| Summary: | Introduction
E-cigarettes have been steadily increasing in popularity, both as
cessation methods for smoking and for recreational and social reasons. This
increase in vaping may pose cardiovascular and respiratory risks. We aimed to
assess respiratory symptoms in youth users of e-cigarettes and cigarettes.
Methods
A retrospective survey design was utilized to assess Canadian youth aged
16–25 years. Participants were recruited from the Ontario Tobacco Research Unit
Youth and Young Adult Research Registration Panel November 2020 to March
2021. A total of 3082 subjects completed the baseline survey. Of these, 2660
individuals who did not have asthma were included in the analysis. The exposure
of interest was pack-equivalent years, a novel measure of vaping exposure
equivalent conceptually to cigarette pack years incorporating number of puffs
per day, number of days vaped per month, and number of years vaped. Respiratory
symptoms were measured using the five-item Canadian Lung Health Test. Poisson
regression analyses were performed while adjusting for demographic confounders,
stratified by smoking status. A non-stratified model tested the interaction of status
and vaping dose and the effect of vaping device used was assessed among ever
vapers. Analyses controlled for demographic characteristics, use of cannabis and
alcohol, and survey date.
Results
Each additional puff year increased the rate ratio (RR) of respiratory
symptoms by a factor of 11.36 (95% CI: 4.61–28.00; p<0.001) for never smokers,
but among current daily smokers higher pack-equivalent years were not associated
with more respiratory symptoms (RR=0.83; 95% CI: 0.23–3.11). Among current
vapers, those using pod-style devices were more likely to have more respiratory
symptoms (RR=1.25; 95% CI: 1.08–1.45) after adjusting for dose.
Conclusions
Vaping is associated with an increased risk of reporting respiratory
symptoms among never smoking youth and non-daily ever cigarette smokers. Use
of e-cigarettes among non-smokers should be discouraged.
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