Longitudinal Association Between Exclusive and Dual Use of Cigarettes and Electronic Nicotine Delivery Systems and Asthma Among U.S. Adolescents

Akash Patel; Steven Cook; Delvon T. Mattingly; Geoffrey D. Barnes; Douglas A. Arenberg; David T. Levy; Rafael Meza; Nancy L. Fleischer; Jana L. Hirschtick

doi:10.1016/j.jadohealth.2023.04.009

Longitudinal Association Between Exclusive and Dual Use of Cigarettes and Electronic Nicotine Delivery Systems and Asthma Among U.S. Adolescents

Akash Patel, Steven Cook, Delvon T. Mattingly, Geoffrey D. Barnes, Douglas A. Arenberg, David T. Levy, Rafael Meza, Nancy L. Fleischer, Jana L. Hirschtick

Research output: Contribution to journal › Article › peer-review

Abstract

Purpose: Electronic Nicotine Delivery Systems (ENDS) use among adolescents has increased greatly over the past decade, but its impact on chronic respiratory health conditions, like asthma, is not fully understood. Methods: We examined data from Waves 1–5 (2013–2019) of the Population Assessment of Tobacco and Health Study using discrete time hazard models to analyze the association between time-varying tobacco product use and incident diagnosed asthma among adolescents aged 12–17 years at baseline. We lagged the time-varying exposure variable by one wave and categorized respondents by current use status (1+ days in the past 30 days): never or non-current, exclusive cigarette, exclusive ENDS, and dual cigarette and ENDS use. We also controlled for sociodemographic (age, sex, race/ethnicity, parental education) and other risk factors (urban/rural setting, secondhand smoke exposure, household combustible tobacco use, body mass index). Results: At baseline, over half the analytic sample (n = 9,141) was 15–17 years old (50.4%), female (50.2%), and non-Hispanic White (55.3%). Adolescents who exclusively smoked cigarettes had a statistically significant higher risk of incident diagnosed asthma at follow-up (adjusted Hazard Ratio (aHR): 1.68, 95% confidence interval (CI): 1.21–2.32) compared to those not currently using cigarettes or ENDS, but adolescents using ENDS exclusively (aHR: 1.25, 95% CI: 0.77–2.04) or in combination with cigarettes (aHR: 1.54, 95% CI: 0.92–2.57) did not. Discussion: Short-term exclusive cigarette use was associated with a higher risk of incident diagnosed asthma over five years of follow-up among adolescents. We did not find conclusive evidence for an association between exclusive ENDS or dual use and incident diagnosed asthma.

Original language	English
Pages (from-to)	437-444
Number of pages	8
Journal	Journal of Adolescent Health
Volume	73
Issue number	3
DOIs	https://doi.org/10.1016/j.jadohealth.2023.04.009
State	Published - Sep 2023

Bibliographical note

Funding Information:
This work was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and the Food and Drug Administration's (FDA) Center for Tobacco Products (CTP) under Award Number U54CA229974. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The opinions expressed in this work are the authors' own and do not reflect the views of the National Institutes of Health, the Food and Drug Administration, the Department of Health and Human Services, nor the United States government. Disclaimer: Preliminary findings were presented at the Society for Research on Nicotine and Tobacco Annual Meeting in March 2022, in Baltimore, Maryland.Conclusive findings were presented at the Fall 2022 Tobacco Centers of Regulatory Science Grantee Meeting in October 2022 virtually.

Funding Information:
This work was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and the Food and Drug Administration's (FDA) Center for Tobacco Products (CTP) under Award Number U54CA229974. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The opinions expressed in this work are the authors' own and do not reflect the views of the National Institutes of Health, the Food and Drug Administration, the Department of Health and Human Services, nor the United States government.

Publisher Copyright:
© 2023 Society for Adolescent Health and Medicine

Keywords

Adolescence
Asthma
Electronic nicotine delivery systems
Epidemiology
Smoking
Tobacco

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Public Health, Environmental and Occupational Health
Psychiatry and Mental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.jadohealth.2023.04.009

Cite this

Patel, A., Cook, S., Mattingly, D. T., Barnes, G. D., Arenberg, D. A., Levy, D. T., Meza, R., Fleischer, N. L., & Hirschtick, J. L. (2023). Longitudinal Association Between Exclusive and Dual Use of Cigarettes and Electronic Nicotine Delivery Systems and Asthma Among U.S. Adolescents. Journal of Adolescent Health, 73(3), 437-444. https://doi.org/10.1016/j.jadohealth.2023.04.009

