Beyond smoke and mirrors: unravelling the complexities of e-cigarettes for smoking cessation.

Abstract

Tobacco is a major cause of mortality worldwide and the World Health Organization (WHO) attributes over 8 million deaths annually to tobacco use including 1.3 million deaths amongst non-smokers exposed to second hand smoke1. Smoking is an established risk factor for multiple cancers especially lung cancer; chronic obstructive pulmonary disease (COPD); cardiovascular disease including ischaemic heart disease (IHD), hypertension, and strokes; macular degeneration; and erectile dysfunction, to name a few. Smoking also adversely affects the outcomes of surgical procedures and management of a wide range of acute and chronic conditions including diabetes mellitus (DM), and chronic kidney disease (CKD). The adverse effects of smoking on oral health are also well-established and tobacco smoking is a known risk factor for oral premalignant lesions (e.g., leukoplakia, erythroplakia); oral malignancies especially squamous cell carcinoma; periodontal disease, periimplantitis, xerostomia (which can increase the risk of dental caries); opportunistic oral infections such as oral candidiasis; and delayed wound healing and infections following oral surgical interventions.