Vaping Linked to a Noisy, Foreboding Consequence of Poor Lung Health

Electronic cigarettes are marketed as less harmful alternatives to cigarette smoking, but researchers are increasingly concerned about the potential long-term health consequences of vaping. A study released Thursday in the journal Tobacco Control adds to the growing number of reasons the phenomenon is more risky than it might appear.

According to scientists from the University of Rochester and the Roswell Park Comprehensive Cancer Center, people who vape are nearly twice as likely to experience wheezing compared to people who don’t regularly use tobacco products. Wheezing — which is typically caused by inflammation and narrowing of the airway between the throat and lungs — is often seen as a precursor to serious health conditions, including lung cancer and heart failure.

“The take-home message is that electronic cigarettes are not safe when it comes to lung health,” study author Deborah Ossip, Ph.D., announced Thursday. “The changes we’re seeing with vaping, both in laboratory experiments and studies of people who vape, are consistent with early signs of lung damage, which is very worrisome.”

Importantly, this study doesn’t prove that vaping causes wheezing. Instead, it identifies an association between the two. This association has been found in previous studies as well, including a 2017 paper in PLOS One that found a link between e-cigarette use and greater odds of wheezing and shortness of breath.

Here the researchers analyzed self-reported data collected from 28,000 Americans who participated in the Population Assessment of Tobacco and Health (PATH) study. The study participants including current vapers who used e-cigarettes exclusively, people who only smoked traditional cigarettes, dual users, and non-users who avoided tobacco products.

When they compared non-users to those who exclusively vape, they found that the risk of wheezing and related respiratory symptoms significantly increased: Adult vapers were 1.7 times more likely to experience difficulty breathing. Meanwhile, vapers had lower odds of wheezing compared to those who only smoked cigarettes and those who used both tobacco products.

“Promoting complete cessation of both smoking and vaping will be beneficial to maximize the risk reduction of wheezing and other related respiratory symptoms,” the study authors recommend. “Importantly, we reported that ex-smokers who did not vape, although they had already quit smoking, still have significantly elevated risk of wheezing and other related respiratory symptoms, compared with never smokers, suggesting long-term impact of prior smoking.”

The authors note these results are particularly concerning because of the mass use of e-cigarettes by both adults and juveniles alike. They write statistics indicate that close to 13 percent of American adults have tried vaping, and four percent currently do so. Meanwhile, Centers for Disease Control and Prevention data show that in 2018, vaping increased by 78 percent among ninth- to twelfth-graders and 48 percent in sixth- to eighth-graders. In 2017, more than 2 million middle and high school students were regular users of e-cigarettes.

It’s a rise that caused Food and Drug Administration Commissioner Scott Gottlieb, M.D., to announce in September that the use of e-cigarettes by teenagers has now reached “nothing short of an epidemic proportion of growth.” According to Gottlieb, the “FDA won’t tolerate a whole generation of young people becoming addicted to nicotine,” and is putting pressure on e-cigarette makers to cease marketing to teenagers.

In turn, the scientists behind this study are concerned that their research indicates that if young people continue to vape, they will develop serious health consequences. Vaping might be healthier than smoking cigarettes, but that doesn’t mean the act itself is healthy.

Abstract:

Background: Wheezing is a symptom of potential respiratory disease and known to be associated with smoking. Electronic cigarette use (‘vaping’) has increased exponentially in recent years. This study examined the cross-sectional association of vaping with wheezing and related respiratory symptoms and compare this association with smokers and dual users.

Methods: The Population Assessment of Tobacco and Health study wave 2 data collected from October 2014 to October 2015 with 28 171 adults were used. The cross-sectional association of vaping with self-reported wheezing and related respiratory symptoms relative to smokers and dual users of tobacco and electronic cigarettes were studied using multivariable logistic and cumulative logistic regression models with consideration of complex sampling design.

Results: Among the 28 171 adult participants, 641 (1.2%) were current vapers who used e-cigarettes exclusively, 8525 (16.6%) were current exclusive smokers, 1106 (2.0%) were dual users and 17 899 (80.2%) were non-users. Compared with non-users, risks of wheezing and related respiratory symptoms were significantly increased in current vapers (adjusted OR (aOR)=1.67, 95% CI: 1.23 to 2.15). Current vapers had significantly lower risk in wheezing and related respiratory symptoms compared with current smokers (aOR=0.68, 95% CI: 0.53 to 0.87). No significant differences were found between dual users and current smokers in risk of wheezing and related respiratory symptoms (aOR=1.06, 95% CI: 0.91 to 1.24).

Conclusions: Vaping was associated with increased risk of wheezing and related respiratory symptoms. Current vapers had lower risk in wheezing and related respiratory symptoms than current smokers or dual users but higher than non-users. Both dual-use and smoking significantly increased the risk of wheezing and related respiratory symptoms.