For young people with asthma, using combustible tobacco — cigarettes above all — means worse symptoms, poorer asthma control and more need for medical care. And any nicotine product is unsafe for youths. Earlier studies suggested that teens with asthma take up tobacco at least as often as others, but usually looked only at high school students and only some products. The Florida Department of Health used the 2016 Florida Youth Tobacco Survey to take a fuller look.
The survey
- A school-based, pencil-and-paper questionnaire for Florida public middle schools (grades 6–8) and high schools (grades 9–12), with a statewide representative sample: 36,082 middle and 33,558 high school students took part (response rates 78.0% and 71.0%).
- Asthma: a "yes" to Has a doctor or nurse ever told you that you have asthma? — 19.5% of middle and 20.6% of high school students said yes.
- Current use: any use on at least one of the past 30 days, for cigarettes, e-cigarettes (including e-cigars, vape pipes, vaping pens, e-hookah and hookah pens), hookah, smokeless tobacco and cigars.
Findings
Across Florida, about 190,000 middle and high school students (8.5% and 24.9%) were using some tobacco product, and about 86,000 (3.1% and 9.0%) were using two or more.
Students with asthma used every product more than those without:
| Current use | Middle school, with asthma | Middle school, without | High school, with asthma | High school, without |
|---|---|---|---|---|
| Any tobacco product | 11.1% | 7.9% | 27.9% | 24.2% |
| Two or more products | 4.2% | 2.8% | 10.9% | 8.6% |
| E-cigarettes | 7.9% | 5.8% | 19.6% | 17.2% |
| Hookah | 3.8% | 2.4% | 9.7% | 6.8% |
| Cigars | 2.3% | 1.3% | 7.3% | 5.5% |
| Cigarettes | 2.2% | 1.4% | 5.7% | 4.6% |
| Smokeless tobacco | 2.1% | 1.2% | 4.3% | 3.3% |
In numbers, about 10,000 middle and 34,000 high school students with asthma were current users. E-cigarettes led at both levels, followed by hookah, cigars, cigarettes and smokeless tobacco.
Why it matters
The higher use of combustible products is especially worrying, since tobacco's health risks are greater for people with asthma. Possible reasons for the higher use:
- the same factors linked to smoking in this group — tobacco use in their social environment, and using it to cope with psychosocial distress;
- young people who skip their asthma medicines also report being more rebellious and risk-taking;
- a belief that e-cigarettes and hookah are more socially acceptable or less harmful — but nicotine in any form is unsafe for youths.
Limitations
- Only public school students were surveyed, so results do not represent all Florida youths.
- Answers were self-reported, open to recall and response bias.
- Use in the past 30 days may not mean regular or daily use.
- The questions could not tell whether e-cigarette users were vaping nicotine or other substances.
What to do
Statewide tobacco prevention, alongside other proven measures, can help reduce every form of tobacco use among young people — especially those with asthma. As tobacco products multiply, youths need to learn the health risks of all of them.
Sources
Based on "Tobacco Product Use Among Youths With and Without Lifetime Asthma — Florida, 2016," by Keshia M. Reid, Jamie R. Forrest and Lauren Porter, Florida Department of Health, Morbidity and Mortality Weekly Report 67(21), Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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