E-cigarette use and respiratory disorder in an adult sample

Wills, Thomas A.; Pagano, Ian; Williams, Rebecca; Tam, Elizabeth K.

doi:10.1016/j.drugalcdep.2018.10.004

Cited by 148 publications

(111 citation statements)

References 46 publications

Supporting

Mentioning

102

Contrasting

Unclassified

Order By: Relevance

“…Other cross sectional surveys have also found associations of e-cigarette use with a history of asthma and with asthma exacerbations on the basis of state-wide surveys of young people in Hawaii and Florida 252627. In adults, a recent analysis of data from the Behavioral Risk Factor Surveillance Survey found an association of e-cigarette use with asthma or chronic obstructive pulmonary disease (COPD), effects that were larger in non-smokers 28. In a population based study in Sweden, associations of e-cigarette use with respiratory symptoms (chronic cough, sputum, or wheeze) were strongest among dual users with cigarettes 29.…”

Section: Human Studiesmentioning

confidence: 99%

What are the respiratory effects of e-cigarettes?

Gotts

Jordt

McConnell

et al. 2019

BMJ

379

303

View full text Add to dashboard Cite

Electronic cigarettes (e-cigarettes) are alternative, non-combustible tobacco products that generate an inhalable aerosol containing nicotine, flavors, propylene glycol, and vegetable glycerin. Vaping is now a multibillion dollar industry that appeals to current smokers, former smokers, and young people who have never smoked. E-cigarettes reached the market without either extensive preclinical toxicology testing or long term safety trials that would be required of conventional therapeutics or medical devices. Their effectiveness as a smoking cessation intervention, their impact at a population level, and whether they are less harmful than combustible tobacco products are highly controversial. Here, we review the evidence on the effects of e-cigarettes on respiratory health. Studies show measurable adverse biologic effects on organ and cellular health in humans, in animals, and in vitro. The effects of e-cigarettes have similarities to and important differences from those of cigarettes. Decades of chronic smoking are needed for development of lung diseases such as lung cancer or chronic obstructive pulmonary disease, so the population effects of e-cigarette use may not be apparent until the middle of this century. We conclude that current knowledge of these effects is insufficient to determine whether the respiratory health effects of e-cigarette are less than those of combustible tobacco products.

show abstract

Section: Human Studiesmentioning

confidence: 99%

What are the respiratory effects of e-cigarettes?

Gotts

Jordt

McConnell

et al. 2019

BMJ

379

303

View full text Add to dashboard Cite

show abstract

“…A recent comprehensive review summarized findings of in vitro studies, animal models, and population studies to describe adverse effects of e-cigarette use on the respiratory system, including the large airways and the alveolar space (29). E-cigarette use in general can cause airway and alveolar inflammation and injury, affect immune function, increase susceptibility to bacterial or viral infections, and worsen existing lung diseases such as asthma or chronic obstructive pulmonary disease, but respiratory effects of e-cigarette flavors are unclear (29,30). Most e-cigarette flavors, including popular fruit or sweet flavors, contain chemical constituents that can be efficiently aerosolized for inhalation and cause oxidative stress, DNA damage, or pulmonary epithelial toxicity and inflammation (31)(32)(33)(34)(35).…”

