Evaluation des risques sanitaires liés aux produits du vapotage:Avis de l'ANSES: rapport d'expertise collective

Abstract

This report provides an in‑depth assessment of the health effects associated with the use of vaping products through two complementary approaches: a systematic literature review evaluating respiratory, cardiovascular and carcinogenic impacts, and a quantitative risk assessment method applied to aldehydes emitted during vaping. The report offers scientific insights into vaping practices among the general population, pregnant women, and adolescents; the determinants of addiction and product attractiveness; comparative levels of risk between vaping and combustible tobacco; and the extent to which electronic cigarettes may serve as a harm‑reduction tool. Overall, evidence confirms that vaping exposes users to fewer toxic substances and poses lower health risks than conventional smoking. However, several potential or probable effects are identified: probable impacts on certain cardiovascular markers; possible respiratory and carcinogenic effects; and possible risks for fetal cardiovascular and respiratory development following in‑utero exposure. No category of effect exceeds, in severity or evidence level, those observed with smoking, with the absence of combustion remaining a major advantage of vaping. Despite lower risks compared to smoking, vaping is not risk‑free. Quantitative assessment of aldehydes indicates that, under certain conditions, exposure margins may be insufficient, suggesting non‑negligible health risks. When nicotine‑containing e‑liquids are used, the aerosol has addictive potential similar to cigarette smoke. The report formulates several recommendations: non‑smokers and former smokers should not begin vaping; smokers should seek professional cessation support, with vaping considered only as a transitional harm‑reduction tool and not for dual use. Particular caution is advised for pregnant women, for whom complete smoking cessation remains the priority. The report also highlights the need to reduce the attractiveness of vaping products for non‑smokers, improve public understanding of relative risks, strengthen market surveillance, and enhance health‑professional training. Finally, it identifies major research gaps and calls for standardized long‑term human, epidemiological, and experimental studies to better characterize the health effects of vaping, including effects on vulnerable populations.