New Evidence on Vaping Risks: What Australians Need to Know

Recent peer-reviewed research, including studies funded by the U.S. National Institutes of Health (NIH) and evidence reviews led by Australian researchers, has added to growing concerns about the health effects of e-cigarette use (vaping). These studies suggest that vaping may damage blood vessels, irritate the respiratory system, and produce biological changes associated with increased cancer risk.

While researchers continue to investigate the long-term health consequences of vaping, the latest evidence provides important information for Australian adults and people who vapes, parents, healthcare professionals, and policymakers. Understanding both the known risks and the remaining uncertainties can help people make informed decisions about vaping, smoking cessation, and nicotine use.

Why This Emerging Evidence Matters

In May 2024, researchers from the University of New South Wales (UNSW) published a comprehensive evidence review examining the potential cancer risks associated with e-cigarette use. Based on laboratory studies, animal research, and human biomarker data, the review concluded that e-cigarette aerosols are likely carcinogenic to tissues in the lung and mouth. Importantly, this conclusion reflects biological evidence and cancer-related mechanisms rather than direct proof from long-term human population studies.

Around the same period, NIH-funded research identified measurable changes in vascular function among people who vape. These findings included endothelial dysfunction, inflammation, and other early indicators associated with cardiovascular disease. Although researchers have not yet determined the exact long-term health impact of these changes, they are recognised risk factors for heart and blood vessel disease.

Major Australian health organisations, including the Royal Australian College of General Practitioners (RACGP) and Cancer Institute NSW, have highlighted these findings as part of ongoing public health discussions. Together, the available evidence suggests that vaping should not be considered harmless and that potential long-term risks deserve serious attention.

Also READ - Why Quitting Smoking Strengthens Your Overall Wellness Strategy

Understanding What the Research Shows

Evidence of Potential Cancer Risk

The UNSW-led review evaluated several categories of scientific evidence, including cell-based laboratory experiments, animal studies, and human biomarker research. Researchers identified multiple mechanisms through which vaping may contribute to cancer development, including:

• DNA damage in exposed cells.

• Exposure to chemicals known or suspected to be carcinogenic.

• Oxidative stress and chronic inflammation.

• Biological changes associated with tumour development.

It is important to understand what the term “likely carcinogenic” means in this context.

Researchers have identified strong biological evidence suggesting cancer-causing potential, but they do not yet have decades of human data showing exactly how vaping affects cancer rates over time. This distinction is important because many cancers develop after years or decades of exposure.

Cardiovascular Health Concerns

Several NIH-supported studies have reported that vaping can negatively affect the cardiovascular system. Researchers observed:

• Impaired endothelial function.

• Increased vascular inflammation.

• Temporary increases in blood pressure.

• Biological changes associated with atherosclerosis (plaque buildup in arteries).

These findings are concerning because endothelial dysfunction is widely recognised as an early step in the development of cardiovascular disease. However, researchers caution that more long-term studies are needed to determine the exact level of cardiovascular risk associated with prolonged vaping.

Respiratory Effects

Evidence consistently shows that vaping can irritate and inflame the airways. Reported effects include:

• Increased airway inflammation.

• Reduced lung function markers.

• Greater susceptibility to respiratory infections.

• Persistent cough and respiratory symptoms in some users.

Healthcare professionals also continue to monitor rare but serious lung injuries associated with vaping. Although the 2019 EVALI outbreak was primarily linked to vitamin E acetate in illicit THC products, respiratory complications related to vaping remain an important area of clinical concern.

What Experts Agree On

Despite ongoing debates about the role of vaping in smoking cessation, there is broad agreement among public health experts on several key points:

• Vaping is not risk-free.

• Vape aerosols contain potentially harmful chemicals.

• Nicotine is addictive.

• Youth vaping remains a significant public health concern.

• More long-term research is needed to fully understand disease risks.

Where experts differ is primarily in how vaping should be used within smoking cessation strategies. Some clinicians view vaping as a potential harm-reduction tool for adults who have been unable to quit smoking through approved methods. Others argue that established therapies, such as nicotine replacement therapy and prescription medications, should remain the preferred first-line options.

