The debate over the relative risks of vaping compared to smoking is crucial, particularly concerning cancer risks. As e-cigarettes (vapes) have become a popular alternative to traditional tobacco products, understanding their cancer risks compared to those of smoking is essential for public health. This blog reviews scientific studies and evidence to compare the cancer risks associated with smoking and vaping.

Understanding the Basics

Smoking: Traditional smoking involves burning tobacco, which produces a complex mixture of harmful chemicals, including nicotine, tar, carbon monoxide, and numerous carcinogens. The combustion process releases substances known to cause cancer.

Vaping: E-cigarettes heat a liquid (e-liquid) to create an aerosol or vapor. This e-liquid typically contains nicotine, flavorings, and base liquids such as propylene glycol (PG) and vegetable glycerin (VG). Unlike smoking, vaping does not involve combustion, which alters the chemical composition of the inhaled substances.

Cancer Risks Associated with Smoking

1. Lung Cancer

• Primary Cause: Smoking is the leading cause of lung cancer. According to research published in JAMA Oncology, cigarette smoke contains a high concentration of carcinogens such as benzene, formaldehyde, and polycyclic aromatic hydrocarbons (PAHs). These substances damage DNA and lead to cancerous mutations in lung cells.
• Statistical Evidence: Studies, including those from the American Cancer Society, indicate that smokers are 15 to 30 times more likely to develop lung cancer compared to non-smokers. The risk increases with the duration and intensity of smoking.

2. Oral Cavity Cancer

• Increased Risk: Smoking is strongly associated with cancers of the oral cavity, including the mouth, throat, and tongue. Research in Cancer Research demonstrates that tobacco smoke contains carcinogens that contribute to the development of these cancers.
• Mechanism: The carcinogens in smoke irritate and damage the cells in the oral cavity, leading to pre-cancerous lesions and eventually cancer.

3. Other Cancers

• Esophageal and Bladder Cancer: Smoking is also linked to an increased risk of cancers of the esophagus and bladder. According to a study in The Lancet, tobacco smoke contains carcinogens that contribute to the development of these cancers by causing mutations and damage in cells throughout the body.

Cancer Risks Associated with Vaping

1. Reduced Carcinogen Exposure

• Lower Levels of Harmful Chemicals: E-cigarettes are generally thought to expose users to fewer carcinogens compared to traditional cigarettes. A study published in Environmental Science & Technology found that e-cigarette vapor contains lower levels of harmful substances, such as formaldehyde and benzene, compared to cigarette smoke.
• Carcinogenic Potential: Despite lower levels of carcinogens, the long-term effects of vaping on cancer risk are not yet fully understood. Research, including studies reviewed in Tobacco Control, indicates that while vaping may reduce exposure to some cancer-causing chemicals, it is not without risk.

2. Potential for Harm

• Emerging Evidence: Research in The Journal of the American College of Cardiology suggests that certain e-cigarette flavorings and ingredients may have the potential to cause cellular damage, although the evidence is still emerging. Some studies have raised concerns about the presence of potentially harmful substances in e-cigarette vapor, but these are generally at lower levels compared to smoking.
• Long-Term Risks: The long-term cancer risks associated with vaping are not yet well established. A review in The American Journal of Preventive Medicine highlights the need for more research to fully understand the potential cancer risks of long-term e-cigarette use.

3. Specific Studies on Vaping and Cancer

• Cellular Studies: Some studies, such as those published in Toxicology Reports, have investigated the effects of e-cigarette vapor on cell cultures and animal models. These studies have shown that while vaping exposes cells to fewer carcinogens, there is still evidence of potential cytotoxicity and DNA damage.
• Population Studies: Longitudinal studies tracking the cancer incidence among e-cigarette users are still limited. Research in Cancer Epidemiology, Biomarkers & Prevention indicates that while e-cigarettes may be a less harmful alternative to smoking, their long-term impact on cancer risk requires further investigation.

Comparative Analysis of Cancer Risks

1. Overall Risk Comparison

• Smoking: The cancer risks associated with smoking are well-established and severe. Smoking is a major cause of lung cancer, oral cancers, and several other types of cancer due to the high levels of carcinogens in tobacco smoke.
• Vaping: Vaping is generally considered less harmful than smoking due to reduced exposure to carcinogens. However, it is not without risks, and the long-term cancer effects of e-cigarette use are still under study. While vaping may present a lower risk compared to smoking, it is not risk-free.

2. Harm Reduction

• For Smokers: Switching from smoking to vaping may reduce exposure to some carcinogens, potentially lowering cancer risk. However, the best health outcome is achieved by quitting all nicotine products.
• For Vapers: Individuals who use e-cigarettes should remain aware of emerging research and potential risks. While vaping may offer a less harmful alternative to smoking, the long-term health effects, including cancer risks, are not yet fully known.

Health Recommendations

1. Smoking Cessation: Quitting smoking remains the most effective way to reduce cancer risk. Comprehensive cessation strategies, including counselling, medication, and support programs, are recommended for those looking to quit.

2. Informed Choices: For those who switch from smoking to vaping, it is crucial to stay informed about potential risks and follow public health guidelines. Vaping should be used as a transitional tool to eventually quit nicotine use entirely.

3. Ongoing Research: Continued research is essential to fully understand the cancer risks associated with vaping. Individuals should keep up with the latest scientific findings and consult healthcare professionals for personalized advice on smoking cessation and vaping.

Conclusion

In summary, smoking is associated with a significantly higher cancer risk, particularly for lung, oral, oesophagal, and bladder cancers, due to the high levels of carcinogens in tobacco smoke. Vaping is considered less harmful than smoking, with lower levels of carcinogens in e-cigarette vapour. However, the long-term cancer risks of vaping are not yet fully understood. Switching from smoking to vaping may reduce cancer risk, but the ultimate goal should be to quit all nicotine products.

Additional Resources

• American Cancer Society: Provides information on cancer risks related to smoking and tips for quitting.
• CDC’s Smoking and Tobacco Use: Offers resources on the effects of smoking and strategies for quitting.
• National Institute on Drug Abuse: Includes insights into nicotine addiction and its health impacts.

Understanding the cancer risks associated with both smoking and vaping helps individuals make informed choices about their health. By staying informed and seeking to quit all forms of nicotine use, individuals can significantly reduce their risk of cancer and improve their overall well-being.