Key result
Dual cigarette and e-cigarette use linked to worse FEV1, 6MWT, and quality of life.
Why the study?
Despite declines in tobacco smoking, e-cigarette use is growing, prompting evaluation of the long-term effects of smoking, vaping, and dual use on cardiopulmonary function capacity and quality of life.
Does cigarette smoking, e-cigarette use, or dual use impair cardiopulmonary function capacity and quality of life compared to never smoking or vaping?
Does cigarette smoking, e-cigarette use, or dual use impair cardiopulmonary function capacity and quality of life compared to never smoking or vaping?
Cigarette and e-cigarette use, particularly dual use, is associated with significant impairments in lung function, exercise capacity, and quality of life compared to never smoking or vaping.
Clinicians should caution against dual cigarette-e-cigarette use; challenges consensus on vaping as a safe cardiopulmonary alternative.
Background: Smoking is a leading cause of heart and lung diseases worldwide. Though there is a decline in tobacco smoking the use of e-cigarettes is growing in popularity. Objective: To assess the long-term effects of smoking, vaping, and dual use on cardiopulmonary function capacity and quality of life. Methods: The study participants were classified into five groups: 1- The control group included participants who had never smoked or vaped. 2- Individuals who use cigarettes only had a history of smoking for at least 3.5 pack years or above and smoked only cigarettes based on previously conducted study. 3- E-cigarette use only group participants were required to have a history of vaping for at least 3.5 years and above. 4- The previously smoked and currently uses e-cigarette group includes participants who report no smoking for the past year and a history of vaping for at least 3.5 years and above. 5- Use of both cigarette and e-cigarette group, participants had smoked for 3.5 years and had vaped for at least 3.5 years. Participants performed PFT, 6MWT and completed HRQOL using RAND SF-36 questionnaire. Results: A total of 175 (85.7% male) participants with an average age of mean (± SD) 27.38 (± 5.75) enrolled in the study. PFT results showed significant difference in FEV1 (L/s) [F(4,170) = 7.73, P ≤ .001]; FEV1 (%predicted) [F(4,170) = 24.63, P ≤ .001]; and FEV1/FVC (%) [F(4,170) = 16.85, P ≤ .001] values across the 5 groups. On further analysis, FEV1 and FEV1 (%predicted) significantly decreased in all user groups. Similarly, in FEV1/FVC (%) significant difference was observed with user groups except those who only use e-cigarettes. 6MWT showed a significant difference in walking distance [F(4,170) = 19.93, P ≤.001]. HRQOL reported a significant difference in physical function [H(4) = 20.55, P ≤ .001], emotional well-being [H(4) = 19.21, P = .001], and social function [H(4) = 29.63, P ≤ .001] domains. Individuals who use both cigarettes and e-cigarettes reported a significant decline in lung function [(FEV1 2.96 ± 0.41, FEV1 (% predicted) 72.6 ± 6.07 and FEV1/FVC (%) 73.65 ± 11], 6MWT walking distance (m) (mean ± SD) 416.26 ± 53.49. Conclusions: We observed a significant long-term impairment in lung function, cardiopulmonary capacity, and quality of life among individuals who use cigarettes and e-cigarettes compared to those who never smoked or vaped. Also, individuals who use both cigarettes and e-cigarettes showed the worst health outcomes.
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Gokul et al. (2024) studied this question. Users of both cigarettes and e-cigarettes experienced significant declines in FEV1, 6MWT distance, and quality of life compared to non-users.
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