Evaluation of Cytological Changes in Oral Mucosa among Smokers and e-cigarette Users
DOI:
https://doi.org/10.22317/jcms.v11i5.2035Keywords:
Vaping, Electronic Nicotine Delivery Systems, Mouth Neoplasms, Tobacco UseAbstract
Objective: Oral cancer remains a major global health concern closely linked to tobacco use. With the increasing popularity of electronic cigarettes, it is essential to evaluate their biological impact on oral tissues. This study compared cytological changes in the oral mucosa of traditional cigarette smokers, e-cigarette users, and non-smokers in a Saudi population to understand potential precancerous risk.
Methods: Buccal mucosal samples were collected from 150 adults divided equally into three groups: traditional cigarette smokers, e-cigarette users, and non-smokers. The samples were stained using the Papanicolaou method and examined for pleomorphism, hyperchromatism, nuclear-to-cytoplasmic ratio, keratinization, inflammation, and infection. Statistical analysis was performed using chi-square and Fisher’s exact tests, and the strength of associations was expressed as odds ratios with 95 percent confidence intervals.
Results: Significant cytological alterations were identified among smokers compared with non-smokers. Pleomorphism was observed in 83 percent of smokers and 6 percent of non-smokers (odds ratio 76.49, p = 0.00000). Hyperchromatism and an increased nuclear-to-cytoplasmic ratio were detected in 45 percent and 36 percent of smokers respectively, while absent in non-smokers (p = 0.00000 for both). Infection was significantly higher in smokers (52 percent) than in non-smokers (14 percent; odds ratio 6.65, p = 0.00001). Keratinization and inflammation were more frequent in smokers but without statistical significance. Comparison between traditional and e-cigarette users revealed no significant differences in any cytological parameter, indicating similar cellular effects.
Conclusion: Both traditional and e-cigarette smoking produce cytological alterations in the oral mucosa that may predispose to dysplastic transformation. E-cigarettes, despite being marketed as safer alternatives, demonstrated cytological patterns comparable to those of traditional smoking, highlighting the need for continued surveillance and public awareness.
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