/VG, flavourings and other substances can still be inhaled.
A serious statement is therefore balanced: for adult smokers, a complete switch to e-cigarettes can be significantly less harmful than continuing to smoke. For non-smokers, young people and pregnant women, vaping is not a sensible or harmless option.
2.4 E-cigarettes and health: what is known?
E-cigarettes heat a liquid and create an aerosol that is inhaled. They contain no tobacco and do not produce classic tobacco smoke. This is the central difference from tobacco cigarettes.
Health bodies such as the NHS and GOV.UK classify nicotine vaping for adult smokers as less harmful than smoking if tobacco cigarettes are fully replaced. At the same time, they clearly emphasise: vaping is not risk-free and the long-term effects are not yet fully known.
The FOPH also describes e-cigarettes cautiously. E-cigarettes contain no tobacco, but they create nicotine-containing aerosols. According to the FOPH, these products can increase risks for the lungs and cardiovascular system, and some substances produced are carcinogenic.
The earlier “95 percent less harmful” formulation from England should no longer be used as an isolated advertising sentence. A more serious classification is: vaping is probably significantly less harmful than continuing to smoke for adult smokers, but not harmless, not intended for non-smokers and not free of uncertainty.
For vape.ch, the statement should therefore remain sober: the health benefit does not come from additional vaping, but from fully replacing tobacco cigarettes. Dual use, youth use and trivialising communication must be clearly avoided.
2.5 Are there metals in e-cigarette vapour?
Yes. Studies have shown that metals can be detected in e-cigarette aerosol. These include nickel, chromium, lead and other elements. Depending on the device, the source can include the coil, heating wire, solder joints, metal parts, device construction or operating temperature.
This does not mean that every e-cigarette is equally contaminated. The concentration depends strongly on device type, power, coil condition, liquid composition, use and product quality. Studies show that open systems, pods and disposable devices can produce different metal levels.
The important classification: e-cigarettes do not burn tobacco and therefore do not produce classic tobacco smoke. Still, the aerosol is not simply water vapour. Besides nicotine, PG/VG and flavourings, it can also contain unwanted substances such as aldehydes, reactive oxygen species and metals.
In its information on e-cigarettes, the FOPH also names metals such as nickel, chromium and lead as substances detected in aerosol. Newer investigations into certain disposable e-cigarettes also show that individual products can release conspicuously high metal concentrations.
The sober conclusion is: metals in aerosol are a real issue and one reason not to present e-cigarettes as harmless. For adult smokers, a complete switch can still have a different risk profile than continuing to smoke. For non-smokers, young people and pregnant women, there is no sensible reason to start vaping.
2.6 What do long-term studies say about e-cigarettes?
A frequently cited long-term study by Polosa and colleagues followed regular e-cigarette users who had never previously smoked over 3.5 years. In this small observational study, no relevant deterioration in lung function, respiratory symptoms or high-resolution lung imaging was found.
This study is interesting, but it is not final proof of safety. The group examined was small, relatively young and the observation period was limited. The authors themselves stated that later health damage cannot be excluded.
Such results should therefore not be used as advertising claims. A serious classification is: there are studies that show no clear lung damage over several years in certain user groups. At the same time, the long-term data remains limited, especially for very long use duration, different device types, high power, disposable devices and different liquids.
The FOPH formulates this cautiously as well: according to current knowledge, e-cigarettes contain fewer harmful substances than conventional cigarettes, but the long-term consequences of use are still largely unknown. Nicotine dependence can also remain.
The correct conclusion is therefore not: e-cigarettes are harmless. For adult smokers, a complete switch can have a different risk profile than continuing to smoke. For non-smokers, young people and pregnant women, however, there is no sensible reason to start vaping.
2.7 How should you classify this?
If you would otherwise continue smoking, a complete switch to e-cigarettes is probably significantly less harmful.
If you do not smoke at all, vaping would add extra risks and possible nicotine addiction – completely unnecessarily.
3. Studies on youth use and public health
3.1 WHO and global trends
The WHO clearly warns in current reports about the increasing spread of e-cigarettes, especially among young people.
Estimates now assume more than 100 million users worldwide, including at least 15 million young people aged 13–15.
In countries with available data, young people are on average significantly more likely to vape than adults.
There is concern about a new wave of nicotine dependence.
3.2 Why this perspective matters
For adult smokers, vaping can be a tool for smoking cessation.
For young people and non-smokers, the e-cigarette is a problem from a public health perspective, not a benefit.
4. Data and study situation in Switzerland
4.1 Swiss consumption figures
According to official Swiss surveys, around a quarter of the population aged 15 and over smoked in 2022. The share has declined slightly in recent years.
4.2 Swiss specialist bodies on e-cigarettes
Swiss specialist organisations and factsheets on e-cigarettes emphasise several points.
E-cigarettes are very different products with large differences in nicotine delivery and pollutants.
They can play a role in harm reduction for smokers.
At the same time, they are seen as a public health problem, mainly because of youth use, easy availability and early nicotine dependence.
4.3 Legal framework in Switzerland
In Switzerland, the rule is: sale and promotion of e-cigarettes only for adults aged 18 and over. Advertising on your own website is generally possible, but youth protection requirements and partly cantonal rules apply.