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abstract = "Purpose: Electronic Nicotine Delivery Systems (ENDS) use among adolescents has increased greatly over the past decade, but its impact on chronic respiratory health conditions, like asthma, is not fully understood. Methods: We examined data from Waves 1–5 (2013–2019) of the Population Assessment of Tobacco and Health Study using discrete time hazard models to analyze the association between time-varying tobacco product use and incident diagnosed asthma among adolescents aged 12–17 years at baseline. We lagged the time-varying exposure variable by one wave and categorized respondents by current use status (1+ days in the past 30 days): never or non-current, exclusive cigarette, exclusive ENDS, and dual cigarette and ENDS use. We also controlled for sociodemographic (age, sex, race/ethnicity, parental education) and other risk factors (urban/rural setting, secondhand smoke exposure, household combustible tobacco use, body mass index). Results: At baseline, over half the analytic sample (n = 9,141) was 15–17 years old (50.4%), female (50.2%), and non-Hispanic White (55.3%). Adolescents who exclusively smoked cigarettes had a statistically significant higher risk of incident diagnosed asthma at follow-up (adjusted Hazard Ratio (aHR): 1.68, 95% confidence interval (CI): 1.21–2.32) compared to those not currently using cigarettes or ENDS, but adolescents using ENDS exclusively (aHR: 1.25, 95% CI: 0.77–2.04) or in combination with cigarettes (aHR: 1.54, 95% CI: 0.92–2.57) did not. Discussion: Short-term exclusive cigarette use was associated with a higher risk of incident diagnosed asthma over five years of follow-up among adolescents. We did not find conclusive evidence for an association between exclusive ENDS or dual use and incident diagnosed asthma.",

keywords = "Adolescence, Asthma, Electronic nicotine delivery systems, Epidemiology, Smoking, Tobacco",

author = "Akash Patel and Steven Cook and Mattingly, {Delvon T.} and Barnes, {Geoffrey D.} and Arenberg, {Douglas A.} and Levy, {David T.} and Rafael Meza and Fleischer, {Nancy L.} and Hirschtick, {Jana L.}",

note = "Funding Information: This work was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and the Food and Drug Administration's (FDA) Center for Tobacco Products (CTP) under Award Number U54CA229974. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The opinions expressed in this work are the authors' own and do not reflect the views of the National Institutes of Health, the Food and Drug Administration, the Department of Health and Human Services, nor the United States government. Disclaimer: Preliminary findings were presented at the Society for Research on Nicotine and Tobacco Annual Meeting in March 2022, in Baltimore, Maryland.Conclusive findings were presented at the Fall 2022 Tobacco Centers of Regulatory Science Grantee Meeting in October 2022 virtually. Funding Information: This work was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and the Food and Drug Administration's (FDA) Center for Tobacco Products (CTP) under Award Number U54CA229974. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The opinions expressed in this work are the authors' own and do not reflect the views of the National Institutes of Health, the Food and Drug Administration, the Department of Health and Human Services, nor the United States government. Publisher Copyright: {\textcopyright} 2023 Society for Adolescent Health and Medicine",

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Patel, A, Cook, S, Mattingly, DT, Barnes, GD, Arenberg, DA, Levy, DT, Meza, R, Fleischer, NL & Hirschtick, JL 2023, 'Longitudinal Association Between Exclusive and Dual Use of Cigarettes and Electronic Nicotine Delivery Systems and Asthma Among U.S. Adolescents', Journal of Adolescent Health, vol. 73, no. 3, pp. 437-444. https://doi.org/10.1016/j.jadohealth.2023.04.009

TY - JOUR

T1 - Longitudinal Association Between Exclusive and Dual Use of Cigarettes and Electronic Nicotine Delivery Systems and Asthma Among U.S. Adolescents

AU - Patel, Akash

AU - Cook, Steven

AU - Mattingly, Delvon T.

AU - Barnes, Geoffrey D.

AU - Arenberg, Douglas A.

AU - Levy, David T.

AU - Meza, Rafael

AU - Fleischer, Nancy L.

AU - Hirschtick, Jana L.

