scholarly journals Differences in Levels of Biomarkers of Potential Harm among Users of a Heat-not-burn Tobacco Product, Cigarette Smokers, and Never-Smokers in Japan: A Post-Marketing Observational Study

2021 ◽  
Author(s):  
Chikako Sakaguchi ◽  
Yasufumi Nagata ◽  
Akira Kikuchi ◽  
Yuki Takeshige ◽  
Naoki Minami
Keyword(s):  
Cigarette Smoking ◽  
Tobacco Smoke ◽  
Cigarette Smokers ◽  
Potential Harm ◽  
Actual Use ◽  
Post Marketing ◽  
Harmful Substances ◽  
Never Smokers ◽  
The Impact

Abstract Introduction Cigarette smoking is associated with the risk of certain diseases, but non-combustible products may lower these risks. The potential long-term health effects of the next-generation non-combustible products (heat-not-burn tobacco products (HNBP) or electronic vapor products) have not been thoroughly studied. The present study aimed to investigate the impact of biomarkers of potential harm (BoPH) of one of HNBP (a novel vapor product: NTV), under the conditions of actual use. Methods This study was an observational, cross-sectional, three-group, multi-center study. Exclusive NTV users (NTV, n = 259), conventional cigarette smokers (CC, n = 100) and never-smokers (NS, n=100) were enrolled. Biomarkers of tobacco smoke exposure (cotinine and total NNAL) and BoPH including parameters of physical pulmonary functions relevant to smoking-related diseases were examined, and subjects answered a questionnaire on cough-related symptoms (J-LCQ) and health-related quality of life (SF-36v2®). Results Levels of cotinine, total NNAL and BoPH (HDL-cholesterol, triglyceride, sICAM-1, WBC count, 11-DHTXB2, 2,3-d-TXB2, 8-epi-PGF2α, FEV1, %FEV1 and FEF25-75) were significantly different in the NTV group as compared to levels in CC group (p<0.05). Significantly higher levels of cotinine, total NNAL, and 2,3-d-TXB2, and lower levels of FEV1 and %FEV1, were observed among NVT users compared to the NS group. Conclusion In a post-marketing study under actual use conditions, BoPH associated with smoking-related disease examined in exclusive NTV users were found to be favorably different from those of CC smokers, a finding attributable to a reduction in exposure to harmful substances of tobacco smoke. Implications Cigarette smoking is associated with increased risk of pulmonary diseases like COPD, cardiovascular diseases, and certain cancers. There is a growing body of evidence that HNBP reduces the exposure associated with smoking and that there is a favorable change in BoPH. However, long-term effects regarding the relative health risks to HNBP users compared to CC smokers have not been examined. This study provides post-marketing data under actual use conditions of the effects on biomarkers of potential harm in NTV, one of HNBP, exclusive users compared to CC smokers and never-smokers. The evidence suggests that exclusive NTV users have favorable levels of BoPH compared to CC smokers, and that is result from a sustained reduction in exposure to harmful substances of tobacco smoke.

scholarly journals Real-World Evidence of Differences in Biomarkers of Exposure to Select Harmful and Potentially Harmful Constituents and Biomarkers of Potential Harm Between Adult E-Vapor Users and Adult Cigarette Smokers

2019 ◽  
Vol 22 (7) ◽  
pp. 1114-1122 ◽  
Author(s):  
Douglas Oliveri ◽  
Qiwei Liang ◽  
Mohamadi Sarkar
Keyword(s):  
Oxidative Stress ◽  
Carbon Monoxide ◽  
Cigarette Smoking ◽  
Real World ◽  
Cigarette Smokers ◽  
Potential Harm ◽  
Biomarkers Of Exposure ◽  
Real World Evidence ◽  
Actual Use ◽  
Lower Health

