Abstract
BackgroundKnowledge about the health effects of e-cigarette use (or vaping) among past and current combustible cigarette users is limited. Several studies have assessed vaping-related adverse events (AEs) and beneficial health effects, however, most studies focused on AEs in general and examined only a few physiological changes that vapers experience. This study aims to explore self-reported AEs and perceived health changes due to e-cigarette use among Hungarian adult e-cigarette-only users (former smokers who switched completely to e-cigarette use) and dual users (smokers who use e-cigarettes and combustible tobacco cigarettes concomitantly).MethodsA cross-sectional, web-based survey of 1042 adult Hungarian e-cigarette users was conducted in 2015. Participants reported AEs and changes in physiological functions since they switched from smoking to e-cigarette use or while dually using e-cigarettes and combustible cigarettes. Confirmatory factor analysis with covariates was applied to explain perceived health changes due to e-cigarette-only use and dual use.ResultsDual users (17.6%) were significantly more likely to report AEs of vaping than e-cigarette-only users (26.2% vs. 11.8%, p < 0.001). Experiencing health improvements were significantly more likely among e-cigarette-only users than for dual users for all surveyed physiological functions. E-cigarette-only users reported larger effects of vaping on sensory, physical functioning, and mental health factors compared to dual users. Self-reported changes in sensory and physical functioning were significantly higher among individuals using e-cigarettes more than a year and people who were past heavy smokers (smoked ≥20 cigarettes per day). Gender was related to sensory improvement only; males reported greater improvement than females.ConclusionsThe majority of e-cigarette-only users reported more perceived beneficial changes in physiological functions and fewer AEs than dual users. Perceived short-term benefits of e-cigarette use may reinforce users despite the uncertainty of long-term health consequences. Health professionals should provide balanced information regarding the possible short- and long-term positive and negative health effects of e-cigarette use during consultations with patients.
Highlights
Knowledge about the health effects of e-cigarette use among past and current combustible cigarette users is limited
Some studies have shown that e-cigarettes may emit substantially less toxic substances than combustible cigarettes [3, 4], others have found higher metal and silicate concentration in the aerosol compared to combustible cigarette smoke [5], while nicotine intake from advanced generation devices is similar to that of tobacco cigarettes [1]
The majority of e-cigarette-only users reported vaping more than 20 times a day while only half of dual users responded
Summary
Knowledge about the health effects of e-cigarette use (or vaping) among past and current combustible cigarette users is limited. Advocates of e-cigarettes emphasize the harm reduction potential of these products as substitutes for combustible tobacco among persons trying to quit or reducing the amount of cigarette smoking (aka dual users). Dual use will undermine the potential harm reduction due to the known short- and long-term health effects of smoking [6]. Opponents argue that there are unknown long-term risks of e-cigarette use (or vaping). These include the potential for negative health effects, e-cigarettes serving as a gateway to traditional tobacco use among youth, and a decreased likelihood of conventional cigarette smoking cessation [6, 7]. Some data demonstrate a favorable public health impact of switching from cigarettes to e-cigarette use [8], while others are more cautious, emphasizing the uncertainties of health harm, instigating tobacco initiation among youth, and maintaining addiction among adults [9]
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