Though some think that vaping is a safer alternative to smoking traditional cigarettes, Canadian research suggests it could raise the risk of developing asthma or having asthma attacks for teens and adults.
"Emerging research really suggests that vaping may actually worsen preexisting health conditions such as asthma," said study author Teresa To, senior scientist in the Child Health Evaluative Sciences program at The Hospital for Sick Children in Toronto.
"Recently, most research really focused on acute or immediate health effects from vaping. The knowledge on long-term health consequences of e-cigarette smoking, especially in young people, in adolescents, young adults, remains very limited and unknown," she said.
The aim of the study was to determine whether youth and young adults who use e-cigarettes had increased odds of asthma and an attack within the last 12 months.
Researchers used data from the 2015-2016 and 2017-2018 cycles of the self-reported Canadian Community Health Survey. They included more than 17,000 people aged 12 and up.
Study participants included just over 3% who answered that they had used e-cigarettes in the past 30 days. That's equal to about 1 of every 32 people, To said. About half of the e-cigarette users also smoked traditional cigarettes daily.
One in 8 people, or 13%, of e-cigarette users had asthma. E-cigarette users had 19% higher odds of having asthma. Current smokers had 20% higher odds of having asthma, while former smokers had 33% higher odds. About half of people who smoked e-cigarettes and had asthma reported asthma attacks in the past 12 months, To said.
Study participants who never smoked or used e-cigarettes did not have significant associations with asthma.
A significantly higher proportion of those who used e-cigarettes, 15%, have fair to poor mental health compared to those who did not vape, which was 7%, the study also found. Those who used e-cigarettes also had 60% higher odds of self-reported high levels of stress.
The study wasn't designed to determine causation, but the researchers did observe a very strong and statistically significant association between smoking e-cigarettes and asthma, To said.
"No doubt there is an association there. Whether they cause it or not, we need to do more research to look into that, but we are also very confident from our findings that if you already have asthma and you smoke e-cigarettes, it no doubt would worsen your asthma over time," To said.
Other research has found lung damage and death, To noted. E-cigarettes also contain nicotine, which could increase heart rate and blood pressure, potentially adding to cardiovascular risk, she said.
This new research will be presented at the American Thoracic Society's virtual conference, May 14-19. Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.
Unlike with traditional cigarettes, e-cigarettes have only existed about 10 to 15 years, said Dr. Albert Rizzo, chief medical officer of the American Lung Association. While the history of study on their impact is shorter, there is more evidence over time that e-cigarettes emit some of the same harmful chemicals that are in traditional cigarettes, Rizzo said.
"The American Lung Association takes a stand that anything you inhale into your lungs could be potentially harmful. So, we don't advise using anything of that nature because of the consequences to the airways," Rizzo said.
For current smokers, it's important to convince them that there are other ways to quit besides switching to an e-cigarette, Rizzo said. The lung association suggests quitting, not switching, using an U.S. Food and Drug Administration-approved smoking cessation product, like a patch or an inhaler, combined with counseling or a support group.
It's also important to educate people about the potential impact of e-cigarettes and cigarettes, Rizzo said. This includes making parents and children aware of the risks of e-cigarettes to help arm them against peer pressure and marketing efforts.
"Education and advocacy are really where we put a lot of our efforts and we also fund research around the effects of e-cigarettes on developing lungs," Rizzo said. "We try to do everything we can to give the public information that's trusted by way of research and advocate for the right type of legislation to make it harder for young people to get access to these devices before they understand what's really going on."
The U.S. Centers for Disease Control and Prevention has more information on electronic cigarettes.
SOURCES: Teresa To, PhD, senior scientist, Child Health Evaluative Sciences program, The Hospital for Sick Children, Toronto, Canada; Albert Rizzo, MD, chief medical officer, American Lung Association; American Thoracic Society 2021 International Conference, May 14-19, 2021