Understanding these differing perspectives requires recognising the distinction between evidence showing biological harm and evidence demonstrating long-term disease outcomes. Both forms of evidence contribute to public health decision-making, but they provide different levels of certainty.

Who Is at Greatest Risk?

Although vaping may affect anyone who uses e-cigarettes, current evidence suggests that some groups face greater potential harm.

Young People and Adolescents

Young people are particularly vulnerable because the brain continues developing into the mid-20s. Exposure to nicotine during this period can affect attention, learning, mood regulation, and impulse control. Early nicotine use also increases the likelihood of long-term dependence and prolonged exposure to vaping-related toxicants.

Dual Users (People Who Smoke and Vape)

Individuals who both smoke cigarettes and vape may face increased health risks because they continue to be exposed to harmful chemicals from combustible tobacco while also inhaling vape aerosols. Research suggests that dual use may reduce some potential harm-reduction benefits associated with completely switching away from cigarettes.

Former Smokers Who Continue Vaping

Some ex-smokers successfully quit cigarettes but continue using e-cigarettes for extended periods. While this may reduce exposure to many tobacco-related toxins, long-term vaping still exposes users to substances that may affect respiratory, cardiovascular, and oral health.

Healthcare professionals generally encourage a long-term plan to become nicotine-free where possible.

Pregnant People and Children

Pregnant individuals should avoid nicotine exposure whenever possible. Nicotine can cross the placenta and may affect fetal development, including brain and lung development.

Children exposed to second-hand vape aerosol may also be exposed to nicotine, ultrafine particles, and other potentially harmful substances.

People with Existing Heart or Lung Conditions

Individuals with asthma, chronic obstructive pulmonary disease (COPD), cardiovascular disease, hypertension, or other respiratory and vascular conditions may experience worsening symptoms from vaping-related inflammation and irritation. Anyone with pre-existing health conditions should discuss vaping with a qualified healthcare professional.

Practical Guidance: What to Do If You Vape

Current evidence suggests that avoiding or stopping vaping is the most effective way to eliminate exposure to vape-related toxicants. For people who currently vape, the following evidence-based strategies may help reduce risk.

Consider Quitting or Reducing Use

Reducing vaping may lower cumulative exposure to potentially harmful chemicals. However, complete cessation provides the greatest reduction in health risk.

Use Proven Smoking and Nicotine-Cessation Support

Australian health authorities recommend evidence-based quitting approaches, including:

• Nicotine replacement therapy (NRT), such as patches, gum, lozenges, inhalators, and sprays.

• Support from a GP or healthcare professional.

• Behavioural counselling and structured quit plans.

• Quitline (13 78 48) and other Australian cessation services.

Combining behavioural support with approved cessation treatments generally produces higher quit rates than attempting to quit without assistance.

Avoid Illicit or Modified Devices

Unregulated products, modified devices, and homemade e-liquids may contain unknown contaminants or operate at temperatures that increase toxic chemical production. These products may present additional health risks beyond those associated with regulated devices.

Avoid Long-Term Dual Use

For smokers who have switched to vaping as part of a smoking-cessation strategy, experts generally recommend working toward complete cessation of both smoking and vaping.

Continuing to use both products may prolong exposure to harmful substances and reduce

overall health benefits.

Monitor Your Health

Speak with a healthcare professional if you experience:

• Persistent cough.

• Shortness of breath.

• Chest discomfort.

• Recurrent respiratory infections.

• Unexplained weight loss.

• New or worsening cardiovascular symptoms.

Seek Urgent Medical Attention If You Experience:

• Sudden severe breathing difficulty.

• Severe chest pain.

• Fainting or collapse.

• Rapidly worsening respiratory symptoms.

• High fever with breathing problems.

• Signs of a severe allergic reaction, including facial swelling or difficulty breathing.

Policy and Public Health Implications for Australia

The growing body of evidence surrounding vaping-related harms has important implications for public health policy in Australia.

Many public health experts support measures such as:

• Stronger enforcement of age restrictions.

• Enhanced product safety standards.

• Restrictions on marketing that targets young people.

• Greater oversight of flavourings that may appeal to adolescents.

• Improved public education campaigns regarding vaping risks.

Healthcare systems may also need to update clinical guidance as new evidence emerges regarding cardiovascular, respiratory, and potential cancer-related effects. At the same time, researchers continue to call for large-scale, long-term studies that can better quantify disease risks and identify the factors that contribute most to harm.

