Is There a Link Between Vaping E-Cigarettes and Lung Cancer?

Posted on March 29, 2023 in Lung Cancer

Over the past few decades, there has been an impressive campaign against smoking. According to the American Lung Association, the proportion of people smoking more than 24 cigarettes a day decreased 76 percent between 1974 and 20181. Some say vaping, or the use of electronic cigarettes, has contributed to this reduction in smoking. 

Nevertheless, e-cigarettes are still dangerous. Early information has revealed that vaping has significant risks, including higher rates of lung cancer. People with chronic lung conditions who use e-cigarettes are at an even greater risk of developing serious health problems. However, at this time, more research is needed to determine if vaping can cause cancer.

Can Vaping E-Cigarettes Cause Lung Cancer?

hands holding a vape in one hand and 3 cigarettes in the other

Unlike regular cigarettes, which release nicotine using tobacco and a flame, e-cigarettes release nicotine by heating e-liquid (or vape juice) using a battery. Since e-cigarettes are tobacco-free, people generally consider them a “healthier” option. In weighing vaping vs. smoking, most assume that vaping cannot cause lung cancer

As of right now, there is no research confirming or denying that assumption. Since vaping is a relatively new practice, scientists currently lack the quantitative data to link e-cigarettes to lung cancer. However, vaping does introduce your lungs to a host of toxic chemicals, many of which are carcinogenic.

What Does Cause Lung Cancer?

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Many people ask: Can vaping cause cancer? Though vape juice does contain carcinogenic chemicals, scientists are still working to answer that question. In the meantime, however, understanding what cancer is and how it develops can help you weigh vaping vs. smoking and the risk of cancer. 

As a general definition, cancer is the division of cells with mutated DNA. Unlike normal cells, which have proteins that tell them when to divide and when to stop, a cancer cell grows and multiplies uncontrollably. DNA mutations can happen in many ways. These abnormalities can be inherited, for instance. But more often, DNA is damaged by radiation (such as from the sun) or by carcinogenic chemicals like those in tobacco smoke. 

What Is in E-Cigarette Vape Juice?

E-liquid is made of four primary ingredients: water, nicotine, flavorings and a vegetable glycerin base. Though e-cigarettes do not contain tobacco, they do contain many other dangerous chemicals that can cause cancer. In 2009, for instance, the Food and Drug Administration2 (FDA) announced that e-cigarettes have detectable levels of known carcinogens — substances that promote the formation of cancer. 

Some of these cancer-causing chemicals include:

  • Acetaldehyde, a chemical that can harm the skin, eyes and respiratory tract. It has also been shown to cause cancer. 
  • Benzene, a volatile organic compound (VOC) found in car exhaust.
  • Acetone, a solvent that quickly dissolves other substances. Because of these properties, it is commonly used in paint thinner and nail polish remover. 

The FDA has also detected antifreeze, a compound that is known to be toxic to humans, in e-cigarettes. Another study3 found formaldehyde in numerous cartridges of e-cigarettes, sometimes in higher amounts than what is allowed by the Environmental Protection Agency (EPA). Formaldehyde is used in the embalming process and is known to cause cancer. 

Vape juice contains heavy metals as well. Some studies have found higher levels of metals and metalloids in people who vape than in people who smoke cigarettes and cigars. Exposure to heavy metals like chromium, nickel, manganese, and lead can have serious health consequences, including but not limited to lung cancer.

What Are the Side Effects of E-Cigarettes?

The most common side effect of vaping is nicotine addiction. Nicotine is a very addictive stimulant drug that spikes adrenaline. For centuries, people have delivered nicotine to their bodies by smoking tobacco. Though vape juice does not contain tobacco, it still contains nicotine. 

Other side effects of vaping include:


Irritation of the Mouth

The chemicals released while using an e-cigarette can damage the inside of the mouth. 



If vapor is swallowed instead of inhaled, it can lead to burping.



High levels of nicotine can cause intense headaches and migraines. 


Increased Saliva Production

Another side effect of using e-cigarettes is increased salivation. This could come from the nicotine itself as well as the mechanical stimulation of having something in the mouth.


Throat Pain

Inhaling chemicals into the throat can irritate the lining, leading to pain.

What Does Vaping E-Cigarettes Do to Your Lungs?

With a traditional cigarette, users inhale smoke created from burning tobacco. With an e-cigarette, there is no tobacco involved. Instead, users inhale aerosol that is created when a battery vaporizes vape juice. This liquid contains nicotine, propylene glycol, ultra fine particles and other chemicals including those discussed above.   

