Department of Oncology, Georgetown University, Washington, DC.
Department of Epidemiology, University of Michigan, Ann Arbor.
JAMA Netw Open. 2023 Apr 3;6(4):e236247. doi: 10.1001/jamanetworkopen.2023.6247.
The prevalence of electronic nicotine delivery systems (ENDS) use has increased, leading to a concern about their respiratory health outcomes. It is unclear whether ENDS use increases the risk of wheezing, a common symptom of respiratory conditions.
To provide an analysis of the longitudinal association between ENDS and cigarette use and self-reported wheezing among US adults.
DESIGN, SETTING, AND PARTICIPANTS: The US nationally representative Population Assessment of Tobacco and Health (PATH) Study was used. Longitudinal data for adults 18 years or older from wave 1 (2013-2014) to wave 5 (2018-2019) were analyzed. Data were analyzed from August 2021 to January 2023.
The prevalence of self-reported wheezing (waves 2-5) was estimated for 6 strata of tobacco product use (never cigarette and noncurrent ENDS use, never cigarette and current ENDS use, current cigarette and noncurrent ENDS use, current cigarette and current ENDS use, former cigarette and noncurrent ENDS use, and former cigarette and current ENDS use). A generalized estimating equations framework evaluated the association between cigarette and ENDS use and self-reported wheezing at the subsequent wave. An interaction term between cigarette and ENDS use was added to estimate the association between joint cigarette and ENDS use categories and the association of ENDS within strata of cigarette use.
The analytical sample consisted of 17 075 US adults with a mean (SD) age of 45.4 (17) years, of whom 8922 (51%) were female and 10 242 (66%) were Non-Hispanic White. When compared with never cigarette and noncurrent ENDS use, the greatest association in reporting wheezing was for current cigarette and current ENDS use (adjusted odds ratio [AOR], 3.26; 95% CI, 2.82-3.77), which was similar to current cigarette and noncurrent ENDS use (AOR, 3.20; 95% CI, 2.91-3.51) and substantially greater than former cigarette and current ENDS use (AOR, 1.94; 95% CI, 1.57-2.41). Associations were small and not statistically significant for the odds of self-reported wheezing among never cigarette and current ENDS use when compared with never cigarette and noncurrent ENDS use (AOR, 1.20; 95% CI, 0.83-1.72), and for odds of wheezing and current cigarette and current ENDS use when compared with current cigarette and noncurrent ENDS use (AOR, 1.02; 95% CI, 0.91-1.15).
In this cohort study, exclusive ENDS use was not associated with an increase in the risk of self-reported wheezing. However, a small increase in risk between ENDS use and wheezing was reported by individuals who use cigarettes. This study adds to the literature about the potential health effects associated with ENDS use.
电子尼古丁传送系统（ENDS）的使用日益普及，这引发了人们对其呼吸系统健康后果的担忧。目前尚不清楚ENDS 使用是否会增加喘息的风险，而喘息是一种常见的呼吸道疾病症状。
提供美国成年人中，关于 ENDS 和香烟使用与自我报告喘息之间的纵向关联的分析。
设计、设置和参与者：使用了具有全国代表性的美国人口烟草与健康评估（PATH）研究。对 18 岁或以上成年人从第 1 波（2013-2014 年）到第 5 波（2018-2019 年）的纵向数据进行了分析。数据分析于 2021 年 8 月至 2023 年 1 月进行。
使用 6 个烟草产品使用分层（从不吸烟和非当前 ENDS 使用、从不吸烟和当前 ENDS 使用、当前吸烟和非当前 ENDS 使用、当前吸烟和当前 ENDS 使用、以前吸烟和非当前 ENDS 使用以及以前吸烟和当前 ENDS 使用）来估计自我报告喘息（波 2-5）的流行率。使用广义估计方程框架评估了香烟和 ENDS 使用与随后波次自我报告喘息之间的关联。在吸烟分层中添加了香烟和 ENDS 使用的交互项，以评估联合使用香烟和 ENDS 类别与仅使用 ENDS 之间的关联。
分析样本包括 17075 名美国成年人，平均（SD）年龄为 45.4（17）岁，其中 8922 名（51%）为女性，10242 名（66%）为非西班牙裔白人。与从不吸烟和非当前 ENDS 使用相比，报告喘息的最大关联是当前吸烟和当前 ENDS 使用（调整后的优势比[OR]，3.26；95%CI，2.82-3.77），这与当前吸烟和非当前 ENDS 使用相似（OR，3.20；95%CI，2.91-3.51），且显著大于以前吸烟和当前 ENDS 使用（OR，1.94；95%CI，1.57-2.41）。与从不吸烟和非当前 ENDS 使用相比，从不吸烟和当前 ENDS 使用时自我报告喘息的几率（OR，1.20；95%CI，0.83-1.72）和当前吸烟和当前 ENDS 使用时喘息和当前吸烟的几率（OR，1.02；95%CI，0.91-1.15）的关联较小且无统计学意义。
在这项队列研究中，单独使用 ENDS 与自我报告喘息的风险增加无关。然而，有报道称，使用香烟的个体中，ENDS 使用与喘息之间的风险略有增加。这项研究增加了关于与 ENDS 使用相关的潜在健康影响的文献。
