Cited by 38Smoking Behavior and CessationSex and Gender in HealthcareLGBTQ Health, Identity, and Policy

Sex Differences in E-Cigarette Use and Related Health Effects

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Alam, Fatima, Silveyra, Patricia·2023·International Journal of Environmental Research and Public Health

Abstract

Background: Electronic cigarettes (e-cigarettes) comprise a variety of products designed to deliver nicotine, flavorings, and other substances. To date, multiple epidemiological and experimental studies have reported a variety of health issues associated with their use, including respiratory toxicity, exacerbation of respiratory conditions, and behavioral and physiological effects. While some of these effects appear to be sex- and/or gender-related, only a portion of the research has been conducted considering these variables. In this review, we sought to summarize the available literature on sex-specific effects and sex and gender differences, including predictors and risk factors, effects on organ systems, and behavioral effects. Methods: We searched and selected articles from 2018–2023 that included sex as a variable or reported sex differences on e-cigarette-associated effects. Results: We found 115 relevant studies published since 2018 that reported sex differences in a variety of outcomes. The main differences reported were related to reasons for initiation, including smoking history, types of devices and flavoring, polysubstance use, physiological responses to nicotine and toxicants in e-liquids, exacerbation of lung disease, and behavioral factors such as anxiety, depression, sexuality, and bullying. Conclusions: The available literature supports the notion that both sex and gender influence the susceptibility to the negative effects of e-cigarette use. Future research needs to consider sex and gender variables when addressing e-cigarette toxicity and other health-related consequences.

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Authors
Alam, F., & Silveyra, P.
Affiliations
Indiana University Bloomington (US)
Corresponding author
Silveyra, Patricia
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2023-11-18
Volume
20
Issue
22
Pages
7079
ISSN
1660-4601 (ISSN-L)
OpenAlex
W4388796020
Cited by
38
References
149
Citations by year
2026: 13 · 2025: 17 · 2024: 8
FWCI
1.36
Type
journal article
Language
en
Open access
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • IUScholarWorks (Indiana University) (submittedVersion, cc-by)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
Indiana University Bloomington School of Public Health
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
  • Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Keywords
electronic cigarettes, sex differences, gender differences, e-cigarette health effects, nicotine, respiratory toxicity, polydrug use, smoking history, anxiety and depression, bullying, sexual behavior, e-cigarette initiation
MeSH terms
Vaping, Female, Flavoring Agents, Humans, Male, Nicotine, Sex Characteristics, Sex Factors, Tobacco Products, Electronic Nicotine Delivery Systems

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