Short-term effects of a nicotine-free e-cigarette compared to a traditional cigarette in smokers and non-smokers

Abstract

BackgroundA few studies have assessed the short-term effects of low-dose nicotine e-cigarettes, while data about nicotine-free e-cigarettes (NF e-cigarettes) are scanty. Concerns have been expressed about the use of NF e-cigarettes, because of the high concentrations of propylene glycol and other compounds in the e-cigarette vapor.MethodsThis laboratory-based study was aimed to compare the effects of ad libitum use of a NF e-cigarette or and a traditional cigarette for 5 min in healthy adult smokers (n = 10) and non-smokers (n = 10).The main outcome measures were pulmonary function tests, fraction of exhaled nitric oxide (FeNO) and fractional concentration of carbon monoxide (FeCO) in exhaled breath.ResultsThe traditional cigarette induced statistically significant increases in FeCO in both smokers and non-smokers, while no significant changes were observed in FeNO. In non-smokers, the traditional cigarette induced a significant decrease from baseline in FEF75 (81 % ± 35 % vs 70.2 % ± 28.2 %, P = 0.013), while in smokers significant decreases were observed in FEF25 (101.3 % ± 16.4 % vs 93.5 % ± 31.7 %, P = 0.037), FEV1 (102.2 % ± 9.5 % vs 98.3 % ± 10 %, P = 0.037) and PEF (109.5 % ± 14.6 % vs 99.2 % ± 17.5 %, P = 0.009). In contrast, the only statistically significant effects induced by the NF e-cigarette in smokers were reductions in FEV1 (102.2 % ± 9.5 % vs 99.5 ± 7.6 %, P = 0.041) and FEF25 (103.4 % ± 16.4 % vs 94.2 % ± 16.2 %, P = 0.014).DiscussionThe present study demonstrated that the specific brand of NF e-cigarette utilized did not induce any majoracute effects. In contrast, several studies have shown that both traditional cigarettes and nicotine-containing e-cigarettes have acute effects on lung function. Our study expands on previous observations on the effects of NF e-cigarettes, but also for the first time describes the changes induced by smoking one traditional cigarette in a group of never smokers.ConclusionsThe short-term use of the specific brand of NF e-cigarette assessed in this study had no immediate adverse effects on non-smokers and only small effects on FEV1 and FEF25 in smokers. The long-term health effects of NF e-cigarette use are unknown but worthy of further investigations.Trial registrationClinicaltrials.gov: NCT02102191

Overview of Electronic Nicotine Delivery Systems: A Systematic Review

“…Laboratory studies find modest increases in nicotine biomarkers after vaping. 169,195,197,203,206,209–211,215,222,223,232,233,239,246,248,264,271,284,300 Vaping has no or minimal impact on other physiologic measures (i.e., exhaled carbon monoxide, complete blood count, body weight), 142,202,203,230,237,239,242,257,265,272,274,276,282,285,292,303 with improvements in outcomes seen for smokers switching to ENDS, such as reduced blood pressure, improved lung function, and improved disease symptoms (i.e., asthma and chronic obstructive pulmonary disease). 214,230,273,287 Some studies have examined cardiovascular measures associated with vaping, 195,197,209,222,223,226,232,246,248,257,273,300,301 with the majority finding an increase in heart rate, 195,223,232,246,248,300 but three finding no change after use.…”

Organizing pneumonia related to electronic cigarette use: A case report and review of literature

“…While some of the studies found that e cigarette users experience increased airway resistance along with compromise in pulmonary function upon exposure to e cigarette vapor, 5,6 others reported that short term use of e cigarettes have no significant changes in lung function. 7,8 Further, two studies reported immediate reduction in exhaled nitric oxide similar to what is seen in tobacco smoking. 5,6 Another study found increase in inflammatory signalling molecules upon inhalation, in resemblance to what is seen in tobacco smoking.…”

Electronic cigarettes—A review of the physiological health effects

“…Ferrari et al (2015) discovered that in a group of 10 smokers and 10 non-smokers, 5 min of ad libitum use of a nicotine-free EC decreased the FEV1 value and the forced expiratory flow after 25% of the air in the lungs has been expelled (FEF25 value). This indicates that ECs can impair lung volume as well as the force lungs can generate, unrelated to nicotine.…”

“…These effects were, however, more pronounced in the 10 smokers. Among the smokers, there was also a decreased peak (highest) expiratory flow (PEF value) when air was being expelled from the lungs (Ferrari et al 2015). Walele et al (2016) found no change in pulmonary function (including in values such as the FEV1) for flavoured or unflavoured liquid or varying nicotine concentrations when 24 smokers took 10 puffs from the EC device four times per day for 4 d. Again, these different results may be due to different puffing regimes or the use of different liquids or devices that may affect lung function differently.…”