{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T13:02:40Z","timestamp":1781096560084,"version":"3.54.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Pragmatic Assessment of Influenza Vaccine Effectiveness in the Department of Defense (PAIVED) study was a clinical trial of three influenza vaccines in military beneficiaries enrolled at 10 military treatment facilities over four influenza seasons (2018\/19\u20132021\/22). This secondary analysis aimed to assess the relationship between cigarette smoking and e-cigarette use and influenza-like illness (ILI) incidence and severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Demographic information, including cigarette smoking and e-cigarette use, was collected at enrollment. ILIs were identified during the influenza season of enrollment using weekly surveys. ILI symptoms were reported using the inFLUenza Patient-Reported Outcome (FLU-PRO) instrument. The relationship between smoking status and risk of reporting an ILI was estimated using Poisson regression; ILI severity was compared by cigarette smoking and e-cigarette use using multivariable linear regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 8,708 participants with cigarette smoking status, 4.3% were current smokers and 11.9% were former smokers. Current cigarette smokers reported higher respiratory domain scores (0.24 (95% CI: 0.07, 0.41)) than non-smokers; former cigarette smokers were at higher risk of reporting an ILI than non-smokers [rate ratio 1.11 (95% CI: 1.02, 1.20)] and reported ILI episodes that were on average 1.23\u202fdays longer in duration (95% CI: 0.29, 2.17). Among 8,119 participants with e-cigarette use status, 3.9% were current users and 2.6% were former users. Current e-cigarette users reported more than one additional day with limited activity (1.14\u202fdays, 95% CI: 0.10, 2.18) and 0.78 additional days with fever (95% CI, 0.20, 1.35); former e-cigarette users were at higher risk of reporting an ILI than nonusers [rate ratio 1.20 (95% CI, 1.04, 1.38)] and reported higher respiratory domain scores than non-users (0.27 (95% CI 0.08, 0.46)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We observed slightly higher ILI risk in former cigarette smokers and e-cigarette users, longer symptom duration in former cigarette smokers, and higher respiratory symptom scores in current cigarette smokers and former e-cigarette users compared to non-smokers\/users. Findings in this secondary analysis are exploratory and hypothesis-generating; additional studies are needed to confirm the relationships reported here.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1725232","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T14:09:25Z","timestamp":1776348565000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Influenza-like illness in cigarette smokers and electronic-cigarette users: a secondary analysis from the PAIVED study"],"prefix":"10.3389","volume":"14","author":[{"given":"Rachael D. C.","family":"Jones","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine, Uniformed Services University of the Health Sciences","place":["Bethesda, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kat","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences","place":["Bethesda, MD, United States"]},{"name":"The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.","place":["Bethesda, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Schofield","sequence":"additional","affiliation":[{"name":"Madigan Army Medical Center","place":["Tacoma, WA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuradha","family":"Ganesan","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences","place":["Bethesda, MD, United States"]},{"name":"The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc.","place":["Bethesda, MD, United States"]},{"name":"Walter Reed National Military Medical Center","place":["Bethesda, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley","family":"Campbell","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center","place":["Bethesda, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hrncir","sequence":"additional","affiliation":[{"name":"Carl R. Darnell Army Medical Center","place":["Fort Hood, TX, United States"]},{"name":"Wilford Hall Ambulatory Surgical Center, Lackland Air Force Base","place":["San Antonio, TX, United States"]},{"name":"Immunization Healthcare Division, Defense Health Agency","place":["Falls Church, VA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahaniyat","family":"Lalani","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences","place":["Bethesda, MD, United States"]},{"name":"The Henry M. 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