Vaping: Does It Really Cause Cancer?

Summary

Podcast Summary: Science Vs – "Vaping: Does It Really Cause Cancer?" Spotify Studios, April 23, 2026 Host: Wendy Zuckerman
Co-Host/Senior Producer: Rose Rimler
Key Guests: Professor Bernard Stewart (University of New South Wales), Professor Leon Schaub (University College London), Professor Becky Freeman (University of Sydney)

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Main Theme & Purpose

This episode investigates alarming media headlines and a recent scientific review suggesting that vaping (e-cigarettes) is as dangerous as smoking and may cause cancer. The Science Vs team puts these claims under the microscope, examining the quality of the evidence, disagreements within the scientific community, and the implications for public health. The episode also explores whether vaping is effective for smoking cessation and how Big Tobacco may be muddying the waters.

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Key Discussion Points & Insights

1. The Breaking News: Vaping “Causes Cancer”?

• Start (00:00)
  • Introduction of the new scientific review linking vaping to lung and oral cancer.
  • Headlines claim vaping is as risky as conventional cigarettes, contradicting past consensus.

“Vaping is as bad as cigarette smoking. Now, if this is true, it is a huge switcheroo for science and also for Science Vs...”
Wendy Zuckerman, 00:58

• A decade ago, Science Vs told listeners that vaping was safer than smoking based on expert consensus (01:24).
• Some researchers challenge the new paper, calling it "misleading," "problematic," and "lacking credibility" (01:32–02:30).

2. What Does the Science Actually Show?

• Main segment resumes (04:19)

• Interview with Prof. Bernard Stewart (lead author of new review):

  • Stewart’s background: Exposing carcinogens like PFAs, microplastics, pesticides (05:19).
  • Stewart’s evidence for vaping causing cancer:
    • Chemicals in vape aerosols that are known carcinogens (acrylamide, benzene, metals) are found in the blood/urine of vapers (07:08).
    • In vitro studies: Vape liquids cause DNA damage and oxidative stress in cells (07:17–07:32).
    • Animal studies: Mice exposed to vape for a year developed lung cancer; concerns about chronic exposure and inflammation (07:32–08:07).
    • Case reports: A few oral cancer cases in people who vaped, although confounded by prior smoking history (08:07–08:35).

“Those chemicals are detectable. In other words, they have been absorbed into the body and not just exhaled.”
Prof. Bernard Stewart, 07:08

“All of that data...lead us inexorably to the conclusion that vaping is likely to cause oral and lung cancer.”
Prof. Bernard Stewart, 08:44

3. The Rebuttal: What Are Other Scientists Saying?

• Rose investigates pushback from experts like Prof. Leon Schaub.

  • Critiques of Stewart’s review:
    • Not a systematic review; includes flawed studies (09:35–09:39).
    • Issues with animal study methods: Mice “hotboxed” with vapor for unrealistic lengths of time, and they might ingest chemicals by licking fur (10:01–10:55).
    • Human studies are confounded by most vapers being current or former smokers, so causality is unclear (13:00–13:20).

“It doesn't seem like a realistic use condition for a human.”
Prof. Leon Schaub on rodent studies, 10:19

- The “dose makes the poison”: Carcinogen levels in vapers are detectable but much lower than in smokers—uncertain if at a harmful threshold (12:29).

“It’s unclear whether this lower level of exposure ... represents an actual risk for cancer formation.”
Prof. Leon Schaub, 12:29

• Most experts: Vaping could carry a risk but current evidence isn’t strong enough to assert it causes cancer in humans (13:19–13:48).

4. So Should We Wait for More Evidence?

• Stewart’s response to criticism is blunt:

“The criticisms are absurd, and I treat them with complete contempt.”
Prof. Bernard Stewart, 14:02

• Stewart argues that waiting for decades of data before warning the public would be irresponsible—cites the long lag before cigarettes were “proven” to cause cancer (15:35–16:12).

• Rose highlights risk of overstatement “getting out over their skis” and the need for caution in scientific messaging (16:12).

5. Where Do Most Scientists Stand?

• The Science Vs team surveyed 35 researchers in vaping and tobacco control (16:43–17:07):
  • Most: “We don’t know, but it’s possible” that vaping causes cancer.
  • If it does, the relative risk (how much it increases cancer risk) is still unknown.

6. Is Vaping as Bad as Smoking?

• Headlines (especially in Australia) claim “vaping is not safer than cigarettes,” but Stewart’s paper doesn’t systematically compare the two; the line equating the risks is more a throwaway (22:25–22:37).

“For the whole paper, the scientists are breaking up with vaping...then toss off, 'Oh, and you’re bad in bed too, and you’re just as bad as smoking.'”
Wendy Zuckerman, 22:51

• Smoking’s dangers remain “stratospherically high.”

“Two out of three people who continue to smoke...will die as a result of their addiction. It is so deadly.”
Prof. Becky Freeman, 23:25

• Some actual studies suggest vaping and smoking may be equally bad for cardiovascular problems (stroke, heart disease, metabolic dysfunction), though these studies have their own methodological issues (24:04–25:12).

• Despite uncertainty, when it comes to cancer risk and levels of exposure to carcinogens, smokers have far higher risk than vapers (26:28–27:17).

• Surveyed scientists overwhelmingly say smoking is more dangerous:
  “90% said smoking is more dangerous than vaping and the rest said probably.” (27:32).

7. Does Vaping Help People Quit Smoking?

• Vaping is somewhat more effective than patches or gum, but the absolute rate of quitting is low—about 10% (30:06–30:20).
  • According to Cochrane reviews: 8–11 out of 100 people quit smoking with e-cigs, 6 with patches/gum, 4 with other methods (30:21–31:09).
• Most people who quit with vapes continue vaping long-term (80% still vaping a year later), while very few stick with patches or gum (32:12–32:41).

8. New Generation of Non-Smokers Addicted to Vaping

• Majority of young adult vapers never regularly smoked—so the “is it safer than smoking?” comparison is increasingly irrelevant (33:14–34:06).

