Systematic review: e-cigarettes vs. conventional cigarettes
DOI:
https://doi.org/10.12775/JEHS.2025.78.57621Keywords
e-cigarettes, vaping, health effects, conventional cigarettes, tobacoo, respiratory system, cardiovascular system, immune system, oral health, cellular effectAbstract
Introduction
Electronic cigarettes have gained widespread popularity by being marketed as a safer alternative to traditional smoking. Possibility of inhaling vapor created by heating nicotine liquid instead of combusting tobacco leaves revolutionized tobacco market, bringing a lot of questions about harmfulness or advantages of e-cigarettes. Their popularity is increasing and many aspects about their influence on health are still unclear. At the same time, better social acceptance than tobacco cigarettes brings out questions if they are a step to smoking cessation or if they encourage more people to start using nicotine.
Aim of the review
This systematic review provide an analysis of the existing literature on the influence of e-cigarettes on the human body with their economic and behavioral aspects. By examining a wide range of studies, we aim to elucidate the potential risks and benefits associated with e-cigarette use and provide a comparison of both electronic and conventional forms of nicotine consumption.
Methods
A systematic search was conducted using electronic databases such as PubMed, Scopus, and Web of Science. Keywords included "e-cigarettes", "vaping", "health effects", "conventional cigarettes", "tobacco", "respiratory system", "cardiovascular system", "immune system", "oral health", and "cellular effects". The search was limited to studies published up to December 2023. Both observational and experimental studies were included.
Conclusion
While e-cigarettes are often promoted as a safer alternative to conventional cigarettes, the evidence suggests that they are not without significant health risks. It is important to remember that they are a new form of substance use, and many aspects related to them are still unknown. E-cigarettes and conventional cigarettes present distinct usage patterns and cost profiles. Years of research on larger sample sizes are needed to determine their impact on humans.
References
1. The WHO tobacco free initiative, Geneva, Switzerland. Cited July 14, 2014. http://www.who.int/tobacco/mpower/ tobacco_facts/en/
2. Are E-cigarettes a safe and good alternative to cigarette smoking? Oren Rom, Alessandra Pecorelli, Giuseppe Valacchi, and Oren Rom Reznick; https://doi.org/10.1111/nyas.12609
3. Zhu, S.H. et al. 2014. Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation. Tob. Contro; https://doi.org/10.1136/tobaccocontrol-2014-051670
4. Kinouani S, Pereira E, Tzourio C. Electronic cigarette use in students and its relation with tobacco-smoking:
a cross-sectional analysis of the i-Share Study. Int J Environ Res Public Health. 2017; https://doi.org/10.3390/ijerph14111345
5. Awan KH. Experimentation and correlates of electronic nicotine delivery system (electronic cigarettes) among university students – A cross sectional study. Saudi Dent J. 2016; https://doi.org/10.1016/j.sdentj.2015.12.002
6. Hoek J, Thrul J, Ling P. Qualitative analysis of young adult END users’ expectations and experiences. BMJ Open. 2017; https://doi.org/10.1136/bmjopen-2016-014990
7. Kong G, Morean ME, Cavallo DA, Camenga DR, KrishnanSarin S. Reasons for electronic cigarette experimentation and discontinuation among adolescents and young adults. Nicotine Tob Res. 2015; https://doi.org/10.1093/ntr/ntu257
8. Schroeder, M.J. & A.C. Hoffman. 2014. Electronic cigarettes and nicotine clinical pharmacology. Tob. Control; https://doi.org/10.1136/tobaccocontrol-2013-051469
9. Polosa, R. et al. 2011 Effect of an electronic nicotine delivery device (e-cigarette) on smoking reduction
and cessation: a prospective 6-month pilot study. BMC Public Health; https://doi.org/10.1186/1471-2458-11-786
10. Siegel, M.B., K.L. Tanwar & K.S. Wood. 2011. Electronic cigarettes as a smoking-cessation: tool results from an online survey. Am. J. Prev. Med.; https://doi.org/10.1016/j.amepre.2010.12.006
11. Caponnetto, P. et al. 2013. Efficiency and safety of an electronic cigarette (ECLAT) as tobacco cigarettes substitute: a prospective 12-month randomized control design study. PLoS One; https://doi.org/10.1371/journal.pone.0066317
12. Bullen, C.et al. 2013. Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet; https://doi.org/10.1016/S0140-6736(13)61842-5
13. Garrison, G.D. & S.E. Dugan. 2009. Varenicline: a first-line treatment option for smoking cessation. Clin. Ther; https://doi.org/10.1016/j.clinthera.2009.03.021
14. Gotts, J. E., Jordt, S. E., McConnell, R., & Tarran, R. (2019). What are the respiratory effects of e-cigarettes? BMJ, 366, l5275.; https://doi.org/10.1136/bmj.l5275
15. Benowitz, N. L., & Burbank, A. D. (2016). Cardiovascular toxicity of nicotine: Implications for electronic cigarette use. Trends in Cardiovascular Medicine, 26(6), 515-523.; https://doi.org/10.1016/j.tcm.2016.03.001
