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The Biological Reality Both expose lungs to: Oxidative stress Inflammatory cytokine activation Epithelial barrier dysfunction Impaired mucociliary clearance What I Tell My Patients If the question is: Is vaping safer than smoking? The honest medical answer is: Vaping may reduce exposure to some carcinogens compared to traditional cigarettes but it introduces new chemical risks and does not make inhalation safe

Remember also, because a scant hour or so after I loped up the Piccadilly line escalator, a fellow puffer dropped their still-smouldering cigarette in the grooves of a tread, and it was carried into the oily, fluffy, highly combustible netherworld

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