Vaping and Asthma – Everything You Need to Know

By Dr. Annie Macpherson
Updated: 2019-09-14

Vaping With Asthma

Vaping With Asthma

Asthma causes your lungs to constrict making it difficult to breathe. Experts still don’t know if vaping long-term could cause asthma.

Let’s take a closer look at some of the current research. We’ve split the data into positive or neutral results, and negative results:

Negative Results
– A 2014 study in mice showed e-cigarette exposure caused lung hyperreactivity, a symptom of asthma [2] .

– A study designed to improve safety for food industry workers labelled over 1000 food-grade flavorings as potential respiratory hazards. Flavorings listed carry the potential to cause asthma or make it worse, and many are found in e-cigarettes. Common e-cigarette flavorings on this list included: diacetyl, acetoin, 2,3-pentanedione (buttery flavors), camphor and cyclohexanone (minty flavors), benzaldehyde (cherry or almond flavors), cinnamaldehyde (cinnamon flavor), and isoamyl acetate (banana flavor) [10] .

– Long term exposure to propylene glycol (PG – the base of many e-liquids) emitted from cleaning substances and paint is considered a significant risk factor in the development of asthma in young children [15] .

– E-cigarette vapor is made up of ‘ultra-fine’ particles, similar in size to cigarette smoke. Inhaling particles in this size range is known to irritate the lungs and cause inflammation (a symptom and cause of asthma) as these particles can reach the deepest parts of the lungs [16] .

Positive/neutral Results
– A study of thirty asthmatic and non-asthmatic individuals showed that after one hour of vaping nicotine- and flavor-free e-cigarettes, people with asthma don’t experience more short-term side-effects than people without asthma [7] . This supports earlier research that the short-term effects of vaping are minimal [8, 9].

– Asthmatic smokers who switched to e-cigarettes displayed improved long-term respiratory symptoms and lung function, but no change in how frequently they had asthma attacks [12].

– There have been no reported cases of asthma caused by vaping

Is Vaping Bad for Asthma?

It seems like vaping does not dramatically affect asthmatic symptoms in the short-term, and could even improve symptoms if you are using vaping as a tool to stop smoking [12]. But, some e-cigarette flavors and bases may have the potential to cause asthmatic symptoms long term. Research into the effects of inhaling different constituents of e-liquids, outside of vaping, suggests there is potential for vaping in general to make asthma worse. New research also suggests nicotine alone has the capacity to induce symptoms of asthma in mice [14]. Vaping can cause mild, short-term irritation the lungs and chest, and this may be enough to exacerbate asthma in some individuals.

It is important to remember that there is very limited research into the effects of long-term vaping on asthma.

Asthma and Second-Hand Vaping

A 2010 study showed that young children exposed long-term to PG from fresh paint and cleaning solutions in their homes were much more likely to get asthma. This means that if you are vaping a lot in confined spaces, PG-based second-hand vapor may have an effect on young children, and potentially induce asthma [15].

The ultra-fine particle size of second-hand vapor also means it can be considered a lung irritant, that may make somebody else’s existing asthma near you worse in the short term [16].

Can You Get Asthma From Vaping?

No reported cases of asthma caused from vaping exist, and we know from research that vaping does not affect asthma in the short-term. However, experts still don’t know if vaping can cause asthma after long-term use, and current opinion is that vaping is not entirely harm-free.

Although PG is generally considered safe, we still don’t really know how inhaling it affects adults long-term. Entertainment industry workers exposed long-term to PG-based theatrical fog displayed no changes in lung function right after exposure, but in general had significantly worse lung function than non-entertainment workers [11]. This suggests that inhaling PG vapor over long periods of time could have made their lung function worse. Likewise, these results could mean that vaping PG-based e-liquids could make your asthma worse in the long term, particularly if you are a non-smoker.

Conclusion

In this article, we’ve tried to summarise how vaping might affect your asthma. It seems like vaping will have very few short term side effects for people with asthma, but there is still potential that it might cause damage in the long term or cause an asthma attack. It really comes down to personal circumstances (for example, whether you smoke or not) as to whether you deem vaping worth any potential risks to your lung health if you have asthma. The key take-home points from this article are:

– Inhaling anything other than clean air will, no doubt, affect your asthma in some way. 

– Asthmatic smokers will likely see big improvements in their lung function if they switch to e-cigarettes.

– Long term exposure to PG vapor can slowly make your lung function worse and cause asthma in children.

– Some food-grade e-cigarette flavorings are known lung irritants, and carry the potential to cause asthma, or make it worse.

– People with asthma should not experience any more short-term side-effects of vaping than non-asthmatic people.

– We will not know the cumulative, long-term effects of vaping on asthma for at least another decade.

