Risk for respiratory symptoms, lung injury increased in adolescents who vape cannabis

Adolescents who vape cannabis have greater risk for lung injury and respiratory symptoms compared with those who smoke or vape other substances, according to findings published in the Journal of Adolescent Health.

“To date, most of the studies that focused on adolescents e-cigarette use and associated respiratory symptoms did not assess cannabis vaping, although research suggests e-cigarette vapor is associated with lung damage in humans as well as in animal study models,” Carol J. Boyd, PhD, research professor in the department of Health Behavior and Biological Sciences and co-director at the Center for the Study of Drugs, Alcohol, Smoking and Health at the University of Michigan School of Nursing, Ann Arbor, and colleagues wrote. “Furthermore, small clinical and record reviews have documented [that] THC was often vaped before symptoms.”

Using a sample of adolescents from the 2016-2018 wave of the PATH study, researchers collected data on 14,798 adolescents (48.9% girls) aged 12 to 17 years.

Among respondents, 3.1% currently used cigarettes, 4.2% currently used e-cigarettes and 4.7% currently used cannabis, with 8.9% vaping cannabis through electronic nicotine-delivery systems. Seventeen percent of respondents had diagnosed asthma.

The odds of wheezing or whistling in the chest was two times greater among adolescents who vaped cannabis through electronic nicotine-delivery systems (adjusted OR = 1.81; 95% CI, 1.47-2.22). Adolescents who had ever vaped cannabis had increased odds for the following respiratory symptoms:

• wheezing or whistling in the chest (aOR = 1.82; 95% CI, 1.55-2.13);
• sleep disturbed due to of wheezing (aOR = 1.89; 95% CI, 1.42-2.53);
• speech limited due to of wheezing (aOR = 1.79; 95% CI, 1.4-2.31);
• sounded wheezy during or after exercise (aOR = 1.29; 95% CI, 1.13-1.47); and
• dry cough at night not associated with a cold/chest infection (aOR = 1.23; 95% CI, 1.06-1.44).

The researchers reported no association with e-cigarettes or cigarettes and these respiratory symptoms in fully adjusted models.

“This study suggests that the inhalation of cannabis via vaping with electronic nicotine-delivery systems is associated with pulmonary irritation among adolescents,” the researchers wrote. “As we learn more about the negative health consequences of vaping, we may discover that the respiratory symptoms identified here put youth at risk for future lung injury and infections.”