Electronic Cigarettes: Impact on Lung Function and Fractional Exhaled Nitric Oxide Among Healthy Adults

Am J Mens Health. 2019 Jan-Feb;13(1):1557988318806073. doi: 10.1177/1557988318806073. Epub 2018 Oct 15.


Electronic cigarettes (e-cigarettes) are rapidly becoming an alternative form of nicotine consumption worldwide and a disruptive element in the global health diplomacy. This study aimed to investigate the impact of e-cigarettes on lung function and fractional exhaled nitric oxide (FeNO) among young healthy male adults. Sixty apparently healthy male volunteers were recruited and divided into two groups. Group 1 (e-cigarette-exposed group) consisted of 30 males who were daily e-cigarette users (age 27.07 ± 6.00 [mean ± SD] years). Group 2 (control group) consisted of 30 males who were not e-cigarette users (age 25.90 ± 7.72 [mean ± SD] years). Both groups were neither current nor former traditional tobacco users. Age, ethnicity, height, weight, and socioeconomic status were considered using a matched design to investigate the impact of e-cigarette use on lung function and FeNO. The lung function test parameters that were found to be significantly decreased in e-cigarette users compared to their control group were forced expiratory volume in the first second (FEV1), forced expiratory ratio (FEV1/FVC), forced expiratory flow-25% (FEF25%), forced expiratory flow-50% (FEF50%), forced expiratory flow-75% (FEF75%), forced expiratory flow-25%-75% (FEF25%-75%), and forced expiratory flow-75%-85% (FEF75%-85%). FeNO was also decreased in e-cigarette users, but it did not reach the level of significance. The use of e-cigarettes significantly impaired various lung function parameters and the pattern of impairment exhibited a peripheral obstructive airway involvement. These findings have a general message for the global health community on the potential harm of e-cigarettes on lung function.

Keywords: FeNO; e-cigarette; lung physiology; pulmonary function.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Breath Tests
  • Electronic Nicotine Delivery Systems / statistics & numerical data*
  • Exhalation / physiology*
  • Forced Expiratory Volume / physiology*
  • Healthy Volunteers
  • Humans
  • Lung Diseases / etiology*
  • Lung Diseases / physiopathology
  • Male
  • Nitric Oxide / analysis*
  • Reference Values
  • Respiratory Function Tests
  • Respiratory Mechanics
  • Risk Assessment
  • Risk-Taking
  • Sex Factors
  • Young Adult


  • Nitric Oxide