Vaping tied to chronic stress, poor QoL in young adults

Use of e-cigarette (EC) shows a significant relation with a higher incidence of chronic stress and is indicative of poorer quality of life (QoL) in young adults, suggests a study presented at ERS 2023.

“Ongoing surveillance of young EC users is important to measure the long-term impact of vaping on their physical, mental health, and QoL and target for interventions,” said the researchers led by Teresa To, professor at the Dalla Lana School of Public Health, University of Toronto, Canada.

To and her colleagues analysed data from the Canadian Health Measures Surveys to explore the cross-sectional associations between QoL indicators and EC use among young Canadian adults. They compared physical activity (daily steps), physiological measurements, self-perceived stress, mental health, and QoL between EC users (ever) and nonusers (never).

The researchers then calculated odds ratios (ORs) and 95 percent confidence intervals (CIs) using multivariable binary or ordinal logistic regressions.

A total of 905 participants (aged 15‒30 years) were included in the analysis. Of these, 115 (12.7 percent) reported using EC and 790 were nonusers. [ERS 2023, abstract OA4231]

After adjusting for confounders, EC users were found to be more physically active (OR, 2.19, 95 percent CI, 1.14‒4.20) than nonusers, but they were also more likely to experience self-reported extreme chronic stress (OR, 2.68, 95 percent CI, 1.45‒4.92).

In addition, EC use was associated with greater odds of poorer QoL (OR, 1.12, 95 percent CI, 0.64‒1.95) but with lower odds of other health morbidities, such as high blood pressure, blood sugar, or lower level of high-density lipoprotein, albeit not statistically significant.

No statistically significant associations were noted between EC use, cigarette smoking, weed consumption, and health outcomes.

Quit smoking

These findings support those of a recent umbrella review of studies humans examining the relationship of EC use to health outcomes published since the 2018 United States National Academies of Sciences, Engineering, and Medicine [NASEM] report.

Synthesis of the global evidence revealed the harmful effects of EC, particularly for nonsmokers and children, adolescents, and young adults, although their effect on other health outcomes remained uncertain. [Med J Aust 2023;218:267-275]

On the one hand, EC use may benefit smokers who wish to quit smoking, but this device is not currently approved for smoking cessation aid, according to the investigators.

The umbrella review included 400 eligible publications: 112 from the NASEM review, 189 from the top-up review search, and 99 cited by other reviews. Conclusive evidence showed the association of EC use with poisoning, immediate inhalation toxicity (including seizures), and EC or vaping use-related lung injury, as well as malfunctioning devices leading to injuries and burns. [Med J Aust 2023;218:267-275]

“There is substantial evidence that nicotine ECs can cause dependence or addiction in nonsmokers, and strong evidence that young nonsmokers who use ECs are more likely than nonusers to initiate smoking and to become regular smokers,” the investigators said. “There is limited evidence that freebase nicotine ECs used with clinical support are efficacious aids for smoking cessation.”