At the 112th annual Scientific Meeting of the American Urological Association, 2 research studies raising concerns for an increased risk of bladder cancer in electronic cigarette (e-cigarette) users were presented.1It is very well documented that smoking increases the risk for certain types of cancers, bladder cancer is one of them, however, the verdict of whether electronic cigarettes (also known as “vaping”) carried the same risks was still unknown. Other studies have linked e-cigarettes to cancer as well,2 but not many.

Ever Popular E-Cigarette

E-cigarette use has grown very popular over the last decade, and there may be a general opinion that they are safer than traditional cigarette smoking. There isn’t research to support this opinion, however, there isn’t much research to the contrary, either. Ninety percent of inhaled nicotine is excreted through the urine, so there is likely a correlation. The current study looked at known bladder carcinogens in the urine of e-cigarette users compared to non-smokers. Urine samples were analyzed for 5 known carcinogens affecting the bladder that are present in traditional cigarettes or common solvents used in some e-cigarette liquids. The research participants were mostly male – average age 30 years. The non-smokers had abstained from tobacco products for at least 6 months. Ninety-two percent of e-cigarette users tested positive for at least 2 of the 5 carcinogens tested.

Second Study Findings

The second study presented looked at e-cigarette smoke as potentially carcinogenic to the actual bladder mucosa. Researchers looked at whether e-cigarette smoke induced DNA damage in urothelial cells. They also looked at the effect of nicotine -and metabolites, nitrosamines and formaldehyde – on DNA repair and mutational susceptibility in cell cultures. The results showed that e-cigarette smoke does induce DNA damage of bladder mucosa indicative of tumorigenicity. Nicotine and all metabolites also induced the same DNA damage in human urothelial cell lines as well as inhibited DNA repair and increased mutational susceptibility.


The overall conclusion of the researchers is that e-cigarette use likely carries a high bladder cancer risk. This supports and emphasizes the need to advocate smoking cessation and cessation of all tobacco products. It also underscores the need for cancer screening in populations using smokeless nicotine alternatives such as e-cigarettes.


  1. Press Release
  2. Erratum: Borderud SP, Li Y, Burkhalter JE, Sheffer CE and Ostroff JS. Electronic cigarette use among patients with cancer: Characteristics of electronic cigarette users and their smoking cessation outcomes. Cancer. doi: 10.1002/ cncr.28811. Cancer. 2015;121(5):800.

Node Smith, associate editor for NDNR, is a fifth year naturopathic medical student at NUNM, where he has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine amongst the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend campout where naturopathic medicine and medical philosophy are experienced in nature. Three years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.

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