PULMONARY RISKS ASSOCIATED WITH E-CIGARETTE USE AMONG ADOLESCENTS: A MULTI-CENTER STUDY ON VAPING-INDUCED RESPIRATORY AILMENTS
Main Article Content
Keywords
E-cigarettes, Adolescents, Pulmonary risks, Vaping, Respiratory symptoms, Lung functions, Inflammatory markers
Abstract
Background: Cigarette smoking electronics or e-cigarette use has risen, especially among youth, because of flavored products and aggressive marketing strategies. Abuse of e-cigarettes is harmful to young people, especially to the respiratory system. The lungs are still developing and are very vulnerable to the dangers caused by e-cigarettes.
Aim: This cross-sectional study aims to estimate the pulmonary adverse effects of e-cigarettes use in adolescents using the prevalence of respiratory symptoms and lung functions, and C-reactive protein levels.
Methodology: This study was a cross-sectional, multi-center survey of five urban Pulmonology clinics in Punjab, Pakistan. A sample of 800 adolescents (500 current e-cigarette users and 300 non-users as control). Qualitative data encompassed participants’ own demographics and questionnaire on vaping behavior and symptoms, while quantitative data comprised Pulmonary Function Tests including spirometry, interleukin-8 (IL-8) and C-reactive protein (CRP) measurements. Data analysis consisted of t-tests, chi-square tests and logistic regression controlling for various potential covariates.
Results: The study group (e-cigarette users) had a higher prevalence of coughing (68%), wheezing (55%), and shortness of breath (48%). FEV1 and FVC were significantly lower in the ‘daily users’ as compared to the ‘non-users’; FEV1/FVC ratio was decreased to 70 % (p < 0.001). Signs of inflammation and IL8 and CRP were higher in users and were inversely associated with lung function measurements. Based on the results of logistic regression analysis, frequency of vaping was positively and significantly linked with respiratory symptoms.
Conclusion: Adolescents who use e-cigarettes experience worse respiratory symptoms, have reduced lung capacity and higher levels of inflammatory markers. There is need for further research aimed at understanding long-term health effects of vaping among adolescents and rigorous implementation of policies and legislation to prevent this hazard.
Aim: This cross-sectional study aims to estimate the pulmonary adverse effects of e-cigarettes use in adolescents using the prevalence of respiratory symptoms and lung functions, and C-reactive protein levels.
Methodology: This study was a cross-sectional, multi-center survey of five urban Pulmonology clinics in Punjab, Pakistan. A sample of 800 adolescents (500 current e-cigarette users and 300 non-users as control). Qualitative data encompassed participants’ own demographics and questionnaire on vaping behavior and symptoms, while quantitative data comprised Pulmonary Function Tests including spirometry, interleukin-8 (IL-8) and C-reactive protein (CRP) measurements. Data analysis consisted of t-tests, chi-square tests and logistic regression controlling for various potential covariates.
Results: The study group (e-cigarette users) had a higher prevalence of coughing (68%), wheezing (55%), and shortness of breath (48%). FEV1 and FVC were significantly lower in the ‘daily users’ as compared to the ‘non-users’; FEV1/FVC ratio was decreased to 70 % (p < 0.001). Signs of inflammation and IL8 and CRP were higher in users and were inversely associated with lung function measurements. Based on the results of logistic regression analysis, frequency of vaping was positively and significantly linked with respiratory symptoms.
Conclusion: Adolescents who use e-cigarettes experience worse respiratory symptoms, have reduced lung capacity and higher levels of inflammatory markers. There is need for further research aimed at understanding long-term health effects of vaping among adolescents and rigorous implementation of policies and legislation to prevent this hazard.
