Acute Respiratory Infections Among Active Component Service Members Who Use Combustible Tobacco Products and/or E-cigarette/Vaping Products, U.S. Armed Forces, 2018-2019.

Smoking is known to contribute to the risk of acute respiratory illness (ARI) and long-term medical conditions but little is known about the acute health effects of e-cigarette/vaping product use. The annual electronic Periodic Health Assessment (ePHA), which includes questions related to smoking and e-cigarette/vaping product use, is a screening tool used by the U.S. Armed Forces to evaluate the health and medical readiness of military members. Based on responses to questions on ePHAs completed in 2018, active component service members (ACSMs) were categorized as e-cigarette/vaping product only users, smoking only, dual-product users (users of both cigarettes and e-cigarette/vaping products), or non-users. ACSMs in the youngest age groups were more likely than their older counterparts to use e-cigarette/vaping products. Unadjusted incidence rates of ARI were higher among e-cigarette/vaping product only users and dual-product users than smokers and nonusers. After adjusting for age, sex, service branch, and military occupation, the incidence rate of ARI among dual-product users was higher than the rate among nonusers; this difference was small but statistically significant. Improved understanding of the health impact of e-cigarette/vaping product use has the potential to inform policy related to use of these products and prevent unnecessary harm.