• Ruoyan Sun and Gabriela R Oates.
• Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, United States of America. Electronic address: rysun@uab.edu.
• Prev Med. 2024 Nov 14; 189: 108175108175.

IntroductionAlthough studies have found nicotine and cannabis vaping to be individually associated with respiratory symptoms, little is known about the harm of dual vaping. We aim to assess the association of nicotine-only, cannabis-only, and dual vaping with respiratory symptoms.MethodsUsing a national sample of 8033 U.S. young adults (ages 18-24) interviewed in 2021, we employed multivariable logistic regressions to assess the association between vaping behaviors and past 12-month respiratory outcomes.ResultsOf all participants, 75.4 % did not vape, 15.0 % vaped nicotine only, 4.7 % vaped cannabis only, and 4.9 % vaped both. Compared with no vaping, nicotine-only vaping was associated with sounding wheezy (aPR = 1.75, 95 % CI, 1.28-2.39) and dry cough at night (aPR = 1.43, 95 % CI, 1.19-1.72). Cannabis-only vaping was also associated with these two symptoms, with aPRs at 1.82 (95 % CI, 1.15-2.88) and 1.61 (95 % CI, 1.18-2.21), respectively. In addition to these two symptoms (aPR = 2.24, 95 % CI, 1.42-3.54 for sounding wheezy, and aPR = 1.50, 95 % CI, 1.01-2.22 for dry cough at night), dual vaping was associated with wheezing or whistling (aPR = 1.93, 95 % CI, 1.23-3.04) and high level of respiratory symptoms (aPR = 2.02, 95 % CI, 1.24-3.32). Compared with non-frequent vaping, cannabis-only and dual frequent vaping were associated with higher risks of wheezing or whistling.ConclusionsNicotine-only and cannabis-only vaping were associated with two respiratory symptoms while dual vaping with four. The elevated respiratory risk of dual vaping warrants future research on the underlying mechanisms of different vaping behaviors and respiratory outcomes.Copyright © 2024 Elsevier Inc. All rights reserved.

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