Abstract
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.