E-cigarettes significantly raise users’ risk of developing chronic lung disease, with dual e-cigarette and combustible cigarette use posing the greatest threat to smokers’ health, according to a first-of-its-kind study.
Stanton A. Glantz, PhD, and Dharma N. Bhatta, PhD, MPH, published on Dec. 16 the results of the first longitudinal study linking e-cigarettes to respiratory illness in a representative sample of the entire U.S. population. They wrote in the American Journal of Preventive Medicine that a slew of earlier population studies tied e-cigarette use to lung disease, but the cross-sectional nature of those studies meant it was difficult for researchers to discern whether lung disease was being caused by e-cigs or whether patients with existing lung illness were simply more likely to be e-cigarette users.
Glantz and Bhatta undertook an analysis of publicly available data logged in the Population Assessment of Tobacco and Health (PATH) database, a registry that tracked e-cigarette use, tobacco use and new lung disease diagnoses between 2013 and 2016. Their study population comprised more than 32,000 American adults who, at baseline, did not have any reported lung disease.
Patients were followed for three years, and the authors found that while current and former e-cigarette users were 1.3 times more likely to develop chronic lung disease than non-users, tobacco smokers increased their risk by 2.6 times. The risk was more than tripled for people who reported smoking both e-cigarettes and traditional cigarettes.
“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,” Glantz said in a statement. “We concluded that e-cigarettes are harmful on their own, and the effects are independent of smoking conventional tobacco.
“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.”
E-cigarettes were first popularized as a way to help cigarette smokers quit the habit, and some studies have found they’re successful in that goal. One analysis published in The New England Journal of Medicine in early 2019 found that e-cigs were nearly twice as successful as other nicotine replacement therapies in helping people stop smoking.
Glantz and Bhatta also found that switching from tobacco to e-cigarettes lowered smokers’ risk of developing lung disease—but fewer than 1% of smokers actually make the switch.
“Switching from conventional cigarettes to e-cigarettes exclusively could reduce the risk of lung disease, but very few people do it,” Glantz said. “For most smokers, they simply add e-cigarettes and become dual users, significantly increasing their risk of developing lung disease above just smoking.”
The authors noted their findings are independent of the recent EVALI (e-cigarette or vaping product use-associated lung injury) epidemic, which to date has affected around 2,300 people and claimed 48 lives.
After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.