Short-Term Effect of E-Cigarette Use on Spirometry and FENO on Young Adults

Abstract

Background: There is limited research on the effects of vaping with electronic nicotine delivery systems (ENDS). Inflammation markers and morphological lung changes have been shown within 24 hours of vaping in cell studies (doi:10.1016/j.tox.2016.07.020). There are several factors that could possibly contribute to decreased lung function and increased inflammation regarding vaping including the flavoring compounds. The aim of this pilot study was to determine if clinical measures could detect changes in lung function soon after vaping. Methods: This IRB-approved study recruited healthy volunteers (no fever and self-reported health status, ages 21-28, 71% female). Baseline testing (prior to vaping) involved participants abstaining form vaping for 12 hours prior to measurement of forced expiratory volume in first second (kg/m²), forced vital capacity (FVC), peak expiratory flow rate (PEFR) and fractional exhaled nitric oxide (F_ENO). Participants then vaped for 10 minutes, waited 30 minutes, and then repeated testing. The participants were recruited based upon age and vaping at least 3 times per week. Manufacturer guidelines for F_ENO testing and American Thoracic Society guidelines for spirometry were followed. Results: Basic spirometry showed no significant change after vaping occurred. The peak flow had a modest decrease and F_ENO values increased but still remained within normal range for the seven subjects. The pre- and post F_ENO changes for three participants who vaped >5 times per week exhibited a 22.7% percent change increase. Conclusions: There were no significant short-term effects, but these findings cannot be extrapolated to long-term effects of ENDS use. Study limitations include small sample size, a narrow age range and excluding those with lung conditions. It is unknown if 30 minutes post-vaping is adequate to observe the maximum effect on F_ENO. Also, each participant used their personal e-juice and ENDS device (the same flavor/brand/ingredients were not required). Some participants used e-juice with nicotine while others did not. It would be interesting to see if a nicotine component used by the entire sample group has an independent effect. Asthmatics and those with compromised airways may be more susceptible to lung function decline with e-cigarette use. Next steps for future investigation could explore the effect of ENDS on specific chronic lung disease groups. Disclosures: Loan of NIOX device and disposable patient filters provided by Circassia Inc.