Tobacco Product Use and Functionally Important Respiratory Symptoms Among US Adolescents/Young Adults

Susanne Tanski; Michael J Halenar; Kathryn C Edwards; Jennifer Emond; Steven Woloshin; Mary Brunette; Lisa Schwartz; Kristie A Taylor; Maciej L Goniewicz; Ray Niaura; Gabriella Anic; Yanling Chen; Priscilla Callahan-Lyon; Lisa D Gardner; Theresa Thekkudan; Nicolette Borek; Heather L Kimmel; K Michael Cummings; Andrew Hyland; James Sargent

doi:10.1016/j.acap.2022.03.001

Tobacco Product Use and Functionally Important Respiratory Symptoms Among US Adolescents/Young Adults

Acad Pediatr. 2022 Aug;22(6):1006-1016. doi: 10.1016/j.acap.2022.03.001. Epub 2022 Mar 7.

Authors

Susanne Tanski¹, Michael J Halenar², Kathryn C Edwards², Jennifer Emond³, Steven Woloshin⁴, Mary Brunette³, Lisa Schwartz⁴, Kristie A Taylor², Maciej L Goniewicz⁵, Ray Niaura⁶, Gabriella Anic⁷, Yanling Chen⁷, Priscilla Callahan-Lyon⁷, Lisa D Gardner⁷, Theresa Thekkudan⁷, Nicolette Borek⁷, Heather L Kimmel⁸, K Michael Cummings⁹, Andrew Hyland⁵, James Sargent³

Affiliations

¹ Geisel School of Medicine (S Tanski, J Emond, M Brunette, and J Sargent), Hanover, NH; The C. Everett Koop Institute at Dartmouth (S Tanski, J Emond, S Woloshin, M Brunette, L Schwartz, and J Sargent), Lebanon, NH. Electronic address: Susanne.E.Tanski@Dartmouth.edu.
² Westat (MJ Halenar, KC Edwards, and KA Taylor), Rockville, MD.
³ Geisel School of Medicine (S Tanski, J Emond, M Brunette, and J Sargent), Hanover, NH; The C. Everett Koop Institute at Dartmouth (S Tanski, J Emond, S Woloshin, M Brunette, L Schwartz, and J Sargent), Lebanon, NH.
⁴ The C. Everett Koop Institute at Dartmouth (S Tanski, J Emond, S Woloshin, M Brunette, L Schwartz, and J Sargent), Lebanon, NH; Dartmouth Institute for Health Policy and Clinical Practice (S Woloshin and L Schwartz), Lebanon, NH; The Lisa Schwartz Foundation (S Woloshin, L Schwartz), Hanover, NH.
⁵ Roswell Park Comprehensive Cancer Center (ML Goniewicz and A Hyland), Buffalo, NY.
⁶ New York University (R Niaura), New York, NY.
⁷ U.S. Food and Drug Administration, Center for Tobacco Products (G Anic, Y Chen, P Callahan-Lyon, LD Gardner, T Thekkudan, and N Borek), Beltsville, Md.
⁸ National Institute on Drug Abuse, National Institutes of Health (HL Kimmel), Bethesda, Md.
⁹ Medical University of South Carolina (KM Cummings), Charleston, SC.

Abstract

Objective: The relation between respiratory symptoms and the range of tobacco product use among US adolescents/young adults is not yet clear. This cross-sectional analysis examines tobacco product use and respiratory symptoms in a nationally representative sample of 21,057 adolescents/young adults aged 12-24 years from Wave 4 (2016-17) of the Population Assessment of Tobacco and Health Study.

Methods: Presence of functionally important respiratory symptoms was defined by questions regarding wheezing and nighttime cough at a cutoff score associated with poorer functional health status. Past-30-day tobacco use was analyzed 2 ways: never-tobacco users (reference) versus combustible users, noncombustible-only users, and former users; or frequency of use of cigarettes and/or e-cigarettes. Weighted Poisson regression adjusted for past-30-day marijuana use, secondhand smoke exposure, and asthma.

Results: Functionally important respiratory symptoms were present in 10.0% overall: 13.8% of combustible users, 9.0% of noncombustible users, 8.2% of noncurrent users and 9.7% of never users. Functionally important respiratory symptoms were associated with combustible tobacco use (relative risk [RR] = 1.52[95% CI 1.29, 1.80]), marijuana use (RR = 1.54[1.34, 1.77]) and secondhand smoke exposure (RR = 1.04[1.03, 1.05]). Higher cigarette smoking frequency was also associated with functionally important respiratory symptoms for frequency categories >14 days/month (eg, RR = 1.93[1.50, 2.49] for 15-29 days/month). Frequency of e-cigarette use was not associated with functionally important respiratory symptoms.

Conclusions: During 2016-17, smoking cigarettes, marijuana use, and secondhand smoke exposure were cross-sectionally associated with functionally important respiratory symptoms in adolescents/young adults. Risk increased with increased frequency of cigarette use but not e-cigarette use. Given changes to contemporary e-cigarettes and use, findings may not generalize to newer products.

Keywords: adolescents; respiratory symptoms; tobacco use; young adults.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adolescent
Cross-Sectional Studies
Electronic Nicotine Delivery Systems*
Humans
Tobacco Products*
Tobacco Smoke Pollution*
Tobacco Use / epidemiology
Young Adult

Substances

Tobacco Smoke Pollution

Abstract

Publication types

MeSH terms

Substances

Grants and funding