TY - JOUR
T1 - Tobacco Product Use and Functionally Important Respiratory Symptoms Among US Adolescents/Young Adults
AU - Tanski, Susanne
AU - Halenar, Michael J.
AU - Edwards, Kathryn C.
AU - Emond, Jennifer
AU - Woloshin, Steven
AU - Brunette, Mary
AU - Schwartz, Lisa
AU - Taylor, Kristie A.
AU - Goniewicz, Maciej L.
AU - Niaura, Ray
AU - Anic, Gabriella
AU - Chen, Yanling
AU - Callahan-Lyon, Priscilla
AU - Gardner, Lisa D.
AU - Thekkudan, Theresa
AU - Borek, Nicolette
AU - Kimmel, Heather L.
AU - Cummings, K. Michael
AU - Hyland, Andrew
AU - Sargent, James
N1 - Funding Information:
Funding/support: This manuscript is supported with Federal funds from the National Institute on Drug Abuse, National Institutes of Health, and the Center for Tobacco Products, Food and Drug Administration, Department of Health and Human Services, under contract to Westat (Contract No. HHSN271201100027C).
Funding Information:
Raymond Niaura receives funding from the Food and Drug Administration Center for Tobacco Products via contractual mechanisms with Westat and the National Institutes of Health. Within the past 3 years, he has served as a paid consultant to the Government of Canada via a contract with Industrial Economics Inc. and has received an honorarium for a virtual meeting from Pfizer Inc. Dr. Niaura was an unpaid grant reviewer for the Foundation for a Smoke Free World.
Funding Information:
Tragically, co-author Lisa Schwartz, MD, MS, our extraordinary friend and colleague, died before publication of this article. We would like to acknowledge the contributions of Jennifer J. Hebb, BSN (Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth) who assisted with the many research and administrative tasks required for this protocol. Disclosures: K. Michael Cummings provides expert testimony on the health effects of smoking and tobacco industry tactics in lawsuits filed against the tobacco industry. He has also received payment as a consultant to Pfizer, Inc. for services on an external advisory panel to assess ways to improve smoking cessation delivery in health care settings. Maciej Goniewicz has received a research grant from Pfizer and served as a member of scientific advisory board to Johnson & Johnson, pharmaceutical companies that manufacture smoking cessation medications. Raymond Niaura receives funding from the Food and Drug Administration Center for Tobacco Products via contractual mechanisms with Westat and the National Institutes of Health. Within the past 3 years, he has served as a paid consultant to the Government of Canada via a contract with Industrial Economics Inc. and has received an honorarium for a virtual meeting from Pfizer Inc. Dr. Niaura was an unpaid grant reviewer for the Foundation for a Smoke Free World. Funding/support: This manuscript is supported with Federal funds from the National Institute on Drug Abuse, National Institutes of Health, and the Center for Tobacco Products, Food and Drug Administration, Department of Health and Human Services, under contract to Westat (Contract No. HHSN271201100027C). Role of Funder: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the U.S. Department of Health and Human Services or any of its affiliated institutions or agencies. Authorship Statement: Drs Brunette, Edwards, Tanski, Sargent, and Mr. Halenar conceptualized and designed the study, assisted with the data analysis and interpretation of data, assisted with drafting the manuscript, and reviewed and revised the manuscript. Drs Woloshin, Schwartz, Hyland, Kimmel, Taylor, and Emond, assisted with the data analysis and interpretation of data, and reviewed and revised the manuscript. Drs Callahan-Lyon, Niaura, Gardner, Chen, Goniewicz, Anic, and Thekkudan conceptualized and designed the study, along with reviewing and revising the manuscript. Dr Borek conceptualized and designed the study, assisted with analysis of the data, and reviewed and revised the manuscript. Dr Cummings conceptualized and designed the study, assisted with drafting the initial manuscript, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Publisher Copyright:
© 2022 Academic Pediatric Association
PY - 2022/8
Y1 - 2022/8
