Vaping, Smoking, and the Physical Fitness of Active Young Men

  • Eero Dinkeloo
    Address correspondence to: Eero Dinkeloo, MPH, U.S. Army Public Health Center, Clinical Public Health and Epidemiology Directorate, 8977 Sibert Road, Aberdeen Proving Ground MD 21010.
    Injury Prevention Division, Clinical Public Health and Epidemiology Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, Maryland

    Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
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  • Tyson L. Grier
    Injury Prevention Division, Clinical Public Health and Epidemiology Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, Maryland
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  • Raina D. Brooks
    Injury Prevention Division, Clinical Public Health and Epidemiology Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, Maryland
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  • Bruce H. Jones
    Injury Prevention Division, Clinical Public Health and Epidemiology Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, Maryland
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Published:November 21, 2019DOI:


      Adverse effects of cigarette smoking on physical performance are well studied. Because of the recent rise in popularity of vaping, it is important to evaluate its effect on fitness both independently and in conjunction with traditional cigarette use.


      This was a secondary analysis performed in 2018 on data collected from U.S. Army Soldiers during 2016. All metrics were self-reported via an electronic questionnaire. Personal characteristics of current ENDS users, smokers, and dual users were compared with a reference group that reported no history of use. Adjusting for age and physical training habits, an ANCOVA was used to compare Army physical fitness test results. A Fisher's exact test determined specific mean differences between groups.


      This study population consisted of 2,854 men aged 24.6 years on average. Differences in physical training and fitness were shown between the groups. Never users averaged the most total physical training, followed by ENDS users, smokers, and then dual users. Compared with never users on the fitness tests, ENDS users had an adjusted mean difference of +27 seconds on the 2-mile run, −4.56 push-ups, and −2.01 sit-ups; smokers averaged +8 seconds, −2.15 push-ups, and −1.44 sit-ups; and dual users averaged +32 seconds, −5.17 push-ups, and −3.88 sit-ups. Dual users had significantly (p<0.05) lower scores than current smokers and never users on all 3 fitness events.


      This study suggests that individuals who use e-cigarettes and tobacco cigarettes average a lower level of fitness than individuals who abstain.
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        • Walton KM
        • Abrams DB
        • Bailey WC
        • et al.
        NIH electronic cigarette workshop: developing a research agenda.
        Nicotine Tob Res. 2015; 17: 259‒269
      1. HHS. E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General. Published 2016. Accessed 2018.

        • King BA
        • Patel R
        • Nguyen KH
        • Dube SR
        Trends in awareness and use of electronic cigarettes among US adults, 2010-2013.
        Nicotine Tob Res. 2015; 17: 219‒227
        • McMillen RC
        • Gottlieb MA
        • Shaefer RM
        • Winickoff JP
        • Klein JD
        Trends in electronic cigarette use among U.S. adults: use is increasing in both smokers and nonsmokers.
        Nicotine Tob Res. 2015; 17: 1195‒1202
      2. QuickStats: percentage of adults who ever used an e-cigarette and percentage who currently use e-cigarettes, by age group - National Health Interview Survey, United States, 2016 [editorial].
        MMWR Morb Mortal Wkly Rep. 2017; 66: 892
        • Walley SC
        • Jenssen BP
        Section on Tobacco Control. Electronic nicotine delivery systems.
        Pediatrics. 2015; 136: 1018‒1026
      3. E-cigarettes surpass tobacco cigarettes among teens [press release]. Michigan News: University of Michigan; December 16, 2014.

