E-Cigarettes with Fruit-flavor Increase Risk of Nocturnal Dry Cough: Study

A recent study published in the PLOS ONE journal highlights a concerning association between the use of flavored electronic cigarettes (ECIGs) and respiratory symptoms, particularly nocturnal dry cough, among adult users. This longitudinal study analyzed data from the Population Assessment of Tobacco and Health Study (2014 to 2019) and brought out the potential respiratory risks associated with flavored ECIG use.

The study involved 18,925 adults who contributed to a total of 38,638 observations to assess the relationship between exposure to ECIG flavors and the incidence of nocturnal dry cough. By utilizing weighted-incidence estimates and advanced statistical models, this research compared current and former ECIG users with non-ECIG users.

The analysis revealed that current and former users of fruit-flavored ECIGs face a significantly higher risk of developing nocturnal dry cough when compared to non-users. The weighted incidence proportion (WIP) of nocturnal dry cough was 16.6% among both current and former fruit-flavored ECIG users when compared to 11.1% in non-ECIG users. Also, the adjusted relative risk (aRR) demonstrated that current users of fruit-flavored ECIGs were 40% more likely to report nocturnal dry cough than non-users (aRR: 1.40). Former users of multiple flavors expressed an alarming 300% higher risk of developing the symptom (aRR: 3.33), while former users of other flavors faced a 66% increased risk (aRR: 1.66).

The study suggests that nocturnal dry cough, often an early marker of respiratory inflammation, could signal broader health risks linked to flavored ECIG use. This is specifically relevant as flavored ECIGs are frequently marketed in ways that appeal to younger demographics by potentially leading to prolonged exposure and elevated risks.

The findings add to growing concerns about the pulmonary toxicity of ECIG flavors which was previously demonstrated in laboratory and animal models. While these preclinical studies have flagged potential harm, this research represents a significant step in epidemiological evidence, connecting flavor-specific ECIG use with measurable respiratory outcomes.

Nocturnal dry cough might be an early warning sign of inflammation which calls for the need for increased awareness and regulation around flavored ECIGs. As ECIGs remain a popular alternative to traditional smoking among young adults, these findings highlight the importance of monitoring potential long-term health effects. Overall, this study reinforces calls for public health interventions to limit the availability of flavored ECIGs and educate users about their risks.

Source:

Quinones Tavarez, Z., Croft, D. P., Li, D., Gill, S. R., Wojtovich, A. P., Rahman, I., & Ossip, D. J. (2024). Fruit flavors in electronic cigarettes (ECIGs) are associated with nocturnal dry cough: A population longitudinal analysis. In M. S. Aslam (Ed.), PLOS ONE (Vol. 19, Issue 6, p. e0306467). Public Library of Science (PLoS). https://doi.org/10.1371/journal.pone.0306467