• Posted August 16, 2023

Vaping Can Hamper Breathing in the Young

When teens vape, their lungs pay a price, researchers report.

The warning stems from a detailed analysis of smoking habit histories shared by just over 2,000 U.S. teens during a series of recent annual surveys.

The upshot: When compared with teens who've never vaped, those who reported using electronic cigarettes in the month prior to being surveyed saw their risk for wheezing and shortness of breath shoot up by about 80%.

Vapers also faced double the risk for telltale signs of bronchitis, the survey revealed. And most of the hits to respiratory health linked to vaping held up even after taking into account whether the teens also smoked cigarettes or marijuana.

"While e-cigarettes likely have fewer negative health impacts than traditional cigarettes, they are not risk-free, especially for youth or young adults who have never used any other tobacco product,"said study lead author Alayna Tackett. She is a pediatric psychologist and researcher with the Center for Tobacco Research at The Ohio State University Comprehensive Cancer Center, in Columbus.

Tackett and her colleagues explored the impact vaping has on respiratory health by analyzing four years' worth of surveys administered by the Southern California Children's Health Study between 2014 and 2018.

On average, roughly 1,700 teens participated in the annual survey, though the final analysis focused on about 2,100 teens, equally divided between boys and girls, with an average age of 17.

Each year, teens were asked to indicate e-cigarette use and conventional cigarette use. (Cannabis use was also assessed, but only in 2017 and 2018.) Teens were also asked about the presence of key lung health complications.

Those included wheezing in the year prior to being surveyed and shortness of breath when hurrying about or walking up an incline. Bronchitis diagnoses in the proceeding 12 months and/or symptoms suggestive of bronchitis were also noted, including congestion or phlegm in the absence of a cold, or daily coughing over three consecutive months.

Over the four-year study period, e-cigarette use increased from 12% to 16% among those surveyed.

The percentage of teens who reported bronchitis symptoms also increased during the study, rising from about 20% in 2014 to 26% by 2018.

In the end, the investigators determined that wheezing and shortness of breath was 81% and 78%, respectively, more frequent among vapers. Vapers were also twice as likely to struggle with bronchitis-related issues.

But might some of that vaping-attributed lung risk actually be rooted in other factors, like smoking cigarettes, smoking weed, routine exposure to secondhand smoke or chronic asthma?

Not so much. After accounting for all those factors, the team determined that while the direct link between vaping and respiratory risk was "slightly"less strong, it remained "significant."The sole exception was wheezing, the risk for which no longer appeared to be driven up directly by vaping.

Tackett and her colleagues published their findings in the Aug. 15 issue of the journal Thorax.

Investigators did stress that the findings were based solely on self-reported observations and therefore cannot be considered definitive proof that vaping undermines lung health.

On that point, Gregory Conley, a spokesperson for the American Vapor Manufacturers Association, agreed.

"The reliance on self-reported data and the lack of control over examined variables limit the conclusions that can be drawn,"Conley said. "Correlation does not equal causation, and more rigorous research is needed to establish a clear link between vaping and respiratory concerns."

Until then, concluding that vaping products actually cause harm "is premature, given the potential confounding factors and competing body of literature involved,"he added.

Still, Tackett said, "it is known that e-cigarette aerosol contains substances that harm the lungs, including flavorings and oxidant metals with known pulmonary toxicity."And it is only because vaping entered the mainstream market so quickly that scientists are still playing catch-up in an effort to understand the full scope of the health threat vaping poses, she added.

Meanwhile, the "regulation of these [e-cigarette] products should be done with thoughtful consideration, to balance potential benefits of e-cigarettes as a potential smoking cessation tool and the risk to health, especially for younger users,"Tackett said.

That thought was seconded by Aruni Bhatnagar, co-director of the American Heart Association's Tobacco Center for Regulatory Science and principal investigator of the Cardiovascular Injury Due to Tobacco Use project.

"From a regulatory point of view, it may be important to identify the harmful or potentially harmful substances in e-cigarettes,"he said. "And to minimize their levels in -- or their production during -- vaping, to decrease the respiratory toxicity and irritation caused by e-cigarettes."

At the same time, when it comes to protecting teenage lung health, "the most effective solution is to stop vaping completely,"advised Bhatnagar.

On that point, Conley agreed yet again.

"While vaping products offer massive harm reduction for smokers -- so much so that the Food and Drug Administration has authorized certain vaping products as appropriate for public health -- they are not risk-free and should not be used by youth,"he said.

More information

There's more on vaping and young people at the U.S. Centers for Disease Control and Prevention.

SOURCES: Alayna Tackett, PhD, pediatric psychologist and researcher, department of internal medicine, division of medical oncology, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus; Aruni Bhatnagar, PhD, professor of medicine, division of cardiovascular medicine, department of medicine, and director, diabetes and obesity center, University of Louisville, Kentucky, and co-director, American Heart Association's Tobacco Center for Regulatory Science; Gregory Conley, director of legislative & external affairs, American Vapor Manufacturers Association; Thorax, Aug. 15, 2023