        • Flouris AD
        • Chorti MS
        • Poulianiti KP
        • et al.
        Acute impact of active and passive electronic cigarette smoking on serum cotinine and lung function.
        Inhal Toxicol. 2013; 25: 91‒101
        • Goniewicz ML
        • Knysak J
        • Gawron M
        • et al.
        Levels of selected carcinogens and toxicants in vapour from electronic cigarettes.
        Tob Control. 2014; 23: 133‒139
        • Callahan-Lyon P
        Electronic cigarettes: human health effects.
        Tob Control. 2014; 23: ii36‒ii40
        • Meo SA
        • Al Asiri SA
        Effects of electronic cigarette smoking on human health.
        Eur Rev Med Pharmacol Sci. 2014; 18: 3315‒3319
        • Barrington-Trimis JL
        • Samet JM
        • McConnell R
        Flavorings in electronic cigarettes: an unrecognized respiratory health hazard?.
        JAMA. 2014; 312: 2493‒2494
        • Cheng T
        Chemical evaluation of electronic cigarettes.
        Tob Control. 2014; 23: ii11‒ii17
        • Chun LF
        • Moazed F
        • Calfee CS
        • Matthay MA
        • Gotts JE
        Pulmonary toxicity of e-cigarettes.
        Am J Physiol Lung Cell Mol Physiol. 2017; 313: L193‒L206
        • Hahn J
        • Monakhova YB
        • Hengen J
        • et al.
        Electronic cigarettes: overview of chemical composition and exposure estimation.
        Tob Induc Dis. 2014; 12: 23
        • Hess CA
        • Olmedo P
        • Navas-Acien A
        • Goessler W
        • Cohen JE
        • Rule AM
        E-cigarettes as a source of toxic and potentially carcinogenic metals.
        Environ Res. 2017; 152: 221‒225
        • Mikheev VB
        • Brinkman MC
        • Granville CA
        • Gordon SM
        • Clark PI
        Real-time measurement of electronic cigarette aerosol size distribution and metals content analysis.
        Nicotine Tob Res. 2016; 18: 1895‒1902
        • Ramôa CP
        • Hiler MM
        • Spindle TR
        • et al.
        Electronic cigarette nicotine delivery can exceed that of combustible cigarettes: a preliminary report.
        Tob Control. 2016; 25: e6‒e9
        • Drummond MB
        • Upson D
        Electronic cigarettes. Potential harms and benefits.
        Ann Am Thorac Soc. 2014; 11: 236‒242
        • McConnell R
        • Barrington-Trimis JL
        • Wang K
        • et al.
        Electronic cigarette use and respiratory symptoms in adolescents.
        Am J Respir Crit Care Med. 2017; 195: 1043‒1049
        • Vakali S
        • Tsikrika S
        • Gennimata S
        • et al.
        E-cigarette acute effect on symptoms and airway inflammation: comparison of nicotine with a non-nicotine cigarette.
        Tob Induc Dis. 2013; 12: A35
        • Kerr DMI
        • Brooksbank KJM
        • Taylor RG
        • et al.
        Acute effects of electronic and tobacco cigarettes on vascular and respiratory function in healthy volunteers: a cross-over study.
        J Hypertens. 2019; 37: 154‒166
        • Marini S
        • Buonanno G
        • Stabile L
        • Ficco G
        Short-term effects of electronic and tobacco cigarettes on exhaled nitric oxide.
        Toxicol Appl Pharmacol. 2014; 278: 9‒15
        • Wang MP
        • Ho SY
        • Leung LT
        • Lam TH
        Electronic cigarette use and respiratory symptoms in Chinese adolescents in Hong Kong.
        JAMA Pediatr. 2016; 170: 89‒91
        • Collée A
        • Clarys P
        • Geeraerts P
        • Dugauquier C
        • Mullie P
        Body mass index, physical activity, and smoking in relation to military readiness.
        Mil Med. 2014; 179: 901‒905
        • Conway TL
        • Cronan TA
        Smoking and physical fitness among Navy shipboard men.
        Mil Med. 1988; 153: 589‒594
        • Conway TL
        • Cronan TA
        Smoking, exercise, and physical fitness.
        Prev Med. 1992; 21: 723‒734
        • Macera CA
        • Aralis HJ
        • Macgregor AJ
        • Rauh MJ
        • Han PP
        • Galarneau MR
        Cigarette smoking, body mass index, and physical fitness changes among male Navy personnel.
        Nicotine Tob Res. 2011; 13: 965‒971
        • Bernaards CM
        • Twisk JW
        • Van Mechelen W
        • Snel J
        • Kemper HC
        A longitudinal study on smoking in relationship to fitness and heart rate response.
        Med Sci Sports Exerc. 2003; 35: 793‒800
        • Boyce RW
        • Perko MA
        • Jones GR
        • Hiatt AH
        • Boone EL
        Physical fitness, absenteeism and workers’ compensation in smoking and non-smoking police officers.
        Occup Med (Lond). 2006; 56: 353‒356
        • Cooper KH
        • Gey GO
        • Bottenberg RA
        Effects of cigarette smoking on endurance performance.
        JAMA. 1968; 203: 189‒192
        • de Borba AT
        • Jost RT
        • Gass R
        • et al.
        The influence of active and passive smoking on the cardiorespiratory fitness of adults.
        Multidiscip Respir Med. 2014; 9: 34
        • Lauria VT
        • Sperandio EF
        • de Sousa TL
        • et al.
        Evaluation of dose–response relationship between smoking load and cardiopulmonary fitness in adult smokers: a cross-sectional study.
        Rev Port Pneumol. 2017; 23: 79-84
        • Sandvik L
        • Erikssen G
        • Thaulow E
        Long term effects of smoking on physical fitness and lung function: a longitudinal study of 1393 middle aged Norwegian men for seven years.
        BMJ. 1995; 311: 715‒718
        • Leyk D
        • Rüther T
        • Witzki A
        • et al.
        Physical fitness, weight, smoking, and exercise patterns in young adults.
        Dtsch Arztebl Int. 2012; 109: 737‒745
        • Misigoj-Durakovic M
        • Bok D
        • Soric M
        • Dizdar D
        • Durakovic Z
        • Jukic I
        The effect of cigarette smoking history on muscular and cardiorespiratory endurance.
        J Addict Dis. 2012; 31: 389‒396
        • Sussan TE
        • Shahzad FG
        • Tabassum E
        • et al.
        Electronic cigarette use behaviors and motivations among smokers and non-smokers.
        BMC Public Health. 2017; 17: 686
      4. U.S. Army Public Health Center. Health of the Force: 2017. Published 2017. Accessed 2018.

