The Effect of Electronic Cigarettes on Voice Quality

J Voice. 2019 Sep;33(5):811.e13-811.e17. doi: 10.1016/j.jvoice.2018.03.015. Epub 2018 Jun 5.


Objectives: Cigarette-associated diseases have frequently been detected in the field of otolaryngology. Cigarettes can cause changes in voice performance. The aim of the present study was to investigate the effect of e-cigarettes on voice performance compared with conventional cigarettes.

Materials and methods: This is a cross-sectional study that included 81 healthy volunteers. To provide standardization, all patients were men. The patients were divided into three groups: e-cigarette users (group 1, n = 21), conventional cigarette users (group 2, n = 30), and nonsmokers who had never smoked (group 3, n = 30). The subjective and objective voice analyses were performed for all the three groups in the study. F0, jitter %, shimmer %, shimmer dB, harmonics-to-noise ratio (HNR) values, and Voice Handicap Index 10 were statistically compared between all groups.

Results: The mean Voice Handicap Index 10 values of the conventional cigarette users were higher than those of the e-cigarette users and control group. No significant difference regarding the F0, jitter, and shimmer percentage values between the groups was detected; however, a significant difference was detected regarding the shimmer dB and HNR values between the groups. The mean shimmer dB values of the conventional cigarette group were higher than those of the control group and electronic cigarette users, but the mean HNR values were lower than those of the control group and electronic cigarette users.

Conclusions: The effects of e-cigarettes on voice were detected as mild compared with conventional cigarettes, according to the subjective and objective voice analysis results in our study.

Keywords: Acoustics; Electronic cigarette; Objective voice analysis; Smoking; Voice Handicap Index.

Publication types

  • Comparative Study

MeSH terms

  • Acoustics
  • Adolescent
  • Adult
  • Cigarette Smoking / adverse effects*
  • Cross-Sectional Studies
  • Disability Evaluation
  • Electronic Nicotine Delivery Systems*
  • Humans
  • Male
  • Middle Aged
  • Phonation*
  • Risk Factors
  • Smokers*
  • Speech Acoustics*
  • Speech Production Measurement
  • Vaping / adverse effects*
  • Vaping / physiopathology
  • Voice Disorders / diagnosis
  • Voice Disorders / etiology*
  • Voice Disorders / physiopathology
  • Voice Quality*
  • Young Adult