ENDS Cancer

Studies, Surveys, Papers, and Case Studies

• Sometimes it's necessary to view the PDF version to access the full study.
• This page is for referencing the possible benefits of ENDS products vs. smoking cigarettes from a Cancer standpoint. (Electronic Nicotine Delivery Systems are also known as vapor technology, ecigarettes, ecigs, EVP, etc.)
• If you'd prefer someone else to add a study to a topic, there is a subject section called "Suggested studies to add to this page". You may put the link in that section for one of the regular page editors to address.

Studies

2020: Cancer potencies and margin of exposure used for comparative risk assessment of heated tobacco products (HTPs) and electronic cigarettes (ECs) aerosols with cigarette smoke

• Even if they should not be considered as risk-free products, however, HTPs and ECs lead to an appreciable risk reduction in comparison to cigarettes, both for cancer and non-cancer diseases. According to the current knowledge, and more specifically to the data presented here, HTPs and ECs might be considered as an acceptable reduced risk substitute for cigarettes for legal-age smokers who would otherwise continue smoking cigarettes.
• A more pronounced cancer risk reduction was observed when comparing the mean lifetime cancer risk for the considered ECs with that for cigarette smoke. This reduction was about two orders of magnitude (ratio of 0.009 and 0.014) with 2.42·10–4 and 3.95·10–4 for ECs compared to 2.73·10–2 for cigarettes. In terms of consumers, this would mean that 1 out of 36 cigarette smokers vs. 1 out of 4132 or 1 out of 2531 EC consumers may develop a cancer if the cancer root cause would be only associated with exposure to the considered HPHCs.
• PDF Version
• Citation: Rodrigo, G., Jaccard, G., Tafin Djoko, D. et al. Cancer potencies and margin of exposure used for comparative risk assessment of heated tobacco products and electronic cigarettes aerosols with cigarette smoke. Arch Toxicol 95, 283–298 (2021). doi: 10.1007/s00204-020-02924-x
• Acknowledgement: Philip Morris International is the sole source of funding and sponsor of this research.

2018: Electronic cigarette use among patients with cancer: Reasons for use, beliefs, and patient-provider communication

• Smoking tobacco cigarettes after a cancer diagnosis increases risk for several serious adverse outcomes. Thus, patients can significantly benefit from quitting smoking. Electronic cigarettes are an increasingly popular cessation method.
• Patients with cancer who use e-cigarettes have positive attitudes toward these devices and use them to aid in smoking cessation. Most participants identified smoking cessation as the reason for initiating (81%) and continuing (60%) e-cigarette use.
• Patients characterized e-cigarettes as more satisfying, more useful for quitting smoking, and more effective at reducing cancer-related stress than nicotine replacement therapies.
• PDF Version
• Citation: Correa JB, Brandon KO, Meltzer LR, et al. Electronic cigarette use among patients with cancer: Reasons for use, beliefs, and patient-provider communication. Psychooncology. 2018;27(7):1757-1764. doi:10.1002/pon.4721
• Acknowledgement: National Cancer Institute, Grant/Award Numbers: R01 CA154596 and P30CA76292

2017: Comparing the cancer potencies of emissions from vapourised nicotine products including e-cigarettes with those of tobacco smoke

• Most e-cigarette analyses indicate cancer potencies <1% that of tobacco smoke and <10% that of a heat-not-burn prototype, although a minority of analyses indicate higher potencies.
• Optimal combinations of device settings, liquid formulation and vaping behaviour normally result in e-cigarette emissions with much less carcinogenic potency than tobacco smoke.
• PDF Version
• Citation: Stephens WEComparing the cancer potencies of emissions from vapourised nicotine products including e-cigarettes with those of tobacco smokeTobacco Control 2018;27:10-17.
• Article in Lung Disease News: E-Cigarettes Carry Much Less Risk of Lung Cancer Than Cigarette Smoke, Study Finds

2017: Comparative tumor promotion assessment of e‐cigarette and cigarettes using the in vitro Bhas 42 cell transformation assay

• Results from this study suggest that e‐cigarettes may have reduced tumor promoter activity compared to conventional cigarettes and therefore may provide a safer alternative to cigarettes.
• PDF Version
• Citation: Breheny D, Oke O, Pant K, Gaça M. Comparative tumor promotion assessment of e-cigarette and cigarettes using the in vitro Bhas 42 cell transformation assay. Environ Mol Mutagen. 2017;58(4):190-198. doi:10.1002/em.22091
• Acknowledgement: The authors are employees of British American Tobacco or BioReliance Corporation. BioReliance conducted all experimental work and were funded by British American Tobacco. Nicoventures, UK, is a wholly‐owned subsidiary of British American Tobacco.

2017: Have combustible cigarettes met their match? The nicotine delivery profiles and harmful constituent exposures of second-generation (G2) and third-generation (G3) electronic cigarette users

• While not harmless, electronic cigarettes (e-cigarettes) have demonstrated a much more favourable toxicological profile than combustible cigarettes—the worldwide leading cause of preventable death. Average eCO levels (ppm) were significantly higher in smokers than in e-cigarette users. Compared with cigarettes, G2 and G3 e-cigarettes resulted in significantly lower levels of exposure to a potent lung carcinogen and cardiovascular toxicant.
• PDF Version
• Citation: Wagener TL, Floyd EL, Stepanov I, et alHave combustible cigarettes met their match? The nicotine delivery profiles and harmful constituent exposures of second-generation and third-generation electronic cigarette usersTobacco Control 2017;26:e23-e28.
• Acknowledgement: Intramural funds to TLW were used to complete this study. Part of TLW's, ELF's, LMD's, ELL's, NM's, APT's, and LQ's salary support is provided by the Oklahoma Tobacco Research Center, which is provided funding from the Oklahoma Tobacco Settlement Endowment Trust. The Oklahoma Shared Clinical and Translational Resources (U54 GM104938) provided phlebotomy support to this study.

2017: Nicotine, Carcinogen, and Toxin Exposure in Long-Term E-Cigarette and Nicotine Replacement Therapy Users: A Cross-sectional Study

• Conclusion: Former smokers with long-term e-cigarette–only or NRT-only use may obtain roughly similar levels of nicotine compared with smokers of combustible cigarettes only, but results varied. Long-term NRT-only and e-cigarette–only use, but not dual use of NRTs or e-cigarettes with combustible cigarettes, is associated with substantially reduced levels of measured carcinogens and toxins relative to smoking only combustible cigarettes.
• PDF Version
• Citation: Shahab, L., Goniewicz, M. L., Blount, B. C., Brown, J., McNeill, A., Alwis, K. U., … West, R. (2017). Nicotine, Carcinogen, and Toxin Exposure in Long-Term E-Cigarette and Nicotine Replacement Therapy Users. Annals of Internal Medicine, 166(6), 390. doi:10.7326/m16-1107
• Acknowledgement: Funding: Cancer Research UK

2016: Patients with lung cancer: Are electronic cigarettes harmful or useful?

• Based on current knowledge, for patients with lung or other forms of cancer who would otherwise continue to smoke, e-cigarettes offer an alternative way to quit smoking while they undergo medical treatment. The option to switch to e-cigarettes should be considered by healthcare practitioners with patients with cancer who would otherwise continue to smoke.
• No free version of PDF found
• Citation: Dautzenberg, B., & Garelik, D. (2017). Patients with lung cancer: Are electronic cigarettes harmful or useful? Lung Cancer, 105, 42–48. doi:10.1016/j.lungcan.2016.05.011

More Information

• Click on the category link below for more studies by topic on ENDS and Nicotine.