Electronic cigarette use after smoking cessation and lung cancer risk
Menée à partir de données coréennes portant sur 4,5 millions de fumeurs ou anciens fumeurs, cette étude analyse l'effet, sur la réduction du risque de cancer du poumon, d'une utilisation de la cigarette électronique après un sevrage tabagique
Electronic cigarettes (e-cigarettes) have gained popularity as a less harmful alternative to conventional cigarettes, yet their associations with lung cancer risk after smoking cessation remain uncertain. Here we evaluated 4,524,895 adults with a conventional smoking history who participated in the Korean National Health Screening Program in 2018 (baseline), with prior records from 2012–2014. Participants were classified as current smokers, short-term quitters or long-term quitters, and followed up to December 2023. Daily e-cigarette use at baseline was used to define post-cessation e-cigarette use. Lung cancer incidence and lung cancer-specific death (LCSD) were assessed using multivariable Cox models. Over 24,182,543 person-years, 35,887 lung cancers and 12,807 LCSD events occurred. Compared with complete quitters, e-cigarette use after smoking cessation was associated with higher risks of lung cancer incidence (adjusted hazard ratio (aHR) 1.56, 95% confidence interval (CI) 1.24–1.97) and LCSD (aHR 2.00, 95% CI 1.28–3.15). Associations were directionally consistent in short-term and long-term quitters and were prominent in the high-risk subgroup (incidence: aHR 1.91, 95% CI 1.44–2.53; LCSD: aHR 1.92, 95% CI 1.13–3.24). Although causality cannot be established, these findings suggest that e-cigarette use after smoking cessation may attenuate the benefits of complete cessation for lung cancer prevention.
Nature Medicine , article en libre accès, 2026