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Ex-smokers who vaped had higher risk of developing lung cancer than those who did not.
A study of more than 4.5 million adults in South Korea found that former smokers who used e-cigarettes daily had a 56 percent higher relative hazard of developing lung cancer than former smokers who did not vape. The researchers also found roughly double the relative hazard of dying from lung cancer in that comparison. The research does not suggest that continuing to smoke cigarettes is the safer choice. Switching to vaping was reported as less harmful than continued smoking.
Published in Nature Medicine in June 2026, the study used national health records. Participants had a history of cigarette smoking and were followed from 2018 through December 2023. Researchers compared current smokers with people who had quit, separating former smokers according to whether they reported daily e-cigarette use at the start. This was an observational study. It found an association, not proof that vaping caused the additional cancers.
A history of smoking complicates the picture. People who switch to vaping may differ from people who quit without it, including in their past smoking patterns. Statistical adjustments help, but cannot guarantee that every difference has been removed. The 56 percent figure is a relative comparison. It does not mean that 56 percent of people who vape will develop lung cancer, and it does not describe the risk for someone who has never smoked.
Cancer can take years to develop. Longer follow-up and more detailed information about vaping patterns are needed to understand its long-term effects. The International Agency for Research on Cancer notes that the findings suggest that vaping after smoking cessation may reduce some of the benefits of quitting for lung cancer prevention.
[Kim, Y. W., Park, E. J., Kwak, K. I., et al. (2026). Electronic cigarette use after smoking cessation and lung cancer risk. Nature Medicine, 32, 2410–2419. DOI: 10.1038/s41591-026-04469-5]