If you’ve ever attempted to quit smoking, then you may have tried a smoking alternative such as the nicotine patch, or in more recent years, vape cigarettes. Vape cigarettes were first invented 13 years ago and have steadily increased in both availability and popularity each year. In fact, by the year 2014, even the Oxford Dictionary couldn’t deny its popularity, naming “vaping” the official “word of the year."

One of the main reasons why vape cigarettes have been so quick to gain popularity is because many individuals believe it to be a safer alternative to smoking traditional cigarettes. But the facts about vape cigarettes (which are sometimes called e-cigarettes) have been clouded in a mist of myths, says Frank T. Leone, MD, MS, physician and Director of Comprehensive Smoking Treatment Programs at Penn Medicine.

Four myths about vape cigarettes

To clear the air, here are 4 myths about vape cigarettes that everyone should know.

Myth #1: It’s just water

Fact: The first myth is that vaping has anything at all to do with a vapor,” says Dr. Leone. “It doesn’t. It’s an aerosol.”

But the word “aerosol” has a lot of negative connotations, he adds. So, you likely won’t see it in advertising for vape cigarettes. “‘Vapor’ has a lot of positive connotations, including that it’s really water vapor you’re inhaling,” Dr. Leone says.

It’s not. According to Dr. Leone, a vapor forms when a liquid is turned into a gas. An aerosol is similar, but it contains tiny particles that are suspended in the air. This is why you can see what’s being released from a vape cigarette.

There’s very little water involved. What you’re actually seeing is a chemical called propylene glycol,” explains Dr. Leone. “And it goes down into the mouth, the upper airway, the back of the throat, the esophagus, and the stomach—as well as into the lungs.

Myth #2: Vaping is safer than smoking traditional cigarettes

Fact: "People have been fed this line from day one,” says Dr. Leone. “The people trying to sell vaping are positioning the e-cigarette as a safer, healthier alternative to tobacco smoking.

On average, there are far lower concentrations of unsafe chemicals that cause lung cancer in vape cigarettes compared to regular cigarettes, says Dr. Leone. However, he adds, “The problem with thinking this means e-cigarettes are safer is that what’s true of the average is not necessarily true of all individual instances.

Studies looking at averages combine data from several different e-cigarettes. As Dr. Leone explains, “I can find e-cigarettes that deliver more of a particular carcinogen than a brand of regular cigarettes. This is because what’s true on average isn’t always true of the whole group.”

Myth #3: Vaping has no health risks

Fact: Vape cigarettes have their own unique potential health risks.

“There are organs in the body that are immune to the effects of cigarette smoke but can potentially be harmed by e-cigarette aerosol,” says Dr. Leone.

“For example, e-cigarette aerosol contains propylene glycol. This is metabolized by the liver into propionaldehyde, which is actually related to formaldehyde,” he explains. “When propionaldehyde accumulates in the body, it increases the potential for liver damage.”

"This chemical also accumulates in the retina, so there’s the potential for retinal damage and blindness," he adds.

Additionally, the American Lung Association also recently revealed that many e-cigarette products may contribute to a rise in the number of cases of “popcorn lung” - a scarring of the tiny air sacs in the lungs resulting in the thickening and narrowing of the airways. Many e-cigarette products are not as natural or healthy as they claim to be. In fact, a majority of these products, especially those with added flavors, contain diacetyl, a dangerous chemical known to cause “popcorn lung”. “Popcorn lung” is a serious lung disease that causes coughing, wheezing and shortness of breath, similar to the symptoms of chronic obstructive pulmonary disease (COPD).

Myth #4: Vaping is the best option for those who want to quit smoking

Fact: Dr. Leone gets asked all the time how he handles patients who want to quit smoking traditional cigarettes by turning to vape cigarettes instead.

“I don’t ever tell someone to just stop doing what they’re doing. But if somebody is using an e-cigarette, that tells me it’s filling some gap for him,” says Dr. Leone.

“My job as a physician is to think about what’s important to him and what he’d like to avoid, and try to figure out a plan to move forward that maximizes the good parts and minimizes the bad parts,” he says.

“For example, someone might come to me and say, ‘I like e-cigarettes because they’re discreet, and I can use them at work.’ Then, I might say, ‘The nicotine inhaler is discreet, and you can use it at work. Why don’t we start with that and see how far it gets us?’” he explains.

“I always try to meet the patient’s needs—but without asking them to accept the downsides,” he adds. “It’s important for people to understand that they deserve to have their needs fulfilled. They deserve to quit smoking comfortably.”