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

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 (FEV₁), forced expiratory ratio (FEV₁/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.