Abstract Introduction Real-world evidence regarding likely long-term health effects of e-vapor products (EVP) under actual use conditions relative to cigarette smoking is not well studied. Methods In this cross-sectional, observational study, biomarkers of exposure (BOE) to select harmful and potentially harmful constituents and biomarkers of potential harm (BOPH) relevant to smoking-related diseases were measured in exclusive adult EVP users (AEVP, n = 144) and exclusive adult cigarette smokers (AS, n = 73). AEVP used their own brand of EVP for 6+ months following 10+ years of cigarette smoking and AS smoked own brand of cigarettes for 10+ years. Subject recruitment and informed consent were obtained online and urine/blood samples were collected at local clinical laboratories, representing a new paradigm for collecting real-world evidence. Results The levels of total NNAL (NNK metabolite), 3-hydroxypropyl mercapturic acid (acrolein metabolite), and carboxyhemoglobin (carbon monoxide measure) were 46% to 86% lower in AEVP compared with AS (p ≤ .0001) as was nicotine equivalents (nicotine and its five metabolites; 36%, p < .01). The levels of some BOPH were significantly lower in AEVP compared with AS for 11-dehydrothromboxane-B2 (29%, p = .04; platelet activation), 8-epi-prostaglandin F2α (23%, p = .02; oxidative stress) and soluble intercellular adhesion molecule-1 (16%, p = .02; endothelial function). Conclusions This study demonstrates the feasibility of a new approach for collecting real-world evidence. Substantially lower levels of BOEs (NNK, nicotine, acrolein, carbon monoxide) and favorable differences in BOPHs (platelet activation, oxidative stress, endothelial function) suggest EVP users may have lower health risks than cigarette smokers. Implications Cigarette smoking causes serious diseases. Switching from a combustible tobacco product to a noncombustible product is a potential harm reduction pathway for adult smokers unable or unwilling to quit. Real-world evidence regarding the relative risk of EVP use compared with cigarettes is not well established. This study provides data specific to BOE to tobacco smoke constituents and biomarkers of potential harm collected under actual use conditions in a real-world setting. The totality of evidence suggests that exclusive EVP use may present lower health risk compared with smoking cigarettes.

scholarly journals E-Cigarette Use and Future Cigarette Initiation Among Never Smokers and Relapse Among Former Smokers in the PATH Study

2019 ◽  
Vol 134 (5) ◽  
pp. 528-536 ◽  
Author(s):  
Robert McMillen ◽  
Jonathan D. Klein ◽  
Karen Wilson ◽  
Jonathan P. Winickoff ◽  
Susanne Tanski
Keyword(s):  
Cigarette Smoking ◽  
Harm Reduction ◽  
Electronic Cigarettes ◽  
Computer Assisted ◽  
Cigarette Use ◽  
Cigarette Smokers ◽  
Potential Harm ◽  
Increased Risk ◽  
Never Smokers

Objectives: Any potential harm-reduction benefit of electronic cigarettes (e-cigarettes) could be offset by nonsmokers who initiate e-cigarette use and then smoke combustible cigarettes. We examined correlates of e-cigarette use at baseline with combustible cigarette smoking at 1-year follow-up among adult distant former combustible cigarette smokers (ie, quit smoking ≥5 years ago) and never smokers. Methods: The Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal study, surveyed 26 446 US adults during 2 waves: 2013-2014 (baseline) and 2014-2015 (1-year follow-up). Participants completed an audio computer-assisted interview in English or Spanish. We compared combustible cigarette smoking at 1-year follow-up by e-cigarette use at baseline among distant former combustible cigarette smokers and never smokers. Results: Distant former combustible cigarette smokers who reported e-cigarette past 30-day use (9.3%) and ever use (6.7%) were significantly more likely than those who had never used e-cigarettes (1.3%) to have relapsed to current combustible cigarette smoking at follow-up ( P < .001). Never smokers who reported e-cigarette past 30-day use (25.6%) and ever use (13.9%) were significantly more likely than those who had never used e-cigarettes (2.1%) to have initiated combustible cigarette smoking ( P < .001). Adults who reported past 30-day e-cigarette use (7.0%) and ever e-cigarette use (1.7%) were more likely than those who had never used e-cigarettes (0.3%) to have transitioned from never smokers to current combustible cigarette smokers ( P < .001). E-cigarette use predicted combustible cigarette smoking in multivariable analyses controlling for covariates. Conclusions: Policies and counseling should consider the increased risk for nonsmokers of future combustible cigarette smoking use as a result of using e-cigarettes and any potential harm-reduction benefits e-cigarettes might bring to current combustible cigarette smokers.

