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Association of ever use of e-cigarettes with health and lifestyle variables among young adults: a Canadian health measure survey study

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An Editorial to this article was published on 13 April 2024

Abstract

Research suggests that vaping raises oxidative stress levels and has been implicated in poor mental health. The objective of this study is to assess cross-sectional associations between quality of life (QOL) indicators and e-cigarette (EC) use in young Canadian adults. We used data from the 2016–2017 Canadian Health Measures Survey. We compared physical activity (daily steps), physiological measurements (high-density lipoprotein for cholesterol level), self-perceived life stress, mental health, and QOL between ever-use EC users and non-users. Multivariable binary or ordinal logistic regressions were used to calculate odds ratios (OR) with 95% confidence intervals (CI). Analyses included 905 participants (15–30 years) with 115 (12.7%) reporting EC use and 790 non-users. After adjusting for confounders, compared to non-users, EC users had significantly higher odds of being physically active (OR = 2.19, 95%CI: 1.14–4.20) but also with self-reported extreme life stress (OR = 2.68, 95%CI: 1.45–4.92). Albeit statistically non-significant, EC users also had higher odds of poorer QOL (OR = 1.12, 95%CI: 0.64–1.95). No statistically significant interactions between EC use, cigarette smoking, cannabis consumption and health outcomes were observed.

Conclusion: Our study found that EC use was independently and significantly associated with increased odds of life stress and an indication of poorer QOL. Ongoing surveillance on young EC users is important to measure the long-term impact of vaping on their physical, mental health and quality of life to target for interventions.

What is Known:

• E-cigarette use has been associated with high-risk behaviours and adverse mental health outcomes, such as depression and anxiety.

What is New:

• E-cigarette users had significantly higher odds of being physically active and higher amounts of life stress.

Graphical Abstract

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Data Availability

The survey data described in the manuscript is publicly and freely available without restriction at Statistics Canada: https://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getSurvey&SDDS=5071.

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Funding

This study was funded by the Canadian Institutes of Health Research (CIHR) Catalyst Grant: Health Effects of Vaping. Dr. Teresa To is funded by a CIHR Tier 1 Canada Research Chair in Asthma. Data was provided by Statistics Canada. Canadian Institutes of Health Research

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Authors and Affiliations

  1. Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay St, Toronto, ON, M5G 0A4, Canada

    Teresa To, Cornelia M. Borkhoff, Kimball Zhang, Emilie Terebessy & Jingqin Zhu

  2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Teresa To, Cornelia M. Borkhoff, Chung-Wai Chow & Robert Schwartz

  3. Division of Respirology, University Health Network, Toronto, ON, Canada

    Chung-Wai Chow

  4. Division of Respiratory Medicine, Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada

    Theo J. Moraes

  5. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada

    Nick Vozoris

  6. Canadian Thoracic Society, Ottawa, ON, Canada

    Avtar Lal

  7. Research and Impact, Lung Health Foundation, Toronto, ON, Canada

    Wendy Yen

Authors
  1. Teresa To
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  2. Cornelia M. Borkhoff
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  3. Chung-Wai Chow
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  4. Theo J. Moraes
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  7. Avtar Lal
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  8. Wendy Yen
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  9. Kimball Zhang
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  10. Emilie Terebessy
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  11. Jingqin Zhu
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Contributions

TT initiated and designed the study, obtained and secured funding, acquired data, interpreted findings, and drafted the manuscript. KZ and JZ conducted all statistical analysis and interpreted findings. KZ also created all figures and reviewed literature. ET revised the manuscript, summarized results from Masterfile subsets through the Real Time Remote Access (RTRA) online tabulation tool, and reviewed literature. All authors interpreted findings and reviewed and approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Teresa To.

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Disclaimer

The opinions, results, and conclusions reported in this paper are those of the authors and are independent from the funding sources. Parts of this material are based on data and information compiled and provided by Statistics Canada. However, the analyses, conclusions, opinions, and statements expressed herein are those of the author, and not necessarily those of Statistics Canada. The supporters and funders had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.

Ethics accordance

The REB is guided by the ethical principles set out in the standard for research ethics boards in Canada—the Tri-Council Policy Statement (TCP: http://www.ethics.gc.ca). The main guiding ethical principles of the TCPS are (1) respect for human dignity, (2) respect for free and informed consent, (3) respect for vulnerable persons, (4) respect for privacy and confidentiality, (5) respect for justice and inclusiveness, (6) balancing harms and benefits, (7) minimizing harm, (8) maximizing benefit. In addition, the Canadian Institutes of Health Research has developed 10 privacy best practices that are intended to help research ethics boards in the interpretation of the TCPS. These principles are similar to the 10 privacy principles described under the Governing Policy/Legislation of the Privacy Commissioner of Canada. Ethics approval was also obtained from the Hospital for Sick Children Research Ethics Board (Toronto, Ontario, Canada).

Consent to participate

Informed consent was obtained from all subjects involved in the study by Statistics Canada personnel. The CHMS follows the Policy (https://www.statcan.gc.ca/en/record/policy1-1) on Informing Survey Respondents by telling respondents, before and at the time of collection, that their participation is voluntary. Information about the voluntary nature of the CHMS is included in all materials presented to or available to potential respondents before they agree to participate. Even after agreeing, they can decline to answer specific questions that they consider sensitive or that make them uncomfortable. They can also withdraw from any part of the survey at any time, including having their biospecimen samples withdrawn.

Competing interests

The authors declare no competing interests.

Additional information

Communicated by Gregorio Milani

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To, T., Borkhoff, C.M., Chow, CW. et al. Association of ever use of e-cigarettes with health and lifestyle variables among young adults: a Canadian health measure survey study. Eur J Pediatr (2024). https://doi.org/10.1007/s00431-024-05499-2

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  • DOI: https://doi.org/10.1007/s00431-024-05499-2

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