{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:20:52Z","timestamp":1793830852903,"version":"4.6.1"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T00:00:00Z","timestamp":1709164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R21CA260423"],"award-info":[{"award-number":["R21CA260423"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","award":["T32ES007324"],"award-info":[{"award-number":["T32ES007324"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL139239"],"award-info":[{"award-number":["R01HL139239"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>We assessed longitudinal effects of e-cigarette use on respiratory symptoms in a nationally representative sample of US adults by combustible tobacco smoking status.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We analyzed Waves 4\u20135 public-use data from the Population Assessment of Tobacco and Health Study. Study sample included adult respondents who reported no diagnosis of respiratory diseases at Wave 4, and completed Waves 4\u20135 surveys with no missing data on analytic variables (N = 15,291). Outcome was a validated index of functionally important respiratory symptoms based on 7 wheezing\/cough questions (range 0\u20139). An index score of \u22652 was defined as having important respiratory symptoms. Weighted lagged logistic regression models were performed to examine the association between e-cigarette use status at Wave 4 (former\/current vs. never use) and important respiratory symptoms at Wave 5 by combustible tobacco smoking status (i.e., never\/former\/current smokers), adjusting for Wave 4 respiratory symptom index, sociodemographic characteristics, secondhand smoke exposure, body mass index, and chronic disease.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among current combustible tobacco smokers, e-cigarette use was associated with increased odds of reporting important respiratory symptoms (former e-cigarette use: adjusted odds ratio [AOR] = 1.39, 95% confidence interval [CI]: 1.07\u20131.81; current e-cigarette use: AOR = 1.55, 95% CI: 1.17\u20132.06). Among former combustible tobacco smokers, former e-cigarette use (AOR = 1.51, 95% CI: 1.06\u20132.15)\u2014but not current e-cigarette use (AOR = 1.59, 95% CI: 0.91\u20132.78)\u2014was associated with increased odds of important respiratory symptoms. Among never combustible tobacco smokers, no significant association was detected between e-cigarette use and important respiratory symptoms (former e-cigarette use: AOR = 1.62, 95% CI: 0.76\u20133.46; current e-cigarette use: AOR = 0.82, 95% CI: 0.27\u20132.56).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The association between e-cigarette use and respiratory symptoms varied by combustible tobacco smoking status. Current combustible tobacco smokers who use e-cigarettes have an elevated risk of respiratory impairments.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0299834","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T18:32:10Z","timestamp":1709231530000},"page":"e0299834","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Longitudinal association between e-cigarette use and respiratory symptoms among US adults: Findings from the Population Assessment of Tobacco and Health Study Waves 4\u20135"],"prefix":"10.1371","volume":"19","author":[{"given":"Emma","family":"Karey","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pan","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond S.","family":"Niaura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6931-9904","authenticated-orcid":true,"given":"Charles M.","family":"Cleland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R.","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1752-7303","authenticated-orcid":true,"given":"Scott E.","family":"Sherman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3342-6377","authenticated-orcid":true,"given":"Omar","family":"El-Shahawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Cantrell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0714-750X","authenticated-orcid":true,"given":"Nan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,2,29]]},"reference":[{"key":"pone.0299834.ref001","unstructured":"U.S. Department of Health and Human Services. 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cigarettes, ENDS, and cigars, the three most popular tobacco products, and wheezing symptoms among U.S. adults","volume":"22","author":"LM Schneller","year":"2020","journal-title":"Nicotine Tob Res"},{"issue":"2","key":"pone.0299834.ref012","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.amepre.2019.07.028","article-title":"Association of e-cigarette use with respiratory disease among adults: A longitudinal analysis","volume":"58","author":"DN Bhatta","year":"2020","journal-title":"Am J Prev Med"},{"issue":"11","key":"pone.0299834.ref013","doi-asserted-by":"crossref","first-page":"e2020816","DOI":"10.1001\/jamanetworkopen.2020.20816","article-title":"Association of electronic cigarette use with incident respiratory conditions among US adults from 2013 to 2018","volume":"3","author":"W Xie","year":"2020","journal-title":"JAMA Netw 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Institute on Drug Abuse, U.S. Department of Health and Human Services Food and Drug Administration Center for Tobacco Products. Population Assessment of Tobacco and Health (PATH) Study [United States] Public-Use Files (ICPSR 36498) 2021 [updated December 16. 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