Impact of Electronic Cigarettes on the Upper Aerodigestive Tract: A Comprehensive Review for Otolaryngology Providers

OBJECTIVE: The use and effects of electronic (e)‐cigarettes (e‐cigs) are particularly relevant for otolaryngology providers as tobacco plays a major role in benign and malignant diseases of the upper aerodigestive tract. This review aims to (1) summarize the recent policies regarding e‐cigs and important patterns of use and (2) serve as a comprehensive resource for clinical providers on the known biologic and clinical effects of e‐cigs on the upper aerodigestive tract. DATA SOURCES: PubMed/MEDLINE. REVIEW METHODS: We conducted a narrative review on (1) general information on e‐cig use and informative findings in the lower respiratory system and a comprehensive review on (2) the effects of e‐cigs on cell and animal models and the clinical implications of these products on human health as is relevant to otolaryngology. CONCLUSIONS: Although e‐cigs are likely less harmful than conventional cigarettes, preliminary research on e‐cigs suggest several deleterious effects including in the upper aerodigestive tract. Due to this, there has been increased interest in restricting e‐cig usage, particularly among the adolescent population, and caution in recommending e‐cigs to current smokers. IMPLICATIONS FOR PRACTICE: Chronic e‐cig use is likely to have clinical implications. It is critical for otolaryngology providers to be aware of the rapidly changing regulations and use patterns regarding e‐cigs and how e‐cigs influence human health, particularly with regards to the upper aerodigestive tract, to accurately council patients regarding potential risks and benefits of use.