Nicotine e-cigarettes are likely carcinogenic to humans and may be linked to lung and oral cancers. This is the conclusion reached by the authors of a qualitative risk assessment published in the journal Carcinogenesis and based on an analysis of studies from 2017 to 2025.
The authors of the review emphasize that there is currently insufficient long-term population data on actual incidence rates, as vaping has emerged relatively recently. Therefore, the researchers relied on a body of other evidence—biomarkers of harm in humans, animal experiments, the chemical composition of aerosols, and mechanisms related to carcinogenesis.
The review states that changes considered to be precancerous markers have already been observed in vape users, including DNA damage, oxidative stress, inflammation, and epigenetic changes in the tissues of the respiratory tract and oral cavity. Additionally, in experiments on mice, exposure to e-cigarette aerosols was linked to the development of lung tumors.
The researchers specifically note that their conclusion pertains specifically to nicotine vapes and is phrased as “likely to be carcinogenic,” meaning probable carcinogenicity rather than a definitively quantified risk. The authors also write that it is currently impossible to accurately estimate the future burden of cancer cases associated with vaping.
The publication increases pressure on regulators and the market, as it calls into question the notion of vaping as a “safe alternative” to smoking. At the same time, some external experts urge caution in interpreting the findings, noting that vaping does not involve the combustion of tobacco and that longer-term human studies are still needed for definitive assessments.
On March 12, the NGO “Life” together with researchers from the Kyiv International Institute of Sociology (KIIS) presented the results of the all-Ukrainian survey “Use of Tobacco and Nicotine Products and Attitudes Towards Anti-Tobacco Measures” conducted in November-December 2023 as part of the regular Omnibus.
According to the survey, 30% of the population in Ukraine currently use tobacco or nicotine products: 43% of men and 20% of women. Daily smokers account for 24.5% of Ukrainians (36% of men, 15% of women).
Surveys show that consumption of tobacco products in Ukraine was actively declining until 2017. However, after the introduction of aggressive advertising of heating tobacco products, e-cigarettes and nicotine products, consumption of tobacco products in Ukraine has not decreased for 7 years. If we look at the structure of smoking, the consumption of tobacco and nicotine products among Ukrainian women has doubled in 7 years. According to the GATS survey, in 2017, 7% of Ukrainian women were daily tobacco users and 1% of e-cigarettes users, and today this figure is 15%. Tobacco and nicotine use is most widespread among young women aged 18-29 years – 37%, of whom 28.4% use it daily and 8.4% use it occasionally. This means that one in three young women is currently addicted to nicotine.
Among daily users, 79% smoke manufactured cigarettes. This is followed by electrically heated tobacco products (18%) and e-cigarettes (14%). The use of HTPs and e-cigarettes is more common among younger respondents: 37% of young people aged 18-29 use electrically heated tobacco products, and 36% use e-cigarettes. Women are more likely than men to use electrically heated tobacco products (27% vs. 13%) and e-cigarettes (25% vs. 11%).
“The survey results demonstrate a clear correlation between the answers of respondents who were most exposed to tobacco and nicotine advertising and the prevalence of use of these products among the youngest population group. Also, for the first time, we observe parity between tobacco and nicotine users among men and women in the 18-29 age group, but while the indicators for men remain stable, there has been a significant increase for the female population,” said Oleksandr Shcherbatiuk, researcher, project coordinator at the Kyiv International Institute of Sociology.
The survey showed that it is the young population that notices tobacco and nicotine advertising the most – 73% of young people aged 18-29. Further, this figure decreases with each age group and falls to 19% among respondents aged 70 and older. This confirms that tobacco and nicotine advertising is aimed at the youngest age group of men and women.
Display of tobacco and nicotine products in points of sale is the main channel for advertising these products – 32% of respondents said they notice it. Banner ads on the Internet (23%) and personal pages on social media (20%) are in second place. Outdoor advertising was seen by 14%. Most often, respondents saw ads for traditional and heated cigarettes (35%), 31% saw ads for tobacco heating devices, 24% saw ads for e-cigarettes, and 10% saw ads for nicotine snus.
“The tobacco industry is bringing back the tobacco epidemic among young people. Tobacco companies’ marketing preys on young women and men. The health of the population and, above all, children and youth is a matter of national security for the restoration of Ukraine’s human capital. Public support for anti-tobacco regulations of up to 80% is a guideline for the Verkhovna Rada of Ukraine to protect Ukrainians from tobacco and nicotine,” said Dmytro Kupyra, Executive Director of the NGO “Life”.
Most Ukrainians support anti-tobacco measures to prevent young people from starting to use tobacco.
The vast majority of respondents support the ban on advertising of brands of electronic smoking devices and e-cigarettes (79%) and the ban on the visible placement of tobacco packs in retail outlets (77%). Two-thirds of respondents support a ban on flavored tobacco products (67%) and tax increases to reduce the affordability of tobacco products for children (65%). The introduction of standardized packaging is supported by 61% of respondents.
“At the end of 2021, the Verkhovna Rada of Ukraine adopted the Anti-Tobacco Law 1978-IX, which implemented the key provisions of European Integration Directive 2014/40/EU. We can already see the results of the adopted changes with the appearance of updated health warnings on cigarette packs. Despite these efforts, the tobacco industry continues to attract young people. With the absolute support of citizens, we will propose to the Parliament the following package of proposals to protect the health of children and youth from illicit tobacco and nicotine products. First of all, it is necessary to eliminate all forms of advertising, including the visible placement of tobacco and nicotine products in points of sale, and to ban flavoring (fruit) additives that are not typical for tobacco products. Such steps are in line with the WHO Framework Convention on Tobacco Control and Ukraine’s European integration commitments,” said Lada Bulakh, MP, member of the Committee on National Health, Medical Assistance and Health Insurance.
The survey results revealed the key reasons for the spread of the tobacco and nicotine epidemic in Ukraine and demonstrated significant public support for the immediate implementation of legislative measures to protect the young population. Smoking in Ukraine is the cause of 130 thousand premature deaths annually from diseases such as heart attack, stroke, cancer and others.
