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In the early stages of COPD, there may be no symptoms, or you may only have mild symptoms, such as: 4 A nagging cough (often called "smoker's cough") Shortness of breath, especially with physical activity Wheezing (a whistling sound when you breathe) Tightness in the chest As the disease gets worse, symptoms may include: 4 Having trouble catching your breath or talking Blue or gray lips and/or fingernails (a sign of low oxygen levels in your blood) Trouble with mental alertness A very fast heartbeat Swelling in the feet and ankles Weight loss How severe your COPD symptoms are depends on how damaged your lungs are

Since nicotine is a highly addictive substance and may affect brain development, its dose delivered must be considered when evaluating the safety of e-cigs

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