E-cigarettes, combustible cigarettes, and cannabis each independently linked to asthma in California teens

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.

Williams, Rebecca J et al.·Addictive behaviors·2023·Moderate EvidenceCross-Sectional
RTHC-05029Cross SectionalModerate Evidence2023RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=150,634

What This Study 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.

Key Numbers

150,634 California high school students. E-cigarette, cigarette, and cannabis use each independently associated with asthma. Combined use showed additive effects.

How They Did This

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.

Why This Research 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 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.

What This Study Doesn't 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.

Questions This Raises

  • ?Does cannabis vaping carry the same asthma association as smoked cannabis?
  • ?Would longitudinal follow-up confirm these independent associations?

Trust & Context

Key Stat:
150,634 teens; three substance types independently linked to asthma
Evidence Grade:
Very large population-representative sample with appropriate statistical methods. Cross-sectional design limits causal inference.
Study Age:
Published 2023.
Original Title:
Associations for subgroups of E-cigarette, cigarette, and cannabis use with asthma in a population sample of California adolescents.
Published In:
Addictive behaviors, 145, 107777 (2023)
Database ID:
RTHC-05029

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Can cannabis cause asthma in teenagers?

This study found cannabis use independently associated with asthma in a large sample of California high school students. However, the cross-sectional design cannot determine whether cannabis use triggered asthma or whether teens with breathing problems were more likely to report cannabis use.

Is vaping safer than smoking for teen lungs?

This study found both e-cigarette and combustible cigarette use independently associated with asthma in teens. While the specific mechanisms may differ, neither appears without respiratory risk in this population. Cannabis use added additional independent risk.

Read More on RethinkTHC

Cite This Study

RTHC-05029·https://rethinkthc.com/research/RTHC-05029

APA

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

MLA

Williams, Rebecca J, et al. "Associations for subgroups of E-cigarette, cigarette, and cannabis use with asthma in a population sample of California adolescents.." Addictive behaviors, 2023. https://doi.org/10.1016/j.addbeh.2023.107777

RethinkTHC

RethinkTHC Research Database. "Associations for subgroups of E-cigarette, cigarette, and ca..." RTHC-05029. Retrieved from https://rethinkthc.com/research/williams-2023-associations-for-subgroups-of

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.