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Review
. 2023 Nov 18;20(22):7079.
doi: 10.3390/ijerph20227079.

Sex Differences in E-Cigarette Use and Related Health Effects

Fatima Alam  1 , Patricia Silveyra  1   2
Affiliations
Review

Sex Differences in E-Cigarette Use and Related Health Effects

Fatima Alam et al. Int J Environ Res Public Health. .

Abstract

Background: Electronic cigarettes (e-cigarettes) comprise a variety of products designed to deliver nicotine, flavorings, and other substances. To date, multiple epidemiological and experimental studies have reported a variety of health issues associated with their use, including respiratory toxicity, exacerbation of respiratory conditions, and behavioral and physiological effects. While some of these effects appear to be sex- and/or gender-related, only a portion of the research has been conducted considering these variables. In this review, we sought to summarize the available literature on sex-specific effects and sex and gender differences, including predictors and risk factors, effects on organ systems, and behavioral effects.

Methods: We searched and selected articles from 2018-2023 that included sex as a variable or reported sex differences on e-cigarette-associated effects.

Results: We found 115 relevant studies published since 2018 that reported sex differences in a variety of outcomes. The main differences reported were related to reasons for initiation, including smoking history, types of devices and flavoring, polysubstance use, physiological responses to nicotine and toxicants in e-liquids, exacerbation of lung disease, and behavioral factors such as anxiety, depression, sexuality, and bullying.

Conclusions: The available literature supports the notion that both sex and gender influence the susceptibility to the negative effects of e-cigarette use. Future research needs to consider sex and gender variables when addressing e-cigarette toxicity and other health-related consequences.

Keywords: e-cigarette; electronic cigarette; gender; sex; vaping.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Search strategy and results.
See this image and copyright information in PMC

References

    1. Marques P., Piqueras L., Sanz M.J. An updated overview of e-cigarette impact on human health. Respir. Res. 2021;22:151. doi: 10.1186/s12931-021-01737-5. - DOI - PMC - PubMed
    1. Esteban-Lopez M., Perry M.D., Garbinski L.D., Manevski M., Andre M., Ceyhan Y., Caobi A., Paul P., Lau L.S., Ramelow J., et al. Health effects and known pathology associated with the use of E-cigarettes. Toxicol. Rep. 2022;9:1357–1368. doi: 10.1016/j.toxrep.2022.06.006. - DOI - PMC - PubMed
    1. Tsai M., Byun M.K., Shin J., Crotty Alexander L.E. Effects of e-cigarettes and vaping devices on cardiac and pulmonary physiology. J. Physiol. 2020;598:5039–5062. doi: 10.1113/JP279754. - DOI - PMC - PubMed
    1. Birdsey J., Cornelius M., Jamal A., Park-Lee E., Cooper M., Wang J., Sawdey M., Cullen K., Neff L. Tobacco Product Use among U.S. Middle and High School Students—National Youth Tobacco Survey, 2023; MMWR Morb Mortal Wkly Rep 2023; pp. 1173–1182. [(accessed on 12 October 2023)]; Available online: https://www.cdc.gov/mmwr/volumes/72/wr/mm7244a1.htm. - PMC - PubMed
    1. Butler A.R., Lindson N., Fanshawe T.R., Theodoulou A., Begh R., Hajek P., McRobbie H., Bullen C., Notley C., Rigotti N.A., et al. Longer-term use of electronic cigarettes when provided as a stop smoking aid: Systematic review with meta-analyses. Prev. Med. 2022;165:107182. doi: 10.1016/j.ypmed.2022.107182. - DOI - PubMed

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