Vaping: Does It Really Cause Cancer?

Headlines have been screaming about a new study suggesting that vaping could cause cancer — and that vaping could be just as dangerous as cigarettes. And if this were true, it would be a HUGE deal. We’ve been hearing for years that vaping is a safer option — and can help you quit ciggies. But the new paper has run up against angry criticisms from other scientists, with some calling the paper "misleading" and "problematic." So what’s going on?? Do scientists still think vaping is safer than cigarettes? How well do vapes actually help people quit smoking? And could Big Tobacco be behind the scenes, clouding the truth about all of this?? We get help sorting it out from Professor Bernard Stewart, Professor Lion Shahab and Professor Becky Freeman. Find our transcript here: https://tinyurl.com/ScienceVsVapingCancer In this episode, we cover: (00:00) Vaping world set alight by new study (02:50) Why Some Scientists Have Linked Vaping to Cancer (07:45) Why Some Scientists Pushed Back Against Vaping-Cancer Claims (17:51) Is Vaping as Dangerous as Smoking? (25:15) Do Vapes Help People Quit Smoking? (30:52) Big Tobacco Is Funding Vaping Research This episode was produced by Wendy Zukerman and Rose Rimler, with help from Ekedi Fausther-Keeys, Meryl Horn and Michelle Dang. We’re edited by Blythe Terrell. Wendy Zukerman is our 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. Additional music from Parry Music Library / BMGPM. Thanks so much to the Australian science media centre and all the scientists who responded to our emails on this — we asked a lot of you!. A big thanks to Joseph Lavelle Wilson and the Zukerman family. Science Vs is a Spotify Studios Original. Listen for free on Spotify or wherever you get your podcasts. Follow us and tap the bell for episode notifications. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Wendy Zukerman?

  Hi, I'm Wendy Zukerman, this is Science Versus.

• 0:04Wendy Zukerman?

  The show that pits facts against fumes.

• 0:13Wendy Zukerman?

  Groundbreaking new research has confirmed a deadly link between e-cigarettes and cancer.

• 0:18Speaker 01

  Vaping is likely to cause lung and oral cancer.

• 0:22Wendy Zukerman?

  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 it likely to cause cancer, but also that something that scientists have been telling us for years is wrong.

• 0:40Wendy Zukerman?

  So is it safer to vape than smoke? Well, now the science is in. New research has found vapes are no safer than conventional cigarettes.

• 0:50Speaker 03

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

• 0:58Wendy Zukerman?

  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.

• 1:32Wendy Zukerman?

  So did we lie to you? Prue Song? Will we fall on our own betad? 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.

• 2:13Wendy Zukerman?

  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...

• 2:33Wendy Zukerman?

  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.

• 2:47Wendy Zukerman?

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• 3:26Speaker 04

  This episode is brought to you by Google Chrome. You think you know a browser, but Gemini and Chrome, that's new. It can help you with practically anything on the web, like restoring a vintage motorcycle from a 50-page restoration block, or finally break down that long article you've had open for weeks. Gemini and Chrome is here for it. Ready to make anything online make sense? There's no place like Chrome. Check responses set up required. Compatibility and availability varies; 18+.

• 3:53Wendy Zukerman?

  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 Rimmler.

• 4:03Speaker 05

  Hi, Wendy.

• 4:04Wendy Zukerman?

  Hello, Rose.

• 4:05Speaker 05

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

• 4:13Wendy Zukerman?

  We played it.

• 4:16Speaker 05

  So memorable, seemingly.

• 4:17Wendy Zukerman?

  I've had it in my head all week. In the middle of the night, this acoustic guitar would just start ringing. Oh, all right, let's jump into this new study that's setting the vaping world alight, igniting all these news reports. It is quite interesting and the implications are super, super important. So I want to look at what's going on. What's this science fight all about?

• 4:41Speaker 05

  Yeah.

• 4:42Wendy Zukerman?

  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.

• 4:53Speaker 03

  Good morning.

• 4:54Wendy Zukerman?

  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 chemicals.

• 5:18Speaker 03

  Microplastics, pesticides in soil.

• 5:22Wendy Zukerman?

  But when he was watching the data coming out on vapes or e-cigarettes, he told me.

• 5:27Speaker 03

  This to me was a far greater worry.

• 5:31Speaker 05

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

• 5:36Wendy Zukerman?

