E-Cigarette use linked to COPD and hypertension in large study

Still, the risk is less than smoking cigarettes

By Mark Huffman of ConsumerAffairs

April 16, 2025

Key takeaways

• COPD Risk Confirmed: Exclusive e-cigarette use is significantly associated with new cases of chronic obstructive pulmonary disease.

• Hypertension Warning: A modest increase in high blood pressure was observed among adult vapers aged 3070.

• Traditional Smoking Still More Harmful: Combustible cigarettes remain the most dangerous, linked to the highest risk across all studied health outcomes.

A comprehensive study led by Johns Hopkins Medicine has found a significant association between the exclusive use of e-cigarettes and an increased risk of chronic obstructive pulmonary disease (COPD), as well as a slight rise in high blood pressure among adults aged 30 to 70.

The research, published in Nicotine & Tobacco Research, analyzed medical data from nearly 250,000 participants over a four-year period, offering one of the most detailed longitudinal assessments of e-cigarette health risks to date.

Funded by the National Institutes of Health, the analysis is being promoted as a crucial step in understanding the long-term health consequences of vapingparticularly as e-cigarette use continues to rise among adolescents and young adults. While combustible cigarettes remain the leading cause of tobacco-related illness, the study suggests that vaping is not without its own significant risks.

These results are a critical stepping stone for future prospective research on the health effects of e-cigarettes, said Dr. Michael Blaha, senior author of the study and professor of cardiology and epidemiology at the Johns Hopkins University School of Medicine.

Key findings

The study examined four distinct user groups: exclusive e-cigarette users (3,164 individuals), exclusive combustible cigarette users (33,778), dual users (8,316), and non-users (203,932). Over the four-year follow-up period, the researchers documented thousands of new disease diagnoses across all groups.

Exclusive e-cigarette use was notably linked to a significantly increased risk of COPD, a modest increase in hypertension in adults age 30 to 70 but no significant link to type 2 diabetes, heart failure, or atherosclerotic cardiovascular disease.

In comparison, exclusive use of combustible cigarettes was strongly associated with increased risks across all measured outcomes, including COPD, diabetes, cardiovascular disease, and heart failure. Dual users experienced the highest risk levels, reinforcing existing concerns about combining both products.

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