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. 2020 Nov 16;21(1):300.
doi: 10.1186/s12931-020-01569-9.

Use of electronic cigarettes and secondhand exposure to their aerosols are associated with asthma symptoms among adolescents: a cross-sectional study

Abdullah Alnajem  1 , Abdullah Redha  1 , Dalal Alroumi  1 , Ahmed Alshammasi  1 , Mohamad Ali  1 , Maram Alhussaini  1 , Waad Almutairi  1 , Ali Esmaeil  1 , Ali H Ziyab  2
Affiliations

Use of electronic cigarettes and secondhand exposure to their aerosols are associated with asthma symptoms among adolescents: a cross-sectional study

Abdullah Alnajem et al. Respir Res. .

Abstract

Background: Globally, a surge in electronic cigarette (e-cigarette) use has been observed in recent years, with youth being the most susceptible group. Given their recent emergence, studies assessing the health consequences of using e-cigarettes and exposure to their secondhand aerosols (SHA) are limited. Hence, this study sought to assess associations between e-cigarette use and household exposure to SHA from e-cigarettes with asthma symptoms among adolescents.

Methods: A school-based cross-sectional study was conducted by enrolling high school students (n = 1565; aged 16-19 years) in Kuwait. Participants self-completed a questionnaire on tobacco products use (e-cigarettes and cigarettes) and asthma symptoms. Current e-cigarette use and cigarette smoking were defined as any use in the past 30 days. Household exposure to SHA from e-cigarettes in the past 7 days was reported as none (0 days), infrequent (1-2 days), and frequent (≥ 3 days). Asthma symptoms included current (past 12 months) wheeze, current asthma (history of clinical diagnosis and current wheeze and/or medication use), and current symptoms of uncontrolled asthma (≥ 4 attacks of wheeze, ≥ 1 night per week sleep disturbance from wheeze, and/or wheeze affecting speech). Associations were assessed using Poisson regression with robust variance estimation, and adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) were estimated.

Results: Among the analytical study sample (n = 1345), current e-cigarette use and cigarette smoking was reported by 369 (27.4%) and 358 (26.6%) participants, respectively. Compared to never e-cigarette users and never cigarette smokers, current e-cigarette users with no history of cigarette smoking had increased prevalence of current wheeze (aPR = 1.54, 95% CI 1.01-2.45) and current asthma (aPR = 1.85, 95% CI 1.03-3.41). Moreover, the frequency of exposure to household SHA from e-cigarettes was associated with asthma symptoms. For example, compared to those with no exposure to household SHA, frequent exposure to household SHA was associated with current wheeze (aPR = 1.30, 95% CI 1.04-1.59), current asthma (aPR = 1.56, 95% CI 1.13-2.16), and current uncontrolled asthma symptoms (aPR = 1.88, 95% CI 1.35-2.62).

Conclusions: E-cigarette use and their household SHA exposure were independently associated with asthma symptoms among adolescents. Hence, such observations indicate that e-cigarette use and passive exposure to their aerosols negatively impact respiratory health among adolescents.

Keywords: Adolescents; Asthma; Combustible cigarettes; Electronic cigarettes; Kuwait; Respiratory symptoms; Vaping.

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Conflict of interest statement

The authors declare that they have no competing interests.

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