Special Edition: Advanced Clinical Research Internship Session III (2024), Vol. 4 No. S2 https://doi.org/10.47488/dhrp.v4iS2.6 DHR Proceedings ǀ http://dhrproceedings.org 48 2024, Vol. 4 No. S2 Pg. 42-54 MANUSCRIPT Vaping and Respiratory Health: A Literature Review Focused on Hispanic Adolescents in the Rio Grande Valley Marisol Acosta1, Edely Sanchez1,2, Desirae Urbina1,3, Diego Sierra1,2, Sofia P. Prukop1,2, Carlos Garza1,2, John Luna1,3, Renata Cantu-Cepeda1,3 1 DHR Health High School and Community Outreach 2 South Texas ISD Medical Professions 3 South Texas ISD Health Professions Received: July 3, 2024 Accepted for publication: January 24, 2025 Introduction The rising prevalence of e-cigarette use among adolescents is a significant public health concern, particularly within specific demographic groups and geographic locations. This literature review focuses on the impact of vaping on respiratory health among Hispanic adolescents residing in the Rio Grande Valley (RGV), a region characterized by unique sociocultural factors and health disparities. The RGV, situated on the Texas-Mexico border, presents a complex context where cultural influences, socioeconomic factors, and access to healthcare intersect to shape adolescent health behaviors. This review synthesizes existing research on vaping's effects on respiratory health in adolescents, with a specific focus on the Hispanic population in the RGV, highlighting the need for culturally sensitive interventions and future research. Prevalence of E-cigarette Use Among Hispanic Adolescents in the RGV While precise data on e-cigarette prevalence specifically within the RGV's Hispanic adolescent population is limited, national and state-level studies provide a crucial foundation for understanding the scope of the problem. National surveys consistently reveal high rates of e- cigarette use among adolescents, and these trends likely mirror, or even exceed, those observed in specific high-risk communities like the RGV.1,3 The RGV's unique border location and cultural dynamics may contribute to increased accessibility and normalization of vaping among youth.4 Further research is needed to obtain accurate, RGV-specific data on e-cigarette prevalence among Hispanic adolescents, considering factors such as access to tobacco products, cultural norms, and marketing strategies targeting this demographic. The lack of localized data represents a significant gap in the current literature.5 Special Edition: Advanced Clinical Research Internship Session III (2024), Vol. 4 No. S2 https://doi.org/10.47488/dhrp.v4iS2.6 DHR Proceedings ǀ http://dhrproceedings.org 49 2024, Vol. 4 No. S2 Pg. 42-54 Respiratory Effects of Vaping in Adolescents: General Findings Numerous studies demonstrate a clear association between e-cigarette use and various respiratory problems in adolescents.1,6-13 These effects range from increased respiratory symptoms like wheezing and coughing to more severe conditions like EVALI (e-cigarette or vaping product use-associated lung injury).11,14-20 Studies have shown that e-cigarette aerosols contain various harmful chemicals, including flavorings, that can directly damage the respiratory system.7-8, 21-24 The long-term effects remain largely unknown, necessitating further longitudinal research to fully understand the cumulative impact of vaping on adolescent respiratory health.8,13,22 Asthma and Vaping The impact of vaping on adolescents with asthma is a particularly pressing concern.6-7 Existing evidence suggests that e-cigarette use can exacerbate asthma symptoms, potentially leading to increased frequency and severity of asthma attacks.6,7 The inflammatory and irritant effects of e- cigarette aerosols can worsen airway inflammation and hyperresponsiveness in asthmatic individuals.25 However, more research is needed to establish a definitive causal link and quantify the extent of this risk within the Hispanic adolescent population in the RGV.6 The existing research often lacks the specificity needed to address the unique health challenges faced by this population. Secondhand Exposure The effects of secondhand exposure to e-cigarette aerosol are also concerning.7,16 Studies have shown that exposure to secondhand vape can lead to respiratory symptoms in non-users.16 This is especially relevant in the RGV, where multigenerational households are common, potentially exposing younger children to secondhand vaping aerosols.26 This area needs further investigation, particularly within the specific context of the RGV's social and family structures. Data on secondhand exposure and its impact on respiratory health within Hispanic families in the RGV are scarce.26 Socio-Cultural Factors Influencing Vaping in the RGV The RGV's unique cultural context plays a crucial role in shaping adolescent health behaviors, including vaping. The region's high Hispanic population, strong family ties, and bicultural influences, all contribute