Vaping: What to know about the cancer concerns

As students return to classrooms this fall, health experts say vaping remains one of the biggest health concerns facing teenagers and young adults.

Although many students believe e-cigarettes are a safer alternative to traditional cigarettes, researchers say that doesn't mean they are safe, especially for developing brains and bodies. While scientists are still studying the long-term cancer risks of vaping, growing evidence suggests the products expose users to harmful chemicals and may increase health risks, particularly when used alongside traditional cigarettes.

"While some researchers support e-cigarettes as a way to help adults quit smoking, they also agree that these products were never intended for use by youth," said Pramil N. Singh, DrPH, professor of cancer sciences at Loma Linda University School of Medicine, and director of the Cancer Center's Transdisciplinary Tobacco Research Program. "The Centers for Disease Control and Prevention already provides clear guidance that youth, young adults, and pregnant women should not use e-cigarettes for any reason."

Vaping remains common among young people

E-cigarettes have become the most commonly used tobacco product among youth in the United States. According to the Centers for Disease Control and Prevention (CDC), about 6% of middle and high school students currently use e-cigarettes, while usage rises to between 14% and 18% among young adults.

Those numbers concern Singh because adolescence is a critical period for brain development.

"The current trends are cause for concern since nicotine can harm brain development and lung health in youth," Singh said. "Recent data also support that e-cigarettes can serve as a gateway to harmful dual-use patterns, where individuals use both cigarettes and e-cigarettes."

Is vaping really safer?

One of the biggest misconceptions among students and even parents is assuming vaping products are harmless simply because they don't involve burning tobacco.

"We do not have the long-term cancer outcome data for e-cigarettes since these are relatively new products on the market," Singh said.

That doesn't mean researchers are without concerns.

According to the American Cancer Society, research suggests that people who both smoke cigarettes and use e-cigarettes are about four times more likely to develop lung cancer than those who smoke cigarettes alone. Researchers believe that increased risk may be related to carcinogens found in e-cigarette vapor, including formaldehyde, acetaldehyde, and benzene.

"While we don't yet have decades of cancer outcome data for e-cigarettes alone, the presence of known carcinogens in vaping aerosols and the potential for increased risk in dual users are important warning signs that warrant continued research," Singh said.

Research continues to uncover potential cancer risks

Researchers at Loma Linda University Cancer Center are working to better understand how vaping may affect health beyond nicotine addiction.

Through the Cancer Center's Transdisciplinary Tobacco Research Program, investigators are studying how prenatal exposure to e-cigarette vapor and smokeless tobacco products may affect newborn health, including potential cancer-related outcomes.

Researchers are also enrolling patients with periodontal disease to examine how vaping tobacco or cannabis products may alter the oral microbiome. Scientists are exploring whether changes in oral bacteria may play a role in future cancer development.

"These studies reflect the many questions researchers are still working to answer about the long-term health effects of vaping," Singh said.

Dr. Singh says, "Safety of e-cigarette products for use by youth should not be assumed."

How nicotine affects adolescence

Even before scientists fully understand vaping's long-term cancer risks, decades of research have established that nicotine itself can significantly affect the developing adolescent brain.

According to the CDC, nicotine exposure during adolescence harms areas of the brain responsible for attention, learning, and memory. It also alters the brain's reward system, increasing vulnerability to nicotine addiction and potentially other substance use later in life.

"It is noteworthy that e-cigarettes deliver a high dosage of nicotine relative to other products," Singh said.

Flavored products continue to attract young users

Flavored vaping products remain one of the primary drivers of youth vaping.

"The data is very convincing in national samples that the predominant form of tobacco use by youth is flavored e-cigarettes and vapes," Singh said.

Sweet flavors, colorful packaging and discreet devices have helped make disposable vaping products especially appealing to adolescents.

Signs parents should watch for

Parents may not always recognize the signs that a child is vaping.

Singh says fruity or sweet-smelling odors, vape cartridges, refill pods and specialized chargers found in bedrooms, backpacks or vehicles may be warning signs. Physical symptoms can also include fatigue, nosebleeds, dry mouth, mood swings, and poor lung health.

He encourages parents to approach the conversation with curiosity rather than judgment and to discuss the health risks before vaping becomes a long-term habit.

Protecting students this school year

As students head back to school, Singh hopes families understand that vaping should not be viewed as a harmless alternative to smoking. While researchers continue studying the long-term relationship between vaping and cancer, health experts already know that nicotine can interfere with healthy brain development and that e-cigarette vapor contains potentially harmful chemicals.

"Safety of the product for use by youth should not be assumed," Singh said.

Learn more about cancer prevention, tobacco research and comprehensive cancer care at Loma Linda University Cancer Center by visiting lluh.org/cancer-center.