In fact, in a by Flouris et al., the investigators found that real cigarettes, but not the fake ones, had a significant detrimental effect on pulmonary function, measured by spirometry. This study documents that while active smoking has immediate, clinically meaningful effects in reducing lung function, electronic cigarettes do not.

The study is notable because it found that even among dual users, there was a substantial improvement in respiratory health symptoms and a significant increase in several measures of acute lung function, especially small airways flow rates. Thus, the results of this study suggest that dual use of cigarettes and electronic cigarettes might result in respiratory health improvement if the reduction in cigarette use is dramatic, as it was among the dual users in this study.

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