SEOUL — A sweeping new study out of South Korea is casting serious doubt on the idea that switching to e-cigarettes is a safe way to quit smoking. Researchers found that former smokers who took up daily vaping faced a 56 per cent higher risk of developing lung cancer compared to those who quit nicotine entirely. The findings, published in Nature Medicine, come from a nationwide cohort study led by researchers at Seoul National University Bundang Hospital.
They analysed health records from 4,524,895 Korean adults with a history of smoking combustible cigarettes, drawing on data from the Korean National Health Screening Program. Participants were followed until December 2023, yielding over 24.18 million person-years of follow-up.
During that period, researchers recorded 35,887 new lung cancer cases and 12,807 lung cancer-related deaths. The scale makes it one of the largest investigations into the long-term health effects of vaping after smoking cessation. The study grouped former smokers into those who quit both cigarettes and e-cigarettes completely, those who switched to daily e-cigarette use, and those who continued smoking traditional cigarettes.
The healthiest outcomes were consistently seen among complete quitters. Former smokers who used e-cigarettes daily had an adjusted hazard ratio of 1.56 for lung cancer and 2.00 for lung cancer-specific death compared with complete quitters.
For context, people who continued smoking combustible cigarettes had an even higher risk — a 1.78 times greater risk of lung cancer. The pattern suggests that while vaping may be less harmful than continued smoking, it is not a harmless alternative. For years, e-cigarettes have been marketed as a less harmful option, with many smokers turning to vaping in the hope of protecting their lungs while quitting.
The Korean data offers a stark warning: quitting smoking isn’t enough if you start vaping. The researchers’ message is clear — the best outcome for lung health is to give up both cigarettes and e-cigarettes entirely. Consult your doctor for medical advice.
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