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The effect was even worse on people who don't vape or smoke. They were three times more likely to develop bronchitis symptoms and twice as likely to develop wheeze or shortness of breath, the researchers found.
"Those people are really suffering much more," said lead researcher Dr. Talat Islam. He is an assistant professor of research population and public health sciences at the University of Southern California in Los Angeles. "The effect of secondhand exposure to vape was much bigger" among people who never vape or smoke.
The health effects from secondhand vapor are similar in magnitude to those associated with secondhand smoking, and should prompt more U.S. locales to ban vaping in public places, Islam and his colleagues concluded.
Sixteen states and the District of Columbia have added e-cigarettes to their indoor clean air laws, according to the American Lung Association. Overall, 28 states have passed comprehensive indoor clean air laws.
This study adds to mounting evidence that e-cigarettes are not as safe as people have been told, said Dr. Laura Crotty Alexander, section chief of pulmonary critical care medicine with the VA San Diego Healthcare System.
"Some people still believe that vape contains water-based aerosols, and there's no water in there at all. It's pure chemicals, some very similar to antifreeze," said Alexander, who co-wrote an editorial accompanying the study.
"Typically, about 50 to 100 chemicals are found in these e-cigarette aerosols, and your lungs don't like it," she continued. "It's not healthy for your lungs. It damages the lungs and causes disease."
For this study, Islam and his colleagues analyzed data gathered by the Southern California Children Health Study, an ongoing study that surveyed a group of teens and young adults annually from 2014 to 2019.
In each survey, participants were asked if they had suffered from bronchitis, a daily cough, congestion, phlegm, wheezing or shortness of breath during the previous year. They also were asked if they had been exposed to either secondhand vaping or smoke.
The percentage of teens and young adults exposed to secondhand vaping rose from 12% to 16% between 2014 and 2019, while the percentage exposed to secondhand smoking declined from 27% to 21%, the investigators found.
The researchers reported that those exposed to secondhand vaping had an increased risk of bronchitis and shortness of breath, even after they took into account other possible lung health factors like active vaping or exposure to smoke from tobacco or weed.
Of the nearly 2,100 teens included in this study, almost 1,200 said they hadn't smoked or vaped within the past month. These were the young people whose lung health was most strongly affected by secondhand vape, the findings showed.
"Children have gotten a pretty high level of exposure because parents are unaware of the risks," Alexander said. "People really understand the dangers of cigarette smoke to a pretty large degree, and so people would be careful about smoking around their kids. They'd stop smoking in their cars and inside the house."
But, she continued, "When they started adding in e-cigarettes, because the perception of those devices was that they were safe, they'd vape in the cars and at home."
According to the American Lung Association, chemicals included in e-cigarette vapor can include:
- Propylene glycol, a common food additive that's also used to make antifreeze and paint solvent.
- Carcinogens like acetaldehyde and formaldehyde.
- Acrolein, a weed killer.
- Diacetyl, which has been shown to cause "popcorn lung."
- Diethylene glycol, another substance used in antifreeze.
- Heavy metals like nickel, tin and lead.
- Smog components like benzene and ultrafine particles.
"When people are vaping, that aerosol that comes out can have nicotine or not, but it also comes with a lot of other things," Islam said. "Those chemicals, they can be very harmful for respiratory health."
The American Lung Association has more about indoor clean air laws.
SOURCES: Talat Islam, MD, PhD, assistant professor, research population and public health sciences, University of Southern California, Los Angeles; Laura Crotty Alexander, MD, section chief, pulmonary critical care medicine, VA San Diego Healthcare System; Thorax, Jan. 10, 2022, online
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