Australian researchers from leading universities have delivered a sobering verdict on vaping: nicotine-based e-cigarettes are likely carcinogenic and could cause lung and oral cancer. This conclusion comes from a landmark qualitative risk assessment report released by the Clinical Oncology Society of Australia (COSA) in August 2025, spearheaded by Professor Bernard Stewart AM from the University of New South Wales (UNSW). The multidisciplinary working group, drawing expertise from institutions like Flinders University, Curtin University, the University of Sydney, University of Queensland, and University of South Australia, synthesized evidence from lab studies, animal models, and human biomarkers to reach this determination.

The report marks a pivotal moment in higher education-led public health research, shifting the conversation from whether vaping is 'safer than smoking' to acknowledging its independent hazards. With vaping rates tripling in Australia over four years—one in five people having tried e-cigarettes by 2024—this university-driven analysis underscores the urgency for campuses to prioritize student wellness and contribute to national policy.

University Researchers Behind the Breakthrough Findings

The COSA report was chaired by Professor Bernard Stewart, an adjunct professor in Paediatrics and Child Health at UNSW, renowned for his work in cancer prevention. The working group included Professor Billie Bonevski from Flinders Health and Medical Research Institute at Flinders University, Emeritus Professor Lin Fritschi from Curtin School of Population Health, Associate Professor Ashley Hopkins from Flinders University College of Medicine and Public Health, Dr Malinda Itchins from the University of Sydney Faculty of Medicine and Health, Associate Professor Henry Marshall from the University of Queensland Thoracic Research Centre, Dr Natansh Modi from the University of South Australia, Associate Professor Marissa Ryan from the University of Queensland School of Pharmacy, and Associate Professor Freddy Sitas from UNSW School of Population Health.

These academics represent a collaborative effort across Australian higher education, pooling epidemiology, oncology, pharmacology, and public health expertise. Their involvement highlights how universities are at the forefront of addressing emerging health threats like vaping, often partnering with bodies like Cancer Council Australia. For instance, UNSW's Kirby Institute and School of Population Health have long tracked tobacco-related cancers, providing foundational data.

This university network not only advances knowledge but also trains the next generation of researchers through PhD programs and grants focused on tobacco control and carcinogen exposure.

Animal Studies: Direct Evidence of Lung Cancer from Vape Aerosols

One of the report's strongest pillars is animal research demonstrating e-cigarette aerosols cause cancer. In a 54-week inhalation study by Tang et al. (2019), mice exposed to e-cigarette vapor with 36 mg/mL nicotine developed lung adenocarcinoma in 22.5% of cases, alongside bladder urothelial hyperplasia—a precursor to cancer. This mirrors tobacco smoke effects, with histopathological changes like alveolar hyperplasia and inflammation.

Australian universities like the University of Queensland have contributed to similar models, emphasizing how vaping induces chronic lung injury. These findings, replicated across labs, provide mechanistic proof beyond human epidemiology, which lags due to vaping's recency.

Human Biomarkers: DNA Damage and Cellular Changes Linked to Cancer

Human studies reveal vaping triggers cancer hallmarks. Biomarkers like urinary NNAL (tobacco-specific nitrosamine metabolite) are elevated 5-fold in vapers versus non-users (Goniewicz 2023). DNA adducts from acrolein (γ-hydroxy-1,N²-propano-dG) and formaldehyde appear in oral cells, with levels 8 times higher in users.

University of Wollongong research (2016, updated analyses) showed e-cig vapor induces double-strand DNA breaks in lung and bladder cells, comparable to cigarettes. Recent USC genome-wide studies (2024) confirm similar DNA methylation changes in vapers and smokers, linked to disease risk. Oxidative stress markers (8-OHdG) and inflammation (IL-6, MMP-9) persist, fostering genomic instability.

Curtin and Flinders researchers in the COSA group noted reduced DNA repair genes (XPC, OGG1), amplifying mutation risks—a focus for ongoing uni lab work.

Carcinogenic Chemicals in Vape Aerosols Exposed by University Analysis

E-cig aerosols harbor Group 1 carcinogens (formaldehyde, benzene, arsenic) and others (acrolein, NNN/NNK nitrosamines formed endogenously). Heavy metals (nickel, chromium, cadmium) leach from coils, with vapers showing higher urinary levels than smokers in some cases.

• Formaldehyde: Retained 99.7% in lungs, causes DNA-protein crosslinks.
• Acrolein: Propylene glycol byproduct, highest in flavored vapes.
• Flavorings: Diacetyl (popcorn lung), pulegone (mint)—toxic at smoker levels.
• Metals: Nickel (Group 1 lung carcinogen) from coils.

University of Queensland pharmacologists quantified these, noting flavors exacerbate risks, informing TGA bans on disposables.

Photo by 0xk on Unsplash

Australia's Vaping Epidemic: University Data on Prevalence and Youth Uptake

National Health Survey (2022): 14.4% adults ever-used, 4% current. Youth: 18% of 15-17 year-olds vape (2022), doubled since 2020; 38% 18-24 ever-used. Generation Vape (University of Sydney-led) shows regulations curbed teen rates to 15% by 2025.

Uni campuses mirror trends: surveys at USyd, UNSW reveal 10-20% student use, prompting health campaigns. QIMR Berghofer (UQ affiliate) estimates $180M annual costs if vapers transition to smoking.

Government Regulations and Universities' Role in Policy Influence

2024 TGA reforms: Pharmacy-only sales, nicotine caps. COSA report bolsters calls for enforcement amid illicit market. Universities like UNSW advocate via submissions, training policymakers.

Flinders and Curtin epidemiologists track impacts, with Generation Vape informing NSW bans on youth sales.

Research Gaps: What Australian Universities Are Tackling Next

No long-term epi data due to latency; gaps in flavor/device specifics, cancer survivors' use. Calls for prospective cohorts at UQ Thoracic Centre, UNSW population studies. IARC prioritizes e-cigs 2025-2029.

Funding opportunities in uni research jobs for biomarkers, longitudinal trials.

Implications for University Students and Campus Health Programs

With 1 in 5 young Aussies trying vapes, unis face addiction, respiratory issues. USyd's programs reduced odds 65%; UNSW integrates cessation in med curricula. Student researchers lead peer education.

Stakeholder Perspectives: Quotes from University Experts

"E-cigarettes are likely to cause lung cancer and oral cancer." – Prof Bernard Stewart, UNSW.

"There is enough evidence... all should cause cancer." – Prof Brian Oliver, UNSW.

Photo by Jeremy Huang on Unsplash

Vaping exposes a new generation to risks; unis must lead prevention.Prof Sabe Sabesan, COSA President

Future Outlook: University-Led Solutions and Research Horizons

Australian higher ed is pivotal: expanded grants for oncology, public health PhDs. Actionable insights: campus quitlines, flavor bans. By integrating findings, unis position as trusted voices against nicotine epidemics.

For those seeking careers in this field, opportunities abound in research assistant roles at UNSW, UQ, and Flinders.