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Home > E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies.

Wills, Thomas A and Soneji, Samir S and Choi, Kelvin and Jaspers, Ilona and Tam, Elizabeth K (2021) E-cigarette use and respiratory disorders: an integrative review of converging evidence from epidemiological and laboratory studies. European Respiratory Journal, 57, p. 1901815. doi: 10.1183/13993003.01815-2019.

External website: https://erj.ersjournals.com/content/57/1/1901815

BACKGROUND: Use of electronic cigarettes (e-cigarettes) is prevalent among adolescents and young adults, but there has been limited knowledge about health consequences in human populations. We conduct a systematic review and meta-analysis of results on respiratory disorders from studies of general-population samples and consider the mapping of these results to findings about biological processes linked to e-cigarettes in controlled laboratory studies.

METHOD: We conducted a literature search and meta-analysis of epidemiological studies on the association of e-cigarette use with asthma and with COPD. We discuss findings from laboratory studies about effects of e-cigarettes on four biological processes: cytotoxicity, oxidative stress/inflammation, susceptibility to infection and genetic expression.

RESULTS: Epidemiological studies, both cross-sectional and longitudinal, show a significant association of e-cigarette use with asthma and COPD, controlling for cigarette smoking and other covariates. For asthma (n=15 studies), the pooled adjusted odds ratio (aOR) was 1.39 (95% CI 1.28-1.51); for COPD (n=9 studies) the aOR was 1.49 (95% CI 1.36-1.65). Laboratory studies consistently show an effect of e-cigarettes on biological processes related to respiratory harm and susceptibility to illness, with e-cigarette conditions differing significantly from clean-air controls, although sometimes less than for cigarettes.

CONCLUSIONS: The evidence from epidemiological studies meets established criteria for consistency, strength of effect, temporality, and in some cases a dose-response gradient. Biological plausibility is indicated by evidence from multiple laboratory studies. We conclude that e-cigarette use has consequences for asthma and COPD, which is of concern for respirology and public health.


Item Type
Article
Publication Type
International, Open Access, Review, Article
Drug Type
Tobacco / Nicotine
Intervention Type
Harm reduction
Date
January 2021
Identification #
doi: 10.1183/13993003.01815-2019
Page Range
p. 1901815
Publisher
European Respiratory Society
Volume
57
EndNote

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