Abstract Purpose The purpose of this study was to explore the association between respiratory symptoms among U.S. adolescents who were current (past 30-day) users of cigarettes, e-cigarettes, and/or cannabis, as well as lifetime users of cannabis with electronic nicotine delivery systems (ENDS). Methods Wave 4 from a national probability sample (N = 14,798) of adolescents (12–17 years) using Population Assessment of Tobacco and Health Study data was used for this study. Retention rate was 88.4%. Results The odds of indicating “wheezing or whistling” in the chest were roughly two times higher among those who had used cannabis in ENDS (adjusted odds ratio 1.81, 95% confidence interval 1.47–2.22);...