N1 - Funding Information: This work was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and the Food and Drug Administration's (FDA) Center for Tobacco Products (CTP) under Award Number U54CA229974. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The opinions expressed in this work are the authors' own and do not reflect the views of the National Institutes of Health, the Food and Drug Administration, the Department of Health and Human Services, nor the United States government. Disclaimer: Preliminary findings were presented at the Society for Research on Nicotine and Tobacco Annual Meeting in March 2022, in Baltimore, Maryland.Conclusive findings were presented at the Fall 2022 Tobacco Centers of Regulatory Science Grantee Meeting in October 2022 virtually. Funding Information: This work was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) and the Food and Drug Administration's (FDA) Center for Tobacco Products (CTP) under Award Number U54CA229974. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The opinions expressed in this work are the authors' own and do not reflect the views of the National Institutes of Health, the Food and Drug Administration, the Department of Health and Human Services, nor the United States government. Publisher Copyright: © 2023 Society for Adolescent Health and Medicine

PY - 2023/9

Y1 - 2023/9

N2 - Purpose: Electronic Nicotine Delivery Systems (ENDS) use among adolescents has increased greatly over the past decade, but its impact on chronic respiratory health conditions, like asthma, is not fully understood. Methods: We examined data from Waves 1–5 (2013–2019) of the Population Assessment of Tobacco and Health Study using discrete time hazard models to analyze the association between time-varying tobacco product use and incident diagnosed asthma among adolescents aged 12–17 years at baseline. We lagged the time-varying exposure variable by one wave and categorized respondents by current use status (1+ days in the past 30 days): never or non-current, exclusive cigarette, exclusive ENDS, and dual cigarette and ENDS use. We also controlled for sociodemographic (age, sex, race/ethnicity, parental education) and other risk factors (urban/rural setting, secondhand smoke exposure, household combustible tobacco use, body mass index). Results: At baseline, over half the analytic sample (n = 9,141) was 15–17 years old (50.4%), female (50.2%), and non-Hispanic White (55.3%). Adolescents who exclusively smoked cigarettes had a statistically significant higher risk of incident diagnosed asthma at follow-up (adjusted Hazard Ratio (aHR): 1.68, 95% confidence interval (CI): 1.21–2.32) compared to those not currently using cigarettes or ENDS, but adolescents using ENDS exclusively (aHR: 1.25, 95% CI: 0.77–2.04) or in combination with cigarettes (aHR: 1.54, 95% CI: 0.92–2.57) did not. Discussion: Short-term exclusive cigarette use was associated with a higher risk of incident diagnosed asthma over five years of follow-up among adolescents. We did not find conclusive evidence for an association between exclusive ENDS or dual use and incident diagnosed asthma.

AB - Purpose: Electronic Nicotine Delivery Systems (ENDS) use among adolescents has increased greatly over the past decade, but its impact on chronic respiratory health conditions, like asthma, is not fully understood. Methods: We examined data from Waves 1–5 (2013–2019) of the Population Assessment of Tobacco and Health Study using discrete time hazard models to analyze the association between time-varying tobacco product use and incident diagnosed asthma among adolescents aged 12–17 years at baseline. We lagged the time-varying exposure variable by one wave and categorized respondents by current use status (1+ days in the past 30 days): never or non-current, exclusive cigarette, exclusive ENDS, and dual cigarette and ENDS use. We also controlled for sociodemographic (age, sex, race/ethnicity, parental education) and other risk factors (urban/rural setting, secondhand smoke exposure, household combustible tobacco use, body mass index). Results: At baseline, over half the analytic sample (n = 9,141) was 15–17 years old (50.4%), female (50.2%), and non-Hispanic White (55.3%). Adolescents who exclusively smoked cigarettes had a statistically significant higher risk of incident diagnosed asthma at follow-up (adjusted Hazard Ratio (aHR): 1.68, 95% confidence interval (CI): 1.21–2.32) compared to those not currently using cigarettes or ENDS, but adolescents using ENDS exclusively (aHR: 1.25, 95% CI: 0.77–2.04) or in combination with cigarettes (aHR: 1.54, 95% CI: 0.92–2.57) did not. Discussion: Short-term exclusive cigarette use was associated with a higher risk of incident diagnosed asthma over five years of follow-up among adolescents. We did not find conclusive evidence for an association between exclusive ENDS or dual use and incident diagnosed asthma.

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KW - Electronic nicotine delivery systems

KW - Epidemiology

KW - Smoking

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Longitudinal Association Between Exclusive and Dual Use of Cigarettes and Electronic Nicotine Delivery Systems and Asthma Among U.S. Adolescents

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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