E-cigarettes

Young E-Cigarette Users Develop Wheezing, Other Respiratory Symptoms

A new study found that both current and former e-cigarette users were more likely to develop respiratory symptoms within 12 months of use than those who did not use e-cigarettes.

Young adults who used e-cigarettes were more likely to develop respiratory issues within one year of vaping, according to a new study led by School of Public Health researchers.

Published in the American Journal of Respiratory and Critical Care Medicine, the study found that participants who used e-cigarettes had greater incidence of self-reported respiratory symptoms, such as wheezing, dry cough during sleeping, and wheezing during exercise, within 12 months of use. These symptoms were reported regardless of former combustible cigarette use.

Funded by the American Lung Association (ALA), National Heart, Lung, and Blood Institute, and American Heart Association, the study fills a gap in robust data on e-cigarette use and respiratory symptoms among young adults.

“The present study finds a significant prospective association of vaping with subsequent respiratory symptom development in a large, nationally representative cohort of young adults with no previous history of respiratory symptoms,” says study corresponding author Andrew Stokes, assistant professor of global health. “This evidence highlights an urgent public health imperative for more robust regulatory standards at all levels of government to stop the youth vaping epidemic in its tracks.”

Stokes and colleagues analyzed data from the PATH (Population Assessment of Tobacco and Health) study, a longitudinal study tracking changes in tobacco use over time among participants. They studied young adults aged 18-24 years who were current or former e-cigarettes users and had no respiratory disease or symptoms prior to entering the study. 

The researchers found that current e-cigarette users had 32 percent greater odds of developing any respiratory symptom and 51 percent greater odds of developing wheezing in the chest. Former e-cigarette users had 20 percent greater odds of developing any respiratory symptom and 41 percent greater odds of developing wheezing in the chest. 

“The study is among the first to associate these respiratory symptoms with young adults across the US, independent of cigarette smoking or other combustible tobacco use,” says study lead author Wubin Xie, senior research scientist in the Department of Global Health. “By restricting the analyses to a sample of young adults with no history of respiratory disease or wheezing symptom, the study mitigated potential bias that patterns of use and exposure may have influenced by pre-existing respiratory conditions.”

The study also found that tobacco flavored e-cigarette users had 170 percent greater odds of developing any respiratory symptom compared to never users.

The ALA has called on the US Food and Drug Administration (FDA) to create a standard and define which chemicals should go into the tobacco flavored e-cigarettes. The organization recognizes that all flavors in e-cigarettes are additives and there is no “tobacco” flavor inherent in e-cigarettes.

“This study provides more evidence that e-cigarettes are harmful to the lungs and that the FDA needs to provide stronger public health protections from these products including removing all flavored products from the marketplace,” says Albert Rizzo, chief medical officer for the ALA. “This research adds further evidence that there is no safe e-cigarette and that vaping is harmful to your health.”

At SPH, the study was co-authored by Emelia Benjamin, professor of epidemiology.