Cigarette to e-cigarette switch improves wheeze, dual use does not

Key takeaways:

• Researchers reported a positive outcome in terms of wheeze when cigarette smokers moved to e-cigarettes.
• When assessing dual users with maintained/higher smoking intensity, symptom resolution rates went down.

Among adult smokers who moved from smoking cigarettes to e-cigarettes exclusively, wheeze resolution went up, but this was not the case if they moved to dual use, according to results published in Nicotine and Tobacco Research.

Jonathan B. Berlowitz

“It is important for clinicians to inform patients interested in using e-cigarettes for smoking cessation that there are unlikely to be any health benefits from e-cigarette-assisted smoking cessation unless the patients are able to fully quit cigarettes,” Jonathan B. Berlowitz, MD, of the department of global health at Boston University School of Public Health and department of emergency medicine at University of Massachusetts Medical School, told Healio.

In this study, Berlowitz and colleagues evaluated 5,210 observations of U.S. adult smokers with cough (50% women; 68% non-Hispanic white) and 5,367 of smokers with wheeze (50% women; 75% non-Hispanic white) all attempting to switch from smoking cigarettes to e-cigarettes to determine if this change has an impact on respiratory symptom resolution.

Notably, during follow-up, a greater proportion of cough vs. wheeze observations were resolved (65% vs. 53%).

Researchers reported a positive outcome in terms of wheeze when adults moved from smoking cigarettes to e-cigarettes, as the rate of wheeze resolution went up with this switch vs. persistent cigarette smoking (incidence rate ratio [IRR] = 1.33; 95% CI, 1.01-1.75). In contrast, no link was found between this transition and higher rates of cough resolution.

In instances where the transition ended up with use of both e-cigarettes and cigarettes, researchers did not find a link between this behavior and symptom resolution improvement.

Further, in the analysis assessing dual users with maintained or higher smoking intensity against persistent smokers, the cough resolution rate (IRR = 0.86; 95% CI, 0.76-0.99) and wheeze resolution rate (IRR = 0.85; 95% CI, 0.72-1) went down, according to the study.

“We were not surprised by these findings,” Berlowitz told Healio. “There is increasing evidence that e-cigarettes are associated with decreased respiratory morbidity compared with cigarettes. However, the introduction of new e-cigarette use along with persistent cigarette smoking is likely to only increase toxic exposure, thereby increasing respiratory symptom burden.”

Researchers also looked at rates of those who went beyond exclusive e-cigarette use to nonuse of both cigarettes and e-cigarettes and reported rises in the cough resolution rate (IRR = 1.16; 95% CI, 1.02-1.32) and the wheeze resolution rate (IRR = 1.21; 95% CI, 1.06-1.38).

“Future research assessing the utility of e-cigarette-assisted smoking cessation must balance the potential benefits to those who completely transition from cigarettes to e-cigarettes with the risk to those becoming dual users,” Berlowitz told Healio.

Reference:

• Smokers who switch to vaping see improved respiratory health. https://www.eurekalert.org/news-releases/1064122. Published Nov. 12, 2024. Accessed Nov. 12, 2024.

For more information:

Jonathan B. Berlowitz, MD, can be reached at berlowij@umassmemorial.org.