E-cigarette use and asthma in a multiethnic sample of adolescents
Section snippets
Background
The use of electronic cigarettes (e-cigarettes) among adolescents has increased substantially over the past five years. Recent US data show prevalence estimates for current e-cigarette use (i.e., any use in the last 30 days) of 14%–16% in high school populations (Jamal et al., 2017, Miech et al., 2017a). Similar prevalence estimates have been noted in other countries (Dutra and Glantz, 2014, Goniewicz et al., 2014a, Goniewicz et al., 2014b, White et al., 2015). However, there is little evidence
Procedure and participants
The HYRBS is administered every 2 years by the University of Hawaii to students in public middle and high schools throughout the state of Hawaii. The present research uses data from high school students (9th grade–12th grade) in the 2015 HYRBS. The 99-item survey was self-administered by students in classrooms, supervised by project staff, in 33 randomly selected high schools during the spring of 2015. Out of 43 high schools in Hawaii, participating schools were selected using a three-stage
Prevalence for substance use and asthma
Prevalence estimates (Table 1) showed 25% of the participants had ever smoked cigarettes and 10% had smoked in the past 30 days (i.e., current use). These estimates are comparable to national studies (Jamal et al., 2017, Miech et al., 2017a). In contrast, e-cigarette prevalence estimates of 45% for ever use and 25% for current use are both higher than national rates (Jamal et al., 2017, Miech et al., 2017a). Ever-use of marijuana was reported by 33% of the participants and a substantial
Discussion
This research investigated the association between e-cigarette use and asthma in a multiethnic sample of adolescents in Hawaii surveyed in 2015. Our analytic approach controlled for the correlation of e-cigarette use with cigarette smoking and with other variables that were significantly related to asthma in this population. E-cigarette use was associated with higher odds of asthma, independent of cigarette smoking, marijuana use, and the covariates, with an effect size comparable to that of
Conclusion
This research adds to knowledge about e-cigarette use and health indices among adolescents. E-cigarette use was shown to be significantly associated with asthma when controlling for several variables in the multivariate analysis. The findings provide a new perspective on e-cigarettes and suggest attention to possible respiratory effects from e-cigarette use and mechanisms of how e-cigarette use could affect health-related variables as well as behavioral variables (Cho and Paik, 2016, Lerner et
Acknowledgments
We thank the staff of the Hawaii Department of Health for assisting with access to the data and providing information for the analysis.
Contributors
RJS obtained the data set, conceptualized the manuscript, co-wrote the first draft, and reviewed drafts of the manuscript critically for important intellectual content. TAW assisted with conceptualizing the manuscript, performed the initial data analyses, co-wrote the first draft, and reviewed drafts of the manuscript critically for important intellectual content. EKT assisted with conceptualization of the manuscript and reviewed drafts of the manuscript critically for important intellectual
Funding
This research was supported by grants R01 CA153145 and P30 CA071789-16S2 from the National Cancer Institute (TAW). Dr. Choi's effort was supported by the Division of Intramural Research, National Institute on Minority Health and Health Disparities. The content is solely the responsibility of the authors and does not necessarily reflect the views of the National Institutes of Health.
Conflicts of interest
None.
Ethics approval
This study was approved by the Institutional Review Board for the University of Hawaii.
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