A cross-sectional analysis of electronic cigarette use in US adults by asthma status

Electronic cigarette (e-cigarette) use has been shown to worsen the asthma symptoms, but there is little information on current e-cigarette use patterns in the general US adult asthma population. We examined the unadjusted and adjusted estimates of current e-cigarette use in a nationally representative sample of US adults by asthma status and what factors influence this use.

We determined the prevalence of current e-cigarette use in adults with and without asthma using the 2016-2018 Behavioural Risk Factor Surveillance System datasets. A multinomial logistic regression model was used to obtain adjusted estimates of e-cigarette use by asthma status while also identifying which sociodemographic and clinical factors are associated with e-cigarette use in adults with asthma.

Of the 23,071 adults with asthma in the study, 22.5% were currently using e-cigarettes. After adjusting for sociodemographic and clinical factors associated with asthma and current e-cigarette use, adults with asthma had similar odds of every day e-cigarette use (odds ratio (OR): 1.04, 95% confidence interval (CI): 0.93-1.15) but higher odds of e-cigarette use on some days (OR: 1.18, 95% CI: 1.10-1.27) compared to adults without asthma. Younger age, male sex and former or current traditional cigarette use were significantly associated with both e-cigarette use on some days and every day in adults with asthma.

Current e-cigarette use estimates among US adults with asthma indicate a need for further e-cigarette education and cessation interventions that are specifically tailored to sociodemographic and clinical groups who are especially prone to e-cigarette use within this population.