SYDNEY: A major multidisciplinary review led by researchers at the University of New South Wales (UNSW) Sydney has concluded that nicotine-based vaping is likely to contribute to both oral cancer and lung cancer, marking one of the strongest scientific assessments to date linking e-cigarettes with cancer-related harm.
The findings, published in the peer-reviewed journal Carcinogenesis, were led by Adjunct Professor Bernard Stewart AM, a UNSW cancer researcher known for his work on cancers associated with environmental pollutants and lifestyle factors. The review involved experts from multiple Australian institutions, including The University of Queensland, Flinders University, The University of Sydney, as well as clinicians from Royal North Shore Hospital, The Prince Charles Hospital, and Sunshine Coast University Hospital.
The review analyzed evidence from clinical studies, laboratory investigations, mechanistic research, and animal experiments to assess whether vaping contributes to cancer development.
“Considering all the findings—from clinical monitoring, animal studies and mechanistic data—e-cigarettes are likely to cause lung cancer and oral cancer,” said Adjunct Professor Bernard Stewart AM.
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Researchers described the review as the “most definitive determination” currently available linking vaping with increased cancer risk among users compared to non-users.
According to the researchers, e-cigarette aerosols contain harmful compounds including volatile organic chemicals and metals released from device heating coils. These substances may trigger DNA damage, oxidative stress, chronic inflammation, and cellular disruption—all biological processes strongly associated with cancer formation.
The study also included experiments on mice, which demonstrated that exposure to vaping compounds caused cellular damage and disrupted biological pathways linked to cancer progression.
Because vaping products have only been widely used for around two decades, researchers noted that long-term epidemiological data remains limited compared to conventional smoking, which has been studied for nearly a century. This lack of long-term evidence has historically created uncertainty among healthcare professionals advising patients about vaping risks.
However, the review argues that current mechanistic and experimental evidence is now strong enough to raise major clinical concerns.
“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,” Prof. Stewart said.
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The report also highlights the importance of early recognition of oral cancer symptoms, especially among individuals with a history of vaping or smoking.
Common warning signs may include:
- Persistent mouth or throat soreness
- Ear or jaw pain
- Difficulty swallowing or chewing
- Unexplained weight loss
- Fatigue
- Swollen lymph nodes
- Hoarseness or voice changes
- Persistent cough
- Numbness
- Lumps in the head or neck region
Experts warn that even painless lumps may require urgent evaluation.
Susan Cotten, CEO of Oral Cancer Consulting and creator of The Cotten Method, emphasized the importance of prompt specialist referral when symptoms persist.
“They know to reach out to their dentist, or I really encourage making an appointment with an ENT, ear, nose, and throat, because they're the specialists of the head and neck,” Cotten said.
Related story: Vape Tongue: Top dentist warns of disturbing new condition caused by vaping
She noted that symptoms lasting longer than two weeks should be professionally investigated.
The review underscores the growing importance of comprehensive oral cancer screening in dental practice, particularly for patients who vape.
Screening typically begins with a detailed review of a patient’s medical and dental history, including smoking, vaping, or smokeless tobacco use. Clinicians then perform both extraoral and intraoral examinations to detect abnormalities.
According to Cotten, structured oral cancer risk assessment forms can help clinicians collect more complete patient information and strengthen early detection efforts.
Examinations may include assessment of the temporomandibular joint, lymph nodes, salivary glands, oral tissues, tongue, tonsils, uvula, throat, and surrounding structures for changes in symmetry, texture, swelling, discoloration, or soreness.
The findings are expected to intensify global debate over the long-term safety of vaping and could influence future oral health guidance, preventive dentistry strategies, and public health messaging worldwide.
References
University of New South Wales (UNSW) Newsroom — “Vaping Likely to Cause Cancer, New Findings,” published March 2026 by Stewart B. et al. Published in Carcinogenesis journal.
Susan Cotten, “The Cotten Method of Screening,” published by RDH Magazine on April 22, 2024.
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