Efeitos diretos e indiretos de dispositivos eletrônicos para fumar na voz: uma revisão de escopo
Direct and indirect effects of electronic nicotine delivery systems on the voice: a scoping review
Ana Paula de Oliveira Quiodine; Gilberto da Cruz Leal; Arthur Pedro Ivis da Silva Araújo; Marcia Simões-Zenari; Katia Nemr
Resumo
Palavras-chave
Abstract
Purpose: To conduct an exploratory mapping of the available scientific evidence on the direct and indirect effects of Electronic Nicotine Delivery Systems (ENDS) use on the voice.
Research strategy: A scoping review conducted according to the Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses— Extension for Scoping Reviews (PRISMA-ScR), with the protocol registered on the Open Science Framework. The databases searched included Embase, MEDLINE, SCOPUS, Web of Science, CINAHL, and LILACS.
Selection criteria: Studies published in Portuguese, English, or Spanish were included, without time restrictions. Studies with restricted access or not available in full text, even after contacting the authors, as well as grey literature, letters to the editor, opinion articles, and reviews, were excluded.
Results: Of the 279 studies identified, 6 met the eligibility criteria. Direct findings included dysphonia, changes in acoustic parameters, and impacts on voice-related quality of life. Indirect findings included epiglottitis, supraglottic inflammation, chemical lesions, and cytotoxicity of the vocal folds, which may influence vocal function over time.
Conclusion: The exploratory mapping suggests that the use of ENDS may affect the voice due to both direct and indirect effects. Despite these findings, the available evidence remains limited, highlighting the need for longitudinal and experimental studies to better understand the impacts of electronic cigarettes on vocal function and laryngeal health.
Keywords
References
1 WHO: World Health Organization. Report on the global tobacco epidemic 2021: addressing new and emerging products [Internet]. Geneva: WHO; 2021 [citado em 2025 Out 31]. Disponível em:
2 Rasmussen M, Larsson M, Gilljam H, Adami J, Wärjerstam S, Post A, et al. Effectiveness of tobacco cessation interventions for different groups of tobacco users in Sweden: a study protocol for a national prospective cohort study. BMJ Open. 2022;12(1):e053090.
3 The Tobacco Atlas. Challenges: deaths [Internet]. Atlanta: American Cancer Society, Vital Strategies; 18 maio 2022 [citado em 2025 Out 31]. Disponível em:
4 Soneji S, Barrington-Trimis JL, Wills TA, Leventhal AM, Unger JB, Gibson LA, et al. Association between initial use of e-cigarettes and subsequent cigarette smoking among adolescents and young adults: a systematic review and meta-analysis. JAMA Pediatr. 2017;171(8):788-97.
5 Farsalinos KE, Stimson GV. Is there any legal and scientific basis for classifying electronic cigarettes as medications? Int J Drug Policy. 2014;25(3):340-5.
6 Bertoni N, Szklo AS. Dispositivos eletrônicos para fumar nas capitais brasileiras: prevalência, perfil de uso e implicações para a Política Nacional de Controle do Tabaco. Cad Saude Publica. 2021;37(7):e00261920.
7 Dutra LM, Grana R, Glantz SA. Philip Morris research on precursors to the modern e-cigarette since 1990. Tob Control. 2017;26(e2):e97-105.
8 Kavuluru R, Han S, Hahn EJ. On the popularity of the USB flash drive-shaped electronic cigarette Juul. Tob Control. 2019;28(1):110-2. PMid:29654121.
9 NIDA: National Institute on Drug Abuse. Vaping devices (electronic cigarettes) drugfacts [Internet]. Bethesda: National Institutes of Health; 2020 [citado em 2025 Oct 31]. Disponível em:
10 EBC: Empresa Brasil de Comunicação. Comissão adia votação do PL que regulamenta cigarro eletrônico [Internet]. Agência Brasil; 11 jul 2024 [citado em 2024 Out 29]. Disponível em:
11 Caponnetto P, Campagna D, Papale G, Russo C, Polosa R. The emerging phenomenon of electronic cigarettes. Expert Rev Respir Med. 2012;6(1):63-74.
12 Sarin A, Khan A, Seth S. How more than 1000 medical doctors writing for ban on e-cigarettes in India helped. Tob Induc Dis. 2021;19(Suppl 1):A8.
13 McCausland K, Maycock B, Leaver T, Wolf K, Freeman B, Thomson K, et al. E-cigarette promotion on twitter in australia: content analysis of tweets. JMIR Public Health Surveill. 2020;6(4):e15577.
14 Bertoni N, Szklo A, De Boni R, Coutinho C, Vasconcellos M, Silva PN, et al. Electronic cigarettes and narghile users in Brazil: do they differ from cigarettes smokers? Addict Behav. 2019;98:106007.
15 Pinto AGL, Crespo AN, Mourão LF. Influence of smoking isolated and associated to multifactorial aspects in vocal acoustic parameters. Braz J Otorhinolaryngol. 2014;80(1):60-7.
16 Pavlovska I, Taushanova B, Zafirova B. Risk for occurrence of laryngeal cancer among current cigarette smokers. J Glob Oncol. 2018;4(13, Suppl 2):13s.
