Document Type

Conference Proceeding

Publication Date


Publication Title

Ann Oncol


Background: Current e-cigarette use has been rising, assuming as a safe alternative to traditional smoking. Therefore, we aim to evaluate the prevalence of cancer and types of cancers amongst e-cigarette and traditional smokers.

Methods: A retrospective cross-sectional survey study was performed using NHANES (National Health And Nutrition Examination Survey) database from 2015 to 2018. History of cancer (MCQ220), type of cancers (MCQ230a), and smoking status (E-cigarette: SMQ900 or SMQ905 and Traditional smoking: SMQ020) were identified. Univariate and multivariable logistic regression analysis was performed to find out prevalence and association between e-cigarette smoking and cancer. We have excluded respondents with dual smoking.

Results: Out of 154,856 participants, 7756 (5.01%) were e-cigarette users, 48625 (31.4%) were traditional smokers, 98475 (63.59%) were non-smokers. Females (49 vs 38%), Mexican Americans (20 vs 13%), high annual household income (>$100,000: 23 vs 15%) were having a higher prevalence of e-cigarette smoking in comparison with traditional smoking. (p<0.0001) Prevalence of cancer (any type) was 11.61%. Cancer prevalence was higher amongst traditional smokers in comparison with e-cigarette smokers. (16.77 vs 2.32%; p<0.0001) E-cigarette smokers were younger at the diagnosis of 1st cancer in comparison with traditional smokers. (median: 45 vs 63-years; p<0.0001) Cervical (21.99 vs 2.01%), thyroid (10.64 vs 2.45%), leukemias (8.51 vs 1.08%), and breast (12.06 vs 12.01%) cancers were more prevalent amongst e-cigarette smokers in comparison to traditional smokers. (p<0.0001) In adjusted multivariable regression analysis, e-cigarette smokers [aOR: 1.3 (95%CI: 1.32-1.33); p<0.0001] and traditional smokers [1.6 (1.64-1.65); p<0.0001] were having higher odds of prevalence of cancer in comparison with non-smoker.

Conclusions: E-cigarette smokers had an early age of cancer onset and higher odds of cancer prevalence. Females had higher use of e-cigarette and cervical, thyroid, and breast cancers were prevalent amongst e-cigarette users. More prospective studies should be planned to mitigate the risk and before considering e-cigarette as a safe alternative to traditional smoking.


Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.



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