Electronic cigarettes and respiratory diseases in Russian Tobacco Control Policy evaluation survey

Abstract

Background Though electronic cigarettes (EC) and heated tobacco products (HTP) are marketed as harm reduction products, the evidence is that like smoking, their use is dangerous for the lung health. Aim To explore the associations between EC and HTP use and major respiratory diseases (RD). Methods Cross-sectional data of adult representative sample from Russian Tobacco Control Policy Evaluation Survey are analysed, based on multistage sampling in 10 Russian regions in 2017-2018, stratified by smoking status: n = 11625: 6569 smokers, 2377 former smokers, 2679 never smokers. Self-reported formerly diagnosed RD as outcome indicators were analysed in relation with ever EC and HTP use, and current EC use, including HTP. Multiple logistic regression is employed; odds ratios (OR) with 95% CI adjusted by smoking status and socio-demographic factors. Results Chronic bronchitis (CB) was reported by 14% respondents, COPD-by 4.3%, asthma-by 3.1%, emphysema-1.5%, lung cancer-1.1%, tuberculosis (TB)-1.3%. Ever EC use was prevalent in 9.3%, HTP use-in 3.3%, and current EC use-in 2.5% of population. The prevalence of ever EC and HTP use and current EC use was higher among current smokers (13%,4.4%,3.5%), compared to former smokers (7.4%,3.4%,3.5%) and never smokers: 2.2%, 0.7% and 0.6% respectively, (p<.001). Ever HTP users had 2.5 times higher chances of CB: OR 2.52(95%CI 1.9-3.3), and 4 times higher chances of COPD: OR3.97(95%CI 2.8-5.7). The risk is even greater in case of dual EC and tobacco use in current smokers: OR 3.0(95%CI 2.2-4.1) and 4.2(95%CI 2.8-6.3) respectively. Current EC use was significantly associated with asthma: OR 2.9(95%CI 1.5-5.8) and OR 5.0(95%CI 2.6-11.3) in current smokers, lung cancer: OR 4.9(95%CI 1.6-14.8) and 7.2(95%CI 1.9-27.4); and TB:OR4.1(95%CI 1.7-11.6) and 5.4(95%CI 1.6-17.9) respectively. Conclusions EC and HTP use independent from smoking may increase the risk for major RD, combined with tobacco smoking the risk of RD is even greater. Key messages The use of Electronic cigarettes and heated tobacco products, independent from smoking, may increase the risk for major respiratory diseases. Prevalence of EC and HTP use is higher among smokers, compared to former and never smokers; combination of EC and HTP use with tobacco smoking makes the risk of respiratory diseases even greater.