Health impact of e-cigarettes and heated tobacco products in chronic obstructive pulmonary disease: current and emerging evidence

Expert Rev Respir Med. 2022 Nov-Dec;16(11-12):1213-1226. doi: 10.1080/17476348.2023.2167716. Epub 2023 Jan 22.

Abstract

Introduction: Quitting is the only proven method to attenuate the progression of chronic obstructive pulmonary disease (COPD). However, most COPD smokers do not seem to respond to smoking cessation interventions and may benefit by lessening the negative health effects of long-term cigarette smoke exposure by switching to non-combustible nicotine delivery alternatives, such as heated tobacco products (HTPs) and e-cigarettes (ECs).

Areas covered: Compared with conventional cigarettes, HTPs and ECs offer substantial reduction in exposure to toxic chemicals and have the potential to reduce harm from cigarette smoke when used as tobacco cigarette substitutes. In this review, we examine the available clinical studies and population surveys on the respiratory health effects of ECs and HTPs in COPD patients.

Expert opinion: The current research on the impact of ECs and HTPs on COPD patients' health is limited, and more high-quality studies are needed to draw definitive conclusions. However, this review provides a comprehensive overview of the available literature for health professionals looking to advise COPD patients on the use of these products. While ECs and HTPs may offer some benefits in reducing harm from cigarette smoke, their long-term effects on COPD patients' health are still unclear.

Keywords: Alternative nicotine delivery systems; chronic obstructive pulmonary disease; electronic cigarettes; electronic nicotine delivery systems; heated tobacco products; modified risk tobacco product; reduced risk product; smoking cessation; tobacco harm reduction; vaping.

Publication types

  • Review

MeSH terms

  • Electronic Nicotine Delivery Systems*
  • Humans
  • Nicotine
  • Pulmonary Disease, Chronic Obstructive*
  • Smokers
  • Tobacco Products*

Substances

  • Nicotine