N2 - Objective: The relation between respiratory symptoms and the range of tobacco product use among US adolescents/young adults is not yet clear. This cross-sectional analysis examines tobacco product use and respiratory symptoms in a nationally representative sample of 21,057 adolescents/young adults aged 12–24 years from Wave 4 (2016–17) of the Population Assessment of Tobacco and Health Study. Methods: Presence of functionally important respiratory symptoms was defined by questions regarding wheezing and nighttime cough at a cutoff score associated with poorer functional health status. Past-30-day tobacco use was analyzed 2 ways: never-tobacco users (reference) versus combustible users, noncombustible-only users, and former users; or frequency of use of cigarettes and/or e-cigarettes. Weighted Poisson regression adjusted for past-30-day marijuana use, secondhand smoke exposure, and asthma. Results: Functionally important respiratory symptoms were present in 10.0% overall: 13.8% of combustible users, 9.0% of noncombustible users, 8.2% of noncurrent users and 9.7% of never users. Functionally important respiratory symptoms were associated with combustible tobacco use (relative risk [RR] = 1.52[95% CI 1.29, 1.80]), marijuana use (RR = 1.54[1.34, 1.77]) and secondhand smoke exposure (RR = 1.04[1.03, 1.05]). Higher cigarette smoking frequency was also associated with functionally important respiratory symptoms for frequency categories >14 days/month (eg, RR = 1.93[1.50, 2.49] for 15–29 days/month). Frequency of e-cigarette use was not associated with functionally important respiratory symptoms. Conclusions: During 2016–17, smoking cigarettes, marijuana use, and secondhand smoke exposure were cross-sectionally associated with functionally important respiratory symptoms in adolescents/young adults. Risk increased with increased frequency of cigarette use but not e-cigarette use. Given changes to contemporary e-cigarettes and use, findings may not generalize to newer products.
AB - Objective: The relation between respiratory symptoms and the range of tobacco product use among US adolescents/young adults is not yet clear. This cross-sectional analysis examines tobacco product use and respiratory symptoms in a nationally representative sample of 21,057 adolescents/young adults aged 12–24 years from Wave 4 (2016–17) of the Population Assessment of Tobacco and Health Study. Methods: Presence of functionally important respiratory symptoms was defined by questions regarding wheezing and nighttime cough at a cutoff score associated with poorer functional health status. Past-30-day tobacco use was analyzed 2 ways: never-tobacco users (reference) versus combustible users, noncombustible-only users, and former users; or frequency of use of cigarettes and/or e-cigarettes. Weighted Poisson regression adjusted for past-30-day marijuana use, secondhand smoke exposure, and asthma. Results: Functionally important respiratory symptoms were present in 10.0% overall: 13.8% of combustible users, 9.0% of noncombustible users, 8.2% of noncurrent users and 9.7% of never users. Functionally important respiratory symptoms were associated with combustible tobacco use (relative risk [RR] = 1.52[95% CI 1.29, 1.80]), marijuana use (RR = 1.54[1.34, 1.77]) and secondhand smoke exposure (RR = 1.04[1.03, 1.05]). Higher cigarette smoking frequency was also associated with functionally important respiratory symptoms for frequency categories >14 days/month (eg, RR = 1.93[1.50, 2.49] for 15–29 days/month). Frequency of e-cigarette use was not associated with functionally important respiratory symptoms. Conclusions: During 2016–17, smoking cigarettes, marijuana use, and secondhand smoke exposure were cross-sectionally associated with functionally important respiratory symptoms in adolescents/young adults. Risk increased with increased frequency of cigarette use but not e-cigarette use. Given changes to contemporary e-cigarettes and use, findings may not generalize to newer products.
KW - adolescents
KW - respiratory symptoms
KW - tobacco use
KW - young adults
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U2 - 10.1016/j.acap.2022.03.001
DO - 10.1016/j.acap.2022.03.001
M3 - Article
C2 - 35263656
AN - SCOPUS:85128304585
VL - 22
SP - 1006
EP - 1016
JO - Academic Pediatrics
JF - Academic Pediatrics
SN - 1876-2859
IS - 6
ER -