Comparative effects of electronic and traditional cigarette use on pulmonary function, autonomic regulation, and exercise capacity in young adults

E-cigarette use among university students has been increasing. While substantial information exists on the impact of e-cigarette use on respiratory function, limited data exists on its early effects on cardiac autonomic function and exercise capacity in young individuals. This study evaluated respiratory function, heart rate variability (HRV), and exercise capacity in electronic cigarette users compared to traditional cigarette smokers and non-smokers among university students. Sixty-one healthy volunteers aged 18-35 years were divided into three groups: nonsmokers (n=20), tobacco smokers (n=21), and e-cigarette users (n=20). Respiratory function was assessed using spirometry, HRV was measured using a Polar H10 chest strap, and exercise capacity was evaluated using the incremental shuttle walk test (ISWT). Results showed forced vital capacity was significantly higher in non-smokers than in traditional cigarette and e-cigarette users (P =0.013). No significant differences were found in spirometry parameters, HRV indices, total shuttle number, or ISWT distance. The percentage of predicted distance was significantly higher in non-smokers than other groups (p=0.018). The percentage of maximal heart rate and post-test heart rate differed significantly between groups (p = 0.004; η² = 0.172 and η² = 0.174), with traditional cigarette smokers showing lower values than non-smokers and e-cigarette users. Post-exercise dyspnea scores were significantly lower in e-cigarette users than nonsmokers (p=0.009). Both tobacco and e-cigarette use may negatively affect respiratory function and exercise performance of university students. Further research is needed to clarify the long-term health effects of electronic cigarette use in both healthy and chronic disease populations.