When these chemicals are inhaled into the lungs, they cause damage similar to that of regular cigarettes. The body responds to foreign invaders by triggering an inflammatory response. Over time, inflammation can trigger chronic lung diseases such as:

  • Bronchitis
  • Bronchiectasis
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Emphysema
  • Cancer

Effects of Vaping E-Cigarettes on the Lungs

Scientists are still trying to fully understand the effects of vaping on the lungs. However, research currently suggests that in addition to causing chronic lung diseases like emphysema and COPD, vaping can contribute to specific disorders including:


Popcorn Lung

Popcorn lung, also known as bronchiolitis obliterans, is caused by the chemical known as diacetyl. This organic compound is produced by brewer’s yeast and has a very intense buttery flavor. Its damaging effects were first realized in 2000 when workers at a Missouri microwave popcorn plant became very sick after inhaling diacetyl. 

Diacetyl is commonly added to vape juice to give it a fruity or dessert-like flavor. Unfortunately, repeatedly inhaling diacetyl can irritate and scar the tiny air passageways in the lungs. Bronchiolitis obliterans causes coughing and shortness of breath. Other symptoms of popcorn lung are:

  • Flu-like illness with fever
  • Fatigue
  • Weight loss
  • Wheezing

Though a chest X-ray or CT scan can suggest popcorn lung, a surgical lung biopsy is the most definitive way to diagnose this condition. There currently are no cures for popcorn lung; doctors can only prescribe cough suppressants and bronchodilators (medications to open the airways) to treat the symptoms.


Lipoid Pneumonia

Typically, pneumonia is caused by viruses or bacteria. But lipoid pneumonia occurs when fatty acids enter the lungs and create inflammation. Vaping-related lipoid pneumonia, also called exogenous lipoid pneumonia, is caused by inhaling the oily substances found in e-juice. 

Lipoid pneumonia symptoms vary from person to person and tend to become more severe over time. An individual with lipoid pneumonia may experience:

  • Chest pain
  • Chronic cough
  • Difficulty breathing

In rare situations, a patient may experience:

  • Fever
  • Weight loss
  • Coughing up blood
  • Night sweats
  • Difficulty swallowing  

Doctors typically prescribe anti-inflammatory medications such as corticosteroids to treat lipid pneumonia. Depending on the severity of symptoms, doctors may also recommend oxygen and respiratory therapy. 


Primary Spontaneous Pneumothorax

Primary spontaneous pneumothorax, or collapsed lung, occurs when a small air blister called a bleb rupture and causes air to leak out into the space around the lung. This buildup of air prevents the lung from expanding as it normally would. Activities like scuba diving and flying can cause spontaneous pneumothorax in otherwise healthy people. Smoking — and now vaping — can also cause this condition. 

Patients with a collapsed lung typically experience:

  • Sharp chest pain
  • Shortness of breath
  • Chest tightness
  • Fatigue
  • Rapid heart rate
  • Bluish color of the skin
  • Nasal flaring

A collapsed lung is diagnosed using a chest X-ray. Treatment depends on the severity of the patient’s condition. For a small pneumothorax, the patient may simply receive supplemental oxygen. In more severe cases, a chest tube might be inserted to drain air from the chest cavity. Surgery may also be needed to repair the hole.

Do E-Cigarettes Help People Quit Smoking?

Many people attempt to use e-cigarettes as a “bridge” to help them stop smoking. However, there is little evidence suggesting that this is effective. In a recent randomized trial4, for instance, smoking cessation programs were more effective than e-cigarettes at encouraging smokers to stop. Patients interested in programs should ask their healthcare provider or investigate public health programs.

E-Cigarettes and Children

Vaping is a growing problem among children. According to surveys conducted in 2016, two million high schoolers were using e-cigarettes. Worse yet, one in five middle schoolers said they had tried e-cigarettes but not traditional cigarettes5.

Much like how big tobacco once marketed cigarettes to kids, the industry is now using tactics to attract adolescents to vaping. E-juice comes in nearly 16,000 flavors, from bubblegum to buttered popcorn to gummy bears. The packaging is often bright and colorful, much like a box of candy. Since many e-liquids are fruit-flavored, children have even mistaken them for juice.   

Unfortunately, when children are exposed to e-cigarettes early in life, they are more likely to become addicted to nicotine and later pick up conventional smoking. Children’s brains are also still developing and nicotine, among other chemicals, can inhibit this brain development. If you think your child may be vaping, you should have an honest conversation and explain these dangers.

Vaping E-Cigarettes vs. Smoking Cigarettes and Cancer

Scientists are still working to determine if vaping can cause cancer. However, if you are concerned about your own history of vaping and the risk of lung cancer, contact us to schedule an appointment at one of our cancer treatment centers. 

At SERO, our radiation oncologists are skilled at diagnosing lung cancer. Our board-certified physicians are also adept at providing advanced radiation therapy for patients in the Charlotte Metro area.