Vaping Risks: The Link Between E-Cigarettes, Cancer, and Oral Health

A comprehensive review led by cancer researchers at UNSW Sydney has concluded that nicotine-based e-cigarettes, or vapes, are likely to cause cancers of the oral cavity and the lungs. The findings, published in the journal Carcinogenesis, suggest that these risks exist even before long-term studies can fully confirm the exact level of risk.

The study was led by Adjunct Professor Bernard Stewart AM and included a multidisciplinary team of investigators from The University of Queensland, Flinders University, and The University of Sydney. The research team also included experts from Sunshine Coast University, The Prince Charles, and Royal North Shore hospitals, incorporating the perspectives of thoracic surgeons, epidemiologists, public health researchers, and pharmacists.

Evaluating Carcinogenicity Independent of Tobacco

The review focused specifically on whether vaping devices cause cancer on their own, rather than treating vaping solely as a gateway to traditional smoking. To reach its conclusions, the team analyzed a wide body of global research, including laboratory research on chemicals produced by e-cigarettes, animal experiments, and clinical monitoring.

To our knowledge, this review is the most definitive determination that those who vape are at increased risk of cancer compared to those who don’t

Prof. Bernard Stewart AM

Professor Stewart stated that considering the combined evidence from mechanistic data, animal studies, and clinical monitoring, e-cigarettes are likely to cause oral and lung cancer.

Oral Health Risks and Potentially Malignant Disorders

The link between e-cigarettes and oral health is a growing concern for dental clinicians. A rapid systematic review published in Medicina Oral Patología Bucal aimed to assess clinical evidence regarding electronic nicotine delivery systems (ENDS) as a risk factor for oral cancer and oral potentially malignant disorders (OPMD).

Health professionals and dental clinicians are encouraged to provide evidence-based advice to implement preventive measures against oral cancer. However, some research has noted the difficulty in assessing e-cigarettes as an independent risk factor due to associated habits.

A separate review published in Translational Cancer Research utilized the Bradford Hill criteria of causation to examine the oral carcinogenic potential of e-cigarettes, highlighting the complexity of isolating vaping as a standalone risk factor when other habits are present.

Public Health Implications

The emergence of these findings has prompted discussions regarding the regulation of vaping products. Some editorial perspectives suggest that the sale of vapes should be managed with restrictions similar to those applied to alcohol and cigarettes.

The research underscores a critical shift in understanding vaping risks, moving from the view of vapes as merely a tool for smoking cessation or a gateway to tobacco, to recognizing them as potential primary causes of malignancy in the lung and oral cavity.