What is the risk of oropharyngeal cancer from nicotine (nicotine) vaping?

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Last updated: March 7, 2025View editorial policy

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From the Guidelines

The risk of oropharyngeal cancer from nicotine vaping is uncertain, but it is likely lower than from traditional smoking, and complete cessation of all tobacco and nicotine products is the safest option to minimize this risk. While vaping eliminates the combustion process that creates many carcinogens in cigarette smoke, e-cigarette aerosols still contain some potentially harmful chemicals including formaldehyde, acetaldehyde, and acrolein that may damage cells in the throat and mouth 1. Nicotine itself is not considered a direct carcinogen but may promote tumor growth. The long-term cancer risks of vaping remain uncertain as e-cigarettes have only been widely used for about 15 years, which is insufficient time to fully assess cancer outcomes that typically develop over decades. Key factors to consider include:

  • The primary screening test for oral cancer is a systematic clinical examination of the oral cavity, which should include a visual inspection and palpation of the regional lymph nodes, tongue, and floor of the mouth 1.
  • Oropharyngeal cancer is difficult to visualize and is usually located at the base of the tongue, the soft palate, the tonsils, and the side and back walls of the throat.
  • Regular dental checkups that include oral cancer screenings are recommended for early detection, especially for those with a history of smoking or vaping.
  • The USPSTF recommends that clinicians screen all adults for tobacco use, recommend against tobacco use, and provide tobacco cessation interventions for those who use tobacco products 1. People who vape should be aware that while it may be less harmful than smoking, it is not risk-free, and those concerned about oropharyngeal cancer risk should consider complete cessation of all tobacco and nicotine products as the safest option.

From the Research

Oropharyngeal Cancer Risk from Nicotine Vaping

  • The risk of oropharyngeal cancer from nicotine vaping is not directly addressed in the provided studies, but some studies discuss the potential cancer risk associated with e-cigarette use 2, 3.
  • A study published in 2023 suggests that e-cigarette use may contain potentially harmful chemicals that can damage DNA and lead to cancer, but the long-term cancer risk remains uncertain 2.
  • Another study from 2015 reviews the evidence that nicotine is involved in cancer development and suggests that it may cause aggravation and recurrence of the disease 3.
  • A study published in 2022 found that patients with oral cavity and oropharyngeal cancer showed the greatest dependence on nicotine, but it does not directly address the risk of oropharyngeal cancer from nicotine vaping 4.
  • A 2021 study discusses the need to balance the risks and benefits of e-cigarettes, including the potential for e-cigarettes to assist smokers in quitting smoking, but it does not provide direct evidence on the risk of oropharyngeal cancer from nicotine vaping 5.

Related Health Risks

  • E-cigarette use may contain carcinogenic chemicals that could increase the risk of lung and bladder cancer in humans 2.
  • Nicotine can affect several important steps in the development of cancer and may cause aggravation and recurrence of the disease 3.
  • Tobacco-specific N-nitrosamines (TSNA) may be formed from nicotine in the body and contribute to tobacco-related cancer 3.

Limitations and Future Research

  • The provided studies do not provide conclusive evidence on the risk of oropharyngeal cancer from nicotine vaping 2, 3.
  • More research is needed to fully understand the potential risks and benefits of e-cigarettes, including the risk of oropharyngeal cancer from nicotine vaping 2, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Motivation to smoking cessation in head and neck cancer and dysplasia patients in confrontation with the attitudes of otorhinolaryngologists in delivering anti-smoking therapies.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2022

Research

Balancing Consideration of the Risks and Benefits of E-Cigarettes.

American journal of public health, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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