E-cigarette use and prevalence of lung diseases among the U.S. population: a NHANES survey

Abstract

The primary aim of this study was to evaluate epidemiological characteristics and prevalence of lung disease among e-cigarettes users in the United States. A population-based, cross-sectional survey was performed using the National Health and Nutrition Examination Survey (NHANES) of 2015–2018. Adults using e-cigarettes (SMQ900), traditional smoking (SMQ020: > 100 cigarettes in lifetime or SMQ040: current cigarettes use), and dual smoking (e-cigarettes and traditional smoking) were identified and compared in their sociodemographic characteristics and prevalence of lung diseases (Asthma: MCQ010 and COPD: MCQ160O). We used the chi square test (categorical variables) and Mann–Whitney test and unpaired-student t test (continuous variables). p-value <0.05 was used as a reference. We excluded respondents <18 years and missing data on demographics and outcomes. Out of 178,157 respondents, 7745 (4.35%), 48,570 (27.26%), and 23,444 (13.16%) were e-cigarette smokers, traditional smokers, and dual smokers, respectively. Overall prevalence of asthma was 15.16% and COPD was 4.26%. E-cigarette smokers were younger in comparison to traditional smokers (median: 25 years vs 62 years; p < 0.0001). In females (49.34% vs 37.97%), Mexican (19.82% vs 13.35%), annual household income above $100,000 (23.97% vs 15.56%), prevalence of e-cigarette smoking was higher in comparison to traditional smoking (p < 0.0001). The prevalence of COPD was higher among dual smokers in comparison to e-cigarette and traditional smoking (10.14% vs 0.25% vs 8.11%; p < 0.0001). Prevalence of asthma was higher among dual and e-cigarette smokers in comparison with traditional smokers and non-smokers (22.44% vs 21.10% vs 14.46% vs 13.30%; p < 0.0001). Median age (Q1–Q3) was lower at which asthma (7 years (4–12) vs 25 years (8–50)) was diagnosed first among e-cigarettes smokers in comparison with traditional smokers. In a mixed effect multivariable logistic regression analysis, we found higher odds of asthma among e-cigarette users in comparison with non-smokers (Odds ratio (OR): 1.47; 95% Confidence Interval (CI): 1.21–1.78; p = 0.0001). Chronic Obstructive Pulmonary Disease (COPD) respondents were also associated with 11.28 higher odds of e-cigarette utilization (Oddsratio (OR): 11.28; 95% Confidence Interval (CI): 5.59–22.72; p < 0.0001). We conclude the higher prevalence of e-cigarette users is seen among the younger population, female, Mexican race, and annual income above $100,000 in comparison to traditional smokers. Chronic Obstructive Pulmonary Disease (COPD) and asthma were both more prevalent in dual smokers. As asthma was more prevalent and diagnosed at an early age in e-cigarette smokers, more prospective studies are needed to understand the effects of e-cigarette among the population at risk to mitigate the sudden rise in utilization and to create awareness.

Association Between Myocardial Infarction and Triglyceride-Glucose Index: A Study Based on NHANES Database

“…Chronic obstructive pulmonary disease was defined as a positive response ('yes') to the question 'Ever told you had COPD?' [31]. Health-associated behaviors included alcohol intake (yes/no) and smoking.…”

Association between use of heated tobacco products and long-term health effects considering smoking history: Internet-based cross-sectional study in Japan

“…The following factors other than tobacco use affecting the occurrence of outcomes that were used in past crosssectional studies investigating the relationship of e-cigarette or HTP use to the occurrence of outcomes (COPD, 12,[16][17][18][19][20][21][22] asthma, 12,16,18,20,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] wheezing, 13,32,[39][40][41][42][43] breath shortness/cough/phlegm, 32,33,41,42 lung function abnormality 44 ) and cohort study 45 investigating the relationship between smoking and COPD were used as adjustment factors in this study: age, sex, BMI, resident area population size, education level, household income, whether employed or unemployed, lifestyle habits (frequency of exercise, frequency of alcohol drinking, level of stress), whether historical or concurrent diseases were present (diabetes, lipid abnormality, hypertension, stroke, allergic dermatitis/rhinitis, angina pectoris, coronary heart diseases (CHD)). Information about passive smoking was not obtained in this study, because no statistical effect from passive smoking was observed 16,39 in past cross-sectiona...…”