Skip to main content

E-cigarettes in ENT: what do we need to know?

  • N Stobbs (a1), A Lillis (a2) and N Kumar (a3)
Abstract Background:

E-cigarette use in the UK is increasing and we are commonly encountering patients in the ENT clinic who are e-cigarette smokers. Currently, there is no regulatory body or licensing for e-cigarettes. This means that the contents, and therefore potential carcinogenic and toxic risks, can vary greatly from product to product. Patients are starting to ask about the risks of e-cigarettes and their use in smoking cessation.


This review aimed to examine the regulations, trends, and carcinogenic and health risks of e-cigarettes, and summarise the evidence for their use in smoking cessation. It also aimed to provide a general awareness regarding the advice and information that can be safely given to patients.

Corresponding author
Address for correspondence: Miss Nicola Stobbs, C/o ENT Secretaries, Royal Albert Edward Infirmary, Wigan Lane, Wigan WN1 2NN, UK E-mail:
Hide All
1 Electronic cigarettes: A report commissioned by Public Health England. In: [8 March 2016]
2 International Agency for Research on Cancer. A Review of Human Carcinogens: Personal Habits and Indoor Combustions. In: [8 March 2016]
3 Electronic nicotine delivery systems: Report by WHO. In: [8 March 2016]
4 Odum L, O'Dell K, Schepers J. Electronic cigarettes: do they have a role in smoking cessation? J Pharm Pract 2012;25:611–14
5 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
6 Grana R, Benowitz N, Glantz S. E-cigarettes: a scientific review. Circulation 2014;129:e490–2
7 Dockrell M, Morrison R, Bauld L, McNeill A. E-cigarettes: prevalence and attitudes in Great Britain. Nicotine Tob Res 2013;15:1737–44
8 Adkison S, O'Connor R, Bansal-Travers M, Hyland A, Borland R, Yong H et al. Electronic nicotine delivery systems: international tobacco control four-country survey. Am J Prev Med 2013;44:207–15
9 Action on Smoking and Health. Use of electronic cigarettes (vapourisers) among adults in Great Britain. In: [8 March 2016]
10 Action on Smoking and Health. The regulation of e-cigarettes and other nicotine products in the UK - Q&A. In: [10 March 2016]
11 Directive 2001/37/EC of the European Parliament and of the Council of 5 June 2001 on the approximation of the laws, regulations and administrative provisions of the Member States concerning the manufacture, presentation and sale of tobacco and related products. In: [10 March 2016]
12 National Institute for Health and Care Excellence. Smoking: reducing and preventing tobacco use (QS82). In: [8 March 2016]
13 Williams M, Villarreal A, Bozhilov K, Lin S, Talbot P. Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol. PLoS One 2013;8:e57987
14 Westenberger B. Evaluation of E-cigarettes. St Louis: Food and Drug Administration, 2009;18
15 Trehy M, Ye W, Hadwiger M, Moore TW, Allgire J, Woodruff J. Analysis of electronic cigarette cartridges, refill solutions, and smoke for nicotine and nicotine related impurities. J Liq Chromatogr Relat Technol 2011;34:1442–58
16 Hecht S, Carmella S, Kotandeniya D, Pillsbury M, Chen M, Ransom B et al. Evaluation of toxicant and carcinogen metabolites in the urine of e-cigarette users versus cigarette smokers. Nicotine Tob Res 2015;17:704–9
17 Goniewicz M, Knysak J, Gawron M, Kosmider L, Sobczak A, Kurek J et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control 2014;23:133–9
19 Kienhuis AS, Soeteman-Hernandez LG, Bos PM, Cremers HW, Klerx WN, Talhout R. Potential harmful health effects of inhaling nicotine-free shisha-pen vapor: a chemical risk assessment of the main components propylene glycol and glycerol. Tob Induc Dis 2015;13:15
20 Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J et al. Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet 2013;382:1629–37
21 McRobbie H, Bullen C, Hartmann-Boyce J, Hajek P. Electronic cigarettes for smoking cessation and reduction. Cochrane Database Syst Rev 2014;(12):CD010216
22 Manzoli L, Flacco ME, Fiore M, La Vecchia C, Marzuillo C, Gualano MR et al. Electronic cigarettes efficacy and safety at 12 months: cohort study. PLoS One 2015;10:e0129443
23 Born H, Persky M, Kraus D. Electronic cigarettes: a primer for clinicians. Otolaryngol Head Neck Surg 2015;153:514
24 Harrell P, Simmons V, Correa J. Electronic nicotine delivery systems (“e-cigarettes”): review of safety and smoking cessation efficacy. Otolaryngol Head Neck Surg 2014;151:381–93
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 15
Total number of PDF views: 84 *
Loading metrics...

Abstract views

Total abstract views: 512 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 25th November 2017. This data will be updated every 24 hours.