Strong public health campaigns and strict regulation have seen rates of tobacco smoking almost halve over the last three decades in Australia. However, the number of people vaping every day has grown from 6% in 2016 to 9% in 2019 – a trend that’s sounding alarm bells for many health experts.
Here's what you need to know about vaping and what the evidence so far shows when it comes to men’s health.
What is vaping?
E-cigarettes (you might know them as e-cigs, electronic nicotine delivery systems (ENDS), vapes or by their brand names, like Juul) are battery-powered devices that heat up liquid to make a vapour you inhale.
When e-cigarettes first became available, vaping liquids contained nicotine and a range of chemicals to add flavour, but as of October 2021, all nicotine vaping products can only be purchased with a doctor’s prescription. Nicotine-free devices and e-liquids can still be legally bought in most parts of Australia.
A 2019 study found that 60% of “nicotine-free” liquids contained nicotine, however, follow up research in 2021 found nicotine was detected much less frequently and in lower concentrations.
Is vaping harmful to your health?
There’s not enough evidence to be sure that vaping is safe. We can’t be sure, but it looks like vaping makes lung function worse and affects wound healing2.
Because many diseases take a long time to develop, and long-term studies on the health effects of using e-cigarettes aren’t available yet. It’s important to remember that just because there is currently no proof that vaping causes disease, this is not proof that it is safe. Laboratory studies suggest that regular vaping is likely to have bad effects on your health.
An analysis of 65 common liquids used in vapes available in Australia found many contained carcinogenic and other harmful ingredients, including a group of chemicals called polycyclic aromatic hydrocarbons (PAHs), which have been linked to lung, bladder and gastrointestinal cancers. There was high levels of benzaldehyde – a lung irritant – in 61 of the samples, and a chemical called 2-chlorophenol, which is commonly used in disinfectants and pesticides, was detected in up to 30 samples. Cancer-causing chemicals in e-cigarette liquids are found in the bodies of people who vape.
Is vaping better for you than smoking tobacco?
Vaping is often marketed as a better alternative to smoking cigarettes. When e-cigarettes are used by smokers instead of conventional cigarettes there is evidence for improvement in individual health. However, many people who use e-cigarettes also smoke cigarettes, and diseases caused by smoking are unlikely to be reduced by e-cigarettes if you continue to smoke3.
If you start vaping, you’re three times more likely than non-vapers to take up smoking tobacco later on. We know that smoking increases the risk of cancer, breathing problems, chronic respiratory conditions, heart disease, stroke, blood circulation problems, diabetes, infections, dental problems, hearing and vision loss, fertility problems and osteoporosis. While two out of three long term smokers in Australia will die from smoking, quitting before 45 years old can reduce your mortality risk close to that of never smokers but how this might be affected by vaping is not known.
Does vaping help smokers quit?
Quitting smoking can be difficult, so the best option is not to vape or smoke at all. Many people use e-cigs to try and stop smoking, to reduce the number of cigarettes smoked or to avoid restarting a smoking habit when they quit.
Ex-smokers who use nicotine e-cigarettes are more likely to not smoke than those who use other nicotine replacement options such as patches, gum, lozenges, mouth spray, inhalators and intranasal sprays. However, most studies showing this effect have a moderate or high level of bias and more research is needed.
Most published studies of e-cigarettes were funded or otherwise supported by manufacturers of e-cigarettes (including the tobacco industry), which appeared to influence the conclusions.
Key Australian health organisations such as the Australian Medical Association, Cancer Council Australia and the Australian Council on Smoking and Health, say there isn’t enough evidence to promote the use of e-cigarettes for smoking cessation. You may be able to use nicotine e-cigarettes as a last-line tool for quitting smoking but only under medical supervision if your doctor thinks it’s right for you.
Vaping and erectile dysfunction
Men have long been more likely to smoke than women and younger men who have higher psychological stress and are current smokers are more likely to use e-cigarettes. There’s plenty of evidence to suggest nicotine impairs normal erectile function and negatively affects male sexual performance. Erectile dysfunction is twice as common among men who vape every day, compared to those who have never vaped. The bad effects of conventional cigarette smoking on men’s reproductive health are proven but more research on vaping’s impact is needed.
 Kim, K. H., Jahan, S. A., Kabir, E., & Brown, R. J. (2013). A review of airborne polycyclic aromatic hydrocarbons (PAHs) and their human health effects. Environment international, 60, 71–80. https://doi.org/10.1016/j.envint.2013.07.019
 Byrne S, Brindal E, Williams G, Anastasiou KM, Tonkin A, Battams S and Riley MD (2018), E-cigarettes, smoking and health. A Literature Review Update. CSIRO, Australia
 Baenziger ON, Ford L, Yazidjoglou A, Joshy G, and Banks E. (2021) E-cigarette use and combustible tobacco cigarette smoking uptake among non-smokers, including relapse in former smokers: Umbrella review, systematic review and meta-analysis. BMJ Open
 Banks E, Joshy G, Weber MF, Liu B, Grenfell R, et al. (2015) Tobacco smoking and all-cause mortality in a large Australian cohort study: Findings from a mature epidemic with current low smoking prevalence. BMC Medicine
 Gary C.K. Chan, Daniel Stjepanović, Carmen Lim, Tianze Sun, Aathavan Shanmuga Anandan, Jason P. Connor, Coral Gartner, Wayne D. Hall, Janni Leung (2021) A systematic review of randomized controlled trials and network meta-analysis of e-cigarettes for smoking cessation. Addictive Behaviours
 Pisinger C and Dossing M. (2014). A systematic review of health effects of electronic cigarettes. Preventive Medicine
 Greenhalgh, EM, Jenkins, S & Scollo, MM. (2021) 18B.3 Prevalence of e-cigarette use. In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria
 El-Shahawy, O., Shah, T., Obisesan, O., Durr, M., Stokes, A., & Uddin, I. et al. (2021). Association of E-Cigarettes With Erectile Dysfunction: The Population Assessment of Tobacco and Health Study. American Journal Of Preventive Medicine doi: 10.1016/j.amepre.2021.08.004