E-cigarettes have long-term adverse effects on health

By Dr. Ananya Mandal, MDDec 16 2019

A new study has revealed that use of electronic cigarettes is associated with a raised risk of developing chronic lung diseases such as asthma, bronchitis, chronic obstructive lung disease (COPD) or emphysema.

This study from researchers at the UC San Francisco is one of the first study that looked at the long-term effects of these e-cigarettes and development of lung diseases. This study followed up a sample of the entire population of the United states to have come to this conclusion wrote the researchers. The results of the study were published today 16th of December 2019 in the journal American Journal of Preventive Medicine.

E-cigarette. Image Credit: Oleg GawriloFF / Shutterstock

For this study the team of researchers looked at the data collected by the Population Assessment of Tobacco and Health (PATH). PATH has also been gathering information regarding use of tobacco and e cigarettes among American adults. This study was conducted on over 32,000 Americans over the age of 18 years who were diagnosed with lung disease between 2013 and 2016.

The team explained that there have been numerous case reports as well as small studies that show an association between vaping or e cigarette use and lung disease. These were so called cross sectional studies that looked at presence of absence of lung disease among e cigarettes user in a particular period of time. They explained that a cross sectional study fails to explain if the e cigarette users developed lung disease or the lung disease patients were more likely to be users of e cigarettes. This was the first large study that looked at the association in a longitudinal manner. This meant that the people, some of who were users of e cigarettes or smoked tobacco, enrolled in the study with no lung disease could be followed up over time to see if they developed the lung disease.

Stanton Glantz, PhD, a UCSF professor of medicine and director of the UCSF Center for Tobacco Control Research and Education, senior author of the study said in a statement, “What we found is that for e-cigarette users, the odds of developing lung disease increased by about a third, even after controlling for their tobacco use and their clinical and demographic information. We concluded that e-cigarettes are harmful on their own, and the effects are independent of smoking conventional tobacco.”

Results of this study revealed that those who were using e-cigarettes were 1.3 times more at risk of developing chronic lung diseases while those who smoked traditional cigarettes had a 2.6 times more risk of developing chronic lung disease, the risk was three times for those who used both e cigarettes as well as traditional cigarettes, found the study. Glantz warned, “Dual users -- the most common use pattern among people who use e-cigarettes -- get the combined risk of e-cigarettes and conventional cigarettes, so they're actually worse off than tobacco smokers.”

Experts have advocated the use of e cigarettes among tobacco smokers who wished to quit. There have been several studies that have shown that use of e cigarettes could help smokers quit or cut down on their tobacco smoking to a significant extent. According to Glantz, this study shows that many smokers who try e-cigarettes in the hope of quitting smoking end up smoking both. He added that less than 1 percent of smokers of tobacco actually manage to quit smoking and switch to e cigarettes. Glantz explained, “Switching from conventional cigarettes to e-cigarettes exclusively could reduce the risk of lung disease, but very few people do it. For most smokers, they simply add e-cigarettes and become dual users, significantly increasing their risk of developing lung disease above just smoking.”

He concluded, “This study contributes to the growing case that e-cigarettes have long-term adverse effects on health and are making the tobacco epidemic worse.”

There have been case reports saying that use of e cigarettes is associated with actue lung injuries in some individuals. This has been named, “EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury)”. According to the researchers, this chronic damage to the lungs is different from EVALI and could affect as significant population. Researchers have found that in some individuals vaping can trigger an immune response mediated by release of stress related proteins in the lungs. The toxic chemicals within the vaping fluids are capable f triggering these immune responses that can lead to lung injury and can result in hospitalization or even death.

This study was funded by the National Institute of Drug Abuse, National Cancer Institute and the U.S. Food and Drug Administration Center for Tobacco Products, National Heart, Lung, and Blood Institute and the Food and Drug Administration Center for Tobacco Products and others.