Dataset Information

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.

Conclusions

Use of e-cigarettes is an independent risk factor for respiratory disease in addition to combustible tobacco smoking. Dual use, the most common use pattern, is riskier than using either product alone.

SUBMITTER: Bhatta DN

PROVIDER: S-EPMC6981012 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

Bhatta Dharma N DN Glantz Stanton A SA

American journal of preventive medicine 20191216 2

<h4>Introduction</h4>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.<h4>Methods</h4>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-cig ...[more]

PMID: 31859175

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Project description:Importance:Generating robust and timely evidence about the respiratory health risks of electronic cigarettes (e-cigarettes) is critical for informing state and federal regulatory standards for product safety. Objective:To examine the association of e-cigarette use with incident respiratory conditions, including chronic obstructive pulmonary disease (COPD), emphysema, chronic bronchitis, and asthma. Design, Setting, and Participants:This prospective cohort study used data from the nationally representative cohort of US adults from the Population Assessment of Tobacco and Health (PATH) study, including wave 1 from 2013 to 2014, wave 2 from 2014 to 2015, wave 3 from 2015 to 2016, and wave 4 from 2016 to 2018. Individuals aged 18 years and older at baseline with no prevalent respiratory conditions were included in the analyses. Analyses were conducted from February to July 2020. Exposures:e-Cigarette use was assessed by self-reported current use status (never, former, or current) at baseline. Main Outcomes and Measures:Incident respiratory conditions, including COPD, emphysema, chronic bronchitis, and asthma, as well as a composite respiratory disease encompassing all 4 conditions. Results:Among 21?618 respondents included in the analyses, 11?017 (491%) were men and 12?969 (65.2%) were non-Hispanic White. A total of 14?213 respondents were never e-cigarette users, 5076 respondents (11.6%) were former e-cigarette users, and 2329 respondents (5.2%) were current e-cigarette users. Adjusted for cigarette and other combustible tobacco product use, demographic characteristics, and chronic health conditions, there was an increased risk of respiratory disease among former e-cigarette uses (incidence rate ratio [IRR], 1.28; 95% CI, 1.09-1.50) and current e-cigarette users (IRR, 1.31; 95% CI, 1.08-1.59). Among respondents with good self-rated health, the IRR for former e-cigarette users was 1.21 (95%CI, 1.00-1.46) and the IRR for current e-cigarette users was 1.43 (95% CI, 1.14-1.79). For specific respiratory diseases among current e-cigarette users, the IRR was 1.33 (95% CI, 1.06-1.67) for chronic bronchitis, 1.69 (95% CI, 1.15-2.49) for emphysema, 1.57 (95% CI, 1.15-2.13) for COPD, and 1.31 (95% CI, 1.01-1.71) for asthma. Conclusions and Relevance:This cohort study found that e-cigarette use was associated with an increased risk of developing respiratory disease independent of cigarette smoking. These findings add important evidence on the risk profile of novel tobacco products.

Project description:IntroductionElectronic cigarette use (vaping) has been found to be associated with respiratory symptoms like wheezing or whistling in the chest. Whether or not lifetime vaping occurrences are associated with wheezing has not yet been investigated.MethodsPopulation Assessment of Tobacco and Health (PATH) Study Wave 4 data with 22,233 adults collected from December 2016 to January 2018 were used. The cross-sectional association of lifetime vaping occurrences with wheezing and related respiratory symptoms was examined using multivariable weighted logistic regression models considering the complex sampling design.ResultsAccording to the weighted PATH Wave 4 data, about 89.9% adults never vaped, 3.2% adults vaped one time, 3.2% vaped 2-10 times, 1.3% vaped 11-20 times, 1.1% vaped 21-50 times, 0.4% vaped 51-99 times, and 0.9% vaped 100 or more times in their entire life. Compared to adults who never vaped, adults who vaped 2-10 times had a significantly higher association with ever wheezing (aOR = 1.4, 95% CI: 1.1 to 1.6), past 12-month wheezing (aOR = 1.5, 95% CI: 1.2 to 1.9) and the number of wheezing attacks in the past 12 months (aOR = 1.5, 95% CI: 1.2 to 1.8). Adults who vaped 11-20 times and 100 or more times had similar associations with wheezing as that for adults who vaped 2-10 times. Controlling other tobacco use attenuated the associations.ConclusionsLifetime vaping occurrences were found to be associated with some definitions of self-reported wheezing in cross-sectional analyses adjusted for other tobacco use.ImplicationsUsing the cross-sectional PATH Wave 4 data with 22,233 adults, we found significant associations between lifetime vaping occurrences and ever wheezing or whistling in the chest, past 12 months wheezing or whistling in the chest, as well as the number of wheezing attacks in the past 12 months. The study results suggest that larger studies with more precise time frames and measures are needed to further understand possible connections between vaping experimentation and wheezing symptoms that could inform our understanding of the health effects of electronic cigarettes and resultant policy decisions.

