Vaping May Cause Cancer, DNA Damage According To New Study

A newly published comprehensive qualitative risk assessment of vaping concluded that smoking vapes “are likely to be carcinogenic to humans… causing an indeterminate burden of oral cancer and lung cancer.” Lead author Bernard Stewart also wrote an article for The Conversation and said this is the strongest evidence that vaping likely causes cancer. Stewart explained that it took 100 years for researchers to definitively prove that smoking tobacco causes cancer.

Most of the research into the harms of vaping has evaluated the likelihood that the activity would serve as a gateway to smoking tobacco, which has been considered to be a greater threat of cancer. However, there have been no long-term studies evaluating cancer risk for people who vape alone.

Stewart explained that the aerosol from vaping devices demonstrates all 10 key characteristics of carcinogens identified by the World Health Organization (WHO). He described it as a “complex range of chemicals, including nicotine and its byproducts.”

There has been a known link between cancer and cigarette smoking since the 1950s and rates have steadily declined from over 40% in 1965 to 11% in 2022.

“Physiological evidence of exposure using biomarkers reveals DNA damage correlated with vape-derived metabolites attributable to carcinogens including nicotine-derived nitrosamines, volatile organic compounds, flavour-derived agents, and certain metals,” the study authors wrote. “Biomarkers also indicate vaping-attributable oxidative stress, epigenetic change and inflammation in oral and respiratory tissue often specified in comparison with smoking.”

E-cigarettes and vapes have long been considered a less harmful alternative to smoking cigarettes or a potential cessation strategy for people who are addicted to nicotine. In recent years, the perception has changed greatly and many people have started to believe that vaping is more harmful – a belief that UT Southwestern researchers say is false after conducting a recent study. 

“The perception that e-cigarettes are more harmful than cigarettes has been linked to both a decreased willingness to use e-cigarettes for smoking cessation and an increased likelihood of switching from vaping to smoking. Understanding the ramifications of this perception change represents a critical consideration when developing cessation strategies,” said co-author David Gerber, M.D.

Researchers are suggesting the public should understand the nuance when discussing the risks of vaping. Stewart’s research finds that the product is likely to cause cancer, but Gerber and co-authors stress that it is still less harmful than smoking cigarettes and can be a useful tool for adults who are looking to quit smoking cigarettes.

“Our findings show the need to strike a balance in public health messaging that discourages youths from using either product while also ensuring that adults who do smoke have access to accurate information about product risks and cessation options,” co-author Dr. Cristina Thomas said.

Dependence on vaping is still very prevalent, and it is more socially acceptable among teens and young adults than smoking cigarettes. A 2021 literature review came to three important differences between dependence as it relates to smoking cigarettes and vaping. There is greater variability in vaping products, vaping can be done more discreetly, and it is more socially acceptable among youth. The authors of the 2021 review suggest there is an “urgent need” for effective vaping cessation interventions for youth.

The latest research by Stewart and co-researchers suggests vaping is likely to cause cancer, but he says there needs to be large and careful studies to determine causality and prevalence. Other researchers are concerned that worries about the harms associated with vaping will prevent adults from utilizing it as a cessation tool. However, the social acceptability and discretion of vaping make it a threat to teenagers who can more easily become addicted to nicotine.

In addition to these concerns, the amount of nicotine in a vape cartridge has increased substantially over time. In about 10 years, the amount of nicotine in some cartridges has increased 30-fold. It was once equivalent to the amount of nicotine in a pack of cigarettes, but now a cartridge can contain the equivalent of 30 packs of cigarettes, or three cartons.

135-150 puffs a day is considered normal for daily e-cigarette users. 200-500 puffs is considered “moderate use.” A 2021 study evaluated nicotine levels in Juul pods and determined that 200 puffs is equal to 13-30 cigarettes. The peak of the teen vaping trend was around 2019, before the COVID-19 pandemic, when about one-third of teens were vaping. In 2024, about 1.6 million teens were using vapes.

HHS released a teen vaping guide in September to explain the harms associated with the product on teen brains, including potential impacts on attention, learning, mood, and impulse control. FDA Commissioner Marty Makary was also taking steps to crack down on an illicit vaping market that was providing illegal “gamified” vaping products from China that are designed to get teens to use the product more frequently.