Unintended Side Effects of Electronic Cigarettes in Otolaryngology: A Scoping Review

Abstract

Objective Electronic cigarettes (E-cigs) are nicotine delivery systems with increasing popularity. The US Food and Drug Administration defines side effects as unwanted or unexpected events or reactions. Our objective was to examine the unintended otolaryngology-related side effects associated with E-cigs. Data Sources Medline, EMBASE, CINAHL, Web of Science, and CENTRAL databases. Review Methods Study selection was independently performed by 2 authors in accordance with the PRISMA-ScR statement (Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews); discrepancies were resolved by the senior author. English studies from database inception to May 1, 2020, with a sample size >5 were included. In vitro, animal, and lower respiratory tract studies were excluded. The main outcome was defined as otolaryngology-related side effects following E-cig use. Levels of evidence per the Oxford Centre for Evidence-Based Medicine were used to determine study quality. Results From 1788 articles, 32 studies were included. The most common unintended side effects were throat irritation (n = 16), cough (n = 16), mouth irritation (n = 11), and oral mucosal lesions (n = 8). A large proportion of participants also reported conventional tobacco use in addition to E-cigs. Eight studies investigated the effectiveness of vaping on smoking cessation. The quality of the literature was level 2 to 4. Given the significant heterogeneity in the studies, meta-analysis was not performed. Conclusion The most reported side effects were throat and mouth irritation, followed by cough. The long-term impact of E-cigs is not known given the recent emergence of this technology. Future studies are warranted.

Effects of e-cigarette smoking on periodontal health: A scoping review

“…Our findings are in accord with previous systematic reviews which have reported that vaping is associated with adverse effects on periodontal health, although the severity of periodontal damage is less compared to cigarette smoking [ 7 , 57 ]. In addition to the effects on periodontal health, ECs are reported to be associated with a wide range of oral health sequelae such as cough, throat and mouth irritation, and intraoral lesions such as nicotinic stomatitis, hairy tongue, and hyperplastic candidiasis [ 60 ]. In addition, flavored e-liquids may be associated with an increased risk of dental caries and the presence of inflammatory and carcinogenic biomarkers in saliva and crevicular fluid [ 61 ].…”

A Close Look at Vaping in Adolescents and Young Adults in the United States

“…Cough has been repeatedly noted to be commonly associated with inhalation of respiratory irritants in EC emission aerosols (e.g. propylene glycol -PG, some flavourings, formaldehyde, acetaldehyde, and acrolein) (53,69). This triggering of the (physiological) reflex of the cough has been shown to be transitory (56,70) (Figure 4) and is of uncertain prognostic value with regard to the development of actual respiratory illnesses.…”