A recently published study in the European Journal of Paediatric Dentistry evaluated and compared the effects of secondhand smoke and emissions from electronic cigarettes and heated tobacco products on the oral health of children and adolescents.
According to WHO data, over 40% of children worldwide are exposed to secondhand smoke, with consequences of varying severity for their health. Exposure to toxic substances in smoke, including formaldehyde, heavy metals, and carbon monoxide, can impair immune function, disrupt normal physiological development, and increase the risk of numerous pathological conditions, including respiratory infections and asthma. Dental health is also seriously compromised by passive smoke exposure, which can contribute to an increased risk of dental caries.
Although the scientific evidence regarding emissions from conventional cigarettes is extensive, much less is known about the effects on children’s oral health from exposure to non-combustible products, such as electronic cigarettes and heated tobacco products.
A group of researchers from the University of Padua and the University of Messina therefore sought to assess the potential harm caused by exposure to so-called “secondhand aerosol” in a group of children and adolescents.
“The results of our work confirm that exposure to secondhand smoke, regardless of its source, produces measurable and harmful effects on children’s oral health, with a significant increase in cotinine levels in crevicular fluid and a higher incidence of dental caries,” explains Prof. Francesco Ludovichetti, researcher at the University of Padua.
“In particular, children exposed to conventional cigarette smoke showed the highest values, both in terms of exposure biomarkers and caries indices, confirming the seriousness of the impact of traditional smoking.
By contrast, exposure to emissions from electronic cigarettes and heated tobacco devices, while still causing an increase in cotinine levels and caries risk compared to unexposed children, showed lower values than those observed with traditional cigarettes. This finding suggests that, although not risk-free, electronic products may represent harm reduction tools compared to combusted tobacco.”
The study involved 160 children aged 3 to 14, divided into four groups of 40 each:
- exposure to conventional cigarette smoke
- exposure to aerosol from IQOS
- exposure to aerosol from e-cigarettes
- control group with no exposure
The potential level of harm was assessed by measuring cotinine levels, the main metabolite of nicotine, which is produced when the body—primarily the liver—metabolizes nicotine absorbed through smoking, vaping, or passive exposure.
To evaluate parents’ smoking or vaping habits, environmental factors, and the oral hygiene practices of the participants, a questionnaire was administered. The findings revealed frequent cigarette smoking or e-cigarette use indoors by parents, along with suboptimal oral hygiene practices, in the group of children exposed to secondhand cigarette smoke.
“However, it is crucial to underline that no form of exposure to nicotine-containing products can be considered safe for children. Our conclusions reinforce the importance of promoting smoke- and aerosol-free home and social environments, while at the same time indicating that switching from conventional cigarettes to alternative devices can reduce—though not eliminate—the negative impact on pediatric oral health,” concludes Prof. Ludovichetti.
