Electronic cigarette use among adults with asthma: 2014-2017 National Health Interview Survey

Electronic cigarette (e-cigarette) use has increased dramatically in the United States among adults and adolescents. Patients with asthma may be most vulnerable to the chemical components of e-cigarettes as they may be a potential asthma trigger.

To assess the prevalence of e-cigarette use among adult asthmatics and to evaluate the factors associated with e-cigarette use.

This was a retrospective, cross-sectional study that used data from the 2014-2017 National Health Interview Survey (NHIS) database. The study sample included current asthmatics who were 18-85 years old. The outcome variable was ever use of an e-cigarette (Yes/No). The Andersen Behavioral Model of Health Services Utilization was used to identify independent variables with the potential to influence the patient's decision to try e-cigarettes. Descriptive statistics were used to describe the sample. Factors associated with e-cigarette use were assessed using logistic regression. All analyses were stratified by age group. Appropriate survey weights were used to account for the complex survey design.

The study sample included 10,578 adults with current asthma and about 18% of the sample had ever tried an e-cigarette. About 20% of males and 20% of non-Hispanic Whites reported ever trying an e-cigarette. From 2014 to 2017, the e-cigarette use among the 18-24 year old age group increased the most from 20.3% to 29.1%. Current smokers were more likely to have tried e-cigarettes than former/never smokers (18-24 years OR: 11.5 CI: 7.4-18.0). This trend was significant among all age groups. Non-Hispanic Blacks were less likely to have tried e-cigarettes than non-Hispanic Whites (50-64 years OR: 0.34 CI: 0.22-0.52).

The prevalence of e-cigarette use among adult asthmatics has continued to increase over time. Smoking status was the most consistent predictor of e-cigarette use among all age groups in this asthmatic population.