Pediatric Pulmonology, Yale School of Medicine, Yale University, New Haven, CT 06510, USA.
Yale Center for Analytical Sciences, Yale School of Public Health, Yale University, New Haven, CT 06510, USA.
Int J Environ Res Public Health. 2021 Aug 3;18(15):8208. doi: 10.3390/ijerph18158208.
The purpose of this study is to evaluate the association of electronic nicotine product (ENP) use and its respiratory manifestations in a nationally representative sample of adolescents in the US. Cross-sectional evidence from 9750 adolescents in wave 3 (October 2015-October 2016) of the Population Assessment of Tobacco and Health (PATH) survey was used. Adjusting for demographics, lifetime number of cigarettes and cigars used, home rules about tobacco use, and tobacco used by other household members, we used logistic regression models to examine associations between ENP use and its respiratory manifestations in the past year. Among 9750 adolescents, 12% ( = 1105) used ENP in the past year. Compared to non-users, past-year ENP-users had 37% higher odds of wheezing in general (Adjusted Odds Ratio (AOR) = 1.37, 95% Confidence interval (CI): 1.11-1.71, = 0.005) and higher odds of wheezing 4-12 times or >12 times per year versus no wheezing (AOR = 1.57, 95% CI: 1.01-2.46, = 0.05 and AOR = 2.58, 95% CI: 1.04-6.41, = 0.04, respectively). Additionally, odds of dry cough at night were 23% higher among ENP-users than among non-users (AOR = 1.23, 95% CI: 1.04-1.46, = 0.02). There was no association between past-year ENP use and exercise-induced wheezing or asthma diagnosis. Among those with asthma, there was no evidence of an association between ENP use and long-acting inhaler or quick-relief inhaler use. ENP use among adolescents is associated with increased frequency of wheezing and dry cough. Early recognition of pulmonary clinical manifestations among young ENP users should be critical considerations in regulatory and prevention efforts to protect public health, and clinical efforts to prevent progression to serious pulmonary complications.
本研究旨在评估美国具有代表性的青少年人群中电子尼古丁产品（ENP）使用及其与呼吸系统表现之间的关联。使用来自 2015 年 10 月至 2016 年 10 月期间“烟草与健康人群评估”（PATH）调查第 3 波（波 3）中 9750 名青少年的横断面数据。通过调整人口统计学、终生使用的香烟和雪茄数量、家庭关于烟草使用的规定以及其他家庭成员使用的烟草数量，我们使用逻辑回归模型来检验过去一年中 ENP 使用与呼吸系统表现之间的关联。在 9750 名青少年中，12%（=1105）在过去一年中使用了 ENP。与非使用者相比，过去一年中使用 ENP 的青少年出现一般性喘息的几率高 37%（调整后的优势比（AOR）=1.37，95%置信区间（CI）：1.11-1.71，=0.005），出现每年 4-12 次或更多次喘息与无喘息的几率分别高 1.57 倍（95%CI：1.01-2.46，=0.05）和 2.58 倍（95%CI：1.04-6.41，=0.04）。此外，与非使用者相比，ENP 使用者夜间干咳的几率高 23%（AOR=1.23，95%CI：1.04-1.46，=0.02）。过去一年中使用 ENP 与运动诱导性喘息或哮喘诊断之间无关联。在患有哮喘的人群中，没有证据表明 ENP 使用与长效吸入器或快速缓解吸入器的使用之间存在关联。青少年使用 ENP 与喘息和干咳频率增加有关。在监管和预防工作中，应特别关注年轻 ENP 使用者的肺部临床表现，以保护公共健康，并在临床工作中防止进展为严重肺部并发症。