“I need to vape in the middle of the night. I can’t go a day at work without having a vape...all I do is think about it.”
Prof. Becky Freeman, 34:06

9. Role of Big Tobacco and Industry Influence

• Most major vaping brands are owned by tobacco companies.
• Industry tactics include funding research and sowing doubt.
  • One review found ~35% of vaping-related health studies had industry ties (37:43).
  • Industry-funded studies are more likely to report results favorable to vaping (38:03–38:23).

“My budget, the health department’s budget pales in comparison to that of Big Tobacco and Big Vape.”
Prof. Becky Freeman, 39:17

10. Concluding Thoughts: The Bottom Line

• Vaping: Bad for you. Smoking: Worse.
• Vaping possibly causes cancer and heart/lung problems, but evidence in humans is not definitive yet.
• If you smoke and want to quit, other options (patches, gum) should be tried before vaping.
• People who never smoked should not start vaping; it can lead to addiction and harms.

“Even though we know vaping is safer than smoking, we may still find cause for concern.”
Song lyric from expert-written tune, 40:14 (paraphrased)

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Notable Quotes & Memorable Moments

• “Did we lie to you through song? Will we fall on our own batad? I mean, will we be hoisted on our own petard?”
  Wendy Zuckerman, 01:32
• “If your fingers switch into vaping…” Recurring musical gag, e.g., 02:30
• “You know, if there was no potential benefit to vaping, it would be very easy to close the book on this…”
  Rose Rimler, 17:27
• “I try leaving [the vape] in my car, and all I do is think about it.”
  Prof. Becky Freeman, 34:06

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Important Timestamps for Segments

• 00:00–02:33 — Setting up the episode & headlines
• 04:19–11:41 — Reviewing the new “vaping causes cancer” paper & Stewart interview
• 11:41–16:31 — Rebuttals and expert critiques (Leon Schaub)
• 16:43–18:39 — Science Vs' survey results & discussion about scientific uncertainty
• 21:16–27:32 — Is vaping as bad as smoking?
• 30:06–32:41 — Effectiveness of vaping for quitting smoking
• 33:14–34:24 — Non-smoking teens/young adults now addicted to vaping
• 34:28–39:17 — Role of Big Tobacco, industry-funded research, and spreading doubt
• 40:14–43:31 — Conclusions, public health messaging, and final thoughts

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Final Takeaways (with the show's signature tone)

• Vaping may not be the miracle cure nor the death sentence that headlines suggest—science is still out.
• Smoking remains far more dangerous, especially when it comes to cancer. Vaping is not harmless and should not be ignored, especially as a new generation picks it up.
• Industry influence and scientific uncertainty both drive confusion in the public.
• If you want to quit smoking, try gum or patches first, and definitely don’t take up vaping if you never smoked.
• As always, “the findings we have can’t tell us what’ll happen long term...but we may still find cause for concern.” (song lyric, 40:14)

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For further detail, see the episode transcript and references in the show notes (78 citations!).

Transcript

[Wendy Zuckerman]

Hi, I'm Wendy Zuckerman. This is Science Versus, the show that pits facts against fumes. Groundbreaking new research has confirmed a deadly link between e cigarettes and cancer. Vaping is likely to cause lung and oral cancer. Headlines have been screaming about a new paper that's rocking the vaping world, claiming that vaping is more dangerous than we thought. We're hearing that not only is is it likely to cause cancer, but also that something that scientists have been telling us for years is wrong.

[Rose Rimler]

So is it safer to vape than smoke? Well, now the science is in.

[Wendy Zuckerman]

New research has found vapes are no

[Co-host/Producer (likely Rose Rimler or another producer)]

safer than conventional cigarettes.

[Professor Bernard Stewart]

The conclusion is unavoidable. We can hardly say that e cigarettes are somehow safer than conventional cigarettes.

[Wendy Zuckerman]

Vaping is as bad as cigarette smoking. Now, if this is true, it is a huge switcheroo for science and also for science versus for literally a decade, we've been telling you that vaping is a safer and better alternative to smoking. In a past episode, we even played you a song written by a bunch of researchers about it.

[Singer/Musician (performing the song)]

If you're thinking of switching to vaping, do it. That's what the experts agree.

[Wendy Zuckerman]

So did we lie to you through song? Will we fall on our own batad? I mean, will we be hoisted on our own petard? Well, the thing is, while some nerds have been supportive of this new paper that's sparking all these headlines, others are not. And in fact, right after the paper was published, a bunch of scientists wrote angry responses, calling the paper misleading, problematic, and saying it has little credibility. So what's going on here and getting this right is a big deal. Millions of folks, including kids, have picked up vaping around the world. So today on the show, we are asking, one, does vaping cause cancer? Two, is vaping as bad as smoking now? And three, could picking up a vape ever be good for your health? When it comes to vaping, there's a lot of.

[Singer/Musician (performing the song)]

If your fingers switch into vaping.

[Wendy Zuckerman]

No. No more songs until we work out what the devil's going on here. And it's all coming up just after the break.

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[Wendy Zuckerman]

hi, Wendy. Here today we are finding out, is vaping more dangerous than we thought? And with me to sort all of this out is senior producer Rose Rimler.

[Rose Rimler]

Hi, Wendy.

[Co-host/Producer (likely Rose Rimler or another producer)]

Hello, Rose.

[Rose Rimler]

I don't think I've ever heard that song before in my life. Did we play that?

[Singer/Musician (performing the song)]

If asking your mate down the pub about vaping, here's what they play.

[Co-host/Producer (likely Rose Rimler or another producer)]

We played it.

[Rose Rimler]

So memorable. Seemingly I've had it in my head all week.

[Co-host/Producer (likely Rose Rimler or another producer)]

In the middle of the night, this acoustic guitar would just start ringing. All right, let's jump into this new study that's setting the vaping world alight, igniting all these news reports.

[Wendy Zuckerman]

It is quite interesting and the implications

[Co-host/Producer (likely Rose Rimler or another producer)]

are super, super important.

[Wendy Zuckerman]

So I want to work out what's going on. What's this science fight all about?

[Rose Rimler]

Yeah.