Note: For binding legal information, you should always consult current legal texts or a legal specialist.
5. What does this mean for you in practice?
If you currently smoke
A complete switch to e-cigarettes can significantly reduce your risk compared with continuing to smoke.
E-cigarettes increase your chance of permanently quitting tobacco.
If you do not smoke
The study situation offers no reason to start vaping.
Stay away from it if you are not a smoker.
1
Complete switch from cigarettes to e-cigarettes.
2
Gradually reduce nicotine strength in the medium term.
3
In the long term – if possible – become completely nicotine-free.
6. Overview: important studies and reviews
Smoking cessation
Cochrane Review «Electronic cigarettes for smoking cessation» · 2023–2025
Nicotine-containing e-cigarettes increase the success rate for smoking cessation compared with nicotine replacement and no support.
Public health overall
NASEM «Public Health Consequences of E-Cigarettes» · 2018
Fewer toxic substances than tobacco smoke, but open long-term risks and clear concerns about youth use.
Harm reduction
Public Health England / OHID evidence reviews · 2015–2022
Vaping is probably significantly less harmful than smoking, but not recommended for non-smokers.
Metals in aerosol
Olmedo et al. «Metal Concentrations in e-Cigarette Liquid and Aerosol Samples» · 2018
Metals such as nickel, chromium and lead can be detected in aerosol; device, coil and use influence the values.
Long-term observation
Polosa et al. «Health impact of E-cigarettes» · 2017
A small 3.5-year observational study without clear lung damage, but without final long-term proof of safety.
International public health
WHO reports on e-cigarettes and global tobacco trends · 2023–2025
Sharp increase in youth use, open long-term risks and recommendation for stricter regulation.
Switzerland
Data from federal bodies and ENDS factsheets · 2022–2024
Smoking is declining slightly, vaping is spreading; opportunities for quitting, while concerns about young people remain.
7. FAQ – Frequently asked questions about studies on e-cigarettes
Are e-cigarettes «95% less harmful»?
The figure comes from early British assessments and is not an exact scientific value. The current consensus is: significantly less harmful than smoking, but not risk-free and with open long-term questions.
What do the findings from England say?
British evidence reviews classify nicotine vaping for adult smokers as significantly less harmful than smoking if tobacco cigarettes are fully replaced. At the same time, vaping is not risk-free and not intended for non-smokers or young people.
Do e-cigarettes really help people quit?
Yes. Large meta-analyses show that nicotine-containing e-cigarettes help more smokers remain smoke-free long term than many other aids.
Are there metals in e-cigarette vapour?
Yes. Studies and FOPH information name metals such as nickel, chromium and lead in e-cigarette aerosol. The levels depend strongly on device, coil, power, liquid and use.
What do long-term studies say about e-cigarettes?
There are individual observational studies over several years, but no final long-term safety over decades. E-cigarettes should therefore not be presented as harmless.
How dangerous is nicotine salt?
Nicotine salt mainly allows faster nicotine absorption that is perceived as smoother – especially at higher strengths. This often makes vaping more pleasant for heavy smokers, but can increase addiction potential, especially among inexperienced users and young people.
Long-term data specifically on nicotine salt is still limited, so as a precaution: only for adult, informed ex-smokers or switchers.
Is vaping less bad than smoking for young people?
From the perspective of the WHO, specialist societies and Swiss specialist bodies, the answer is clear: No, it is not harmless fun.
There is a risk of nicotine addiction, possible effects on the developing brain are an issue and long-term effects remain unclear. That is why the rule is: in Switzerland, vaping is from 18 – and young people should neither smoke nor vape.
Which position is “right” – pro or against e-cigarettes?
The serious answer lies in the middle: for adult smokers, e-cigarettes can be a tool for harm reduction and smoking cessation if they would otherwise continue smoking. For non-smokers and young people, e-cigarettes are an additional health and addiction problem without benefit.
8. Conclusion
The best option for your health remains: do not smoke, do not vape.
However, if you currently smoke and cannot quit without support, the study situation is fairly clear: a complete switch to regulated e-cigarettes can probably reduce your risk significantly compared with continuing to smoke. The less nicotine you need long term, the better.
Adult smokers – sensible as a cessation aid. Non-smokers and young people – clearly no.
Principle
Adults make their own decisions, but they should always think about the possible effects of consumption and be aware of them.
The author
Jürgen has dealt with the entire topic of vaping for many years. The latest studies in particular have always been very interesting to him. Here he summarises these studies and examines the situation factually and professionally, without glorifying or demonising the e-cigarette – simply neutrally according to the current state of knowledge.
Note
This article does not replace medical advice and does not constitute legal advice. In Switzerland, e-cigarettes are intended exclusively for adults aged 18 and over.
Sources and further information
OHID / GOV.UK: Nicotine vaping in England: 2022 evidence update
Olmedo et al. 2018: Metal Concentrations in e-Cigarette Liquid and Aerosol Samples
Polosa et al. 2017: Health impact of E-cigarettes: a prospective 3.5-year study
