Introduction
Rising trends in stroke incidence and hospitalizations because of combustible cigarette
smoking have been noted among younger adults. However, the association between e-cigarette
use and stroke in this population remains largely unknown. This study examines the
association between e-cigarette use with or without a history of previous or concurrent
combustible cigarette use and stroke among young adults.
Methods
Pooled data (2016–2017) were analyzed from the Behavior Risk Factor Surveillance System,
a nationally representative, cross-sectional telephone survey, in 2019. The sample
size was 161,529 participants aged 18–44 years. The association between e-cigarette
use and stroke was examined using logistic regression adjusting for patient demographics,
relevant comorbidities without or with history, and concurrent use of combustible
cigarette use.
Results
Current dual use of e-cigarettes and combustible cigarettes was associated with 2.91
times higher odds of stroke versus nonsmokers (AOR=2.91, 95% CI=1.62, 5.25) and 1.83
times higher odds versus current sole combustible cigarette users (AOR=1.83, 95% CI=1.06,
3.17). Compared with nonsmokers, current sole e-cigarette users did not show significantly
different odds of stroke (AOR=0.69, 95% CI=0.34, 1.42). However, odds of stroke were
lower for sole e-cigarette users versus current sole combustible cigarette users (AOR=0.43,
95% CI=0.20, 0.93).
Conclusions
Sole e-cigarette use is not associated with greater odds of stroke in young adults.
However, if young adults have former or current combustible cigarette use, odds of
stroke are significantly increased even compared with current sole combustible cigarette
use. Switching from combustible cigarettes to e-cigarettes does not confer stroke
benefits.
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Article Info
Publication History
Published online: January 06, 2020
Identification
Copyright
© 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