Section: Original Researchmentioning

confidence: 99%

Changes in Flavor Preference in a Cohort of Long-Term Electronic Cigarette Users

Du¹,

Bascom²,

Fan³

et al. 2020

Annals ATS

View full text Add to dashboard Cite

Rationale: The use of electronic cigarettes (e-cigarettes) has rapidly increased in the United States, and thousands of e-cigarette flavors are available. However, there remains a dearth of evidence on e-cigarette flavor use patterns among older e-cigarette users. Objectives: This longitudinal study examined changes in flavor use patterns in long-term e-cigarette users, assessed self-reported adverse reactions, and evaluated users' anticipated reactions to possible U.S. Food and Drug Administration e-cigarette flavor regulatory scenarios. Methods: The study population was 383 adult participants who completed two online e-cigarette surveys in 2012-2014 (baseline survey) and in 2017-2019 (follow-up survey). In both surveys, participants were asked, "Thinking about your preferred liquid, what is the name of this liquid flavor?" and to list all flavors used in the past 30 days. Flavor preference was classified using the Penn State Three-Step Flavor Classification method. Participants reported adverse events (open-ended description) with the associated flavor. Regulatory scenarios were presented, and participants selected perceived actions from among a list of 15 options. Results: Participants' age averaged 44 6 12 years; 86% were exclusive e-cigarette users, and 13% reported "poly-use" (i.e., e-cigarette and other tobacco product use). E-cigarette flavor preference migration occurred in all demographic groups: only 36-44% maintained a preference for their original flavor. Preference for tobacco and menthol or mint decreased over time (40% baseline vs. 22% follow-up); preference for fruit remained stable (23% baseline and follow-up), but chocolate/candy or other sweets preference significantly increased (16% baseline vs. 29% follow-up), and other flavors increased slightly. Migration to sweet flavors was more noticeable in younger adults (18-45 yr); exclusive e-cigarette users preferred sweet flavors more commonly than poly-users did (31% vs. 19%). Flavor-associated adverse reactions, mainly respiratory irritations, were reported by 26 (6.9%) participants. Nearly 50% of the participants reported that they would "find a way" to buy their preferred flavor or add flavoring agents themselves if nontobacco flavors were banned. Conclusions: Flavor migration toward sweet flavors occurred in long-term e-cigarette users, a trend most pronounced in younger and exclusive e-cigarette users. The anticipated maintenance of access to flavors despite regulation suggests an element of e-cigarette-related dependence that requires further evaluation. This information could help clinicians understand the health impacts of e-cigarette flavors, develop appropriate strategies for smoking cessation, and inform the U.S. Food and Drug Administration to plan future regulation of e-cigarette flavors.

show abstract

“…[2][3][4] Recent outbreaks of e-cigarette related lung injury have raised concerns about the safety of these products. [5][6][7][8][9][10][11] To examine the diversity of persons at risk and assess the extent to which all users may be prone to developing adverse health outcomes, we assessed temporal trends in ecigarette use across a large urban medical center based population and examined associated rates of healthcare utilization.…”

Section: Backgroudmentioning

confidence: 99%

Temporal Trends in Vaping Use: Demographic Diversity and Healthcare Utilization Outcomes

Nguyen

Nikova

Luong

et al. 2020

Preprint

View full text Add to dashboard Cite

BACKGROUND: Use of electronic cigarettes (e-cigarettes) has increased substantially in recent years. Marketed as a safer alternative to conventional tobacco cigarettes, the safety profile of e-cigarettes is now being questioned. Importantly, the clinical consequences of e-cigarette use remain poorly characterized. METHODS: Using data from the electronic health record (EHR), we identified a cohort of e-cigarette users and never-smokers in the region of central Los Angeles. Using information extracted from the EHR, we assessed temporal trends in the demographic characteristics of e-cigarette users, including race/ethnicity and location of residence. We also used data on urgent medical visits (i.e. emergency department encounters and hospital admissions) occurring during the study period (January 2014 to January 2020) and employed a negative binomial regression model to compare healthcare utilization rates between e-cigarette users and never-smokers. RESULTS: We identified a total of 698 e-cigarette users, in addition to 999 never-smokers, with demographic, clinical, and outcomes data available over the duration of the study period. From the beginning to the end of the study period, e-cigarette use increased across all race/ethnicity groups and across all geographic regions of residence. Notably, e-cigarette users experienced a 4.96 higher rate of urgent medical visits when compared to never-smokers evaluated over the same study period. CONCLUSION: E-cigarettes use continues to expand, with evidence of racial/ethnic as well as geographic variation in uptake. Use of e-cigarette devices is associated with substantially higher rates of urgent healthcare utilization. These findings highlight the need for a more granular understanding of e-cigarette use and enhanced attention to the diversity as well as breadth of the population affected by this burgeoning health crisis.

show abstract

E-cigarette use and respiratory disorder in an adult sample

Cited by 148 publications

References 46 publications

What are the respiratory effects of e-cigarettes?

What are the respiratory effects of e-cigarettes?

Changes in Flavor Preference in a Cohort of Long-Term Electronic Cigarette Users

Temporal Trends in Vaping Use: Demographic Diversity and Healthcare Utilization Outcomes

Contact Info

Product

Resources

About