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Vaping, e-Cigarettes Linked to Asthma Risk Among US Teenagers


A rapid growth in vaping and e-cigarettes use among teens is associated with increased risk of asthma, according to a new study.

A new study has found that vaping may increase the risk of asthma in teenagers who have never smoked conventional cigarettes or tobacco products.

Modern boy in cap smoking vape. Trendy new vaping device, smoke e-liquid instead of nicotine cigarettes. Tobacco free e-juice | Image credit:  MaximB - stock.adobe.com

Modern boy in cap smoking vape. Trendy new vaping device, smoke e-liquid instead of nicotine cigarettes. Tobacco free e-juice | Image credit: MaximB - stock.adobe.com

The use of e-cigarettes vapes has increased dramatically over the past several years, offering to consumers a less toxic form of smoking compared with traditional cigarettes. However, e-cigarettes still contain a mixture of harmful chemicals that raise concerns of respiratory diseases.

This cross-sectional study is published in Preventative Medicine.1

“This study aims to identify the factors associated with e-cigarette use and explore the potential association between e-cigarette use and asthma among adolescents in Texas and the United States, based on data from the Youth Risk Behavior Surveillance System from 2015 to 2018,” wrote the researchers of the study.

This survey included information on e-cigarette use, how many days participants had used an e-cigarette in the past 30 days, and whether they had ever been told by a health care professional they had asthma. The researchers included risk factors such as gender, age, race and ethnicity, body mass index, presence of depression symptoms, and the use of other substances, such as traditional cigarettes, alcohol, and illicit drugs.

The researchers analyzed data from the Youth Risk Behavior Surveillance System, a national survey established by the CDC in 1990 to monitor the behaviors and experiences of children and adolescents to evaluate the trends of disease, deaths, disabilities, social issues, and associated risk factors. The researchers performed multivariable logistic regression and stratified analyses on this dataset pertaining to e-cigarette use from 2015 and 2019 among 3042 high school students aged 13 to 17 years in Texas and more than 32,000 adolescents in the United States.

After adjusting for covariates, an association was found between e-cigarette use and asthma in adolescents who had never smoked traditional tobacco products, both in Texas (odds ratio [OR], 1.32; 95% CI, 1.06-1.66) and across the United States (OR, 1.18; 95% CI, 1.02-1.37).

Furthermore, some risk factors that were identified for demographics, substance use, and the presence of depression were associated with e-cigarette use. Male gender (adjusted OR [aOR], 1.19; 95% CI, 1.07-1.32; P < .05), previous combustible use (aOR, 14.1; 95% CI, 11.3-17.7; P < .05), substance use (aOR, 1.30; 95% CI, 1.05-1.61; P < .05), and depression (aOR, 2.12; 95% CI, 1.80-2.49; P < .05) were associated with higher odds of ever using e-cigarettes, while current use was associated with age (aOR, 1.09; 95% CI, 1.00-1.15; P < .05) and White race (aOR, 0.43; 95% CI, 0.34-0.54; P < .05).

In Texas, 44% of adolescents reported ever e-cigarette use and 13.4%, current e-cigarette use. Additionally, Hispanic teenagers living in Texas were significantly less likely to have used e-cigarettes (aOR, 0.61, 95% CI, 0.52-0.72; P < .05) compared with non-Hispanic White teenagers living in Texas. However, the researchers found no significant differences between e-cigarette use among racial and ethnic groups across the United States, overall.

The researchers acknowledged some limitations to the study, including using self-reported data, not including socioeconomic status in the analysis, and being cross-sectional in design.

Although the investigators believe that more research is needed to identify risk factors that could be associated with lower e-cigarette use among Hispanic teenagers living in Texas, they also believe the study adds relevant context to the burdens presented by asthma and the growing use of e-cigarettes among adolescents in the United States. Furthermore, the researchers hope this study is useful in public health efforts to reduce e-cigarette use.

“Increasing knowledge about the harmful effects of e-cigarette use, implementing stricter regulations, and promoting alternative coping mechanisms for mental health are potential interventions to mitigate e-cigarette use,” said Taehyun Roh, PhD, assistant professor, Texas A&M University School of Public Health, and lead author of the study, in a statement.2


1. Mitchell RL. Researchers find association between vaping and asthma among US adolescents. News release. EurekAlert! September 18, 2023. Accessed September 19, 2023. https://www.eurekalert.org/news-releases/1001912.

2. Roh T, Uyamasi K, Aggarwal A, Obeng A, Carrillo G. Association between e-cigarette use and asthma among US adolescents: Youth Risk Behavior Surveillance System 2015–2019. Prev Med. 2023;175:107695. doi:10.1016/j.ypmed.2023.107695

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