Asthma and Vaping: Are The Two Compatible?

Asthma and Vaping

We are all well informed of the perils of smoking. To counter this, many have switched to a new modern form of smoking - vaping or e-cigarettes - which is now, owing to its popularity and suggested reduced health risks, a billion dollar industry.

An e-cigarette is a reusable battery-powered device that has the ability to produce aerosols or vaporised content, which is then mixed with nicotine and other additives and flavours. While it is believed to be a safer alternative to smoking, there has not been significant scientific research to support this claim.

There have been recent cases and reports suggesting that vaping can cause long-term health problems, and aggravate or increase the severity of  pre-existing lung problems such as asthma. Asthma is a form of chronic obstructive pulmonary disease (COPD), where the airways are narrow and lead to the production of excess mucus. This causes wheezing and shortness of breath. It is important to understand the relationship between vaping and asthma in order to make informed decisions regarding the use of e-cigarettes and vapes.

What is Vaping?

Vaping refers to the inhalation of vapours (aerosol) from a vape (e-cigarette device). The devices use a rechargeable battery to heat nicotine, chemicals, and other flavours present in the vape liquid that is usually inserted into the vape tank. Some devices use a pod system while other devices, such as pen devices, are mouth-to-lung systems.. 

How Vaping Affects Asthma

A recent study has shown the effects of cigarettes and e-cigarettes on cardiac and lung problem related symptoms. The study highlights the increase in symptoms such as difficulty breathing.1 While mucus linings are present in all individuals to provide protection by entrapping bacteria and other foreign particles that can enter the airway tract, people who already have asthma have trouble breathing due to excess mucus in their airway tracts.

The systems in e-cigarettes and vapes described above contain an atomisation chamber, which heats the liquid. This vapour has chemicals that narrow the airways, which are already constricted in asthma sufferers, and can also induce inflammation due to their toxic nature. In cases of allergic asthma, it can also cause inflammation; this means that any allergen, pollutant, or irritant that enters the airway system can trigger an immune response from the body to fight the foreign substance.

While the defensive response is supposed to protect the body, allergic asthma causes this to misfire. The symptoms are similar to that of asthma (wheezing, coughing, shortness of breath). Vaping, by increasing inflammation, can also increase the severity of symptoms experienced during allergic asthma, as evidenced by research.2

Does vaping affect asthmatics?

Vapes affect the respiratory system and the immune system, which are the primary systems also involved in asthma. A study has discovered that flavouring additives, such as diacetyl that gives a creamy flavour, have been found to cause problems associated with breathing upon inhalation.3 There is also increasing evidence supporting the fact that using vapes can increase the susceptibility of the expression of adverse symptoms in asthmatic patients.4

Difficulty breathing

Asthma is caused when irritants enter the system through the airway systems. These irritants are recognised by the body as foreign and can induce an immune response. Therefore, any irritant or asthmatic trigger can lead to an asthma attack.

Based on this principle, any toxins present in vapour smoke, upon inhalation, can potentially cause an asthmatic attack. The irritants or triggers can also increase the severity of symptoms of asthma. Difficulty in breathing can cause discomfort and pain.

Increased symptoms

Vaping  can aggravate asthmatic symptoms. 

A study of Korean High School students in 2016 suggested the potential link between e-cigarette usage and asthma symptom severity. The research was suggestive of increased symptom expression in students using vapes, and who were patients of asthma, causing increased high school absences.5

This can be linked to the presence of irritants in vape liquids that are toxic. Another study was indicative of the presence of respiratory problems post-e-cigarette usage in asthmatic patients. This included airway irritation and slow recovery.6 

Does second-hand vaping affect asthma?

Altered immune response

There is evidence to suggest that vaping has the potential to alter the immune response within the body. These immune responses are similar to those triggered in asthma patients. The study was indicative of the fact that e-cigarette chemicals can stop the movement of immune cells called macrophages (alveolar macrophages, based in the lungs), across the body to remove dust, pollutants, allergens, and other triggers of asthma.

