Chronic obstructive pulmonary disease develops over decades and we are missing the window to prevent it A new study published in Nicotine & Tobacco Research found that those using e cigarettes alone were more than twice as likely to develop COPD than people who didn't use any tobacco products, Electronic Cigarette Use in US Adults at Risk for or with COPD: Analysis from Two Observational Cohorts Journal of General Internal Medicine Springer Nature Link Increased risk of COPD observed in individuals using e cigarette: Study