Effects of electronic cigarette aerosol exposure on oral and systemic health

Abstract

Conventional cigarette smoke harms nearly every organ of the body and is the leading cause of death in the United States and in the world. Decades of research have associated conventional cigarette smoke with several diseases and death. Heavily marketed, electronic nicotine delivery systems such as electronic cigarettes (e-cigarettes) are available in a variety of flavors and high nicotine concentrations. In 2019, a severe lung disease outbreak linked to e-cigarette use led to several deaths, which was called electronic-cigarette or vaping product use-associated lung injury (EVALI). Even though the trend of e-cigarette use among teens continues to increase, information on the effects of e-cigarette smoke on oral and overall health are still scarce. This review discusses the possible health effects due to unregulated e-cigarette use, as well as the health effects of second-hand smoke and third-hand smoke on non-smokers.

Keywords: E-cigarettes; Electronic-cigarette or vaping product use-associated lung injury; Oral health; Smoking; Tobacco.

Fig. 1

Examples of different electronic nicotine delivery system (ENDS) commercially available.

Fig. 2

Scheme illustrating the different ways that smoking or vaping can affect overall health. The figure shows examples of smoking causing harm to oral health and systemic health, as well as second-hand smoke and third-hand smoke being harmful to non-smokers. Smoking is associated with higher risks of developing periodontal disease, caries, and oral cancer. It is also associated with systemic diseases such as respiratory and cardiovascular disease, adverse pregnancy outcomes and cancer. Second-hand smoke can affect non-smokers and may cause asthma and lung cancer. Third-hand smoke (pollutants that cling to furniture and overall surroundings) is dangerous especially to children due to their hand-to-mouth and exploratory habits. This image exemplifies a smoker using a common computer and leaving third-hand smoke to the next user. This image was created in BioRender.com.