Study shows vaping + smoking is riskier than e-smoking alone

Chris Burns - Dec 16, 2019, 2:09pm CST
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Study shows vaping + smoking is riskier than e-smoking alone

A study from the University of California showed that splitting one’s tobacco use between e-cigarettes and traditional cigarettes is more dangerous to one’s health than full-time vaping. The obvious least-risky choice here is avoiding tobacco outright, but the study centers on respiratory disease amongst tobacco users specifically. The continued use of traditional combustable tobacco appears to be just as risky to one’s health as smoking traditional cigarettes 100% of the time.

Use of tobacco in an e-cigarette and use of tobacco with fire (most commonly in a traditional cigarette) affect the body in different ways. While neither is entirely healthy, this study suggests that using both only serves to multiply the risk one takes of developing respiratory disease. “The finding that the effects of e-cigarettes and cigarette smoking were independent risks is consistent with the evidence of substantial differences in the proteins expressed in human lung epithelial cells derived from smoker and e-cigarette user airways,” wrote researchers Bhatta and Glantz.

That’s Dharma N. Bhatta, PhD, MPH, and Stanton A. Glantz, PhD., who did a study on a total of 19,475 (that’s over 19-thousand) tobacco users. They accounted for e-cigarette users, combustible tobacco use, and cigarette use. Results with analysis controlling for cigarette smoking alone yielded similar results to those respondents who were “combustible tobacco smokers.”

The risks for smoking pre-made cigarettes (the kind you buy in a pack) were were almost identical to those for any other “combustible tobacco.” That’s any tobacco you have to burn to ingest.

NOTE: This study is independent from studies on marijuana/THC product use in e-cigarettes. This study focused specifically on the use of tobacco products in traditional cigarettes, combustible tobacco, and tobacco ingested with e-cigarettes.

Their findings showed that using e-cigarettes to ingest tobacco resulted in lower risks for the respiratory conditions for which they tested. This includes COPT, Chronic bronchitis, emphysema, asthma, and “any lung disease.” Their study also showed that the risk of having had respiratory disease was “significantly associated with” former e-cigarette use (with tobacco). They also showed a similar risk for combustible tobacco smoking.

Per the study, “current e-cigarette use elevated the odds of developing incident respiratory disease by a factor of 1.29.” Compared to a control subject who’d never smoked an e-cigarette, someone who currently smokes tobacco with an e-cigarette has a 1.29x chance of developing incident respiratory disease.

Odds of developing incident respiratory disease:
• Former e-cigarette use: 1.31
• Current e-cigarette use: 1.29
• Former tobacco smoking: 1.16
• Current tobacco smoking: 2.56
• Current dual-user: 3.30

Per the study, “Dual use, the most common use pattern, is riskier than using either product alone.” You can learn more in the original study entitled “Association of E-Cigarette Use With Respiratory Disease Among Adults: A Longitudinal Analysis” if you wish. This paper has code DOI:10.1016/j.amepre.2019.07.028 and was published online December 16, 2019 in the American Journal of Preventive Medicine. This study was independent of the study being done by the CDC which shows the recent death count for vaping-related incidents in the USA.


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