Association between dual use of e-cigarette and cigarette and chronic obstructive pulmonary disease: an analysis of a nationwide representative sample from 2013 to 2018

Abstract

Background The association between the dual use of electronic cigarette (e-cigarette) and conventional cigarettes (c-cigarette) and spirometry-defined chronic obstructive pulmonary disease (COPD) has not been studied thoroughly. Methods A total of 47,217 participants were identified in the 2013–2018 Korea National Health and Nutrition Examination Survey; of them, 12,919 participants aged ≥ 40 who underwent spirometry and had no missing data were enrolled. Pulmonary function testing, urinary cotinine, and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) levels were compared between dual users, current smokers, former smokers, and non-users using complex sample linear regression analysis. The odds ratio (OR) for COPD was calculated using a complex sample logistic regression model after adjusting for covariates. Results Among current e-cigarette users, approximately 85% of the participants used c-cigarette concurrently, and 1.3% of all the participants were dual users (2.3% in males and 0.1% in females). Both dual users and current smokers showed higher levels of urine cotinine and NNAL than non-users and former smokers. The weighted prevalence of COPD was the highest in dual users (13.8% for all participants and 14.1% for males). The multivariate-adjusted OR of COPD for male dual users, compared to non-users, was 3.46 (Ptrend < 0.001). The OR for COPD was 3.10 (Ptrend < 0.001) in middle-aged (40–64 years) and 3.70 (Ptrend < 0.001) in older (≥ 65 years) men. In females, the association was not observed and could not be precisely measured because of the small proportion of the smoking population. Conclusions Dual use of e-cigarette and c-cigarette is associated with COPD in males.

Factors Associated with Quit Intentions among Adult Smokers in South Korea: Findings from the 2020 ITC Korea Survey

“…Moreover, most users of NVPs or HTPs also tend to concurrently smoke cigarettes [ 45 , 46 ]. Over 80% of current HTP users in South Korea were either concurrent users with either cigarettes or e-cigarettes (ECs) or triple users [ 45 ].…”

“…Over 80% of current HTP users in South Korea were either concurrent users with either cigarettes or e-cigarettes (ECs) or triple users [ 45 ]. Likewise, over 80% of NVP users were concurrent users with cigarettes [ 46 ]. HTPs and NVPs are often marketed as less harmful products compared to cigarettes, and users of these products are perceived to be able to have higher quit intentions and quit more easily than cigarette smokers [ 47 , 48 ].…”

Association between a History of herpes zoster and the risk of Sjögren’s syndrome: a nationwide, population-based, case–control study

“…Second, the NHIRD does not provide information regarding individual habits, including smoking and self-paid medication, such as herpes zoster vaccination, which may be confounding factors. However, we adjusted for smoking-related comorbidities, namely chronic pulmonary disease51 52 cardiovascular disease (myocardial infarction, congestive heart failure, peripheral vascular disease, and cerebrovascular disease), peptic ulcer53 and tumour, which may serve as a proxy of the confounding effect of smoking. In addition, we adjusted for medications used for treating herpes zoster infection based on NHI payment guidelines.…”

Empfehlungen zum Umgang mit der elektronischen Zigarette (E-Zigarette)

“…Die Mehrzahl der E-Zigarettenraucher:innen konsumiert gleichzeitig Tabakzigaretten [33][34][35][36]. Bei dual-use ist im Vergleich zu ausschließlichem Tabakkonsum die Rate an Atembeschwerden, COPD, Herzbeschwerden und Herz-Kreislauferkrankungen erhöht [34][35][36][37].…”

“…Die Mehrzahl der E-Zigarettenraucher:innen konsumiert gleichzeitig Tabakzigaretten [33][34][35][36]. Bei dual-use ist im Vergleich zu ausschließlichem Tabakkonsum die Rate an Atembeschwerden, COPD, Herzbeschwerden und Herz-Kreislauferkrankungen erhöht [34][35][36][37]. Für die Praxis ist bedeutsam, dass nicht weniger Tabakkonsum, sondern nur der vollständige Rauchstopp das kardiovaskuläre Risiko reduziert [38].…”