  Yes. Yes, he did. And he actually, he specifically told me, you know, we have this idea that everything causes cancer, but he said, that's not true.

• 5:45Speaker 05

  Okay, that's good.

• 5:46Wendy Zukerman?

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

• 6:31Wendy Zukerman?

  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've found.

• 6:42Speaker 03

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

• 6:51Wendy Zukerman?

  So, strike one.

• 6:53Speaker 05

  Uh huh.

• 6:53Wendy Zukerman?

  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.

• 7:05Speaker 05

  Yeah.

• 7:06Wendy Zukerman?

  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.

• 7:34Speaker 05

  Mm hmm.

• 7:35Wendy Zukerman?

  So then finally Bernard's team point to a few case reports. So here he is on that.

• 7:41Speaker 03

  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.

• 7:59Wendy Zukerman?

  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.

• 8:09Speaker 05

  Like real regular cigarettes. Yes, I noticed that.

• 8:12Wendy Zukerman?

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

• 8:18Speaker 03

  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.

• 8:37Wendy Zukerman?

  So that's, you know, in the case of vaping versus cancer, that is the case that Bernard is making. But Rose, you were gonna play defense on this, right?

• 8:49Speaker 05

  Yes. So there were a lot of scientists who were pissed off by this paper.

• 8:54Wendy Zukerman?

  Yeah, yeah.

• 8:55Speaker 05

  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.

• 9:10Wendy Zukerman?

  Yeah.

• 9:10Speaker 05

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

• 9:13Speaker 06

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

• 9:24Wendy Zukerman?

  Tell me more.

• 9:26Speaker 05

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

• 9:35Wendy Zukerman?

  Yes.

• 9:36Speaker 05

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

• 9:46Wendy Zukerman?

  Yes.

• 9:47Speaker 05

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

• 9:53Speaker 06

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

• 10:00Wendy Zukerman?

  Isn't it? I mean, obviously, you're not living in a cloud if you vape, but you are breathing it in directly from the vape, right?

• 10:09Speaker 05

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

• 10:15Wendy Zukerman?

  Unless you truly are a vape lord.

• 10:18Speaker 05

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

• 10:29Wendy Zukerman?

  Oh, right. So they'd be licking their fur that then has the vape.

• 10:35Speaker 05

  Crap on their Which would have gotten some extra exposure, a different route of exposure. It'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. Yeah. And, yeah, he said, like, we tried carefully to create conditions that are as natural as possible to what 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 effect of e-cigarette aerosols in mice." So like, of course, we can't say the same is going to be true for humans. Of course, it's step one, it's step one. Yeah. So, the other point that Leon made, and this has to do with, I think the first thing

• 11:20Speaker 05

  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. Mm-hmm. 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-

• 11:47Speaker 06

  The dose makes the poison, right?

• 11:50Speaker 05

  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-

• 12:02Speaker 06

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

• 12:10Speaker 05

  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. Mm-hmm. And one reason is, we actually don't have much data in actual human beings with actual cancer. Yes. 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 lung cancer, for example. But in all the studies that I could find, a lot of the vapors also smokes, or used to smoke. Right.

• 12:54Speaker 05

  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.

• 13:22Wendy Zukerman?

  Hmm, yeah. I mean, I did ask Bernard about some of the heat that this paper's been getting. Nobody intended. 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?

• 13:36Speaker 03

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

• 13:44Wendy Zukerman?

  Whoa, that's a strong word. Is he mad at me? Oh no. I mean, I think he was bristling at some of the criticisms he's been getting about how there's nothing new in this paper. You know, it's a review, but ultimately he said, "If you've got problems, write a letter to the editor."

• 14:03Speaker 05

  Does making a podcast count?

• 14:06Wendy Zukerman?

  I think he would treat that with contempt. No, but seriously, he did, he told me, you know, of course he knows that this is not rock solid evidence. 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.

• 14:49Wendy Zukerman?

  And vaping was only invented in the, in the 2000s. That's actually why they call it the naughties.

• 14:55Speaker 05

  Hmm, that's not true, kids. Don't let Wendy do revisionist history.

• 15:01Wendy Zukerman?

  No, okay, so I asked Bernard, "And why not wait for better evidence before making this claim?"

• 15:09Speaker 03

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

• 15:19Wendy Zukerman?

  Well, I want you to explain it so that we have, we can take to our audience.

• 15:23Speaker 03

  Look, the definitive, the definitive proof will take decades, okay?

