As the use of e-cigarettes and other vaping devices increases, especially among young people, one question carries added urgency: Does vaping cause lung cancer? Researchers don’t know yet, but using e-cigarettes can increase your risk of the disease—an important reason to quit.
How E-Cigarettes Work
To understand how vaping may contribute to lung cancer, it helps to know how e-cigarettes, the most common vape products, work.
Typically, e-cigarettes have a liquid-filled cartridge. The liquid usually contains nicotine, the addictive ingredient in tobacco products, as well as other chemicals and flavoring. A battery powers a heating element called an atomizer, which turns the liquid into a vapor. Users inhale the vapor with a mouthpiece.
What You Inhale When You Vape
You might be surprised at how many harmful chemicals and other substances enter your lungs when you vape.
Nicotine doesn’t directly cause lung cancer, but it can hook you on smoking or vaping. It can also alter brain development in young people up to about age 25, according to the Centers for Disease Control and Prevention.
Nicotine is just the tip of the iceberg when it comes to the dozens of ingredients that e-cigarettes may include. These products can contain:
- Benzene, a common chemical in car exhaust that’s associated with a higher risk of cancer
- Carcinogens (substances known to cause cancer), such as formaldehyde
- Chemicals found in antifreeze (propylene glycol and diethylene glycol) and herbicides (acrolein), which can cause nausea, vomiting and irritation of the eyes, nose and throat
- Heavy metals, including cadmium, lead, nickel and tin, which can contribute to cardiovascular disease
In addition, e-cigarette vapor may have ultrafine (tiny) particles that can settle deep in your lungs. These specks can cause inflammation, worsen asthma and contribute to other lung problems.
How Vaping Damages Your Lungs
Vaping hasn’t been proven to cause lung cancer, but it can still harm your lungs.
For one thing, people who vape can develop e-cigarette or vaping product use-associated lung injury (EVALI). EVALI includes several types of lung disease. One, bronchiolitis obliterans, is often called popcorn lung because it was first seen in employees of a microwave popcorn plant. The workers had breathing problems after inhaling diacetyl, a chemical that provided a buttery flavor. Popcorn makers no longer use the chemical because of its risks to lung problems in workers.
Another type of EVALI, acute respiratory distress syndrome (ARDS), happens when the lungs sustain a major injury. Trauma and infection are common causes, but ARDS can also occur due to inhaling toxic substances. With ARDS, fluid from tiny blood vessels in the lungs leaks into the alveoli (air sacs where oxygen and carbon dioxide exchange takes place). As a result, breathing becomes more difficult.
Hypersensitivity pneumonitis, a third type of EVALI, occurs when you have an allergic reaction to something you inhale. This reaction causes inflammation in the lungs.
The Link Between Vaping and Lung Cancer
E-cigarettes have only been available in North America since 2007. Lung cancer can take decades to develop, with most cases of lung cancer diagnosed at age 65 or older, according to the American Cancer Society. As a result, it’s still too soon to tell whether people who started vaping during the past two decades will develop lung cancer in the future.
Some researchers are finding evidence that vaping might make lung cancer more likely, though. In a 2024 study, researchers at The Ohio State University compared nearly 5,000 people with recently diagnosed lung cancer to more than 27,000 people without cancer. They found that people who vaped and smoked cigarettes had a four-times-higher risk of lung cancer than people who only smoked cigarettes. “Our results suggest that the addition of vaping to smoking accelerates the risk of developing lung cancer,” the authors wrote.
In a scientific review article from 2023, scientists in the U.S., Egypt and Saudi Arabia called vaping products “a highly potential risk factor for lung cancer and an area of significant concern for the future.” They called for more research to learn how these products and environmental factors may affect lung diseases.
Is Vaping Worse Than Smoking?
By now, you may be wondering how vaping compares to cigarette smoking in terms of health risks. Which is worse? Is vaping a healthier alternative to smoking?
Vaping isn’t healthy, and it certainly isn’t harmless. Compared with smoking, though, it’s less harmful.
Smoking is the leading cause of both major types of lung cancer—non-small cell (the most common type) and small cell. In addition, smoking can cause at least 15 other types of cancer. Vaping, on the other hand, hasn’t been shown to cause cancer, although it’s full of toxic chemicals that can harm your health.
According to the U.S. Food and Drug Administration (FDA), “e-cigarettes can generally be a lower-risk alternative for adults who smoke cigarettes.” As a result, many people turn to vaping because they view it as a healthier choice than smoking. The FDA is quick to point out, however, that “the use of e-cigarettes is not risk-free” due to its harmful ingredients.
For young people, e-cigarettes can be a gateway to a more harmful habit. Those who vape may be more likely to take up cigarette smoking when they get older. Plus, people who smoke and start vaping (known as dual use) may be more likely to continue using cigarettes—and to develop lung cancer in the future.
The bottom line: Smoking may be considered worse than vaping, but using e-cigarettes poses serious health risks. It’s best for your health to not start vaping, and to quit smoking without taking up e-cigarettes as an alternative. Need help quitting smoking? Capital Health Cancer Center’s Quit Smoking Program can guide the way.
A low-dose CT lung cancer screening at Capital Health Cancer Center can find the disease early, increasing your chances of successful treatment. To see if you qualify or to schedule a screening, call 1-844-303-LUNG (5864).