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Electronic Cigarettes and Adverse Respiratory Symptoms in Adolescents

A recent study investigated the association between electronic cigarettes and bronchitic symptoms or wheezing in a cohort of high school students.


The use of electronic cigarettes, or e-cigarettes, has risen rapidly in recent years, particularly amongst adolescents and young adults. According to the U.S. National Youth Tobacco Survey, e-cigarette use amongst high school students increased from 1.5% in 2011 to 16.0% in 2015. With the emergence of vape pens, e-hookahs, and e-cigars, along with many different flavors, the e-cigarette market is now worth approximately $2 billion. Part of this is due to clever marketing schemes that promote e-cigarettes as safe alternatives to conventional cigarettes. What people fail to appreciate, however, is that e-cigarettes still contain many lung toxicants, including flavorings, volatile aldehydes, and oxidant metals. Studies have shown that exposure to these toxicants can induce reactive oxidative stress and inflammation in human cells. Moreover, cross-sectional studies have found associations between e-cigarette use and the prevalence of bronchitic symptoms and asthma in young children.

A recent study, published in the American Journal of Respiratory and Critical Care Medicine, investigated the association between e-cigarette use and adverse respiratory effects, including bronchitic symptoms and wheezing. The study recruited participants in grade 11 and 12 from the Southern California Children’s Health Study (CHS). Participants completed self-administered questionnaires regarding e-cigarette use, as well as wheezing and bronchitic symptoms. Further questionnaires were completed to assess covariates including asthma, exposure to second-hand smoking, and sociodemographic characteristics.

Of the 2,086 participants included, 502 had used e-cigarettes in the past. More specifically, 301 of these were defined as past-users (had not used e-cigarettes in the last 30 days), while 201 were current users (used e-cigarettes in the last 30 days at least once). The authors found that bronchitic symptoms were associated with past and current use of e-cigarettes, before adjustment of confounding factors. After adjustments, however, only the association between past use and bronchitic symptoms remained significant. In contrast, wheezing was not associated with past and current use of e-cigarettes following adjustment of confounding factors.

The study highlights the importance of educating the public, particularly young adolescents, on the potentially harmful side-effects of e-cigarettes. Long-term bronchitic symptoms can significantly impact a person’s quality of life by making breathing difficult and sometimes painful. Moving forward, basic research is necessary to further study the effects of each toxicant on the human body. Additionally, a larger sample size of participants that have been using e-cigarettes for a longer duration of time may provide further insight into how significantly e-cigarettes affect health and health outcomes. This study, along with future research, provides valuable information to policy makers responsible for developing effective regulatory policies and recommendations on the safe use of e-cigarettes.


Written By: Haisam Shah, BSc


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