Health Effects from Secondhand Exposure to E-Cigarettes: A Systematic Review of Peer-Reviewed Articles from 2004–2024

Roengrudee Patanavanich (), Chawaphat Thatasawakul, Kamolnut Youngcharoen, Veerapattra Soponvashira and Panpetch Pichetsin
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Roengrudee Patanavanich: Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
Chawaphat Thatasawakul: Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
Kamolnut Youngcharoen: Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
Veerapattra Soponvashira: Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand
Panpetch Pichetsin: Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok 10400, Thailand

IJERPH, 2025, vol. 22, issue 9, 1-14

Abstract: Background : Since the emergence of e-cigarettes on the market in the early 2000s, the prevalence of e-cigarette use has increased globally. The health risks of using e-cigarettes have been increasingly revealed; however, the health effects on non-users exposed to e-cigarettes are less known. Methods : A systematic review was conducted of peer-reviewed articles from 2004 to October 2024 from PubMed and Embase. We focused on the studies that described health outcome measures among non-smokers/vapers exposed to secondhand e-cigarettes. We excluded animal studies and those that did not include human participants. We also omitted studies with financial conflicts of interest with the tobacco industry. Results : Of the 8635 studies we found in our search, 16 were included in the final review. Study designs included in our review included a case study, a cohort, eight experimental, four cross-sectional studies, and two observational studies. Health outcome measures were self-reported health symptoms and biomarkers. Ten out of fourteen studies examined respiratory health risks, six described immunological effects, two examined cardiovascular risks, and one explored mental health effects. Self-reported health symptoms such as bronchitis, shortness of breath, asthma, throat irritations, ear infections, and mental health disorders were observed among secondhand e-cigarette exposures when compared with controls. Biomarker measures varied among studies, except for cotinine concentrations of non-smokers/vapers exposed to secondhand e-cigarettes, which were likely to be higher than non-exposed. However, all studies encountered potential limitations. Conclusions : Our review found that secondhand e-cigarette exposure is not harmless and may have negative health consequences. However, higher-quality prospective studies remain essential to examine long-term secondhand exposure.

Keywords: e-cigarettes; secondhand; exposure; vaping; passive (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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