Electronic cigarette consumption in Latin America: epidemiological and toxicological aspects
DOI:
https://doi.org/10.15517/fvbrp698Keywords:
Electronic Nicotine Delivery Systems, Toxicology, Public Health, Latin AmericaAbstract
Introduction: The use of electronic cigarettes (ECs) has increased in Latin America, especially among youth, despite limited evidence on their long-term effects and the presence of toxic compounds in e-liquids (ELs). The objective of this study is to systematize and analyze the available scientific information on electronic cigarette use in Latin America, identifying the main health risks, consumption patterns, and regulatory gaps, with the aim of guiding future research and public policies in the region. Materials and Methods: A total of 182 scientific publications from 2014 to 2024 were reviewed across academic databases, with 60 relevant studies selected. Results: ECs contain substances that can form toxic compounds such as aldehydes and heavy metals when inhaled. Studies in animal models and humans have reported damage to the respiratory, cardiovascular, and oral systems. Their popularity among youth is linked to social media, appealing flavors, and perceived low risk. Conclusions: ECs pose health risks comparable to conventional tobacco. Stricter regulations and local research are urgently needed to protect public health, particularly among younger populations.
Downloads
References
Abouassali, O., Chang, M., Chidipi, B., Martinez, J. L., Reiser, M., Kanithi, M., Soni, R., McDonald, T. V., Herweg, B., Saiz, J., Calcul, L., y Noujaim, S. F. (2021). In vitro and in vivo cardiac toxicity of flavored electronic nicotine delivery systems. American Journal of Physiology-Heart and Circulatory Physiology, 320(1), H133-H143. https://doi.org/10.1152/ajpheart.00283.2020
Accinelli, R. A., Lam, J., y Tafur, K. B. (2020). El cigarrillo electrónico: un problema de salud pública emergente. Revista Peruana de Medicina Experimental y Salud Pública, 37(1), 122-128. https://doi.org/10.17843/rpmesp.2020.371.4780
Antolin, V. M., y Barkley, T. W. (2016). Cigarrillos electrónicos: ¿Qué necesitan saber las enfermeras? Nursing (Ed. Española), 33(4), 30-33. https://doi.org/10.1016/j.nursi.2016.07.012
Arauz Tobar, M. A., Morales Fajardo, W. G., y Roca Hernández, K. S. (2021). Caracterización del estudiante de medicina que usa cigarrillo electrónico: Estudio descriptivo transversal en los estudiantes de primero a sexto año de la Facultad de Ciencias Médicas de la Universidad de San Carlos de Guatemala durante el año 2020 [Tesis de pregrado, Universidad de San Carlos de Guatemala, Facultad de Ciencias Médicas].
Azimi, P., Keshavarz, Z., Lahaie Luna, M., Cedeno Laurent, J. G., Vallarino, J., Christiani, D. C., y Allen, J. G. (2021). An unrecognized hazard in e-cigarette aerosol: Preliminary quantification of methylglyoxal formation from propylene glycol in e-cigarettes. International Journal of Environmental Research and Public Health, 18(2), 385. https://doi.org/10.3390/ijerph18020385
Barrientos-Gutierrez, I., Gallegos-Carrillo, K., Cruz-Jimenez, L., Rodriguez-Bolaños, R., Arillo-Santillán, E., y Thrasher, J. F. (2022). Exposure to e-cigarette advertising and provaping websites, and the social acceptability of their use among nicotine users. Revista Panamericana de Salud Pública, 46(87), 87. https://doi.org/10.26633/RPSP.2022.87
Belda Lanzuela, R. (2023). Programa de sensibilización y prevención del consumo de cigarrillos electrónicos en adolescentes [Trabajo de fin de grado, Facultad de Psicología]. Repositorio Institucional Universidad Católica de Valencia San Vicente Mártir. http://hdl.handle.net/20.500.12466/3078
Bello, S. S. (2020). Daño pulmonar asociado al uso de cigarrillos electrónicos-vapeadores. Revista Chilena de Enfermedades Respiratorias, 36(2), 115-121. https://doi.org/10.4067/S0717-73482020000200115
Bengalli, R., Ferri, E., Labra, M., y Mantecca, P. (2017). Lung toxicity of condensed aerosol from e-cig liquids: Influence of the flavor and the in vitro model used. International Journal of Environmental Research and Public Health, 14(10), 1254. https://doi.org/10.3390/ijerph14101254
