Self-Perceived Hoarseness and Voice Disorders in E-cigarette and Conventional Cigarette Users

E-cigarettes have rapidly gained popularity across different age groups, particularly among adolescents and young adults. A growing body of research indicates that e-cigarettes can adversely affect the phonatory system.

To explore the self-perceived voice handicap and types of voice disorders in e-cigarette users presenting with hoarseness, and to compare these outcome measures with those of conventional cigarette smokers.

Patients with a history of e-cigarette smoking and a group of traditional cigarette smokers matched by age and gender who presented with a history of hoarseness were included in this study. Data collected included age, gender, type of smoking, history of allergies, history of reflux disease, Voice Handicap Index-10, and types of voice disorders.

Twenty-five e-cigarette smokers, 25 cigarette smokers, and 25 non-smokers were included. The mean VHI-10 score in non-smokers was lower than that of e-cigarette smokers and traditional cigarette smokers (3.92 ± 5.10 vs 7.04 ± 9.19 vs 12.68 ± 9.12, respectively). The difference between the two groups was statistically significant (P = 0.001). Twenty-eight percent of e-cigarette smokers had a VHI-10 score ≥11, compared with 60% in cigarette smokers and 16% in non-smokers (P = 0.003). There was no statistically significant difference in the types of voice disorders or vocal fold pathology between the two groups.

E-cigarette users presenting with hoarseness had less severe self-perceived voice handicap than traditional cigarette smokers, and their voice handicap was less likely to impact their quality of life. However, they exhibited more severe voice handicap, greater impact on quality of life, and more vocal fold pathology compared to non-smokers.