Global health survey of people who vape and never smoked. Protocol for the Vaping Effects: Real-world InTernAtional Surveillance (VERITAS) Study (Preprint)

Abstract

Introduction: There is only limited information about the health effects of regular vaping. Because any research on health status of people who used to smoke faces the challenge that the previous smoking caused unknown health effects, only studies of people who vape, but have never smoked tobacco cigarettes can enable detection of harms attributable to vaping. Large prospective studies of well-characterized EC users with and without a history of tobacco smoking are warranted to establish the long-term effects of regular vaping on respiratory health. Objective: We will conduct a global cross-sectional survey of subjects from six world regions. Respiratory symptoms (assessed by a validated questionnaire, RSES) of never smokers who vape daily will be compared with matched controls with no history of vaping, smoking, or use of any other tobacco products. Methods: This will be a multi-country, cross-sectional internet-based survey of adults ≥ 18 years of age who satisfied criteria for inclusion in either a group of people who vape and have never smoked (“Vapers Cohort”, N = 500) or a group of people who have never vaped nor smoked (“Controls Cohort”, N = 250). The primary endpoint of the study is RSES score RSES scores of people in the “Vapers Cohort” will be compared with people in the “Controls Cohort”. Additionally, the study will collect data to carefully characterize people who vape and have never smoked in the “Vapers cohort”. Data collection will include information about age initiation of using vape products, reasons to start using, and continuing using vape products, specific types of products used, flavor preferences, nicotine levels, frequency and pattern of use, level of weekly consumption, and number of different flavors used monthly. Subject recruitment has started in April 2023 and enrolment is expected to be completed by November 2023. Results will be reported in 2024. Conclusions: This will be the first study providing key insights into respiratory health effects associated with using e-cigarettes in people who vape, but have never smoked tobacco cigarettes.