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Article

Effect Comparison of E-Cigarette and Traditional Smoking and Association with Stroke—A Cross-Sectional Study of NHANES

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Department of Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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Department of Public Health, University of California, Berkeley, CA 92093, USA
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Department of Biology, York University, Toronto, ON M3J 1P3, Canada
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Department of Public Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA
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Department of Neurology, Larkin Community Hospital, Miami, FL 33143, USA
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Department of Internal Medicine, Texas Tech University Health Sciences Center, Transmountain Campus, El Paso, TX 79430, USA
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Department of Internal Medicine, Hudson Regional Hosp, Secaucus, NJ 07094, USA
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Department of Child Neurology, Jersey Shore University Medical Center, Neptune City, NJ 07753, USA
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Department of Internal Medicine, Geisinger Med Center, Danville, PA 17822, USA
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Department of Epidemiology and Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
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Department of Neurology, Mayo Clinic, Albert Lea, MN 56007, USA
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Department of Neurology, Stormont Vail Health, Topeka, KS 66604, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Axel Steiger
Neurol. Int. 2022, 14(2), 441-452; https://doi.org/10.3390/neurolint14020037
Received: 1 May 2022 / Revised: 19 May 2022 / Accepted: 23 May 2022 / Published: 27 May 2022
Introduction: Tobacco use is one of the most significant risk factors for stroke. Besides traditional cigarettes and combustible products, the use of e-cigarettes and electronic nicotine delivery products has been widespread among young adults in the recent era. Furthermore, the trend of vaping has increased over the last decade. However, the relationship between e-cigarettes and stroke is largely unknown. The aim of this study was to evaluate the prevalence and identify the relationship between e-cigarette smoking and stroke. Methods: A cross-sectional study was performed using the NHANES database of the US population. Adults with a history of smoking were considered in our study and divided into three groups, e-cigarette users, traditional, and dual smokers. The Chi-squared test, Wilcoxon rank-sum test, and multivariable logistic regression analysis were used to identify the prevalence and association of e-cigarette consumption and stroke. Results: Out of a total of 266,058 respondents from 2015 to 2018, we found 79,825 respondents who smoked e-cigarettes (9.72%) or traditional (29.37%) or dual smoking (60.91%). Stroke prevalence among e-cigarette smokers was 1.57%. Stroke was more prevalent among traditional smokers than among e-cigarette smokers. (6.75% vs. 1.09%; p < 0.0001) E-cigarette smokers had early onset of stroke in comparison with traditional smokers. (median age: 48 vs. 59 years; p < 0.0001). Among females with stroke, the prevalence of e-cigarette use was higher in comparison with traditional smoking (36.36% vs. 33.91%; p < 0.0001). Among the stroke population, the prevalence of e-cigarette use was higher among Mexican-Americans (21.21% vs. 6.02%) and other Hispanics (24.24% vs. 7.70%) compared with traditional smoking (p < 0.0001). The regression analysis found higher odds of stroke history among e-cigarette users than traditional smokers [aOR: 1.15; 95% CI: 1.15–1.16)]. Conclusion: Though stroke was more prevalent in traditional smokers, the incidence of stroke was early-in-onset and was strongly associated with e-cigarette use compared to traditional smokers. We have also identified vascular effects of e-cigarettes components as possible triggers for the stroke. View Full-Text
Keywords: e-cigarette; vaping; ENDS; e-cigs; smoking; ischemic stroke; cerebrovascular disorders; stroke risk factors; NHANES e-cigarette; vaping; ENDS; e-cigs; smoking; ischemic stroke; cerebrovascular disorders; stroke risk factors; NHANES
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MDPI and ACS Style

Patel, U.; Patel, N.; Khurana, M.; Parulekar, A.; Patel, A.; Ortiz, J.F.; Patel, R.; Urhoghide, E.; Mistry, A.; Bhriguvanshi, A.; Abdulqader, M.; Mehta, N.; Arumaithurai, K.; Shah, S. Effect Comparison of E-Cigarette and Traditional Smoking and Association with Stroke—A Cross-Sectional Study of NHANES. Neurol. Int. 2022, 14, 441-452. https://doi.org/10.3390/neurolint14020037

AMA Style

Patel U, Patel N, Khurana M, Parulekar A, Patel A, Ortiz JF, Patel R, Urhoghide E, Mistry A, Bhriguvanshi A, Abdulqader M, Mehta N, Arumaithurai K, Shah S. Effect Comparison of E-Cigarette and Traditional Smoking and Association with Stroke—A Cross-Sectional Study of NHANES. Neurology International. 2022; 14(2):441-452. https://doi.org/10.3390/neurolint14020037

Chicago/Turabian Style

Patel, Urvish, Neel Patel, Mahika Khurana, Akshada Parulekar, Amrapali Patel, Juan Fernando Ortiz, Rutul Patel, Eseosa Urhoghide, Anuja Mistry, Arpita Bhriguvanshi, Mohammed Abdulqader, Neev Mehta, Kogulavadanan Arumaithurai, and Shamik Shah. 2022. "Effect Comparison of E-Cigarette and Traditional Smoking and Association with Stroke—A Cross-Sectional Study of NHANES" Neurology International 14, no. 2: 441-452. https://doi.org/10.3390/neurolint14020037

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