Vaping with e-cigarettes associated with higher COPD risk
Users more than twice as likely to develop disease over non-tobacco users
Using e-cigarettes, often called vaping, significantly increases the risk of chronic obstructive pulmonary disease (COPD), a U.S. study suggests.
People who used e-cigarettes, which are battery-powered devices that heat a liquid that typically contains nicotine to produce an inhalable aerosol, alone were more than twice as likely to develop COPD than people who didn’t use any tobacco products. The risk was even higher for those who smoke traditional cigarettes and those using both e- and traditional cigarettes.
“The new study suggests that e-cigarettes have definite potential health risks, although the risks may be less than what is seen for traditional combustible cigarette smoking alone,” Michael Blaha, MD, the study’s senior author and a professor of cardiology and epidemiology at the Johns Hopkins University School of Medicine, said in a university news release.
“These findings highlight some potential risks of e-cigarette use and provide context to inform advisories and regulatory policies on novel products on their health risks,” the researchers wrote.
The study, “E-cigarette Use and Incident Cardiometabolic Conditions in the All of Us Research Program,” was published in Nicotine & Tobacco Research.
COPD is a progressive, inflammatory lung condition often linked to lifelong cigarette smoking or secondhand smoke exposure. Characterized by symptoms such as shortness of breath, chronic coughing, wheezing, and recurring respiratory infections, COPD can severely limit a person’s quality of life.
Smoking cigarettes is an established risk factor for COPD, but the rising popularity of e-cigarettes, often perceived as a safer alternative, has raised concerns about their possible long-term impact on lung health.
Despite recent findings linking e-cigarette use to asthma and respiratory disease symptoms, “there remains great uncertainty about the relative harm of e-cigarettes as compared to traditional smoking,” Blaha said.
Increased risk with e-cigarettes
Here, researchers analyzed medical data from 249,190 adults followed for nearly four years. The data came from All of Us research program, a nationwide initiative launched in 2018 by the National Institutes of Health to speed up health research by building one of the largest and diverse health databases through the enrollment of more than a million participants in the U.S. Most had never used e-cigarettes or traditional cigarettes, while 3,164 were exclusive e-cigarette users, 33,778 exclusively smoked cigarettes, and 8,316 reported using both.
The study examined the association between using these products and the risk of developing COPD, along with cardiometabolic conditions such as high blood pressure (hypertension), heart failure, and type 2 diabetes.
While the risk of COPD was highest among traditional cigarette smokers and dual users, e-cigarette users also had a significantly increased risk of COPD over people who’d never used e-cigarettes or tobacco cigarettes.
Over a nearly four-year follow-up, exclusive e-cigarette use was significantly associated with a more than doubled risk of COPD, even after adjusting for other potential risk factors such as age, sex, race, ethnicity, and body mass index, which is a ratio of height and weight.
Exclusive e-cigarette use wasn’t significantly associated with an increased risk of the other conditions, except for hypertension among adults ages 30 to 70, with e-cigarette smokers having a 39% higher risk over non-users.
People who smoked traditional cigarettes alone or used both e-cigarettes and combustible cigarettes faced higher risks for all major health conditions studied.
“These results are a critical stepping stone for future prospective research on the health effects of e-cigarettes,” Blaha said. “While in this short-term study there was no association between exclusive e-cigarette use and cardiovascular events, there was an association with incident COPD and possibly hypertension that will need to be closely watched over longer term follow-up.”
The study was partially funded by grants from the National Heart, Lung, and Blood Institute of the National Institutes of Health, and the U.S. Food and Drug Administration’s Center for Tobacco Products.
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