Secondhand Exposure to Aerosols From Electronic Nicotine Delivery Systems and Asthma Exacerbations Among Youth With Asthma

Chest. 2019 Jan;155(1):88-93. doi: 10.1016/j.chest.2018.10.005. Epub 2018 Oct 22.


Background: Current research suggests an association between the use of electronic nicotine delivery systems (ENDS) and asthma symptoms in youth, but little is known about the association of secondhand ENDS aerosol exposure and asthma control. The present study examines the relationship of secondhand ENDS aerosol exposure and asthma exacerbations among youth with asthma.

Methods: Youth who participated in the 2016 Florida Youth Tobacco survey (aged 11-17 years) with a self-reported diagnosis of asthma (N = 11,830) reported asthma attacks in the past 12 months, demographic characteristics, cigarette use, cigar use, hookah use, ENDS use, past 30-day secondhand smoke exposure, and past 30-day secondhand ENDS aerosol exposure. Weighted multivariable logistic regression models were used to examine the association between secondhand ENDS aerosol exposure and past 12-month asthma attack status, adjusting for covariates.

Results: Overall, 21% of youth with asthma reported having an asthma attack in the past 12 months, and 33% reported secondhand ENDS aerosol exposure. Secondhand ENDS aerosol exposure was associated with higher odds of reporting an asthma attack in the past 12 months, adjusting for covariates (adjusted OR, 1.27; 95% CI, 1.11-1.47).

Conclusions: Secondhand exposure to ENDS aerosols may be related to asthma symptoms in youth. Physicians may need to counsel youth with asthma regarding the potential risks of exposure. Future research is necessary to evaluate the longitudinal relationship between secondhand ENDS aerosol exposure and asthma control.

Keywords: asthma; electronic cigarettes; electronic nicotine delivery systems; secondhand exposure.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Aerosols / adverse effects*
  • Asthma / epidemiology*
  • Child
  • Cross-Sectional Studies
  • Electronic Nicotine Delivery Systems*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Morbidity / trends
  • Retrospective Studies
  • Smoking / adverse effects*
  • Time Factors
  • Tobacco Smoke Pollution / adverse effects*
  • United States / epidemiology


  • Aerosols
  • Tobacco Smoke Pollution