[Wendy Zuckerman]

So to get to the bottom of this, Rose, you and I, we read this paper, and then I called up one of the lead authors, Professor Bernard Stewart. He's at the University of New South Wales in Sydney.

[Professor Bernard Stewart]

Good morning.

[Wendy Zuckerman]

Morning. Now, Bernard told me that basically his entire career has been using research to figure out whether various things in our environment cause cancer. So a decade ago, he was part of this big international team that looked at the characteristics that a substance has to have for it to be considered carcinogenic. He's looked at PFAs, you know, forever

[Professor Bernard Stewart]

chemicals, microplastics, pesticides in soil.

[Wendy Zuckerman]

But when he was watching the data coming out on vapes or E cigarettes,

[Professor Bernard Stewart]

he told me this, to me was a far greater worry.

[Rose Rimler]

Out of curiosity, did he ever find evidence that something didn't cause cancer?

[Wendy Zuckerman]

Yes. Yes, he did. And he actually, he specifically told me, you know, we have this idea that

[Co-host/Producer (likely Rose Rimler or another producer)]

everything causes cancer, but he said, that's not true.

[Rose Rimler]

Okay, that's good.

[Co-host/Producer (likely Rose Rimler or another producer)]

And in that context, he was worried about vaping causing cancer.

[Wendy Zuckerman]

So he and his colleagues pulled together studies published from 2017 to the Middle of last year that were looking for a link between vaping and cancer. And they wrote it up in a review paper. And so now I kind of want to go through the case that Bernard is making that vaping causes cancer. So we know that some of the chemicals found in vape aerosols, I'm thinking acrylamide, benzene, and various metals, they can cause cancer in humans. But there was this question of when you use a vape and inhale that stuff, do you just breathe it out again, or does it go into your system where it can then cause damage? And so scientists have tested the blood and urine of vapors for these kinds of chemicals, and here's what they found.

[Professor Bernard Stewart]

Those chemicals are detectable. In other words, they have been absorbed into the body and not just exhaled.

[Wendy Zuckerman]

So strike one. There are also studies in cells where scientists expose them to vape liquid, and then they can see that these cells pick up DNA damage and oxidative stress, which we know can lead to cancer.

[Rose Rimler]

Yeah.

[Wendy Zuckerman]

On top of that, scientists have exposed rats and mice to the vapor from E cigarettes, and they can see markers of inflammation in their lungs. And this is worrying to Bernard because we know that inflammation, when it's chronic in other circumstances, can lead to cancer. One study in particular exposed mice to vape fumes for almost a year, which is a long time in the life of a mouse, and a bunch of them developed lung cancer. So then finally, Bernard's team point to a few case reports. So here he is on that.

[Professor Bernard Stewart]

Individual dentists say, I saw a patient with oral cancer, and this patient never smoked, which is the well known cause of oral cancer, but he or she did vape, and I suspect the vaping was connected with the cancer.

[Wendy Zuckerman]

Now, it's messy because in the four case reports that Bernard cites, two of those people did have a history of smoking as well.

[Rose Rimler]

Regular cigarettes. Yes, I noticed that.

[Co-host/Producer (likely Rose Rimler or another producer)]

Yes.

[Professor Becky Freeman]

Still.

[Wendy Zuckerman]

But when Bernard looks at the totality of the evidence, here's what he thinks.

[Professor Bernard Stewart]

So all of that data, the laboratory data, the biomarker data, the animal data, the case reports, all of that taken together, lead us inexorably to the conclusion that vaping is likely to cause oral and lung cancer.

[Wendy Zuckerman]

So that's, you know, in the case of vaping versus cancer, that is the case that Bernard is making.

[Co-host/Producer (likely Rose Rimler or another producer)]

But, Rose, you were gonna play defense on this, right?

[Rose Rimler]

Yes. So there were a lot of scientists who were pissed off by this paper yeah, yeah. And I wanted to find out why. And so we called up one of them, Professor Leon Schaub. He is a vaping expert at University College London. And Leon didn't think the review was put together in a systematic way. He didn't like that.

[Wendy Zuckerman]

Yeah.

[Rose Rimler]

But he said that's not the only reason that he's skeptical.

[Professor Leon Schaub]

The concern is further deepened by the fact that this review includes several papers that claim evidence that E cigarettes cause cancer, but that have themselves been heavily criticized.

[Wendy Zuckerman]

Tell me more.

[Rose Rimler]

Well, so you mentioned the rodent studies, like the one where some of the mice that got exposed to vape aerosol got lung cancer.

[Wendy Zuckerman]

Yes.

[Rose Rimler]

In that study, the mice were living in a chamber that got filled up with the vape fumes. Basically, they were being hot boxed with vape.

[Wendy Zuckerman]

Yes.

[Rose Rimler]

That's how they do these. Right. And they got hotboxed for four hours a day, five days a week.

[Professor Leon Schaub]

They were basically enveloped in a cloud of vapor. It doesn't seem like a realistic use condition for a human.

[Wendy Zuckerman]

Isn't it? I mean, obviously you're not living in a cloud if you vape, but you

[Co-host/Producer (likely Rose Rimler or another producer)]

are breathing it in directly from the vape, right?

[Rose Rimler]

Sure. But you're not sitting in a chamber of vape clouds for hours and hours

[Co-host/Producer (likely Rose Rimler or another producer)]

unless you truly are a vape lord.

[Rose Rimler]

I mean, most people I know don't do that. And I've never seen vapers lick the vape off their body, which is what mice might be doing because, you know, rodents groom themselves.

[Interjecting Commentator]

Oh, right.

[Co-host/Producer (likely Rose Rimler or another producer)]

So they'd be licking their fur that

[Wendy Zuckerman]

then has the vape crap on their

[Rose Rimler]

fur, which would have gotten some extra exposure. Different route of exposure. That's just a criticism you can make about these studies. You know, I emailed the author of the paper, that paper about the mice, some questions.

[Wendy Zuckerman]

Yeah.

