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THE ASSOCIATION BETWEEN COPD AND E-CIGARETTE SMOKING: A RETROSPECTIVE STUDY OF NHANES

      TOPIC: Tobacco Cessation and Prevention
      TYPE: Original Investigations
      PURPOSE: Since its launch in the market, the prevalence of e-cigarette/vaping also known as electronic nicotine delivery system (ENDS) is increasing every day. E-cigarettes are being advertised as safer alternatives to traditional smoking but little is known about their effects on the lungs. Our study aims to evaluate the prevalence of E-cigarette smoking and the association between chronic obstructive pulmonary disease (COPD) and E-cigarette smoking.
      METHODS: A retrospective cross-sectional study was carried out using NHANES database from 2013 to 2018, including participants with >18 years of age who had been diagnosed with COPD (Chronic obstructive Pulmonary Disease) by a health care professional and smoking status (e-cigarette vs traditional cigarette vs dual smoker) determined by a questionnaire. Non-smokers were excluded. Univariate analysis was performed to evaluate epidemiological characteristics of various smoking methods and multivariable logistic regression analysis to find the association of e-cigarette and dual smoking with COPD.
      RESULTS: Out of 120,335 survey participants, e-cigarette users were 7,756 (6.45%), traditional smokers were 89,135 (74.07%), and dual smokers were 23,444 (19.48%). E-cigarette users were younger (25 vs 59 vs 41 years old). There was a higher prevalence of e-cigarette smoking among females (7.6%), Asian (11.5%), Mexican Americans (10.3%), and participants with an annual household income of $ >100,000 (9.6%) compared to their respective other groups. Female: 7.62% v/s male: 5.61%, asian (11.15% v/s mexican: 10.27% v/s other hispanics: 7.57% v/s black: 7.13% v/s non-hispanic whites: 3.90%), annual household income $ >100000 (9.56% vs 65000-100000:7.63% v/s 25000-65000: 5.36% v/s <25000:5.28%) had higher prevalence of e-cigarette users in comparison with their respective groups. Prevalence of COPD was higher among dual and traditional smokers (10.14% vs 7.39%) in comparison with e-cigarette users (0.25%) (p<0.0001). In multivariable logistic regression analysis, e-cigarette smokers had higher odds of having COPD (aOR:1.82; 95%CI: 1.81-1.82) compared to traditional smokers. Dual smokers were associated with higher odds of developing COPD (aOR:1.40; 95%CI:1.40-1.41).
      CONCLUSIONS: Although the prevalence of COPD is lower in e-cigarette smokers, having higher odds of developing COPD in e-cigarette smokers compared to traditional and dual smokers, emphasizes higher toxicity of E-cigarette than traditional smoking. These findings open up a portal to further research.
      CLINICAL IMPLICATIONS: Since the invention and sales of e-cigarettes (electronic nicotine delivery system), their use has been increasing day by day considering their marketing as a safe alternative to smoking. On the contrary, very little has been known about their effects on pulmonary health. But in reality, there are higher odds of developing COPD in e-cigarette users which does suggest higher toxicity of e-cigarettes compared to traditional smoking. These findings emphasize a need for further research.
      DISCLOSURES: No relevant relationships by Abbas Altamimi, source=Web Response
      No relevant relationships by Avantika Israni, source=Web Response
      No relevant relationships by Faizan Malik, source=Web Response
      No relevant relationships by Preeti Malik, source=Web Response
      No relevant relationships by Harsh Patel, source=Web Response
      No relevant relationships by Urvish Patel, source=Web Response
      No relevant relationships by Suveenkrishna Pothuru, source=Web Response
      No relevant relationships by Abdur Raheem, source=Web Response
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      No relevant relationships by Chail Shah, source=Web Response
      No relevant relationships by SATISH TADEPALLI, source=Web Response