E-Cigarettes and Cancer Risk

Cancer Prev Res (Phila). 2020 Feb;13(2):137-144. doi: 10.1158/1940-6207.CAPR-19-0346. Epub 2019 Oct 16.


From the time of their introduction, the popularity of e-cigarettes (electronic nicotine-delivery systems) has been rising. This trend may reflect the general belief that e-cigarettes are a less hazardous alternative to combustible cigarettes. However, the potential cancer-related effects of increased activation of the sympathoadrenal system induced by the inhalation of nicotine, the primary component of the e-cigarettes, are completely overlooked. Therefore, the aim of this review is to describe mechanisms that may connect the use of e-cigarettes and an increased risk for cancer development, as well as their stimulatory effect on cancer progression. Available preclinical data indicate that activation of the sympathetic nervous system by nicotine inhaled from e-cigarettes may stimulate cancer development and growth by several mechanisms. This issue might be especially important for oncological patients as they may have the misconception that compared with combustible cigarettes, e-cigarettes represent a risk-free alternative.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Inhalation
  • Disease Progression
  • Electronic Nicotine Delivery Systems*
  • Heating / adverse effects
  • Heating / instrumentation
  • Humans
  • Neoplasms / epidemiology*
  • Neoplasms / etiology
  • Neoplasms / prevention & control
  • Nicotine / administration & dosage
  • Nicotine / adverse effects*
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / therapy*
  • Smoking Cessation / methods
  • Sympathoadrenal System / drug effects
  • Tobacco Products / adverse effects


  • Nicotine