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How safe are e-cigarettes for patients with COPD? A systematic review

02 March 2022
11 min read
Volume 33 · Issue 3

Abstract

The use of e-cigarettes has risen rapidly in recent years. Joanne Brook and Dr Mary Turner performed a systematic review to identify if e-cigarettes are appropriate for patients with COPD

Background:

A high smoking-related burden is placed on health services in diagnosing, treating and managing associated long-term illnesses such as chronic obstructive pulmonary disease (COPD). While there are many smoking cessation options available, the use of e-cigarettes has risen rapidly.

Aim:

To identify if the promotion of e-cigarettes is an appropriate intervention for patients with COPD.

Methods:

A systematic process was used to search databases and identify research papers detailing the effects of e-cigarettes on pulmonary health outcomes in COPD; analysis identified five main themes.

Findings:

Eight papers were reviewed. Findings support current clinical guidance endorsing the use of e-cigarettes for smoking cessation; however, COPD patients may be at greater risk of inflammatory responses, exacerbation, disease progression and worsening general health.

Conclusion:

The effects of e-cigarettes are not fully understood, but they are not risk-free. More evidence is needed about both the short and long-term impact of their use in this cohort.

Smoking is one of the main causes of chronic lung disease (Royal College of General Practitioners (RCGP), 2017). As more people are diagnosed with COPD, not only is the financial burden placed on health services increasing, but a rise in workload has been noted, particularly in primary care settings where a large proportion of COPD care is delivered (British Lung Foundation, 2017; Public Health England (PHE), 2017).

Hand-held vaping devices or e-cigarettes began to emerge as an alternative nicotine replacement therapy (NRT) around 2015. As e-cigarettes do not contain tobacco and other harmful toxins found in cigarettes, it is believed they help reduce lung disease and smoking-related deaths (Hartmann-Boyce et al, 2020). With the National Institute for Health and Care Excellence (NICE) guidance (2018; 2021) and the RCGP (2017) recommending healthcare professionals (HCPs) discuss the use of e-cigarettes as a means to quit smoking, their popularity has risen. However, there is now a rising trend of smokers using e-cigarettes in addition to conventional cigarettes in the long-term (Action on Smoking and Health (ASH), 2021).

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