Child Health Evaluative Sciences and.
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Ann Am Thorac Soc. 2023 Jun;20(6):815-824. doi: 10.1513/AnnalsATS.202207-578OC.
Emerging research suggests that e-cigarette (EC) use may have detrimental health effects, increasing the burden on healthcare systems. To determine whether young EC users had increased asthma, asthma attacks, and health services use (HSU). This cohort study used the linked Canadian Community Health Survey (cycles 2015-16 and 2017-18) and health administrative data (January 2015-March 2018). A propensity score method matched self-reported EC users to up to five control subjects. Matched multivariable logistic and negative binomial regressions were used to calculate odds ratios, rate ratios (RRs), and 95% confidence intervals (CIs) with EC use as the exposure and asthma, asthma attacks, and all-cause HSU as the outcomes. Analyses included 2,700 matched Canadian Community Health Survey participants (15-30 yr), 505 (2.4% of 20,725 participants) EC users matched to 2,195 nonusers. After adjusting for confounders, EC users with asthma had over twofold higher odds of having an asthma attack in the last 12 months (odds ratio, 2.30; 95% CI, 1.29-4.12). Dual EC and conventional tobacco users had a twofold increased all-cause HSU rate compared with nonusers who never smoked tobacco (RR, 2.13; 95% CI, 1.53-2.98). This rate was greater than that for EC users who never smoked tobacco (RR, 1.73; 95% CI, 1.00-3.00) and non-EC users who regularly smoke tobacco (RR, 1.72; 95% CI, 1.29-2.29). Compared with male nonusers, female EC users had the highest increased all-cause HSU (RR, 1.94; 95% CI, 1.39-2.69) over male EC users and female nonusers (RR, 1.13; 95% CI, 0.86-1.48; RR, 1.41; 95% CI, 1.16-1.71, respectively). Current EC use is associated with significantly increased odds of having an asthma attack. Furthermore, concurrent EC use and conventional cigarette smoking are associated with a higher rate of all-cause HSU. The odds of asthma attack and all-cause HSU were highest among women. Thus, EC use may be an epidemiological biomarker for youth and young adults with increased health morbidity.
新兴研究表明，电子烟（EC）的使用可能对健康有害，增加了医疗系统的负担。为了确定年轻的 EC 用户是否有更高的哮喘、哮喘发作和健康服务使用（HSU）的风险。这项队列研究使用了加拿大社区健康调查的链接（周期 2015-16 和 2017-18）和健康管理数据（2015 年 1 月至 2018 年 3 月）。采用倾向评分匹配方法将自我报告的 EC 用户与多达五名对照匹配。使用多变量逻辑回归和负二项回归来计算比值比（ORs）、率比（RRs）和 95%置信区间（CI），EC 使用作为暴露因素，哮喘、哮喘发作和所有原因 HSU 作为结局。分析包括 2700 名匹配的加拿大社区健康调查参与者（15-30 岁），505 名（20725 名参与者中的 2.4%）EC 用户与 2195 名非使用者匹配。在调整了混杂因素后，有哮喘的 EC 用户在过去 12 个月内发生哮喘发作的几率高出两倍以上（比值比，2.30；95%CI，1.29-4.12）。与从未吸烟的非使用者相比，同时使用 EC 和传统烟草的人因所有原因 HSU 的发生率增加了两倍（RR，2.13；95%CI，1.53-2.98）。这一比率大于从不吸烟的 EC 用户（RR，1.73；95%CI，1.00-3.00）和定期吸烟的非 EC 用户（RR，1.72；95%CI，1.29-2.29）。与男性非使用者相比，女性 EC 用户的所有原因 HSU 增加率最高（RR，1.94；95%CI，1.39-2.69），高于男性 EC 用户和女性非使用者（RR，1.13；95%CI，0.86-1.48；RR，1.41；95%CI，1.16-1.71）。目前的 EC 使用与哮喘发作的几率增加显著相关。此外，同时使用 EC 和传统香烟与更高的所有原因 HSU 发生率相关。女性的哮喘发作和所有原因 HSU 几率最高。因此，EC 使用可能是青少年和年轻成年人健康发病率增加的一个流行病学生物标志物。
