Estimating the Population attributable Fraction of asthma Due to Electronic Cigarette Use and Other Risk Factors Using Kentucky Behavioral Risk Factor Survey Data, 2016-2017.

Introduction: Electronic nicotine delivery systems ENDS have become popular in the United States
among both new users of nicotine and those seeking less harmful alternatives to traditional cigarettes.
Users often perceive ENDS as being less harmful than traditional cigarettes. This study investigated
the relationship between use of ENDS and asthma in a representative sample of adults. Methods: For
this cross-sectional study, we used data from the Kentucky Behavioral Risk Factor Surveillance System
telephone survey data from 2016-2017. Using a weighted multivariable logistic regression analysis, we
identified important covariates to adjust for to calculate the population attributable fraction (PAF) of
asthma due to ENDS and other modifiable risk factors factors (cigarette use, obesity, education, and
employment). The confidence intervals for the PAFs were estimated using bootstrap methods of variance
estimation. Results: We found that 10.6% of those aged 18-30 reported currently had asthma.
After adjusting for noted covariates, ENDS use did not significantly increase the odds of asthma. In
the final PAF model, the PAF of asthma due to ENDS was 0.4% (95% CI: -5.41, 6.21). Conclusion: While
these findings suggest only modest effects of ENDS use on asthma prevalence, future research including
older age groups and more long-term users might produce different results.

Walker CJ, Christian WJ. Estimating the Population attributable Fraction of asthma Due to Electronic Cigarette Use and Other Risk Factors Using Kentucky Behavioral Risk Factor Survey Data, 2016-2017. Substance use & misuse. 2021;56(3):353-358. doi:10.1080/10826084.2020.1868002