Chronic health effects associated with electronic cigarette use: A systematic review

Abstract

IntroductionOver the last decade, e-cigarette use has been on the rise but with growing health concerns. The objective of this systematic review was to update findings for chronic health outcomes associated with e-cigarette use from the 2018 National Academies of Sciences, Engineering, and Medicine (NASEM) report.MethodsThree bibliographic databases were searched to identify studies comparing the chronic health effects of e-cigarette users (ECU) to non-smokers (NS), smokers, and/or dual users indexed between 31 August 2017 and 29 January 2021. Two independent reviewers screened abstracts and full texts. Data were extracted by one reviewer and verified by a second one. Outcomes were synthesized in a narrative manner using counts and based on statistical significance and direction of the association stratified by study design and exposure type. Risk of bias and certainty of evidence was assessed. The protocol was prospectively registered on Open Science Framework https://osf.io/u9btp.ResultsA total of 180 articles were eligible. This review focused on 93 studies for the 11 most frequently reported outcomes and from which 59 reported on daily e-cigarette use. The certainty of evidence for all outcomes was very low because of study design (84% cross-sectional) and exposure type (27% reported on exclusive ECU, i.e., never smoked traditional cigarettes). Overall, the summary of results for nearly all outcomes, including inflammation, immune response, periodontal and peri-implant clinical parameters, lung function, respiratory symptoms, and cardiovascular disease, suggested either non-significant or mixed results when daily ECU was compared to NS. This was also observed when comparing exclusive ECU to NS. The only notable exception was related to oral health where most (11/14) studies reported significantly higher inflammation among daily ECU vs. NS. Compared to the smokers, the exclusive-ECUs had no statistically significant differences in inflammation orperiodontal clinical parameters but had mixed findings for peri-implant clinical parameters.ConclusionsThis review provides an update to the 2018 NASEM report on chronic health effects of e-cigarette use. While the number of studies has grown, the certainty of evidence remains very low largely because of cross-sectional designs and lack of reporting on exclusive e-cigarette exposure. There remains a need for higher quality intervention and prospective studies to assess causality, with a focus on exclusive e-cigarette use.

Prevalence of self‐reported severe periodontitis: Data from the population‐based CONSTANCES cohort

“…The higher frequency of periodontitis in participants with a low socio-economic status is in line with most recent reviews (Khajavi et al, 2022;Singh et al, 2019). Although the effects of e-cigarette on periodontal health are still debated (Robbins & Ali, 2022;Wasfi et al, 2022), it cannot be ruled out that the higher prevalence of severe periodontitis risk among e-cigarette users in our sample could be explained by the fact that the vast majority of adult e-cigarette users are current or former smokers. Finally, the higher prevalence of severe periodontitis in participants with excessive alcohol consumption is consistent with recent studies investigating this association (Baumeister et al, 2021).…”

Os efeitos do uso do cigarro eletrônico na saúde dos usuários: Uma revisão integrativa

“…Em controvérsia com o exposto, de acordo com Wasfi et al (2022), o qual comparou estudos entre usuários de cigarros eletrônicos com não fumantes, não encontraram diferenças estatísticas com significado para saúde cardiovascular (doenças cardiovasculares, pressão arterial, biomarcadores do metabolismo lipídico e função cardiovascular), inflamação respiratória, resposta imunológica, função pulmonar e sintomas respiratórios. Destaca-se que o tempo curto de exposição ao uso pode ser um fator limitante para a análise.…”

Implicaciones sistémicas y bucales del cigarrillo electrónico

“…No obstante, conforme avanzan las investigaciones se evidencian efectos negativos para la salud aumentando riesgo de ser un fumador de cigarrillo tradicional pues suelen ser sistemas eléctricos de dispensadores de nicotina. Dentro de las principales causas para el consumo de estos artefactos se encuentran los factores socioculturales de aprobación, por lo cual, dentro de la edad entre 16 a 24 años, se ve una tasa significativamente alta de tabaco y alcohol (11,12).…”

“…Wasfi R. et al(11), por su parte indica en su estudio llamado "Efectos crónicos en la salud asociados con el uso de cigarrillos electrónicos." que, dentro de los principales efectos cardiovasculares son la enfermedad coronaria, infarto agudo de miocardio y accidentes cerebrovasculares.…”