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Nicotine vapes or e-cigarettes have been widely touted as the safe alternative to cigarettes. They can be used as part of quitting, but even despite restrictions, they are popular recreationally, despite evidence that they are a gateway to tobacco smoking.
Researchers and cancer experts have been warning for a while that there's little or no evidence of vapes being safe, and once lung and mouth cancers start to appear in 20 or 30 years, it will be too late. Which is why a group of Australian researchers decided to pull together the available evidence from cell studies, tissue analysis, animal experiments and genetic research published since 2017.
While lung and oral cancers are yet to appear in vape users, there is no basis for calling vapes safe, and there is now good evidence of major risk
They found that the components of vapes such as flavouring, the nicotine itself, compounds produced by the heat in the device, and even metals produce a significant range of effects which are known to be on the road to cancer. They include oxidative stress (essentially biological rusting and tissue ageing), DNA damage, epigenetic changes (chemical alterations to DNA which change the way genes function), and inflammation, which adds to tissue damage and ageing.
Individually, each of these mechanisms is part of the cancer causation process, but the researchers point out that they're all working together, amplifying the process.
The Australian review, led by UNSW Sydney and published in the journal Carcinogenesis, is described by its authors as the most definitive determination to date that people who vape are at increased cancer risk compared to non-users. Supporting animal studies found that 22.5% of mice exposed to e-cigarette aerosol over 54 weeks developed lung adenocarcinoma. Case reports have also documented heavy vapers presenting with aggressive oral cancers in the absence of traditional risk factors such as smoking or viral infection.
The bottom line is that while lung and oral cancers are yet to appear in vape users, there is no basis for calling vapes safe, and there is now good evidence of major risk.
References
Stewart B et al. Evidence that nicotine e-cigarettes are likely to cause lung and oral cavity cancers. Carcinogenesis, 2025. UNSW Sydney.
Tommasi S et al. E-cigarette aerosol induces DNA damage in lung, heart and bladder tissue of mice. Cancer Prevention Research / PMC, National Institutes of Health.
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