E-cigarette users exhibit lower pulmonary function compared to tobacco smokers and non-smokers

Abstract

Abstract Introduction: The global rise in electronic cigarette (e-cigarette) use has raised concerns due to limited evidence regarding its impact on respiratory health. Objective: To evaluate and compare pulmonary function among e-cigarette users, tobacco smokers, and non-smokers aged 18 to 40 years. Methods: In this cross-sectional study, 45 participants were allocated into three groups: non-smokers (control), tobacco smokers, and e-cigarette users. All participants underwent spirometry testing. Inclusion criteria required a minimum of one year of consistent smoking or vaping. Individuals with less than three months of exposure, bronchodilator use, or inability to perform the test were excluded. Results: The mean age was 25.47 ± 3.93 years for the control group, 23.2 ± 3.3 years for tobacco smokers, and 21.53 ± 3.27 years for e-cigarette users. Dyspnea and wheezing were more frequently reported by tobacco smokers, while cough and wheezing predominated among e-cigarette users. Spirometric analysis revealed no significant differences in forced vital capacity (FVC) among groups. However, e-cigarette users exhibited significantly lower forced expiratory volume in one second (FEV1) and FEV1/FVC ratio compared to non-smokers, and lower FEV1/FVC compared to tobacco smokers, indicating early signs of airflow obstruction. Conclusion: Despite similar FVC values, e-cigarette users demonstrated reduced expiratory performance, as evidenced by lower FEV1 and FEV1/FVC ratio. These findings suggest that e-cigarette use may be associated with early functional impairment of pulmonary function, potentially exceeding the impact observed in conventional tobacco smokers.