Abstract 16156: Association of Electronic Nicotine Delivery Systems (ENDS) Usage and EVALI-like Symptoms

Abstract

Introduction: Comprehensive studies regarding clinical symptoms related to electronic nicotine delivery systems (ENDS) usage are sparse. Methods: The sample included 1,432 current ENDS users, ages 18-64, drawn from a national online survey conducted in 2016. A quota sampling method was used for key demographic characteristics such as age, gender, and race/ethnicity. ENDS use included types of devices, flavors, and knowledge of e-liquid used. Outcomes included any E-cigarette or Vaping use-Associated Lung Injury (EVALI)-like symptoms (e.g., cough, shortness of breath, nausea) and any clinical symptoms (see Table footnotes). Results: Of the sample, 50% were female, 23% non-Hispanic (NH) White, 23% NH Black, 54% Hispanic, 18% aged 18-24, 17% LGBTQ, 41% with <$50K income, 55% 1+ any symptoms, and 33% 1+ any EVALI-like symptoms. Cough and nausea were most prevalent among EVALI-like symptoms (27% and 7.3%, respectively). The proportion of having any EVALI-like symptoms was higher in the following groups: younger, Hispanic, current smokers, and current other product users. With multiple adjustments (see Table footnotes), those who used refillable devices, varied nicotine content, flavored products or made their own e-liquids were more likely to have clinical symptoms than their counterparts. For example, the odds (95% CI) of having 1+ EVALI-like symptoms in those who used refillable devices with e-liquid pour or with e-liquid cartridge replacement were 1.70 (1.13, 2.56) and 1.95 (1.27, 2.99), respectively, compared to the non-refillable group (see Table). It should be noted that those who used non-refillable devices were also more likely not to know the nicotine content in their e-liquid. However, their use pattern seemed stable: They tended to use only one brand, one type of device, and non-flavored e-liquid (results not tabulated). Conclusions: ENDS use was significantly associated with the odds of having clinical symptoms, including EVALI-like symptoms.