Comparative analysis of cytological changes in the buccal mucosa among traditional cigarette and electronic cigarette users.

Abstract

Introduction: The study aimed to evaluate cytological changes in the buccal mucosa among traditional cigarette smokers and electronic cigarette smokers.

Methods: A cross-sectional study was conducted with 159 participants, including 97 smokers (users of traditional cigarettes, electronic cigarettes, or both) and 62 non-smokers. Participants were recruited from the student and staff population at the College of Applied Medical Sciences, Taif University. Buccal smears were collected from the lateral buccal mucosa using a wooden spatula and stained with the Papanicolaou technique for cytological evaluation.

Results: Cytological analysis using Papanicolaou (Pap) staining showed negative results in 51.6% of participants, reactive changes in 29.6%, and inflammatory changes in the remainder. Reactive changes were significantly more common in smokers (46.4%) than non-smokers (3.2%) (p=0.001), with higher prevalence in traditional cigarette users (51.4%) compared to e-cigarette users (37.5%) and dual users (50.0%). These changes were most frequent in individuals who smoked for ≥5 years (71.8%) versus <5 years (33.8%) (p=0.001).

Conclusions: This study demonstrates a strong association between smoking and cytomorphological changes in the buccal mucosa, with severity linked to smoking duration and intensity, particularly in traditional and dual users. The findings highlight the cytotoxic impact of smoking on oral cells and the need for targeted public health interventions.