Smoking and Vaping Together Increases Lung Cancer Risk More Than Smoking Alone

People who both smoke cigarettes and use electronic cigarettes (e-cigarettes, e-cigs, or vapes) are 4 times more likely to develop lung cancer than people who only smoke cigarettes, new research finds.

The study found that combining both cigarette smoking and vaping is much more common in people with lung cancer. In fact, people with lung cancer were 8 times more likely to both smoke and vape than people without lung cancer. The researchers also found that both men and women who smoked and vaped had an increased risk of lung cancer. The study was published in the Journal of Oncology Research and Therapy.

“My takeaway from this study is that patients who smoke and vape really need to make efforts to quit both, because it’s very clear that both are harmful to the lungs. And both, particularly in combination, increase the risk of developing lung cancer. Frankly, this is at a degree much higher than I would have expected,” said Ryan Gentzler, MD, an American Society of Clinical Oncology (ASCO) expert and an associate professor in hematology and oncology at the University of Virginia Comprehensive Cancer Center.

Effects of vaping: Misconceptions and facts

Misconception: Many people believe vaping doesn’t carry the same health risks as cigarette smoking because e-cigarettes do not contain tobacco.

Fact: Most e-cigarettes are classified as “tobacco products.” This is because they contain nicotine, the chemical found naturally in tobacco plants that makes these products so addictive.

Misconception: Some people also think vaping is safer than smoking because they believe the vapor from e-cigarettes does not contain the same harmful chemicals as smoke.

Fact: Vaping produces an aerosol made up of tiny particles, including chemicals known to be harmful and cause serious health problems such as cancer.

Vaping health risks

Short-term health effects of vaping include coughing and shortness of breath. But vaping can also cause serious long-term health problems, including lung disease, heart disease, and cancer.

“Anything that is consumed repetitively and causes damage to organs in the body is going to lead to chronic inflammation and damage the cells,” said Dr. Gentzler. “And that chronic damage and inflammation over time can lead to the development of cancer.”

Dangers of smoking and vaping at the same time

Using both cigarettes and e-cigarettes at the same time is known as “dual use.” The dual use of e-cigarettes and tobacco cigarettes can lead to significant health risks.

For people who don't already smoke, vaping makes it more likely that they will start using other, more harmful tobacco products, such as cigarettes. Decades of research show that smoking cigarettes increases lung cancer risk. However, Dr. Gentzler notes that vaping is still relatively new. While this recent study makes a clear link between vaping and lung cancer risk, more long-term research is needed. It’s especially important for researchers to learn more about how vaping alone may impact cancer risk.

The American Cancer Society recommends people who use any tobacco product, including e-cigarettes, to stop. Quitting as soon as possible can reduce the risk of ongoing health problems and nicotine addiction. 

How to quit vaping and smoking

First, know it’s never too late to stop vaping or smoking. But the sooner you quit, the more you can reduce your cancer risk.

Next, remember there isn’t a “right” way to quit. And quitting can be hard. However, here are some steps that may be helpful:

1. Discuss quitting with your doctor. It's best to talk with your doctor about a plan that's right for you. Talking to a pharmacist might be helpful, too. Be sure to check with your insurance company to see what quit programs and products might be covered.
2. Schedule a “Quit Day.” Your “Quit Day” can be a day that has special meaning to you. Or, it can be a day that’s part of a bigger movement to stop smoking. For example, you may consider joining the Great American Smokeout on the third Thursday in November as your first step.
3. Choose a quit method. Some people may benefit from following a quit program. One example is the American Cancer Society’s Empowered to Quit Program. Other people might prefer using medications to stop smoking. Often combining a quit program with prescription medicines and counseling or a support group can work better than using just one method. Talk with your doctor about what they recommend based on your preferences and health history.
4. Find a “quit buddy.” A quit buddy is someone who is also trying to stop smoking. “Having another person who’s working through this with you, someone to talk to about the temptations and struggles, can really make a big difference in helping you quit,” said Dr. Gentzler. Ask your doctor about support groups available nearby.

Dr. Gentzler is a member of ASCO’s Patient Information Editorial Board.