16. Vlachopoulos, C., Ioakeimidis, N., Abdelrasoul, M., Terentes-Printzios, D., Georgakopoulos, C., Pietri, P., ... & Stefanadis, C. (2016). Electronic cigarette smoking increases aortic stiffness and blood pressure in young smokers. Journal of the American College of Cardiology, 67(23), 2802-2803.; https://doi.org/10.1016/j.jacc.2016.03.569
17. Sussan, T. E., Gajghate, S., Thimmulappa, R. K., Ma, J., Kim, J. H., Sudini, K., ... & Biswal, S. (2015). Exposure to electronic cigarettes impairs pulmonary anti-bacterial and anti-viral defenses in a mouse model. PLoS One, 10(2), e0116861.; https://doi.org/10.1371/journal.pone.0116861
18. Clapp, P. W., Pawlak, E. A., Lackey, J. T., Keating, J. E., Reeber, S. L., Glish, G. L., & Jaspers, I. (2017). Flavored e-cigarette liquids and cinnamaldehyde impair respiratory innate immune cell function. American Journal of Physiology-Lung Cellular and Molecular Physiology, 313(2), L278-L292.; https://doi.org/10.1152/ajplung.00452.2016
19. Pushalkar, S., Paul, B., Li, Q., Yang, J., Vasconcelos, R., Makwana, S., ... & Saxena, D. (2020). Electronic cigarette aerosol modulates the oral microbiome and increases risk of infection. iScience, 23(3), 100884.; https://doi.org/10.1016/j.isci.2020.100884
20. Rouabhia, M., Daudelin, J. F., & Semlali, A. (2017). Effect of e-cigarettes on oral health: A literature review. Journal of Oral Health and Dental Management, 16(2), 1-5.; PMID: 32543367
21. Lee, H. W., Park, S. H., Weng, M. W., Wang, H. T., Huang, W. C., Lepor, H., ... & Tang, M. S. (2018). E-cigarette smoke damages DNA and reduces repair activity in lung cells. Proceedings of the National Academy of Sciences, 115(7), E1560-E1569.; https://doi.org/10.1073/pnas.1718185115
22. Wang, Q., Khan, N. A., Muthumalage, T., Lawyer, G. R., McDonough, S. R., Chuang, T. D., ... & Rahman, I. (2016). Toxicological and microbiome changes following e-cigarette vaping in mice. Toxicology, 365, 29-40.
23. Durmowicz, E.L. 2014. The impact of electronic cigarettes on the paediatric population. Tob. Control; https://doi.org/10.1136/tobaccocontrol-2013-051468
24. National Youth Tobacco Survey (NYTS). (2020). Prevalence of e-cigarette use among high school students. Retrieved from CDC website
25. Gentzke AS, Creamer M, Cullen KA, et al. Vital Signs: Tobacco Product Use Among Middle and High School Students - United States, 2011-2018. Morbidity and Mortality Weekly. 2019; https://doi.org/10.15585/mmwr.mm6806e1
26. Federal Drug Administration (FDA). FDA News Release. Trump Administration Combating Epidemic of Youth E-Cigarette Use with Plan to Clear Market of Unauthorized, Non-Tobacco-Flavored E-Cigarette Products. September 11, 2019.
27. Stokes, A., Xie, W., Wilson, A. E., Yang, H., & Yu, E. (2018). Prevalence and correlates of e-cigarette use in adults: Evidence from the Population Assessment of Tobacco and Health Study. Journal of Public Health, 40(3), e276-e283.
28. Yingst, J. M., Hrabovsky, S., Hobkirk, A., Trindle, R. C., & Foulds, J. (2019). Nicotine absorption during electronic cigarette use among regular users. PloS One, 14(7), e0220300.; https://doi.org/10.1001/jamanetworkopen.2019.15494
29. Editorial (no authors listed). E-cigarettes: Public Health England’s evidence-based confusion. Lancet 2015; https://doi.org/10.1016/s0140-6736(15)00042-2
30. Kanwal R, Kullman G, Piacitelli C, et al. Evaluation of flavorings-related lung disease risk at six microwave popcorn plants. J Occup Environ Med 2006; https://doi.org/10.1097/01.jom.0000194152.48728.fb
31. FDA. Generally recognized as safe. 1982; 21 CFR 184.1666, www.gpo.gov/fdsys/pkg/CFR2000-title21-vol3/pdf/CFR-2000-title21-vol3- sec184-1666.pdf (1982, accessed 3 August 2017).
32. Niven R, Lynch M, Moutvic R, et al. Safety and toxicology of cyclosporine in propylene glycol after 9-month aerosol exposure to beagle K Farsalinos journals.sagepub.com/home/tar 15 dogs. J Aerosol Med Pulm Drug Deliv 2011; https://doi.org/10.1089/jamp.2010.0863
33. Fuoco, F.C. et al. 2014. Influential parameters on particle concentration and size distribution in the mainstream of e-cigarettes. Environ. Pollut; https://doi.org/10.1016/j.envpol.2013.10.010
34. Levy, D. T., Yuan, Z., Luo, Y., & Abrams, D. B. (2017). The relationship of e-cigarette use to cigarette quit attempts and cessation: Insights from a large, nationally representative U.S. survey. Nicotine & Tobacco Research, 20(8), 931-939.; https://doi.org/10.1093/ntr/ntx166
35. Zhu, S. H., Zhuang, Y. L., Wong, S., Cummins, S. E., & Tedeschi, G. J. (2017). E-cigarette use and associated changes in population smoking cessation: Evidence from US current population surveys. BMJ, 358, j3262.; https://doi.org/10.1136/bmj.j3262
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Mateusz Janik, Barbara Ufnalska, Joanna Rychlewska-Duda, Justyna Lisiecka, Artur Fabijański, Anna Konarska, Anna Machowiak, Michał Nowak, Wojciech Firlej, Adrianna Dukacz

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 56
Number of citations: 0