A new comprehensive scientific review concludes that vaping, including nicotine-containing products, is likely to cause oral and lung cancers. The authors identified early warning signs strongly linked to cancer risk, such as DNA damage, inflammation, and epigenetic changes associated with later lung cancer. They warned that delaying recognition of vaping’s dangers could have dire consequences, given cancer latency periods of 20 to 40 years and the roughly 15-year window of widespread e-cigarette availability.
Large-scale human data on vapers who develop cancer will take decades to accumulate. “The evidence was remarkably consistent across fields. It dictated an unequivocal finding now, though human studies that estimate the risk will take decades to accumulate,” Associate Professor of Epidemiology Freddy Sitas said. He noted it took 100 years for authorities to recognize smoking as a cause of lung cancer and urging regulators not to let vaping follow the same path, according to Bloomberg.
Cellular damage
The review reports cellular damage and disrupted biological pathways linked to cancer in lab studies. Animal experiments found that mice exposed to e-cigarette vapor developed lung tumors at higher rates than unexposed mice, with one study reporting that 22.5% of mice developed lung cancer after inhaling e-cigarettes.
Biomarker analyses showed absorption by vapers of chemicals known to be linked to cancer, with evidence of DNA mutations in the mouth and lungs. Researchers cite the deposition of tiny particles deep in the bronchial tree from vaping, similar to tobacco smoking, as a plausible pathway to cancer. The aerosol’s mix of vaporized metals and organic compounds underpins the biological plausibility that e-cigarettes can initiate and promote carcinogenesis.
Studies show that people who vape absorb nicotine-related compounds, heavy metals, and other chemicals that can damage DNA and trigger inflammation—both hallmarks of cancer development.
Four-fold risk
According to the review vaping may cause cancer independently, even in people who have never smoked conventional cigarettes. It cites case reports, including a 19-year-old with aggressive oral cancer, and dentists’ observations of mouth cancers in non-smoking patients attributed to vaping.
The review challenges the dominant framing of e-cigarettes solely as a gateway to smoking. A 2021 meta-analysis of 25 studies found that young people who had never smoked but started vaping were three times more likely to become regular cigarette smokers.
Many people who try to quit smoking by switching to vaping end up in dual-use limbo, unable to stop either behavior. Dual users of conventional cigarettes and vapes face a significantly amplified risk.
Those who both vape and smoke face a four-fold increased risk of lung cancer, Sitas warned.