Combustible cigarette smoking (CCS) is causally associated with major morbidity and mortality. Numerous experimental and clinical investigations have linked tobacco use with over 25 different diseases, including oral diseases. According to the Canadian Tobacco, Alcohol and Drugs Survey (CTADS, 2017), 15% of Canadians aged 15 and older reported currently smoking cigarettes (15%), including 8% of teens aged 15 - 19 years.
In an effort to counter the adverse effects of CCS on human health, multiple smoking cessation strategies have been developed, including pharmacotherapy, nicotine replacement therapy, and abstinence; however in many cases, these have met with limited success with regards to long term cessation success rates. Electronic cigarettes (e-cigarettes) were developed as an alternative to CCS that is intended to provide smokers with a less harmful source of nicotine delivery and a new smoking cessation aid.
The oral cavity is the first site to encounter tobacco smoke, which comes in direct contact with soft and hard tissues. While studies have linked smoking to an elevated risk of oral diseases, evidence exists to support e-cigarettes use as a less harmful alternative to CCS associated with reduced adverse oral health effects. Nevertheless, the scientific literature on the subject is still limited and mostly based on self-reported, short-term follow-up studies. Moreover, public health strategies are needed to educate the public that e-cigarette use is not harmless, especially for young people who have never used CCS.
This report summarizes existing evidence on the effects of electronic cigarette use on oral health, identifies knowledge gaps and provides evidence-based recommendations to support patients' oral health care regarding the use of electronic cigarettes.
Smoking is a global public health issue responsible for significant oral and general health problems, which can be prevented by the cessation of tobacco use. Although complete smoking cessation is the best solution, the powerful addictive properties of nicotine represent an enormous obstacle, even for those with a strong desire to quit smoking. Different nicotine replacement strategies have been developed, including e-cigarettes. Several self-reported and randomized studies suggest e-cigarettes, while not harmless, are a harm reduction tool that may improve the oral and general health of smokers and may contribute to smoking cessation. However, additional long term studies are needed to validate these observations. Most importantly, all levels of public health should take steps to prevent initiation and encourage cessation of e-cigarette use among individuals who never used CCS, particularly in youth, as this practice is not harmless.
