Does vitamin E increase the risk of lung cancer?

December 15, 2025 •

3 min read

According to findings from the VITAL cohort, long-term use of supplemental vitamin E was associated with a small increased risk of lung cancer, particularly among current smokers. The relationship between vitamin E and lung cancer risk is complex and depends heavily on the source and dosage.

Quick Summary

The impact of vitamin E on lung cancer risk varies significantly, with studies showing different outcomes for dietary consumption versus high-dose supplementation, especially in specific populations.

Key Points

Supplements vs. Diet: High-dose vitamin E supplements may increase lung cancer risk, particularly in smokers, while dietary intake is associated with a reduced risk.
Alpha-Tocopherol is Not All: Many supplements contain only alpha-tocopherol, which has shown mixed results, while other forms like gamma- and delta-tocopherols found in foods may offer more effective anti-cancer properties.
High Dose Risks: Large-scale trials, such as SELECT, have indicated that high-dose vitamin E supplementation can have harmful effects and does not prevent cancer.
Dietary Focus: For cancer prevention, experts recommend obtaining vitamin E from a balanced diet of whole foods rather than relying on supplements.
Mechanism Nuance: High levels of isolated antioxidants may have different, potentially pro-oxidant, effects in a cellular environment compared to the complex interactions within whole foods.
Smokers Should Be Wary: Smokers, in particular, have shown a potentially higher risk of lung cancer when taking certain supplements, reinforcing the advice to avoid high-dose antioxidant pills.

Conflicting Evidence on Vitamin E and Cancer

For many years, vitamin E was thought to protect against cancer due to its antioxidant properties. Early studies linking high dietary vitamin E intake with lower cancer rates supported this idea. However, large controlled trials have shown inconsistent or concerning results regarding high-dose supplements. This has created confusion about whether vitamin E, particularly in supplement form, increases lung cancer risk.

Dietary vs. Supplemental Vitamin E: A Critical Distinction

Research highlights the importance of the vitamin E source.

Dietary Vitamin E: Consuming vitamin E from foods like nuts and leafy greens is linked to a lower risk of lung cancer. The benefit may come from vitamin E interacting with other compounds in these foods.
Supplemental Vitamin E: High-dose supplements have not shown protective effects and may increase risk, particularly in smokers. One study found supplemental vitamin E increased lung cancer risk, mainly in current smokers.

Insights from Key Clinical Trials

Trials like the ATBC study and SELECT have significantly influenced the understanding of this topic.

The Alpha-Tocopherol, Beta-Carotene (ATBC) Trial

This trial in male smokers studied alpha-tocopherol (vitamin E) and beta-carotene supplementation. It found no overall effect of alpha-tocopherol on lung cancer but observed an increase in lung cancer with beta-carotene. This indicated that single-nutrient supplements might not offer the same benefits as nutrient-rich diets.

The Selenium and Vitamin E Cancer Prevention Trial (SELECT)

SELECT examined selenium and high-dose vitamin E on prostate cancer risk. It was stopped early because the supplements weren't effective. Follow-up showed a 17% increased risk of prostate cancer with vitamin E alone, raising concerns about high-dose antioxidant supplements generally.

The Role of Tocopherol Forms

Vitamin E includes various compounds, like alpha, gamma, and delta-tocopherols. Many supplements only contain alpha-tocopherol, but other forms found in food may be more effective against cancer. High alpha-tocopherol intake can reduce levels of other beneficial forms, like gamma-tocopherol.

Comparison of Dietary vs. Supplemental Vitamin E


Feature	Dietary Vitamin E	Supplemental Vitamin E (High Dose)
Source	Whole foods (nuts, seeds, leafy greens)	Isolated, often synthetic alpha-tocopherol capsules
Associated Lung Cancer Risk	Generally associated with reduced risk	Some studies show increased risk, especially in smokers
Form of Vitamin E	Contains a mixture of tocopherols and tocotrienols	Often contains only high doses of alpha-tocopherol
Overall Effect	Part of a healthy diet, contributes to overall wellness	Conflicting results; potential risks outweigh unproven benefits for prevention

Natural Sources of Vitamin E

Getting vitamin E from food is recommended. Good sources include:

Seeds and Nuts: Sunflower seeds, almonds, hazelnuts.
Vegetable Oils: Wheat germ oil, sunflower oil.
Green Leafy Vegetables: Spinach, broccoli.
Fortified Foods: Many cereals and spreads.

Conclusion: The Bottom Line on Vitamin E and Lung Cancer Risk

Dietary vitamin E from food is linked to a lower risk of lung cancer, but high-dose supplements, particularly alpha-tocopherol, have been associated with increased risk in smokers and a higher risk of prostate cancer. Focusing on a balanced diet rich in whole foods is the most consistent advice for cancer prevention, rather than relying on isolated nutrient supplements. Reputable sources like the National Cancer Institute (NCI) offer further health information.

Evidence does not support the use of high-dose vitamin E supplements for cancer prevention, and potential risks exist. Always consult a healthcare professional before starting new supplements.

Frequently Asked Questions

Yes, dietary intake of vitamin E from food sources is considered safe and is associated with a reduced risk of lung cancer in some studies. The beneficial effects are likely due to the combination of nutrients found in whole foods.

The mechanism isn't fully understood, but some research suggests that high doses of supplemental vitamin E may act as a pro-oxidant under certain conditions, potentially harming cells rather than protecting them. This effect was observed particularly in smokers during some trials.

Alpha-tocopherol is the most common form in supplements, but vitamin E is a family of compounds. Other forms, such as gamma- and delta-tocopherols, are more abundant in food and have demonstrated stronger anti-cancer effects in laboratory studies.

Yes, studies have shown that high-dose supplementation with vitamin E (and beta-carotene) did not prevent lung cancer in male smokers and may have increased their risk.

The SELECT trial primarily investigated prostate cancer but also examined other cancers. It found no effect on the incidence of lung or colorectal cancers from the high-dose vitamin E and selenium supplements, but it did find an increased risk of prostate cancer.

The safest way is through your diet. Incorporate foods such as sunflower seeds, almonds, hazelnuts, wheat germ oil, sunflower oil, and green leafy vegetables like spinach and broccoli into your meals.

Research has mostly focused on high, isolated doses of vitamin E supplements. However, a balanced diet is generally considered superior to supplements for cancer prevention, and consulting a doctor is recommended before taking any high-dose supplements.