Reviewing: Nature Medicine
NEJM Clinician
Clinical Takeaway
In a population-based study, lung cancer risk was similar in ex-smokers who used e-cigarettes and in current smokers.
Context
Electronic cigarettes (e-cigarettes) might help people quit smoking; however, their effect on lung cancer risk remains unclear (see ). To explore the association between e-cigarette use and lung cancer, researchers conducted a retrospective cohort study of 4.5 million current and ex-smokers in the Korean national health insurance program. The investigators used 2018 survey data to define baseline smoking and e-cigarette use, and they examined lung cancer outcomes through 2023.
Figure 1
Key Results
- Risks for lung cancer and lung cancer–specific death were similar among ex-smokers who used e-cigarettes and current smokers.
- Former smokers who used e-cigarettes had a 50% higher risk for developing lung cancer and had twice the risk for lung cancer–related death than did ex-smokers who didn’t use e-cigarettes.
Comment
As a primary care and preventive medicine physician, I have fielded a lot of patients’ questions about the safety of e-cigarettes, and I certainly have had patients who felt strongly that e-cigarette use helped them quit. This study strengthens the link between e-cigarette use and cancer risk, and moving forward, I plan to encourage patients who are interested in using these products for smoking cessation to consider other options first.