Does vaping cause cancer? Is it actually better than smoking?

Researchers in Australia have recently claimed that vaping can cause mouth and lung cancer. A story that was quickly picked up by outlets, including the Daily Mail, reigniting media discussion about the risks associated with vaping in general. The claims come from a risk assessment by Bernard W. Stewart et al., published in Carcinogenesis, which looked at the theoretical harm of e-cigarettes and vaping across studies published between 2017 and 2025.

The paper’s limitations didn’t stop it from making headlines – and those headlines did what headlines tend to do, leaving readers with the impression that vaping is no safer than smoking.

We’re all for reviewing the health effects of vaping, as it’s an important conversation and one we actively engage with. But research like this, and the media that covers it, come with a responsibility to present evidence fairly, in proper context, and with proper caveats. This paper, in our view, does none of those things particularly well, given expert reactions on the paper posted by SMC.

At Totally Wicked, we are dedicated to accurate, evidence-based information on vaping. We won’t stay quiet when we think the science is being misrepresented, especially when those misrepresentations end up in national headlines.

What the article says about vaping

The paper’s core claims, as represented in the SMC piece, are:

• Vaping exposes users to carcinogenic chemicals and causes DNA damage.
• These causes represent plausible pathways to cancer.
• Case reports of vapers developing cancer are cited as supporting evidence.
• The overall conclusion is that vaping has transitioned from “needs more research” to “there are clear and demonstrable cancer pathways”.

So what does the Stewart et al. paper really claim? Essentially, that vaping exposes people to carcinogenic chemicals, causes biological changes like DNA damage, and these could be pathways to cancer. The authors also point to individual case reports of vapers developing cancer, and imply that nicotine itself may play a role in causing cancer. Despite Cancer Research UK arguing against this fact.

How this information is misrepresented

We’re not alone in this. A number of independent experts, responding to the paper through the Science Media Centre, raised many of the same concerns on the matter. Professors and researchers from institutions including UCL, Queen Mary University of London, University of Cambridge, and Newcastle University all questioned the paper’s methodology, its selective use of evidence, and the conclusions it draws from that.

Here are the most significant issues they (and we) think you should know about.

Lack of comparison to smoking

Here’s where it gets really important. The people most likely to be reading headlines about this research aren’t scientists or lecturers, they’re smokers who are considering making the switch to vaping, or vapers who are wondering whether they’ve made the right choice. When a study like this lands in the Daily Mail without the proper context, those are the people it affects the most.

And the context that’s missing here is hard to ignore. Stewart et al. didn't compare vapers to smokers, which is something the authors acknowledge early on. But if you’re assessing whether vaping poses a cancer risk, without comparing it to the thing it’s designed to replace, the conclusions you can draw are very limited.

The study identifies the presence of harmful chemicals in vaping aerosol, which isn’t new information, but without a meaningful baseline for comparison, it’s very difficult to know what to do with that finding.

Yes, vaping aerosol contains some harmful substances – no credible voice in this debate is arguing otherwise. But the question that actually matters to the millions of smokers weighing up their options is: compared to smoking, how harmful is it? That question, according to experts, is largely left unanswered. And that’s a significant gap in a paper that draws such far-reaching conclusions.

The concern isn’t about intent, it’s much more about impact. When research with these kinds of limitations gets picked up by mainstream media without those caveats attached, it shapes the decisions of real people. We know better than most that fear of vaping already leads some smokers to stick with cigarettes rather than switch. Poorly contextualised research, however well-meaning, can make that problem worse.

The missing comparison to smokers isn’t the only issue with this paper. There are several other points worth addressing.

Confirmation biases

The paper cites individual cases of vapers developing cancer as evidence of vaping’s risks. But dig a little deeper, and most of those cases involve long-term smokers who had only recently made the switch to vaping. Pointing to those cases as evidence of vaping’s dangers, without accounting for potentially decades of prior smoking, doesn’t really hold up.

You can't hurt yourself outside, then walk into a soft play area and use your injury as evidence that soft play areas are dangerous. It didn't happen under the same conditions you're referencing, and the failure to provide the full picture results in a wild misrepresentation of the findings.

Sure, you can absolutely get injured in a soft play area, but the risk is much less than throwing yourself around on the tarmac outside. You're not exposed to dangers in the same quantity.

Extreme lab conditions

A number of the harmful chemical levels reported in the paper come from lab studies where e-liquid was heated at temperatures far beyond anything a real person would ever vape at. Those aren’t real-world conditions, but the findings are presented as though they are, with no meaningful caveat attached.

This creates a real use-case problem. Testing a product at conditions far beyond how it’s actually used, and then presenting those results as a genuine danger, doesn’t really hold up. It’s a bit like saying ammonia-based cleaning solutions are dangerous because they can release toxic gas when boiled – technically true, but not really relevant to someone using it to clean their kitchen within its noted use case.

There are risks, sure, but they need to be understood in the right context. Stripping that context out doesn’t inform people; it just worries them.

Sensitive chemical detection

There’s also a broader problem with how the paper handles chemical detection. Modern testing methods are incredibly sensitive, enough to find trace amounts of potentially harmful substances in all kinds of everyday things.

The paper spots the presence of harmful chemicals in vaping aerosol, which sounds alarming, but doesn’t seriously engage with whether the doses detected are anywhere near levels that would actually cause harm in humans. In toxicology, the dose makes the poison. That principle feels very absent here.

Taken individually, any one of these issues might be considered a limitation. Taken together, they paint a picture of a paper whose conclusions run significantly ahead of what its evidence can reliably support.

The facts – Vaping is still much less harmful than smoking

It’s worth being clear on something that gets lost in coverage like this: vaping is not risk-free, but it is considerably less harmful than smoking. This isn’t our opinion – it’s the position of the NHS.

Cigarettes release thousands of chemicals when they burn, up to 70 of which are known to cause cancer. The vast majority of those (including tar and carbon monoxide) just aren’t present in vaping aerosol.

People who switch completely from smoking to vaping have meaningfully reduced exposure to the toxins linked to cancer, lung disease, and heart disease. That’s a significant difference, and one this paper does very little to acknowledge, according to experts.

On nicotine specifically, the NHS is unambiguous and aligns with Cancer Research UK’s findings. It’s addictive, yes. Carcinogenic? No. Nicotine has been used safely for years in stop smoking medicines, and it is not classified as a sole cause of cancer, lung disease, or heart disease.

For the full picture, the NHS has a solid breakdown of vaping myths and the facts.

Conclusion

None of this is about attacking the researchers behind this paper, or the media – scrutiny is part of how science works. Our concern is when research with significant limitations gets presented as fact, it creates confusion where clarity matters the most.

Vaping isn’t without risk. Nobody credible is claiming otherwise. But the evidence consistently shows that for smokers looking to quit, it remains considerably less harmful than continuing to smoke – and that’s not something that should get lost in the noise.

We’re not here to dismiss concerns about vaping. We’re here to make sure those concerns are proportionate, properly evidenced, and presented in a way that actually helps people make informed decisions about their health.

Sources

1. https://www.dailymail.co.uk/health/article-15690637/Vaping-linked-lung-mouth-cancer-major-study-experts-warn-NOT-safer-smoking.html
2. https://www.sciencemediacentre.org/expert-reaction-to-qualitative-risk-assessment-on-the-carcinogenicity-of-e-cigarettes/
3. https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/is-vaping-harmful
4. https://www.nhs.uk/better-health/quit-smoking/ready-to-quit-smoking/vaping-to-quit-smoking/vaping-myths-and-the-facts/