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Secondhand nicotine vape exposure doubles risk of bronchitic symptoms in young adults

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Secondhand Vape Exposure to nicotine from e-cigs increases the risk of bronchitic symptoms and shortness of breath in young adults by more than 40%

A new study published today in the journal Thorax found that Secondhand Vape Exposure at home to nicotine from e-cigs increases the risk of bronchitic symptoms and shortness of breath in young adults.

Despite the growing popularity of vaping, the researchers claim that little is known about the potential health implications of secondhand nicotine vapor exposure from e-cigarettes and other vaping devices.

While secondhand contact to particulate matter from e-cigarettes is lower than from traditional cigarettes, ultrafine particle levels in e-cigarette aerosol can be higher. This aerosol also contains metals and volatile chemicals that can injure lung tissue.

The researchers used data from 2090 participants in the Southern California Children’s Health Study to further investigate the impact on respiratory health.

From 2014, when participants were on average 17 years old, until 2019, this study collected thorough annual data on respiratory health, active and secondhand nicotine vaping, and conventional tobacco and cannabis smoke exposure in the home.

Respondents were deemed to have bronchitic symptoms if they had bronchitis in the previous 12 months, had a daily cough in the morning for 3 months in a row, had a daily cough at other times of the day for 3 months in a row, or had congestion or phlegm that wasn’t caused by a cold.

Wheeze was determined by self-reported chest wheezing or whistling over the past 12 months. And the experience of shortness of breath was based on walking up a little incline or hurrying on level terrain.

Between 2014 and 2019, the prevalence of secondhand nicotine vaping climbed from 12% to 16%, whereas the prevalence of secondhand smoking decreased from 27% to 21%. Cigarettes, e-cigarettes, and cannabis use in the previous 30 days increased during the study period.

The majority of participants (76–93%) who were exposed to secondhand nicotine vaping during any of the research years were also more likely to use tobacco or cannabis products actively or to have been exposed to secondhand smoking.

The frequency of self-reported wheeze and bronchitic symptoms increased from 12% to 15% and from 19.5% to 26%, respectively. The prevalence of shortness of breath fluctuated between 16.5 and 18% over time.

Participants who had been exposed to secondhand nicotine vaping were more likely to experience bronchitic symptoms and shortness of breath, but not wheeze, when compared to those who hadn’t.

After controlling for secondhand smoking, cannabis exposure, and active vaping or smoking, individuals exposed to secondhand nicotine vaping were 40% more likely to report bronchitic symptoms and 53% more likely to report shortness of breath.

When the study was limited to 1181 people who reported no personal vaping or smoking in the previous 30 days, greater associations emerged.

After controlling for demographics and secondhand smoking/cannabis exposure, these participants were more than twice as likely to report wheeze, three times as likely to report bronchitic symptoms, and twice as likely to report shortness of breath as those who had not been exposed to secondhand nicotine vaping.

As this is an observational study, it cannot show cause and effect. The findings, however, are equivalent in magnitude to those seen with secondhand smoking, according to the researchers.

They advise that if the link is proven causal in future studies, a ban on vaping in public areas is needed.

“If causal, reduction of secondhand e-cigarette exposure in the home would reduce the burden of respiratory symptoms and would provide a compelling rationale for regulation of e-cigarette use in public places,” they say. 

Drs. Anna Lucia Fuentes and Laura Crotty Alexander of the University of California San Diego and the San Diego Healthcare System, respectively, note out in a linked editorial that vaping devices were first marketed as a lower-risk nicotine replacement.

“But increasing evidence points to the contrary,” they comment. “Even more concerning is that marketing has targeted the vulnerable adolescent population, with 78% of middle school and high school students exposed to at least one e-cigarette advertisement between 2014 and 2016.” 

They add: “Some may be comforted by studies that argue that nicotine use has not increased with the rise of vaping. However, it is important to note that the nicotine content reported on product labels and what is chemically measured can vary widely. 

“This means that users may be unaware of what they are truly vaping and thus are at risk of unwittingly becoming nicotine addicts.”

They conclude: “While association is not causation, this study is the first to describe the negative effects of [secondhand nicotine vape] exposure on respiratory symptoms. 

“More work needs to be done to prove that this exposure directly causes harm. 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.” 

Source: 10.1136/thoraxjnl-2021-217041

Image Credit: Getty

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