Association Between E-Cigarette Use and Chronic Obstructive Pulmonary Disease by Smoking Status: Behavioral Risk Factor Surveillance System 2016 and 2017

Introduction: The association between e-cigarette use and chronic bronchitis, emphysema, and
chronic obstructive pulmonary disease has not been studied thoroughly, particularly in populations
defined by concomitant combustible smoking status.

Methods: Using pooled 2016 and 2017 data from the Behavioral Risk Factor Surveillance System,
investigators studied 705,159 participants with complete self-reported information on e-cigarette use,
combustible cigarette use, key covariates, and chronic bronchitis, emphysema, or chronic obstructive
pulmonary disease. Current e-cigarette use was the main exposure, with current use further classified
as daily or occasional use. The main outcome was defined as reported ever having a diagnosis of

chronic bronchitis, emphysema, or chronic obstructive pulmonary disease. For all the analyses, multi-
variable adjusted logistic regression was used, with the study population stratified by combustible ciga-
rette use status (never, former, or current). All the analyses were conducted in 2019.

Results: Of 705,159 participants, 25,175 (3.6%) were current e-cigarette users, 64,792 (9.2%) current
combustible cigarette smokers, 207,905 (29.5%) former combustible cigarette smokers, 432,462

(61.3%) never combustible cigarette smokers, and 14,036 (2.0%) dual users of e-cigarettes and combus-
tible cigarettes. A total of 53,702 (7.6%) participants self-reported chronic bronchitis, emphysema, or

chronic obstructive pulmonary disease. Among never combustible cigarette smokers, current e-ciga-
rette use was associated with 75% higher odds of chronic bronchitis, emphysema, or chronic obstruc-
tive pulmonary disease compared with never e-cigarette users (OR=1.75, 95% CI=1.25, 2.45), with

daily users of e-cigarettes having the highest odds (OR=2.64, 95% CI=1.43, 4.89). Similar associations
between e-cigarette use and chronic bronchitis, emphysema, or chronic obstructive pulmonary disease
were noted among both former and current combustible cigarette smokers.
Conclusions: The results suggest possible e-cigarette−related pulmonary toxicity across all thecategories of combustible cigarette smoking status, including those who had never smoked combus-
tible cigarettes.

Author/s:

Osei , A.D., Mirbolouk, M., Orimoloye, O.A., Dzaye, O.

Subconcussive Football Hits May Leave a Telltale Signature of Brain Damage

John Bayhi — Fri, 04 Oct 2019 13:19:44 +0000

Date Added:

October 4, 2019

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

October 3, 2019

URL:

Subconcussive Football Hits May Leave a Telltale Signature of Brain Damage

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1001/jama.2019.15361

Keywords

PMID (1):

31580382

MeSH

Humans

male

football

Chronic Traumatic Encephalopathy

Diffuse Axonal Injury

White Matter

Diffusion Magnetic Resonance Imaging

Head Protective Devices

brain concussion

brain

Craniocerebral Trauma

Soccer

retrospective studies

cohort studies

Even sub-concussive head injuries can injure the brains of football players. James W. Mold, MD, MPH

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College football players in the United States endure over 1000 head hits every season. Although many don’t produce symptoms such as dizziness or blurred vision that often accompany frank concussion, these “clinically silent” hits are associated with the same type of brain damage as concussion, according to a recent Science Advances study.

Author/s:

Sancar, F