How E-cigarettes and vaping can affect asthma in children and adolescents.

Introduction:
This text discusses the potential effects of vaping on pediatric asthma and the growing epidemic of electronic cigarette (EC) use among adolescents, including those with asthma. The authors review recent studies on the composition of EC and its potential effects on the respiratory system, as well as the observed association between EC use and self-reported asthma diagnosis and respiratory symptoms in adolescents.

Key Points:

* EC are made up of three main components: a power source, a heating element, and a liquid storage unit.
* EC liquids, also known as e-liquids, consist of a solution mainly composed of propylene glycol or vegetable glycerin, flavoring additives, and may or may not contain nicotine.
* There are concerns about the safety of e-liquid ingredients, as some studies have shown that the description of the ingredients does not always correspond to their real composition.
* EC use has been associated with cytotoxic effects, oxidative stress, and host defense impairment in vitro and in animal models.
* Recent evidence in adult vapers shows that vaping can exert negative effects on the respiratory system at multiple levels.
* Vaping also exerts acute effects on lung function, resulting in increased respiratory flow resistance and reduced fractional exhaled nitrogen oxide.
* A severe acute lung injury known as E-cigarette or Vaping use-Associated Lung Injury (EVALI) has been described in adolescents and young adults who vape.

Main Message:
The evidence suggests that vaping is not harmless, and its exposure should be limited in children and adolescents, especially when affected by asthma. Healthcare professionals should educate their young patients and their families on the potential consequences of smoking and vaping in order to prevent initiation and consider screening with specific questions on EC use all patients with recurrent respiratory symptoms of unknown origin or uncontrolled asthma. Governmental bodies should also strengthen measures aimed at reducing and discouraging the use of ENDS among young people.

Di Cicco M, Sepich M, Beni A, Comberiati P, Peroni DG. How E-cigarettes and vaping can affect asthma in children and adolescents. Current opinion in allergy and clinical immunology. 2022;22(2):86-94. doi:10.1097/ACI.0000000000000807