Effects of Daily Electronic Cigarette Use on the Vocal Mechanism: A Multimodality Study

ObjectivesTo compare self-reported voice, cough, and dyspnea symptom impacts, aerodynamics, and laryngeal kinematics in young adults who do and do not use electronic cigarettes.MethodsA total of 26 electronic cigarette users (EC group; 10 male, 16 female) and 39 nonusers (control group; 10 male, 29 female) completed the study. Standardized questionnaires related to voice, dyspnea, and cough symptoms were completed. Aerodynamic measures of peak expiratory flow and volume for cough, subglottal pressure, and vital capacity were obtained. Laryngeal kinematics were evaluated during tasks of sustained /i:/ and /hi-hi/ from high-speed videoendoscopy. Comparisons between EC and controls were examined, and regression analyses were calculated to evaluate how characteristics of use (e.g., duration, frequency, co-use with marijuana) were related to outcome measures.ResultsThe EC group reported significantly greater voice and cough symptoms on standardized questionnaires compared to controls, with a longer duration of use significantly related to greater symptoms. Use of marijuana was related to greater cough symptoms as well. The EC group also exhibited significantly smaller vocal fold adductory velocities during /hi-hi/ productions as well as significantly lower amplitude quotient variability and phase asymmetry.ConclusionThis study provides preliminary evidence of the negative effects of daily electronic cigarette use in young adults, with users reporting more voice/cough symptoms, along with subtle changes to laryngeal kinematics. However, voice and cough aerodynamics were not affected. Future studies should investigate how factors of duration and use of marijuana influence voice and cough in electronic cigarette users.Level of EvidenceIII.