The Impact of Vaping on Primary Spontaneous Pneumothorax Outcomes

Abstract

Introduction Cigarette smoking is associated with primary spontaneous pneumothorax (PSP). Electronic cigarettes (E-cigarettes) are touted as a healthier alternative to cigarettes; however, the impact E-cigarette use has on PSP management is not known. The goal of this study was to determine if E-cigarette use is associated with inferior outcomes after PSP, compared to never smokers and cigarette smokers. Methods We conducted a retrospective cohort study of patients in a large tertiary care hospital system in an urban area who presented with PSP from September 2015 through February 2019. Primary spontaneous pneumothorax patients were identified from the institutional Society of Thoracic Surgeon (STS) database. Patients with pneumothoraces from traumatic, iatrogenic, and secondary etiologies were excluded. Baseline clinical and demographic data and outcomes including intervention(s) required, length of stay, and recurrence were evaluated. Results Identified were 71 patients with PSP. Seventeen (24%) had unverifiable smoking history. Of the remaining, 7 (13%) currently vaped, 27(50%) currently smoked cigarettes, and 20(37%) were never smokers. Mean age was 33 years; 80% male. All vapers required tube thoracostomy vs 74% of current smokers and 75% of never smokers. Vaping was associated with increased odds of recurrence compared to never smokers (OR 2.00, 95% CI 0.35,11.44). Vapers had the shortest median time to recurrence after initial hospitalization (10 d[4,18] v 20 d[5,13] cigarette smokers v 27 d[13 275] never smokers, P < .001). Conclusion Vaping may complicate PSP outcomes. As vaping use increases, especially among adolescents, it is imperative that the manner of tobacco use is documented and considered when caring for patients, especially those with pulmonary problems.

Recurrent Spontaneous Pneumothorax in a 15-Year-Old Female Associated with Electronic Cigarettes

“…]3 cm, should undergo lung expansion with placement of a chest tube or catheter (10). In one study, all e-cigarette using patients with spontaneous pneumothorax required tube thoracostomy (11). VATS is a minimally invasive technique that can be used with blebectomy and/or pleurodesis.…”

Recurrent spontaneous pneumothorax in a 15‐year‐old female associated with electronic cigarettes

“…According to the American College of Chest Physicians, a large pneumothorax, defined as ≥3 cm, should undergo lung expansion with placement of a chest tube or catheter 11 . In one study evaluating the need for tube thoracostomy in different types of smokers with pneumothorax, all e‐cigarette‐using patients with spontaneous pneumothorax requiring tube thoracostomy 12 . VATS is a minimally invasive technique that can be used with blebectomy and/or pleurodesis.…”

“…11 In one study evaluating the need for tube thoracostomy in different types of smokers with pneumothorax, all e-cigarette-using patients with spontaneous pneumothorax requiring tube thoracostomy. 12 VATS is a minimally invasive technique that can be used with blebectomy and/or pleurodesis. Blebectomy is a procedure to remove air blebs from the lung while pleurodesis adheres to the lung tissue to the chest wall.…”

Spontaneous pneumothorax risk factor mapping: A Mendelian randomization study

“…It is categorized into Primary Spontaneous Pneumothorax (PSP) and Secondary Spontaneous Pneumothorax (SSP), and the cause of Primary Spontaneous Pneumothorax is still unknown [2] . Some studies have shown that cigarette smoking, marijuana use [3,4] , changes in atmospheric pressure, air pollution [5,6] , high lean body mass, low body mass index (BMI), are closely associated with SP [7] . Secondary spontaneous pneumothorax is often associated with underlying lung diseases, commonly chronic obstructive pulmonary disease (COPD) [8] , cystic pulmonary fibrosis (CPF) [9] , lung tumors, and lung infections [10] .…”