Association of Electronic Cigarette Use with Respiratory Symptom Development among U.S. Young Adults
Wubin Xie, Alayna P. Tackett, Jonathan B. Berlowitz, Alyssa F. Harlow, Hasmeena Kathuria, Panagis Galiatsatos, Jessica L. Fetterman, Junhan Cho, Michael J. Blaha, Naomi M. Hamburg, Rose Marie Robertson, Andrew P. DeFilippis, Michael E. Hall, Aruni Bhatnagar, Emelia J. Benjamin, Andrew C. Stokes
Abstract
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 PATH (Population Assessment of Tobacco and Health) 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 2–4, with respiratory symptom development approximately 12 months later at waves 3–5. 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.