Breast Cancer & E-Cigarettes: Is Vaping a Safer Alternative to Smoking?

Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.

Vaping and electronic cigarettes (also called e-cigs or vape pens) have long been touted as healthier alternatives to smoking. But how does vaping compare to traditional smoking, especially when it comes to breast cancer?

How Does Smoking Cause Breast Cancer?

Medical studies from the last twenty years agree that smoking is bad news when it comes to breast cancer. Smoking increases breast cancer recurrence, increases breast cancer mortality and is linked to poor prognosis (SOURCE). In addition, smoking between a woman’s first period and first pregnancy is particularly risky.

We know that smoking is a substantial risk factor for breast cancer. According to the National Cancer Institute at least 250 chemicals found in tobacco smoke are known to be harmful and at least 69 of those have been shown to cause cancer in general, not just breast cancer. We know chemicals from cigarette smoke reach the breast because those chemicals have been found in the breast fluid of female smokers and lactating women. Numerous carcinogenic chemicals found in cigarette smoke are known to induce mammary tumors in rats.

Vapor Smoke vs. Cigarette Smoke

So the question is, does vapor smoke have the same cancer-causing properties as cigarette smoke?

Smoke from e-cigarettes is different from cigarette smoke. While cigarette smoke results from the burning of tobacco and other cigarette additives, e-cigs create “smoke” by heating a liquid, creating a chemical-filled aerosol which is then inhaled. Since they don’t contain combustion byproducts (many of which are carcinogenic), e-cigarettes do offer an improvement over traditional cigarettes in this area. According to a FDA-sponsored report, “there is substantial evidence that except for nicotine, under typical conditions of use, exposure to potentially toxic substances from e-cigarettes is significantly lower compared with combustible tobacco cigarettes.”

But what’s in vapor smoke exactly? Here’s the thing, we don’t know. Because e-cigarettes only recently came under FDA regulation in 2016, many e-cig manufacturers haven’t registered and submitted product data and only preliminary regulations have been created. We know at a minimum that most e-cigs contain tobacco-extracted nicotine, a base (often propylene glycol), and most contain colors, flavorings, and other additives.

Early studies are a bit alarming, though. In February, scientists from Johns Hopkins Bloomberg School of Public Health studied devices from 56 users and found significant and “potentially unsafe levels of lead, chromium, manganese and/or nickel” that were leaking from some e-cig heating coils. In addition, acetaldehyde, a known human carcinogen has also been found in e-cigarette smoke according to a 2017 study

And in 2015, the New England Journal of Medicine reported that multiple samples of e-cigarette vapor contained formaldehyde-releasing agents, thought to be a byproduct of the vaporization of the propylene glycol e-liquid base. Researchers stated,

“If we assume that inhaling formaldehyde-releasing agents carries the same risk per unit of formaldehyde as the risk associated with inhaling gaseous formaldehyde, then long-term vaping is associated with an incremental lifetime cancer risk…. 5 times as high… or even 15 times as high… as the risk associated with long-term smoking.”

Some known e-cig flavorings are approved for food usage but once aerosolized, have either unknown or negative health effects. Diacetyl, for instance, is a buttery-flavored food additive known to cause the lung disease “popcorn lung” when it is inhaled. To make matters worse, many retailers of e-cigarettes also mix custom “e-liquids,” making ingredients and possible side effects more difficult to track and regulate.

A study published in January found that e-cig smoke caused DNA damage in mice and created mutations in lungs, bladders and hearts of mice. While it is a preliminary study, the researchers point out that the results likely point to similar effects in humans.

The one chemical which cigarettes and vaping tools seem to universally have in common is nicotine. As noted earlier, nicotine is one of the many cancer-causing chemicals found in traditional cigarettes and is also capable of transferring directly to breast tissue. The chemical nicotine is linked to resistance to cancer-treatment drugs, and tobacco, which nicotine is derived from, is a known carcinogen.

The Bottom Line

For current smokers thinking of switching to vaping, e-cigarettes could be a good thing. Based on an FDA-sponsored analysis of over 800 studies, e-cigarettes still contain toxins, but less overall than conventional smoking. Existing smokers would benefit from switching to e-cigarettes from traditional cigarettes, especially as a path to quitting all forms of smoking.

E-cigarettes come in a variety of styles, including ones that look like pens, bracelets, USB sticks and other common items. (Photo courtesy FDA)

For non-smokers, however, vaping is a bad thing. According to the FDA report, e-cigarettes:

  • increase second-hand exposure to particulates and nicotine
  • increase fatal poisonings
  • increase the likelihood of smoking conventional cigarettes
  • increase dependency on e-cigarettes
  • increase exposure to numerous toxic substances
  • increase coughing and wheezing and exacerbate asthma

According to the U.S. Department of Health and Human Services, “In 2015, more than 3 million youth in middle and high school, including about 1 of every 6 high school students, used e-cigarettes in the past month. More than a quarter of youth in middle and high school have tried e-cigarettes.” These statistics are particularly troubling, since teen e-cigarette users are 4-7 times as likely to begin smoking traditional cigarettes (SOURCE). And we know smoking conventional tobacco products substantially raises the risk for breast cancer.

As we visit schools through our breast health programs, we will aim to educate students about the risks, both known and unknown, of vaping and encourage healthier lifestyle choices. With up-to-date information, students will be empowered to make educated choices to improve their overall health and breast health for many years to come.