The American Journal of Preventive Medicine recently published a new paper, titled “Cigarette-E-cigarette Transitions and Respiratory Symptom Development,” which assessed the respiratory health effects of 16 tobacco product transitions, including from non-use to e-cigarette use.

Funded in part by the American Lung Association, the study suggests e-cigarette initiation among nonusers and subsequent cigarette smoking may cause significant lung health impacts. These results reinforce the urgency for robust e-cigarette regulations, as well as demonstrate that additional research is needed to better determine the specific harms of e-cigarettes.

“The topline finding that e-cigarette initiation among nonusers is associated with increased respiratory morbidity is an important point to emphasize given continued high rates of e-cigarette usage among youth and young adult never smokers in the U.S.,” stated Andrew Stokes, PhD, assistant professor of global health at the Boston University School of Public Health and senior author of the paper. “It adds to our body of scientific evidence urgently calling for the public health intervention in support of more stringent regulatory e-cigarette standards.”

Dr. Stokes was a 2020-2022 recipient of the Lung Association’s Public Policy Research Award, which aims to empower scientists who are impacting lung health. In February 2022, he likewise served as senior author of a paper published in the American Journal of Respiratory and Critical Care Medicine, revealing young adults who use e-cigarettes are more likely to develop respiratory issues within one year of vaping.

The latest study, like the one published in February, used data from the Food and Drug Administration’s (FDA) Population Assessment of Tobacco and Health (PATH) cohort, a longitudinal study tracking changes in tobacco use over time among participants. Among 33,231 observations from 13,528 unique participants, the study authors found that nonusers who started e-cigarette use had 62% greater rate of wheezing.

Albert Rizzo, MD, Chief Medical Officer of the Lung Association, added, “Anything that can be done to help curb the e-cigarette epidemic is an important step forward. This research further amplifies our organization’s warning against e-cigarette use due to the resulting health ramifications. It’s a mission-critical public policy initiative, now and always.”

“What is exceedingly clear is that e-cigarette initiation among nonusers is associated with increased respiratory morbidity,” continued Dr. Stokes. “We’re just starting to scratch the surface in our systematic identification of behavioral patterns most closely tied to respiratory events.”

The Lung Association has called on the FDA to end the sale of all flavored tobacco products, including flavored e-cigarettes. Flavors attract youth and the high levels of nicotine found in many e-cigarettes quickly hook kids. States including California and Massachusetts, as well as Washington, D.C. and multiple other cities have passed legislation to end the sale of flavored tobacco products in their states.

In addition, the Lung Association has called on federal officials to do more to ensure youth who are addicted to vaping and other tobacco products have resources to help them end their addiction.

To learn more about e-cigarette risks or a list of proven-effective cessation programs available to help youth and adults quit all tobacco products for good, please visit:

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