Electronic Cigarettes Versus Combustible Cigarettes in Oral Squamous Cell Cancer Patients: A Systematic Review

Oral squamous cell carcinoma (OSCC) is associated with tobacco. In order to reduce the burden of smoking, e-cigarettes emerge as devices to aid cessation of tobacco addiction. However, growing evidence shows that e-cigarettes can lead to harmful effects.

The aim is to analyze the prevalence of combustible or electronic cigarette smoking in patients with a diagnosis of OSCC, analyze the prevalence of precancerous lesions in smokers of combustible or electronic cigarettes, and describe the location and differentiation of OSCC.

PRISMA guidelines were followed. PubMed, Web of Science, and Scopus were used, introducing specific algorithms related to electronic and combustible cigarettes associated with OSCC.

Of 400 potentially eligible articles, 15 met the inclusion criteria: 13 studies on combustible and 2 on e-cigarettes. Regarding combustible, the mean smoking prevalence in patients was 56.38% with a prevalence of precancerous lesions of 2.50%, among other parameters. For the e-cigarette group, the mean prevalence was 4.26% with a prevalence of precancerous lesions of 2.20%. Tongue and lower lip are common and frequent locations in both cigarettes.

Despite certain limitations, developing OSCC is mostly associated with combustible cigarettes and to a lesser extent with e-cigarettes. Both cigarettes show a similar prevalence of precancerous lesions, with the tongue as a common and frequent location.