Vapes up asthma incidence in teens regardless of cigarette, marijuana use

E-cigarette appears to be a risk factor for asthma in teens, independently of cigarette smoking and marijuana use, according to a recent study.

“Data from a representative sample of US adolescents show e-cigarette use is associated with a higher likelihood of having asthma, above and beyond several other variables that create risk of respiratory disease,” the researchers said. “This indicates that e-cigarettes are a continuing concern for adolescents using recent generations of electronic nicotine delivery devices.”

Data were obtained from the 2017 Youth Risk Behaviour Survey, from which the researchers draw a sample size of 12,672 for the present analysis of e-cigarette device ever use. Over half (51 percent) were female, and the mean age was 16.0±1.2 years. Multivariable logistic regression analysis was performed to identify important risk factors for asthma.

E-cigarette use was much more prevalent in this sample than tobacco smoking (42 percent vs 29 percent); marijuana use was likewise more common than cigarette smoking (36 percent). The lifetime prevalence rate of asthma was 24 percent. [J Adolesc Health 2020;67:524-530]

Cross-tabulation analysis found a significant unadjusted correlation between current device use and asthma (p=0.0001). Cigarette smoking (p=0.003) and marijuana use (p<0.0001) likewise had the same effects.

Multivariable analysis showed that the past 30-day use of e-cigarettes was associated with a significant and independent 24-percent increase in the risk of asthma (adjusted odds ratio [OR], 1.24, 95 percent confidence interval [CI], 1.03–1.51; p=0.03). The effect of current cigarette smoking was likewise significant and was slightly stronger (adjusted OR, 1.30, 95 percent CI, 1.10–1.53; p=0.002).

However, for the model analysis of ever-use, only e-cigarette devices emerged as a significant risk factor, resulting in a 15-percent spike in the risk of asthma (adjusted OR, 1.15, 95 percent CI, 1.02–1.30). Ever use of cigarettes failed to reach statistical significance. Likewise, marijuana use did not emerge as a significant correlate in either the ever-use or current-use analyses.

“We note that these results are based on dichotomous predictors but when scaled scores for frequency of current e-cigarette, cigarette, and marijuana were entered in the model, the results were similar,” the researchers explained.

In addition, researchers also showed that asthma prevalence was higher in exclusive e-cigarette users relative to nonusers (current use: adjusted OR, 1.29, 95 percent CI, 1.07–1.55). Nevertheless, current dual use of both electronic and combustible cigarettes had a stronger effect on asthma prevalence (adjusted OR, 1.62, 95 percent CI, 1.32–1.99).

“While there are multiple environmental and individual factors that contribute to asthma, we conclude that e-cigarettes represent a significant public health concern. Efforts are needed to educate youth about risks, specifically study vaping of marijuana, and institute regulations to reduce the prevalence of e-cigarette use among adolescents,” the researchers said.