Variations in Adverse Events Typology Following E-Cigarette Use: The Role of Preexisting Medical Conditions

Abstract

Background Electronic cigarettes (e-cigarettes) are often marketed as safer alternatives to traditional smoking, yet evidence suggests potential health risks, especially among vulnerable populations. This study examines the immediate adverse events following e-cigarette use in individuals with preexisting health conditions to better understand these risks. Methods We conducted a STROBE-compliant observational study to identify specific preexisting medical conditions that may increase the risk of adverse events following e-cigarette use. A cross-sectional survey was deployed from January 3rd to March 3rd, 2023. A total of 4695 current and former e-cigarette users completed the survey. Logistic regression models were utilized to examine associations between 23 distinct preexisting conditions and 48 adverse events, adjusting for age, sex, race/ethnicity, education level, and income. Results The analysis encompassed 4,421 respondents, demonstrating that individuals with solid organ transplants faced notably pronounced risks, with odds ratios indicating a seven-fold increase in mouth/tongue blisters (OR = 7.05), nearly five-fold for heart palpitations (OR = 4.92), and heartburn (OR = 4.79). Stem cell transplantation recipients also showed significantly heightened risks for similar adverse events, including mouth/tongue blisters (OR = 5.53) and heart palpitations (OR = 4.65). Metabolic diseases were linked to substantially increased odds of mouth/tongue blisters (OR = 5.63), hair loss (OR = 4.09), and migraine (OR = 3.50), highlighting a specific vulnerability to e-cigarette aerosol exposure among these groups. Conclusion The findings highlight the acute health risks associated with e-cigarette use in individuals with certain preexisting conditions. These results challenge the notion that e-cigarette use poses limited harm to human health and highlight the need for tailored public health strategies to protect vulnerable populations.