Cannabis, Vaping, and Respiratory Symptoms in a Probability Sample of U.S. Youth

J Adolesc Health. 2021 Jul;69(1):149-152. doi: 10.1016/j.jadohealth.2021.01.019. Epub 2021 Mar 3.


Purpose: The purpose of this study was to explore the association between respiratory symptoms among U.S. adolescents who were current (past 30-day) users of cigarettes, e-cigarettes, and/or cannabis, as well as lifetime users of cannabis with electronic nicotine delivery systems (ENDS).

Methods: Wave 4 from a national probability sample (N = 14,798) of adolescents (12-17 years) using Population Assessment of Tobacco and Health Study data was used for this study. Retention rate was 88.4%.

Results: The odds of indicating "wheezing or whistling" in the chest were roughly two times higher among those who had used cannabis in ENDS (adjusted odds ratio 1.81, 95% confidence interval 1.47-2.22); neither e-cigarettes nor cigarettes had a significant association with all five respiratory symptoms in the fully adjusted models.

Conclusions: This study provides preliminary evidence that adolescents' cannabis use with ENDS may have negative health consequences. Lifetime cannabis use with ENDS was substantially associated with higher odds of respiratory symptoms.

Keywords: Adolescents; Cannabis; Cigarettes; E-cigarettes; Electronic nicotine delivery systems (ENDS); Nicotine use; Population Assessment of Tobacco and Health (PATH) study; Vaping.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Cannabis*
  • Cross-Sectional Studies
  • Electronic Nicotine Delivery Systems*
  • Humans
  • Sampling Studies
  • Vaping*