Do e-cigarettes give you cancer? Here's what science says

Electronic cigarettes have entered the daily lives of millions of people as a 'safe' alternative to traditional smoking. In recent years, however, scientific research has started to raise growing doubts about their safety. In March 2026, a narrative review of more than a hundred studies concluded that nicotine-based e-cigarettes are "probably carcinogenic" to those who use them. This is a very serious statement, which deserves to be read carefully, taking into account what the science really says and the limits of the evidence still available.

In March 2026, a review of more than one hundred studies conducted between 2017 and 2025 was published in an international scientific journal. The work, led by Australian researchers, analysed three types of evidence: so-called biomarkers (measurable biological signals in the body), animal experiments and the biological mechanisms by which certain substances can cause cancer. The results show that e-cigarette users are exposed to DNA-damaging chemicals, such as nicotine-derived nitrosamines, certain metals and volatile organic compounds. In laboratory animals, inhaling the aerosols induced the formation of lung tumours in a significant percentage of cases. The authors conclude that e-cigarettes are "probably carcinogenic" and could cause oral and lung tumours. This conclusion, however, should be read carefully. Several international experts pointed out that the review does not follow the rigorous methodologies of systematic reviews and that the criteria for selecting studies were not defined in advance. The transition from 'altered biological signals' to 'established cancer in humans' is not yet proven by epidemiological data.

This is an important question, and the answer is not easy. It is true that e-cigarettes do not produce tobacco combustion compounds, which are among the main causes of cancer in smokers. However, this does not mean that they are harmless. A recent systematic review with meta-analysis compared the health effects of e-cigarettes, traditional cigarettes and combined use of both, showing associations between e-cigarette use and several diseases, including increased cardiovascular risk. Concerning the effects on cancer, a study conducted in South Korea on more than 4 million people showed that traditional smokers who switched to e-cigarettes had a similar risk of lung cancer and an approximately four times higher risk of death from lung cancer compared to smokers who quit altogether. A systematic review published in 2025 concluded that there is a potential association between the use of e-cigarettes and lung cancer, especially among those who use them alongside traditional cigarettes (so-called 'dual use'). In a major US case-control study involving 4,975 lung cancer cases and 27,294 controls, 'dual use' was also found to be associated with a 59-fold higher risk of lung cancer compared to non-smokers, which was more than four times higher than that observed in smokers of traditional cigarettes exclusively.

Another worrying finding relates to epigenetic modifications: chemicals in aerosols can alter the way the body 'reads' instructions contained in DNA, paving the way for the same mechanisms that in traditional smokers lead to the development of tumours.

Yes. As of 2019, a serious lung disease called EVALI has been identified, an English acronym meaning 'lung damage associated with the use of e-cigarettes or vaping products' It is an inflammatory condition that can range from mild respiratory symptoms to full-blown respiratory failure, requiring hospitalisation. The most common symptoms are a persistent cough; chest pain; difficulty breathing; fever; nausea; and dizziness. As they resemble those of pneumonia or other respiratory diseases, it is essential that e-cigarette users always report this to their doctor, especially if symptoms worsen rapidly.