Evaluating The Carcinogenic Effects Of Flavoured E-Cigarette Aerosols On Oral Epithelial Cells

Background: The increasing use of e-cigarettes, particularly flavoured varieties, has raised concerns regarding their potential health risks, including carcinogenic effects on oral health. Objective: This study aims to evaluate the impact of flavoured e-cigarette aerosol exposure on oral epithelial cells and explore the association between e-cigarette use and oral health issues.Methods: This in-vitro analysis was conducted at Jinnah Postgraduate Medical Center, Karachi during January 2024 to July 2024. A total of 355 patients were added in the study. The study employed an in vitro approach using HOK-16B (human oral keratinocyte) and FaDu (human hypopharyngeal carcinoma) cell lines exposed to flavoured e-cigarette aerosols for various durations (24, 48, and 72 hours). Cell viability, cytotoxicity, oxidative stress, DNA damage, and gene expression were assessed. Results: In vitro results showed significant cytotoxicity, with a reduction in cell viability to 55% at 72 hours (p = 0.01). There was a significant increase in oxidative stress (ROS) and DNA damage, with fold increases of 2.1 and 2.3, respectively (p = 0.01). Clinically, the incidence of oral lesions increased with the duration of e-cigarette use, reaching 50% among those using e-cigarettes for more than 18 months (p = 0.01). Salivary malondialdehyde levels, indicative of oxidative stress, were significantly higher in e-cigarette users (3.5 μM) compared to non-users (1.4 μM, p = 0.01). Conclusion: The findings suggest that flavoured e-cigarette use is associated with significant cellular damage, oxidative stress, and an increased risk of oral lesions, particularly with prolonged use.