Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 29;19(2):e0299834.
doi: 10.1371/journal.pone.0299834. eCollection 2024.

Longitudinal association between e-cigarette use and respiratory symptoms among US adults: Findings from the Population Assessment of Tobacco and Health Study Waves 4-5

Emma Karey  1 , Shu Xu  2 , Pan He  3 , Raymond S Niaura  2 , Charles M Cleland  3 , Elizabeth R Stevens  3 , Scott E Sherman  3   4 , Omar El-Shahawy  2   3 , Jennifer Cantrell  2 , Nan Jiang  3
Affiliations

Longitudinal association between e-cigarette use and respiratory symptoms among US adults: Findings from the Population Assessment of Tobacco and Health Study Waves 4-5

Emma Karey et al. PLoS One. .

Abstract

Background: We assessed longitudinal effects of e-cigarette use on respiratory symptoms in a nationally representative sample of US adults by combustible tobacco smoking status.

Methods: We analyzed Waves 4-5 public-use data from the Population Assessment of Tobacco and Health Study. Study sample included adult respondents who reported no diagnosis of respiratory diseases at Wave 4, and completed Waves 4-5 surveys with no missing data on analytic variables (N = 15,291). Outcome was a validated index of functionally important respiratory symptoms based on 7 wheezing/cough questions (range 0-9). An index score of ≥2 was defined as having important respiratory symptoms. Weighted lagged logistic regression models were performed to examine the association between e-cigarette use status at Wave 4 (former/current vs. never use) and important respiratory symptoms at Wave 5 by combustible tobacco smoking status (i.e., never/former/current smokers), adjusting for Wave 4 respiratory symptom index, sociodemographic characteristics, secondhand smoke exposure, body mass index, and chronic disease.

Results: Among current combustible tobacco smokers, e-cigarette use was associated with increased odds of reporting important respiratory symptoms (former e-cigarette use: adjusted odds ratio [AOR] = 1.39, 95% confidence interval [CI]: 1.07-1.81; current e-cigarette use: AOR = 1.55, 95% CI: 1.17-2.06). Among former combustible tobacco smokers, former e-cigarette use (AOR = 1.51, 95% CI: 1.06-2.15)-but not current e-cigarette use (AOR = 1.59, 95% CI: 0.91-2.78)-was associated with increased odds of important respiratory symptoms. Among never combustible tobacco smokers, no significant association was detected between e-cigarette use and important respiratory symptoms (former e-cigarette use: AOR = 1.62, 95% CI: 0.76-3.46; current e-cigarette use: AOR = 0.82, 95% CI: 0.27-2.56).

Conclusions: The association between e-cigarette use and respiratory symptoms varied by combustible tobacco smoking status. Current combustible tobacco smokers who use e-cigarettes have an elevated risk of respiratory impairments.

PubMed Disclaimer

Conflict of interest statement

Dr. Emma Karey is an employee and owns stock in AstraZeneca. No pharmaceutical financial support was provided for this work and all contributions occurred outside of working hours. All remaining authors declared no competing interests.This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Study sample determination.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
    1. National Academies of Sciences E, Medicine,. Public Health Consequences of E-Cigarettes. Washington, DC; 2018. Report No.: 978-0-309-46834-3.
    1. Sleiman M, Logue JM, Montesinos VN, Russell ML, Litter MI, Gundel LA, et al.. Emissions from electronic cigarettes: Key parameters affecting the release of harmful chemicals. Environ Sci Technol. 2016;50(17):9644–51. doi: 10.1021/acs.est.6b01741 - DOI - PubMed
    1. Wang P, Chen W, Liao J, Matsuo T, Ito K, Fowles J, et al.. A device-independent evaluation of carbonyl emissions from heated electronic cigarette solvents. PLoS One. 2017;12(1):e0169811. doi: 10.1371/journal.pone.0169811 - DOI - PMC - PubMed
    1. Wills TA, Pagano I, Williams RJ, Tam EK. E-cigarette use and respiratory disorder in an adult sample. Drug Alcohol Depend. 2019;194:363–70. doi: 10.1016/j.drugalcdep.2018.10.004 - DOI - PMC - PubMed