Secondhand nicotine vape exposure linked with risk for bronchitic symptoms in young adults
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In young adults, secondhand nicotine vape exposure was associated with an increased risk for bronchitic symptoms and shortness of breath, researchers reported in Thorax.
“Although secondhand exposure to particulate matter from e-cigarettes is lower than from combustible cigarettes, the ultrafine particle concentration in e-cigarette aerosol can be higher than in cigarette smoke, potentially delivering toxins to the distal airways and alveoli,” Talat Islam, PhD, assistant professor of research population and public health sciences at the University of Southern California, Los Angeles, and colleagues wrote. “E-cigarette aerosol also contains volatile aldehydes and oxidant metals, compounds that are known to cause lung toxicity.”
Researchers evaluated the effects of secondhand nicotine vape exposure on annually reported wheeze, bronchitic symptoms and shortness of breath among 2,097 participants (mean age, 17.3 years; 50.4% male; 51.8% Hispanic white) from the prospective Southern California Children Health Study cohort. Participants completed annual surveys from 2014 to 2019 that collected detailed information on e-cigarette and cigarette secondhand smoke exposure.
During the study period, the prevalence of secondhand nicotine vape exposure increased from 11.7% to 15.6%. The researchers reported the prevalence of wheeze ranged from 12.3% to 14.9%, bronchitic symptoms from 19.4% to 26% and shortness of breath from 16.5% to 18.1% over time.
There were associations between secondhand nicotine vape exposure and bronchitic symptoms (OR = 1.4; 95% CI, 1.06-1.84) and shortness of breath (OR = 1.53; 95% CI, 1.06-2.21) after researchers controlled for vaping, active and passive exposure to tobacco/cannabis and demographic characteristics. The researchers observed stronger associations when restricting the analysis to participants who were non-smokers and non-vapers. There were no associations between wheezing and secondhand nicotine vape exposure after adjusting for confounders.
“The results have important public health implications for the population exposed to secondhand nicotine vape. Unlike active vaping and smoking, secondhand nicotine vape exposure is not a voluntary exposure. Therefore, if the associations we observed are causal, prohibiting e-cigarette use in public places is warranted, just as secondhand tobacco smoke exposure has been prohibited in public spaces for decades, and reducing use indoors would reduce the burden of respiratory illness in the households of e-cigarette users,” Islam and colleagues wrote.
The authors said further research is needed to assess the replicability of these data, as well as the generalizability to individuals in other age groups.
In an accompanying editorial, Ana Lucia Fuentes, MD, resident, and Laura E. Crotty Alexander, MD, assistant profess of medicine, both with the department of medicine at the University of California, San Diego, and the VA San Diego Healthcare System, said the findings in the study “are of critical importance.”
Fuentes and Crotty Alexander noted that the evidence demonstrating health risks associated with secondhand cigarette smoke led to widespread campaigns to ban cigarette smoking in public, but this has not yet translated to secondhand nicotine vape exposure.
“More work needs to be done to prove that this exposure directly causes harm,” Fuentes and Crotty Alexander wrote. “Ultimately, this is a public health concern that — if not addressed — has the potential to negatively affect our population, including those who are most vulnerable.”