388 - Electronic Nicotine Delivery Systems Use and Asthma in Adolescents: A Systematic Review and Meta-Analysis
Friday, May 15, 2020
8:24 AM – 8:32 AM
Location: Vail: Majestic Level
Participants should be aware of the following financial/non-financial relationships:
Daevina Charles: No financial relationships or conflicts of interest
Theodore Gaeta, DO, MPH: No disclosure data submitted.
Ted J. Gaeta: No disclosure data submitted.
Background and Objectives: Electronic nicotine delivery systems (ENDS) are handheld devices that emit aerosols via inhalation of a solution containing nicotine, propylene glycol, glycerine, flavoring chemicals and other fine particles that have been associated with pulmonary disease. ENDS are associated with increased respiratory symptoms and affect airway physiology by increasing airway resistance. In 2018, the greatest increase in ENDS use was recorded among adolescents. The rise in ENDs use during adolescence is thought to be related to curiosity, low perceived harm, the appealing flavors and the inconspicuousness of the delivery device. The objective of this study was to assess the prevalence of ENDS use in asthmatic adolescents and evaluate the association between ENDS use and asthma in adolescents.
Methods: The medical literature was searched from 2014 to present in PubMed/MEDLINE, Web of Science, OVID, SCOPUS and bibliographies of selected articles for cross-sectional or longitudinal studies that included ENDS use and reactive airway disease/asthma in adolescents. Two independent reviewers screened the articles for inclusion following the PRISMA flowchart for reporting systematic reviews and meta-analyses. Disputes were settled by consensus. Study and participant characteristics and associated results are reported using pooled percentages and odds ratios. The I-squared index was used to measure heterogeneity.
Results: Fifty-three abstracts were screened and 12 were eligible for full-text review. Nine studies were suitable for qualitative synthesis. We found five studies including 351,285 adolescents meeting our inclusion/exclusion criteria for quantitative synthesis. The prevalence of ENDS use ranged from 7.4% to 22.4%. The meta-analysis revealed that adolescents who used ENDS are 1.4 times more likely to report asthma symptoms or diagnosis of asthma (OR 1.41, 95% CI 1.17- 1.7), based on a random effects model (I-square = 93%, p < 0.01).
Conclusion: A systematic review and meta-analysis of the current medical literature reveals a significant association between ENDS use and asthma. While causality cannot be determined by this analysis, these data reinforces the pressing need for education and interventions to reduce ENDS use in adolescents, especially those who have or are at risk for developing asthma.