DNA damage in human oral cells induced by use of e-cigarettes

Jiehong Guo, Stephen S. Hecht

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations


The use of electronic cigarettes (e-cigarettes) has increased rapidly in the United States, especially among high school students. e-Cigarettes contain some recognized carcinogens and may induce DNA damage in oral cells. The aim of this review is to summarize studies reporting DNA adducts or other types of DNA damage in oral cells in vitro or in vivo upon exposure to e-cigarette vapor and to evaluate the possible connections between e-cigarette exposure and oral cancer. Three databases including PubMed, Scopus, and EMBASE and gray literature were searched for articles published up to April 24, 2022. After screening 321 articles, we extracted 27 for further investigation. Based on the inclusion criteria, 22 articles were eligible for this review. The in vitro studies demonstrate that e-cigarette liquid or vapor can induce DNA damage, oxidative stress, DNA double-stranded breaks, apoptosis, cytotoxicity, and genotoxicity in different types of oral cells. The clinical studies showed that e-cigarette users have significantly higher levels of N′-nitrosonornicotine, acrolein DNA adducts, metanuclear anomalies, gene regulation, and lactate dehydrogenase enzyme expression and significantly lower levels of apurinic/apyrimidinic sites than non-users. Comparison of micronuclei levels between e-cigarette users and non-users gave inconsistent results. e-Cigarettes are implicated in DNA damage to oral cells, but publications to date present limited evidence. Future studies with larger sample sizes are required to investigate the long-term consequences of e-cigarette use.

Original languageEnglish (US)
Pages (from-to)1189-1197
Number of pages9
JournalDrug Testing and Analysis
Issue number10
StatePublished - Oct 2023

Bibliographical note

Funding Information:
This study was supported by grant numbers CA‐203851 and CA‐259652 from the U.S. National Cancer Institute (NIH) and the Food and Drug Administration Center for Tobacco Products. The content is solely the responsibility of the authors and does not necessarily represent the views of the NIH or the Food and Drug Administration. We thank Bob Carlson for editorial support.

Publisher Copyright:
© 2022 The Authors. Drug Testing and Analysis published by John Wiley & Sons Ltd.


  • DNA damage
  • e-cigarettes
  • oral cells

PubMed: MeSH publication types

  • Journal Article
  • Review


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