Association of Electronic Cigarette Use With Incident Respiratory Conditions Among US Adults From 20
Thursday, November 19, 2020
Posted by: Natalia Gromov
Xie
W, Kathuria H, Galiatsatos P, et al.
Association of
Electronic Cigarette Use With Incident Respiratory Conditions Among US Adults
From 2013 to 2018.
JAMA Netw Open. 2020;3(11):e2020816. doi:10.1001/jamanetworkopen.2020.20816
Importance
Generating robust and timely evidence about the respiratory health risks of
electronic cigarettes (e-cigarettes) is critical for informing state and
federal regulatory standards for product safety.
Objective To
examine the association of e-cigarette use with incident respiratory
conditions, including chronic obstructive pulmonary disease (COPD), emphysema,
chronic bronchitis, and asthma.
Design, Setting, and
Participants This prospective cohort study used data from
the nationally representative cohort of US adults from the Population
Assessment of Tobacco and Health (PATH) study, including wave 1 from 2013 to
2014, wave 2 from 2014 to 2015, wave 3 from 2015 to 2016, and wave 4 from 2016
to 2018. Individuals aged 18 years and older at baseline with no prevalent
respiratory conditions were included in the analyses. Analyses were conducted
from February to July 2020.
Exposures e-Cigarette use was assessed by self-reported current use
status (never, former, or current) at baseline.
Main Outcomes and
Measures Incident respiratory conditions, including COPD,
emphysema, chronic bronchitis, and asthma, as well as a composite respiratory
disease encompassing all 4 conditions.
Results
Among 21 618 respondents included in the analyses, 11 017 (491%) were men and
12 969 (65.2%) were non-Hispanic White. A total of 14 213 respondents were
never e-cigarette users, 5076 respondents (11.6%) were former e-cigarette
users, and 2329 respondents (5.2%) were current e-cigarette users. Adjusted for
cigarette and other combustible tobacco product use, demographic
characteristics, and chronic health conditions, there was an increased risk of
respiratory disease among former e-cigarette uses (incidence rate ratio [IRR],
1.28; 95% CI, 1.09-1.50) and current e-cigarette users (IRR, 1.31; 95% CI,
1.08-1.59). Among respondents with good self-rated health, the IRR for former
e-cigarette users was 1.21 (95%CI, 1.00-1.46) and the IRR for current
e-cigarette users was 1.43 (95% CI, 1.14-1.79). For specific respiratory
diseases among current e-cigarette users, the IRR was 1.33 (95% CI, 1.06-1.67)
for chronic bronchitis, 1.69 (95% CI, 1.15-2.49) for emphysema, 1.57 (95% CI,
1.15-2.13) for COPD, and 1.31 (95% CI, 1.01-1.71) for asthma.
Conclusions and
Relevance This cohort study found that e-cigarette use
was associated with an increased risk of developing respiratory disease
independent of cigarette smoking. These findings add important evidence on the
risk profile of novel tobacco products.
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