Electronic Cigarettes: Impact on Lung Function and Fractional Exhaled Nitric Oxide Among Healthy Adults

Abstract

Electronic cigarettes (e-cigarettes) are rapidly becoming an alternative form of nicotine consumption worldwide and a disruptive element in the global health diplomacy. This study aimed to investigate the impact of e-cigarettes on lung function and fractional exhaled nitric oxide (FeNO) among young healthy male adults. Sixty apparently healthy male volunteers were recruited and divided into two groups. Group 1 (e-cigarette-exposed group) consisted of 30 males who were daily e-cigarette users (age 27.07 ± 6.00 [mean ± SD ] years). Group 2 (control group) consisted of 30 males who were not e-cigarette users (age 25.90 ± 7.72 [mean ± SD ] years). Both groups were neither current nor former traditional tobacco users. Age, ethnicity, height, weight, and socioeconomic status were considered using a matched design to investigate the impact of e-cigarette use on lung function and FeNO. The lung function test parameters that were found to be significantly decreased in e-cigarette users compared to their control group were forced expiratory volume in the first second (FEV 1 ), forced expiratory ratio (FEV 1 /FVC), forced expiratory flow—25% (FEF 25% ), forced expiratory flow—50% (FEF 50% ), forced expiratory flow—75% (FEF 75% ), forced expiratory flow—25%–75% (FEF 25%–75% ), and forced expiratory flow—75%–85% (FEF 75%–85% ). FeNO was also decreased in e-cigarette users, but it did not reach the level of significance. The use of e-cigarettes significantly impaired various lung function parameters and the pattern of impairment exhibited a peripheral obstructive airway involvement. These findings have a general message for the global health community on the potential harm of e-cigarettes on lung function.