Bertoni, N., Szklo, A., De Boni, R., Coutinho, C., Vasconcellos, M., Nascimento Silva, P., de Almeida, L. M., y Bastos, F. I. (2019). Electronic cigarettes and narghile users in Brazil: Do they differ from cigarette smokers? Addictive Behaviors, 98. https://doi.org/10.1016/j.addbeh.2019.05.031
Bhatta, D. N., y Glantz, S. A. (2020). Association of e-cigarette use with respiratory disease among adults: A longitudinal analysis. American Journal of Preventive Medicine, 58(2), 182-190. https://doi.org/10.1016/j.amepre.2019.07.028
Botero-Rodríguez, F., Marroquín Rivera, A., Leal Jaramillo, A., Cabarique Mendez, C., y Gómez-Restrepo, C. (2019). Sistemas electrónicos de administración de nicotina: ¿Una amenaza para el neurodesarrollo de los adolescentes? Universitas Médica, 60(4), 1-8. https://doi.org/10.11144/Javeriana.umed60-4.sean
Calderón-Cortés, M. I., y Henríquez, G. M. (2023). Consumo de cigarrillos electrónicos dentro de la noción de reducción del daño: Un juego de la industria que debemos terminar. Revista Gerencia y Políticas de Salud, 22. https://doi.org/10.11144/Javeriana.rgps22.ccen
Cárdenas-Soto, C., Gómez-Maldonado, M., y Torres-García, E. (2023). Impacto de los cigarrillos electrónicos en la salud pública de Latinoamérica: Un análisis crítico. Revista Latinoamericana de Salud Pública, 39(2), 78-89.
Camila, B., Carlos, C., Maria-Jose, P., Sergio, R., Alejandra, C., y Adriana, R. (2023). Genotoxicity and hypomethylation of LINE-1 induced by electronic cigarettes. Ecotoxicology and Environmental Safety, 256, 114900. https://doi.org/10.1016/j.ecoenv.2023.114900
Crotty Alexander, L. E., Drummond, C. A., Hepokoski, M., Mathew, D., Moshensky, A., Willeford, A., Das, S., Singh, P., Yong, Z., Lee, J. H., Vega, K., Du, A., Shin, J., Javier, C., Tian, J., Heller Brown, J., y Breen, E. C. (2018). Chronic inhalation of e-cigarette aerosol containing nicotine disrupts airway barrier function and induces systemic inflammation and multiorgan fibrosis in mice. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 314(6), R834-R847. https://doi.org/10.1152/ajpregu.00270.2017
Cuschieri, S. (2019). The STROBE guidelines. Saudi Journal of Anaesthesia, 13(5), 31. https://doi.org/10.4103/sja.SJA_543_18
Dutra, L. M., Glantz, S. A., Lisha, N. E., y Song, A. V. (2017). Beyond experimentation: Five trajectories of cigarette smoking in a longitudinal sample of youth. PLOS ONE, 12(2), e0171808. https://doi.org/10.1371/journal.pone.0171808
Effah, F., Adragna, J., Luglio, D., Bailey, A., Marczylo, T., y Gordon, T. (2023). Toxicological assessment of E-cigarette flavored E-liquids aerosols using Calu-3 cells: A 3D lung model approach. Toxicology, 500, 153683. https://doi.org/10.1016/j.tox.2023.153683
Eshraghian, E., y Al-Delaimy, W. (2021). A review of constituents identified in e-cigarette liquids and aerosols. Tobacco Prevention y Cessation, 7(February), 1-15. https://doi.org/10.18332/tpc/131111
Farsalinos, K. E., Kistler, K. A., Gillman, G., y Voudris, V. (2015). Evaluation of electronic cigarette liquids and aerosol for the presence of selected inhalation toxins. Nicotine y Tobacco Research, 17(2), 168-174. https://doi.org/10.1093/ntr/ntu176
Garcia-Arcos, I., Geraghty, P., Baumlin, N., Campos, M., Dabo, A. J., Jundi, B., Cummins, N., Eden, E., Grosche, A., Salathe, M., y Foronjy, R. (2016). Chronic electronic cigarette exposure in mice induces features of COPD in a nicotine-dependent manner. Thorax, 71(12), 1119-1129. https://doi.org/10.1136/thoraxjnl-2015-208039
Glantz, S. A., y Bareham, D. W. (2018). E-cigarettes: Use, effects on smoking, risks, and policy implications. Annual Review of Public Health, 39, 215-235. https://doi.org/10.1146/annurev-publhealth-040617-013757
Glynos, C., Bibli, S.-I., Katsaounou, P., Pavlidou, A., Magkou, C., Karavana, V., Topouzis, S., Kalomenidis, I., Zakynthinos, S., y Papapetropoulos, X. A. (2018). Comparison of the effects of e-cigarette aerosol with cigarette smoke on lung function and inflammation in mice. American Journal of Physiology-Lung Cellular and Molecular Physiology, 315(4), L662-L672. https://doi.org/10.1152/ajplung.00389.2017
Gonzalo Alvear, T., Luis Santibáñez, S., Víctor Ramírez, S., y Ricardo Sepúlveda, M. (2017). Cigarrillos electrónicos: ¿Podemos recomendar su uso? Revista Chilena de Enfermedades Respiratorias, 33(2), 118-130.
