Cross-Sectional association of Lifetime Electronic Cigarette Use with Wheezing and Related Respiratory Symptoms in U.S. adults.

Introduction:
This text provides an analysis of the association between lifetime vaping occurrences and self-reported wheezing and related respiratory symptoms using data from the Population assessment of Tobacco and health (PaTh) Study Wave 4. The study focuses on a subset of the nationally representative PaTh Study Wave 4 data collected from December 2016 to January 2018 on 22,233 adults.

Key Points:

* The study found that lifetime vaping occurrences were significantly associated with some definitions of self-reported wheezing in cross-sectional analyses adjusted for other tobacco use.
* The study controlled for various covariates, including age, sex, race/ethnicity, education level, income level, BMI, self-perception of physical health, self-perception of mental health, ever smoked a traditional cigar, ever smoked a cigarillo or filtered cigar, ever smoked a pipe filled with tobacco, ever used snus, ever used smokeless tobacco, ever used dissolvable tobacco, ever used any other tobacco products besides cigarettes, electronic nicotine products, traditional cigars, cigarillos, filtered cigars, pipe tobacco, hookah tobacco, snus, smokeless tobacco and dissolvable tobacco, currently lived with anyone who used tobacco or e-cigarettes, asthma, lived with a regular smoker during childhood, home smoking policies, home vaping policies, average number of cigarettes now smoked each day (for included dual users of e-cigarette and combustible cigarette), and duration of cigarette smoking in years.
* The study defined lifetime vaping occurrences as the number of times used electronic nicotine products in entire life, with seven levels: vaping 0 time (never-users); vaping one time, even just a few puffs; vaping 2-10 times; vaping 11-20 times; vaping 21-50 times; vaping 51-99 times; and vaping 100 or more times.
* The study examined the association between lifetime vaping occurrences and self-reported wheezing and related respiratory symptoms, including ever wheezing, wheezing or whistling in the chest in the past 12 months, chest has sounded wheezy during or after exercise in the past 12 months, in past 12 months, had a dry cough at night not associated with a cold or chest infection, and in past 12 months, number of wheezing attacks.
* The study used weighted frequency distributions and the Rao-Scott Modified Likelihood Ratio tests to examine the association of lifetime vaping occurrences with the covariates and the outcome variables and further investigated the association using both univariable and multivariable weighted logistic regression models with covariates adjusted for in the multivariable weighted logistic regression models.
* The study found that adults who vaped 2-10 times had a significantly higher association with ever wheezing, past 12-month wheezing, and the number of wheezing attacks in the past 12 months.
* The study also found that adults who vaped 11-20 times and 100 or more times had similar associations with wheezing as that for adults who vaped 2-10 times.

Main Message:
The study suggests that there is a significant association between lifetime vaping occurrences and self-reported wheezing and related respiratory symptoms. The study's findings highlight the need for larger studies with more precise time frames and measures to further understand possible connections between vaping experimentation and wheezing symptoms that could inform our understanding of the health effects of electronic cigarettes and resultant policy decisions.

Li D, Xie Z. Cross-Sectional association of Lifetime Electronic Cigarette Use with Wheezing and Related Respiratory Symptoms in U.S. adults. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2020;22:S85-S92. doi:10.1093/ntr/ntaa195