E-Cigarette Use Associated With Increased Odds of Asthma and COPD

Researchers evaluated the relationship between e-cigarettes and obstructive pulmonary diseases, taking into account age, gender, ethnicity, and body mass index.

The following article is a part of conference coverage from CHEST 2021, being held virtually from October 17 to October 20, 2021. The team at Pulmonology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from CHEST 2021.


 The use of e-cigarettes increases the odds of developing asthma and chronic obstructive pulmonary disease (COPD), particularly in older adults, women, and Hispanic individuals, according to new research presented at the CHEST 2021 Annual Meeting, held virtually October 17 to 20.

In the study, investigators analyzed pooled participant data from the Behavioral Risk Factor Surveillance System (BRFSS) from the years 2016, 2017, and 2018. The overall cohort included 741,870 adult participants aged 18 years and above. Researchers estimated the odds ratio (OR) between e-cigarette use and asthma or COPD in crude analyses and analyses adjusted for confounding by age, sex, race, income, cigarette smoking, and body mass index.

A total of 32,114 (4.3%) participants in the pooled cohort were current e-cigarette users, while the remaining 709,756 (95.7%) participants were classified as never users. The current use of e-cigarettes was associated with higher odds of asthma and COPD in the unadjusted analyses (asthma: OR, 1.37; 95% CI, 1.29-1.46; COPD: OR, 1.69; 95% CI, 1.59-1.80) and the adjusted analyses (asthma: OR, 1.21; 95% CI, 1.13-1.29; COPD: OR, 1.43; 95% CI, 1.34-1.54).

The odds of asthma with current e-cigarette use were higher in participants between 55 and 64 years of age (OR, 1.42; 95% CI, 1.22-1.64), women (OR, 1.33; 95% CI, 1.22-1.45), and Hispanic individuals (OR, 1.62; 95% CI, 1.28-2.05). Additionally, the odds of COPD with current e-cigarette use were higher for women (OR, 1.57; 95% CI, 1.43-1.71) and Hispanic individuals (OR, 1.71; 95% CI, 1.28-2.28). In contrast to asthma, participants aged 65 years and above had higher odds of COPD with current e-cigarette use compared with those who were younger than 65 years of age (OR, 2.09; 95% CI, 1.81-2.41).

In their conclusion, the researchers emphasized the importance of regular follow-up and monitoring of signs and symptoms of asthma and COPD in patients who smoke e-cigarettes daily. Additionally, the researchers note that clinicians should provide assistance to these patients in regard to early COPD and asthma prevention, which may include smoking cessation advice. “This is important because e-cigarette has been perceived to be a safer alternative to combustible tobacco use despite their detriments to health,” the researchers explained.


Onaku E, Ajayi A, Babayale O, et al. The association between electronic cigarette use and obstructive pulmonary diseases. Presented at: CHEST 2021; October 17-20, 2021; Orlando, FL/Virtual. Abstract A1898.