Oxidative Stress as a Potential Mechanistic Bridge Between Electronic Cigarette Components and Chronic Disease: A Combined Narrative and Bibliometric Analysis

Despite their introduction two decades ago as cessation tools, vaping devices and electronic cigarettes (ECs) have surged dramatically among adolescents and adults worldwide. The widespread misconception that ECs are harmless has raised substantial concern about their potential contribution to chronic diseases associated with oxidative stress (OS) pathways. To map this rapidly growing field, we combined a bibliometric analysis of human research on vaping-associated OS over the past decade with a narrative review of EC component toxicology and regulatory updates. The bibliometric analysis of 189 human studies identified four keyword clusters reflecting clinico-epidemiological, biological/mechanistic, methodological, and acute-event research themes. The results of this bibliometric analysis structure the narrative synthesis, which evaluates the chemical constituents of ECs, including e-liquid constituents, device-derived contaminants, and their aerosol by-products, and links them to pathways associated with OS development. Oxidative stress was the most frequent bridging keyword, reflecting predominant academic trends as research shifted from acute-focused investigations toward mechanistic chronic disease research. No prior review has integrated EC component toxicology with bibliometric evidence to map this landscape. This combined approach provides researchers, clinicians, and policymakers with an integrated evidence base and identifies priority areas for future investigation, including long-term exposure thresholds, age- and sex-specific outcomes, and the urgent need for harmonized global regulation.