Waterpipe Smoking Is Associated with Changes in Fibrinogen, FVII, and FVIII Levels

2018 ◽  
Vol 140 (3) ◽  
pp. 159-165 ◽  
Author(s):  
Abdel Rahim Mahmoud Muddathir ◽  
Mozfar Idrees Abd Alla ◽  
Omar F. Khabour
Keyword(s):  
Cigarette Smoking ◽  
Factor Viii ◽  
Plasma Levels ◽  
Coagulation Factors ◽  
Factor Vii ◽  
Waterpipe Smoking ◽  
Cigarette Smokers ◽  
Never Smokers ◽  
The Impact ◽  
Apparently Healthy

Cigarette smoking has been shown to be associated with changes in coagulation factors in the circulation and the subsequent thrombosis development. In this study, the impact of waterpipe smoking on the levels of fibrinogen, factor VII (FVII), and factor VIII (FVIII) was investigated. In addition, the effects of waterpipe smoking were compared to those of cigarette smoking and never smokers. A total of 80 male smokers (40 cigarette smokers and 40 waterpipe smokers) and 40 apparently healthy never smokers were recruited in the study. Both waterpipe smoking and cigarette smoking induced significant increases in the plasma levels of fibrinogen, factor VII, and factor VIII (p < 0.01). The magnitude of the increase in fibrinogen levels induced by waterpipe smoking was higher than that induced by cigarette smoking (p < 0.01), while similar increases were observed in other factors (p > 0.05). In addition, in the waterpipe group, the magnitude of the increase in fibrinogen and factor VIII was higher in the smokers with more than 3 years of use (p < 0.05). In conclusion, similar to cigarette smoking, waterpipe smoking modulates the levels of coagulation factors, suggesting its thrombotic potential.

scholarly journals Smoking Functions as a Negative Regulator of IGF1 and Impairs Adipokine Network in Patients with Rheumatoid Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Malin C. Erlandsson ◽  
Roberto Doria Medina ◽  
Sofia Töyrä Silfverswärd ◽  
Maria I. Bokarewa
Keyword(s):  
Rheumatoid Arthritis ◽  
Cigarette Smoking ◽  
Serum Levels ◽  
Negative Regulator ◽  
Lower Serum ◽  
Bivariate Correlation ◽  
Novel Association ◽  
Long Term Prognosis ◽  
Never Smokers

Objectives.Smoking is pathogenic for rheumatoid arthritis (RA) being tightly connected to the genetic and serological risk factors for this disease. This study aims to understand connections between cigarette smoking and serum levels of IGF1 and adipokines in RA.Methods.Serum levels of IGF1 and adipokines leptin, adiponectin, resistin, and visfatin were measured in two independent cohorts of RA patients from Gothenburg (n=350) and Leiden (n=193). An association of these parameters with smoking was tested in a direct comparison and proved by bivariate correlation analysis. The obtained associations were further tested in multivariate regression models where the confounders (age, gender, disease duration, and BMI) were controlled.Results.The smokers had significantly lower serum levels of IGF1, adiponectin, and leptin compared to never smokers. In regression analysis, smoking and low leptin, but not adiponectin, were associated and predicted low IGF1. Additionally, high disease activity and high BMI increased the probability of low leptin.Conclusions.The study indicates cigarette smoking as an important cause of a relative IGF1 and leptin deficiency in RA patients. This novel association between smoking and hypoleptinemia may be of importance for long-term prognosis of RA and for prediction of comorbidities.

Abstract P204: Tobacco Use And The AHA 2030 Impact Goals: A Simulation

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Douglas Levy ◽  
Sydney L Goldberg ◽  
Emily P Hyle ◽  
Krishna P Reddy
Keyword(s):  
Cigarette Smoking ◽  
Smoking Prevalence ◽  
Smoking Initiation ◽  
Potential Contribution ◽  
Cvd Risk ◽  
The Us ◽  
Former Smokers ◽  
Never Smokers ◽  
Projected Changes ◽  
The Impact

Background: The AHA’s 2030 Impact Goals seek to increase population health-adjusted life expectancy (LE) by 2y. Tobacco is a top contributor to all-cause mortality and cardiovascular disease (CVD). We estimated the potential contribution of improved tobacco control to achieve the 2030 Impact Goals in the US. Methods: We used the validated STOP microsimulation model with NHIS estimates of age- and sex-stratified mortality and CVD incidence to project changes in LE, as well as 10y, 20y, and lifetime CVD cumulative incidence, if cigarette smoking declined among the current US population. We assessed the impact of preventing initiation (current v never smokers) or increasing cessation (current v former smokers) at different ages. To examine the maximum impact of population-wide cessation, we projected changes in population LE and CVD incidence if smoking prevalence among those ≥20yo went immediately to 0%. Results: Preventing smoking initiation increases LE by 10.2y (men [M]) and 9.1y (women [W]) and reduces lifetime CVD incidence by 16.8% (M) and 26.2% (W) compared to lifetime smoking. Even cessation at age 60 extends LE by 3.7y (M) and 2.5y (W) and reduces 10y CVD incidence by 39.1% (M) and 59.4% (W) (Table). Total elimination of cigarette smoking in the 2020 US population aged ≥20y (e.g. by outlawing cigarettes) would increase the cohort LE by 0.4 (M) and 0.2 (W) years and reduce 20y CVD incidence by 6.0% (M) and 7.0% (W). Conclusion: Preventing smoking initiation offers the greatest benefit, but cessation at any age substantially improves LE and reduces CVD risk. The modest potential contribution of tobacco elimination to achieving the 2030 Impact Goals is due to already low smoking prevalence: <14% (projected) in 2020.

