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

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.

Health outcomes in COPD smokers using heated tobacco products: a 3-year follow-up

“…Moreover, similar findings have been also reported in COPD patients using another class of combustion-free nicotine delivery products (i.e. e-cigarettes) [ 18 , 26 , 27 ].…”

“…Moreover, similar findings have been also reported in COPD patients using another class of combustion-free nicotine delivery products (i.e. e-cigarettes) [18,26,27]. Nearly 60% of COPD patients using HTPs abstained completely from cigarette smoking throughout the duration of the study, whereas those continuing to smoke (dual users) showed a consistent decline in their daily cigarette consumption from the baseline of at least 70% at all study visits.…”

“…Although not risk free, emerging clinical evidence suggests that, for example, e-cigarettes use in patients with COPD can help patients with COPD abstain from long-term smoking with clinically relevant health gains [ 17 , 18 ].…”

Critical appraisal of the European Union Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) Preliminary Opinion on electronic cigarettes

“…A five year follow-up clinical study (assessments at 12, 24, 48, and 60 months) of patients with COPD compared 19 patients who completely or partially substituted ENDS for smoking to 20 controls who smoked [38]. Switching to ENDS contributed to a rapid improvement in cardiorespiratory health, with better quality of life, improved exercise tolerance, and an approximately 50% reduction in COPD exacerbations.…”

Critical appraisal of the European Union Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) Preliminary Opinion on electronic cigarettes

“…A 5-year follow-up clinical study (assessments at 12, 24, 48, and 60 months) of patients with COPD compared 19 patients who completely or partially substituted ENDS for smoking to 20 controls who smoked [ 38 ]. Switching to ENDS contributed to a rapid improvement in cardiorespiratory health, with better quality of life, improved exercise tolerance, and an approximately 50% reduction in COPD exacerbations.…”