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.
- electronic nicotine delivery devices
- public policy
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Contributors DL, IR, IKS: conceived and designed the study. DL: analysed the data. DL, IR, IKS, SM, DJO, MLG and RJO: wrote and edited the manuscript.
Funding This study was supported by the grants from National Institute of Health NIH 1R01HL135613-(IR) and from the WNY Center for Research on Flavored Tobacco Products (CRoFT) under cooperative agreement U54CA228110. DL’s time is supported by the University of Rochester CTSA award number UL1 TR002001 from the National Center for Advancing Translational Sciences of the National Institutes of Health.
Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration (FDA).
Competing interests MLG received a research grant from Pfizer and served as a member of advisory board to Johnson & Johnson, manufacturers of smoking cessation medications.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The PATH wave 2 data can be downloaded from the National Addiction & HIV Data Archive Program (NAHDAP) website public user files (https://www.icpsr.umich.edu/icpsrweb/NAHDAP/studies/36231/datadocumentation).
Patient consent for publication Not required.