A study based in the United States has identified that the effects of vaping may be damaging for bone health, increasing the risk of developing osteoporosis.
Although smoking conventional cigarettes is a well-established risk factor for osteoporosis and osteoporotic fracture, the effects of vaping – using e-cigarettes – have not been previously investigated regarding bone health. Now, a team of US researchers has conducted a comprehensive study of 5,500 adult e-cigarette users to determine the actual effects of vaping.
The researchers discovered that e-cigarette use was associated with a higher prevalence of fragility fractures across all age groups, which are defined as a composite of self-reported fractures of the hip, spine, or wrist that resulted from minimal trauma such as a fall from standing height or less. The study also illuminated that e-cigarette use may be detrimental to bone health, even in young adults.
The study’s findings are published in the American Journal of Medicine Open.
Increasing vape use
E-cigarettes contain a cocktail of propylene glycol, vegetable glycerine and variable levels of nicotine and additives, generating flavoured vapour. Throughout the last decade, the use of e-cigarettes has risen dramatically, marketed as a healthier alternative to traditional smoking and an effective way of curbing dependence on cigarettes altogether. However, due to the technology still being in its infancy, the true long-term effects of vaping remain unknown.
Dayawa D. Agoons, the lead investigator of the study from the Department of Medicine at UPMC, said: “In my outpatient clinic, I saw a patient after surgery to repair a femoral neck fracture. She was a smoker and used e-cigarettes as an aid to quit smoking. I realised there was a knowledge gap in the literature on the potential relationship between e-cigarettes and fragility fractures and decided to conduct this study.”
Examining the effects of vaping
The researchers performed a cross-sectional analysis employing the 2017-2018 National Health and Nutrition Examination Survey (NHANES) data, enabling them to scrutinise samples from over 5,500 American adult men and women, highlighting the association between e-cigarette use and fragility fractures. The investigation comprised 4,519 (81.2%) people who never used e-cigarettes and 1,050 (18.8%) who did use e-cigarettes, with 444 (8%) having a self-reported fragility fracture.
The results signified a higher prevalence of fragility fractures among e-cigarette users than non-users, finding that dual users of both cigarettes and e-cigarettes had a higher prevalence of fragility fractures than those who smoke cigarettes exclusively.
In the United States, the usage of e-cigarettes is highest in the 18-25 years age group, indicating that young users of e-cigarettes are potentially increasing their risk of osteoporotic fractures over time. Because of these dangerous effects of vaping, the team are imploring healthcare providers – especially those in primary care practice – to consider e-cigarettes as a potential risk factor for fragility fracture and include risk for a fracture to the possible adverse effects of vaping.
Dr Agoons commented: “To our knowledge, this is the first study to investigate the relationship between e-cigarette use and fragility fractures. It fills an important knowledge gap given the increasing popularity of e-cigarette use and the significant economic burden and known morbidity and mortality associated with osteoporotic fractures. Our findings provide data to inform researchers, healthcare policymakers, and tobacco regulators about the potential association of e-cigarette use with reduced bone health.”
Previous studies have also indicated an association between e-cigarettes and various diseases such as COPD, coronary heart disease, and depression.