scholarly journals E-cigarettes: no smoke without fire?

2020 ◽  
Vol 25 ◽  
Author(s):  
N. Daniels ◽  
C. Cosma ◽  
A. Llewellyn ◽  
D. Banks ◽  
H. Morris ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
National Health ◽  
Working Party ◽  
Cigarette Use ◽  
Dual Use ◽  
Common View ◽  
Potential Impact ◽  
The Impact ◽  
Relapse Rates

Abstract Smoking was one of the biggest preventable killers of the 20th century, and it continues to cause the death of millions across the globe. The rapid growth of the e-cigarette market in the last 10 years and the claims that it is a safer form of smoking, and can help with smoking cessation, have led to questions being raised on their possible impact to society, the health of the population and the insurance industry. Recent media attention around the possible health implications of e-cigarette use has also ensured that this topic remains in the public eye. The e-cigarette working party was initiated by the Institute and Faculty of Actuaries’ Health and Care Research Sub-Committee in July 2016, with the primary objective of understanding the impact of e-cigarettes on life and health insurance. In this paper, we have looked at all areas of e-cigarette usage and how it relates to insurance in the UK market. In particular, we have covered the potential risks and benefits of switching to e-cigarettes, the results of studies that have been published, the potential impact on underwriting and claims processes and the potential impact on pricing (based on what modelling is possible with the data available). Research in this area is still in its infancy and data are not yet mature, which makes predicting the long-term impact of e-cigarette smoking extremely challenging, for example, there are no studies that directly measure the mortality or morbidity impact of long-term e-cigarette use and so we have had to consider studies that consider more immediate health impacts or look more simply at the constituents of the output of an e-cigarette and compare them to that of a cigarette. The data issue is further compounded by the findings of studies and the advice of national health authorities often being conflicting. For example, while National Health Service England has publicly stated that it supports the growth of e-cigarette usage as an aid to reduce traditional smoking behaviour, the US Food and Drug Administration has been much more vocal in highlighting the perceived dangers of this new form of smoking. Users’ behaviour also adds complexity, as dual use (using both e-cigarettes and cigarettes) is seen in a high percentage of users and relapse rates back to cigarette smoking are currently unknown. Having talked to a number of experts in the field, we have discovered that there is certainly not a common view on risk. We have heard from experts who have significant concerns but also to experts who do believe that e-cigarettes are far safer than tobacco. We have purposefully considered conflicting evidence and have consulted with various parties so we can present differing points of view, thereby ensuring a balanced, unbiased and fair picture of our findings is presented. The evidence we have reviewed does suggest that e-cigarettes are a safer alternative to traditional smoking, but not as safe as non-smoking. There are no large, peer-reviewed, long-term studies yet available to understand the true impact of a switch to e-cigarette use, so currently we are unable to say where on the risk spectrum between cigarette smoking and life-time non-smoking it lies. We do not yet understand if the benefits seen in the studies completed so far will reduce the risk in the long term or whether other health risks will come to light following more prolonged use and study. This, coupled with concerns with the high proportion of dual use of cigarettes and e-cigarettes, relapse rates and the recent growth in medical problems linked with e-cigarette use, means that we need to wait for experience to emerge fully before firm conclusions can be drawn. Although we have presented a view, it is vitally important that our industry continues to monitor developments in this area and fully considers what next steps and future actions may be required to ensure our position reflects the potential benefits and risks that e-cigarette use may bring. We feel that the time is right for a body such as the IFoA to analyse the feasibility of collecting the necessary data through the Continuous Mortality Investigation that would allow us to better analyse the experience that is emerging.

scholarly journals Exposure to Point-of-Sale Marketing of Cigarettes and E-Cigarettes as Predictors of Smoking Cessation Behaviors