References
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12. Farsalinos, K. E., et al. (2017). E-cigarettes generate high levels of aldehydes only in “dry puff” conditions. Addiction, 110(8), 1352–1356. https://doi.org/10.1111/add.12942
13. Ghosh, A., & Coakley, R. D. (2021). The effects of e-cigarette use on the respiratory system. Annual Review of Physiology, 83, 109–130. https://doi.org/10.1146/annurev-physiol-051920-043700
14. Gotts, J. E., et al. (2019). What are the respiratory effects of e-cigarettes? BMJ, 366, l5275. https://doi.org/10.1136/bmj.l5275
15. Kaur, G., et al. (2018). E-cigarette flavoring chemicals and their toxicological consequences. Frontiers in Physiology, 9, 1119. https://doi.org/10.3389/fphys.2018.01119
16. Layden, J. E., et al. (2020). Pulmonary illness related to e-cigarette use in adolescents. New England Journal of Medicine, 382(8), 717–727. https://doi.org/10.1056/NEJMoa1911614
17. McConnell, R., et al. (2017). Tobacco and marijuana use in adolescence and early lung function decline. American Journal of Respiratory and Critical Care Medicine, 195(4), 464–472. https://doi.org/10.1164/rccm.201606-1272OC
18. Farsalinos, K. E., et al. (2017). E-cigarettes generate high levels of aldehydes only in “dry puff” conditions. Addiction, 110(8), 1352–1356. https://doi.org/10.1111/add.12942
19. Ghosh, A., & Coakley, R. D. (2021). The effects of e-cigarette use on the respiratory system. Annual Review of Physiology, 83, 109–130. https://doi.org/10.1146/annurev-physiol-051920-043700
20. Glantz, S. A., & Bareham, D. W. (2018). E-cigarettes: Use, effects on smoking, risks, and policy implications. Annual Review of Public Health, 39, 215–235. https://doi.org/10.1146/annurev-publhealth-040617-013757
21. Gotts, J. E., et al. (2019). What are the respiratory effects of e-cigarettes? BMJ, 366, l5275. https://doi.org/10.1136/bmj.l5275
22. Layden, J. E., et al. (2020). Pulmonary illness related to e-cigarette use in adolescents. New England Journal of Medicine, 382(8), 717–727. https://doi.org/10.1056/NEJMoa1911614
23. McConnell, R., et al. (2017). Tobacco and marijuana use in adolescence and early lung function decline. American Journal of Respiratory and Critical Care Medicine, 195(4), 464–472. https://doi.org/10.1164/rccm.201606-1272OC
2. Chun, L. F., Moazed, F., Calfee, C. S., Matthay, M. A., & Gotts, J. E. (2017). Pulmonary toxicity of e-cigarettes. American Journal of Physiology-Lung Cellular and Molecular Physiology, 313(2), L193–L206. https://doi.org/10.1152/ajplung.00071.2017
3. Ghosh, A., & Coakley, R. D. (2021). The Effects of E-Cigarette Use on the Respiratory System. Annual Review of Physiology, 83, 109–130. https://doi.org/10.1146/annurev-physiol-051920-043700
4. Layden, J. E., et al. (2020). Pulmonary Illness Related to E-Cigarette Use in Adolescents. New England Journal of Medicine, 382(8), 717–727. https://doi.org/10.1056/NEJMoa1911614
5. McConnell, R., et al. (2017). Tobacco and marijuana use in adolescence and early lung function decline. American Journal of Respiratory and Critical Care Medicine, 195(4), 464–472. https://doi.org/10.1164/rccm.201606-1272OC
6. National Academies of Sciences, Engineering, and Medicine. (2018). Public Health Consequences of E-Cigarettes. Washington, DC: The National Academies Press. https://doi.org/10.17226/24952
7. U.S. Department of Health and Human Services. (2020). E-Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General. Retrieved from https://www.hhs.gov
8. Bhatta, D. N., & Glantz, S. A. (2020). Association of e-cigarette use with respiratory disease among adults: A longitudinal analysis. American Journal of Preventive Medicine, 58(2), 182–190. https://doi.org/10.1016/j.amepre.2019.07.028
9. Blount, B. C., et al. (2020). Vitamin E acetate in bronchoalveolar-lavage fluid associated with EVALI. New England Journal of Medicine, 382(8), 697–705. https://doi.org/10.1056/NEJMoa1916433
