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Related Experiment Video

Updated: Aug 18, 2025

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Cigarette‒E-cigarette Transitions and Respiratory Symptom Development.

Jonathan B Berlowitz1, Wubin Xie2, Alyssa F Harlow3

  • 1From the Department of Global Health, Boston University School of Public Health, Boston, Massachusetts; Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts.

American Journal of Preventive Medicine
|December 5, 2022
PubMed
Summary

Starting exclusive e-cigarette use after not using tobacco products increases wheeze symptoms. Switching from dual use to e-cigarettes significantly reduces cough and wheeze, suggesting potential benefits for smoking cessation.

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Area of Science:

  • Respiratory health
  • Tobacco harm reduction
  • Public health

Background:

  • E-cigarette use is linked to lung inflammation and disease.
  • Previous studies often used static measures of e-cigarette exposure.
  • Transitions between cigarettes and e-cigarettes may impact respiratory health differently.

Purpose of the Study:

  • To examine the association between transitions in tobacco and e-cigarette use and respiratory symptoms.
  • To evaluate the impact of switching product use on cough and wheeze development.

Main Methods:

  • Analysis of longitudinal data from the Population Assessment of Tobacco and Health study (2013-2019).
  • Categorization of participants into nonuse, exclusive e-cigarette use, exclusive smoking, or dual use over multiple waves.
  • Use of mixed-effects Poisson models to assess symptom development following product transitions.

Main Results:

  • Transitioning from nonuse to exclusive e-cigarette use was associated with a 1.62-fold increased incidence of wheeze.
  • Switching from cigarettes to e-cigarettes showed no significant change in dry cough or wheeze.
  • Transitioning from dual use to exclusive e-cigarette use led to significant reductions in both dry cough and wheeze.

Conclusions:

  • Initiating e-cigarette use as a non-tobacco user may increase respiratory issues like wheezing.
  • E-cigarette-assisted smoking cessation warrants further investigation due to symptom reduction in dual users who switch.
  • Understanding product transition dynamics is crucial for assessing e-cigarette risks and benefits.