Vaping effect on respiratory system subject of new research project

The benefits and harms of vaping for long term respiratory health will be the focus of a new research project delivered through the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC).

Building on internationally recognised work in e-cigarette studies at the University of Birmingham, the newly funded EVALUATE study which has received £1.46M by the Medical Research Council (MRC), aims to address unanswered questions about the effect of long-term vaping on the respiratory system by conducting a four-year cohort study.

Dr Aaron Scott, Associate Professor in Respiratory Science at the University of Birmingham, Chief investigator of the EVALUATE study and researcher within the NIHR Birmingham BRC’s Infection and Acute Care research theme, said:

“We will study how vaping affects important airway immune cells and the epithelial cells which line the insides of the lung. Since these cell types play a critical role in the development of smoking-related lung diseases, these changes will provide clear insight into vaping’s on lung health.

“This study will provide critical data needed to understand the safety of vaping as a short-term smoking cessation strategy and in longer-term usage so people can make an informed personal choice.”

David Thickett, Professor of Respiratory Medicine at the University of Birmingham and Clinical lead of University Hospitals Birmingham staff smoking cessation service said:

“The EVALUATE study will investigate changes to immune and lung cell health following vaping, as well as how vaping changes the human microbiome after smoking cessation. For the trillions of microorganisms that live on and in the human body, environmental factors can affect the delicate balance of microbiomes and can impact health if disrupted.”

Dr Dhruv Parekh, Associate Professor in Respiratory Medicine, Director of the University Hospitals Birmingham Clinical Research Facility and researcher for the NIHR Birmingham BRC’s Infection and Acute Care theme, said:

“Studying immune cells from the blood (indirect effects) and from the airways (direct effects) by bronchoscopy, allows us to get a complete picture of how the airways are affected by vaping. This important study will be delivered through our NIHR Birmingham Clinical Research Facility which is integral to the delivery of this work.”

Dr Mike Cox, Assistant Professor Respiratory Microbiome at the University of Birmingham said:

“Smoking can drastically alter microorganisms in our bodies, particularly in the airways. This project will allow us to uncover how vaping impacts this balance and map out how this changes over time.”

Studying toxicants in the airways

Previous work from Dr Scott’s lab at the University of Birmingham has shown that toxicants within e-cigarette vapour, formed by the breakdown of e-liquid, can negatively impact important immune cells, independently to the effects of nicotine. Some of these toxic components of e-cigarette vapour are also found in cigarette smoke. We know this could harm our airways, but this is difficult to sample and measure.

Professor Luis Mur at Aberystwyth University will lead the investigation into the accumulation of toxicants within the airways after vaping. Professor Mur said:

“Using our cutting-edge mass spectroscopy platforms, we can monitor how toxicants in the airways change as people move from smoking to vaping. Combined with data on immune cell function, this interdisciplinary approach will give us a powerful insight into the true nature of e-cigarette exposure on the airways.”

This new study will also run alongside a complementary clinical trial, ECAL and linked EME mechanism study, which is examining the impact of vaping in patients with chronic obstructive pulmonary disease (COPD). The research team will begin recruiting for the EVALUATE study in the Autumn of 2025.