[Rose Rimler]

And yeah, he said, like, we tried carefully to create conditions that are as natural as possible to wet vapors might get exposed to. But even he was like, yeah, ultimately it's a study in mice. He said, this is a quote. The major purpose of exposing mice in an inhalation chamber is to determine the effects of E cigarette aerosols in mice. So, like, of course, we can't say the same is gonna be true for humans.

[Wendy Zuckerman]

Of course. It's step one. It's step one. Yeah.

[Rose Rimler]

So the other point that Leon made, and this has to do with, I think the first thing you mentioned, Wendy, about how, like, oh, it turns out the toxic chemicals, the carcinogens, they like, actually get in the bodies of the vapors. You can find them in their pee. And that is certainly not a good thing. Leon and other experts who commented on this paper, they pointed out that, like, well, these amounts of carcinogens that we find in vapors bodies, they're actually kind of low. And as Leon puts it, the dose makes the poison. Right. And that's just sort of a general rule in epidemiology that the more you're exposed to something that has some kind of risk, the more likely you are to develop that disease, you know? And so with vaping, it's unclear whether

[Professor Leon Schaub]

this lower level of exposure that's quite small, represents an actual risk for cancer formation.

[Rose Rimler]

Now, I mean, Leon did say he agrees it's totally possible vaping could have a risk of causing cancer. He just doesn't think that we currently have the evidence to support saying that for sure. Yes, we know now vaping does cause cancer, and one reason is we actually don't have much data in actual human beings with actual cancer.

[Co-host/Producer (likely Rose Rimler or another producer)]

Yes.

[Rose Rimler]

And I really went looking for other evidence that didn't make it in Bernard's review of people who vape getting cancer. And I did find some studies, and they find things like people who vape are more likely to have cancer, lung cancer, for example. But in all the studies that I could find, a lot of the vapers also smokes or used to smoke.

[Wendy Zuckerman]

Right.

[Rose Rimler]

So we don't know if the cancer came from the vaping or the smoking. It's messy, and that makes it a real mess. Yeah. And so without more, like, evidence in people actually getting cancer, I don't think that these authors should have said that they have produced the. This is what they said in a press release. They call it the most definitive determination that those who vape are at increased risk of cancer compared to those who don't. I think that is an overstatement.

[Wendy Zuckerman]

Yeah. I mean, I did ask Bernard about some of the heat that this paper's been getting.

[Co-host/Producer (likely Rose Rimler or another producer)]

No pun intended.

[Wendy Zuckerman]

You must be aware there's some criticisms of the paper that have been floating around. Do you mind if I just get your thoughts on them?

[Rose Rimler]

Yeah.

[Professor Bernard Stewart]

Yes, the criticisms are absurd, and I treat them with complete contempt.

[Rose Rimler]

Whoa, That's a strong word. Is he mad at me? Oh, no.

[Wendy Zuckerman]

I mean, I think he was bristling

[Co-host/Producer (likely Rose Rimler or another producer)]

at some of the criticisms he's been getting about how there's nothing new in this paper. You know, it's a review.

[Wendy Zuckerman]

But ultimately he said, if you've got problems, write a letter to the editor.

[Rose Rimler]

Does making a podcast count?

[Co-host/Producer (likely Rose Rimler or another producer)]

I think he would treat that with contempt. Um, no, but seriously, he did. He told me.

[Wendy Zuckerman]

You know, of course he knows that.

[Co-host/Producer (likely Rose Rimler or another producer)]

This is not rock solid evidence.

[Wendy Zuckerman]

We don't have a study in thousands of people where you see that those who vape have higher rates of cancer than those who don't vape. You know, like you mentioned, Rose, part of that is because of this messiness that a lot of vapers, and particularly older vapers, are smokers, too, or they used to be smokers. But the other issue here is also time. Bernard estimates we'd need around three decades before you might see that cancer signature, because cancer takes a really long time to develop, even for cigarette smokers. And vaping was only invented in the. In the 2000s. That's actually why they call it the naughties.

[Rose Rimler]

That's not true. Kids, don't let Wendy do revision. That's true.

[Wendy Zuckerman]

No. Okay, so I asked Bernard, and why not wait for better evidence before making this claim?

[Professor Bernard Stewart]

You're serious? You're saying we wait around until enough people are dead from lung cancer before we do anything? Is that what you're suggesting?

[Wendy Zuckerman]

Well, I want you to explain so that we have. We can take to our audience, because that is the.

[Professor Bernard Stewart]

The definitive proof will take decades. Okay. It took just on 100 years to definitively prove that cigarettes caused cancer. Cigarettes by that time had become the major known cause of cancer in the world.

[Rose Rimler]

I mean, I see his point, though. Like, of course, it's like the precautionary principle, right? You know, better to be safe than sorry. At the same time, you. It doesn't really give people license to get out over their skis and say that we have proof that we don't have. That's bad for science more broadly.

[Wendy Zuckerman]

I mean, the truth is, a lot of the team, the whole team at Science versus Struggled with this. And so what we did. We know our limitations.

[Co-host/Producer (likely Rose Rimler or another producer)]

We're podcasters.

[Wendy Zuckerman]

We don't write letters to editors.

[Co-host/Producer (likely Rose Rimler or another producer)]

So we surveyed a bunch of researchers

[Wendy Zuckerman]

who study vaping and tobacco control to see what they make of all this. We asked them outright, does vaping cause cancer? We heard back from 35 scientists, and

[Co-host/Producer (likely Rose Rimler or another producer)]

the results were kind of all over the map. But I would say the majority said, we don't know, but it's possible.

[Wendy Zuckerman]

And some who were then in that,

[Co-host/Producer (likely Rose Rimler or another producer)]

ah, maybe we don't know.

[Wendy Zuckerman]

Camp said, all right, if vaping does cause cancer, then the question becomes, how much does it up your risk of cancer? Is it like breathing in asbestos or eating a salami every now and then? Yeah, and we definitely don't know that

[Rose Rimler]

you know, if there was no potential benefit to vaping, it would be very easy to close the book on this, to say like, okay, this is enough evidence to just assume it does and tell people, quit it. Don't vape and be like, of course, if there is evidence that this thing, you know, playing the kazoo is potentially carcinogenic. And we have animal studies, we have petri dish studies, we have kazoo players have higher levels of this chemical that causes cancer, that everyone stopped playing the kazoo. I think that would be. Even though we don't have studies saying kazoo players get tons of cancer and

[Wendy Zuckerman]

die, it's an irritating sound as well.

