| Summary: | Introduction
Electronic cigarettes (e-cigarette) were introduced for smoking
cessation/reduction but have also become popular among the youth. Although
e-cigarettes contain fewer toxins than combustible cigarettes, their long-term
cardiovascular and pulmonary effects remain unknown. We aimed to assess the
association between self-reported chest pain and e-cigarette use.
Methods
We analyzed data from the PATH (Population Assessment of Tobacco
and Health) study wave 4 (2016–2018) and wave 5 (2018–2019). Based on
questionnaires from wave 4, we categorized tobacco use as: 1) non-use, 2)
exclusive e-cigarette use, 3) combustible cigarette use, and 4) dual use. Presence
of established cardiovascular disease was examined at wave 4, and participants
aged >40 years were asked about chest pain during wave 5. We used binary
logistic regression models to determine the association between tobacco exposures
and self-reported chest pain.
Results
We evaluated a total of 11254 adults. The rates of chest pain were 1518
out of 7055 non-users, 49 from 208 exclusive e-cigarette users, 1192 from 3722
combustible cigarette users, and 99 out of 269 dual users. In the multivariable
models adjusted for relevant covariates, combustible cigarette users (adjusted
odds ratio, AOR=1.77; 95% CI: 1.56–2.01) and dual users (AOR=2.22; 95% CI:
1.61–3.05) had higher odds of reporting ever having chest pain, as well as having
chest pain in the past 30 days. Conversely, exclusive e-cigarette users had similar
odds of reporting chest pain compared to non-users (AOR=1.03; 95% CI: 0.69–
1.54) and lower odds than combustible and dual users. In sensitivity analyses,
categorizing individuals based on their reported history of cardiovascular disease,
overall findings were similar.
Conclusions
Exclusive e-cigarette use is associated with a lower rate of chest pain
compared to combustible cigarette use and dual use.
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