The relationship between electronic-cigarettes, chronic obstructive pulmonary

disease, and age

Tori Winton*, Kristen Peterson, Morgan Stasik, and Brandon Kistler, PhD, RD
Ball State University, Muncie, IN, USA

Smoking cigarettes increases the risk for the development of COPD; a chronic
inflammatory disease associated with nutritional implications. Many adults use e-
cigarettes as an alternative to cigarette smoke. However, less is known about the
influence of smoking status and age on the relationship between COPD and e-cigarette
use. Objective: Therefore, our objective was to examine the relationship between e-
cigarette usage and a diagnosis of COPD stratified by age and smoking status in a large
sample of US adults. Methods: Data from the US Behavioral Risk Factor Surveillance
system (BRFSS) 2016 questionnaire was analyzed using the chi-square test within the
Web Enabled Analysis Tool. The primary analysis of interest was the relationship
between using an e-cigarette and diagnosis of COPD. These analyses were controlled for
current smoking status and age (18-64 and 65+). Significance was set at 0.005 to account
for multiple comparisons. Results: The sample contained a total of 486,303 adults over
the age of 18. 73,147 (15.0%) adults reported using E-cigarettes at least once in their
lifetime and 38,758 (8.0%) had a diagnosis of COPD. There was a significant relationship
between E-cigarette usage and COPD (χ = 537.05, p<0.001). This relationship remained
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significant across all levels of age and smoking status (p<0.05 for all). Implications:
There is a correlation between adults who have used e-cigarettes and COPD that is
independent of age and current smoking status. More research is needed to examine the
influence of e-cigarettes in relation to chronic illnesses.