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March 04, 2022

1 min read


Gordon and Karey report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

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Many e-cigarette and hookah smokers exhale aerosols through the nose, which may increase risk for lung inflammation and nose, sinus and throat cancers, according to findings published in Tobacco Use Insights.

“Our findings suggest that the unique way vapers and hookah smokers use their devices may expose the nose and sinuses to far more emissions than cigarettes, which may in turn increase their risk for upper respiratory diseases,” Emma Karey, PhDpostdoctoral research fellow in the department of environmental medicine at NYU Langone Health at New York University Grossman School of Medicine, said in a related press release.

Source: Adobe Stock.

Researchers recorded smoke exhalation patterns through the mouth only, nose only, and both the mouth and nose in 341 individuals in the New York City tristate area from March 2018 to February 2019. All individuals used tobacco products including cigarettes (n = 122), e -cigarettes (n=123) or hookahs (n=96).

Sixty-two percent of e-cigarette users and 50% of hookah users demonstrated nasal exhalation practices compared with 22% of cigarette users, according to the results. Those who used e-cigarettes had a higher rate of exclusive nasal exhalation compared with cigarette users (19.5% vs. 4.9%). In addition, e-cigarette and hookah users practiced exclusive mouth exhalation less often than cigarette smokers (P < .001), according to proportion tests.

E-cigarette device type was significantly associated with exhalation profile among vapers, the researchers wrote. Users of pod-like devices were more than twice as likely to exclusively exhale smoke from their nose compared with those who used modular-tank devices (26.6% vs. 11.9%).

“Because vaping and hookah devices are used differently than traditional cigarettes, we need to consider diseases of both the nose and lungs to evaluate their safety before judging whether one is more risky than another,” Terry Gordon, PhD, professor in the department of environmental medicine at NYU Grossman School of Medicine, said in the release.


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