Yes, You Can Still Get Lung Cancer If You Vape

Originally marketed in the early 2000s as a safe form of nicotine replacement, vaping was supposed to help people stop smoking cigarettes and lower their risk of lung cancer. Instead, vaping has become a hard-to-break habit of its own — and not only for people trying to quit smoking. Many people who never even smoked cigarettes have picked up the habit.

With more people vaping than ever before, it’s important to be aware of the risks. Just like traditional cigarettes, it’s likely that vaping increases your risk of lung cancer. Compounds found in vaping fluids and electronic cigarettes are known to cause lung cancer. And animal studies and lab research has confirmed the link between vaping and cancer. 

Not only that, there’s emerging evidence that people who vape don’t think of themselves as at risk for lung cancer. So, they’re less likely to attend or schedule lung cancer screenings, which further increases the risk of lung cancer. 

Does vaping cause lung cancer?

It’s too early to say with complete certainty if vaping causes lung cancer. But it’s very likely. 

Vaping fluids and e-cigarette devices do contain substances known to cause cancer. Some examples of these cancer-causing compounds include: 

• Formaldehyde

• Heavy metals

• Nicotine derivatives 

Animal studies and lab research (studies performed in test tubes) have shown that when cells are exposed to these chemicals, they become cancerous. 

Even though plenty of signs point to a link between vaping and lung cancer, it’s hard for researchers and scientists to say with 100% certainty that vaping actually causes lung cancer. This is, in part, because establishing cause and effect in science and medicine is complicated. But there’s another reason, too: Vaping is a recent phenomenon, and lung cancer takes decades to develop. So, vaping simply hasn’t been around long enough for scientific methods to prove that cases of lung cancer have been caused by vaping. 

Put another way, though it’s very likely that vaping does cause lung cancer, the scientific community has to hold back on that claim until there’s more scientific proof. We’ll have to wait many more years for that. 

EXPERT PICKS: WHAT TO READ NEXT

• How to quit vaping: The same treatments that work to quit cigarettes also work to quit vaping. Nicotine withdrawal can be a challenge, so choose nicotine-based products. 

• Addicted to nicotine? There are many FDA-approved nicotine replacement products to help you quit. And they’re all safer than vaping. 

• Want to know more about lung cancer? Read our guide to lung cancer causes, symptoms, prevention, and more.

What ingredients in e-cigarettes can increase your cancer risk?

Proponents of vaping often claim that e-cigarettes are more “pure” than traditional cigarettes. They say this because the liquids that people put into e-cigarettes contain fewer chemicals and toxins known to cause cancer, compared to traditional cigarettes. 

But the truth is more complicated. 

E-cigarettes (also called vape pens or vapes) work by heating a liquid into a vapor. Just like the way cooking changes the chemical composition of the food you eat, heating a liquid changes the chemical composition of the vapor you breathe in. This means that even though the liquid you put in a vape might contain fewer toxins, the vapor you inhale out of it isn’t necessarily less harmful. In other words, what goes in isn’t necessarily what comes out. 

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The process of heating up the chemicals in the reservoir of a vaping device can turn those chemicals into something more dangerous. These dangerous chemicals are carcinogens — things we’re exposed to that have the potential to turn healthy cells into cancerous cells.

Carcinogens cause cancer in a few different ways. They can directly damage the DNA of healthy cells, cause inflammation, affect the genes your body expresses, and more. But, ultimately, carcinogens cause mutations in the DNA of healthy cells, leading them to multiply uncontrollably and form cancers. 

Here are some of the carcinogens found in e-cigarette vapor:

• Heavy metals: Cadmium, lead, nickel, chromium, arsenic, strontium, and mercury have been found in many vape fluids. These heavy metals directly cause DNA mutations in cells and change which genes your body expresses. Heavy metals also generate free radicals, which cause damage to your DNA.

• Formaldehyde: One of the major ingredients in embalming fluid, formaldehyde is a toxic organic compound known to cause cancer.

• Ethyl maltol: This is known to cause damage to the outer layer of your skin and mucous membranes (known as your epithelium). Ethyl maltol also helps create free radicals.

• Diacetyl: This compound is known to damage your lung cells.

• Vitamin E: Lots of manufacturers put vitamin E in their products and claim that it helps create a soothing effect. The truth is that when vitamin E is heated in an e-cigarette, it can form cancer-causing compounds, like benzene.

Does vaping damage the lungs?

While researchers can’t say with 100% certainty that vaping causes cancer, it’s clear that vaping can cause damage to your lungs. In fact, research has shown that vaping affects nearly every part of the respiratory system (and beyond): 

• Nasal epithelium: Vaping causes damage to the cells that line your nose.

• Bronchial epithelium: Vaping has been shown to damage the cells that line your lungs, known as your bronchial epithelia. Vaping causes these cells to become dehydrated. It even alters which genes are expressed by these cells. 

• Cilia: Vaping damages your cilia, which are little brushes that line your lungs and help them get rid of mucus and other irritants.

