Date of Award


Degree Type


Degree Name

Master of Arts in Speech Pathology and Audiology


College of Sciences and Health Professions

First Advisor

Cox, Violet

Subject Headings

Communication, Health, Health Care, Health Sciences, Pathology, Public Health, Speech Therapy


Electronic Nicotine Delivery Systems (ENDS) are non-combustible tobacco products that are rapidly gaining in popularity worldwide. ENDS are marketed as safer alternatives to cigarettes; however, very little research is available to support or deny these claims. ENDS aerosol is inhaled over the vocal folds and into the lungs consistent with cigarette smoke. The larynx is among the primary locations affected by smoking; therefore, it is necessary to evaluate the effect, if any, of ENDS on the larynx. The goal of the present study was to evaluate the laryngeal appearance and function of seven ENDS users as compared to four cigarette smokers. A control group of six nonsmokers was included in this study. Vocal tasks were assessed through acoustic analysis and videostroboscopy. No significant relationship was found between ENDS use and abnormal acoustic measures; however, data compared to norms for age and gender revealed a pattern of raised shimmer percent among ENDS users and smokers. Videostroboscopic analysis revealed significant relationships between ENDS use and abnormal mucosal wave, free edge, phase closure, vocal fold varices and vocal fold edema, as well as a marginally significant relationship between ENDS use and abnormal phase symmetry. These results indicate that ENDS use may have a significant effect on laryngeal structures and their function.