New Research Raises Questions About Vaping and Cancer Risk
A new study is adding to growing concerns about the long-term health effects of e-cigarettes, suggesting vaping may be linked to biological changes associated with lung and oral cancers. While the findings contribute to an evolving body of research, experts say the conclusions should be looked at carefully, especially in the context of tobacco harm reduction.
The study, published in Carcinogenesis, points to early markers such as DNA damage and inflammation in people who vape. These types of changes have been observed before, but their significance remains unclear.
“Findings like DNA damage and inflammation are not new,” said Damon Vidrine, DrPH, chair of the Department of Health Outcomes and Behavior at Moffitt Cancer Center. “What remains unclear is how, or if, these changes translate into meaningful impacts on human health, particularly cancer risk. This paper does not answer that question, so labeling these as ‘pre-cancer signals’ goes too far.”
The study also suggests that e-cigarettes could independently contribute to cancer risk. Vidrine cautioned that such conclusions may overreach the available evidence.
“At best, I find the conclusion that e-cigarettes are likely to be carcinogenic to humans to be overstated and misleading,” he said. “This review should not change how we view e-cigarettes in the context of tobacco harm reduction.”
Vaping Less Risky Than Smoking
That context is key. While vaping is not risk-free, it differs fundamentally from traditional smoking. Combustible cigarettes expose users to thousands of chemicals produced through burning tobacco, many of which are known carcinogens.
“Most cancer risk from smoking comes from combustion, which vaping avoids,” Vidrine said. “As a result, we know vaping is much less risky than smoking.”
That distinction plays an important role in cessation strategies. E-cigarettes are often used by individuals trying to quit smoking, and some evidence suggests they can be effective in that role.
“For people who smoke, the comparison should always be to the well-established risks of combustible cigarettes,” Vidrine said. “There is also strong evidence that e-cigarettes can help people quit. Based on current science, switching completely from smoking to vaping would improve health outcomes.”
At the same time, public health messaging around vaping remains complex, particularly as use among youth and non-smokers continues to be a concern.
“It comes down to balancing two priorities: preventing vaping among youth and helping people who smoke quit,” Vidrine said. “For people who smoke, the message should be that switching to vaping can significantly reduce the risk of cancer and other diseases. For youth and those who do not use tobacco, the message is that vaping is not risk-free and the safest choice is not to start.”
Complications From Misconceptions
Misconceptions about vaping risk can further complicate that messaging. Many people, including some health care providers, believe vaping carries risks similar to smoking.
“In reality, that overestimates the harms of vaping relative to smoking,” Vidrine said. “Better education around the comparative risks would help ensure patients receive clear, accurate information.”
As researchers continue to study the long-term health effects of e-cigarettes, experts emphasize the importance of grounding recommendations in current evidence while acknowledging uncertainty.
“The evidence specific to vaping cessation is still developing, especially for people who never smoked,” Vidrine said. “However, FDA-approved smoking cessation therapies such as nicotine replacement therapy, varenicline and bupropion can be considered, especially when paired with behavioral support.”
Ultimately, he added, cessation strategies should prioritize reducing overall harm without unintended consequences.
“It is critical to avoid pushing individuals from vaping back to combustible cigarette use,” Vidrine said.