10. Centers for Disease Control and Prevention. (2022). Youth and Tobacco Use. Retrieved from https://www.cdc.gov
11. Chun, L. F., et al. (2017). Pulmonary toxicity of e-cigarettes. American Journal of Physiology-Lung Cellular and Molecular Physiology, 313(2), L193–L206. https://doi.org/10.1152/ajplung.00071.2017
12. Farsalinos, K. E., et al. (2017). E-cigarettes generate high levels of aldehydes only in “dry puff” conditions. Addiction, 110(8), 1352–1356. https://doi.org/10.1111/add.12942
13. Ghosh, A., & Coakley, R. D. (2021). The effects of e-cigarette use on the respiratory system. Annual Review of Physiology, 83, 109–130. https://doi.org/10.1146/annurev-physiol-051920-043700
14. Gotts, J. E., et al. (2019). What are the respiratory effects of e-cigarettes? BMJ, 366, l5275. https://doi.org/10.1136/bmj.l5275
15. Kaur, G., et al. (2018). E-cigarette flavoring chemicals and their toxicological consequences. Frontiers in Physiology, 9, 1119. https://doi.org/10.3389/fphys.2018.01119
16. Layden, J. E., et al. (2020). Pulmonary illness related to e-cigarette use in adolescents. New England Journal of Medicine, 382(8), 717–727. https://doi.org/10.1056/NEJMoa1911614
17. McConnell, R., et al. (2017). Tobacco and marijuana use in adolescence and early lung function decline. American Journal of Respiratory and Critical Care Medicine, 195(4), 464–472. https://doi.org/10.1164/rccm.201606-1272OC
18. Farsalinos, K. E., et al. (2017). E-cigarettes generate high levels of aldehydes only in “dry puff” conditions. Addiction, 110(8), 1352–1356. https://doi.org/10.1111/add.12942
19. Ghosh, A., & Coakley, R. D. (2021). The effects of e-cigarette use on the respiratory system. Annual Review of Physiology, 83, 109–130. https://doi.org/10.1146/annurev-physiol-051920-043700
20. Glantz, S. A., & Bareham, D. W. (2018). E-cigarettes: Use, effects on smoking, risks, and policy implications. Annual Review of Public Health, 39, 215–235. https://doi.org/10.1146/annurev-publhealth-040617-013757
21. Gotts, J. E., et al. (2019). What are the respiratory effects of e-cigarettes? BMJ, 366, l5275. https://doi.org/10.1136/bmj.l5275
22. Layden, J. E., et al. (2020). Pulmonary illness related to e-cigarette use in adolescents. New England Journal of Medicine, 382(8), 717–727. https://doi.org/10.1056/NEJMoa1911614
23. McConnell, R., et al. (2017). Tobacco and marijuana use in adolescence and early lung function decline. American Journal of Respiratory and Critical Care Medicine, 195(4), 464–472. https://doi.org/10.1164/rccm.201606-1272OC
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Published
Jan 15, 2022
Article Details
How to Cite
Muhammad Khalid, Muhammad Amin, Syeda Luba Hussain, Razwan Ashraf, Waseem Pasha, & Muhammad Usman Sajid. (2022). PULMONARY RISKS ASSOCIATED WITH E-CIGARETTE USE AMONG ADOLESCENTS: A MULTI-CENTER STUDY ON VAPING-INDUCED RESPIRATORY AILMENTS. Journal of Population Therapeutics and Clinical Pharmacology, 29(01), 567-578. https://doi.org/10.53555/g8pjv192
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Author Biographies
Muhammad Khalid
Associate Professor, Department of Medicine, CMH Kharian Medical College, Pakistan
Muhammad Amin
Assistant Professor, Department of Pulmonology, CMH Kharian Medical College, Pakistan
Syeda Luba Hussain
Assistant Professor Community Medicine, Watim Medical College, Rawalpindi, Pakistan
Razwan Ashraf
General Physician, Health Department Govt. of Punjab, Pakistan
Waseem Pasha
Assistant Professor, Department of Paediatrics, CMH Kharian Medical College, Pakistan
Muhammad Usman Sajid
Associate Professor, Department of Medicine, CMH Kharian Medical College, Pakistan
How to Cite
Muhammad Khalid, Muhammad Amin, Syeda Luba Hussain, Razwan Ashraf, Waseem Pasha, & Muhammad Usman Sajid. (2022). PULMONARY RISKS ASSOCIATED WITH E-CIGARETTE USE AMONG ADOLESCENTS: A MULTI-CENTER STUDY ON VAPING-INDUCED RESPIRATORY AILMENTS. Journal of Population Therapeutics and Clinical Pharmacology, 29(01), 567-578. https://doi.org/10.53555/g8pjv192