to the complex social environment in which adolescents make decisions about vaping.26-30 Acculturation stress, family cohesion, and social support networks within the family and community may influence vaping initiation and persistence.27-28 Further research is needed to explore the interplay of these cultural factors and their influence on vaping among Hispanic adolescents in the RGV. Qualitative studies exploring the perspectives of Hispanic adolescents and their families could provide valuable insights into this complex relationship.4 Special Edition: Advanced Clinical Research Internship Session III (2024), Vol. 4 No. S2 https://doi.org/10.47488/dhrp.v4iS2.6 DHR Proceedings ǀ http://dhrproceedings.org 50 2024, Vol. 4 No. S2 Pg. 42-54 Marketing and Accessibility The marketing and accessibility of e-cigarettes in the RGV also warrant investigation. The proximity to the Mexican border may affect the availability and affordability of vaping products.4 Marketing strategies targeting specific cultural groups or exploiting existing social norms could influence vaping uptake among Hispanic adolescents.4 Research on marketing strategies and their effectiveness within the RGV's Hispanic community is crucial for developing targeted prevention efforts. Socioeconomic Factors Socioeconomic factors may also play a significant role in vaping prevalence and its health consequences among Hispanic adolescents in the RGV. Poverty, limited access to healthcare, and lower health literacy could exacerbate the negative impacts of vaping on respiratory health.4 Studies need to investigate how socioeconomic disparities influence vaping patterns and the severity of respiratory complications within this specific population. Research Gaps and Future Directions Several significant research gaps remain in understanding the impact of vaping on respiratory health among Hispanic adolescents in the RGV. There is a critical need for: RGV-Specific Data: More research is needed to gather precise data on e-cigarette prevalence, patterns of use, and respiratory health outcomes within the RGV's Hispanic adolescent population. Longitudinal Studies: Longitudinal studies are necessary to track the long-term respiratory effects of vaping in this population, considering the relatively recent introduction of e-cigarettes. Culturally Sensitive Research: Qualitative studies employing culturally sensitive methodologies are needed to understand the sociocultural factors influencing vaping initiation, cessation, and health outcomes within the RGV's Hispanic community. Intervention Studies: Research on the effectiveness of culturally tailored interventions to prevent vaping initiation and promote cessation among Hispanic adolescents in the RGV is crucial. Secondhand Exposure Research: Further investigation is needed to assess the impact of secondhand e-cigarette aerosol exposure on the respiratory health of Hispanic children and families in the RGV. Combined Substance Use: Research needs to address the complex interplay between vaping and other substance use (e.g., alcohol, marijuana) among Hispanic adolescents in the RGV, given the potential for synergistic effects on respiratory health. Special Edition: Advanced Clinical Research Internship Session III (2024), Vol. 4 No. S2 https://doi.org/10.47488/dhrp.v4iS2.6 DHR Proceedings ǀ http://dhrproceedings.org 51 2024, Vol. 4 No. S2 Pg. 42-54 Conclusion The growing prevalence of e-cigarette use among adolescents, coupled with the RGV's unique sociocultural context and health disparities, necessitates urgent research to understand and address this critical public health issue. This review highlights the existing evidence on the detrimental effects of vaping on respiratory health, emphasizing the need for RGV-specific studies that incorporate cultural nuances, socioeconomic factors, and the complex interplay of various influences on adolescent health behaviors. Future research should focus on generating localized data, employing longitudinal and qualitative methods, and developing and evaluating culturally appropriate interventions to mitigate the significant respiratory health risks associated with vaping among Hispanic adolescents in the Rio Grande Valley. Addressing this challenge requires a multi-faceted approach involving public health initiatives, educational programs, and policy changes tailored to the specific needs of this vulnerable population. Acknowledgements: Nori Zapata, MSN, RN, Senior Vice President of Education and Career Development, Vanessa Vera, MS, Senior Manager of High School and Community Outreach, Anisa Mirza, Intern Program Coordinator. Funding: Funded by DHR Health High School and Community Outreach; DHR Health; South Texas Independent School District. References 1. Tahniyath U, Begum SS, Unnisa M. Vaping Trends among Adoloscents: Understanding the Rise of E Cigarettes in Youth Culture. 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