• 15:30Speaker 03

  It took just on a hundred years to definitively prove that cigarettes caused cancer. Cigarettes by that time had become the major known cause of cancer in the world.

• 15:47Speaker 05

  I mean, I see his point, though, like,

• 15:50Wendy Zukerman?

  Of course.

• 15:50Speaker 05

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

• 16:05Wendy Zukerman?

  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. We're podcasters. We don't write letters to editors. So we surveyed a bunch of researchers 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 the results were kind of all over the map. But I would say the majority said, we don't know, but it's possible. And some who were then in that, ah, maybe, we don't know, camp, said, all right,

• 16:47Wendy Zukerman?

  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?

• 16:58Speaker 05

  Yeah.

• 16:58Wendy Zukerman?

  And we definitely don't know that.

• 17:02Speaker 05

  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. It'd 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's not playing the kazoo. I think that would be, even though we don't have studies saying kazoo players get tons of cancer and die.

• 17:40Wendy Zukerman?

  It's a irritating sound as well. So that would be great.

• 17:45Speaker 05

  And it irritates people around you with its secondhand kazooing.

• 17:49Wendy Zukerman?

  Yes.

• 17:50Speaker 05

  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.

• 18:14Wendy Zukerman?

  So Rose, we are going to look at that huge pot of the argument and see if it's about to all go up in a puff of smoke after the break. Coming up.

• 18:44Speaker 04

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• 19:41Wendy Zukerman?

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

• 19:49Speaker 05

  Hi Wendy.

• 19:51Wendy Zukerman?

  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.

• 20:11Speaker 05

  Right, yeah.

• 20:12Wendy Zukerman?

  It's why we love it. She's a feisty beast. So there were all these news reports 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, in its own right, is harmful. Forget about comparing it to cigarettes. And yet, did you notice this? In the very last, it's just in the very last line of the paper, it's almost kind of tossed

• 20:52Wendy Zukerman?

  out, they say, quote, "Cancer aside, a range of diseases are attributable to vaping, which can no longer be caricatured as safer than smoking."

• 21:03Speaker 05

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

• 21:09Wendy Zukerman?

  Correct. It almost, I don't know if you had this feeling, but it was almost as if for the whole paper, the scientists are breaking up with vaping, and then they turn around and walk away, but then toss off, "Oh, and you're bad in bed, too." "And you're just as bad as smoking." Do you know what I mean?

• 21:29Speaker 05

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

• 21:33Wendy Zukerman?

  Yeah, and the reason that it is so, whoa, so shocking is because of just 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.

• 21:50Speaker 08

  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 is so uniquely harmful to health. It is so deadly.

• 22:05Wendy Zukerman?

  So, could vaping really be that bad? 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?

• 22:20Speaker 05

  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.

• 22:29Wendy Zukerman?

  Really? So where are those researchers coming from?

• 22:33Speaker 05

  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 of 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.

• 23:04Wendy Zukerman?

  Wow.

• 23:05Speaker 05

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

• 23:07Wendy Zukerman?

  Wow.

• 23:08Speaker 05

  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.

• 23:24Wendy Zukerman?

  Why is vaping so bad for your heart?

• 23:26Speaker 05

  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.

• 23:35Wendy Zukerman?

  Yeah, and vapes have a surprisingly high amount of nicotine in them.

• 23:39Speaker 05

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

• 23:50Wendy Zukerman?

  Whoa. Yeah, wow. Okay, yeah, that's helpful for the bottom line, isn't it?

• 23:58Speaker 05

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

• 24:05Wendy Zukerman?

  Right.

• 24:05Speaker 05

  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.

• 24:17Wendy Zukerman?

  Right.

• 24:18Speaker 05

  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.

• 24:24Wendy Zukerman?

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

• 24:28Speaker 05

  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.

• 24:46Wendy Zukerman?

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

• 24:53Speaker 05

  But that, 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.

• 25:05Wendy Zukerman?

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

• 25:11Speaker 05

  So for example, there's this chemical, it's called, a group of chemicals, they're called tobacco-specific nitrosamines, and they're well-known to cause cancer.

• 25:19Wendy Zukerman?

  Mm-hmm.

• 25:19Speaker 05

  They're present in the pee of vapors at five times the levels they're in the pee of non-vapors.

• 25:25Wendy Zukerman?

  Five times higher in vapors.

• 25:27Speaker 05

  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.

