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Many More Young People Exposed to Secondhand Aerosol From Electronic Cigarettes

MedicalResearch.com Interview with:

Hongying (Daisy) Dai, PhD Associate Professor Department of Biostatistics | College of Public Health University of Nebraska Medical Center Omaha

Dr. Hongying (Daisy) Dai

Hongying (Daisy) Dai, PhD
Associate Professor
Department of Biostatistics | College of Public Health
University of Nebraska Medical Center
Omaha, NE

MedicalResearch.com: What is the background for this study?

Response: E-cigarette use increased dramatically from 11.7% to 27.5% for high school students and from 3.3% to 10.5% for middle school students during the periods of 2017 – 2019. In September 2018, the Food and Drug Administration (FDA) warned that youth e-cigarette use is reaching an epidemic proportion.

Exposure to secondhand aerosol (SHA) from e-cigarettes is not harmless as e-cigarettes aerosol contains nicotine and potentially harmful substances, including carbonyl compounds, TSNAs, heavy metals, and glycols. This study analyzed the 2015-2018 National Youth Tobacco Survey (NYTS) and the main findings are:

  • The prevalence of secondhand aerosol exposure significantly increased from 25.6% in 2017 to 33.2% in 2018 (p<.001) after being stable during 2015 and 2017 (25.2% vs. 25.6%, p>0.05). The increase of SHA exposure from 2017 to 2018 was observed across socio-demographic groups.
  • Among never tobacco users in 2018 NYTS, students who reported secondhand aerosol exposure (vs. no) had higher odds of susceptibility to use e-cigarettes (38.8% vs. 21.0%) and cigarettes (30.7% vs. 21.2%) and higher odds of reporting exposure to e-cigarette marketing.

 MedicalResearch.com: What are the main findings?

Response: This study found a surge in self-reported secondhand aerosol exposure from 2017 to 2018, with an estimate of nearly 1 in 3 U.S. youths exposed to secondhand aerosol. Exposure to secondhand e-cigarette aerosol poses health concerns and problems to nonusers.

This study reports a strong association between secondhand aerosol exposure and susceptibility to e-cigarette use and cigarette smoking among never tobacco users. Exposure to SHA may renormalize tobacco use behaviors and reduce the perceived harm, resulting in increased susceptibility to tobacco use. 

MedicalResearch.com: What should readers take away from your report?

Response: Comprehensive tobacco control strategies, including smoke/vape free laws, raising the minimum legal age of tobacco sales to 21, and educational campaigns, are needed to protect youth from exposure to secondhand aerosol. Future longitudinal studies are needed to assess whether SHA exposure leads to tobacco initiation and progression to heavy users.

I have no conflicts of interest to disclose.


Dai H. Exposure to Secondhand Aerosol From Electronic Cigarettes Among US Youth From 2015 to 2018. JAMA Pediatr. Published online January 27, 2020. doi:10.1001/jamapediatrics.2019.5665


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Last Updated on January 30, 2020 by Marie Benz MD FAAD