AVA Synopsis:
The authors analyzed patients with COPD that had reported daily use of e-cigarettes “at least two follow-up visits over a 24-month period.” A baseline group of similar patients that reported being regular smokers and did not use e-cigarettes was also identified.
The study used the Global Initiative for Chronic Obstructive Lung Disease, requiring that “selected patients had to have a ≥30 pack year smoking history and obstructive post-bronchodilator spirometry ratio documented in their notes.”
At the clinic visits, patients were assessed, with the authors focusing on primary outcomes including: “a) a reduction in cig/day consumption; and b) number of exacerbations in the previous 12 months at each of the visits and how they may have changed over the 24-month period in the [e-cigarette] group compared to the control group.”
Data was collected from a total of 48 participants with mild to very serious COPD, and 24 participants reported daily e-cigarette use.
The authors found a “substantial reduction in conventional cigarette consumption observed in the COPD” e-cigarette users, and no change in the reference group. 13 of the 24 e-cigarette users reported complete abstinence from cigarettes, and dual use was reported by 11 of the 24 e-cigarette users. Among dual users, there was also a “significant reduction in conventional cigarette consumption.” The authors found that combustible cigarette use declined by more than 75 percent among all COPD dual users.
A “significant reduction in annual COPD exacerbation” was reported among the group of exclusive e-cigarette users, and no significant change was noted in the baseline group. Dual users also showed a significant reduction in COPD exacerbations, “but only at 24 months.”
The study showed that e-cigarette users are able to reduce combustible cigarette use and/or quit altogether and the positive effects of e-cigarettes for smokers with COPD. The authors conclude that e-cigarettes are useful cessation device and may “improve subjective and objective COPD outcomes.”
Implications:
This long-term study provides more evidence of the usefulness of e-cigarettes and vapor products as cessation devices. The study also indicates potential health benefits of e-cigarettes, especially among users that are formers smokers with COPD. Policies aimed at regulating such products should take these findings into consideration.
Abstract:
Background: Electronic cigarettes (ECs) are battery-operated devices designed to vaporise nicotine, which may help smokers quitting or reducing their tobacco consumption. There is a lack of data on the health effects of EC use among smokers with COPD and whether regular use results in improvement in subjective and objective COPD outcomes.
We investigated long-term changes in objective and subjective respiratory outcomes in smokers with a diagnosis of COPD who quit or reduced substantially their tobacco consumption by supplementing with or converting only to ECs use.
Methods: We conducted a retrospective chart review of patients with COPD to identify those reporting regular daily use of ECs on at least two follow-up visits at 12- (F/up1) and 24-months (F/up2). Regularly smoking COPD patients were included as a reference group.
Results: A marked reduction in cigarette consumption was observed in ECs users. A significant reduction in COPD exacerbations was reported in the COPD EC user group, their mean (±SD) decreasing from 2.3 (±1) at baseline to 1.8 (±1; p = 0.002) and 1.4 (±0.9; p < 0.001) at F/up1 and F/up2 respectively. A significant reduction in COPD exacerbations was also observed in ECs users who also smoked conventional cigarettes (i.e. ‘dual users’). COPD symptoms and ability to perform physical activities improved statistically in the EC group at both visits, with no change in the control group.
Conclusions: These findings suggest that ECs use may aid smokers with COPD reduce their cigarette consumption or remain abstinent, which results in marked improvements in annual exacerbation rate as well as subjective and objective COPD outcomes.
Further Reading:
The Rest of the Story: Tobacco and Alcohol News Analysis and Commentary, Switching to Vaping Improves Health of Smokers with COPD, 2016
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