Oral health knowledge and associated factors among office workers who use electronic cigarettes: a cross-sectional study

Sarah Mersil, Yufitri Mayasari, Mutiara Rina Rahmawati Ruslan, Nurfianti Nurfianti

Abstract


Introduction: The prevalence of electronic cigarette use is increasing; however, public understanding of their ingredients and associated health risks remains inconsistent. Persistent misconceptions contribute to inaccurate perceptions of product safety, especially regarding oral health. This study aimed to analyze oral health knowledge and associated factors among office workers who use electronic cigarettes. Methods: An analytical cross-sectional study was conducted among 100 office workers who used electronic cigarettes at a state-owned enterprise in Jakarta, Indonesia, between September and October 2025. Participants were recruited using purposive sampling. Data were collected using a structured questionnaire assessing respondents’ demographic characteristics and knowledge of electronic cigarette contents and their oral health effects. Data were analyzed using descriptive statistics, cross-tabulation, and the chi-square test. Results: Overall, 58% of respondents demonstrated good knowledge of oral health, whereas 42% had poor knowledge. High levels of awareness were observed regarding nicotine content (86%) and the addictive potential of electronic cigarettes (65%), while misconceptions persisted regarding carbon monoxide, tooth discoloration, and halitosis. Knowledge level was significantly associated with gender, with female respondents demonstrating higher knowledge than male respondents (p=0.014). No significant associations were observed between knowledge level and education level, smoking status, motivation for electronic cigarette use, or duration of use (all p>0.05). Conclusion: Although most electronic cigarette users demonstrated good overall oral health knowledge, important misconceptions remained regarding carbon monoxide production, tooth discoloration, and halitosis. These findings highlight the need for targeted oral health education focusing on specific misconceptions related to the oral health effects of electronic cigarettes.

Keywords


Electronic cigarettes, oral health, health knowledge, cross-sectional studies

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References


World Health Organization. WHO global report on trends in prevalence of tobacco use 2000-2030. 3rd ed. Geneva: World Health Organization; 2024.

World Health Organization. WHO report on the global tobacco epidemic: country profile Indonesia. Geneva: World Health Organization; 2025.

Rukmi S. Tobacco use and adolescents in Indonesia: narrative review of determinants. KnE Life Sci. 2019;4(10):69. https://doi.org/10.18502/kls.v4i10.3709

Almeida-da-Silva CLC, Matshik Dakafay H, O'Brien K, Montierth D, Xiao N, Ojcius DM. Effects of electronic cigarette aerosol exposure on oral and systemic health. Biomed J. 2021;44(3):252-259. https://doi.org/10.1016/j.bj.2020.07.003

Dhar U, Nagarajappa R, Satyarup D, Jena M, Mohapatra A. Tobacco smoking and cardiovascular diseases: a review. Indian J Forensic Med Toxicol. 2020;14(4):8980-8986. https://doi.org/10.37506/ijfmt.v14i4.13137

Sakinah S, Nugroho SD. Relationship between smoking and ischemic stroke: meta analysis. J Epidemiol Public Health. 2022;7(1):120-129. https://doi.org/10.26911/jepublichealth.2022.07.01.10

Difaputra SA, Kusuma IA, Dewi DP, Retnoningrum D. The difference between salivary viscosity and salivary flow rate on nicotine electric smokers and non-smokers. Acta Odontol Indones. 2025:30-34. https://doi.org/10.14710/actodont.27232

Alwithanani N. Periodontal disease and smoking: systematic review. J Pharm Bioallied Sci. 2023;5(15). https://doi.org/10.4103/jpbs.jpbs_516_22

Ghazali A Fatima, Ahmad Faisal Ismail, Ghasak Ghazi Faisal, Mohd Haikal Muhammad Halil, Azlina Daud. Oral health of smokers and e-cigarette users: a case-control study. J Int Dent Med Res. 2018.

Ministry of Health. Global Adult Tobacco Survey (GATS): Indonesia report 2021. Jakarta: Ministry of Health; 2021.

U.S. Department of Health and Human Services. E-cigarette use among youth and young adults: a report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention; 2016.

Janik M, Ufnalska B, Rychlewska-Duda J, et al. Systematic review: e-cigarettes vs. conventional cigarettes. J Educ Health Sport. 2025;78:57621. https://doi.org/10.12775/JEHS.2025.78.57621

Chun LF, Moazed F, Calfee CS, Matthay MA, Gotts JE. Pulmonary toxicity of e-cigarettes. Am J Physiol Lung Cell Mol Physiol. 2017;313:193-206. https://doi.org/10.1152/ajplung.00071.2017

Martuzevicius D, Prasauskas T, Setyan A, et al. Characterization of the spatial and temporal dispersion differences between exhaled e-cigarette mist and cigarette smoke. Nicotine Tob Res. 2019;21(10):1371-1377. https://doi.org/10.1093/ntr/nty121

Abo-Elkheir OI, Sobh E. Knowledge about electronic cigarettes and its perception: a community survey, Egypt. Respir Res. 2016;17(1). https://doi.org/10.1186/s12931-016-0365-0

Abadi S, Couch ET, Chaffee BW, Walsh MM. Perceptions related to use of electronic cigarettes among California college students. Calif J Health Promot. 2017;15(1):29-39.

