Fruit-Flavored E-Cigarettes Linked to Increased Risk of Nocturnal Dry Cough

Although in vitro and animal studies have identified the pulmonary toxicity of electronic cigarette (ECIG) flavors, epidemiological evidence on their respiratory effects remains limited. This study explored the longitudinal association between exposure to flavored ECIGs and the occurrence of nocturnal dry cough among users using data from the Population Assessment of Tobacco and Health Study (2014-2019).
 A secondary analysis was conducted on 18,925 adults, totaling 38,638 observations, employing weighted-incidence estimates and generalized estimating equation models to assess both unadjusted and adjusted associations.
Findings revealed that the weighted incidence proportion (WIP) of nocturnal dry cough was significantly higher among current (WIP: 16.6%) and former fruit-flavored ECIG users (WIP: 16.6%) compared to non-ECIG users (WIP: 11.1%). Current users of fruit-flavored ECIGs had a 40% higher risk of reporting nocturnal dry cough compared to non-users (aRR: 1.40). Former ECIG users of multiple flavors and other flavors had a markedly increased risk of cough, with 300% and 66% higher risks, respectively (aRR: 3.33 and aRR: 1.66).
The significant association between fruit-flavored ECIG use and increased risk of nocturnal dry cough highlights a potential early indicator of respiratory inflammation and disease risk, raising concerns about the respiratory health impact of flavored ECIGs. Further studies are needed to assess the long-term implications of these findings on respiratory health.