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Current thinking about the effects of e-cigarettes on oral cancer risk

British Dental Journal volume 236, pages 397–400 (2024)Cite this article

Abstract

In the last decade there has been a significant increase in the appeal and popularity of e-cigarettes. Recent national news headlines outline that one million smokers will be given a free vaping starter kit to encourage them to give up tobacco products. An independent report commissioned by the UK Government has cited promotion of vaping as a critical recommendation to ensuring England is smoke-free by 2030. Undoubtedly, the dental team will now encounter many more questions from patients keen to know more regarding the safety of electronic nicotine delivery systems and their effects on the oral cavity. However, it is often difficult to answer these questions due to a lack of evidence regarding their impact. Although there are some preliminary animal and in vitro data, additional well-designed, long-term studies are required to investigate oral health outcomes of e-cigarette use.

We aim to summarise the latest evidence to better inform clinicians about the effects of vaping on oral health, particularly regarding the risks of oral cancer, so they can better inform their patients.

Key points

  • E-cigarettes are popular among those quitting conventional tobacco smoking and evidence has demonstrated they are effective to this end. They are also popular among previously non-smoker adolescents. Their popularity is, in part, likely to be due to their appeal as a safer alternative to conventional cigarettes.

  • Clinicians should expand their routine questions regarding patients' smoking status to include the use of e-cigarettes/vaping and we suggest a documentation tool to aid record-keeping.

  • Current evidence suggests e-cigarette use is not risk-free but well-designed, long-term studies to investigate oral health outcomes of e-cigarette use are needed.

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References

  1. Wilson C, Tellez Freitas C M, Awan K H, Ajdaharian J, Geiler J, Thirucenthilvelan P. Adverse effects of E-cigarettes on head, neck, and oral cells: A systematic review. J Oral Pathol Med 2022; 51: 113-125.

  2. Seddon S, Russell R. Vaping: Free e-cigarettes to be handed out in anti-smoking drive. BBC News (London) 2023 April 11.

  3. Khan J. Making smoking obsolete: summary. 2022. Available at https://www.gov.uk/government/publications/the-khan-review-making-smoking-obsolete/making-smoking-obsolete-summary (accessed February 2024).

  4. Sultan A S, Jessri M, Farah C S. Electronic nicotine delivery systems: Oral health implications and oral cancer risk. J Oral Pathol Med 2021; 50: 316-322.

  5. Yang I, Sandeep S, Rodriguez J. The oral health impact of electronic cigarette use: a systematic review. Crit Rev Toxicol 2020; 50: 97-127.

  6. Szukalska M, Szyfter K, Florek E et al. Electronic Cigarettes and Head and Neck Cancer Risk - Current State of Art. Cancers (Basel) 2020; 12: 3274.

  7. Cameron A, Meng Yip H, Garg M. e-Cigarettes and Oral Cancer: What do we know so far? Br J Oral Maxillofac Surg 2023; 61: 380-382.

  8. Guo J, Hecht S S. DNA damage in human oral cells induced by use of e-cigarettes. Drug Test Anal 2023; 15: 1189-1197.

  9. Szumilas P, Wilk A, Szumilas K, Karakiewicz B. The Effects of E-Cigarette Aerosol on Oral Cavity Cells and Tissues: A Narrative Review. Toxics 2022; 10: 74.

  10. Kumar P S, Clark P, Brinkman M C, Saxena D. Novel Nicotine Delivery Systems. Adv Dent Res 2019; 30: 11-15.

  11. Franco T, Trapasso S, Puzzo L, Allegra E. Electronic Cigarette: Role in the Primary Prevention of Oral Cavity Cancer. Clin Med Insights Ear Nose Throat 2016; 9: 7-12.

  12. Action in Smoking and Health. Headline results ASH Smokefree GB adults and youth survey results 2023. 2023. Available at https://ash.org.uk/uploads/Headline-results-ASH-Smokefree-GB-adults-and-youth-survey-results-2023.pdf (accessed February 2023).

  13. Nguyen H, Kitzmiller J P, Nguyen K T, Nguyen C D, Chi Bui T. Oral Carcinoma Associated with Chronic Use of Electronic Cigarettes. Otolaryngol 2017; 7: 304.

  14. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Tobacco smoke and involuntary smoking. IARC Monogr Eval Carcinog Risks Hum 2006; 88: 1-1438.

  15. De Lima J M, Macedo C S, Barbosa G V et al. E-liquid alters oral epithelial cell function to promote epithelial to mesenchymal transition and invasiveness in preclinical oral squamous cell carcinoma. Sci Rep 2023; 13: 3330.

  16. Cook R, Davidson P, Martin R. E-cigarettes helped more smokers quit than nicotine replacement therapy. BMJ 2019; 365: 2036.

  17. Manyanga J, Ganapathy V, Bouharati C et al. Electronic cigarette aerosols alter the expression of cisplatin transporters and increase drug resistance in oral cancer cells. Sci Rep 2021; 11: 1821.

  18. Herndon P, Jassal J S, Cramer J D. Association between E-cigarette use and oral HPV-16 infection. Oral Oncol 2022; 125: 105676.

  19. O'Brien D, Long J, Quigley J, Lee C, McCarthy A, Kavanagh P. Association between electronic cigarette use and tobacco cigarette smoking initiation in adolescents: a systematic review and meta-analysis. BMC Public Health 2021; 21: 954.

  20. National Cancer Institute. Cancer terms: Pack year. Available at https://www.cancer.gov/publications/dictionaries/cancer-terms/def/pack-year (accessed April 2023).

  21. Young-Wolff K C, Klebaner D, Folck B et al. Do you vape? Leveraging electronic health records to assess clinician documentation of electronic nicotine delivery system use among adolescents and adults. Prev Med 2017; 105: 32-36.

  22. Jose T, Hays J T, Warner D O. Improved Documentation of Electronic Cigarette Use in an Electronic Health Record. Int J Environ Res Public Health 2020; 17: 5908.

  23. Raj A T, Sujatha G, Muruganandhan J et al. Reviewing the oral carcinogenic potential of E-cigarettes using the Bradford Hill criteria of causation. Transl Cancer Res 2020; 9: 3142-3152.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Gloucestershire Hospitals NHS Foundation Trust, Great Western Road, Gloucester, GL1 3NN, UK

    Alice Cameron

  2. Department of Otolaryngology, Barts Health NHS Foundation Trust, Whipps Cross University Hospital, Whipps Cross Road, London, E11 1NR, UK

    Hao Meng Yip

  3. Department of Oral and Maxillofacial Surgery, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital Old Road, Oxford, OX3 9DU, UK

    Montey Garg

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  1. Alice Cameron
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  2. Hao Meng Yip
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Contributions

Alice Cameron: data collection, manuscript writing and editing. Hao Meng Yip: manuscript writing and editing. Montey Garg: conception of manuscript design and manuscript editing.

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Correspondence to Alice Cameron.

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The authors declare no conflicts of interest.

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Cameron, A., Meng Yip, H. & Garg, M. Current thinking about the effects of e-cigarettes on oral cancer risk. Br Dent J 236, 397–400 (2024). https://doi.org/10.1038/s41415-024-7124-2

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