Hafidah F, Apriningsih A, Simanjorang C, Hanifah L. Determinants of electronic smoking behavior among adolescents in Indonesia: analysis of Global Youth Tobacco Survey 2019. Public Health Indones. 2024;10(2):133-142. https://doi.org/10.36685/phi.v10i2.787

Hartwell G, Thomas S, Egan M, Gilmore A, Petticrew M. E-cigarettes and equity: a systematic review of differences in awareness and use between sociodemographic groups. Tob Control. 2017;26(e2). https://doi.org/10.1136/tobaccocontrol-2016-053222

Jiang N, Cleland CM, Wang MP, Kwong A, Lai V, Lam TH. Perceptions and use of e-cigarettes among young adults in Hong Kong. BMC Public Health. 2019;19(1). https://doi.org/10.1186/s12889-019-7464-z

Vasconcelos V, Gilbert H. Smokers' knowledge and perception of electronic cigarettes (e-cigarettes): a qualitative study of non-quitting smokers in a North London general practice. Prim Health Care Res Dev. 2019;20. https://doi.org/10.1017/S1463423618000439

Hartmann-Boyce J, McRobbie H, Lindson N, et al. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2021;2021(4). https://doi.org/10.1002/14651858.CD010216.pub5

Clapp PW, Jaspers I. Electronic cigarettes: their constituents and potential links to asthma. Curr Allergy Asthma Rep. 2017;17(11). https://doi.org/10.1007/s11882-017-0747-5

Wagener TL, Floyd EL, Stepanov I, et al. Have combustible cigarettes met their match? The nicotine delivery profiles and harmful constituent exposures of second-generation and third-generation electronic cigarette users. Tob Control. 2017;26(e1). https://doi.org/10.1136/tobaccocontrol-2016-053041

Hwang JH, Lyes M, Sladewski K, et al. Electronic cigarette inhalation alters innate immunity and airway cytokines while increasing the virulence of colonizing bacteria. J Mol Med. 2016;94(6):667-679. https://doi.org/10.1007/s00109-016-1378-3

Glantz SA, Bareham DW. E-cigarettes: use, effects on smoking, risks, and policy implications. Annu Rev Public Health. 2018;39:215-235. https://doi.org/10.1146/annurev-publhealth-040617-013757

Martell KM, Boyd LD, Giblin-Scanlon LJ, Vineyard J. Knowledge, attitudes, and practices of young adults regarding the impact of electronic cigarette use on oral health. J Am Dent Assoc. 2020;151(12):903-911. https://doi.org/10.1016/j.adaj.2020.08.002

Ganapathy V, Jaganathan R, Chinnaiyan M, et al. E-cigarette effects on oral health: a molecular perspective. Food Chem Toxicol. 2025;196:115216. https://doi.org/10.1016/j.fct.2024.115216

McClelland ML. Comparison of different types of vape products on vital signs following twenty minutes of vaping and exposure to vapor. J Lung Pulm Respir Res. 2022;9(1):1-6. https://doi.org/10.15406/jlprr.2022.09.00270

Krüsemann EJZ, Havermans A, Pennings JLA, De Graaf K, Boesveldt S, Talhout R. Comprehensive overview of common e-liquid ingredients and how they can be used to predict an e-liquid's flavour category. Tob Control. 2021;30(2):185-191. https://doi.org/10.1136/tobaccocontrol-2019-055447

Satyana RPU, Uli RE, Magliano D, Zomer E, Liew D, Ademi Z. Assessing the impact of smoking on the health and productivity of the working-age Indonesian population using modelling. BMJ Open. 2020;10(11). https://doi.org/10.1136/bmjopen-2020-041832

Misnaniarti, Misnaniarti. Situation analysis of elderly people and efforts to improve social welfare in Indonesia. J Ilmu Kesehat Masy. 2017;8(2).

amadhani T, Tualeka AR, Widajati N. The effect of smoking on respiratory tract infections among workers in Indonesia. J Kesehat Medika Saintika. 2026;17(1):1-10.http://dx.doi.org/10.30633/jkms.v17i1.30712

Syawqie A, Sovira G, Najmi N, Anggraini J, Susilawati S. The characteristics of electronic cigarette users in Indonesia: a cross-sectional study. Open Dent J. 2025;19. https://doi.org/10.2174/0118742106364373250211111257

Kierstead EC, Azadi M, Minter T, et al. Demographic predictors of menthol cigarette and flavored e-cigarette restriction policy support among a cross-sectional sample of U.S. adults. BMC Public Health. 2026. https://doi.org/10.1186/s12889-026-28547-y

Turan A, Duru Çetinkaya P, Uysal MA. Demographic characteristics of electronic cigarette users: a survey study. Hamidiye Med J. 2021;2(3):91-96.