• 25:40Wendy Zukerman?

  It's way higher.

• 25:42Speaker 05

  Way higher.

• 25:43Wendy Zukerman?

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

• 25:50Speaker 05

  Uh-huh.

• 25:51Wendy Zukerman?

  Well, on this question of is vaping more dangerous than smoking, they were much more clear-eyed. 90% said smoking is more dangerous than vaping.

• 26:03Speaker 05

  Mm-hmm.

• 26:03Wendy Zukerman?

  And the rest said probably?

• 26:07Wendy Zukerman?

  One person said, it's hard to say. So, you know, 90%, that is like dentist recommended Colgate.

• 26:16Speaker 05

  Uh, rock solid.

• 26:17Wendy Zukerman?

  I think we can say vaping is still safer than smoking. And we did not lie to our audience in song.

• 26:24Speaker 05

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

• 26:26Wendy Zukerman?

  Oh, gosh, I know. And I, so I think the broad message around vaping, when compared to smoking, hasn't changed that much. I mean, when Science vs. did our first episode on vaping, one of the key scientists I interviewed said, quote, "Because 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 Gayatungking is still pretty tricky.

• 27:00Speaker 05

  Is that the 15th tallest mountain in the world?

• 27:02Wendy Zukerman?

  Yeah.

• 27:05Speaker 05

  Well, no one said they didn't learn anything from this episode, because they did.

• 27:10Wendy Zukerman?

  That's right. Um, okay. But seriously, though, this has made me 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 Gashabrum 1, which is the 11th highest mountain in the world?

• 27:44Wendy Zukerman?

  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.

• 27:57Speaker 05

  Right.

• 27:58Wendy Zukerman?

  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. So it's very important for you to know as a smoker, wait, should I switch to this healthier thing or not?

• 28:21Speaker 05

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

• 28:24Wendy Zukerman?

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

• 28:32Speaker 08

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

• 28:37Wendy Zukerman?

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

• 28:40Speaker 08

  Even in the best clinical trials, it's about 10%. So it's a 90% failure rate, right? This is not a miracle cure. This is not some sort of tech bro solution to the smoking epidemic that we have.

• 28:54Wendy Zukerman?

  Wow, I'm surprised it's that small. 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 100 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 100 might successfully quit if you do other things, like you go cold turkey.

• 29:36Speaker 05

  You were kind of surprised, right, that it doesn't work that well? How come? Well, I know a couple of people who have quit smoking and vapes instead. In general, I feel like I've seen that work, but I think also I didn't know that the other methods were so bad.

• 29:53Wendy Zukerman?

  But here is why, because I can hear people really holding on to this, particularly if you want to keep holding on to your vapes. Here is why experts will say, try 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.

• 30:30Speaker 05

  Keep smoking?

• 30:32Wendy Zukerman?

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

• 30:36Speaker 05

  They've become vapors, yeah.

• 30:38Wendy Zukerman?

  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%.

• 30:59Speaker 05

  Right.

• 31:00Wendy Zukerman?

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

• 31:07Speaker 05

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

• 31:13Wendy Zukerman?

  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 wanna quit, vaping may help you. But for all the reasons we just talked about, try using other stuff first, like gum, like patches.

• 31:39Speaker 05

  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?

• 31:52Wendy Zukerman?

  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 funzy thing to a full-blown addiction.

• 32:32Speaker 08

  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 it in my car and all I do is think about it.

• 32:49Wendy Zukerman?

  So vaping's bad for you. Smoking, worse for you, also bad for you. Mm-hmm. 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. Is this the conspiracy theory portion of the episode? Maybe, maybe, but hear me out, okay? Uh-huh. The major international tobacco companies own many of the top vaping brands, right? Mm-hmm, yes. Okay, and it is well documented that big tobacco wrote the playbook on spreading

• 33:34Wendy Zukerman?

  misinformation. Mm-hmm. 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 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? Uh-huh. In this case, we can see doubt all through. This episode, right? Oh, vapes that bad?

• 34:10Speaker 05

  Yeah, the study had this issue.

• 34:12Wendy Zukerman?

  Yep. And doubt, creating doubt amongst science is so damn easy, right? Because well-meaning scientists will nitpick at each other's research to get to the truth.

• 34:23Speaker 05

  Yeah.

• 34:24Wendy Zukerman?

  Making it so handy for Big Vape to say, "Look, the scientists are fighting."

