The Importance of Balancing Vape Safety, Youth Protection, and Public Education
Rising misinformation and lack of clear guidance, are pushing vapers back to smoking despite vaping’s lower harm profile.
A study from Georgia State University revealed that most young people who use e-cigarettes are altering their devices—often in ways that could be dangerous. A national survey of nearly 2,000 youth and adults found that over 84% of younger users had modified their vapes. While some changes, such as replacing a coil or installing a manufacturer-approved battery, are considered safe, many involve practices that increase risks.
Moreover, more than half of the youth and young adults surveyed, reported modifying the e-liquid itself by adding extra nicotine, mixing homemade flavourings, or incorporating cannabis. These actions can raise exposure to harmful chemicals, including heavy metals. Another 40% admitted to making battery-related changes that manufacturers do not recommend. Such alterations—like rewiring or installing unauthorized batteries—can lead to overheating, fires, and even explosions. From 2015 to 2017, over 2,000 emergency room visits in the United States were linked to e-cigarette explosions or burn injuries.
With all this in mind, as vapes remain the most widely used nicotine product among teenagers, and adult usage continues to grow, some public health groups remain on guard. The products present a dual challenge: protecting youth from nicotine addiction while ensuring that accurate information reaches adults who might benefit from switching away from cigarettes. Campaigns that simply highlight the dangers of vaping may unintentionally push some people back to smoking—an outcome that carries far greater long-term harm.
Fear and confusion are driving smokers back to cigarettes
This concern is already visible. Despite years of evidence showing that vaping exposes users to fewer toxic substances than smoking, public distrust is rising. In England, more than half of young people now believe vaping is just as harmful—or even more harmful—than smoking. That perception has doubled in only a year. Some individuals have returned to cigarettes, reasoning that their risks are at least familiar and well-documented, whereas the long-term effects of vaping remain uncertain.
Personal experience often reinforces these doubts. Some former smokers report that they now use vapes far more frequently than they ever smoked, consuming more nicotine throughout the day and struggling to cut back. Others have become concerned about possible health effects from metals or other chemicals in vape aerosols. News coverage, online discussions, and anecdotal stories amplify those fears.
Adding to these, recent research has suggested that flavours themselves—independent of nicotine—may influence adolescent behavior. A study from from Marshall University found that certain flavour chemicals, including vanilla, could stimulate brain regions tied to reward and addiction. Even nicotine-free flavoured vapors caused adolescent mice to engage in behaviors linked to reinforcement. These findings suggest that some flavours might increase the likelihood of continued use or future nicotine dependence, and add to the suspicion that vapes may be more dangerous than cigarettes.
Unpacking the vape panic
Experts caution that these beliefs are misleading. Cigarettes remain far more dangerous than regulated vapes. Smoking kills two-thirds of its long-term users, primarily because burning tobacco produces thousands of toxic chemicals and dozens of known carcinogens. Nicotine itself—while addictive—is not the main cause of smoking-related disease. Vapes deliver nicotine without combustion, which dramatically reduces exposure to those toxins.
For a harm reduction–focused public health approach, these studies underline two urgent needs: keeping vapes out of the hands of teens while providing adults with accurate, evidence-based information. Misinformation can be dangerous, but so can a lack of education about safe device use. Clear product labeling, better instructions, and public campaigns that explain both the risks of tampering and the relative safety of regulated vapes compared to cigarettes are critical steps.