By Lisa Rapaport

(Reuters Health) – American adults are more likely to use e-cigarettes when they have children at home, especially when kids have asthma, a U.S. study suggests.

Nationwide, 4.4 percent of adults reported current e-cigarette use in 2016 and 2017, the study found. The proportion was higher – 4.9 percent – among adults with kids, and higher still – 5.6 percent – among adults who lived with a child with asthma.

“E-cigarette users commonly perceive the aerosols as harmless ‘water vapors’ and are unlikely to have family rules governing e-cigarette use in homes and vehicles,” said lead study author Jenny Carwile of Maine Medical Center in Portland.

While the study didn’t examine health outcomes of second-hand e-cigarette exposure, “e-cigarette aerosols contain potentially harmful compounds including volatile organic compounds like formaldehyde, nicotine, heavy metals, and ultrafine particulates,” Carwile said by email.

Big U.S. tobacco companies are all developing e-cigarettes. The battery-powered gadgets feature a glowing tip and a heating element that turns liquid nicotine and flavorings into a cloud of vapor that users inhale.

Even when e-liquids don’t contain nicotine, the lungs are still exposed to flavoring chemicals when the vapors are inhaled. While many of the flavorings are considered safe to eat, some previous research suggests that inhaling vapor from these chemicals may damage the lungs, blood vessels and heart.

For the current study, researchers examined data from the 2016 to 2017 U.S. Behavioral Risk Factor Surveillance System, a nationally representative phone survey.

The proportion of adults who used e-cigarettes ranged from as low 2.3 percent in the District of Columbia to as high as 7.7 percent in Oklahoma, researchers report in JAMA Pediatrics.

The study wasn’t designed to show what leads adults to use e-cigarettes or whether inhaling e-cigarette vapors might damage kids’ health.

But the results suggest that at least some parents may be vaping around kids because they believe it’s safer than exposing children to second-hand cigarette smoke, said Jeremy Drehmer, a researcher at Massachusetts General Hospital in Boston who wasn’t involved in the study.

“This study highlights the need for more research to better understand the long-term health consequences to children from secondhand and thirdhand exposure to e-cigarette aerosol,” Drehmer said by email. “It also highlights an immediate need to educate people who live with a child about the potential risks to children’s health from exposure to secondhand e-cigarette aerosol.”

Kids may be more vulnerable to exposure to second-hand e-cigarette vapors than adults, said Alex Prokhorov of the University of Texas MD Anderson Cancer Center in Houston.

“Children’s bodies and brains are still developing and fragile,” Prokhorov, who wasn’t involved in the study, said by email. “Childhood is the time period when organs and tissues are particularly vulnerable to the multiple compounds identified in e-cigarette’s aerosol, and this is especially true for those kids who suffer of asthma and other chronic diseases.”

Another risk is that kids who see their parents vaping may be more apt to take up smoking or vaping themselves, researchers say.

While e-cigarettes haven’t been around long enough to see if vaping may be a habit that’s handed down from one generation to the next, there is plenty of evidence showing that children of smokers are more likely to become smokers themselves, said Stanton Glantz of the Center for Tobacco Control Research and Education at the University of California, San Francisco.

“Adults should not use e-cigarettes indoors or around kids,” Glantz, who wasn’t involved in the study, said by email. “They are not harmless and the kids are absorbing toxic chemicals that are known to cause asthma and other respiratory diseases.”

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