Is There a Link Between Vaping E-Cigarettes and 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.

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.

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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. 

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.

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:

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

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:

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.

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.

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.

1. https://www.lung.org/research/trends-in-lung-disease/tobacco-trends-brief/overall-tobacco-trends
2. https://www.fda.gov/
3. https://www.lung.org/quit-smoking/e-cigarettes-vaping/lung-health
4. https://www.nejm.org/doi/full/10.1056/NEJMsa1715757
5. https://www.fda.gov/TobaccoProducts/Labeling/ProductsIngredientsComponents/ucm456610.htm