Exclusive E-Cigarette Use Linked to COPD and Hypertension in Adults, finds study
Researchers have identified in a new study that sole e-cigarette use is strongly linked with the risk of chronic obstructive pulmonary disease (COPD) and hypertension in adults between 30 and 70 years. The current study, based on longitudinal data from the All of Us research program, sheds light on the potential health hazards of e-cigarettes. The results call for regulation policy covering the health threats of emerging tobacco products. This study was conducted by John E. and colleagues published in the journal Nicotine & Tobacco Research.
Data from 249,190 participants, including 67.2% female and 52.0% classified as non-Hispanic White, were followed up during a duration of 3.7-3.9 years. The investigators used Cox regression models to evaluate the correlation between exclusive e-cigarette smoking (EE), exclusive combustible cigarette smoking (ECC), and dual use (DU) with the risk of hypertension, type 2 diabetes mellitus (T2DM), COPD, heart failure (HF), and atherosclerotic cardiovascular disease (ASCVD). The models were controlled for important variables including age, sex, race and ethnicity, and body mass index (BMI). ECC was utilized as a positive control to confirm the results.
Key Findings
Exclusive E-Cigarette Use (EE) Outcomes:
EE was strongly related to COPD (adjusted hazard ratio [aHR] 2.29, 95% confidence interval [CI] 1.42-3.71).
In subjects between the ages of 30-70 years, EE was strongly correlated with hypertension (aHR 1.39, 95% CI 1.09-1.77).
No substantial correlations were noted between EE and hypertension in the overall population (aHR 1.01, 95% CI 0.83-1.23), T2DM (aHR 0.88, 95% CI 0.66-1.16), ASCVD (aHR 1.05, 95% CI 0.59-1.86), or HF (aHR 0.82, 95% CI 0.47-1.41).
Exclusive Combustible Cigarette Use (ECC) and Dual Use (DU) Outcomes:
ECC and DU were strongly correlated with all examined cardiometabolic disorders.
DU had increased point estimates for the majority of outcomes, with a very high association with ASCVD (aHR 2.18, 95% CI 1.82-2.62), suggesting possibly increased risk in dual users.
The research offers strong evidence of a relationship between exclusive e-cigarette use and heightened risk of COPD and hypertension in adults aged 30-70 years. Dual use of combustible cigarettes and e-cigarettes was also highly correlated with all cardiometabolic conditions examined, with a particularly high risk for ASCVD. These results underscore the need for well-informed public health warnings and strict regulation to counteract the possible harms of e-cigarette use.
Reference:
John Erhabor, Zhiqi Yao, Erfan Tasdighi, Emelia J Benjamin, Aruni Bhatnagar, Michael J Blaha, E-cigarette Use and Incident Cardiometabolic Conditions in the All of Us Research Program, Nicotine & Tobacco Research, 2025;, ntaf067, https://doi.org/10.1093/ntr/ntaf067
