The safety and long-term health effects of using e-cigarettes or other vaping products still aren’t well known. In September 2019, federal and state health authorities began investigating an outbreak of a severe lung disease associated with e-cigarettes and other vaping products. We’re closely monitoring the situation and will update our content as soon as more information is available.

Chronic obstructive pulmonary disease (COPD) is a progressive illness of the respiratory system.

Around 30 million people in the United States are living with COPD. Many have early-stage COPD and don’t know it yet.

The leading cause of COPD is cigarette smoking. The link between inhaling tobacco smoke and COPD is clear. About 90 percent of people with COPD are smokers or former smokers.

When you inhale an e-cigarette, a process known as vaping, you’re not inhaling smoke. You’re inhaling water vapor and a mixture of chemicals. The liquid in many e-cigarettes contains nicotine. When you exhale the vapor, others can breathe in this mixture.

Vaporizers also include hookah pens, vape pens, and e-pipes.

Read on to find out what the research says about vaping and COPD, the early warning signs of COPD, and how to quit smoking for good.

One thing is clear: There hasn’t been enough research on the general health risks of vaping or whether it can increase your chances of developing of COPD.

According to the National Institute on Drug Abuse:

  • There’s insufficient data regarding the health consequences of these vaping products. E-cigarettes and other vaporizers haven’t yet been thoroughly evaluated in scientific studies.
  • E-cigarettes contain the highly addictive drug nicotine. Some products have a vapor containing known carcinogens, toxic chemicals, and toxic metal nanoparticles.
  • Although many people turn to vaping as a way to quit smoking tobacco, it’s unclear if e-cigarettes are effective aids for smoking cessation.
  • One small 2016 study found that vaping e-cigarette fluids containing nicotine triggered the effects associated with the development of COPD. This included lung inflammation and destruction of lung tissue. The study used cultured human lung cells and mice. Both were found to be nicotine-dependent by the end of the study.

The author of a 2015 commentary wrote that e-vapor products are at least 96 percent less harmful than conventional cigarettes and may be able to reverse harm from tobacco smoking.

It’s worth noting that the author has served as a consultant for an e-cigarette distributor and the Electronic Cigarette Industry Trade Association in the U.K.

He also stated that larger and longer studies are needed to clarify if e-cigarettes are less harmful than traditional cigarettes, and if switching to e-cigarettes provides any health benefit to smokers.

Starting in 2018, the U.S. Food and Drug Administration (FDA) will require warnings on vaping products that contain nicotine. The warnings will note that nicotine is an addictive chemical. Vaping products that don’t contain nicotine will have to state that the product is made from tobacco.

More research is needed to determine the full impact of vaping on overall health.

Although smoking cigarettes is the reason most people get COPD, it’s not the only reason. Inhaling cigar and pipe smoke also increases your risk.

Long-term exposure to the following lung irritants and pollutants can also lead to COPD:

  • secondhand smoke
  • chemical fumes
  • fuels
  • dust
  • air pollution

Certain genetic conditions, such as alpha-1 antitrypsin deficiency (AATD), can increase your risk of COPD — even if you’ve never smoked.

Symptoms of COPD usually start out mild and progress slowly. Early symptoms might include:

  • occasional shortness of breath
  • persistent cough
  • tightness in the chest

Later, you might also experience:

  • wheezing
  • coughing up a lot of mucus
  • chest pain
  • frequent shortness of breath

Eventually, the shortness of breath may make it difficult to walk, climb the stairs, or take care of everyday chores. As COPD progresses, breathing problems can become disabling.

Learn more: Early COPD symptoms »

If you’re experiencing ongoing shortness of breath, chest pain, or coughing, talk to your doctor. You may have developed COPD.

Your doctor will assess your symptoms and perform a physical exam to get a sense of how you’re doing. From there, they’ll conduct a number of tests that will help them make a diagnosis.

First, they’ll want to see how well your lungs are functioning. This is usually done with a test called spirometry, or pulmonary function tests.

Spirometry can detect COPD in its earliest stage. The test is noninvasive and painless. For the procedure, you blow into a tube connected to the spirometer. This measures how much air you exhale, and how fast you exhale.

In some cases, your doctor may have you inhale medicine that makes it easier to open your airways. Blowing into the spirometer again will allow for a before-and-after comparison.

Imaging tests, such as an X-ray or CT scan, may detect signs of COPD in your chest.

An arterial blood gas test can measure how much oxygen and carbon dioxide you have in your blood. The results can help indicate the severity of the COPD and which treatment might be best.

These tests can also eliminate COPD as a diagnosis. Your symptoms may be a sign of a different underlying medical condition. In some cases, they may not be indicative of any lung issue at all.

Although there’s no cure for COPD, early treatment can improve symptoms and slow the progression of the disease.

Learn more: What spirometry can tell you about your COPD »

The number one way to prevent COPD is to quit smoking. If you’re diagnosed with COPD, quitting can help alleviate your symptoms and slow the disease progression.

Knowing you should quit smoking is one thing. Figuring out how to quit for good is quite another. As anyone who’s tried to quit knows, smoking is a powerful addiction. Here are a few tips to help you succeed.

Pick your “quit day”

What day works for you? Consider workdays versus days off. You may want to avoid starting the quitting process during a high-stress week.

You might want to associate quitting with a date that holds special meaning. Or perhaps you want choose a random date and have a countdown.

Now mark the date on your calendar, put on note on the fridge, and tell your family and friends. This will help make it a real commitment.

Plan ahead

If you’ve ever tried to quit and failed, consider the reasons so that you can avoid the same pitfalls.

  • Think about when and where you usually smoke, as these are bound to trigger cravings. Changing your routine may help you avoid those triggers.
  • Get rid of all your tobacco products and smoking-related items, such as ashtrays, matches, and lighters. Be sure to purge your home, car, and work.
  • Stock up on supplies that might help. Gum, straws, toothpicks, and candy can be used as oral substitutes when a craving hits.

Make a plan for managing stressful situations like doing something active, using a stress ball, or playing a video game. It’s important to have a go-to in place ahead of time to avoid turning to smoking.

Decide ahead of time what you’ll do when a craving hits. You can chew gum, drink a bottle of water, or do some deep breathing. Whatever will get your mind off it. If you know someone who’s successfully quit smoking, ask if you can call them when you’re having a craving.

Know what to expect

You’re likely to experience symptoms of nicotine withdrawal.

It’s perfectly normal to have:

  • intense cravings to smoke
  • difficulty concentrating
  • irritability, anxiousness, and anger — you might feel just plain grouchy
  • increased appetite

The first seven to 10 days are usually the hardest. Withdrawal symptoms should start to ease up after that.

Get information and support

Your doctor is an excellent resource. They can provide advice about products that might help, such as:

  • nonprescription nicotine replacement products, including skin patches, gum, and lozenges
  • prescription-strength nicotine replacement products, including skin patches, inhalers, and nasal spray
  • prescription non-nicotine medications to decrease cravings

They can also provide information about local smoking-cessation programs. Here are a couple other services you can try:

And some tools you can use:

Determine from the start that if you give in and have a smoke, all is not lost. If this happens, figure out what went wrong and re-evaluate your strategy. Start again.

Keep reading: 15 tips for quitting smoking »

Research shows that inhaling tobacco smoke can lead to COPD. But the link between vaping and COPD hasn’t been thoroughly vetted.

If you smoke and are concerned about developing COPD, talk to your doctor about smoking and vaping, especially if you have other risk factors for COPD.