• Posted July 30, 2026

Vaping Is Likely Reshaping The Future Of Cancer In The US, Study Argues

E-cigarettes could be reshaping the future of cancer in the United States, by offering people a less-toxic option than smoking, a new study argues.

Smokers are increasingly switching to vaping and other forms of nicotine use, researchers reported July 27 in the journal JNCI Cancer Spectrum.

They’re also sticking with their vapes, rather than swapping back and forth with tobacco cigarettes, researchers found.

“Our results show that exclusive cigarette use is being replaced by exclusive use of other combustible products, mainly e-cigarettes, especially among young adults,” said lead researcher Kenneth Michael Cummings, in a news release.

"As cigarette smoking continues to decline, it's important to understand what is replacing it,” Cummings said. “If younger adults continue moving away from combustible tobacco, we should be looking at substantially fewer smoking-related cancers several decades from now." He is a professor of psychiatry and behavioral sciences at the Medical University of South Carolina.

For the new study, researchers analyzed data from a federal health survey collected between 2015 and 2023.

“We selected 2015 as the starting point because that is when electronic cigarettes started to gain popularity,” explained Cummings.

Results showed that tobacco cigarette smoking declined across nearly every age group, with the steepest declines among young adults ages 18 to 34.

At the same time, the exclusive use of other nicotine products increased, driven largely by e-cigarettes, researchers said.

Dual use — smoking and using e-cigarettes — was surprisingly uncommon, reported by only 2% to 3% of adults, researchers found.

“There’s this expectation that as cigarette smoking declines, it would be because more people are using both cigarettes and e-cigarettes,” Cummings said. “Instead, dual use stayed remarkably stable while exclusive use of e-cigarettes increased."

However, adults 55 and older have tended to continue to smoke, with lower uptake of vaping, researchers said.

"The red light, or take-home message, for me is that we're failing older people who smoke cigarettes," Cummings said. "These are people with decades of smoking behind them, and they're not changing to lower-risk noncombustible tobacco products as much as younger adults. They're the group that stands to gain the most immediate health benefits from the elimination of smoked tobacco.”

The team also developed a population harm-reduction index that compared smoking against the use of other forms of tobacco, including vapes.

If the index’s ratio increases, it suggests that more people are replacing smoking with other options that may expose them to fewer cancer-causing chemicals, researchers said.

"If you believe, as the scientific evidence increasingly suggests, that noncombustible nicotine products expose people to substantially fewer cancer-causing chemicals than combustible tobacco, then this index gives us a way to measure whether that substitution is happening at the population level," Cummings said.

The index revealed that vaping was more common than any type of smoking among young adults 18 to 24.

Cummings emphasized that no nicotine product is completely safe — the healthiest choice is to never use any form of tobacco, or to quit using them entirely.

But given that smoking is responsible for nearly a third of cancer deaths and 90% of lung cancer deaths, Cummings argues the recent shift away from cigarettes will reshape the nation’s future cancer burden.

However, he warns the full impact will not become visible for decades.

The study was funded by the US National Cancer Institute and the Food and Drug Administration. It received no funding from the vaping industry.

More information

The American Heart Association has more on vaping versus smoking.

SOURCE: Medical University of South Carolina, news release, July 27, 2026