Tobacco Harm Reduction Among COPD Smokers Who Switched to E-Cigarettes


Lindsey Stroud


A December 2016 study published in Respiratory Research examined the effects of e-cigarette use in smokers with COPD. The authors “conducted a retrospective chart review of patients with COPD” that had reported daily vapor product use.

Data was collected from three clinic visits, with follow-up data collected at 12 and 24 months after the initial baseline visit.

At 24 months, the authors collected complete data from 48 COPD patients that “had mild to very serious disease.” Of the 48 patients, 24 patients (50 percent) “reported regular daily [e-cigarette] use on two follow-up visits over the observation period of 24-months.” The authors also identified 24 COPD “matched controls.”

In the e-cigarette user group, the authors noted a “substantial reduction in conventional cigarette consumption” from 21.8 cigarettes per day at baseline, to 1.8 at 12 months, and 1.58 at 24 months. There were “no significant change” in the control group.

Of the 24 e-cigarette users, 13 reported complete abstinence from combustible cigarettes. Of the 11 that reported dual use, “a significant reduction in convention cigarette consumption was also observed.” Indeed, among dual users, combustible cigarette use decreased from 23.7 cigarettes a day at baseline, to 4 cigarettes per day at 12 months, and 3.5 cigarettes per day at 24 months.

The authors found that among all e-cigarette users, combustible cigarette used decreased by more than 75 percent from baseline.

The authors reported “a significant reduction in annual COPD exacerbations” in e-cigarette users, but no changes in the control group. There was also a “significant reduction in COPD exacerbations … observed in dual users, but only at 24 months.”

The authors concluded that e-cigarette use “may help smokers with COPD attenuate conventional cigarette consumption or remain abstinent, as well as improve subjective and objective COPD outcomes.”

Implications: This study offers evidence that the use of e-cigarettes can improve the health of persons with smoking-related health issues. Policymakers should take these findings into consideration when determining regulations on e-cigarettes and vapor products.


Background: Electronic cigarettes (ECs) are battery-operated devices designed to vaporise nicotine, which may help smokers quitting or reducing their tobacco consumption. There is a lack of data on the health effects of EC use among smokers with COPD and whether regular use results in improvement in subjective and objective COPD outcomes.

We investigated long-term changes in objective and subjective respiratory outcomes in smokers with a diagnosis of COPD who quit or reduced substantially their tobacco consumption by supplementing with or converting only to ECs use.

Methods: We conducted a retrospective chart review of patients with COPD to identify those reporting regular daily use of ECs on at least two follow-up visits at 12- (F/up1) and 24-months (F/up2). Regularly smoking COPD patients were included as a reference group.

Results: A marked reduction in cigarette consumption was observed in ECs users. A significant reduction in COPD exacerbations was reported in the COPD EC user group, their mean (±SD) decreasing from 2.3 (±1) at baseline to 1.8 (±1; p = 0.002) and 1.4 (±0.9; p < 0.001) at F/up1 and F/up2 respectively. A significant reduction in COPD exacerbations was also observed in ECs users who also smoked conventional cigarettes (i.e. ‘dual users’). COPD symptoms and ability to perform physical activities improved statistically in the EC group at both visits, with no change in the control group.

Conclusions: These findings suggest that ECs use may aid smokers with COPD reduce their cigarette consumption or remain abstinent, which results in marked improvements in annual exacerbation rate as well as subjective and objective COPD outcomes.


Tobacco and Alcohol News Analysis and Commentary, Researchers Tell Public that Vaping Causes COPD as Scientific Rigor in Tobacco Control Drops to an All-Time Low, 2019

Tobacco and Alcohol News Analysis and Commentary, Switching to Vaping Improves Health of Smokers with COPD, 2016

E-Cigarette Research, A new study in mice provides no information for smokers but verifies e-cigarettes are less harmful, 2015

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