In a new comprehensive review of more than 100 global studies published in the journal Carcinogenesis, the analysis concluded that Nicotine-based vaping is likely to cause lung and oral cancers. The analysis was led by researchers at the University of New South Wales (UNSW) and found that e-cigarette aerosols contain a mixture of carcinogens—including formaldehyde, acrolein, and heavy metals—that trigger biological changes strongly linked to cancer development.
The review noted that the aerosols exhibit nearly all ten “key characteristics of carcinogens” identified by the World Health Organization.
“Though smoking was once given the benefit of doubt,” Freddy Sitas and Bernard Stewart, study co-authors from the University of New South Wales in Australia, said. “The same should not now be accorded to vaping given the strength of relevant carcinogenicity data.”
Through the study, Sitas, Stewart and colleagues wanted to assess “the carcinogenic impact of e-cigarettes in their own right.”
The study categorized the studies into three main groups:
- Biological Evidence: Researchers found evidence of DNA mutations and tissue inflammation in the mouths and lungs of vapers, which are early markers for tumor development.
- Animal Research: Mice exposed to e-cigarette aerosols developed lung tumors at significantly higher rates than unexposed groups, with one study reporting a 22.5 percent cancer rate in exposed mice.
- Case Reports: The review included clinical reports from dentists and physicians identifying oral and lung cancers in young patients who vaped but had no history of traditional smoking.
“To our knowledge, this review is the most definitive determination that those who vape are at increased risk of cancer compared to those who don’t,” Stewart, a cancer researcher, said. “Considering all the findings—from clinical monitoring, animal studies, and mechanistic data—e-cigarettes are likely to cause lung cancer and oral cancer.”
While vaping has been touted as an aid to quit smoking, much evidence suggests that it helps in the short term, but that most don’t completely switch from smoking to vaping. This epidemiological evidence indicates that dual users face a four-fold higher risk of developing lung cancer compared to those who only smoke based on a 2024 study.
Young people who never did smoke but start vaping are also three times more likely to become regular cigarette smokers, according to a 2021 meta-analysis of 25 studies.
“Early reports linked smoking to infectious diseases such as tuberculosis, followed by cardiovascular disease, stroke, and lung cancer,” Sitas, an epidemiologist, said. “E-cigarettes were introduced about 20 years ago. We should not wait another 80 years to decide what to do.”
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