[Co-host/Producer (likely Rose Rimler or another producer)]

So that would be great.

[Rose Rimler]

And it irritates the people around you with its secondhand kazooing.

[Co-host/Producer (likely Rose Rimler or another producer)]

Yes.

[Rose Rimler]

Um, but this is totally ignoring the fact that there is a potential benefit of vaping, and that's for people who smoke. And so if you're evaluating vaping as its own thing, ignoring the fact that its major purpose is as a smoking cessation device to get people to stop smoking when it's very hard to do that, you're missing, like, a huge part of the argument here.

[Co-host/Producer (likely Rose Rimler or another producer)]

So, Rose, we are going to look

[Wendy Zuckerman]

at that huge part of the argument and see if it's about to all go up in a puff of smoke after the break. Coming up. This episode is brought to you by Amazon Health AI. Hey there, it's me, Wendy. Before this podcast continues, I'll need you to fill out 37 forms about your listening history. Oh, wait. Just kidding. That would be ridiculous. Yet we do it every time we need healthcare. But new Amazon Health AI is different. It can connect your health history to offer personalized care so that you can get help fast. Amazon Health AI Healthcare just got less painful.

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[Co-host/Producer (likely Rose Rimler or another producer)]

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[Wendy Zuckerman]

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[Advertisement Voice 4]

I can work with them.

[Wendy Zuckerman]

This should be tons of fun.

[Advertisement Voice 4]

Marvel Television's Daredevil Born Again now streaming only on Disney plus.

[Wendy Zuckerman]

Welcome back. Today on the show, we are looking at the new science on vaping. Rose Rimler is here with me.

[Rose Rimler]

Hi, Wendy.

[Wendy Zuckerman]

Now we're going to look at this claim that vaping is just as dangerous as smoking. And as I mentioned at the start of the show, if true, this would really be a huge turnaround for science, which absolutely happens. We get more data, we find out new things, we change our mind. That is the glory and the frustration of science, right?

[Rose Rimler]

Yeah.

[Wendy Zuckerman]

That's why we love her. She's a feisty beast.

[Co-host/Producer (likely Rose Rimler or another producer)]

So there were all these news reports

[Wendy Zuckerman]

recently, particularly in Australia, saying that vaping is not safer than cigarettes off the back of Bernard's paper. Right. But what's interesting is Bernard's paper was really not comparing vapes to cigarettes. In fact, the whole point of the paper was to say that vaping is in its own right, is harmful. Forget about comparing it to cigarettes.

[Co-host/Producer (likely Rose Rimler or another producer)]

And yet did you notice this in the very last. It's just in the very last line of the paper.

[Wendy Zuckerman]

It's almost kind of tossed out. They say, quote, cancer aside, a range of diseases are attributable to vaping, which can no longer be caricatured as safer than smoking.

[Rose Rimler]

Wild claim. That's where scientists put their wild claims is in the last line of their last paragraph.

[Co-host/Producer (likely Rose Rimler or another producer)]

Right. I don't know if you had this feeling, but it was almost as if for the whole paper, the scientists are

[Wendy Zuckerman]

breaking up with vaping and then they turn around and walk away, but then toss off. Oh, and you're bad in bed, too,

[Co-host/Producer (likely Rose Rimler or another producer)]

and you're just as bad as smoking. Do you know what I mean?

[Rose Rimler]

Yeah, it is like that. I noticed that too. I was like, whoa.

[Wendy Zuckerman]

Yeah.

[Co-host/Producer (likely Rose Rimler or another producer)]

And the reason that it is so, whoa, so shocking is because of just

[Wendy Zuckerman]

how bad cigarette smoking is. So to remind us, here's Professor Becky Freeman. She's a public health researcher who focuses on tobacco control and vaping at the University of Sydney.

[Professor Becky Freeman]

Two out of three people who continue to smoke. So if you're not able to quit, two out of three people who are unable to quit will die as a result of their addiction. There's just something. It's so uniquely harmful to health. It is so deadly.

[Co-host/Producer (likely Rose Rimler or another producer)]

So could vaping really be that bad?

[Wendy Zuckerman]

Given that there's, you know, we've just talked about these unknowns around vaping and cancer. What do we actually know here? I mean, could vaping be as dangerous as smoking?

[Rose Rimler]

So I looked into that claim, and what's interesting is that there are other scientists who say we should rethink this idea that vaping is flat out better for you compared to smoking.

[Co-host/Producer (likely Rose Rimler or another producer)]

Really?

[Wendy Zuckerman]

So where are those researchers coming from?

[Rose Rimler]

Well, I mean, in Bernard's paper, one of the things he cites to make this case that vaping is really bad is a review paper that came out a couple years ago, and this one was looking mostly at heart and lung problems in people who smoke or vape. So for that, we do actually have studies in real people. And this review paper concluded that smoking and vaping are equally bad for cardiovascular disease, stroke, and metabolic dysfunction.

[Advertisement Voice 4]

Wow.

[Rose Rimler]

That's stuff that can lead to, like, diabetes and stuff.

[Professor Becky Freeman]

Wow.

[Rose Rimler]

And that's a pretty big deal. And if so from Bernard's perspective, if he's pretty sure that vaping is, on its own cancer causing, and this other body of research says vaping on its own is heart disease causing, Boom. Like death to vaping.

[Wendy Zuckerman]

Why is vaping so bad for your heart?

[Rose Rimler]

One reason is that nicotine itself is a vasoconstrictor, so it could, like, tighten your blood vessels. And you can imagine how that would be bad for your cardiovascular system.

[Wendy Zuckerman]

Yeah. And vapes have a surprisingly high amount

[Co-host/Producer (likely Rose Rimler or another producer)]

of nicotine in them.

[Rose Rimler]

Yes. And getting higher all the time. Like, there are studies that have found that the cartridges in vapes are bigger and container higher percentage of nicotine than they used to.

