Vaping associated with increased incidence of respiratory symptoms amongst youth

1. In this retrospective analysis, compared to nonsmokers, vaping (both within the previous month and at all in the past) was associated with increased incidence of respiratory symptoms.

2. The use of nicotine salts and fruit-flavoured vapes were also associated with increased odds of self-reported respiratory symptoms. 

Evidence Rating Level: 2 (Good)

Within the past ten years, the use of vapes has increased among US, Canadian, and British adolescents, whereas the prevalence of cigarette smoking has decreased or remained relatively unchanged. While switching from cigarettes to vaping reduces health risks, the use of vapes among adolescents and those who are not previous smokers presents potential risks associated with exposure to ultrafine particles and constituents in vape aerosols. The current study’s aim is to assess self-reported respiratory symptoms in young people from the aforementioned countries. Data from participants (n = 39,214; ages 16 to 19; 65% White, 51.6% male) of the International Tobacco Control Policy Evaluation Project (ITC) Youth Tobacco and Vaping Surveys (Canada, England, US) were included in analyses. Participants were surveyed on their smoking/vaping behaviours within the past 30 days and within their lifetime. They were also asked to self-report for any of the following five respiratory symptoms: shortness of breath, wheezing, chest pain, phlegm, or cough. Within the past 30 days at the time of surveying, most had not smoked or vaped (82.8%), under 3% had smoked or vaped on at least 20 days, and nearly one-fifth reported using at least one other inhaled product (most commonly cannabis) in the past month. Results indicated that over one-quarter (27.8%) of surveyed adolescents reported any of the five respiratory symptoms within the past 7 days (cough was the most common). There were similar odds of experiencing respiratory symptoms between those who only vaped and those who only smoked [adjusted odds ratio, aOR (95% CI): 0.97 (0.85–1.10)], and higher odds if participants both smoked and vaped [aOR (95% CI) 1.26 (1.12–1.42)]. Compared to those who never smoked or vaped, any past use, experimentation, or current regular or occasional use of vapes was associated with increased odds of respiratory symptoms. Those who vaped on at least 20 of the last 30 days were most likely to report respiratory symptoms, with each additional day associated with an increase in odds of developing symptoms (p < .001). The use of nicotine salts and certain vape flavours were also associated with the highest odds of respiratory symptoms, including fruit [1.44 (1.07–1.93)], multiple [1.76 (1.30–2.39)] and ‘other’ [2.14 (1.45–3.16)]. Tobacco, menthol, and mint flavours were nonsignificant, and the type of vaping device used (pre-filled cartridge, pod, disposable, etc.) did not significantly impact the incidence of respiratory symptoms. Overall, in this international cohort of adolescents, vaping was associated with higher odds of self-reporting respiratory symptoms within the last week and odds increased with increased frequency of vaping. 

Click to read the study in BMC Medicine

Image: PD

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