RESUMO
INTRODUCTION: Electronic cigarette (e-cigarette) use is gaining popularity among adults. Monitoring e-cigarette-induced respiratory symptoms is crucial for both clinical and regulatory purposes. We systematically reviewed the current literature to understand the prevalence of respiratory symptoms among exclusive e-cigarette users, dual users, and former smokers. METHODS: Databases searched included PubMed, CINAHL, Cochrane Library, Embase, and Scopus. We included all English-language, empirical quantitative articles that explored the prevalence of e-cigarette-related respiratory symptoms. Random-effects models were utilized in conducting the meta-analyses. The quality of identified studies was evaluated using the NIH Study Quality Assessment Tools. This study is registered with PROSPERO(#CRD42020165973). RESULTS: The literature search identified 1240 references. After removing duplicates and screening for eligibility, 168 studies were included in the final review. The majority of included studies reported a wide range of adverse respiratory symptoms. The respiratory symptoms were prevalent among the exclusive e-cigarette users, dual users, and those who switched from combustible cigarettes to e-cigarettes. Further, out of the RCT studies, 5 were rated as good quality, while 3 were rated as fair. Among the observational studies, 24 were rated as good quality, and 9 were rated as fair. The two experimental studies were both rated as fair quality. CONCLUSIONS: Continued monitoring of respiratory symptoms among e-cigarette users is warranted. Due to the heterogeneity and inconsistencies among studies, which limit result interpretation and highlight the need for studies assessing causal inference, further research using robust study designs is essential. This will provide clinicians with comprehensive knowledge about the potential respiratory risks of e-cigarette use.
RESUMO
Background: Electronic cigarette (e-cigarette) and cannabis (marijuana) use is rapidly increasing. Objectives: To report percentage prevalence and changes over time in current (past 30 days) e-cigarette, cannabis, and dual (concurrent) use in the population of reproductive age women (18-44 years old) in the United States. Methods: Our cross-sectional analysis involved data of 11, 004 women from Waves 1 to 3 of the Population Assessment of Tobacco and Health (PATH) Study (2013-2016). We estimated weighted percentage prevalence and 95% confidence intervals (CIs) and changes between 2013 and 2016 in current e-cigarette, cannabis, and dual use at each wave overall and across race/ethnicity, age, education, cigarette smoking status, alcohol use, and perceived mental health. Changes were reported as p for trend. Results: Between 2013 and 2016, e-cigarette use increased 13.6% (p for trend <.001) [15.2% (95% CI:14.2, 16.2) in 2013-2014; 22.2% (95% CI: 20.2, 24.3) in 2014-2015; and 28.8% (95% CI: 26.3, 31.3) in 2015-2016]; cannabis use increased 6.2% (p for trend <.001) [23.6% (95% CI: 22.1, 25.1) in 2013-2014; 28.5% (95% CI: 26.0, 31.0) in 2014-2015; and 29.8% (95% CI: 27.9, 31.1) in 2015-2016]; and dual use declined 0.3% (p for trend <.001) [5.8% (95% CI: 5.2, 6.3) in 2013-2014; 4.8% (95% CI: 3.7, 5.8) in 2014-2015; and 5.5% (95% CI: 4.2, 6.7) in 2015-2016]. Increases and declines in prevalence varied across sociodemographic characteristics, cigarette smoking status, alcohol use, and perceived mental health. Conclusions: Continued monitoring can capture further changes in prevalence and patterns to inform targeted public health intervention programs.
