Nicotine - Myth - Nicotine Causes Cancer

Looking at the myth that nicotine causes cancer (also a frequently asked question)

• People who smoke tobacco are known to have high rates of cancer. A common misperception is that it's the nicotine that causes the cancer. This myth makes using safer nicotine products a concern for people who are trying to quit smoking. Below we will debunk the junk science making those claims by showing you the studies, articles, and commentary by experts explaining why the cancer myth isn't true. You'll be surprised at the number of medical professionals who have been told this myth and haven't seen the science that proves the truth!

2015: Study Causing Myth Electronic cigarettes induce DNA strand breaks and cell death independently of nicotine in cell lines

• • Article about the study: E-cigarettes are NO better than regular smoking: Devices can 'cause cancer even when they're nicotine FREE'
• 2016: Study That Busts The Myth Exposure to Nicotine and Selected Toxicants in Cigarette Smokers Who Switched to Electronic Cigarettes: A Longitudinal Within-Subjects Observational Study
  • After switching from tobacco to e-cigarettes, nicotine exposure remains unchanged, while exposure to selected carcinogens and toxicants is substantially reduced.
  • Article about the study: This Study Is The Last Thing Anti-E-Cig Crusaders Want To See
    • The Roswell Park findings run counter to what lead author of a University of California, San Diego (UCSD) study, Jessica Wang-Rodriguez, told The Daily Mail.
    • The study found e-cigs are as effective as conventional cigarettes at delivering nicotine to the user, but e-cig users showed a decreased rate of exposure to specific carcinogens and toxins
    • The DCNF reported in December that not only were the cells used in the UCSD study “not completely comparable to cells within a living person,” but the dosage was comparable to someone smoking “for hours on end,” so it wasn’t representative of real world e-cig use. Further, the cell cultures already had “squamous cell carcinoma,” meaning the cells already had cancer.
    • "All this study is highlighting is the fact that exposing already cancerous cells to cigarette smoke, nicotine or vapor may accelerate cell death, but of course, only if you swim in it,” Paul Barnes of Facts Do Matter told The DCNF in December.
• 2013: Study That Busts The Myth Levels of selected carcinogens and toxicants in vapour (vapor) from electronic cigarettes
  • The aim of this study was to screen e-cigarette vapours (vapors) for content of four groups of potentially toxic and carcinogenic compounds: carbonyls, volatile organic compounds, nitrosamines and heavy metals.
  • The levels of the toxicants were 9-450 times lower than in cigarette smoke and were, in many cases, comparable with trace amounts found in the reference product (prescription nicotine inhaler).
  • Our findings are consistent with the idea that substituting tobacco cigarettes with e-cigarettes may substantially reduce exposure to selected tobacco-specific toxicants.

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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.

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.

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. 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.

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.

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.”

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.

More information on the confusion caused by this myth

• Please see our page on Nicotine Misinformation: Nicotine - Misperceptions, Misinformation, or Disinformation