Frequently Asked Questions

Does Nicotine Cause Cancer?

Nicotine itself is not currently classified as a direct human carcinogen. However, it is highly addictive and may influence biological processes involved in cell growth and tumour development. Most concerns about cancer risk from vaping relate to other chemicals found in e-cigarette aerosols and the biological effects observed in laboratory and biomarker studies.

What Are the Long-Term Effects of Vaping?

Researchers are still investigating the long-term health consequences of vaping. Current

evidence indicates that vaping can affect blood vessel function, promote airway inflammation, and cause biological changes associated with DNA damage. However, the exact long-term risks for cancer, heart disease, and chronic lung disease remain under investigation.

Is Vaping Safer Than Smoking?

Most experts agree that vaping exposes users to fewer toxic chemicals than combustible tobacco cigarettes. However, "less harmful" does not mean "safe." Vaping still carries health risks, particularly for young people, pregnant individuals, and people who have never smoked.

Can Vaping Help People Quit Smoking?

Some clinical trials have found that vaping may help certain smokers quit when used alongside behavioural support. However, Australian healthcare guidelines generally recommend approved smoking-cessation therapies, such as nicotine replacement therapy and prescription medications, before considering vaping. Any use of vaping for smoking cessation should occur under appropriate clinical guidance and as part of a plan to eventually stop all nicotine use.

Do Different Vape Products Carry Different Risks?

Yes. Risk can vary depending on device design, power settings, coil materials, e-liquid ingredients, flavourings, nicotine concentration, and individual usage patterns. Researchers continue to study how these differences influence exposure to harmful chemicals and long-term health outcomes.

Sources and Further Reading

Readers seeking additional information should consult primary research papers, systematic reviews, and guidance from recognised health organisations. Useful resources include publications from UNSW, NIH-funded research programmes, the Royal Australian College of

General Practitioners (RACGP), Cancer Institute NSW, the Australian Department of Health, and national smoking cessation services such as Quitline.

Healthcare professionals, journalists, and policymakers should review original research publications whenever possible to understand study methods, limitations, and the strength of the available evidence.

Conclusion

The latest research strengthens concerns that vaping is not harmless. Studies have identified biological markers associated with cancer risk, measurable effects on blood vessel health, and evidence of respiratory irritation and inflammation. While significant questions remain about the precise long-term disease burden, the overall direction of the evidence points toward meaningful health risks.

For Australians who vape—particularly young people, pregnant individuals, dual users, and those with existing heart or lung disease—the most prudent approach is to minimise exposure and seek evidence-based support for quitting.

Healthcare professionals, researchers, and policymakers should continue monitoring emerging evidence while supporting strategies that reduce nicotine dependence and protect public health.

References

1. Cleveland Clinic. "Endothelium: What It Is, Function & Health Conditions." Explains the role of the endothelium (the inner lining of blood vessels) and how endothelial dysfunction contributes to cardiovascular disease. Available at: https://my.clevelandclinic.org/health/body/23471-endothelium

2. American Lung Association. "EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury)." Provides information about vaping-related lung injury, symptoms, risk factors, and ongoing public health concerns associated with e-cigarette use. Available at: https://www.lung.org/lung-health-diseases/lung-disease-lookup/evali

3. American Cancer Society. "Why People Start Using Tobacco." Discusses nicotine addiction, tobacco use behaviors, and factors that influence the initiation and continuation of nicotine-containing products, including vaping. Available at: https://www.cancer.org/cancer/risk-prevention/tobacco/guide-quitting-smoking/why-people-start-using-tobacco.html

4. Medical News Today. "What Is Nicotine?" Reviews the health effects of nicotine, including its impact on the brain, addiction potential, and relationship to smoking and vaping products. Available at: https://www.medicalnewstoday.com/articles/240820

Medical Disclaimer

This article is intended for educational and informational purposes only and should not be considered medical advice. Vaping-related research continues to evolve, and individual health risks may vary. Readers should consult a qualified healthcare professional for personalised medical advice, diagnosis, or treatment. If you are experiencing symptoms that may be related to vaping, seek medical attention promptly.