OBJECTIVES

: As of November 2019, there were 2,290 reported cases of e-cigarette or vaping associated lung injury and 47 deaths.[i] The objective of this scoping review is to summarize the effects of e-cigarettes on pulmonary outcomes from 2009 to 2019.

METHODS

: PubMed, CINAHL, and Science Direct databases were used. Search terms included “vaping, electronic nicotine delivery systems, electronic cigarettes, lung diseases, respiratory diseases, and pulmonary”. Original research articles in English that used human subjects between 1/1/2009 and 11/4/2019 and reported pulmonary outcomes were included.

RESULTS

: Thirty-nine articles met criteria. There were eighteen (46.2%) experimental, 16 (41.0%) cross-sectional, and 5 (12.8%) cohort studies. Fifteen (38.5%) studies were conducted in the US; 24 (61.5%) were conducted across 12 other countries. The total number of subjects across studies was 421,641; subjects ranged from 1 to 99 years old. One-third included subjects with pre-existing conditions. Asthma (n = 8,61.5%) was the most common. Most studies reported smoking history (n=37, 94.9%), with conventional smoking (n=26, 70.3%) and e-cigarette use (n=19, 51.4%) as the most prevalent. Two (5.4%) studies reported dual use (e-cigarette use and conventional smoking). A significant association between e-cigarette use and respiratory symptoms, declined PFTs, chronic obstructive pulmonary disease (COPD) and asthma diagnoses were reported in 34 (87.2%) studies. Respiratory symptoms and risk of asthma were more significant in dual users (n=2, 6.5%). However, e-cigarette users were more prone to respiratory symptoms and COPD and asthma exacerbations compared to former smokers (n=4, 12.9%).

CONCLUSIONS

: Evidence indicates that e-cigarette use leads to negative pulmonary health effects and adverse health outcomes. Dual users are most susceptible. Education on the potential risks of e-cigarette use should be targeted to dual users.

[i] Centers for Disease Control and Prevention. (2019). Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products. https://www.cdc.gov/tobacco/basic_information/e-cigs/severe-lung-disease.html. Accessed November 25, 2019.