Do e-cigarettes cause COPD or is there a COPD epidemic in adolescents in South California?

By Dr Farsalinos

A new study published in the American Journal of Respiratory and Critical Care has been widely covered by the media as showing that “e-cigarettes double the risk of bronchitis in teenagers”. The official press statement, which is released from the American Thoracic Society, is more moderate. It is titled: “E-cigarettes may harm teens’ lung health”. In the text, it is mentioned that:

The study found that when compared to those who never tried e-cigarettes, the risk of the respiratory symptoms was

  • approximately 85 percent higher among past users, and
  • double among current users


But there is a problem with these statements. They are different from what the study found.

The study recruited adolescents (aged 16-18 years) but did not define those with chronic bronchitis based on physician diagnosis or medications intake. Instead, they ASKED them if they had “daily cough for 3 months in a row, congestion or phlegm other than when accompanied by a cold, or bronchitis in the previous 12 months”. Therefore, they based the “diagnosis” on a response to a question. However, all media articles discuss about lung disease and bronchitis. The latter is also wrong, because there is an acute (more common in adolescents) and a chronic (rare in adolescents) form of bronchitis. The question specifically addressed the definition of chronic bronchitis only. I will mention later in my comment why it is important to make the distinction.

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