E-Cigarette Use Associated With Asthma Independent of Cigarette Smoking and Marijuana in a 2017 National Sample of Adolescents



      Knowledge about the health consequences of e-cigarette use in adolescence remains limited. Available studies of asthma among adolescents are based on data collected five or more years ago, and evidence from more recent generations of e-cigarette products is needed.


      We analyzed data from the 2017 Youth Risk Behavior Survey, a cross-sectional study with a representative U.S. national sample of high school students. Multivariable analyses tested for associations of ever and 30-day e-cigarette use with asthma controlling for cigarette smoking, marijuana use, demographics, and obesity.


      A significant association with asthma was found for ever use of e-cigarettes, adjusted odds ratio (AOR) = 1.15 (confidence interval [CI], 1.02–1.30; p = .02) and for currently using e-cigarettes, AOR = 1.30 (CI, 1.10–1.53; p = .002). Also related to asthma were current cigarette smoking, AOR = 1.24 (CI, 1.03–1.51; p = .03) and obesity, AOR = 1.48 (CI, 1.30–1.68; p < .0001). E-cigarettes had an additive effect for asthma beyond smoking (p = .03). Differentials in asthma prevalence by race/ethnicity were found, with lower prevalence of asthma for non-Hispanic Asian (p = .02) and Hispanic (p = .03) and higher prevalence for non-Hispanic black (p < .0001) and non-Hispanic multirace (p < .0001) relative to non-Hispanic white populations.


      E-cigarette use was significantly associated with asthma in recent data on adolescents, controlling for several disease-relevant covariates. The results are consistent with studies based on previous generations of e-cigarettes and support the significance of e-cigarettes as a continuing public health concern.


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