Can e-cigarette use cause asthma?

A study published in the Preventive Medicine Journal finds that using e-cigarettes can significantly increase the risk of asthma among US adolescents who have never used other combustible products.

Study: Association between e-cigarette use and asthma among US adolescents: Youth risk behavior surveillance system 2015–2019. Image Credit: ilkov_igor/Shutterstock.com

Background

The use of e-cigarettes has sharply increased among adolescents and young adults in the United States. According to the 2020 National Health Interview Survey, about 12.6% and 4.7% of US adults are current cigarette smokers and e-cigarette smokers, respectively.

Although e-cigarette was initially introduced as a smoking cessation aid, evidence indicates its usage may be associated with many health adversities.

The short-term effects of e-cigarette use include dry cough, throat and mouth irritation, headache, and nausea, and long-term consequences include cardiovascular and respiratory complications and memory impairment.

Mechanistically, e-cigarettes heat nicotine-based liquids to create aerosols. This e-liquid contains many harmful chemicals, including carcinogens. In contact with the heating coil, e-liquid is exposed to nickel, selenium, chromium, and aluminum in combination with other trace metals.

These carcinogens and trace metals can potentially induce inflammation and oxidative stress in respiratory airways, leading to lung damage and respiratory complications, such as asthma.

In this study, scientists have explored various factors associated with e-cigarette use and determined the association between e-cigarette use and the risk of asthma among US adolescents.

Study design

The study analyzed the data collected from the Youth Risk Behavior Surveillance System, which was established in 1990 to monitor health-related behaviors and experiences of children and adolescents and to estimate the prevalence of major diseases, disabilities, mortality, social issues, and their associated risk factors among youth in the United States.

The data collected between 2015 and 2019 was included in the study analysis because of the availability of e-cigarette usage information.

A total of 3,042 and 32,885 high school students aged 13 to 17 years from Texas and the entire United States, respectively, were included in the analysis.   

A set of statistical analyses was conducted to identify demographic and behavioral factors associated with e-cigarette use and to assess the relationship between e-cigarette use and the risk of asthma.

Important observations

About 44% and 13% of adolescents in Texas reported constantly and currently using e-cigarettes, respectively. E-cigarette use was lower among Hispanic adolescents than among White adolescents.

Overall, among adolescents in Texas, significant associations were observed between constantly using e-cigarettes and older age, history of explosive and other substance use, and presence of depression.

Similarly, significant associations of current e-cigarette use were observed with female gender, White race, and history of combustible and other substance use.     

In the United States, about 60% and 17% of adolescents reported constantly and currently using e-cigarettes, respectively. Constant e-cigarette use showed significant positive associations with male gender, history of combustible and other substance use, and presence of depression. In contrast, obesity showed a significantly inverse association with constant e-cigarette use.

Regarding current e-cigarette use, significant associations were observed with older age, White race, being overweight, and a history of combustible and other substance use.

Risk of asthma

A significant association was observed between constant e-cigarette use and increased asthma risk among Texas adolescents. This association was stronger among adolescents who had never used any combustible substances.

In the United States, no significant association was observed between e-cigarette use and the risk of asthma among adolescents.

However, considering the history of combustible substance use, e-cigarette use increased the risk of asthma among adolescents who had never used any combustible substances.

Study significance

The study identifies older age, White race, previous use of combustible substances, and depression as significant contributing factors associated with e-cigarette use.

The study also finds that e-cigarette use can significantly increase the risk of asthma in adolescents who have never used combustible substances.

The study findings highlight the need for effective public health strategies to control the usage of e-cigarettes and prevent e-cigarette-induced health adversities among adolescents.

More public awareness campaigns, implementation of strict regulations, and promotion of mental health counseling are the strategies to be considered to mitigate e-cigarette-related negative health consequences among adolescents.