Association of E-Cigarette Use With Respiratory Disease Among Adults: A Longitudinal Analysis

Abstract

Introduction: E-cigarettes deliver an aerosol of nicotine by heating a liquid and are promoted as an alternative to combustible tobacco. This study determines the longitudinal associations between e-cigarette use and respiratory disease controlling for combustible tobacco use. Methods:This was a longitudinal analysis of the adult Population Assessment of Tobacco and Health Waves 1, 2, and 3. Multivariable logistic regression was performed to determine the associations between e-cigarette use and respiratory disease, controlling for combustible tobacco smoking, demographic, and clinical variables. Data were collected in 2013-2016 and analyzed in 2018-2019.Results: Among people who did not report respiratory disease (chronic obstructive pulmonary disease, chronic bronchitis, emphysema, or asthma) at Wave 1, the longitudinal analysis revealed statistically significant associations between former e-cigarette use (AOR=1.31, 95% CI=1.07, 1.60) and current e-cigarette use (AOR=1.29, 95% CI=1.03, 1.61) at Wave 1 and having incident respiratory disease at Waves 2 or 3, controlling for combustible tobacco smoking, demographic, and clinical variables. Current combustible tobacco smoking (AOR=2.56, 95% CI=1.92, 3.41) was also significantly associated with having respiratory disease at Waves 2 or 3. Odds of developing respiratory disease for a current dual user (e-cigarette and all combustible tobacco) were 3.30 compared with a never smoker who never used e-cigarettes. Analysis controlling for cigarette smoking alone yielded similar results.

E-cigarettes and their impact on health: from pharmacology to clinical implications

“…This is a prevailing argument that dual use of e -cigarettes and tobacco cigarettes does not reduce the respiratory risk from smoking, but may actually increase such risk. 48 Similar conclusions were presented in the NASEM report, particularly with regard to dual users. Although the report concluded that there is no evidence available that e -cigarettes cause respiratory diseases in humans, it also states that there is limited evidence of improved lung function and respiratory symptoms in adult asthma smokers who switch to e -cigarettes in full or in part (dual use).…”

Evaluation of Respiratory Symptoms Among Youth e-Cigarette Users

“…The outcome variable was any episode of wheezing in the past 12 months (yes or no) as reported on the wave 4 survey. For participants who completed the wave 3 survey (ie, participants whose data were used in this analysis), wheezing was assessed by asking, "Have you had wheezing or whistling in the chest in the past 12 Downloaded From: https://jamanetwork.com/ on 10/31/2020…”

“…6 In addition, there may be respiratory effects of ECs; one concern is that the use of ECs may be associated with risk of respiratory symptoms such as wheezing among youths. 7,8 Although the harmful respiratory effects of combustible tobacco use are well documented, [9][10][11][12] little is known about the respiratory effects of EC use. e-Cigarette aerosol contains several chemical constituents, such as diacetyl or benzaldehyde, that affect the respiratory system.…”

Der Verlauf des E-Zigarettenkonsums im Jugendalter: Eine Kohortenstudie über 18 Monate

“…Methodisch deutlich aussagekräftiger als Querschnittsuntersuchungen sind Kohortenstudien. Eine erste longitudinale Untersuchung beobachtete 26 646 US-Amerikaner, die bei der ersten Befragungswelle noch keine Atemwegserkrankungen hatten, über 2 Jahre [24]. Aktuelle E-Zigarettennutzer hatten verglichen mit Nicht-Konsumenten auch bei Kontrolle des ehemaligen und aktuellen Tabakkonsums ein adjustiertes Odds Ratio (aOR) von 1,29 (95 %-KI: 1,03 -1,61), im Beobachtungszeit eine Atemwegserkrankung zu entwickeln, bei Rauchern von Tabakzigaretten lag das adjustierte Chancenverhältnis bei 2,56 (95 %-KI: 1,92 bis 3,41).…”