Author(s)
Ameen Amanian, MD
Jobanjit Phulka
Amanda Hu, MD, FRCSC
Affiliation(s)
University of British Columbia ;
Abstract:
Introduction: Electronic cigarettes (E-cigs) are nicotine delivery systems with increasing popularity; however, their effects on the upper aerodigestive tract are largely unknown. The objective of this study was to examine the unintended Otolaryngology-related side effects associated with any level of E-cig use.
Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews (PRIMA-ScR) protocol was used to conduct a scoping review of MEDLINE, EMBASE, CINAHL, WEB OF SCIENCE, and CENTRAL databases (PROSPERO: CRD 42020177790). Search strategy contained MeSH terms developed with a librarian. English studies from inception through May 1, 2020 with a sample size >5 were included. In vitro, animal, and studies on the lower respiratory tract were excluded. The main outcome was defined as otolaryngology-related side effects following E-cig use. Oxford Centre for Evidence-Based Medicine Levels of Evidence was used to determine the quality of the studies. Study selection was independently performed by two authors; discrepancies were resolved by the senior author.
Results: From the 1788 articles that were initially identified, 32 studies were included. The most common unintended side effect associated with E-cig use was throat irritation (n = 16), cough (n = 16), mouth irritation (n = 11), and oral mucosal lesions (n = 8). Two studies investigated the pediatric population. Two studies reported on negative voice outcomes with E-cig use. A large proportion of participants also reported conventional tobacco use in addition to E-cigs. Quality of the literature was level 2 to 4. Given the significant heterogeneity in the studies, a meta-analysis could not be performed.
Conclusions: E-cigs are gaining increasing popularity within the adult and youth population. The most commonly reported side effects were throat and mouth irritation, followed by cough. The long-term impact of E-cigs on the upper aerodigestive tract is not known given the recent emergence of this technology. Future studies are warranted to determine the safety profile of E-cigs.