2017 ◽  
Vol 21 (2) ◽  
pp. 212-219 ◽  
Author(s):  
Dale S Mantey ◽  
Keryn E Pasch ◽  
Alexandra Loukas ◽  
Cheryl L Perry
Keyword(s):  
Smoking Cessation ◽  
Cigarette Smoking ◽  
Cue Reactivity ◽  
Cigarette Smokers ◽  
Point Of Sale ◽  
Cigarette Advertising ◽  
Advertising Exposure ◽  
Cigarette Cessation ◽  
Product Displays ◽  
The Impact

Abstract Introduction Cue-reactivity theory suggests that smoking-related visual cues such as point-of-sale (POS) marketing (eg, advertising, product displays) may undermine cessation attempts by causing an increase in nicotine cravings among users. This study examined the relationship between recall of exposure to POS marketing and subsequent cessation behaviors among young adult cigarette smokers. Methods Participants included 813, 18–29 year old (m = 21.1, SD = 2.70), current cigarette smokers attending 24 Texas colleges. Multivariable logistic regression models examined the impact of baseline self-reported exposure to cigarette and e-cigarette advertising and product displays, on using e-cigarettes for cessation and successful cigarette cessation at 6-month follow-up. Two-way interactions between product-specific advertising and between product-specific displays were examined to determine if the marketing of one product strengthened the cue reactivity of the other. Baseline covariates included sociodemographic factors, past quit attempts, intentions to quit smoking, and nicotine dependence. Results Exposure to e-cigarette displays was associated with lower odds of cigarette smoking cessation, controlling for covariates and conventional cigarette display exposure. E-cigarette advertising was positively associated with the use of e-cigarettes for cigarette cessation among participants exposed to low (ie, at least 1 SD below the mean) levels of cigarette advertising. Cigarette advertising was associated with the use of e-cigarettes for cigarette cessation only among those exposed to low levels of e-cigarette advertising. Exposure to cigarette displays was not associated with either outcome. Conclusion Smoking-related cues at POS may undermine successful cigarette cessation. Exposure to product displays decrease odds of cessation. Advertising exposure increased odds for using e-cigarettes for cessation attempts, but may have guided smokers towards an unproven cessation aid. Implications By examining the interaction of conventional cigarette and e-cigarette marketing exposure, this study adds a unique insight into the impact of retail tobacco marketing on cigarette smoking cessation behavior among young adults. These findings suggest that policies that balance encouraging cigarette smoking cessation while limiting marketing strategies should be considered, such as POS product displays, that may undermine successful cessation attempts.

scholarly journals Cannabis use among a nationally representative cross-sectional sample of smokers and non-smokers in the Netherlands: results from the 2015 ITC Netherlands Gold Magic Survey

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. E024497 ◽  
Author(s):  
Brian Vincent Fix ◽  
Danielle Smith ◽  
Richard O’Connor ◽  
Bryan W Heckman ◽  
Marc C Willemsen ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Cannabis Use ◽  
Nicotine Exposure ◽  
Cross Sectional ◽  
Cigarette Smokers ◽  
Current Cigarette ◽  
Former Smokers ◽  
Nationally Representative ◽  
Never Smokers ◽  
Current Tobacco

ObjectivesExisting evidence shows that co-occurring use of tobacco and cannabis is widespread. Patterns of co-use of tobacco and cannabis may change as more jurisdictions legalise medicinal and/or recreational cannabis sales. This analysis examined predictors of current cannabis use and characterised methods of consumption among smokers and non-smokers in a context where cannabis use is legal.SettingThe 2015 International Tobacco Control Netherlands—Gold Magic Survey conducted between July and August 2015.ParticipantsParticipants (n=1599; 1003 current smokers, 283 former smokers and 390 non-smokers) were asked to report their current (past 30-day) use of cigarettes and cannabis. Cigarette smokers reported whether they primarily used factory made of roll-your-own cigarettes. Those who reported any cannabis use in the last 30 days were asked about forms of cannabis used. X2and logistic regression analyses were used to assess relationships among combustible tobacco and cannabis use.ResultsPast 30-day cannabis use was somewhat higher among current tobacco (or cigarette) smokers (n=57/987=5.8%) than among former or never smokers (n=10/288=3.5% and n=6/316=1.9%, respectively). Joints were the most commonly used form of cannabis use for both current cigarette smokers (96.9%) and non-smokers (76.5%). Among those who smoked cannabis joints, 95% current smokers and 67% of non-smokers reported that they ‘always’ roll cannabis with tobacco.ConclusionsIn this Netherlands-based sample, most cannabis was reported to be consumed via smoking joints, most often mixed with tobacco. This behaviour may present unique health concerns for non-cigarette smoking cannabis users, since tobacco use could lead to nicotine dependence. Moreover, many non-cigarette smoking cannabis users appear to be misclassified as to their actual tobacco/nicotine exposure.

