- People who use e-cigarettes have a higher risk for respiratory disease, but those who both smoke cigarettes and vape are even more at risk.
- Researchers found e-cigarette users were 1.3 times more likely to have developed respiratory disease compared to people who had never used any tobacco product.
- The study suggests e-cigarettes are safer than combustible cigarettes, at least in terms of respiratory disease.
People who use e-cigarettes have an increased risk for developing asthma, bronchitis, emphysema, or chronic obstructive pulmonary disease (COPD), a long-term study shows.
“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,” said study author Stanton Glantz, PhD, a University of California, San Francisco (UCSF) professor of medicine and director of the UCSF Center for Tobacco Control Research and Education, in a statement.
People who vaped had a lower risk than cigarette smokers. But for people who both smoked combustible tobacco and vaped — dual users — the risk for developing respiratory disease was even higher.
The new study was published Dec. 16 in the American Journal of Preventive Medicine.
It was based on data from more than 32,000 adults in the United States. None reported having any lung disease when the study began in 2013.
After 3 years, researchers found e-cigarette users were 1.3 times more likely to have developed respiratory disease compared to people who had never used any tobacco product, including vaping.
Meanwhile, people who smoked cigarettes or other combustible tobacco had a 2.6 times higher risk. Those who used both had a 3.3 times higher risk.
“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,” said Glantz in the release.
The data was based on people’s responses to questionnaires completed as part of the U.S. National Institutes of Health’s Population Assessment of Tobacco and Health (PATH) study.
For the purposes of the study, Glantz and his co-author grouped together the four respiratory conditions.
Because of the way the study was designed, it only shows there’s a link between vaping and respiratory disease, not a direct cause and effect.
But Dr. Mangala Narasimhan, regional director of critical care medicine at Northwell Health in New Hyde Park, New York, says the study provides more insight into the long-term risks of e-cigarettes.
Still, “it’d be nice to have a long study that has some objective pulmonary function testing and CAT scan testing,” she said, “so we could see some objective damage to the lungs, rather than just asking people if they’ve ever been diagnosed with a lung disease.”
The study suggests e-cigarettes are safer than combustible cigarettes, at least in terms of respiratory disease.
This is a stance supported by a 2018 review of previous vaping research done by the National Academies of Sciences, Engineering, and Medicine.
“Across a range of studies and outcomes, e-cigarettes appear to pose less risk to an individual than combustible tobacco cigarettes,” write the authors of the review.
However, this hinges on people switching completely from combustible tobacco to e-cigarettes, which Glantz and his co-author found was very uncommon.
After 3 years, less than 1 percent of cigarette smokers who had taken up vaping during the study also stopped smoking combustible tobacco.
“A lot of the push for e-cigarettes was to help patients not smoke regular cigarettes anymore,” Narasimhan said. “I think this gives us a twist. If people are doing both at the same time, their risk of lung disease goes up by threefold over patients who don’t [smoke or vape].”
The study also highlights that e-cigarettes aren’t risk-free. This is in line with
Many of these studies, though, are short term — even shorter than the new study. Longer-term studies are needed.
And given that e-cigarettes have only been in widespread use for about a decade, it could be a long time before we know the full extent of the health risks of vaping.
Also, the lung damage that people in the new study developed is unrelated to the cases of
Narasimhan says in light of the new study — and that many people become dual users — doctors may have to return to recommending other smoking cessation products, such as nicotine patches, lozenges, and medications.
“E-cigarettes had an advantage, in that people felt like they were smoking. So it was easier for some people to [vape] rather than smoke cigarettes,” Narasimhan said. “But I think we’re going to have to go back to the traditional things that we were using.”