Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct 10:11:2040622320961617.
doi: 10.1177/2040622320961617. eCollection 2020.

COPD smokers who switched to e-cigarettes: health outcomes at 5-year follow up

Ricardo Polosa  1 , Jaymin B Morjaria  2 , Umberto Prosperini  3 , Barbara Busà  4 , Alfio Pennisi  5 , Mario Malerba  6 , Marilena Maglia  1 , Pasquale Caponnetto  1
Affiliations

COPD smokers who switched to e-cigarettes: health outcomes at 5-year follow up

Ricardo Polosa et al. Ther Adv Chronic Dis. .

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.

Keywords: COPD; electronic cigarette; smoking cessation; tobacco harm reduction.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement: In relation to his work in the area of tobacco control and respiratory diseases, RP has received lecture fees and research funding from Pfizer, GlaxoSmithKline, CV Therapeutics, NeuroSearch A/S, Sandoz, MSD, Boehringer Ingelheim, Novartis, Duska Therapeutics and Forest Laboratories. He has also served as a consultant for Pfizer, Global Health Alliance for treatment of tobacco dependence, CV Therapeutics, Boehringer Ingelheim, Novartis, Duska Therapeutics, ECITA (Electronic Cigarette Industry Trade Association, in the UK), Arbi Group Srl. and Health Diplomats. RP has been the Director of the Center of Excellence for the acceleration of Harm Reduction at the University of Catania (CoEHAR), which has received a grant from Foundation for a Smoke Free World to develop and carry out eight research projects. RP is also currently involved in the following pro bono activities: scientific advisor for LIAF (Lega Italiana Anti Fumo – Italian acronym for Italian Anti-Smoking League), the Consumer Advocates for Smoke-free Alternatives (CASAA) and the International Network of Nicotine Consumers Organizations (INNCO); Chair of the European Technical Committee for standardization on ‘Requirements and test methods for emissions of electronic cigarettes’ (CEN/TC 437; WG4). All other authors have no relevant conflict of interest to declare in relation to this study. The Associate Editor of Therapeutic Advances in Chronic Disease is an author of this paper, therefore, the peer review process was managed by alternative members of the Board and the submitting Editor had no involvement in the decision-making process

Figures

Figure 1.
Figure 1.
Number of cigarettes smoker per day at baseline, follow-up visit 1 (12 ± 1.5 months), visit 2 (24 ± 2.5 months), visit 3 (48 ± 3 months) and visit 4 (60 ± 3 months) separately for COPD electronic cigarettes users (closed triangles) and COPD controls (closed circles). All data expressed as mean and error bars are standard deviation of the mean. COPD, chronic obstructive pulmonary disease; EC, electronic cigarette.
Figure 2.
Figure 2.
Changes in the number of COPD exacerbations per year from baseline, at follow-up visit 1 (12 ± 1.5 months), visit 2 (24 ± 2.5 months), visit 3 (48 ± 3 months) and visit 4 (60 ± 3 months) separately for COPD electronic cigarettes users (closed triangles) and COPD controls (closed circles). Data expressed as mean and error bars are standard deviation of the mean. COPD, chronic obstructive pulmonary disease; EC, electronic cigarette.
Figure 3.
Figure 3.
Percentage change in median FEV1 (a) and FVC (b) from baseline, at follow-up visit 1 (12 ± 1.5 months), visit 2 (24 ± 2.5 months), visit 3 (48 ± 3 months) and visit 4 (60 ± 3 months) separately for COPD EC users and COPD controls. BL, baseline; COPD, chronic obstructive pulmonary disease; EC, electronic cigarette; FEV1, forced expiratory volume in 1 second; FVC, Forced vital capacity; L, litres; M, months.
Figure 4.
Figure 4.
Percentage change in patients COPD GOLD stage over the study period. BL, baseline; COPD, chronic obstructive pulmonary disease; GOLD, global initiative for chronic obstructive lung disease; EC, electronic cigarette; M, months.
Figure 5.
Figure 5.
Percentage change in the median CAT scores from baseline, at follow-up visit 1 (12 ± 1.5 months), visit 2 (24 ± 2.5 months), visit 3 (48 ± 3 months) and visit 4 (60 ± 3 months) separately for COPD EC users and COPD. BL, baseline; CAT, COPD assessment tool; COPD, chronic obstructive pulmonary disease; EC, electronic cigarette; M, Months.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization. WHO report on the global tobacco epidemic 2017. World Health Organization, 2017.
    1. U.S. Department of Health and Human Services. The health consequences of smoking: 50 years of progress: a report of the sugeon general. Atlanta, GA: US Department of Health and Human Services, Centres for Disease Control and Prevention, National Centre for Chronic Disease Prevetnion and Health Promotion, Office on Smoking and Health, 2014.
    1. Falk JA, Kadiev S, Criner GJ, et al. Cardiac disease in chronic obstructive pulmonary disease. Proc Am Thorac Soc 2008; 5: 543–548. - PMC - PubMed
    1. MacNee W. Pathogenesis of chronic obstructive pulmonary disease. Proc Am Thorac Soc 2005; 2: 258–266; discussion 290–251. - PMC - PubMed
    1. Morjaria JB, Malerba M, Polosa R. Biologic and pharmacologic therapies in clinical development for the inflammatory response in COPD. Drug Discov Today 2010; 15: 396–405. - PubMed

LinkOut - more resources