E-cigarette use associated with respiratory problems among youth: a review

Young people are at risk of experiencing significant respiratory symptoms, including bronchitis and shortness of breath, after just 30 days of using e-cigarettes, according to a new study released Tuesday.

Researchers at The Ohio State University Comprehensive Cancer Center and the Center for Tobacco Research at Southern California Keck School of Medicine used four years of data from online surveys to examine the health effects of e-cigarettes, which produce nicotine and other harmful vapors. items – for teenagers and young adults.

They said the study, funded in part by the National Institutes of Health, adds to existing evidence that e-cigarette use is associated with an increased risk of respiratory symptoms. Drug regulators should take the findings into account and work to minimize the negative health effects of e-cigarette use among young people, the researchers added.

E-cigarettes are exposing a new generation to nicotine in less than a decade, putting the health of millions of children, adolescents and young adults at risk, and threatening years of progress in reducing youth tobacco use.

According to the Centers for Disease Control and Prevention, e-cigarette use among youth and young adults is now much higher than among adults in the United States. In the first two years of the Covid pandemic, sales of e-cigarettes have increased by around 50%, mainly driven by disposable products in sweet and fruity flavors that have long been popular with teenagers.

This increase in sales came despite federal pressure to place more restrictions on the marketing and flavors of tobacco products.

Manufacturers still flood the market with thousands of addictive products, often sold illegally. Brands like Puff Bar, Elf Bar and Breeze Smoke are not approved by the Food and Drug Administration, and some have surpassed vaping pioneer Juul in popularity.

“An important point for consumers is that e-cigarettes are not without risk,” said Alayna Tackett, a pediatric psychologist and researcher at the Center for Tobacco Research. “We want to completely eliminate the initiation and use of e-cigarettes among youth. I think that’s a critical public health goal.”

He noted that the study only looked at teens and young adults, and that across all adult demographics, people “switch to less-risky e-cigarettes more often than they do to cigarettes.”

“I think we need to think about policies to protect these young people while also supporting adults who are interested in choosing a potentially less harmful alternative to smoking,” Tackett said.

Researchers followed more than 2,000 youth with an average age of 17.3 from the Southern California Child Health Study.

In 2014, they asked participants to fill out an online survey about respiratory symptoms and use of e-cigarettes, traditional cigarettes, and cannabis. Approximately 23% of participants reported a history of asthma at baseline.

The researchers collected follow-up data from most of those participants during three additional survey waves in 2015, 2017, and 2018.

Participants were specifically asked whether they used each of the three products. If they said yes, they were asked the number of days they had used the product in the last 30 days.

Those who had never tried the product were classified as “never users,” and participants who had used the product at least once in the past 30 days were classified as “past 30-day” users.

Past 30-day e-cigarette users were 81% more likely to experience a symptom called snoring than never users after adjusting for survey wave, age, sex, race, and parental education. Wheezing was defined as a crackling or whistling sound in the chest in the previous 12 months.

Past 30-day users have a 78% increased risk of shortness of breath and a 50% increased risk of experiencing an infection of the main lung airways that causes bronchitis symptoms, irritation and inflammation.

The association between e-cigarette use and respiratory symptoms was somewhat weaker when the researchers accounted for two factors: co-use of e-cigarettes with traditional cigarettes or cannabis, and secondhand exposure to any of the three products.

For example, past 30-day e-cigarette users had a 41% higher risk of snoring than never users if they did not use traditional cigarettes or cannabis at the same time, or had secondhand exposure to any of the products.

“When we controlled for the combined use of cigarettes and cannabis, snoring was no longer significantly associated with respiratory symptoms associated with e-cigarette use,” Tackett said. But he noted that the symptoms of bronchitis and shortness of breath remained significant.

The association between e-cigarette use and respiratory symptoms was sustained in a subanalysis that excluded participants with a history of asthma. This suggests that the adverse health effects of e-cigarette use were not limited to those with asthma, but to all participants.

Tackett noted that the study has limitations that future research could address.

According to Tackett, further studies could more objectively measure respiratory symptoms and product use rather than using self-administered questionnaires.

He added that future studies, including the one he is currently working on, could further assess the “complex relationship” between e-cigarettes and traditional cigarette or cannabis use.

– CNBC Stephen Sykes contributed to this report.