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J Gen Intern Med. 2017 Dec;32(12):1315-1322. doi: 10.1007/s11606-017-4150-7. Epub 2017 Sep 7.

Electronic Cigarette Use in US Adults at Risk for or with COPD: Analysis from Two Observational Cohorts.

Author information

1
University of Colorado Anschutz Medical Campus, Aurora, CO, USA. BowlerR@NJHealth.org.
2
National Jewish Health, 1400 Jackson Street, Denver, CO, 80206, USA. BowlerR@NJHealth.org.
3
Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
4
National Jewish Health, 1400 Jackson Street, Denver, CO, 80206, USA.
5
Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY, USA.
6
Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
7
VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
8
Department of Medicine, Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
9
Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA.
10
Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, California, Los Angeles, USA.
11
Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA.
12
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
13
Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
14
Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco, School of Medicine, San Francisco, CA, USA.

Abstract

BACKGROUND:

Electronic cigarettes (e-cigarettes) are battery-operated nicotine-delivery devices used by some smokers as a cessation tool as well as by never smokers.

OBJECTIVE:

To determine the usage of e-cigarettes in older adults at risk for or with chronic obstructive pulmonary disease (COPD).

DESIGN:

Prospective cohorts.

PARTICIPANTS:

COPDGene (N = 3536) and SPIROMICS (N = 1060) subjects who were current or former smokers aged 45-80.

MAIN MEASURES:

Participants were surveyed to determine whether e-cigarette use was associated with longitudinal changes in COPD progression or smoking habits.

KEY RESULTS:

From 2010 to 2016, participants who had ever used e-cigarettes steadily increased to 12-16%, but from 2014 to 2016 current use was stable at ~5%. E-cigarette use in African-Americans (AA) and whites was similar; however, AA were 1.8-2.9 times as likely to use menthol-flavored e-cigarettes. Current e-cigarette and conventional cigarette users had higher nicotine dependence and consumed more nicotine than those who smoked only conventional cigarettes. E-cigarette users had a heavier conventional cigarette smoking history and worse respiratory health, were less likely to reduce or quit conventional cigarette smoking, had higher nicotine dependence, and were more likely to report chronic bronchitis and exacerbations. Ever e-cigarette users had more rapid decline in lung function, but this trend did not persist after adjustment for persistent conventional cigarette smoking.

CONCLUSIONS:

E-cigarette use, which is common in adults with or at risk for COPD, was associated with worse pulmonary-related health outcomes, but not with cessation of smoking conventional cigarettes. Although this was an observational study, we find no evidence supporting the use of e-cigarettes as a harm reduction strategy among current smokers with or at risk for COPD.

KEYWORDS:

COPD; electronic cigarette; lung function; tobacco

PMID:
28884423
PMCID:
PMC5698219
[Available on 2018-12-01]
DOI:
10.1007/s11606-017-4150-7
[Indexed for MEDLINE]

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