title: Persisting long term benefits of smoking abstinence and reduction in asthmatic smokers who have switched to electronic cigarettes.
abstract: BACKGROUND
  Improvements in asthma outcomes have been recently reported in asthmatic smokers who have substantially reduced their tobacco consumption by switching to ECs. Confirmation of these preliminary findings is necessary to reassure patients, healthcare professionals and policy makers. Here, we present findings from long term prospective assessment of objective and subjective asthma outcomes as well as safety and tolerability in this group of EC users with asthma.
  
  
  METHODS
  We prospectively re-evaluated respiratory symptoms, lung function, airway hyperresponsiveness, asthma control, asthma exacerbations and tobacco consumption in adult daily ECs users with asthma who were previously studied in a retrospective study. Measurements recorded at baseline prior to switching were compared with those at the follow-up visits at 6, 12, and 24 months.
  
  
  RESULTS
  Eighteen ECs users with mild to moderate asthma were followed up prospectively. Complete data was obtained from sixteen EC users and two relapsers. Significant and stable improvements in respiratory symptoms, lung function, AHR, ACQ, and tobacco consumption were observed in the 16 ECs users with asthma, but no significant changes in exacerbation rates were reported. Similar findings were found in the dual users.
  
  
  CONCLUSIONS
  This prospective study confirms that EC use ameliorates objective and subjective asthma outcomes and shows that these beneficial effects may persist in the long term. EC use can reverse harm from tobacco smoking in asthma patients who smoke. The evidence-based notion that substitution of conventional cigarettes with EC is unlikely to raise significant respiratory concerns, can improve counseling between physicians and their asthmatic patients who are using or intend to use ECs.
authors.affiliation: Department of Clinical and Biomolecular Medicine, University of Catania, Italy.|Centro per la Prevenzione e Cura del Tabagismo (CPCT), "Policlinico - V. Emanuele", University of Catania, Italy.|Internal and Emergency Medicine, "Policlinico - V. Emanuele", University of Catania, Italy.|These authors contributed equally to this article.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Polosa
authors.affiliation: Department of Academic Respiratory Medicine, University of Hull, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, UK.|These authors contributed equally to this article.
authors.forename: Jaymin B
authors.initials: JB
authors.lastname: Morjaria
authors.affiliation: Department of Clinical and Biomolecular Medicine, University of Catania, Italy.|Centro per la Prevenzione e Cura del Tabagismo (CPCT), "Policlinico - V. Emanuele", University of Catania, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Caponnetto
authors.affiliation: Department of Clinical and Biomolecular Medicine, University of Catania, Italy.|Internal and Emergency Medicine, "Policlinico - V. Emanuele", University of Catania, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Caruso
authors.affiliation: Department of Clinical and Biomolecular Medicine, University of Catania, Italy.|Internal and Emergency Medicine, "Policlinico - V. Emanuele", University of Catania, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Campagna
authors.affiliation: Department of Clinical and Biomolecular Medicine, University of Catania, Italy.|Internal and Emergency Medicine, "Policlinico - V. Emanuele", University of Catania, Italy.
authors.forename: Maria Domenica
authors.initials: MD
authors.lastname: Amaradio
authors.affiliation: Accident and Emergency Department, Garibaldi-Central Hospital, Catania, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ciampi
authors.affiliation: Accident and Emergency Department, Garibaldi-Central Hospital, Catania, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Russo
authors.affiliation: Department of Clinical and Biomolecular Medicine, University of Catania, Italy.|Internal and Emergency Medicine, "Policlinico - V. Emanuele", University of Catania, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Fisichella
mesh_terms: D000328:Adult; D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology; D018450:Disease Progression; D066300:Electronic Nicotine Delivery Systems / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D016210:Methacholine Chloride; D012129:Respiratory Function Tests; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014797:Vital Capacity
chemical_list: D016210:Methacholine Chloride