17 Byeon H, Cha S. Evaluating the effects of smoking on the voice and subjective voice problems using a meta-analysis approach. Sci Rep. 2020;10(1):4720.
18 Bhutia TD, Mehendale A, Lad N, Vaishnav P. E-cigarettes: gateway to tobacco addiction among adolescents. Tob Induc Dis. 2021;19(1):A48.
19 Kaleta D, Polanska K. Trends of e-cigarettes and tobacco use among secondary and high school students from Poland over three years observation. Tob Induc Dis. 2021;19(1):A72.
20 Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan-a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210.
21 Salturk Z, Çakır Ç, Sünnetçi G, Atar Y, Kumral TL, Yıldırım G, et al. Effects of electronic nicotine delivery system on larynx: experimental study. J Voice. 2015;29(5):560-3.
22 Tuhanioğlu B, Erkan SO, Ozdas T, Derici C, Tuzun K, Senkal OA. The effect of electronic cigarettes on voice quality. J Voice. 2019;33(5):811.e13-7.
23 Bozzella MJ, Magyar M, DeBiasi RL, Ferrer K. Epiglottitis associated with intermittent e-cigarette use: the vagaries of vaping toxicity. Pediatrics. 2020;145(3):e20192399.
24 Martinez JD, Easwaran M, Ramirez D, Erickson-DiRenzo E. Effects of electronic (e)-cigarette vapor and cigarette smoke in cultured vocal fold fibroblasts. Laryngoscope. 2023;133(1):139-46.
25 Lechien JR, Papon JF, Pouliquen C, Hans S. E-cigarette vaping-related vocal fold injury: a case report. J Voice. 2024;38(1):195-6.
26 Brophy S, Combs J, Hutchison J. Thermal pharyngeal injury resulting from vaping: a case report. Cureus. 2024;16(6):e61718.
27 Lucas JH, Muthumalage T, Wang Q, Friedman MR, Friedman AE, Rahman I. E-liquid containing a mixture of coconut, vanilla, and cookie flavors causes cellular senescence and dysregulated repair in pulmonary fibroblasts: implications on premature aging. Front Physiol. 2020;11:924.
28 Jenssen BP, Walley SC, Groner JA, Rahmandar M, Boykan R, Mih B, et al. Section on tobacco control: e-cigarettes and similar devices. Pediatrics. 2019;143(2):e20183652.
29 Hidayat RC, Saragih AR, Zahara D, Adenin LI, Zaluchu F. Dysphonia causative diagnosis linked to voice handicap index of the patients with dysphonia. Int J Sci Stud. 2018;6(1):134-7.
30 Balouch B, Alnouri G, Valentino W, Sataloff RT. The effect of marijuana on the voice: a pilot study. J Voice. 2022;36(4):559-62.
31 Meehan-Atrash J, Korzun T, Ziegler A. Cannabis inhalation and voice disorders: a systematic review. JAMA Otolaryngol Head Neck Surg. 2019;145(10):956.
32 Zhu SH, Sun JY, Bonnevie E, Cummins SE, Gamst A, Yin L, et al. Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation. Tob Control. 2014;23(Suppl 3):iii3-9.
33 Dunbar MS, Davis JP, Rodriguez A, Tucker JS, Seelam R, D’Amico EJ. Disentangling within- and between-person effects of shared risk factors on e-cigarette and cigarette use trajectories from late adolescence to young adulthood. Nicotine Tob Res. 2019;21(10):1414-22.
34 Walden N, Earleywine M. How high: quantity as a predictor of cannabis-related problems. Harm Reduct J. 2008;5(1):20.
35 Merecz-Sadowska A, Sitarek P, Zielinska-Blizniewska H, Malinowska K, Zajdel K, Zakonnik L, et al. A summary of in vitro and in vivo studies evaluating the impact of e-cigarette exposure on living organisms and the environment. Int J Mol Sci. 2020;21(2):652.
36 Wang P, Chen W, Liao J, Matsuo T, Ito K, Fowles J, et al. A device-independent evaluation of carbonyl emissions from heated electronic cigarette solvents. PLoS One. 2017;12(1):e0169811.
37 Easwaran M, Santa Maria C, Martinez JD, Hung B, Yu X, Soo J, et al. Effects of short-term electronic(e)-cigarette aerosol exposure in the mouse larynx. Laryngoscope. 2024;134(3):1316-26.
38 Pinar D, Cincik H, Erkul E, Gungor A. Investigating the effects of smoking on young adult male voice by using multidimensional methods. J Voice. 2016;30(6):721-5.
39 Tafiadis D, Tatsis G, Ziavra N, Toki EI. Voice data on female smokers: coherence between the voice handicap index and acoustic voice parameters. AIMS Med Sci. 2017;4(2):151-63.
40 Pepper JK, Gilkey MB, Brewer NT. Physicians’ counseling of adolescents regarding e-cigarette use. J Adolesc Health. 2015;57(6):580-6.
Submitted date:
11/05/2025
Accepted date:
05/14/2026
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email