Abstract Rationale Vaping is an endemic phenomenon in the United States, with greatest increases in recent prevalence occurring in young adults. Vaping is known to be associated with respiratory harm, including symptoms and prevalent diagnoses of asthma and COPD; however, the relative health impacts of the two most commonly vaped substances - cannabis and nicotine - have not been differentiated in young adults. Therefore, there is a need to characterize rates of nicotine, cannabis, and dual use and their contribution to concurrent respiratory symptoms, which may have implications for counseling and cessation strategies. Methods We performed a cross-sectional analysis of vaping practices and patterns in the American Lung Association Lung Health Cohort, which enrolled US adults aged 25-35 years without severe cardiopulmonary disease starting in 2021 in 28 sites in the US. Participants responded to surveys about vaping at study entry and were classified as current (past 30 day), former, or never use of cannabis and nicotine vaping. Associations of vaping status (current, former, or never) and current product (nicotine, cannabis, or both) with having at least one current respiratory symptom (cough, phlegm, wheezing, shortness of breath) were assessed using multivariable logistic regression, adjusted for sex, ethnicity, race, smoking, and education. Results The study enrolled 2,844 participants (median age 29, 64% female, 28% Hispanic or Latino, 19% Black). Of these, 5% were current, and 33% former, combustible cigarette users. Among 238 participants currently vaping, 160 (67%) maintained exclusive lifetime use of a single product, and 60% used cannabis (Figure 1). Current vaping any product (adjusted OR 1.29 p = 0.009, 53% with symptoms) and former vaping (adjusted OR 1.66 p 0.001, 61% with symptoms) were associated with respiratory symptoms compared with never (44% with symptoms). Compared to current nicotine-only vaping (56% with symptoms), current dual use of cannabis and nicotine was associated with greater respiratory symptoms (adjusted OR 4.08 p = 0.006, 83% with symptoms), but current cannabis-only vaping was not (adjusted OR 1.30 p = 0.45, 59% with symptoms). Conclusion In a nationally representative sample of U.S. young adults, both cannabis and nicotine individually were associated with respiratory symptoms, and cannabis vaping was more common than nicotine. Notably, dual use of cannabis and nicotine carried synergistically higher risk than nicotine alone. These findings demonstrate that cannabis vaping, especially combined with nicotine, is not benign in this age group. Clinicians should be aware of high rates of cannabis vaping and its potential for respiratory harm in young adults. This abstract is funded by: NHLBI U01HL146408-06
Wharton et al. (Fri,) studied this question.
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