The meta -analysis states that vaping associated with a higher risk of

In a recent review published in the journal A group of researchers quantitatively determined the relationship between the use of an electronic cigarette (e-cigarette) and opportunities for the development of chronic obstructive lung disease (Pocket) In observation studies.

Most of the research included came from the United States, with only individual cohorts from China and South Korea, which may limit the generalization of results for other global populations.

Background

Every 4 seconds, someone around the world dies from COPD, a progressive disease that reduces air flow blamed almost exclusively for burning tobacco. Now e-cigarette devices, formally called electronic nicotine supply systems (tips), have flooded markets, promising safer inhalation, but generating an aerosol rich in ultraphic particles, aldehydes and metals.

Public health officials face a dilemma: Do the burn curb of smoking without sowing a new wave of COPD? Epidemiological signals appear, but the discoveries remain inconsistent and often disturbed by double use. Explanation of this relationship is necessary for clinicists, decision -makers and millions of vapers; That is why rigorous evidence is needed.

About the study

Investigators carried out a systematic review and meta -analysis, observing the preferred reporting positions for systematic reviews and meta -analyzes (Prisma) and registered a protocol in the international prospective register of systematic reviews (Prospero).

Scientists systematically searched Pubmed, Embase and Web of Science from their creation to February 15, 2024, pairing synonyms of e-cigarettes with COPD descriptors. They included adult observation tests that categorized the exhibition of e-cigarettes as the current, earlier or ever using effects estimates, such as the Affairs quotient (OR), risk factor (RR), risk factor (HR) or frequency factor (IRR) for COP.

Reviewers independently checked the records, distinguished data via a nested knowledge platform and assessed the quality of Newcastle-Ottawa (nose). Random meta -analysis in R version 4.4 was used to combine the sizes of logarithmically transmitted effects, and statistical heterogeneity was quantitatively determined using I² statistics.

Analyzes of sensitivity to exit and predefined sensitivity were limited to confirmed spirometry of diagnosis or high quality (nose ≥ 7) research tests. Podgroup analysis contrasted the cross -section with cohort projects. All risk estimates have been harmonized to OR for comparison before joining. The potential bias of the publication were visually checked using a funnel chart and formally assessed using the Egger regression test. Double -sided value p below the threshold of 0.05 means significance in the entire text.

Research results

Seventeen studies that meet all inclusion criteria contributed to data on over 4.3 million adults attracted mainly from the United States, with individual cohorts from China and South Korea. Twelve tests were cross -sectional and five were oblong; The sample sizes ranged from 8 087 to over 705,000 participants.

While two cohorts confirmed COPD with spirometry, using forced exhaust volume in 1 second to a forced relevant capacity (FEV1/FVC), fifteen tests were based on the diagnosis of doctors reported by themselves, which may introduce incorrectly classification prejudices. Nose quality results ranged from 5 to 9, and most of the tests are moderate to high quality.

After the harmonization of OR estimates, the collective analysis revealed that current e-cigarette users had a 48% greater chance of COPD than never users (OR = 1.48, 95% confidence interval (CI) 1,36-1.61) without heterogeneity between students (i i 0%).

Former users showed the largest relative excess: 84% higher opportunities (OR = 1.84, 95% CI 1.51-2.23), although with moderate inconsistency (i² = 56%). People who have ever experimented with e-cigarettes, regardless of the current status, still carried 79% higher opportunities (OR = 1.79, 95% CI 1.42–2,25) and again showed irrelevant heterogeneity (i i² = 0%).

In particular, all studies evaluating users ever-e-cigarette in this meta-analysis corrected to age, helping to ensure that the observed connection was not simply caused by age differences. Podgroup analysis suggested a nuance related to the project.

Cross-sectional studies have shown a stronger relationship for the current use of e-cigarettes (OR = 1.592, 95% CI 1.349–1,879) than cohort investigations, whose summary estimation dropped to 1.145 (95% CI 0.842–1.557) and the spread of the unit, suggesting limited longitudinal support. However, the contrast test based on the project did not reach statistical significance (p = 0.06).

Solidity assessments Confirmed stability: Removal of each study in turn has been shifted by collective or values ​​by three percentage points and limitation of the pool to high -quality articles (nose ≥ 7) Significant connections for those present (OR = 1.56, 95% CI 1.07–2.25) and former users (or = 2.57, 95% CI 1.91–3,46).

And vice versa, limiting the analysis to two cohort of verified spirometry reduced the connection and made it irrelevant (OR = 1.14, 95% CI 0.82-1.58), emphasizing that the connection is less solid when only objective COPD diagnoses are used.

The error of the publication seemed unlikely; The funnel chart was symmetrical, and Egger’s regression was given by p = 0.1449. It should be noted that these discoveries are connections from observation tests and do not determine the causality. In the context of traditional cigarette smoking remains a much stronger risk factor of COPD, with previous meta -analyzes reporting a quotient of opportunities of about 3.5 for current smokers compared to never smokers.

By translating interest into persons, the authors did not directly calculated the percentage of COPDs attributed to vaping; Such interpretations should be made carefully.

Conclusions

To sum up, aggregated evidence indicates that the exposure of e-cigarettes is associated with greater chances of COPD, even after taking into account the quality of the examination, the history of smoking and the analytical approach. The current vapers are in the face of about 50% of the increased risk, while former users maintain an even greater burden.

However, the reasons cannot be deduced, and the observed connections may be influenced by misleading factors, such as double use of flammable tobacco and earlier history of smoking. Clinicists should ask about vaping, advice on cessation and monitor the function of lungs, especially in younger adults, who could otherwise be overlooked.

Decision -makers must balance all the benefits of smoking in relation to the emerging respiratory persons and support longitudinal tests to clarify the causality. Further tests with objective COPD diagnoses are necessary, careful adaptation of the smoking status and a detailed assessment of the duration and intensity of the use of e-cigarettes to explain the long-term impact of VAPING on respiratory health.