        • Knapik JJ
        • Bedno SA
        Epidemiological evidence and possible mechanisms for the association between cigarette smoking and injuries (part 1).
        J Spec Oper Med. 2018; 18: 108‒112
        • Schoenborn CA
        • Gindi RM
        Electronic cigarette use among adults: United States, 2014.
        NCHS Data Brief. 2015; 217: 1‒8
        • Kok MO
        • Hoekstra T
        • Twisk JW
        The longitudinal relation between smoking and muscle strength in healthy adults.
        Eur Addict Res. 2012; 18: 70‒75
        • Bahrke MS
        • Baur TS
        • Poland DF
        • Connors DF
        Tobacco use and performance on the U.S. Army Physical Fitness Test.
        Mil Med. 1988; 153: 229‒235
        • Vardavas CI
        • Anagnostopoulos N
        • Kougias M
        • Evangelopoulou V
        • Connolly GN
        • Behrakis PK
        Short-term pulmonary effects of using an electronic cigarette: impact on respiratory flow resistance, impedance, and exhaled nitric oxide.
        Chest. 2012; 141: 1400‒1406
        • Lynch JP
        • Hanson K
        • Kao TC
        Health-related behaviors in young military smokers.
        Mil Med. 2004; 169: 230‒235
        • Scioli ER
        • Biller H
        • Rossi J
        • Riebe D
        Personal motivation, exercise, and smoking behaviors among young adults.
        Behav Med. 2009; 35: 57‒64
        • Dunbar MS
        • Tucker JS
        • Ewing BA
        • et al.
        Frequency of e-cigarette use, health status, and risk and protective health behaviors in adolescents.
        J Addict Med. 2017; 11: 55‒62
        • Leventhal AM
        • Strong DR
        • Sussman S
        • et al.
        Psychiatric comorbidity in adolescent electronic and conventional cigarette use.
        J Psychiatr Res. 2016; 73: 71‒78
        • Wills TA
        • Knight R
        • Williams RJ
        • Pagano I
        • Sargent JD
        Risk factors for exclusive e-cigarette use and dual e-cigarette use and tobacco use in adolescents.
        Pediatrics. 2015; 135: e43‒e51
        • Jones SB
        • Knapik JJ
        • Sharp MA
        • Darakjy S
        • Jones BH
        The validity of self-reported physical fitness test scores.
        Mil Med. 2007; 172: 115‒120
        • Martin RC
        • Grier T
        • Canham-Chervak M
        • et al.
        Validity of self-reported physical fitness and body mass index in a military population.
        J Strength Cond Res. 2016; 30: 26‒32

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