Inhaled nicotine and lung cancer: Potential role of the nicotinic acetylcholine receptor

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The article by Tang et al. (1) shows electronic-cigarette smoke (ECS) causes lung cancer and bladder hyperplasia in mice. Tang et al. (1) should be congratulated for their research contributing to this body of work, raising concerns about the effect of ECS on the lungs (1, 2). We outline below why we think nicotine may be directly carcinogenic when inhaled into the lungs and how this would explain why low levels of nitrosamines provide no comfort with regard to the safety of ECS (1). Tang et al. (1) make important findings in this and earlier work (1, 2). First, lung cancer developed in the mice inhaling nicotine mixed with vehicle but not vehicle alone. … [↵][1]1To whom correspondence may be addressed. Email: roberty{at}adhb.govt.nz or rhopkins{at}adhb.govt.nz. [1]: #xref-corresp-1-1