• Blood vessels: Beyond damaging the insides of your lungs, vaping also causes the blood vessels that surround your lungs to become stiff. This makes them less able to do their job: exchanging oxygen and carbon dioxide.

• Respiratory immune system: Vaping affects your immune system, causing your body to create more mucus and sputum than it otherwise would.

In short, vaping is known to cause damage to your pulmonary tract, from the tip of your nose to the bottom of your lungs.

If you vape, should you schedule lung cancer screenings?

Yes, it’s worth screening for lung cancer if you vape. But, because vaping is such a recent phenomenon and lung cancer takes decades to develop, the guidelines are still catching up with reality. Here’s where things stand currently. 

Lung cancer screening for people with a smoking history who vape

The U.S. Preventive Services Task Force (USPSTF) recommends annual lung cancer screening starting at age 50 for people who currently smoke or have smoked cigarettes in the past. So, if you’ve ever smoked cigarettes, regardless of whether you or not you still do, you should get screened for lung cancer. 

Evidence shows that people who’ve switched from cigarettes to vaping are actually less likely to get screened for cancer, even if they’re eligible for it. This is thought to be due to the fact that people who switch from smoking to vaping consider vaping safer than smoking. But, whether or not this is true, switching from smoking cigarettes to vaping doesn’t undo lung damage already caused by a past smoking habit. 

In other words, if you’re eligible for lung cancer screening because of your smoking history, you should get screened — even if you’ve stopped smoking or switched to vaping.

Lung cancer screening for people who vape but never smoked

As of now, there are no recommendations for lung cancer screening for people who vape but have never smoked. But, as noted, it’s very likely that chemicals in e-cigarette vapors increase your risk for lung cancer.

Screening recommendations are periodically reviewed based on new research as it becomes available. As researchers and scientists learn more about the harms of e-cigarettes, you can expect that recommendations on lung cancer screening for e-cigarette users will get updated. In the meantime, speak with your primary care provider about which screening options make sense for you.

What causes lung cancer?

Lung cancer happens when cells in the lungs mutate, multiply, and organize into tumors. Typically, cancers happen as a result of your individual genetics and the things you’re exposed to in your environment. Cancers also become more likely with age. 

The most common known causes of lung cancer are:

• Smoking

• Radon

• Asbestos

In rare cases, people who’ve never smoked and have never been around radon or asbestos can still get lung cancer. In these people, lung cancer is probably caused by genetic factors or by random changes to their DNA that happen by chance.

As researchers and scientists learn more about the harms of vaping, it wouldn’t be surprising if vaping gets added to this list.

Smoking 

Tobacco smoking is by far the number one cause of lung cancer. You’re 15 to 30 times more likely to get lung cancer if you smoke than if you don’t. And about 80% of deaths from lung cancer are caused by smoking tobacco. This includes smoking traditional cigarettes, cigars, or pipes. 

Tobacco smoke causes cancer because it contains more than 7,000 toxic chemicals. At least 70 of these are known carcinogens.

People who smoke cigarettes are 10 to 40 times more likely to get lung cancer than people who don’t smoke. The risk goes up the more you smoke, and the longer you smoke for. People who’ve been exposed to secondhand smoke also have a higher risk of lung cancer. 

Smoking tobacco causes more than lung cancer. It also causes cancer in almost every part of the body, from mouth and throat cancer to bowel cancer, and even cervical cancer. 

Radon

Radon is a gas that’s naturally found in the environment. It’s formed when small amounts of radioactive elements in soil and rocks break down. Because radon is an odorless and colorless gas, you can breathe it in without realizing it. Over time, it can lead to lung cancer. If radon is detected in your home or workplace, the best thing to do is to install a good ventilation system.

Asbestos

Asbestos is another cause of lung cancer. Specifically, asbestos causes mesothelioma (cancer in the lining of the lung). Asbestos was used as an insulation material in houses and other buildings for much of the 20th century. Even though asbestos was banned in 1989, it’s still found in many older buildings throughout the U.S. Because of this, it still causes more than 40,000 deaths per year from lung cancer, especially in people with repeated exposure. This includes people who’ve worked in shipbuilding, plumbing, and insulation — and their family members. 

Is vaping better than smoking cigarettes?

The short answer is we don’t know if vaping is better than smoking cigarettes. Because vaping is so new, we don’t have nearly as much research about vaping as we do about smoking. Though vaping liquids don’t contain all the contaminants that cigarette smoke has, scientists are learning that it nevertheless comes with many of the same dangers. Because vaping is addictive and vaping liquid contains dangerous, cancer-causing compounds, like formaldehyde and diacetyl, vaping certainly isn’t considered safe.

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Written by:

Farzon A. Nahvi, MD

Dr. Nahvi is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works clinically at Concord Hospital in Concord, New Hampshire, and is a clinical assistant professor of emergency medicine at the Geisel School of Medicine at Dartmouth. Prior to this, he worked as an ER physician and clinical assistant professor of emergency medicine at the Mount Sinai Health System, NYU Langone Health, NYC Health + Hospitals/Bellevue, and the Manhattan VA. He is a graduate of Cornell University and NYU School of Medicine.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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