Among 150,634 California high school students, e-cigarette, combustible cigarette, and cannabis use were each independently associated with asthma, with combinations showing additive effects.
Pediatric pulmonologists, school health professionals, adolescent medicine providers, and tobacco/cannabis prevention programs.
150,634 teens; three substance types independently linked to asthma
What the researchers found
Each substance (e-cigarettes, combustible cigarettes, and cannabis) was independently associated with asthma among California adolescents. Combined use of multiple substances showed additive respiratory effects.
Why it matters
Adolescent substance use often involves multiple products simultaneously. Understanding whether each independently contributes to asthma risk, rather than just confounding each other, is important for targeted prevention.
The numbers in context
150,634 California high school students. E-cigarette, cigarette, and cannabis use each independently associated with asthma. Combined use showed additive effects.
How the study worked
Cross-sectional analysis of a population-based sample of 150,634 public high school students (10th and 12th graders) representative of California. Examined independent and combined associations of e-cigarette, cigarette, and cannabis use with asthma.
What this study cannot tell us
Cross-sectional design cannot establish causation. Self-reported asthma diagnosis and substance use. Cannot determine timing of asthma onset relative to substance use. Asthma may predispose to certain substance use patterns rather than the reverse.
How to read the evidence
Very large population-representative sample with appropriate statistical methods. Cross-sectional design limits causal inference.
When this study was published
Published 2023.
The bigger picture
The respiratory effects of adolescent inhalation behaviors are a growing concern as vaping and cannabis use increase simultaneously. This large population study helps untangle which products contribute independently to respiratory harm.
Questions still open
- Does cannabis vaping carry the same asthma association as smoked cannabis? Would longitudinal follow-up confirm these independent associations?
Common questions
Can cannabis cause asthma in teenagers?
Is vaping safer than smoking for teen lungs?
Read the original research
Associations for subgroups of E-cigarette, cigarette, and cannabis use with asthma in a population sample of California adolescents.
Addictive behaviors, 145, 107777
Citation
Williams, Rebecca J; Wills, Thomas A; Choi, Kelvin; Pagano, Ian. (2023). Associations for subgroups of E-cigarette, cigarette, and cannabis use with asthma in a population sample of California adolescents.. Addictive behaviors, 145, 107777. https://doi.org/10.1016/j.addbeh.2023.107777
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