• 34:29Speaker 05

  Yeah.

• 34:30Wendy Zukerman?

  "Let's just keep vaping until they work it all out."

• 34:34Wendy Zukerman?

  You know? But of course, in the 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.

• 34:48Speaker 05

  Mm-hmm.

• 34:49Wendy Zukerman?

  So, for example, today you can find the Foundation for a Smoke-Free World, whose goal is the end of tobacco use achieved through funding research and promoting innovation.

• 35:06Wendy Zukerman?

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

• 35:12Speaker 05

  Wow, that's bleak.

• 35:14Wendy Zukerman?

  They are entirely, entirely funded by Big Tobacco. And just a couple of years ago, they changed their name, by the way, to Global Action to End Smoking. And this is just one of these groups. Other companies that sell these products are out there funding science, too.

• 35:36Speaker 05

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

• 35:43Wendy Zukerman?

  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?

• 36:06Speaker 05

  50%?

• 36:08Wendy Zukerman?

  It was 35%.

• 36:10Speaker 05

  Okay, that's still pretty high.

• 36:12Wendy Zukerman?

  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.

• 36:22Speaker 05

  Mm-hmm.

• 36:23Wendy Zukerman?

  Which, you know, one in three, one in four.

• 36:27Speaker 05

  Yeah.

• 36:28Wendy Zukerman?

  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 be pro-vaping more generally. So you say things like, wow, they look pretty good compared to cigarettes.

• 36:52Speaker 05

  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.

• 37:22Wendy Zukerman?

  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.

• 37:43Speaker 08

  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.

• 37:56Wendy Zukerman?

  You know, and meanwhile.

• 37:59Wendy Zukerman?

  We are getting more and more evidence that vaping on its own is bad, right? Even if it, we don't know if it causes cancer yet. 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. More and more evidence showing it's not good for your heart.

• 38:15Speaker 05

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

• 38:19Wendy Zukerman?

  Yeah, I'm sorry. You know, but the good news is that there's a, you know that song that we played for people that we didn't lie to them with?

• 38:29Speaker 05

  Uh huh.

• 38:31Wendy Zukerman?

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

• 38:38Speaker 05

  Yeah, let's, we'll play me out.

• 38:53Speaker 05

  The prophecy came true.

• 38:55Wendy Zukerman?

  The prophecy came true.

• 39:05Wendy Zukerman?

  John asked me how many citations are in this episode?

• 39:07Speaker 05

  So Wendy, how many citations are in this episode?

• 39:09Wendy Zukerman?

  There's 78.

• 39:10Speaker 05

  Thanks so much for telling me.

• 39:16Wendy Zukerman?

  If 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.

• 39:24Speaker 05

  Thanks, Wendy.

• 39:25Wendy Zukerman?

  If you're thinking of switching to vaping.

• 39:29Speaker 05

  Do it!

• 39:30Wendy Zukerman?

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

• 39:38Speaker 05

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

• 39:51Wendy Zukerman?

  Bye!

• 40:00Wendy Zukerman?

  Science vs. 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 Zukerman and Rose Rimler, with help from Akedi Foster Keys, Merrill Horn and Michelle Dang. We're edited by Blythe Sherrell. I'm the executive producer. Fact checking by Erica Akiko Howard. Mix and sound design by Bobby Lord. Music written by Boomihidaka, Peter Leonard, Emma Munger and Bobby Lord. Thank you so much to the Australian Science Media Centre for all your help with this episode. Also, thank you to the scientists who responded to our emails on this.

• 40:44Wendy Zukerman?

  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 Zukerman family. I'm Wendy Zukerman. Back to you next time.

• 41:03Wendy Zukerman?

  You know, it's kind of like, do you need to watch seven seasons of Young Sheldon? Or Star Wars: The Phantom Menace?

• 41:13Speaker 05

  Wait, which, that analogy, which is vaping and which is smoking?

• 41:17Wendy Zukerman?

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

• 41:27Speaker 05

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

• 41:34Wendy Zukerman?

  Would it help if I said, Misa, no need to...

• 41:39Speaker 05

  It wouldn't help actually, no.

• 41:48Wendy Zukerman?

  You know what Becky Freeman has actually watched as...

• 41:51Speaker 05

  Watched all seven seasons of Young Sheldon?

• 41:57Wendy Zukerman?

  Rise, I'm trying to make a serious point here. Okay.

• 42:02Speaker 09

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