E-cigarette use among individuals with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is strongly linked to tobacco smoking, and smoking cessation is central to disease management. E-cigarettes are widely promoted as a harm reduction option in the United Kingdom, yet patterns of use among people with COPD remain poorly described. This study examined the prevalence and correlates of current e-cigarette use among individuals with COPD in Scotland using data from the 2018 to 2022 Scottish Health Survey. The analysis included adults aged 16 years and above who reported a COPD diagnosis (n = 891). Survey-weighted logistic regression was used to estimate crude and adjusted associations between sociodemographic, behavioural, and health characteristics and current e-cigarette use, with additional models stratified by smoking status and smoking intensity. The weighted prevalence of current e-cigarette use was 11.9% (95%CI 9.7-14.5). Older age was associated with lower odds of current use (adjusted odds ratio [aOR] 0.60; 95%CI 0.41-0.89), while socioeconomic deprivation showed a positive gradient (aOR 1.21; 95%CI 1.01-1.45). Smoking status was the strongest correlate: odds were higher among ex-smokers (aOR 10.80; 95%CI 1.66-70.06) and current smokers (aOR 14.86; 95%CI 2.37-93.33) compared with never-smokers. Among current smokers, younger age, female sex, and higher deprivation were associated with use, whereas no clear determinants were identified among former smokers. Light and moderate smokers had greater odds of current e-cigarette use than non-smokers, while heavy smokers did not differ. Overall, e-cigarette use was relatively common and concentrated among younger, more deprived adults with a smoking history. Longitudinal studies are needed to determine the implications for respiratory outcomes.