Vaping associated with wheezing in adults

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Electronic cigarette use or ‘vaping‘ is associated with wheezing in adults, according to a University of Rochester study. People who vaped were nearly twice as likely to experience wheezing compared to people who didn’t regularly use tobacco products. Wheezing, which is caused by narrowed or abnormal airways, is often a precursor to other serious health conditions such as emphysema, gastro-oesophageal reflux disease, heart failure, lung cancer and sleep apnoea.

Study author Dr Deborah J Ossip says the findings, published in the journal Tobacco Control,  are consistent with past research that shows emissions from electronic cigarette aerosols and flavourings damage lung cells by generating harmful free radicals and inflammation in lung tissue.

“The take-home message is that electronic cigarettes are not safe when it comes to lung health,” says Ossip, a tobacco research expert and professor in the department of public health sciences at the University of Rochester Medical Centre (URMC). “The changes we’re seeing with vaping, both in laboratory experiments and studies of people who vape, are consistent with early signs of lung damage, which is very worrisome.”

Electronic cigarettes are extremely popular in the US. Data from the National Centre for Health Statistics indicates that close to 13% of US adults have tried electronic cigarettes and nearly 4% currently use them. Although electronic cigarettes are marketed as a less harmful alternative to cigarette smoking, many concerns remain related to the long-term health consequences of vaping.

Researchers from URMC analysed data from more than 28,000 adults in the US who took part in the Population Assessment of Tobacco and Health (PATH) study. After adjusting for age, gender, race/ethnicity, body mass index, second-hand smoke exposure and other factors, adult vapers were 1.7 times more likely to experience wheezing and related respiratory symptoms (such as difficulty breathing) compared to non-users.

Lead study author Dr Dongmei Li, associate professor in the department of clinical and translational research at URMC, acknowledges that there are limitations to the study. PATH study data are self-reported, so it’s possible that information collected from participants is subject to recall bias. The analysis cannot prove that vaping causes wheezing; it only identifies an association between the two. Finally, PATH data does not include information on some important factors that could influence the results, such as participants’ diet and physical activity levels.

Despite these limitations, senior study author Dr Irfan Rahman, professor of environmental medicine at URMC, says the research clearly identifies another health repercussion from vaping. This is particularly concerning given new data released from the US Centre for Disease Control and Prevention that shows a dramatic uptick in youth vaping.

According to the report, in 2018 vaping increased by 78% among ninth to 12th graders and 48% in sixth to eighth graders. With the emergence of small, sleek vaping devices like Juuls that are used with nicotine pods in hundreds of different flavours (popular flavouring chemicals include fruit, candy and dessert), Rahman fears the number of young people who vape will continue to grow and that serious health consequences, including allergies, loss of immunity, and subsequent infections will follow.

Association of smoking and electronic cigarette use with wheezing and related respiratory symptoms in adults: cross-sectional results from the Population Assessment of Tobacco and Health (PATH) study, wave 2

The journal Tobacco Control.

Abstract

Authors
Dongmei Li, Isaac K Sundar, Scott McIntosh, Deborah J Ossip, Maciej Lukasz Goniewicz, Richard J O’Connor and Irfan Rahman

Background

Wheezing is a symptom of potential respiratory disease and known to be associated with smoking. Electronic cigarette use (‘vaping’) has increased exponentially in recent years. This study examined the cross-sectional association of vaping with wheezing and related respiratory symptoms and compare this association with smokers and dual users.

Methods

The Population Assessment of Tobacco and Health study wave 2 data collected from October 2014 to October 2015 with 28 171 adults were used. The cross-sectional association of vaping with self-reported wheezing and related respiratory symptoms relative to smokers and dual users of tobacco and electronic cigarettes were studied using multivariable logistic and cumulative logistic regression models with consideration of complex sampling design.

Results

Among the 28 171 adult participants, 641 (1.2%) were current vapers who used e-cigarettes exclusively, 8525 (16.6%) were current exclusive smokers, 1106 (2.0%) were dual users and 17 899 (80.2%) were non-users. Compared with non-users, risks of wheezing and related respiratory symptoms were significantly increased in current vapers (adjusted OR (aOR)=1.67, 95% CI: 1.23 to 2.15). Current vapers had significantly lower risk in wheezing and related respiratory symptoms compared with current smokers (aOR=0.68, 95% CI: 0.53 to 0.87). No significant differences were found between dual users and current smokers in risk of wheezing and related respiratory symptoms (aOR=1.06, 95% CI: 0.91 to 1.24).

Conclusions

Vaping was associated with increased risk of wheezing and related respiratory symptoms. Current vapers had lower risk in wheezing and related respiratory symptoms than current smokers or dual users but higher than non-users. Both dual use and smoking significantly increased the risk of wheezing and related respiratory symptoms.

University of Rochester Medical Centre material
Tobacco Control abstract


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