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Project description:BackgroundThe link between e-cigarette use and subsequent development of respiratory diseases remains an open question.Aims and methodsA subset of a probability sample of U.S. adults from the Population Assessment of Tobacco and Health Study Waves 1 and 2 were selected for biospecimen analysis (n = 4614). Subjects were divided into three mutually exclusive groups at baseline: nonusers (n = 2849), exclusive e-cigarette users (n = 222), and poly e-cigarette/tobacco users (n = 1,543). Geometric mean concentrations of baseline biomarkers from five classes of harmful and potentially harmful constituents were reported. Multivariable linear regressions were conducted to examine the relationship between baseline biomarkers and subsequent respiratory symptoms among user groups.ResultsBaseline exclusive e-cigarette users (33.6%[confidence interval, CI: 26.7% to 41.4%]) and poly e-cigarette/tobacco users (50.8%[CI: 47.4% to 54.2%]) had higher prevalence of subsequent respiratory symptoms than nonusers (21.7%[19.2% to 24.4%]). As compared with nonusers, poly e-cigarette/tobacco users had higher concentrations in clinically relevant biomarkers at baseline than exclusive e-cigarette users. Among poly e-cigarette/tobacco users, baseline nicotine metabolites (TNE2, cotinine), tobacco-specific nitrosamine (NNAL), PAH (1-NAP, 3-FLU), and volatile organic compound (N-Acetyl-S-(2-carboxyethyl)-l-cysteine, N-acetyl-S-(2-cyanoethyl)-l-cysteine) were significantly higher among those reporting subsequent respiratory symptoms than those who did not. Among exclusive e-cigarette users, baseline NNAL was significantly higher among those reporting subsequent respiratory symptoms than those who did not. Within subjects with subsequent respiratory symptoms, NNAL was 2.5 times higher in exclusive e-cigarette users (10.7[6.5 to 17.5]) and 63.4 times higher in poly e-cigarette/tobacco users (199.6[176.7 to 225.4]) than nonusers (3.1[2.4 to 3.9]).ConclusionsE-cigarette use is associated with higher concentrations of known tobacco-related toxicants and risks of subsequent respiratory symptoms than nonusers. Poly e-cigarette/tobacco users exhibit higher risk than exclusive e-cigarette users.ImplicationsThis longitudinal study identified positive associations between baseline urinary biomarkers of exposure to tobacco-related toxicants and increased risks of subsequent respiratory symptoms across varying e-cigarette use groups. E-cigarette use is associated with increased exposure to known tobacco-related toxicants, and certain toxicant exposure increases the risk of respiratory symptoms.

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Project description:Importance:There is an ongoing debate about whether electronic cigarettes (e-cigarettes) are the solution to the tobacco epidemic or a new public health threat. Large representative studies are needed to study e-cigarette use in the general population, but hardly any have been published. Objectives:To estimate the prevalence of e-cigarette use and to investigate the association of e-cigarette use with smoking habits, demographic factors, and respiratory symptoms. Design, Setting, and Participants:Cross-sectional, population-based study of random samples of the population, performed within the Obstructive Lung Disease in Northern Sweden (OLIN) study and West Sweden Asthma Study (WSAS). The same validated questionnaire including identical questions was used in OLIN and WSAS. In 2016, OLIN and WSAS conducted postal questionnaire surveys in random samples of adults aged 20 to 75 years. In OLIN, 6519 participated (response rate, 56.4%); in WSAS, 23?753 participated (response rate, 50.1%). Main Outcomes and Measures:Electronic cigarette use, smoking habits, and respiratory symptoms. Results:Of 30?272 participants (16?325 women [53.9%]), 3897 (12.9%) were aged 20 to 29 years; 4242 (14.0%), 30 to 39 years; 5082 (16.8%), 40 to 49 years; 6052 (20.0%), 50 to 59 years; 6628 (21.9%), 60 to 69 years; and 4371 (14.4%), 70 to 75 years. The number of current smokers was 3694 (12.3%), and 7305 (24.4%) were former smokers. The number of e-cigarette users was 529 (2.0%), and e-cigarette use was more common among men (275 of 12?347 [2.2%; 95% CI, 2.0%-2.5%]) than women (254 of 14?022 [1.8%; 95% CI, 1.6%-2.0%]). Among current smokers, 350 of 3566 (9.8%; 95% CI, 8.8%-10.8%) used e-cigarettes compared with 79 of 6875 (1.1%; 95% CI, 0.9%-1.3%) in former smokers and 96 of 15?832 (0.6%; 95% CI, 0.5%-0.7%) in nonsmokers (P?<?.001). Among e-cigarette users who answered the survey question about cigarette-smoking habits (n?=?525), 350 (66.7%; 95% CI, 62.7%-70.7%) were current smokers, 79 (15.0%; 95% CI, 11.9%-18.1%) were former smokers, and 96 (18.3%; 95% CI, 15.0%-21.6%) were nonsmokers (P?<?.001 for trend). In a regression analysis, e-cigarette use was associated with male sex (odds ratio [OR], 1.35; 95% CI, 1.12-1.62); age groups 20 to 29 years (OR, 2.77; 95% CI, 1.90-4.05), 30 to 39 years (OR, 2.27; 95% CI, 1.53-3.36), 40 to 49 years (OR, 1.65; 95% CI, 1.11-2.44), and 50 to 59 years (OR, 1.47; 95% CI, 1.01-2.12); educational level at primary school (OR, 1.99; 95% CI, 1.51-2.64) and upper secondary school (OR, 1.57; 95% CI, 1.25-1.96); former smoking (OR, 2.37; 95% CI, 1.73-3.24); and current smoking (OR, 18.10; 95% CI, 14.19-23.09). All respiratory symptoms were most common among dual users and former smokers and nonsmokers who used e-cigarettes. Conclusions and Relevance:Use of e-cigarettes was most common among smokers, and dual users had the highest prevalence of respiratory symptoms. On a population level, this study indicates that the present use of e-cigarettes does not adequately serve as a smoking cessation tool.

Dataset Information

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

Introduction

Methods

Results

Conclusions

Publications

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

Similar Datasets

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