Abstract Rationale E-cigarettes have become a large public health concern over the last decade regarding their use as an alternative to combustible tobacco products and the lack of long-term data to prove their safety. Few retrospective cohort studies exist comparing the outcomes between “cigarette-only groups” and “cigarette plus e-cigarette groups”. Methods Using TriNetX, a global federated health research network providing access to electronic medical records across 153 large healthcare organizations under the Global Collaborative Network, two cohorts were arranged: Cigarette-only (Cig-only) with 4,560,594 patients and Cigarette plus E-Cigarette (Dual Use) with 3,893 patients. After propensity score matching, an outcomes analysis was performed using the Cig-only and Dual Use groups with 3,893 patients each. Results Among the outcomes analyzed comparing the Cig-only group to the Dual Use group, statistically significant with p 0.05 were the risk differences of -0.024 (95% confidence interval, -0.046, -0.002) in admissions, -0.023 (95% confidence interval, -0.030, -0.015) in mortality, -0.043 (95% confidence interval, -0.053, -0.032) in emphysema, -0.013 (95% confidence interval, -0.018, -0.008) in pneumothorax, and -0.084 (95% confidence interval, -0.099, -0.069) in COPD. There was also a greater CRP mean value in the Dual Use group (50.841 mg/L) compared to the Cig-only group (39.043 mg/L). Conclusion This data suggests that Dual Use poses a higher health risk than Cig-only use, which can be used to argue against e-cigarettes being advertised as a safer alternative to combustible tobacco use. This is supported by Glantz et al., who found worse odds in cardiovascular disease, stroke, metabolic dysfunction, asthma, COPD, and oral health among Dual Use individuals. With this, the authors of this abstract propose increased education on the effects of nicotine to persons of all ages and on the poor outcomes of dual use, especially amongst youth e-cigarette users who may consider combustible tobacco products or tobacco users who are unable to achieve cessation with e-cigarettes for an extended period of time. Also, we wish to increase awareness and distinction of ICD-10 codes on e-cigarette use by the WHO to hopefully improve future study design. Limitations of this study include inability to expand on years spent smoking combustible tobacco products among the Dual Use group as the data may be confounded by late-stage COPD patients that switch to e-cigarettes or patients with severe nicotine dependence. Glantz SA, Nguyen N, Oliveira da Silva AL. Population-Based Disease Odds for E-Cigarettes and Dual Use versus Cigarettes. NEJM Evid. 2024;3(3):EVIDoa2300229. doi:10.1056/EVIDoa2300229 This abstract is funded by: None
Do et al. (Fri,) studied this question.