Nuclear Abnormalities and Apoptotic Index of Buccal Cells in Tobacco and Electronic Cigarette Smokers

Abstract

Smoking has been shown to have detrimental impacts on dental health all around the world. Electronic cigarettes have become increasingly popular due to manufacturers’ claims that their products are less dangerous and can even enhance oral health by offering alternatives to smoking. This study aimed to investigate possible cytotoxic damage through the evaluation of nuclear abnormalities and apoptotic index in the buccal mucosa of tobacco cigarette (TC) and e-cigarette (EC) smokers compared to non-smokers (NS). Sixty male participants were recruited for 3 groups, with 20 participants per group. A history of ≥ 2 years of smoking was required for TC and EC groups. Buccal mucosal smears were obtained, which were further processed with the modified Papanicolaou stain. The frequencies of each type of nuclear abnormality and apoptotic index were recorded and statistically analyzed at a level of significance of p < 0.05. Duration of smoking was significantly longer in TC than in EC group (p = 0.000). Frequencies of nuclear abnormalities were significantly higher in both TC and EC than in the NS group (p = 0.000). Conversely, apoptotic index was significantly lower in TC and EC than in the NS group (p = 0.000). However, there were no significant differences in nuclear abnormalities or the apoptotic index between TC and EC. The marked increase in nuclear abnormalities and the lower decrease of apoptotic index over a much shorter smoking duration suggest greater potential toxicity and damage from e-cigarette use.