Kasza KA, Rivard C, Goniewicz ML, Fong GT, Hammond D, Cummings KM, et al. E-cigarette characteristics and cigarette cessation among adults who use e-cigarettes. JAMA Netw Open. 2024;7(8). https://doi.org/10.1001/jamanetworkopen.2024.23960

Chang JT, Mayer M, Jackson RA, Rostron BL, Coleman B, Lee T, et al. Characteristics and patterns of cigarette smoking and vaping by past-year smokers who reported using electronic nicotine delivery system to help quit smoking in the past year: findings from the 2018-2019 Tobacco Use Supplement to the Current Population Survey. Nicotine Tob Res. 2023;25(3):596-601. https://doi.org/10.1093/ntr/ntac199

Farsalinos K, Russell C, Polosa R, et al. Patterns of flavored e-cigarette use at the time of quitting smoking: comparison between American young adults (18-24 years old) and older adults (>24 years old). Harm Reduct J. 2026;23(9). https://doi.org/10.1186/s12954-025-01343-4

Farsalinos K, Russell C, Polosa R, Poulas K, Lagoumintzis G, Barbouni A. Patterns of flavored e-cigarette use among adult vapers in the USA: an online cross-sectional survey of 69,233 participants. Harm Reduct J. 2023;20(1):147. https://doi.org/10.1186/s12954-023-00876-w

CDC Foundation. Flavored e-cigarettes drive youth e-cigarette use. Published April 23, 2026. Accessed July 30, 2026. https://www.cdcfoundation.org

Al-Hamdani M, Hopkins DB, Davidson M. The 2020-2021 youth and young adult vaping project. Ottawa: Heart and Stroke Foundation of Canada; 2021 Mar. Available from: https://www.heartandstroke.ca/-/media/pdf-files/get-involved/yyav-full-report-final-eng-24-3-2021.ashx

Beard CZ, Ragbir AJ, Rice TL, Thomas MM, Naidu RS. E-cigarette use and knowledge of its effect on oral health among health sciences students in Trinidad and Tobago. Front Oral Health. 2025;6:1547246. https://doi.org/10.3389/froh.2025.1547246

Cichońska D, Kusiak A, Goniewicz ML. The impact of e-cigarettes on oral health—a narrative review. Dent J (Basel). 2024;12(12). https://doi.org/10.3390/dj12120404

Lee JY, Song CH, Kim J, Jang YS, Park EC. Association between smoking behavior and oral health problems: a national cross-sectional study in Korea. Tob Induc Dis. 2025;23. https://doi.org/10.18332/tid/200693

Seiler-Ramadas R, Sandner I, Haider S, Grabovac I, Dorner TE. Health effects of electronic cigarette (e-cigarette) use on organ systems and its implications for public health. Wien Klin Wochenschr. 2021;133(19-20):1020-1027. https://doi.org/10.1007/s00508-020-01711-z

More A, Rodrigues A, Sadhu B. Effects of smoking on oral health: awareness among dental patients and their attitude towards its cessation. Indian J Dent Res. 2021;32(1):23-26. https://doi.org/10.4103/ijdr.IJDR_711_18

Holliday R, Chaffee BW, Jakubovics NS, Kist R, Preshaw PM. Electronic cigarettes and oral health. J Dent Res. 2021;100(9):906-913. https://doi.org/10.1177/00220345211002116

Kendrich I, Sinaga BYM. Knowledge, attitude, and behavior toward smoking among medical students in Universitas Sumatera Utara. Indones J Public Health. 2023;18(1):1-10. https://doi.org/10.20473/ijph.v18i1.2023.1-10

Lindson N, Pritchard G, Hong B, Fanshawe TR, Pipe A, Papadakis S. Strategies to improve smoking cessation rates in primary care. Cochrane Database Syst Rev. 2021;2021(9). https://doi.org/10.1002/14651858.CD011556.pub2

Maulina SZ, Firdausy AA, Ayuningtyas NF. Oral mucosa lesions in electric smokers (e-cigarettes): a scoping review. World J Adv Res Rev. 2024;24(2):1632-1639. https://doi.org/10.30574/wjarr.2024.24.2.3448

Tashkandi M, Nourah D, Alhazmi H, et al. Comparative assessment of oral health findings among e-cigarette users, conventional smokers, and non-smokers in Makkah City: a cross-sectional study. Open Dent J. 2025;19(1). https://doi.org/10.2174/0118742106400186250801050338

Alwafi A, Abuljadyel L. Oral health of the electronic cigarette smokers: a systematic review. J Pharm Bioallied Sci. 2025;16(5). https://doi.org/10.4103/jpbs.jpbs_573_24

Gunardi I, Amtha R, Hartanto FK, Falatehan N, Heriandi A. Perception of conventional cigarettes and vaping among smokers and nonsmokers: a cross-sectional study. J Dent Indones. 2025;32(2):96-103.

Garcia B, Nascimento B, Marques E, et al. The use of electronic cigarettes and other tobacco products among university students and their potential relationship with oral health: a cross-sectional study. J Am Dent Assoc. 2024;155(8):647-656. https://doi.org/10.1016/j.adaj.2024.04.012




DOI: https://doi.org/10.24198/pjd.vol38no2.70377

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