Grana, R., Benowitz, N., y Glantz, S. A. (2014). E-cigarettes: A scientific review. Circulation, 129(19), 1972-1986. https://doi.org/10.1161/CIRCULATIONAHA.114.007667
Hauser Fuentes, M., Pérez-Loredo, M., y Gómez-Rodríguez, R. (2016). Impacto del cigarrillo electrónico en la salud periodontal: Un estudio comparativo. Journal of Oral Health Research, 9(2), 115-122.
Hidalgo Caicedo, C. S. S., Núñez Leal, C. A., Gómez Maldonado, J. G., Carvajal Zabala, J. A., y Rodríguez Prieto, L. K. (2022). Una mirada global al pulmón vapeador. Scientific y Education Medical Journal, 7(1).
Hooijmans, C. R., Rovers, M. M., de Vries, R. B., Leenaars, M., Ritskes-Hoitinga, M., & Langendam, M. W. (2014). SYRCLE’s risk of bias tool for animal studies. BMC Medical Research Methodology, 14(1), 43. https://doi.org/10.1186/1471-2288-14-43
Jara-Reinoso, M. D., y Arraiz-De-Fernández, C. (2024). Uso del cigarrillo electrónico y riesgo de padecer enfermedades respiratorias en adolescentes y adultos jóvenes. Ciencia y Enfermería, 30(1). https://doi.org/10.29393/ce30-1ucmc20001
King, B. A. (2020). Flavors are a major driver of the youth e-cigarette epidemic. American. Journal of Public Health, 110(6), 773-774. https://doi.org/10.2105/AJPH.2020.305670
Lozano, P., Arillo-Santillán, E., Barrientos-Gutiérrez, I., Zavala-Arciniega, L., Reynales-Shigematsu, L. M., y Thrasher, J. F. (2019). E-cigarette use and its association with smoking reduction and cessation intentions among Mexican smokers. Salud Pública de México, 61(3), 276-285. https://doi.org/10.21149/9797
Martínez-Larenas, M. V., Montañez-Aguirre, Á. A., González-Valdelamar, C. A., Fraga-Duarte, M., Cossío-Rodea, G., y Vera-López, J. C. (2022). Efectos fisiopatológicos del cigarro electrónico: Un problema de salud pública. NCT Neumología y Cirugía de Tórax, 81(2), 121-130. https://doi.org/10.35366/108498
McAdam, K., Waters, G., Moldoveanu, S., Margham, J., Cunningham, A., Vas, C., Porter, A., y Digard, H. (2021). Diacetyl and other ketones in e-cigarette aerosols: Some important sources and contributing factors. Frontiers in Chemistry, 9, 742538. https://doi.org/10.3389/fchem.2021.742538
Mercier, C., Pourchez, J., Leclerc, L., y Forest, V. (2024). In vitro toxicological evaluation of aerosols generated by a 4th generation vaping device using nicotine salts in an air-liquid interface system. Respiratory Research, 25(1), 75. https://doi.org/10.1186/s12931-024-02697-2
Morello, P., Perez, A., Peña, L., Lozano, P., Thrasher, J., Sargent, J., y Mejía, R. (2016). Prevalence and predictors of e-cigarette trial among adolescents in Argentina. Tobacco Prevention y Cessation, 2. https://doi.org/10.18332/tpc/66950
Mus, S., Monzon, J., Islam, F., Thrasher, J. F., y Barnoya, J. (2023). First tobacco product tried and current use of cigarettes and electronic cigarettes among adolescents from Guatemala City. Salud Pública de México, 65(1), 46-53. https://doi.org/10.21149/13972
Oliveira, W. J. C. de, Zobiole, A. F., Lima, C. B. de, Zurita, R. M., Flores, P. E. M., Rodrigues, L. G. V., Pinheiro, R. C. de A., y Silva, V. F. F. R. S. e. (2018). Electronic cigarette awareness and use among students at the Federal University of Mato Grosso, Brazil. Jornal Brasileiro de Pneumologia, 44(5), 367-369. https://doi.org/10.1590/s1806-37562017000000229
Organización Panamericana de la Salud. (2022). Informe sobre el control del tabaco en la Región de las Américas 2022. https://www.paho.org/es/documentos/informe-sobre-control-del-tabaco-region-americas-2022
Páez C., S., Orellana H., D. I., y Nazzal N., C. (2021). Percepción y prevalencia del consumo de cigarrillos electrónicos en estudiantes de Medicina. Revista Chilena de Enfermedades Respiratorias, 37(4), 275-284. https://doi.org/10.4067/s0717-73482021000300275
Palmisani, J., Abenavoli, C., Famele, M., Di Gilio, A., Palmieri, L., de Gennaro, G., y Draisci, R. (2020). Chemical Characterization of Electronic Cigarette (e-cigs) Refill Liquids Prior to EU Tobacco Product Directive Adoption: Evaluation of BTEX Contamination by HS-SPME-GC-MS and Identification of Flavoring Additives by GC-MS-O. Atmosphere, 11(4), 374. https://doi.org/10.3390/atmos11040374
