Young, female e-cigarette users more likely to have asthma attack, use health services

January 18, 2024

3 min read

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Key takeaways:

• E-cigarette use raised the likelihood for an asthma attack, especially among young females.
• Females using e-cigarettes also had elevated hospitalization, ED visit rates vs. males.

Young females using e-cigarettes had greater odds for an asthma attack than young males not using e-cigarettes, according to results published in Annals of the American Thoracic Society.

Further, between these two sets of individuals, the females had higher rates of all-cause health services use, according to researchers.

Data were derived from To T, et al. Ann Am Thorac Soc. 2023;doi:10.1513/AnnalsATS.202207-578OC.

Teresa To

“Smoking, whether it is regular cigarettes or e-cigarettes, is a modifiable behaviour (or risk factor) and it is associated with significant health risks,” Teresa To, PhD, MSc, BSc, senior scientist at The Hospital for Sick Children and professor at the Dalla Lana School of Public Health at University of Toronto, both in Toronto, Canada, told Healio. “Clinicians who see adolescents and young adults should query if they are current smokers (regular or e-cigarette) and 1) raise their awareness of the potential harmful health effects of vaping, 2) develop and implement evidence-based strategies to prevent and reduce vaping (especially in youths) and 3) provide means and support to help those who vape to quit.”

Using the Canadian Community Health Survey (2015-2016 and 2017-2018) and health administrative data (2015-2018), To and colleagues assessed 2,700 individuals aged 15 to 30 years to evaluate odds/rates of asthma, asthma attacks and health services use among those who used e-cigarettes vs. those who did not use e-cigarettes in the last 30 days.

Researchers matched e-cigarette users (n = 505; 65.35% male) to nonusers (n = 2,195; 62.64% male) using propensity scores and compared the two groups through multivariable logistic and negative binomial regression models adjusted for confounders.

It is important to note that 20,725 individuals took the survey outlined above when thinking about e-cigarette usage among Canadian youth, To told Healio.

“We found that 3% of survey participants aged 12 years and above reported e-cigarette use within the previous 30 days, which corresponds to 1 in 32 individuals using e-cigarettes during that time period,” To said. “Approximately half of e-cigarette users also reported smoking cigarettes daily.”

The prevalence of self-reported asthma was similar between both e-cigarette users (19.8%) and matched nonusers (17.54%), as was the prevalence of self-reported asthma attacks (6.93% vs. 5.92%).

Although researchers did not find a significant link between e-cigarette use and the odds for asthma, they did find that the likelihood for an asthma attack in the past year was heightened among female e-cigarette users vs. male nonusers (aOR = 2.3; 95% CI, 1.29-4.12). Females who did not use e-cigarettes also had elevated odds for this outcome vs. males (aOR = 2.29; 95% CI, 1.57-3.35).

When assessing confounder-adjusted rates of all-cause health services use (hospitalization, ED visit), researchers looked at both individuals who used e-cigarettes and individuals who smoked tobacco.

Compared with individuals who never used e-cigarettes or smoked tobacco, researchers found similar rates of health services use among exclusive e-cigarette users (RR = 1.73; 95% CI, 1-3) and exclusive tobacco users (RR = 1.72; 95% CI, 1.29-2.29).

Notably, use of both e-cigarettes and tobacco raised this rate (RR = 2.13; 95% CI, 1.53-2.98), according to researchers.

Dividing e-cigarette users and nonusers based on sex revealed elevated health services use rates among females who used e-cigarette vs. males who did not (RR = 1.94; 95% CI, 1.39-2.69). In this analysis, female nonusers had a lower rate (RR = 1.41; 95% CI, 1.16-1.71), followed by male e-cigarette users (RR = 1.13; 95% CI, 0.86-1.48).

Additionally, among those who did consume alcohol, researchers found a significant increased health services use rate in the group who used e-cigarettes vs. the group who did not (RR = 5.07; 95% CI, 2.4-10.71).

“Since 1 in 2 e-cigarette smokers also smoked cigarettes daily, moving forward, it would be paramount to conduct longitudinal studies in young e-cigarette users and help reduce their risk of dual or multiple use (including regular cigarette and/or other cannabis use),” To told Healio. “Future efforts should target prevention in youths and young adults from taking any nicotine products.”

Sources/Disclosures

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Disclosures:
To reports receiving support for this study from the Canadian Institutes of Health Research. Please see the study for all other authors’ relevant financial disclosures.

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