Cigarette, shisha, and electronic smoking and respiratory symptoms in Swiss children: The LUIS study

Abstract

Background Smoking habits in adolescents are changing. We assessed active smoking of conventional cigarettes, e‐cigarettes and shishas in Swiss schoolchildren, studied risk factors and compared respiratory problems between smokers and non‐smokers. Methods We used data from LuftiBus in the school (LUIS), a school‐based survey of respiratory health of children carried out 2013 to 2016 in the canton of Zurich, Switzerland. Participants were asked about use of cigarettes, shishas, and electronic smoking devices (ESD), and current respiratory symptoms. We studied associations between smoking and risk factors using logistic regression. Results We included 3488 schoolchildren. Among 6 to 12‐year‐olds, 90/1905 (5%) had smoked occasionally (<once/week). Among 13 to 17‐year‐olds, 563/1583 (36%) had smoked occasionally of whom 414 smoked ESDs, 409 shishas, and 276 cigarettes. Among 13 to 17‐year‐olds who smoked frequently (≥once/week), 41/54 (76%) smoked cigarettes. A 22% of 15 to 17‐year‐olds (104/477) had used all three products. Smoking was more common in adolescents who were male (adjusted OR, 2.1; 95% CI, 1.7‐2.6), lived in rural areas (1.8, 95% CI, 1.2‐2.9 vs small urban), and whose mother (1.7, 95% CI, 1.3‐2.3) or father (1.5, 95% CI, 1.2‐1.9) smoked. Current respiratory symptoms like rhinitis, dyspnea, and wheeze were more common among frequent smokers (44%, 30%, 12%, respectively) and occasional smokers (32%, 22%, 13%) than in never smokers (29%,19%, 8%, P for trend <.05). Conclusion Smoking of shishas and ESDs is common among Swiss adolescents and often combined with smoking cigarettes. Adolescent smokers reported more respiratory symptoms than never smokers. We recommend smoking preventive strategies that include all forms of smoking.

Association between electronic cigarette use in children and adolescents and coughing a systematic review

“…Information was collected by student self‐report and a parental questionnaire. Cough, apart from colds, was reported by 26% of never smokers, 29% of occasional smokers (adjusted OR: 1.3, 95% CI: 1.0–1.7), and 34% of frequent smokers (adjusted OR: 1.7, 95% CI: 0.9–3.2) ( p trend .112) and cough more than others was reported by 4% of never smokers, 4% of occasional smokers (adjusted OR: 1.4, 95% CI: 0.8–2.4), and 8% of frequent smokers (adjusted OR: 3.0, 95% CI: 0.9–9.5) ( p trend .261) 32 …”

“…Ninety‐eight studies were found in the initial search with a further six papers identified by searching the Grey Literature. Seven studies met the inclusion criteria 29–35 . No further studies were found by cross‐checking the reference list of the included studies.…”

“…Of the seven studies included in this systematic review, 29–35 six studies are cross‐sectional surveys (four studies are school‐based, 30–32,35 one is a cross‐sectional telephone survey, 29 and one was conducted within a hospital setting 34 ); and one is a retrospective medical chart review 33 . Five studies were rated as fair quality and two studies were rated as good quality (see Table 1).…”

“…Studies included in this review used a collection of respiratory symptoms as one outcome and, therefore, have shown that e‐cigarette use can also result in other respiratory symptoms 31,35 . Two studies included in this review have found an association between e‐cigarette use and increased rates of wheeze 31,32 and a study from South Korea showed an association between asthma, as well as more severe asthma and e‐cigarette use in high school students 38 . Dyspnoea, rhinitis, dry mouth, and headaches have also been associated with e‐cigarette use in adolescents 29,32 …”

LuftiBus in the school (LUIS): a population-based study on respiratory health in schoolchildren

“…LUIS will cover knowledge gaps on children’s respiratory health. This dataset allows to determine prevalence of upper and lower respiratory symptoms, to describe lifestyle characteristics like physical activity and smoking [37], and to study associations with lung function. We are able to use information from both parents and children and several lung function tests including markers of ventilatory function (spirometry), ventilation inhomogeneity (DTG-SBW) and Th2 airway inflammation (FeNO), to answer research questions in a comprehensive way [32, 38].…”