[Singer/Musician (performing the song)]

Whoa.

[Wendy Zuckerman]

Yeah.

[Co-host/Producer (likely Rose Rimler or another producer)]

Wow. Okay, so that's helpful for the bottom line, isn't it?

[Rose Rimler]

Yeah. And so, like, Wendy, I have to tell you that this review paper I just mentioned did also get a lot of criticism.

[Interjecting Commentator]

Right.

[Rose Rimler]

All kinds of things people said about like, oh, they didn't account for the fact that people might have been former smokers and switched to vaping because they got sick and they needed to switch.

[Interjecting Commentator]

Right.

[Rose Rimler]

The authors do argue back, like, hey, we tried to adjust for a lot of these things and da, da, da, da. We think we've seen something real here.

[Wendy Zuckerman]

So we're kind of stuck in this scientific limbo. Land.

[Rose Rimler]

Yes. So vaping is clearly bad for your heart. Whether it's as bad as cigarettes, I mean, I think that's a little bit remains to be seen. But where the case that smoking is still the worst option is very strong. Is when it comes to cancer.

[Wendy Zuckerman]

Yeah, I mean of course, because we know smoking causes cancer and we're not even sure about that with vaping. Right.

[Rose Rimler]

But yeah, but that's not even the, that's not even exactly what I'm talking about here. Also, when you look at the amount of carcinogens that people are exposed to when they vape versus when they smoke, it's just so much higher in smokers.

[Wendy Zuckerman]

Right. All of these DNA damaging chemicals, so much higher in smokers.

[Rose Rimler]

So for example, there's this chemical, it's called, they're a group of chemicals, they're called tobacco specific nitrosamines and they're well known to cause cancer. They're present in the pee of vapors at five times the levels they're in the pee of non vapors.

[Wendy Zuckerman]

Five times higher in vapors.

[Rose Rimler]

But when you look at smokers, these tobacco specific nitrosamines, they're in the smoker's pee 220 times as much as, you know, your goody two shoe that doesn't smoke or vape.

[Wendy Zuckerman]

It's way higher.

[Rose Rimler]

Way higher.

[Wendy Zuckerman]

Yes. And when we go back to our survey of scientists, remember those cautious fence sitting nerds.

[Rose Rimler]

Uh huh.

[Wendy Zuckerman]

Well on this question of is vaping

[Co-host/Producer (likely Rose Rimler or another producer)]

more dangerous than smoking, they were much more clear eyed.

[Wendy Zuckerman]

90% said smoking is more dangerous than vaping and the rest said probably. One person said it's hard to say. So you know, 90% that is like

[Co-host/Producer (likely Rose Rimler or another producer)]

dentists recommending Colgate Rock solid.

[Wendy Zuckerman]

I think we can say vaping is still safer than smoking.

[Co-host/Producer (likely Rose Rimler or another producer)]

And we did not lie to our audience in song.

[Rose Rimler]

Great. We could sleep at night now. I'm so glad.

[Co-host/Producer (likely Rose Rimler or another producer)]

Oh gosh. I know. And so I think the broad message around vaping when compared to smoking hasn't changed that much.

[Wendy Zuckerman]

I mean when Sides versus did our

[Co-host/Producer (likely Rose Rimler or another producer)]

first episode on vaping, one of the key scientists I interviewed said, quote, because

[Wendy Zuckerman]

the danger of cigarettes is so stratospherically high, it's like comparing the 15th highest mountain in the world that would be vaping to Mount Everest. And the joke I made back then, which I still think is pretty good, is that climbing Mount Gaia Chung Kang is still pretty tricky.

[Rose Rimler]

Is that the 15th tallest mountain in the world? Yeah. Well no one say they didn't learn anything from this episode because they Did.

[Co-host/Producer (likely Rose Rimler or another producer)]

That's right. Okay. But seriously though, this has made me

[Wendy Zuckerman]

wonder, why are we comparing vaping to smoking? Why are we doing this mountain comparison? Because, you know, even if we get more data that vaping is bad and it becomes, I don't know, Gashabrum 2, the 13th highest mountain in the world, what if it even gets so bad that it's Gashabram 1, which is the 11th highest mountain in the world? I mean, the. I mean, the broader point is that currently, at least when we compare vaping to smoking, vaping looks good. Still, despite these headlines, you hear vaping looks good.

[Rose Rimler]

Right?

[Wendy Zuckerman]

But if you look at vaping just on its own, vaping looks bad. And so the reason that we have been making this comparison is because vaping was brought on the scene as this tool to help people quit smoking.

[Co-host/Producer (likely Rose Rimler or another producer)]

So it's very important for you to know as a smoker.

[Wendy Zuckerman]

Wait, should I switch to this healthier thing or not?

[Rose Rimler]

Yes, that's what I was trying to say earlier.

[Co-host/Producer (likely Rose Rimler or another producer)]

Yeah, yeah.

[Wendy Zuckerman]

Which leads us to our next question, which is how well do vapes actually help people quit smoking?

[Professor Becky Freeman]

It's actually a really tiny number of people who successfully quit smoking using vapes.

[Wendy Zuckerman]

Here's Becky Freeman again, the public health researcher.

[Professor Becky Freeman]

Even in the best clinical Trials, it's about 10%. So it's a 90% failure rate.

[Wendy Zuckerman]

Right.

[Professor Becky Freeman]

This is not a miracle cure. This is not some sort of tech bro solution to the smoking epidemic that we have.

[Rose Rimler]

Wow, I'm surprised it's that small.

[Wendy Zuckerman]

Yeah, yeah, no. So that number comes from a Cochrane review which pulled together a ton of trials looking at thousands of people, and ultimately concluded that for every hundred folks who use nicotine e cigs to stop smoking, eight to 11 of them might successfully stop, which is where you get that 90% failure rate. It's worth pointing out, according to that review, vapes don't look too bad when you compare it to the other stuff. So six out of 100 people might successfully quit smoking when they use patches or gum. Four out of a hundred might successfully quit if you do other things, like

[Co-host/Producer (likely Rose Rimler or another producer)]

you go cold turkey.

