Association between e-cigarette exposure and ventilation homogeneity in young adults: A cross-sectional study

Eur Respir J. 2024 Nov 27:2401675. doi: 10.1183/13993003.01675-2024. Online ahead of print.

Abstract

Background: The number of young people who use electronic cigarettes (e-cigarettes) is rising. It remains unclear whether e-cigarettes use impairs lung function. We aimed to compare ventilation distribution between young adults exposed to e-cigarettes with an unexposed group.

Methods: Study participants included otherwise healthy young adults (18 to 24 years) who self-reported e-cigarette use, and participates who had no history of e-cigarette, tobacco or cannabis exposure. Exposure to e-cigarettes was defined using three measures 1) ever exposed, 2) daily use, and 3) puff frequency, which includes: none (unexposed), low (1-2 puffs/hour), moderate (3-4 puffs/hour) and heavy (5+ puffs/hour). Ventilation distribution was measured using the multiple breath washout test and reported as lung clearance index (LCI).

Results: A total of 93 participants were recruited, 38 unexposed and 41 exposed participants had LCI measures. The exposed group consisted predominately of participants who used flavoured e-liquids (94.5%) that contained nicotine (93.5%). The magnitude and direction of the difference in LCI across the exposure definitions was similar. Compared with the unexposed group, in the unadjusted models LCI was higher in those with any e-cigarette use (mean difference 0.16 units; 95% CI 0.004; 0.31), daily users (mean difference 0.11; 95% CI 0.06; 0.28) and heavy users (mean difference 0.22; 95% CI 0.03; 0.41).

Conclusion: This preliminary work suggests that LCI may be a useful biomarker to measure the effects of e-cigarette use on ventilation distribution and to track early functional impairment of the small airways.