Increased risk of COPD observed in individuals using e-cigarette: Study

A new study published in the journal of Respiratory Medicine showed a strong correlation between a higher risk of chronic obstructive pulmonary disease (COPD) and electronic nicotine delivery systems (ENDS).

In the early 2000s, electronic cigarettes, also known as e-cigarettes, were first released as vaping devices that produced vapor by heating an e-liquid. By simulating traditional cigarettes through simultaneous motor and sensory stimulation, e-cigarettes made it easier to limit or stop using traditional tobacco products.

In particular, e-cigarette users are more likely to acquire chronic respiratory conditions, including chronic obstructive pulmonary disease, and cardiovascular disorders like atherosclerosis, arrhythmia, myocardial infarction, hypertension, and heart failure. Furthermore, e-cigarette usage may worsen pre-existing respiratory issues, which might lessen the efficacy of Continuous Positive Airway Pressure (CPAP) in treating sleep apnea, a disorder that frequently co-occurs with COPD.

Pooled estimates of the effect of e-cigarette usage on COPD are currently scarce. The influence of e-cigarette usage on COPD is therefore assessed in the current meta-analysis of extensive population-based observational studies. In accordance with PRISMA Guidelines, a systematic search of observational studies published between January 2020 and January 2024 was carried out in MEDLINE and Scopus for this study.

A total of 7 observational studies (including 4 cross-sectional studies and 3 prospective cohort studies) out of the 3670 publications that were initially retrieved matched all search criteria and were incorporated in the current meta-analysis. These studies included 35,52,424 individuals in total, including 1,38,698 cases with COPD.

According to the results of the random-effects meta-analysis, e-cigarette usage among non-cigarette users was linked to a 1.50-fold increased risk of COPD (pooled Relative Risk, pRR). The results indicated above were validated by sensitivity analysis using leave-one-out analysis.

According to stratified pooled effect estimates from prospective cohort studies and cross-sectional studies alone, e-cigarette users had a considerably greater risk of COPD, ranging from 52% to 55%. Overall, e-cigarette users are more likely to acquire COPD, according to the present meta-analysis. 

Reference:

Song, C., Hao, X., Critselis, E., & Panagiotakos, D. (2025). The impact of electronic cigarette use on chronic obstructive pulmonary disease: A systematic review and meta-analysis. Respiratory Medicine, 239(107985), 107985. https://doi.org/10.1016/j.rmed.2025.107985