[Wendy Zuckerman]

You were kind of surprised, right, that

[Co-host/Producer (likely Rose Rimler or another producer)]

it doesn't work that well.

[Wendy Zuckerman]

How come?

[Rose Rimler]

Well, I know a couple people who have quit smoking and vaped instead of. In general, I've, I feel like I've seen that work, but I think also I, I didn't know that the other methods were so bad, but here is

[Wendy Zuckerman]

why, because I can hear people really

[Co-host/Producer (likely Rose Rimler or another producer)]

holding on to this, particularly if you want to keep holding onto your vapes. Here Is why experts will say, try

[Wendy Zuckerman]

all that other stuff first before going for vapes. One is, well, let's say if you're just using patches, you are not breathing in that vape crap. But also because people who use vapes to quit smoking, like the friends in your life, keep vaping, they then pick up the habit.

[Rose Rimler]

Keep smoking.

[Wendy Zuckerman]

No, they keep vaping. They pick up the habit of vaping, they become vapers.

[Co-host/Producer (likely Rose Rimler or another producer)]

Yeah.

[Wendy Zuckerman]

Whereas people who use patches, gum, stuff like that, they eventually manage. They've got a much higher chance of quitting their dependency altogether. So, for example, one randomized control trial found that 80% of the people who quit cigarettes using vapes were still vaping a year later. 80%.

[Rose Rimler]

Right.

[Wendy Zuckerman]

While only 9% of those who did stuff like patches and gums were. Were still using those products.

[Rose Rimler]

You know, it's so funny, I wasn't even thinking of the fact that you're supposed to stop vaping. I don't know anyone that stopped vaping.

[Wendy Zuckerman]

I know, I know. But, okay, so here's where we are at. Most scientists agree that vaping is safer than smoking. And that means that if you are a smoker and you want to quit, vaping may help you.

[Co-host/Producer (likely Rose Rimler or another producer)]

But for all the reasons we just

[Wendy Zuckerman]

talked about, try using other stuff first. Like gum, like patches.

[Rose Rimler]

Yeah. And I guess, like, if we're wondering, why are we comparing vaping to smoking in 2026, it's not even relevant for a ton of people. They aren't vaping to quit smoking. They're just vaping to vape, right?

[Wendy Zuckerman]

Well, yeah, exactly. I mean, one survey of thousands of Americans found that over half of established vaping young adults never regularly smoked. So if that's you, I mean, who cares if vaping is safer than smoking, right? And now we have a new generation of people addicted to vaping. And in fact, Becky Freeman does this study where her and her colleagues will talk to thousands of young people, and she has actually seen vaping go from this funsy thing to a full blown addiction.

[Professor Becky Freeman]

A few years ago, when we first started this research, young people were like, oh, vaping's fun. It's something I do socially on the weekend. It's no big drama. And then over the years, it's become more of, I'm so addicted, I need to vape in the middle of the night. I can't go a day at work without having a vape. I try leaving in my car, and all I do is think about it.

[Wendy Zuckerman]

So vaping bad for you, Smoking worse for you.

[Co-host/Producer (likely Rose Rimler or another producer)]

Also bad for you.

[Rose Rimler]

Mm.

[Wendy Zuckerman]

But there's still so much doubt and confusion in the public, I think, to our listeners. And I am wondering if at least part of that is thanks to Big Tobacco being up to their old tricks again.

[Rose Rimler]

Is this the conspiracy theory portion of the episode?

[Co-host/Producer (likely Rose Rimler or another producer)]

Maybe, maybe.

[Wendy Zuckerman]

But hear me out. Okay.

[Rose Rimler]

Uh huh.

[Wendy Zuckerman]

The major international tobacco companies own many of the top vaping brands, right?

[Rose Rimler]

Mm, yes.

[Wendy Zuckerman]

Okay. And it is well documented that Big Tobacco wrote the playbook on spreading misinformation. It is the playbook that Big Oil reads to spread misinformation about climate change. And so one of the key tactics that they learned really early on was is so effective at allowing them to keep selling their cigarettes in the face of all this science about lung cancer is using doubt. Are the scientists sure about what is going on?

[Rose Rimler]

Uh huh.

[Wendy Zuckerman]

In this case, we can see doubt

[Co-host/Producer (likely Rose Rimler or another producer)]

all through this episode.

[Wendy Zuckerman]

Right. Are vapes that bad?

[Rose Rimler]

Yeah, the study had this issue. Yep.

[Wendy Zuckerman]

And doubt creating doubt among science is so damn easy. Right. Because well meaning scientists will nitpick at

[Co-host/Producer (likely Rose Rimler or another producer)]

each other's research to get to the truth.

[Rose Rimler]

Yeah.

[Co-host/Producer (likely Rose Rimler or another producer)]

Making it so handy for Big Vape

[Wendy Zuckerman]

to say, look, the scientists are fighting. Yeah, let's just keep vaping until they work it all out.

[Rose Rimler]

Yeah. You know, but of course, in the

[Wendy Zuckerman]

playbook, it's not just about leaning on the doubt to sell your product. Big Tobacco is also actively funding science and a lot of that science helps their cause. So for example, today you can find the foundation for a smoke free world

[Co-host/Producer (likely Rose Rimler or another producer)]

whose goal is the end of tobacco

[Wendy Zuckerman]

use achieved through funding research and promoting innovation.

[Co-host/Producer (likely Rose Rimler or another producer)]

What could create a smoke free world but a vape filled world?

[Rose Rimler]

Wow, that's bleak.

[Co-host/Producer (likely Rose Rimler or another producer)]

They are entirely, entirely funded by Big Tobacco.

[Wendy Zuckerman]

And just a couple of years ago they changed their name, by the way,

[Co-host/Producer (likely Rose Rimler or another producer)]

to Global Action to End Smoking. And this is just one of these groups. Other companies that sell these products are

[Wendy Zuckerman]

out there funding science too.

[Rose Rimler]

Wow. Dang. Do you think this like, really corrupts the majority of this research? Like how big of a problem is this?

