New study finds smoking and vaping dual use increases lung cancer risk; expert says it increases risk for other diseases too

By Melissa Patrick
Kentucky Health News

People who use electronic cigarettes and smoke traditional cigarettes are more likely to develop lung cancer than people who just smoke, according to a new study.

Centers for Disease Control and Prevention photo 

The Ohio State University study, published in the Journal of Oncology Research and Therapy, found that vaping combined with cigarette smoking was eight times more common in the cases with lung cancer than the control subjects, and the risk of developing lung cancer was four times higher among those who combined vaping and cigarette smoking than those who only smoked. These findings were consistent across genders and races and for all major cell types of lung cancer.

 

"This study presents clear evidence showing that vaping in addition to smoking can increase your risk for lung cancer," Marisa Bittoni, lead author and researcher at Ohio State's College of Medicine, said in a news release. "This is especially concerning given the rate of youth and young adults using these products." 

Dr. Randall Harris, co-author and professor of epidemiology at Ohio State's College of Public Health, added that while most people know that tobacco smoke contains cancer-causing chemicals, there is less known about the chemicals inhaled through vaping products. 

“Our findings provide the first evidence that smoking in combination with vaping significantly increases the risk of lung cancer compared to smoking alone," Harris said. 

Dual use and other chronic diseases

Amanda Bucher, director of tobacco policy research and outreach at the University of Kentucky College of Nursing, explained that because e-cigarettes contain a different mix of toxic chemicals than cigarettes do, including some new compounds that are formed when the chemicals are heated, people who are dual users are exposed to a broader range of toxins than they would be if they just used one device or the other. 

"Using both e-cigarettes and traditional cigarettes is associated with a higher risk of developing other diseases too, a higher risk than just smoking traditional cigarettes," Bucher said. "So not just a higher risk of developing lung cancer, but also cardiovascular disease, stroke, metabolic dysfunction, asthma, COPD and oral diseases."

Smoking cessation, prevention and lung cancer screening

Bucher said the good news is that Kentucky ranks second among states for lung cancer screening, but the bad news is that there is more work to be done because Kentucky continues to lead the nation in the rate of new lung cancer cases and deaths from it. 

Lung cancer screening with annual low-dose CT scans is recommended for people who: 

• are 50 to 80 years old
• smoke or have quit smoking within the past 15 years
• have at least a 20-pack-year smoking history, which means a pack a day for 20 years or two packs a day for 10 years, and so on. A pack year is the number of packs smoked per day multiplied by the number of years the person smoked.

According to the Centers for Disease Control and Prevention, around 30% of adult smokers in the United States are dual users. In Kentucky, the Truth Initiative, a tobacco-control advocacy group,  reports that 10.5% of adults use e-cigarettes and 17.4% are smokers. Among the state's high-school students, 4.9% are smokers and 21.9% vape. All of these Kentucky rates are higher than the national averages.

Bucher encouraged anyone trying to quit smoking and/or vaping to reach out to the Kentucky Quit Line at 1-800-QUIT-NOW, go to QuitNowKentucky.org or text QUITKY to 797979. 

She said help can also be found with a primary care provider who can offer counseling support and access to U.S. Food and Drug Administration-approved medications to help with cessation. 

"Research definitely shows that using medicines to help with tobacco treatment can double your chances of successfully quitting," she said. 

In addition, she said 39 local health departments receive funds to support cessation and prevention programs. Asked why all of the state's 61 district and county health departments don't offer this service, she said they used to, but reductions in funding from the state tobacco program have led to fewer of them offering such programs. 

"We know that almost 50% of Kentucky adults who smoke have tried to quit in the last year," she said. "It's really important for us to do everything we can to support those individuals." 

Bucher said policy matters when it comes to decreasing lung cancer rates and deaths in Kentucky.  

"We know that individuals who live in a Kentucky community with a comprehensive smoke-free workplace law are 8% less likely to be diagnosed with lung cancer," she said. "So just living in a place that has a certain kind of law means that you're less likely to get lung cancer. It doesn't matter what behavioral choices you are making." 

She added that only 38.1% of the state's population is covered by a comprehensive smoke-free workplace law, which means there is a lot of opportunity for communities to pass such laws to provide protections for their citizens. 

Further, she said, "We know that smoke-free laws make it easier for people to quit because they aren't exposed to those triggers. And, we also know that when fewer people are smoking and vaping inside public places, youth are less likely to start using tobacco products. So a smoke-free policy can also be something that is protective."