This is a pilot study on the impact of switching from cigarettes to Electronic Cigarettes (EC) on disease-related clinical symptoms and biomarkers of harm in smokers with preexisting Chronic Obstructive Pulmonary Disease (COPD). The researchers hypothesize that the smokers who switch to EC completely or significantly will experience reduced COPD symptoms, risks of exacerbations, and decreased levels of oxidative stress and inflammation.

Smokers with COPD have a higher pack-year history and nicotine dependence compared to regular smokers as exemplified by the relatively large proportion of patients diagnosed with COPD that continue to smoke (95%).

This is a translational project which addresses the changing profile of tobacco product use in the United States (US) and the need for data regarding toxicity pathways for new nicotine products such as EC. In particular it focuses on critical scientific and clinically relevant gaps relating to oxidants in EC and their potential long-term cardiopulmonary effects. The study will obtain new information regarding the potential cardiopulmonary toxicity resulting from exposure to EC-derived oxidants that may lead to long-term disease development.

Inclusion Criteria:

• Mild to moderate COPD
• Smokes a popular brand of cigarette
• Willing to use an e-cigarette to reduce cigarette smoking down to 75% of their daily baseline cigarette use
• Ability to read, write and understand English
• Ability to provide informed consent and attend study visits

Exclusion Criteria:

• History of active, chronic drug abuse or alcohol abuse problems
• Actively changing smoking behavior
• Unwilling or unable to provide blood samples
• Pregnant, planning to become pregnant, or nursing
• Use of tobacco products other than cigarettes in the past 30 days
• Recent history (< 6 months) of myocardial infarction (MI)
• Any unstable or life threatening cardiac arrhythmia or cardiac arrhythmia requiring intervention or drug therapy within the past year. Antiarrhythmic drugs include amiodarone, flecainide, IV ibutilide, IV lidocaine, procainamide, propafenone, quinidine, tocainide
• Hospitalization for heart failure (NY Heart Association III or IV) within the past year
• Uncontrolled hypertension
• Known allergy to vegetable glycerin and propylene glycol
• History of seizures or medications to prevent seizures

We propose to make de-identified data, codebooks, documentation, and research protocols available to interested researchers after completion of the study.

Data will be available within 3 years of the culmination of data collection activities.

Any investigator interested in collaboration or in using the data collected in this study for their own work will be invited to submit a 1-page abstract of their proposed research, including purpose, analytical plan, and dissemination plans. The study leadership team will review these proposals and decide on each based on the individual merits. Review criteria and prioritization of projects include: potential of the proposed work to advance public health, qualifications of the applicant, the potential for publication, the potential for future funding, and enhancing the scientific, geographic, and demographic diversity of the research portfolio.