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Acute pulmonary effects of using an e-cigarette: impact on respiratory flow resistance, impedance and exhaled nitric oxide

http://chestjournal.chestpubs.org/content/early/2011/12/21/chest.11-2443.abstract


1.
Constantine I. Vardavas, MPH, PhD,

2. Nektarios Anagnostopoulos, MD,

3. Marios Kougias, MD,

4. Vassiliki Evangelopoulou, MD,

5. Gregory N. Connolly, DMD, MPH and

6. Panagiotis K. Behrakis, MD, PhD

+ Author Affiliations

1.   Center for Global Tobacco Control, Department of Society, Human Development & Health, Harvard School of Public Health, Boston, USA and Smoking and Lung Cancer Research Center, Hellenic Cancer Society, Athens, Greece (Dr Vardavas, (vardavas@hsph.harvard.edu);
2.   Smoking and Lung Cancer Research Center, Hellenic Cancer Society, Athens, Greece and Laboratory of Respiratory Physiology, Department of Medicine, University of Athens, Greece (Dr Anagnostopoulos(kirchoffan222@hotmail.gr) and Dr Kougias (mkougias@hotmail.gr);
3.   Smoking and Lung Cancer Research Center, Hellenic Cancer Society, Athens, Greece (Dr Evangelopoulou(vevangelopoulou@hotmail.gr);
4.   Center for Global Tobacco Control, Department of Society, Human Development & Health, Harvard School of Public Health, Boston, USA (Dr Connolly (gconnoll@hsph.harvard.edu);
5.   Center for Global Tobacco Control, Department of Society, Human Development & Health, Harvard School of Public Health, Boston, USA and Smoking and Lung Cancer Research Center, Hellenic Cancer Society, Athens, Greece and Laboratory of Respiratory Physiology, Department of Medicine, University of Athens, Greece (Dr Behrakis pbehraki@hsph.harvard.edu

1.   Corresponding author:
Dr. Constantine I Vardavas, Center for Global Tobacco Control, Department of Society, Human Development & Health, Harvard School of Public Health, Boston, MA, USA Email: vardavas@hsph.harvard.edu

Abstract

Background: Debate exists as to the scientific evidence for their claims that e-cigarettes have no health related ramifications. Our aim was to assess whether using an e-cigarette for five minutes has an impact on pulmonary function tests and exhaled nitric oxide (FeNO) among healthy adult smokers.

Methods: 30 healthy non smokers (ages 19-56, 14 male) participated in this laboratory based experimental vs. control group study. Ab lib use of an e-cigarette for 5 minutes with the cartridge included (experimental group n=30) or removed from the device (control group n=10) was assessed.

Results: Using an e-cigarette for 5 minutes was found to lead to an immediate decrease in exhaled FeNO within the experimental group by 2.14ppb, (p=0.005) while not in the control group (p=0.859). Total impedance (Z5Hz) in the experimental group was found to also increase by 0.033kPa/(L/s) (p<0.001) while flow resistance at R5Hz, R10Hz and R20Hz also statistically increased.). Regression analyses controlling for baseline measurements indicated statistically significant decrease in FeNO and an increase in impedance by 0.04kPa/(L/s), (p=0.003), resistance at R5Hz by 0.04kPa/(L/s), (p=0.003),at R10Hz by 0.034kPa/(L/s), (p=0.008), at R20Hz by 0.043kPa/(L/s), (p=0.007), and overall peripheral airway resistance (beta: 0.042 kPa/(L/s), (p=0.024), after using an e-cigarette.

Conclusions: E-cigarettes assessed in the context of this study were found to have immediate adverse physiologic effects after short term use that are similar to some of the effects seen with tobacco smoking, however the long term health effects of e-cigarette use are unknown but potentially adverse and worthy of further investigation.

Copyright © 2011 American College of Chest Physicians

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