Smoking Alternatives – Are They Safer?

The number of people who smoke cigarettes and cigars has slowly and steadily been declining in the United States in the past several years. However, while smoking has declined, smoking alternatives and tobacco products have soared in popularity due to marketing strategies that claim they are safer and healthier. But are they actually?

Alternative tobacco products include e-cigarettes, herbal cigarettes, smokeless tobacco, and water pipes. Even though these are typically marketed as safer they can actually cause serious health problems such as cancer and heart disease.

Smoking Alternatives


E-Cigarettes hit the market in 2004 as a safer alternative to smoking by mimicking the action of smoking without the tobacco. The e-cigarette works by heating up a chemical mixture which is inhaled through the artificial cigarette. This provides the physical and the psychological stimulus of smoking including the hit of nicotine. By 2014, the e-cigarette industry hit $7 billion thanks to unique offerings such as variety, flavors, and independent sellers.

Due to the novelty of the product, long-term health effects are currently unknown. Short-term studies have reported finding damage to the immune system and the respiratory system which may lead to long-term health problems.

Herbal Cigarettes

Herbal cigarettes are marketed to be a safer option because they are made without the tobacco. They are typically made with herbs or flowers such as menthol, ginseng, or rum. Herbal cigarettes also have a synthetic chemical which can cause vomiting and seizures. Smokers typically do not realize this can cause an unexpectedly high and medical problems. These cigarettes can also cause psychological effects like agitation, anxiety, and hallucinations.

Smoking herbal cigarettes may actually be more dangerous than typical cigarettes, not only because of the synthetic chemical, but also due to the large amounts of tar and carbon monoxide. Tar and carbon monoxide are the substances that cause increased risk of cancer and lung disease or lung distress.

Smokeless Tobacco

Smokeless tobacco includes chew, snuff (sniff or swallow finely ground tobacco), snus (moist tobacco powder put in a pouch that is placed inside the cheek of the mouth for absorption), and dissolvable tobacco (powdered tobacco that is compressed to resemble candy that dissolves in the mouth). Long-term use of these products can cause cancer and heart disease. Smokeless tobacco can have as much as 3 to 4 times more nicotine than a cigarette, thus making them highly addicting.

The substances in smokeless tobacco increase the risk of cancer of the mouth and throat. The risk of developing white patches or leukoplakia on the gums, tongue, or lining of the mouth is also increased. Those who use smokeless tobacco will likely develop gum disease and have a higher rate of tooth decay compared to even smokers.

Water Pipes or Hookah

In the past several years, water pipes have increased in popularity among young people and college-aged students. It is typically consumed as a social event, but the risk of exposure to the same toxins as cigarettes are even higher. They contain heavy metals, carbon monoxide, and dangerous chemicals also found in cigarettes. All of these substances are linked to the cancer of the lungs, stomach, bladder, and esophagus. Water pipes or hookah also are known to clog arteries, which leads to heart disease and respiratory disease such as emphysema. Emphysema is a progressive disease that blocks the airflow which makes it difficult to breathe.

Smoking from a water pipe lasts about an hour, causing a smoker to inhale about 100% to 200% more smoke compared to a single cigarette. Water pipes also raise the risk of spreading infectious diseases since one mouthpiece is shared among several people. Nicotine is also present in water pipes which can lead to a nicotine addiction just like smoking cigarettes.

Other health risks to using smoking alternatives include cancer of the pancreas, increased risk of early delivery and stillbirth if using while pregnant, nicotine poisoning in children, and increased risk of death from a heart attack and stroke.


If you are currently using any smoking alternatives ask your doctor how to quit. Alternatives may be marketed as safer than smoking but they are not. Your risk of developing cancer or heart disease is the same as smoking if not greater. Be smart. Talk to your doctor.


Emily Erickson, M.ED. – CDL Wellness Coach