Use of e-cigarettes plus tobacco cigarettes linked to increased risk of respiratory symptoms

“People who vape e-cigarettes in an effort to stop smoking tobacco cigarettes should be cautioned against using both 

New research revealed that respiratory symptoms, such as cough and wheeze, are more likely to develop when people use both e-cigarettes and tobacco cigarettes together compared with using either one alone.

The findings of the study were published in the American Journal of Respiratory and Critical Care Medicine, the flagship journal of the American Thoracic Society. Exclusively using or vaping e-cigarettes can help people quit smoking, but many people using e-cigarettes to quit smoking continue to smoke cigarettes. This research led by investigators at Massachusetts General Hospital (MGH) suggested that respiratory symptoms are more likely to develop when people use both e-cigarettes and tobacco cigarettes together.

The investigators analyzed information on 20,882 individuals aged 12 years and older in the Population Assessment of Tobacco and Health (PATH) Study, a US nationally representative longitudinal survey.

They analyzed participants who had no respiratory symptoms when surveyed in 2015-2016. When they were surveyed about one year later, respiratory symptoms were reported by 10.7 percent of those who did not use e-cigarettes or tobacco cigarettes, 11.8 percent of exclusive e-cigarette users, 17.1 percent of exclusive tobacco smokers, and 19.7 percent of dual users (those who both vaped e-cigarettes and smoked tobacco cigarettes).

Dual users had a 1.9-times higher odds of developing respiratory symptoms compared with exclusive e-cigarette users and a 1.24-times higher odds compared with exclusive tobacco smokers. The risk of new respiratory symptoms among individuals who vaped but did not smoke was not significantly higher than the risk among individuals who neither vaped nor smoked.

“To help people quit smoking, FDA-approved medications, such as the nicotine patch or the medication varenicline, are preferred,” said lead author Krishna Reddy, MD, MS, an investigator in MGH’s Division of Pulmonary and Critical Care Medicine and the MGH Tobacco Research and Treatment Center.

“People who vape e-cigarettes in an effort to stop smoking tobacco cigarettes should be cautioned against using both and instead should switch over completely from smoking to vaping, with an ultimate goal of stopping vaping as well,” added Reddy.

Senior author Nancy Rigotti, MD, director of the Tobacco Research and Treatment Center, said, “This study helps identify how e-cigarettes can best be used to reduce the harms caused by smoking cigarettes. Exclusive e-cigarette use did not increase the risk of new respiratory symptoms while using both products (e-cigarettes and cigarettes) did.”