Switching to E-Cigs Leads to Long-Term Health Improvements in Smokers Suffering from Asthma, Small Study FInds
While the media is busy covering every single incident involving exploding e-cigarettes, in an attempt to make using them seem even more dangerous than smoking, respectable scientists are hard at work conducting research that shows vaping can have very positive effects on smokers’ health.
One such researcher is Dr. Ricardo Polosa, an internationally recognized expert on tobacco harm reduction and professor at the University of Catania, Italy. Back in 2013, he and his team conducted a small study on a cohort of 18 smokers suffering from mild asthma who were introduced to electronic cigarettes. During the one-year research, 10 of the smoking asthmatics switched to electronic cigarettes completely, while 8 became dual users. At the one-year-followup, both categories showed significant improvement in asthma symptoms and lung function, especially small airways obstruction. While the improvements in lung function were small, those in asthma symptoms were clinically relevant.
These preliminary findings were obviously well received by the vaping community and fellow scientists in the tobacco harm reduction movement, but Dr. Polosa and his team were more interested in the long-term effects of e-cigarette use on smokers and former smokers suffering from asthma. They followed participants in the original study for a second year, from October 2013 to January 2015, and their findings indicate significant and stable improvements in respiratory symptoms, lung function and tobacco consumption.
Researchers note that of the original 18 participants in the study, two – one who had completely switched two e-cigs and a dual users – relapsed to exclusive tobacco smoking by the final followup at 24 months, so by the end of the followup they ended up analyzing data for 10 ex-smokers who had switched to e-cigarettes completely and 6 dual-users. Their evaluation consisted of Juniper’s Asthma Control Questionnaire (ACQ), number of asthma exacerbations (increase in respiratory symptoms requiring the administering of parenteral corticosteroids), simple spirometry, forced vital capacity assessment, a number of bronchial provocation tests, daily cigarette consumption in dual users and a review of electronic cigarettes.
After analyzing the data, Prof. Polosa’s team found that improvements detected at 12 months were still present at 24 months. Compared to baseline, there were significant improvements in ACQ scores and all lung function parameters including methacholine PC20, in both single users (those who used e-cigs exclusively) and dual users. The latter category smoked an average of just 6 tobacco cigarettes per day at first follow up, and 4 on the second and third followup. On the other hand, for the two participants that relapsed to smoking tobacco exclusively, researchers noted a deterioration in objective and subjective asthma outcomes. “The normal FEV1/FVC of 79.5% at 12 months decreased to 71.0% at 24 months, which indicates worsening obstructive disease. Their methacholine PC20 was reduced three-fold from 2.95 mg/ml to 1.05 mg/ml and their ACQ score increased substantially from 1.45 to 2.3,” the study mentions.
“Here we confirm that regular EC use ameliorates asthma outcomes and shows that these beneficial effects may persist in the long term. Moreover, it was shown that similar benefits could be also noted in the dual users and that regular EC use was well tolerated,” Polosa and his team conclude. “The success in reducing cigarette consumption or quitting smoking with EC in these asthmatic patients may be explained by the combined compensatory effect at both physical and behavioral level . In agreement with this, nicotine-free plastic inhalators can improve quit rates only in smokers for whom cigarette handling and manipulation play a key role in their smoking ritual.”
Most importantly, researchers believe that the negative effects of smoking on respiratory function can be reversed. “This study confirms that lung function of smokers with asthma may improve when stopping smoking for a sufficient period of time. The improvement reported persisted in the long-term prospective follow up. These findings are in agreement with the positive results of prospective studies looking at the effect of stopping smoking on lung function in asthma. Taken together, the evidence suggests that the harmful effects of smoking on the asthmatic airways can be reversed. It is plausible that the attenuation in pro-inflammatory effects of cigarette smoke on the airways after reducing smoking consumption by switching to EC use might have caused overall improvement in lung function.”
In closing, it’s worth pointing out that at the start of the first study, participants were using cig-alikes, but by the end of the second one, they had all transitioned to second-generation refillable e-cigs, which appears to have kept them from relapsing to smoking and maybe even had a role to play in the amelioration of their asthma symptoms.