Vaping in small, enclosed spaces and being exposed to this smoke can be harmful. This is particularly  due to the absence of airflow to reduce the concentration of toxins present in the air. Thus it is vital to avoid these situations, and people who vape should consider doing so in open spaces or designated smoking areas whilst treating vaping protocols in ways similar to smoking protocols.

What are the health effects of vaping?

The side effects of vaping differ amongst people and include, but are not limited to, the following symptoms:

  • Abdominal pain
  • Chest pain 
  • Coughing
  • Dehydration
  • Dizziness
  • Dry mouth
  • Dry throat
  • Gum problems
  • Headache 
  • Increased heart rate 
  • Nausea 
  • Shortness of breath
  • Sore throat

These symptoms are primarily due to the presence of the chemicals in the vapours released from the vape. The harmful chemicals have effects ranging throughout the body, primarily involving the cardiovascular system, pulmonary system, and the immune system.  However, more research is needed to fully understand the effects of e-cigarettes on health, asthmatic disease, and other lung problems. 

Conclusion

Vaping is usually perceived as the lesser of two evils as compared to smoking cigarettes. However, it is vital to understand that we do not have a significant amount of knowledge from scientific research in these areas. Authority bodies, including the government, have imposed bans and/or restrictions on vape products to decrease their usage, indicating the potential chemical toxicity of the usage of vapes.

It is evident that e-cigarettes are harmful to both non-asthmatic and asthmatic patients. Therefore, it is advisable to consider stopping the use of these devices, especially if you suffer from asthma. It can further increase the severity of your symptoms and cause more discomfort.

It can also reduce the effects of medication as vaping essentially harms the improvement process by introducing harmful toxins into the system. It can increase coughing, wheezing, shortness of breath, and more. To conclude, although scientific research is not that extensive in this area, it is vital to consider the negative effects of vaping and possibly reduce or avoid consumption. 

For more information on quitting smoking for people with asthma, click here

References: 

  1. Wang, J., Olgin, J., Nah, G., Vittinghoff, E., Cataldo, J., Pletcher, M., & Marcus, G. (2018). Cigarette and e-cigarette dual use and risk of cardiopulmonary symptoms in the Health eHeart Study. PLOS ONE, 13(7), e0198681. doi: 10.1371/journal.pone.0198681
  2. Scott, A., Lugg, S. T., Aldridge, K., Lewis, K. E., Bowden, A., Mahida, R. Y., Grudzinska, F. S., Dosanjh, D., Parekh, D., Foronjy, R., Sapey, E., Naidu, B., & Thickett, D. R. (2018). Pro-inflammatory effects of e-cigarette vapour condensate on human alveolar macrophages. Thorax, 73(12), 1161–1169. https://doi.org/10.1136/thoraxjnl-2018-211663
  3. Clapp, P. W., & Jaspers, I. (2017). Electronic Cigarettes: Their Constituents and Potential Links to Asthma. Current allergy and asthma reports, 17(11), 79. https://doi.org/10.1007/s11882-017-0747-5
  4. Clapp, P. W., Peden, D. B., & Jaspers, I. (2020). E-cigarettes, vaping-related pulmonary illnesses, and asthma: A perspective from inhalation toxicologists. The Journal of allergy and clinical immunology, 145(1), 97–99. https://doi.org/10.1016/j.jaci.2019.11.001
  5. Cho, J., & Paik, S. (2016). Association between Electronic Cigarette Use and Asthma among High School Students in South Korea. PLOS ONE, 11(3), e0151022. https://doi.org/10.1371/journal.pone.0151022
  6. Polosa, R., Cibella, F., Caponnetto, P. et al. Health impact of E-cigarettes: a prospective 3.5-year study of regular daily users who have never smoked. Sci Rep 7, 13825 (2017). https://doi.org/10.1038/s41598-017-14043-2

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Ishana Gole

Master of Science - MS, Bioscience Entrepreneurship, UCL (University College London)
Ishana is a Biomedical Science student with a keen interest in neuroscience and past experience in online consulting, marketing and advertising.

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