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- Title
Assessment of Electronic Nicotine Delivery Systems With Cigarette Use and Self-reported Wheezing in the US Adult Population.
- Authors
Sánchez-Romero, Luz M.; Bondarenko, Irina; Knoll, Marie; Hirschtick, Jana L.; Cook, Steven; Fleischer, Nancy L.; Levy, David T.
- Abstract
This cohort study evaluates the association between electronic nicotine delivery systems, cigarette use, and self-reported wheezing in a population of US adults. Key Points: Question: What is the association between cigarettes, electronic nicotine delivery systems (ENDS) use, and self-reported wheezing symptoms among the US adult population? Findings: Using 2013 to 2019 data from a cohort study of 17 075 participants in the US, this study found that ENDS use is not associated with increased odds of reporting wheezing independent of cigarette smoking. Meaning: These findings suggest ENDS use may not be solely responsible for increasing the odds of reporting wheezing, but it is associated with increased risk in the current and former cigarette smoking population. Importance: The prevalence of electronic nicotine delivery systems (ENDS) use has increased, leading to a concern about their respiratory health outcomes. It is unclear whether ENDS use increases the risk of wheezing, a common symptom of respiratory conditions. Objective: To provide an analysis of the longitudinal association between ENDS and cigarette use and self-reported wheezing among US adults. Design, Setting, and Participants: The US nationally representative Population Assessment of Tobacco and Health (PATH) Study was used. Longitudinal data for adults 18 years or older from wave 1 (2013-2014) to wave 5 (2018-2019) were analyzed. Data were analyzed from August 2021 to January 2023. Main Outcomes and Measures: The prevalence of self-reported wheezing (waves 2-5) was estimated for 6 strata of tobacco product use (never cigarette and noncurrent ENDS use, never cigarette and current ENDS use, current cigarette and noncurrent ENDS use, current cigarette and current ENDS use, former cigarette and noncurrent ENDS use, and former cigarette and current ENDS use). A generalized estimating equations framework evaluated the association between cigarette and ENDS use and self-reported wheezing at the subsequent wave. An interaction term between cigarette and ENDS use was added to estimate the association between joint cigarette and ENDS use categories and the association of ENDS within strata of cigarette use. Results: The analytical sample consisted of 17 075 US adults with a mean (SD) age of 45.4 (17) years, of whom 8922 (51%) were female and 10 242 (66%) were Non-Hispanic White. When compared with never cigarette and noncurrent ENDS use, the greatest association in reporting wheezing was for current cigarette and current ENDS use (adjusted odds ratio [AOR], 3.26; 95% CI, 2.82-3.77), which was similar to current cigarette and noncurrent ENDS use (AOR, 3.20; 95% CI, 2.91-3.51) and substantially greater than former cigarette and current ENDS use (AOR, 1.94; 95% CI, 1.57-2.41). Associations were small and not statistically significant for the odds of self-reported wheezing among never cigarette and current ENDS use when compared with never cigarette and noncurrent ENDS use (AOR, 1.20; 95% CI, 0.83-1.72), and for odds of wheezing and current cigarette and current ENDS use when compared with current cigarette and noncurrent ENDS use (AOR, 1.02; 95% CI, 0.91-1.15). Conclusions and Relevance: In this cohort study, exclusive ENDS use was not associated with an increase in the risk of self-reported wheezing. However, a small increase in risk between ENDS use and wheezing was reported by individuals who use cigarettes. This study adds to the literature about the potential health effects associated with ENDS use.
- Subjects
UNITED States; ELECTRONIC cigarettes; CONFIDENCE intervals; RESPIRATORY organ sounds; RISK assessment; COMPARATIVE studies; DISEASE prevalence; DESCRIPTIVE statistics; RESEARCH funding; TOBACCO products; ODDS ratio; LONGITUDINAL method; ADULTS
- Publication
JAMA Network Open, 2023, Vol 6, Issue 4, pe236247
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2023.6247