The Association Between E-Cigarette Use and Bronchiolitis Obliterans among American Youths

In recent years, the rising popularity of e-cigarettes among American adolescents has sparked growing concern about their long-term respiratory health effects. Although often perceived as a safer alternative to traditional smoking, e-cigarettesparticularly flavored varietiescontain harmful chemicals such as diacetyl, which has been strongly associated with bronchiolitis obliterans (BO), an irreversible condition that scars and narrows the lungs smallest airways. Public health organizations, including the American Lung Association and Johns Hopkins Medicine, have warned about the potential risks of inhaling such flavoring agents. This study investigates the potential association between youth e-cigarette use and the risk of developing BO. Using a literature review and simulated data modeled through logistic regression in R, this paper compares BO risk across three groups: non-users, vapers, and traditional smokers. The results demonstrate that both vapers and smokers have significantly elevated predicted probabilities of BO compared to non-users, with smokers facing the highest risk. These findings reinforce the need for stricter regulation of flavored vaping products and support youth-targeted public health interventions to prevent irreversible lung damage during critical stages of development. Further longitudinal research using clinical data is recommended to validate these patterns in real-world populations.