The Pros and Cons of E-Cigarettes

Are they a safer alternative for people living with COPD?

Man Using An Electric Cigarette
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10/21/2019 UPDATE: Recent illnesses have been associated with the use of e-cigarettes (vaping). Since the specific causes of these lung injury cases are not yet known, the Centers for Disease Control and Prevention (CDC) recommends refraining from all vaping products.

If you have a respiratory condition such as chronic obstructive pulmonary disease (COPD), it is important that you consider all the facts before using electronic cigarettes—popularly known as e-cigarettes.

First introduced into the market in 2003, the devices were promoted as a way to cut back on cigarettes. When you have pulmonary disease, smoking cessation is undoubtedly the most important aspect of taking care of your health. However, evidence supporting the use of e-cigarettes as an effective strategy for smoking cessation is lacking.

As e-cigarette use has increased, it has become clear that the devices pose serious health risks of their own. Amid increasing reports of deaths and serious illnesses, in 2019 the U.S. Food and Drug Administration (FDA) formally announced a plan to restrict flavored e-cigarette products and to increase the regulation of all electronic nicotine delivery systems. These include the components of e-cigarettes as well as e-liquids, cartridges, flavorings, and atomizers.

How E-Cigarettes Work

E-cigarettes are battery-powered devices filled with a solution of liquid nicotine, water, and propylene glycol. They are cylindrical in shape and may resemble a cigarette, flash drive, or mobile phone.

When you take a puff on an e-cigarette, a battery heats up the solution to create a vapor (steam) that you can inhale. The action of inhaling the vapor (which is similar to the sensation of smoking) is described as "vaping.”

Juul, a brand of e-cigarettes that is popular among middle schoolers and high schoolers, is used with a liquid-containing pod. The liquid, which is often flavored, can provide the user with a taste such as bubblegum or grapefruit. There are other brands of e-cigarettes that also can be used with flavored liquid.

The Contents of E-Cigarettes

Cigarettes have been around for many years, and their risks are well understood. Heart disease, lung disease, and an increase in cancer risk are all among the established effects of cigarette smoke and secondhand smoke exposure.

E-cigarettes contain a variety of chemicals, including propylene glycol, glycerin, diacetyl, and benzaldehyde. Each flavor may also contain additional chemical additives. The long term effects of inhaling the vaporized form of these products are not yet known, and they may be associated with effects such as cancer.

Effects of E-Cigarettes on COPD

Researchers have suggested that e-cigarettes may help smokers reduce their use of traditional cigarettes. In the short term, it is not uncommon to experience a sore throat, coughing, eye irritation, and dry mouth shortly after vaping.

Additionally, the impact of substituting traditional cigarettes with e-cigarettes is unclear. The use of these devices has been shown to cause inflammation, especially in the lungs.

It turns out that e-cigarettes may affect those with COPD differently than people who do not have COPD.

The inflammatory response induced by vaping is seen in people who do not have pulmonary disease, but it is higher among people who have COPD. The reason that e-cigarette-mediated inflammation is more pronounced for people who have COPD is not completely clear.

We do know that recurrent and chronic inflammation in the lungs leads to pulmonary disease. Inflammation narrows the bronchi (airways) and can interfere with oxygen and carbon dioxide transfer in the alveoli (air sacs).

Repeated episodes of inflammation ultimately lead to thickening and scarring in the lungs. This produces symptoms such as shortness of breath, wheezing, exercise intolerance, and fatigue. If you already have COPD, further inflammation will worsen your disease and may cause heart disease or other types of pulmonary disease to develop.

If you have another lung disease besides COPD—such as asthma or allergies—keep in mind that e-cigarettes may make your symptoms act up.

A Word From Verywell

If you have a pulmonary condition like COPD, smoking cessation is an important part of your disease management. The use of e-cigarettes has been promoted as a possible strategy for smoking cessation. Yet the evidence is not firm, and the harmful effects of e-cigarettes are coming to light.

Keep in mind that as regulation tightens, illegally obtained pods and new formulations can lead to the availability and use of new and different chemicals with e-cigarettes. The health outcomes of "underground" products and products that comply with tightened regulations are yet to be seen.

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Article Sources

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  1. Centers for Disease Control & Prevention. Electronic Cigarettes. Reviewed March 11, 2019.

  2. US Food & Drug Administration. How FDA is Regulating E-Cigarettes. September 10, 2019.

  3. Bhatnagar A, Whitsel LP, Ribisl KM, et al. Electronic cigarettes: a policy statement from the American Heart Association. Circulation. 2014;130(16):1418-36. doi:10.1161/CIR.0000000000000107

  4. Centers for Disease Control and Prevention. Smoking & Tobacco Use. Health Effects. Reviewed February 8, 2018.

  5. Chaumont M, Van de borne P, Bernard A, et al. Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchange disturbances: results from two randomized clinical trials. Am J Physiol Lung Cell Mol Physiol. 2019;316(5):L705-L719. doi:+10.1152/ajplung.00492.2018

  6. Morjaria JB, Mondati E, Polosa R. E-cigarettes in patients with COPD: current perspectives. Int J Chron Obstruct Pulmon Dis. 2017;12:3203-3210. doi:10.2147/COPD.S135323

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