Vaping and E-Cigarette Use in Children and Adolescents

Association of E-cigarette use With Non-EVALI Respiratory Conditions

A cross-sectional study of 705,159 respondents from the 2016 and 2017 Behavioral Risk Factor Surveillance System pooled data reported that among e-cigarette users who were never combustible cigarette smokers, there was an associated 75% higher odds of chronic bronchitis, emphysema, or chronic obstructive pulmonary disease compared with never e-cigarette users.^[38]

Another large cohort study of 21,618 US adults demonstrated that e-cigarette use was associated with significantly increased risk of major respiratory diseases, independent of cigarette smoking, and other tobacco product use.^[39] Among current e-cigarette respondents with good self-reported health, the incidence rate ratio (IRR) was 1.33 (95% confidence interval [CI], 1.06–1.67) for chronic bronchitis, 1.69 (95% CI, 1.15–2.49) for emphysema, 1.57 (95% CI, 1.15–2.13) for chronic obstructive lung disease (COPD), and 1.31 (95% CI, 1.01–1.71) for asthma. The limitations of this study included a reliance on self-reported data. They concluded that despite existing evidence, the long-term effects of e-cigarette use on clinical respiratory end points remain unclear. As COPD is typically a disease that is evident after years of smoking, future studies, such as serial pulmonary function tests, may be needed to understand the full risk of e-cigarette–attributable lung disease, such as COPD.

Authors and Disclosures

Deborah A. Rusy, MD, MBA, FASA*, Anita Honkanen, MD†, Mary F. Landrigan-Ossar, MD, PhD, FASA, FAAP‡, Debnath Chatterjee, MD, FAAP, FASA§, Lawrence I. Schwartz, MD||, Kirk Lalwani, MBBS, FRCA, MCR¶, Jennifer R. Dollar, MD#, Randall Clark, MD, FASA||, Christina D. Diaz, MD, FASA, FAAP**, Nina Deutsch, MD††, David O. Warner, MD‡‡ and Sulpicio G. Soriano, MD‡

*Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; †Department of Anesthesia, Lucille Packard Children's Hospital, Stanford University School of Medicine, Stanford, California; ‡Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; §Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado; ||Department of Anesthesiology, Children's Hospital Colorado, University of Colorado, Aurora, Colorado; ¶Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon; #Pediatric Anesthesia Associates, Children's of Alabama, University of Alabama at Birmingham, Birmingham, Alabama; **Department of Anesthesiology, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin; ††Department of Anesthesiology, Pain and Perioperative Medicine, Children's National Hospital, The George Washington School of Medicine and Health Sciences, Washington, DC; and ‡‡Department of Anesthesiology and Perioperative Medicine, Mayo Clinic College of Medicine and Science, Mayo Clinic, Rochester, Minnesota.

Address correspondence to
Deborah A. Rusy, MD, MBA, FASA, Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, B6/319 CSC, 600 Highland Ave, Madison, WI 53792. Address e-mail to darusy@wisc.edu.

The authors declare no conflicts of interest.

Disclosures
Name: Deborah A. Rusy, MD, MBA, FASA.
Contribution: This author helped research, write, and submit the manuscript.
Name: Anita Honkanen, MD.
Contribution: This author helped research and write the manuscript.
Name: Mary F. Landrigan-Ossar, MD, PhD, FASA, FAAP.
Contribution: This author helped research and write the manuscript.
Name: Debnath Chatterjee, MD, FAAP, FASA.
Contribution: This author helped research and write the manuscript.
Name: Lawrence I. Schwartz, MD.
Contribution: This author helped research and write the manuscript.
Name: Kirk Lalwani, MBBS, FRCA, MCR.
Contribution: This author helped research and write the manuscript.
Name: Jennifer R. Dollar, MD.
Contribution: This author helped research and write the manuscript.
Name: Randall Clark, MD, FASA.
Contribution: This author helped research and write the manuscript.
Name: Christina D. Diaz, MD, FASA, FAAP.
Contribution: This author helped research and write the manuscript.
Name: Nina Deutsch, MD.
Contribution: This author helped research and write the manuscript.
Name: David O. Warner, MD.
Contribution: This author helped research and write the manuscript.
Name: Sulpicio G. Soriano, MD.
Contribution: This author helped research, write, and submit the manuscript.
This manuscript was handled by: James A. DiNardo, MD, FAAP.