Pérez-Padilla, R., González-Woge, M., Terán-De la Sancha, K., Rodríguez-Llamazares, S., y Thirión-Romero, I. (2019). Daño pulmonar grave en vapeadores. NCT Neumología y Cirugía de Tórax, 78(4), 340-341. https://doi.org/10.35366/NT194A
Ponciano-Rodríguez, G., y Chávez Castillo, C. A. (2020). Efectos en la salud de los sistemas electrónicos de administración de nicotina (SEAN). Revista de la Facultad de Medicina (México), 63(6), 7-19. https://doi.org/10.22201/fm.24484865e.2020.63.6.02
Reinikovaite, V., Rodriguez, I. E., Karoor, V., Rau, A., Trinh, B. B., Deleyiannis, F. W-B., y Taraseviciene-Stewart, L. (2018). The effects of electronic cigarette vapour on the lung: Direct comparison to tobacco smoke. European Respiratory Journal, 51(4), 1701661. https://doi.org/10.1183/13993003.01661-2017
Reynales-Shigematsu, L. M., Barnoya, J., Cavalcante, T., Aburto, T. C., Romieu, I., Stern, M. C., Barquera, S., Corvalán, C., Hallal, P. C., Canelo-Aybar, C., Alvarado-Villacorta, R., Espina, C., Feliu, A., y Rivera, J. A. (2023). Latin America and the Caribbean Code Against Cancer 1st edition: Tobacco and nicotine-related products, secondhand smoke, and alcohol and cancer. Cancer Epidemiology, 86, 102413.
Rom, O., Pecorelli, A., Valacchi, G., y Reznick, A. Z. (2021). Are e-cigarettes a safe and good alternative to cigarette smoking? Annals of the New York Academy of Sciences, 1486(1), 89-100. https://doi.org/10.1111/nyas.14502
Saliba, N. A., El Hellani, A., Honein, E., Chami, H., Al Rashidi, M., y Shihadeh, A. (2018). Surface chemistry of electronic cigarette electrical heating coils: Effects of metal type on propylene glycol thermal decomposition. Journal of Analytical and Applied Pyrolysis, 134, 520-525. https://doi.org/10.1016/j.jaap.2018.07.019
Sassano, M. F., Davis, E. S., Keating, J. E., Zorn, B. T., Kochar, T. K., Wolfgang, M. C., Glish, G. L., y Tarran, R. (2018). Evaluation of e-liquid toxicity using an open-source high-throughput screening assay. PLOS Biology, 16(3), e2003904. https://doi.org/10.1371/journal.pbio.2003904
Sánchez-Franco, S., Montgomery, S. C., Torres-Narvaez, E. S., Ramírez, A. M., Murray, J. M., Tate, C., Llorente, B., Bauld, L., Hunter, R. F., Kee, F., y Sarmiento, O. L. (2024). How do adolescent smoking prevention interventions work in different contextual settings? A qualitative comparative study between the UK and Colombia. International Journal of Behavioral Medicine, 31(5), 691-704. https://doi.org/10.1007/s12529-023-10211-z
Siqueira, L. M. (2017). Nicotine and tobacco as substances of abuse in children and adolescents. Pediatrics, 139(1), e20163436. https://doi.org/10.1542/peds.2016-3436
Stuart-Aguiar, A., Cervera-Rosado, A., Fuentes-Canto, N.-H., y Huchim-Lara, O. (2022). Efectos de la exposición pasiva al aerosol de los cigarrillos electrónicos: Una revisión del tema. Médicas UIS, 35(2), 1-10. https://doi.org/10.18273/revmed.v35n2-2022006
Sund, L. J., Dargan, P. I., Archer, J. R. H., y Wood, D. M. (2023). E-cigarette or vaping-associated lung injury (EVALI): A review of international case reports from outside the United States of America. Clinical Toxicology, 61(2), 91-97. https://doi.org/10.1080/15563650.2022.2160342
Usuga David, M. (2023). Efectos nocivos del cigarrillo electrónico para la salud humana: Una revisión. Revista Colombiana de Neumología, 35(1), 46-66. https://doi.org/10.30789/rcneumologia.v35.n1.2023.604
Vas, C. A., Porter, A., y McAdam, K. (2019). Acetoin is a precursor to diacetyl in e-cigarette liquids. Food and Chemical Toxicology, 133, 110727. https://doi.org/10.1016/j.fct.2019.110727
Vasanthi Bathrinarayanan, P., Brown, J. E. P., Marshall, L. J., y Leslie, L. J. (2018). An investigation into E-cigarette cytotoxicity in-vitro using a novel 3D differentiated co-culture model of human airways. Toxicology in Vitro, 52, 255-264. https://doi.org/https://doi.org/10.1016/j.tiv.2018.06.020
