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Master of Public Health

Association of Electronic Cigarette Use with Respiratory Symptom Development among US Young Adults

AUTHORS

Xie W , Tackett AP , Berlowitz JB , Harlow AF , Kathuria H , Galiatsatos P , Fetterman JL , Cho J , Blaha MJ , Hamburg NM , Robertson RM , DeFilippis AP , Hall ME , Bhatnagar A , Benjamin EJ , Stokes AC , . American journal of respiratory and critical care medicine. 2022 1 28; ().

ABSTRACT

RATIONALE: Electronic cigarette (e-cigarette) use is highly prevalent among young adults. However, longitudinal data assessing the association between e-cigarette use and respiratory symptoms are lacking.

OBJECTIVES: To determine whether e-cigarette use is associated with the development of respiratory symptoms in young adults.

METHODS: Data are derived from the Population Assessment of Tobacco and Health (PATH) Study Waves 2 (2014-2015), 3 (2015-2016), 4(2016-2018), and 5 (2018-2019). Young adults aged 18-24 years at baseline with no prevalent respiratory disease or symptoms were included in the analyses. Binary logistic regression models with a generalized estimating equation were used to estimate time-varying and time-lagged associations of e-cigarette use during Waves 2 to 4 with respiratory symptom development approximately 12 months later at Waves 3 to 5.

MEASUREMENTS AND MAIN RESULTS: The per-wave prevalence of former and current e-cigarette use was 15.2% and 5.6%, respectively. Former e-cigarette use was associated with higher odds of developing any respiratory symptom (adjusted-Odds Ratio [aOR], 1.20; 95% confidence interval [CI], 1.04-1.39), and wheezing in the chest (aOR, 1.41; 95% CI, 1.08-1.83) in multivariable adjusted models. Current e-cigarette use was associated with higher odds for any respiratory symptom (aOR, 1.32; 95% CI, 1.06-1.65), and wheezing in the chest (aOR, 1.51; 95% CI, 1.06-2.14). Associations persisted among participants who never smoked combustible cigarettes.

CONCLUSIONS: In this nationally representative cohort of young adults, former and current e-cigarette use was associated with higher odds of developing wheezing-related respiratory symptoms, after accounting for cigarette smoking and other combustible tobacco product use.

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