Does Vaping Cause Cancer? Risks & Carcinogens

The question of whether vaping causes cancer is a significant public health concern, and the straightforward answer is: we don’t have the decades of research that exist for traditional cigarettes, so the long-term picture isn’t fully clear. However, what scientific evidence does show is that e-cigarette aerosol – the vapor inhaled and exhaled – contains multiple chemicals known to cause cancer. While e-cigarettes are a relatively recent phenomenon, studies are already identifying concerning links between vaping and biomarkers indicative of increased cancer risk, even in very young users.

Understanding E-Cigarette Exposure and Cancer Risk

When discussing the risks associated with vaping, it’s important to understand that exposure isn’t limited to the person using the e-cigarette. The potential for harm extends through firsthand, secondhand, and even thirdhand exposure.

• Firsthand Exposure: This is the direct inhalation of vapor by the person using the e-cigarette. The user is directly exposed to all the chemicals present in the aerosol.
• Secondhand Exposure: This occurs when a non-user inhales the vapor exhaled by someone who is vaping. This exhaled aerosol still contains harmful substances.
• Thirdhand Exposure: This is a less commonly understood but still significant risk. It refers to the residue of chemicals from vape aerosol that settles onto surfaces in an environment where vaping has occurred. These chemicals can then be transferred to the body through touch or ingestion.
  • Example 1: If someone vapes in a kitchen, the aerosol chemicals can settle on countertops. If another person then touches that counter and subsequently eats food with their hands, they can ingest these residues.
  • Example 2: If vaping occurs indoors where a baby is present, chemicals from the aerosol can settle on the floor. When the baby crawls and then puts their hands in their mouth, they can ingest these potentially carcinogenic substances.

The concern is that, much like with tobacco smoke, all three forms of exposure to e-cigarette vapor can increase an individual’s risk of developing cancer over time. The aerosol produced by these devices contains substances classified as Group 1 carcinogens by the International Agency for Research on Cancer (IARC), a part of the World Health Organization. This is the same classification given to tobacco smoke, which is responsible for a significant percentage of all cancer deaths.

Known Carcinogens Found in E-Cigarette Aerosol

Group 1 carcinogens are substances or exposures for which there is sufficient evidence of carcinogenicity in humans. Several of these have been identified in the aerosol produced by e-cigarettes. The heating process of e-liquids, and the components of the devices themselves, can produce or release these harmful chemicals:

• Formaldehyde: This well-known carcinogen can form when the main ingredients in e-liquid, propylene glycol (PG) and vegetable glycerin (VG), are overheated (a phenomenon sometimes referred to as a “dry puff” or when the device malfunctions). Formaldehyde is linked to leukemia and various nasopharyngeal (nose and throat) cancers.
• Heavy Metals (e.g., Cadmium and Nickel): These metals can leach from the heating coils within the vaping device into the aerosol. Cadmium is associated with lung, prostate, and kidney cancer, while nickel is linked to lung and nasal cancers. Other metals like lead have also been detected.
• Acetaldehyde: This chemical can form when propylene glycol and some flavoring chemicals in e-liquids are heated. Acetaldehyde is classified as a Group 1 carcinogen and is associated with an increased risk of esophageal, stomach, breast, and various head and neck cancers.
• Acrolein: Formed during the heating of e-liquid components (especially glycerin), acrolein is a potent irritant and is suspected to contribute to lung and bladder cancer.
• Lead: Often found in the heating coils and solder joints of some vape devices, lead is a toxic metal and a probable human carcinogen, linked to lung, stomach, kidney, brain, and blood cancers.

It’s important to note that the levels of these carcinogens can vary widely depending on the specific device, e-liquid ingredients, voltage/power settings, and user behavior (e.g., puff duration and intensity).

Biomarkers of Cancer Risk

While long-term epidemiological studies directly linking vaping to specific cancer diagnoses in humans will take many more years, current research is focusing on **biomarkers of cancer risk**. These are measurable changes in the body – at a cellular or molecular level – that indicate an increased likelihood of developing cancer. Studies have found that e-cigarette exposure is associated with such biomarkers across various demographics, including adolescents as young as 12-15 years old. These biomarkers can include:

• Damaged DNA within cells
• Inflammation in tissues (chronic inflammation is a known risk factor for cancer)
• Changes in protein structures that could indicate cellular stress or damage

The presence of these biomarkers suggests that even if e-cigarettes are less harmful than combustible tobacco in some respects, they are far from harmless and may indeed be initiating processes that could lead to cancer development over time.

Vaping: Not a Harmless Alternative

E-cigarettes were initially marketed and perceived by some as a “healthier” or “safer” alternative to smoking traditional tobacco cigarettes, primarily due to the absence of tar and many of the combustion byproducts found in cigarette smoke. While it’s true that vape aerosol may contain fewer toxic substances overall compared to cigarette smoke, the assertion that they are “safe” is misleading and not supported by current scientific understanding.

A concerning trend is the uptake of vaping by individuals who have never smoked cigarettes, particularly young people. This introduces a new population to nicotine addiction and exposure to the harmful chemicals in vape aerosol. It is crucial to recognize that the chemicals found in these devices, and particularly in their heated aerosol, are not benign and have the potential to cause significant harm to the human body, including an increased risk of cancer.

The Bottom Line: Caution is Warranted

While it may take more years to definitively quantify the full spectrum and incidence of cancers directly caused by vaping, the current evidence is clear: e-cigarette aerosol contains known Group 1 carcinogens, and exposure is linked to biological markers of increased cancer risk. This risk applies regardless of age and through firsthand, secondhand, and thirdhand exposure. The original perception of vapes as a completely safe alternative to smoking is being increasingly challenged by scientific research. Therefore, exercising caution and understanding the potential long-term health consequences, including cancer risk, is essential for anyone considering or currently using e-cigarettes, and for protecting non-users from exposure.