[Wendy Zuckerman]

Yes, that is what I wanted to know. Okay, so around 10 years ago, a researcher in Denmark did one of the first systematic reviews on the health effects of e cigarettes, which looked at almost 100 studies. And then she analyzed all the conflicts of interest. Do you want to guess what percentage of the studies had some industry conflict of interest?

[Rose Rimler]

50%.

[Wendy Zuckerman]

It was 35%.

[Rose Rimler]

Okay, that's still pretty high.

[Wendy Zuckerman]

And there's other studies that have kind of looked at this problem in slightly different ways. They find that maybe it's one in four. So 24% had disclosed industry funding, which, which, you know, one in three, one in four.

[Rose Rimler]

Yeah.

[Wendy Zuckerman]

Studies in this space are industry funded. I mean that's, it's not good. And of course, unsurprisingly, research shows that studies that are industry funded in this space are more likely to say things like vaping is either harmless or pro vaping more generally. So you say things like, wow, they

[Co-host/Producer (likely Rose Rimler or another producer)]

look pretty good compared to cigarettes.

[Rose Rimler]

And that makes me think of that paper that we talked about about like, oh, vaping is just as bad as smoking when it comes to heart stuff. And then I was like, it got a lot of critique and criticism, some of it quite feisty actually. You know, and I did look at some of the declarations, conflicts of interest, and about something like half the responses that I found declared at least some kind of tie to tobacco or getting some funding or some money from a tobacco or vape company. So I've seen it too.

[Wendy Zuckerman]

Yeah, I mean, by the way, more than 90% of the people that we surveyed in our, you know, little science versus survey, they didn't get any industry funding, not even from pharmaceutical companies. And I also talked to Becky about big tobacco and how it's muddying the waters here. And here's what she said.

[Professor Becky Freeman]

There is a lot of misinformation that benefits the bottom line of transnational companies that we're also up against. My budget, the health department's budget pales in comparison to that of Big Tobacco and Big Vape.

[Wendy Zuckerman]

You know, and meanwhile we are getting more and more evidence that vaping on its own is bad. Right? Even if it.

[Co-host/Producer (likely Rose Rimler or another producer)]

We don't know if it causes cancer yet.

[Wendy Zuckerman]

We know it messes with your lungs. We know it increases your risk of asthma. We know it makes it more likely that you'll cough or wheeze.

[Co-host/Producer (likely Rose Rimler or another producer)]

More and more evidence showing it's not good for your heart.

[Rose Rimler]

Well, Wendy, that is a real bummer. So thanks, I guess.

[Wendy Zuckerman]

Yeah, I'm sorry, you know, but the

[Co-host/Producer (likely Rose Rimler or another producer)]

good news is that there's a. You know that song that we played for people that we didn't lie to them with?

[Rose Rimler]

Uh huh.

[Co-host/Producer (likely Rose Rimler or another producer)]

The end of it is really quite prescient. And so, you know. Do you want to hear it?

[Rose Rimler]

Yeah, play me out.

[Singer/Musician (performing the song)]

But remember to mention the findings we have can't tell us what'll happen long term. Even though we know vaping is safer than smoking, we may still find cause for concern.

[Rose Rimler]

The prophecy came true.

[Co-host/Producer (likely Rose Rimler or another producer)]

The prophecy came true.

[Wendy Zuckerman]

John asked me how many citations are in this episode.

[Rose Rimler]

So Wendy, how many citations were in

[Wendy Zuckerman]

this episode, there's 78.

[Rose Rimler]

Thanks so much for telling me.

[Co-host/Producer (likely Rose Rimler or another producer)]

Do people want to see them? They can go to our show Notes. There's a link to the transcript. You can read them in all their glory. Thank you, Rose.

[Rose Rimler]

Thanks, Wendy.

[Wendy Zuckerman]

If you're thinking of switching to vape bang, do it.

[Co-host/Producer (likely Rose Rimler or another producer)]

Probably try gum or patches first. That's my kazoo.

[Rose Rimler]

You said it was your kazoo, but you made emotion like it was a trombone. What do you think a kazoo is?

[Advertisement Voice 3]

Bye.

[Wendy Zuckerman]

Science Versus is a Spotify Studios original. Listen to us for free on Spotify or wherever you get your podcasts. If you are listening on Spotify, you can follow us and tap the bell icon so you get episode notifications. If you like this show, give us a five star review. Write a comment, say hello. This episode was produced by me, Wendy Zuckerman and Rose Rimler with help from Keddie Foster. Keys, Meryl Horne and Michelle Dang. We're edited by Blythe Tyrrell. I'm the executive producer. Fact checking by Erica Akiko Howard Mix and sound design by Bobby Lord. Music written by Bumi Hidaka, Peter Leonard, Emma Munger and Bobby Lord. Thank you so much to the Australian Science Media center for all your help with this episode. Also, thank you to the scientists who responded to our emails on this. Oh, my gosh. Some of you wrote the most lovely and thoughtful emails. We really appreciate you responding to us. A big thanks to Joseph Lavelle Wilson and the Zuckerman family. I'm Wendy Zuckerman. Back to you next time. You know, it's kind of like, do you need to watch seven seasons of Young Sheldon or Star the Phantom Menace?

[Rose Rimler]

That analogy, Witches vaping, witches smoking.

[Wendy Zuckerman]

I think the more painful is Young

[Co-host/Producer (likely Rose Rimler or another producer)]

Sheldon because seven seasons. Either way, you don't have to do it. You could do other things with your time. You don't need to do either is the point.

[Rose Rimler]

Yeah. Point extremely clearly made. I can't think of a better public health message than that.

[Co-host/Producer (likely Rose Rimler or another producer)]

Would it help if I said misa? No need to.

[Rose Rimler]

It wouldn't help.

[Co-host/Producer (likely Rose Rimler or another producer)]

Okay,

[Wendy Zuckerman]

you know what? Becky Freeman has actually watched as watched

[Rose Rimler]

all seven seasons of Young Sheldon

[Co-host/Producer (likely Rose Rimler or another producer)]

Rez. I'm trying to make a serious point here, okay?