Ditched the cigarette for a vape? Will it keep you away from cancer?

According to a new Australian review, nicotine-containing vapes are likely to cause lung and oral cancers. Researchers cautioned that a range of other diseases can be attributable to vaping, and it can no longer be considered a safer alternative to smoking.

Experts argue that there needs to be stronger enforcement of Australia's laws, with a crackdown on wrongly labelled, black-market vapes.

What does the review of evidence say?

Led by the University of New South Wales in Sydney, cancer researchers have examined reviews of evidence from animal studies, human case reports and laboratory research published between 2017 and 2025.

It is considered one of the most in-depth assessments to date of the potential cancer risk from nicotine e-cigarettes. On Tuesday (March 24), the review was published in the journal Carcinogenesis. It has been found that vaping is associated with these pre-carcinogenic changes.

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"Though smoking was once given the benefit of the doubt. The same should not now be accorded to vaping, given the strength of relevant carcinogenicity data," write study co-authors Freddy Sitas and Bernard Stewart of the University of New South Wales in Australia in a related commentary.

The team focused on studies that specifically examined e-cigarettes or compared people who vape with those who do not, excluding research involving dual users (who both vape and smoke) or studies comparing e-cigarettes with traditional smoking.

They also considered case reports of heavy vapers developing aggressive oral cancers, often in the absence or limited presence of common risk factors such as smoking or viral infection were absent or limited, including unusually severe disease in relatively young patients.

In one case, a 19-year-old man with an "extensive history of vaping" developed cancer in his oral cavity.

Stewart, a cancer researcher, said, "To our knowledge, this review is the most definitive determination that those who vape are at increased risk of cancer compared to those who don't."

What do researchers and experts say?

Freddy Sitas, lead author of the study, Associate Professor of epidemiology, said, "It took 100 years of emerging and growing evidence before the US Surgeon General recognised smoking as a cause of lung cancer in 1964," reported the Guardian.

A research fellow at the University of Otago’s Department of Public Health in New Zealand, Calvin Cochra noted: "We risk repeating that same fate with vaping if we don’t take emerging research and warning signs seriously."

“Every study like this should be considered seriously by policymakers, governments and health organisations. There is likely going to be no planting the flag moment where we can conclusively say vaping causes x,y,z types of cancer. That is years and most probably decades away.”

“This study is the first to assert that there is likely an increased cancer risk for people who vape, compared to people who do not vape," said a tobacco control researcher with the University of Sydney, Prof Becky Freeman.

"This information is particularly important for young people who have never smoked. Vaping is not a safe alternative to smoking for nonsmokers," the Guardian quoted him as saying.

What about nicotine-free vapes?

The review only considered nicotine-containing vapes, but experts quickly clarified that this does not mean nicotine-free vapes are safe alternatives.

In 2024, the federal government tightened laws so that both nicotine and non-nicotine vapes can legally be sold only in pharmacies, with the objective "to help people quit smoking or manage nicotine dependence."

"The inaccurate labelling of vapes was an 'ongoing problem,' said Alexander Larcombe, senior research fellow at Curtin University.

Larcombe, who did not contribute to the review, asserted, "Most black market vapes sold in Australia contain nicotine, although the labels are unlikely to indicate this."

He warned that nicotine-free e-cigarettes were "definitely not" safe to use. "They still contain a wide range of harmful substances that shouldn’t be inhaled," he added, according to News.

With inputs from agencies