RESEARCH PAPER
Electronic cigarette use and its association with asthma, chronic obstructive pulmonary disease (COPD) and asthma- COPD overlap syndrome among never cigarette smokers
Emine Bircan 1,   Ummugul Bezirhan 2,   Austin Porter 3, 4,   Pebbles Fagan 5, 6,   Mohammed S. Orloff 1, 7  
 
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1
Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, United States
2
Teachers College, Columbia University, New York, United States
3
Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, United States
4
Arkansas Department of Health, Little Rock, United States
5
Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, United States
6
Center for the Study of Tobacco, Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, United States
7
Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, United States
CORRESPONDING AUTHOR
Mohammed S. Orloff   

Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot #820, Little Rock, AR 72205-7199, United States
Submission date: 2021-09-24
Acceptance date: 2021-09-25
Publication date: 2021-09-30
 
Tob. Induc. Dis. 2021;19(September):75
 
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Corrected and republished from:

Electronic cigarette use and its association with asthma, chronic obstructive pulmonary disease (COPD) and asthma- COPD overlap syndrome among never cigarette smokers
Emine Bircan, Ummugul Bezirhan, Austin Porter, Pebbles Fagan, Mohammed S. Orloff Tob. Induc. Dis. 2021;19(April):23, pages 1-9, doi: 10.18332/tid/132833


Electronic cigarette use and its association with asthma, chronic obstructive pulmonary disease (COPD) and asthma- COPD overlap syndrome among never cigarette smokers
Emine Bircan, Ummugul Bezirhan, Austin Porter, Pebbles Fagan, Mohammed S. Orloff Tob. Induc. Dis. 2021;19(September):74, pages 1, doi: 10.18332/tid/141989

ABSTRACT
Introduction:
Although smoking is a strong risk factor for lung diseases including asthma, COPD, and asthma-COPD overlap syndrome (ACOS), studies are needed to examine the association between e-cigarettes and asthma, COPD, and ACOS. This study evaluated the association between e-cigarette use and self-reported diagnosis of asthma, COPD, and ACOS using a large nationally representative sample of adults aged ≥18 years in the United States.

Methods:
Cross-sectional data from the Behavioral Risk Factor Surveillance System (BRFSS) from 2016 to 2018 were used to examine self-reported information on current e-cigarette use, demographic variables, and asthma and COPD status among never cigarette smokers (n=8736). Asthma and COPD were measured by self-reported diagnosis, and respondents who reported having both diagnoses were then classified as having ACOS. Of the 469077 never cigarette smokers, 4368 non-e-cigarette users were 1:1 propensity score-matched to e-cigarette users on age, sex, race/ethnicity and education level. We used multinomial logistic regression to examine association between current e-cigarette use and self-report asthma, COPD, and ACOS while controlling for marital status and employment in addition to matching variables.

Results:
Compared with never e-cigarette users, e-cigarette users had increased odds of self-reported ACOS (OR=2.27; 95% CI: 2.23–2.31), asthma (OR=1.26; 95% CI: 1.25–1.27) and COPD (OR=1.44; 95% CI: 1.42–1.46).

Conclusions:
Our findings suggest that e-cigarette use is associated with an increased odds of self-reported asthma, COPD, and ACOS among never combustible cigarette smokers. BRFSS provides cross-sectional survey data, therefore a causal relationship between e-cigarette use and the three lung diseases cannot be evaluated. Future longitudinal studies are needed to validate these findings.

CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
FUNDING
There was no source of funding for this research.
DATA AVAILABILITY
The data supporting this research is available from the author(s) on reasonable request.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
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