scholarly journals Cigarette smoking and oral microbiota in low-income and African-American populations

2019 ◽  
Vol 73 (12) ◽  
pp. 1108-1115 ◽  
Author(s):  
Yaohua Yang ◽  
Wei Zheng ◽  
Qiu-Yin Cai ◽  
Martha J Shrubsole ◽  
Zhiheng Pei ◽  
...  
Keyword(s):  
African American ◽  
Cigarette Smoking ◽  
Relative Abundance ◽  
Low Income ◽  
Large Population ◽  
Oral Microbiota ◽  
Microbial Composition ◽  
Former Smokers ◽  
Never Smokers ◽  
The Impact

BackgroundCigarette smoking is a common risk factor for diseases and cancers. Oral microbiota is also associated with diseases and cancers. However, little is known about the impact of cigarette smoking on the oral microbiota, especially among ethnic minority populations.MethodsWe investigated cigarette smoking in relationship with the oral microbiota in a large population of predominately low-income and African-American participants. Mouth rinse samples were collected from 1616 participants within the Southern Community Cohort Study, including 592 current-smokers, 477 former-smokers and 547 never-smokers. Oral microbiota was profiled by 16S ribosomal RNA gene deep sequencing.ResultsCurrent-smokers showed a different overall microbial composition from former-smokers (p=6.62×10−7) and never-smokers (p=6.00×10−8). The two probiotic genera, Bifidobacterium and Lactobacillus, were enriched among current-smokers when compared with never-smokers, with Bonferroni-corrected p values (PBonferroni) of 1.28×10−4 and 5.89×10−7, respectively. The phylum Actinobacteria was also enriched in current-smokers when compared with never-smokers, with a median relative abundance of 12.35% versus 9.36%, respectively, and with a PBonferroni=9.11×10−11. In contrast, the phylum Proteobacteria was depleted in current smokers (PBonferroni=5.57×10−13), with the relative abundance being almost three times that of never-smokers (7.22%) when compared with that of current-smokers (2.47%). Multiple taxa within these two phyla showed differences in abundance/prevalence between current-smokers and never-smokers at PBonferroni <0.05. The differences in the overall microbial composition and abundance/prevalence of most taxa were observed among both African-Americans and European-Americans. Meanwhile, such differences were not observed between former-smokers and never-smokers.ConclusionSmoking has strong impacts on oral microbial community, which was recovered after smoking cessation.

A systematic review of the impact of cigarettes and electronic cigarettes in otology

2020 ◽  
pp. 1-6 ◽  
Author(s):  
S Patel ◽  
N Wooles ◽  
T Martin
Keyword(s):  
Systematic Review ◽  
Hearing Loss ◽  
Cigarette Smoking ◽  
Sensorineural Hearing Loss ◽  
Otitis Media ◽  
Electronic Cigarettes ◽  
Sensorineural Hearing ◽  
Suppurative Otitis Media ◽  
The Impact

Abstract Background The detrimental systemic effects of cigarette smoking are well established. Though less pronounced in the field of otology, they are proposed to contribute to the global burden of unaddressed hearing loss. Recently, in efforts to stop smoking, individuals have used electronic cigarettes of which the long-term safety data are largely unknown. This study aimed to conduct a systematic review of cigarette smoking and electronic cigarette effects in the field of otology. Method Relevant articles were identified by a National Institute for Health and Care Excellence healthcare database literature search and by scanning the references of relevant articles and reviews. Results A total of 473 articles were identified, with 43 articles included in the review after trials were excluded. Conclusion Cigarette smoking is associated with recurrent otitis media, otitis media with effusion and sensorineural hearing loss in children exposed to second-hand smoke. In adults, it is associated with active and aggressive chronic suppurative otitis media, worse tympanoplasty success rates, increased post-operative complications and sensorineural hearing loss that is more pronounced in the long term and at high frequencies. The effects of e-cigarettes in otology are largely unknown.

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