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A58-21 Clinical Outcomes of Vaping Versus Cigarette Smoking in Adolescents and Young Adults Hospitalized With Acute Respiratory Failure: A National Case-Control Study

A. Lim, S. Karipineni, M. Chowdhury, A. Doshi, J. Becker, K. Zaman

American Journal of Respiratory and Critical Care Medicine, 2026

17 participants

Abstract

The prevalence of electronic cigarette use has increased substantially over the past decade, particularly among adolescents and young adults due to its promotion as a safer alternative. Despite growing concern of E-cigarette or Vaping Product Use-Associated Lung Injury (EVALI), inpatient studies directly comparing vaping-related illness with traditional cigarette smoking remain limited. In this study, we sought to compare mortality, in-hospital complications, and resource utilization among patients hospitalized with acute respiratory failure (ARF) contrasting vaping and cigarette smoking.

We conducted a retrospective case-control study using 2016-2022 data from the National Inpatient Sample (NIS). Patients aged 12 to 44 years hospitalized with ARF were included. Vaping-related disorder was identified using ICD-10-CM codes consistent with EVALI, and smoking-related disorder was selected using tobacco-related respiratory disease codes. Patients with dual exposure were excluded. Survey weighted multivariable regression assessed in-hospital mortality, complications, length of stay (LOS), and hospital charges, adjusting for patient and hospital characteristics. Models were adjusted for age, sex, race, religion, primary payer, hospital bed size, location, and teaching status.

Out of the 250,485 hospitalizations for ARF, 247,815 were smoking-related and 2,670 were vaping-related admissions. Patients in the vaping group were younger (mean age 25.4 vs 35.0 years) and more likely to…

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