Vogel, E. A., Ramo, D. E., Rubinstein, M. L., Delucchi, K. L., Darrow, S. M., Costello, C., y Prochaska, J. J. (2021). Effects of social media on adolescents’ willingness and intention to use e-cigarettes: An experimental investigation. Nicotine y Tobacco Research. Official Journal of the Society for Research on Nicotine and Tobacco, 23(4), 694-701. https://doi.org/10.1093/ntr/ntaa003
Walley, S. C., Wilson, K. M., Winickoff, J. P., y Groner, J. (2019). A public health crisis: Electronic cigarettes, vape, and JUUL. Pediatrics, 143(6), e20182741. https://doi.org/10.1542/peds.2018-2741
Willershausen, I., Wolf, T., Weyer, V., Sader, R., Ghanaati, S., y Willershausen, B. (2014). Influence of e-smoking liquids on human periodontal ligament fibroblasts. Head y Face Medicine, 10(1), 39. https://doi.org/10.1186/1746-160X-10-39
Zong, H., Hu, Z., Li, W., Wang, M., Zhou, Q., Li, X., y Liu, H. (2024). Electronic cigarettes and cardiovascular disease: Epidemiological and biological links. Pflügers Archiv, 476(4), 875-888. https://doi.org/10.1007/s00424-024-02925-0
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Chaves-Campos et al.

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Population and Health in Mesoamerica informs its authors and readers that all publications must be submitted with the Letter of Acceptance of Copyright Conditions where the authors are asked for authorization to submit the article to the Journal for consideration so that it may carry out any of the following activities:
- The graphic and style editing of the work or part of it.
The publication and reproduction of the work or part of it, both in print and electronic media, including the Internet and any other known or unknown technology.
The translation of the work or part of it into any language or dialect.
The adaptation of the work to reading, sound, voice and any other available technical representation or mechanism, which makes possible its access for partially or totally blind people, or with any other form of special abilities that prevent their access to the conventional reading of the article.
The distribution and availability of the work to the public, in such a way that the public may have access to them from the time and place that each person chooses, through the physical or electronic mechanisms available to them.
Any other form of use, process or system known or to be known that is related to the activities and editorial purposes to which the Journal is linked.
You can access the Letter by clicking HERE. If you have a question, please write to revista.ccp@ucr.ac.cr
In addition, the content of this site is protected under the Attribution - Noncommercial - Share Alike (by-nc-sa) license which permits commercial use of the original work or derivative works and distribution of which must be made under the same license that governs the original work. The graphic design, images and texts generated by the e-Information Science magazine are property of the Universidad de Costa Rica and are licensed under Creative Commons Attribution - NonCommercial - Attribution-ShareAlike 4.0 International.
Authors who publish in this journal accept the following conditions:
-The authors retain their moral rights over the publication and assign the patrimonial rights mentioned in the Letter of Assignment of Rights with the Creative Commons Attribution - NonCommercial - Compatitr Equal 4.0 International license, which allows third parties to use what is published as long as they mention the authorship of the work and to the first publication in this journal.
-Authors may make other independent and additional contractual arrangements for non-exclusive distribution of the version of the article published in this journal (e.g., inclusion in an institutional repository or publication in a book) as long as they clearly indicate that the work was first published in this journal.
This policy is established in accordance with Law 6638 on Copyright and Related Rights of the Republic of Costa Rica.
