Harmful chemicals emitted from electronic cigarettes and potential deleterious effects in the oral cavity

Abstract

Use of electronic nicotine delivery systems (ENDS), such as electronic cigarettes (e-cigs), is increasing across the US population and is particularly troubling due to their adoption by adolescents, teens, and young adults. The industry's marketing approach for these instruments of addiction has been to promote them as a safer alternative to tobacco, a behavioral choice supporting smoking cessation, and as the 'cool' appearance of vaping with flavored products (e.g. tutti frutti, bubble gum, and buttered popcorn etc.). Thus, there is a clear need to better document the health outcomes of e-cig use in the oral cavity of the addicted chronic user. There appears to be an array of environmental toxins in the vapors, including reactive aldehydes and carbonyls resulting from the heating elements action on fluid components, as well as from the composition of chemical flavoring agents. The chemistry of these systems shows that the released vapors from the e-cigs frequently contain levels of environmental toxins that considerably exceed federal occupational exposure limits. Additionally, the toxicants in the vapors appear to be retained in the host fluids/tissues at levels often approximating 90% of the levels in the e-cig vapors. These water-soluble reactive toxins can challenge the oral cavity constituents, potentially contributing to alterations in the autochthonous microbiome and host cells critical for maintaining oral homeostasis. This review updates the existing chemistry/environmental aspects of e-cigs, as well as providing an overview of the somewhat limited data on potential oral health effects that could occur across the lifetime of daily e-cig users.

Are Nigerian oral health workers overlooking opportunities to promote interventions for tobacco smoking cessation?

“…Each year, tobacco use is responsible for approximately 8 million deaths worldwide, including 7 million deaths among persons who use tobacco and 1.2 million deaths among nonsmokers exposed to secondhand smoke (SHS) 19 . In addition to being associated with a number of cancers and coronary conditions, tobacco plays a role in the etiology of a number of oral conditions; tobacco exposes the oral cavity to toxic carcinogens that have a role in initiation and promotion of cancer 20 as well as leukoplakia, periodontitis, and delayed wound healing 21 . The dental practice setting thus provides a unique opportunity to assist tobacco users in achieving tobacco abstinence 17 .…”

Profile of incidental exposures to e-cigarette liquids in Europe, 2018–2019

“…14 Nevertheless, we cannot rule out the possibility that ingredients other than nicotine, including those the effects of which on human health have been understudied, or the combinations of chemical substances would cause or enhance adverse health outcomes. 11,15,16 As data on poisoning effects accumulate, it is important to continue close monitoring of ingredients of e-liquid products that are sold on the market.…”

Comparative Evaluation of Salivary Biomarker Levels in e-Cigarette Smokers and Conventional Smokers

“…Smoking leads to activation of complex inflammatory processes and cascades resulting in cytokine production leading to various oral diseases including carcinoma and periodontal diseases. [ 3 ]…”