AVA SYNOPSIS
There is limited data available on the long-term effects of e-cigarettes in users with chronic obstructive pulmonary disease (COPD). An October 2020 study published in journal, Therapeutic Advances in Chronic Disease, examined the results of a “5-yer prospective assessment of respiratory parameters in a cohort of COPD patients” that had “substantially reduced” and/or abstained from combustible cigarettes.
Between September 2013 and October 2019, data was collected from the patients’ medical records and follow-up visits, with the authors collecting complete data from 39 patients. Patients reported their e-cigarette use at “scheduled outpatients appointments.” The authors cross referenced a group of COPD smokers that did not use e-cigarettes.
The authors measured “respiratory exacerbations, spirometric indices, quality of life using the COPD assessment tool (CAT).” Data analyses were conducted at “approximately 12, 24, 48 and 60 months from baseline.” At 60 months, the authors had complete date from 19 COPD smokers and 20 COPD e-cigarette users.
In the e-cigarette user group, the authors noted a “significant reduction in conventional cigarette use” from 22.1 cigarettes per day to 1.4 cigarettes per day at the 60-month follow-up. Further, 45 percent of e-cigarette users reported complete abstinence. The authors also found that dual users “reduced their daily smoking by at least 80% of their baseline consumption.”
The authors found that e-cigarette users “had a marked reduction in COPD exacerbations” and no changes COPD exacerbations in the COPD smokers group. The authors also found that lung function improved in the COPD e-cigarette users. The authors conclude that “patients with COPD who abstained from smoking or substantially reduced their cigarette consumption by swapping to vaping experienced improvements in objective and subjective health outcomes.” Further, switching from combustible cigarette to e-cigarettes “leads to improved COPD outcomes.” Indeed, the authors note that “COPD exacerbations were reduced by approximately 50% in patients” that had quit or substantially reduced combustible cigarette use “after switching to vaping.”
Implications: This is the latest study to offer evidence that the use of e-cigarettes can improve the health of persons with smoking-related health issues. Policymakers should take these findings into consideration when determining regulations on e-cigarettes and vapor products.
ABSTRACT
Background and Aims: The long-term health effects of the use of electronic cigarettes (ECs) in patients with chronic obstructive pulmonary disease (COPD) are largely unexplored. We present findings from a 5-year prospective assessment of respiratory parameters in a cohort of COPD patients who substantially reduced conventional smoking or achieved abstinence by switching to ECs.
Methods: Patients were evaluated prospectively for their measurements of respiratory exacerbations, spirometric indices, quality of life using the COPD assessment tool (CAT), 6-min walk distance (6MWD), as well as conventional cigarette consumption. Baseline measurements prior to switching to EC use were compared with follow-up visits at 12-, 24-, 48- and 60-months. Age- and sex-matched COPD patients reporting to be regular smokers (not using ECs) were the reference group for the analysis.
Results: Complete data were available from 39 patients. Those in the EC user group achieved a marked decline in cigarette smoking or abstinence. COPD EC users had a significant diminution in COPD exacerbations; with the mean (±SD) exacerbation rate falling from 2.3 (±0.9) at baseline to 1.1 (±1.0) at 5 years (p < 0.001), whereas no significant changes were observed in the control group.
Significant and constant improvements in lung function, CAT scores and 6MWD were reported in the EC user group over the 5-year observation period compared with the reference group (p < 0.05).
Conclusion: The present study suggests that EC use may ameliorate objective and subjective COPD outcomes, and that the benefits gained appear to persist long term. EC use for abstinence and smoking reduction may ameliorate some of the harm resulting from tobacco smoking in COPD patients.
FURTHER READING
International Journal of Chronic Obstructive Pulmonary Disease, “Health effects in COPD smokers who switch to electronic cigarettes: a retrospective-prospective 3-year follow-up,” 2018
Respiratory Research, “Evidence for harm reduction in COPD smokers who switch to electronic cigarettes,” 2016
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