@article{3129080,
    title = "Short-term pulmonary effects of using an electronic cigarette: Impact on respiratory flow resistance, impedance, and exhaled nitric oxide",
    author = "Vardavas, C.I. and Anagnostopoulos, N. and Kougias, M. and Evangelopoulou, V. and Connolly, G.N. and Behrakis, P.K.",
    journal = "Journal of Chest Surgery",
    year = "2012",
    volume = "141",
    number = "6",
    pages = "1400-1406",
    publisher = "The American College of Chest Physicians",
    doi = "10.1378/chest.11-2443",
    keywords = "adult;  airway resistance;  article;  breathing mechanics;  cigarette smoking;  controlled study;  electronic cigarette;  female;  forced expiratory volume;  forced vital capacity;  fraction of exhaled nitric oxide;  human;  human experiment;  lung function test;  lung resistance;  male;  maximal expiratory flow;  normal human;  oscillometry;  oxidative stress;  peak expiratory flow;  priority journal;  respiratory tract parameters;  spirometry",
    abstract = "Background: Debate exists over the scientific evidence for claims that electronic cigarettes (e-cigarettes) have no health-related ramifications. This study aimed to assess whether using an e-cigarette for 5 min has an impact on the pulmonary function tests and fraction of exhaled nitric oxide (FENO) of healthy adult smokers. Methods: Thirty healthy smokers (aged 19-56 years, 14 men) participated in this laboratory-based experimental vs control group study. Ab lib use of an e-cigarette for 5 min with the cartridge included (experimental group, n = 30) or removed from the device (control group, n = 10) was assessed. Results: Using an e-cigarette for 5 min led to an immediate decrease in F ENO within the experimental group by 2.14 ppb (P = .005) but not in the control group (P = .859). Total respiratory impedance at 5 Hz in the experimental group was found to also increase by 0.033 kPa/(L/s) (P < .001), and flow respiratory resistance at 5 Hz, 10 Hz, and 20 Hz also statistically increased. Regression analyses controlling for baseline measurements indicated a statistically significant decrease in FENO and an increase in impedance by 0.04 kPa/(L/s)(P = .003), respiratory resistance at 5 Hz by 0.04 kPa/(L/s)(P = .003), at 10 Hz by 0.034 kPa/(L/s)(P = .008), at 20 Hz by 0.043 kPa/(L/s) (P = .007), and overall peripheral airway resistance (β, 0.042 kPa/[L/s]; P = .024), after using an e-cigarette. Conclusions: e-Cigarettes assessed in the context of this study were found to have immediate adverse physiologic effects after short-term use that are similar to some of the effects seen with tobacco smoking; however, the long-term health effects of e-cigarette use are unknown but potentially adverse and worthy of further investigation. © 2012 American College of Chest Physicians."
}