Updated March 9th, 2022

Vapers and Hookah Smokers Could Be At Higher Risk for Nose, Sinus and Throat Cancers Due To The Way They Exhale, New Research Suggests

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Vaping and Cancer Risk

New research suggests that vapers and hookah smokers are more likely to exhale the smoke from their noses than cigarette smokers. Researchers posit that this puts these users at a higher risk for cancers of the nose and sinuses and throat.
Nasal cavity and sinus cancers are rare, and symptoms don't usually show up during the earlier stages of the disease. Sometimes these cancers are discovered during treatment for a sinus infection.
Throat cancer is a type of head and neck cancer where cancerous cells begin in the throat, voice box or tonsils. It is an HPV-related cancer. To reduce the risk of your children developing HPV or an HPV-related cancer, make sure they get the HPV vaccine, particularly between ages 9 and 12.

There are still many questions to be answered about vaping and cancer risk. But recent research suggests vapers and hookah smokers are much more likely to exhale through their nose which could potentially put those users at a higher risk for inflammation and cancers of the nose, sinuses and throat.

Led by researchers at NYU Grossman School of Medicine, the study of 341 people showed that large numbers of vapers and hookah smokers exhaled through their nose (63 percent and 50 percent, respectively) compared to 22 percent of cigarette smokers.

"Our findings suggest that the unique way vapers and hookah smokers use their devices may expose the nose and sinuses to far more emissions than cigarettes, which may in turn increase their risk for upper respiratory diseases," lead study author Emma Karey, PhD, a postdoctoral research fellow in the Department of Environmental Medicine at NYU Langone Health, said in a statement.

Considering this data, study senior author Terry Gordon, PhD, a professor in the Department of Environmental Medicine, says we should broaden our typical lung-based evaluation of the safety of vaping and hookah devices.

"Because vaping and hookah devices are used differently than traditional cigarettes, we need to consider diseases of both the nose and lungs to evaluate their safety before judging whether one is more risky than another," he said.

In addition, Gordon added that the research team also saw as many as 10 times the levels of inflammatory compounds released by defense cells in the noses of vapers and hookah users than in cigarette smokers. Investigators have yet to determine whether the nasal damage seen in vapers is truly a result of their unique breathing pattern and not due to an unrelated issue.

Vaping and Cancer Risk

Assessing cancer risk for e-cigarette users is difficult because more research is needed to better understand the health implications.

"The big problem with vaping and JUUL is that we just really don't know what's going to happen with it," Dr. Brendon Stiles, chief of thoracic surgery & surgical oncology at Montefiore and Albert Einstein College of Medicine, previously told SurvivorNet.

The Issue With Vaping Doctors Don't Know How Dangerous It Is Yet

Dr. Stiles is concerned that vaping will be a lifestyle factor that leads to lung disease down the line.

"Are there compounds in vaping that we're just not regulating, and we don't know anything about that may cause secondary insults or inflammation in the lungs? There's plenty of history of other inflammatory lung conditions causing or triggering lung cancer," Dr. Stiles said. "So, to me, it's not a great leap to think that inhalation from vaping could trigger lung cancer down the road or other inflammatory lung diseases."

And some experts such as Dr. Sheela Ahmed, a pulmonologist at Fox Chase Cancer Center, say e-cigarettes are worse than actual cigarettes in many ways.

"E-cigarettes don't burn tobacco, so they are marketed as containing fewer toxic chemicals than regular cigarettes," Dr. Ahmed previously told SurvivorNet. "However, this is not true. In the short term, vaping has caused acute lung injury and respiratory failure, which is something not attributed to regular cigarette use."

As for the chemicals in those e-cigarettes? A "cocktail of nicotine, toxic metals, propylene glycol and glycerol, flavorings, and other chemicals that can reach deep into the lungs," according to Dr. Ahmed.

A 2019 study published in Proceedings of the National Academy of Sciences of the United States of America examined how vaping impacted mice. That research showed that vaping caused cells to change in a matter of months.

That would suggest DNA is being injured and the body is failing to repair those injured strands, which is how cancer begins to form in the human body.

"As a cancer center, we are very concerned about the animal studies showing that e-cigarette smoke caused cancer in mice and, in the future, we want to study DNA changes in the cells of people who vape," explained Dr. Ahmed.

She suggested that the "establishment of community education programs regarding the risks of vaping" would be helpful until that time.

Understanding Throat Cancer

Throat cancer is a type of head and neck cancer where cancerous cells begin in the throat, voice box or tonsils. Some of the main risk factors for this disease include smoking, drinking alcohol, a diet lacking in fruits or vegetables, acid reflux disease and the human papillomavirus (HPV). So, one way to decrease the chances of developing the disease is to get the HPV vaccine.

The American Cancer Society recommends that boys and girls get the HPV vaccine between ages 9 and 12. The organization also stresses that teens and young adults through age 26 who are not already vaccinated should get the HPV vaccine as soon as possible. Dr. Jessica Geiger, a medical oncologist at Cleveland Clinic Cancer Center, explains the link between throat cancer and HPV in a previous interview with SurvivorNet.

Get the Facts: What Do We Know About HPV-Linked Throat Cancer?

"There are no screening guidelines to screen for throat cancer, unlike cervical cancer with pap smears. And there are no standard tests to determine if you harbor the (HPV) virus," she said. "However, there is no concern that you're going to spread this cancer to your partner or to anyone else, because at this point your partner has already been exposed to the virus and likely cleared it."

Understanding Nasal Cavity and Sinus Cancers

Nasal cavity and sinus cancers are rare. Memorial Sloan Kettering Cancer Center reports that these cancers only affect about 2,000 people in the United States each year, and tumors are more likely to begin in the nasal cavity than in the sinuses.

Tobacco use is a risk factor for nasal cavity and sinus cancers. And these rare cancers are more common in people who have had significant exposure to wood dust, nickel and chemicals used in leather processing.

It's uncommon for nasal cavity and sinus tumors to cause symptoms at their earliest stages. Unfortunately, most people tend to notice symptoms only once the tumor has grown large enough to block the nasal cavity or the affected sinus, or when it has spread to nearby tissue. That's why your doctor may discover the tumor during treatment for a sinus infection.

Common signs of nasal cavity cancer and sinus cancer include:

nasal congestion that doesn't go away
chronic sinus infections that don't respond to antibiotics
frequent headaches
facial pain
nosebleeds
swelling around the eyes
decreased sense of smell

More advanced disease is associated with:

loose teeth
numbness around the cheek and upper lip
double vision
swelling in the mouth, jaw or neck

Contributing: Chris Spargo

Learn more about SurvivorNet's rigorous medical review process.

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