E-cigarettes were developed for cigarette smokers to help them kick the habit. It was believed that if smokers “vaped” instead of lighting up, they would get their nicotine fix in a way that was less harmful.
However, a new study calls that theory into question. Former cigarette smokers who use e-cigarettes or vaping devices may be at higher risk for lung cancer than those who don’t vape, according to research published at the American Thoracic Society (ATS) 2024 International Conference.
“This is the first large population-based study to demonstrate the increased risk of lung cancer in e-cigarette users after smoking cessation,” said corresponding author Yeon Wook Kim, MD, assistant professor, of the Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
E-cigarettes grew popular after their introduction, embraced by former smokers who said the nicotine delivery system helped them stop thinking about lighting up. However, researchers say there is little knowledge about the long-term consequences of vaping, and epidemiological evidence for the association between e-cigarette use and lung cancer is lacking.
Since their introduction, studies have suggested the devices are not harmless. For example, some research suggests the devices’ heating elements have been shown to contain carbonyl compounds, such as formaldehyde, acetaldehyde, acrolein and diacetyl.
‘Need to consider the potential risks’
“Our results indicate that when integrating smoking cessation interventions to reduce lung cancer risk, the potential harms of using e-cigarettes as an alternative to smoking must be considered,” Kim said.
Researchers followed 4,329,288 people with a history of conventional smoking who participated in the Republic of Korea’s National Health Screening Program at two-time points: 2012-2014 and 2018. They conducted a follow-up in December 2021.
The research team categorized participants into six groups according to their smoking history and habit change. They used statistical analyses to assess each group’s risk of developing lung cancer and of dying from it.
The follow-up determined that 53,354 individuals had developed lung cancer and 6,351 died from lung cancer. The researchers said they found that former cigarette smokers who had quit five years or more and used e-cigarettes were at greater risk of lung cancer-related death than ex-smokers who had quit five years or more and hadn’t used e-cigarettes.
For smokers who had quit less than five years, those who used e-cigarettes were found to have both a higher risk of both lung cancer and lung cancer mortality than non-e-cigarette users.