Prevalence of Voice Fatigue and Its Correlation With Xerostomia in E-Cigarette Smokers.

Hamdan, Abdul-Latif; Ghzayel, Lana; Sarkis, Valerie; Jalkh, Rita Maria; Khalil, Lucien; Zeineddine, Nijad; Semaan, Zeina Maria; Ghadieh, Justin et al. · Laryngoscope · 2026

cross_sectional · Level IV

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Abstract

To investigate the prevalence of voice fatigue in e-cigarette smokers and its correlation with xerostomia. Adults aged 18-65 years who reported current e-cigarette use, recruited from public cafés, were invited to participate in this survey. A control group of non-smokers, frequency-matched by age and gender, was also included. Voice fatigue was assessed using the visual analogue scale (VAS) for voice fatigue, and the question, "Do you run out of air when you talk?" was rated on a 5-point Likert scale. A subgroup of patients also filled the Xerostomia Inventory (XI) questionnaire. A total of 260 participants, 130 e-cigarette smokers and 130 non-smokers, were included. E-cigarette smokers had significantly higher mean VAS scores and a higher mean score for "I run out of air when I talk" compared to non-smokers (2.01 ± 2.35 vs. 0.53 ± 1.15, p < 0.001, and 0.72 ± 0.94 vs. 0.34 ± 0.66, p < 0.001, respectively). Forty e-cigarette smokers and 40 non-smokers filled the Xerostomia Inventory (XI) questionnaire. The mean XI questionnaire score for e-cigarette smokers was 22.35 ± 7.30 compared to 15.95 ± 4.50 in non-smokers. Linear regression analysis showed a significant association between XI questionnaire score and VAS score for voice fatigue and "I run out of air when I talk" (beta = 0.656, adjusted p < 0.001, and beta = 0.245, adjusted p = 0.040). The results of this investigation suggest that voice fatigue is significantly more prevalent in e-cigarette smokers compared to non-smokers. Moreover, there is a moderate and significant correlation between voice fatigue and xerostomia.