Sources

1. Reid, Keshia M et al. “Tobacco Product Use Among Youths With and Without Lifetime Asthma – Florida, 2016” MMWR. Morbidity and mortality weekly report vol. 67,21 599-601.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6038902/

2. E-cigarette exposure induces pathological responses that result in lung tissue destruction and airway hyperreactivity in mice. Patrick Geraghty, Jules Dabo, Itsaso Garcia-Arcos, Neville Cummins, Robert Foronjy. European Respiratory Journal Sep 2014, 44 (Suppl 58) 3435;
http://erj.ersjournals.com/content/44/Suppl_58/3435

3. Discov Med. 2016 Feb;21(114):99-108. Persisting long term benefits of smoking abstinence and reduction in asthmatic smokers who have switched to electronic cigarettes.
Polosa R, Morjaria JB, Caponnetto P, Caruso M, Campagna D, Amaradio MD, Ciampi G, Russo C, Fisichella A.
https://www.ncbi.nlm.nih.gov/pubmed/27011045

5. Ann Epidemiol. 2016 Dec;26(12):865-869. Prevalence of and beliefs about electronic cigarettes and hookah among high school students with asthma. Fedele DA, Barnett TE, Dekevich D, Gibson-Young LM, Martinasek M, Jagger MA.
https://www.ncbi.nlm.nih.gov/pubmed/27839657/

6. Am J Prev Med. 2016 Oct;51(4):446-53. E-Cigarette Use Among Florida Youth With and Without Asthma. Choi K, Bernat D.
https://www.ncbi.nlm.nih.gov/pubmed/27085691/

7. Respir Res. 2017 Feb 10;18(1):33. Acute effects of nicotine-free and flavour-free electronic cigarette use on lung functions in healthy and asthmatic individuals. Boulay MÈ, Henry C, Bossé Y, Boulet LP, Morissette MC.
https://www.ncbi.nlm.nih.gov/pubmed/28183298/

8. BMC Pulm Med. 2015 Oct 12;15:120. Short-term effects of a nicotine-free e-cigarette compared to a traditional cigarette in smokers and non-smokers. Ferrari M, Zanasi A, Nardi E, Morselli Labate AM, Ceriana P, Balestrino A, Pisani L, Corcione N, Nava S.
https://www.ncbi.nlm.nih.gov/pubmed/26459355/

9. Inhal Toxicol. 2013 Feb;25(2):91-101. Acute impact of active and passive electronic cigarette smoking on serum cotinine and lung function. Flouris AD1, Chorti MS, Poulianiti KP, Jamurtas AZ, Kostikas K, Tzatzarakis MN, Wallace Hayes A, Tsatsakis AM, Koutedakis Y.
https://www.ncbi.nlm.nih.gov/pubmed/23363041/

10. Alert N. Preventing Lung Disease in Workers Who Use or Make Flavorings. 2003. (NIOSH Publication No. 2004-110).
https://www.cdc.gov/niosh/docs/2004-110/pdfs/2004-110.pdf

11. Effects of theatrical smokes and fogs on respiratory health in the entertainment industry.
Varughese S, Teschke K, Brauer M, Chow Y, van Netten C, Kennedy SM. Am J Ind Med. 2005 May; 47(5):411-8.
https://www.ncbi.nlm.nih.gov/pubmed/15828073/

12. Discov Med. 2016 Feb;21(114):99-108. Persisting long term benefits of smoking abstinence and reduction in asthmatic smokers who have switched to electronic cigarettes.
Polosa R, Morjaria JB, Caponnetto P, Caruso M, Campagna D, Amaradio MD, Ciampi G, Russo C, Fisichella A.
https://www.ncbi.nlm.nih.gov/pubmed/27011045

13. 7. Farsalinos KE, Romagna G, Tsiapras D, Kyrzopoulos S, Voudris V. Characteristics, perceived side effects and benefits of electronic cigarette use: a worldwide survey of more than 19,000 consumers. Int J Environ Res Public Health. 2014;11(4):4356–4373.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025024/

14. Garcia-Arcos I, Geraghty P, Baumlin N, et al Chronic electronic cigarette exposure in mice induces features of COPD in a nicotine-dependent manner. Thorax 2016;71:1119-1129.
https://thorax.bmj.com/content/71/12/1119

15. PLoS One. 2010 Oct 18;5(10):e13423. Common household chemicals and the allergy risks in pre-school age children. Choi H, Schmidbauer N, Sundell J, Hasselgren M, Spengler J, Bornehag CG.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3037050/

16. Grana, R; Benowitz, N; Glantz, S. “Background Paper on E-cigarettes,” Center for Tobacco Control Research and Education, University of California, San Francisco and WHO Collaborating Center on Tobacco Control. December 2013
http://arizonansconcernedaboutsmoking.com/201312e-cig_report.pdf

17. Clapp, Phillip W and Ilona Jaspers. “Electronic Cigarettes: Their Constituents and Potential Links to Asthma” Current allergy and asthma reports vol. 17,11 79. 5 Oct. 2017, doi:10.1007/s11882-017-0747-5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995565/

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Dr. Annie Macpherson
Dr. Annie Macpherson

Annie has a PhD in Genome Stability from the University of Sussex. She has first-hand experience in cancer and human disease research. This allows her to provide us with new and unbiased insights into the ongoing research of the public and health effects of vaping. She loves an adventure, and has travelled through South East Asia and Australia working for Vaping Insider.