151
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Krakowiak RI, Poklis JL, Peace MR. The Analysis of Aerosolized Methamphetamine From E-cigarettes Using High Resolution Mass Spectrometry and Gas Chromatography Mass Spectrometry. J Anal Toxicol 2020; 43:592-599. [PMID: 31504663 DOI: 10.1093/jat/bkz067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/21/2019] [Accepted: 05/29/2019] [Indexed: 01/20/2023] Open
Abstract
The use of electronic cigarettes (e-cigs) has expanded from a nicotine delivery system to a general drug delivery system. The internet is rife with websites, blogs and forums informing users how to modify e-cigs to deliver illicit drugs while maintaining optimal drug delivery of their device. The goal of this study was to qualitatively identify the presence of methamphetamine in the aerosol produced by an e-cig and to quantitatively assess the effect voltage on the concentration of aerosolized methamphetamine. A KangerTech AeroTank electronic cigarette containing a 30, 60 or 120 mg/mL of methamphetamine in 50:50 propylene glycol: vegetable glycerin formulation was used to produce the aerosol. To qualitatively identify aerosolized methamphetamine, the aerosol was generated at 4.3 V, trapped in a simple glass trapping system, extracted using solid-phase microextraction (SPME), and analyzed by high-resolution Direct Analysis in Real Time AccuTOF™ Mass Spectrometry (DART-MS). To assess the effect of voltage on the concentration of aerosolized methamphetamine, the aerosol was generated at 3.9, 4.3 and 4.7 V, trapped and quantified using gas chromatography mass spectrometry (GC/MS). SPME-DART-MS and SPME-GC-MS demonstrated the aerosolization of methamphetamine. The concentration of aerosolized methamphetamine at 3.9, 4.3 and 4.7 V was not statistically different at 800 ± 600 ng/mL, 800 ± 600 ng/mL and 1,000 ± 800 ng/mL, respectively. The characterization of the vapors produced from e-liquids containing methamphetamine provides an understanding of the dose delivery dynamics of e-cigarettes.
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Affiliation(s)
- Rose I Krakowiak
- Department of Forensic Science, Virginia Commonwealth University, 1015 Floyd Ave, Richmond, VA 23284, USA
| | - Justin L Poklis
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, 1112 E. Clay St., Richmond, VA 23298, USA
| | - Michelle R Peace
- Department of Forensic Science, Virginia Commonwealth University, 1015 Floyd Ave, Richmond, VA 23284, USA
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152
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Comiford AL, Rhoades DA, Spicer P, Dvorak JD, Ding K, Wagener TL, Doescher MP. Impact of e-cigarette use among a cohort of American Indian cigarette smokers: associations with cigarette smoking cessation and cigarette consumption. Tob Control 2020; 30:103-107. [PMID: 32054728 DOI: 10.1136/tobaccocontrol-2019-055338] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/16/2019] [Accepted: 01/13/2020] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Despite American Indian/Alaska Native (AI/AN) people having the highest prevalence of cigarette smoking nationwide, few studies have evaluated e-cigarette use among AI/AN adults who smoke. The primary objective of this observational pilot cohort study was to determine if e-cigarette use is associated with cigarette smoking cessation or reduction among adult AI individuals who smoke. METHODS In 2016, we collected baseline survey and biomarker data among AI adults who smoke. The survey included questions about cigarette consumption and use of e-cigarettes and biomarkers, such as salivary cotinine markers and exhaled carbon monoxide. After 18 months, we repeated data collection, and asked about changes in cigarette smoking status and cigarettes per day (CPD). Comparisons between groups were performed using the χ2 test, Fisher's exact test or Wilcoxon rank-sum test. RESULTS Of 375 baseline participants, 214 (57.07%) returned for follow-up and were included in analyses. Of these, 20 (9.3%) reported having stopped cigarette smoking and had biochemical verification of cigarette smoking abstinence. Among those who quit smoking, 15% were baseline e-cigarette users; while among those who continued to smoke at follow-up, about 11% were baseline e-cigarette users. This difference was not statistically significant (p=0.48). Among all those who continued to smoke at follow-up, there was no overall decrease in CPD, nor a significant difference in change in CPD between baseline e-cigarette users and non-users (p=0.98). CONCLUSIONS E-cigarette use at baseline was not associated with smoking cessation or a change in CPD in this cohort of AI adults who smoke after an 18-month follow-up period.
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Affiliation(s)
- Ashley L Comiford
- Community Health Promotions, Cherokee Nation, Tahlequah, Oklahoma, USA
| | - Dorothy A Rhoades
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Paul Spicer
- Anthropology, University of Oklahoma, Norman, Oklahoma, USA
| | - Justin D Dvorak
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Kai Ding
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Theodore L Wagener
- Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.,Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Mark P Doescher
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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153
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Szostak J, Wong ET, Titz B, Lee T, Wong SK, Low T, Lee KM, Zhang J, Kumar A, Schlage WK, Guedj E, Phillips B, Leroy P, Buettner A, Xiang Y, Martin F, Sewer A, Kuczaj A, Ivanov NV, Luettich K, Vanscheeuwijck P, Peitsch MC, Hoeng J. A 6-month systems toxicology inhalation study in ApoE -/- mice demonstrates reduced cardiovascular effects of E-vapor aerosols compared with cigarette smoke. Am J Physiol Heart Circ Physiol 2020; 318:H604-H631. [PMID: 31975625 DOI: 10.1152/ajpheart.00613.2019] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Smoking cigarettes is harmful to the cardiovascular system. Considerable attention has been paid to the reduced harm potential of alternative nicotine-containing inhalable products such as e-cigarettes. We investigated the effects of E-vapor aerosols or cigarette smoke (CS) on atherosclerosis progression, cardiovascular function, and molecular changes in the heart and aorta of female apolipoprotein E-deficient (ApoE-/-) mice. The mice were exposed to aerosols from three different E-vapor formulations: 1) carrier (propylene glycol and vegetable glycerol), 2) base (carrier and nicotine), or 3) test (base and flavor) or to CS from 3R4F reference cigarettes for up to 6 mo. Concentrations of CS and base or test aerosols were matched at 35 µg nicotine/L. Exposure to CS, compared with sham-exposed fresh air controls, accelerated atherosclerotic plaque formation, whereas no such effect was seen for any of the three E-vapor aerosols. Molecular changes indicated disease mechanisms related to oxidative stress and inflammation in general, plus changes in calcium regulation, and altered cytoskeletal organization and microtubule dynamics in the left ventricle. While ejection fraction, fractional shortening, cardiac output, and isovolumic contraction time remained unchanged following E-vapor aerosols exposure, the nicotine-containing base and test aerosols caused an increase in isovolumic relaxation time similar to CS. A nicotine-related increase in pulse wave velocity and arterial stiffness was also observed, but it was significantly lower for base and test aerosols than for CS. These results demonstrate that in comparison with CS, E-vapor aerosols induce substantially lower biological responses associated with smoking-related cardiovascular diseases.NEW & NOTEWORTHY Analysis of key urinary oxidative stress markers and proinflammatory cytokines showed an absence of oxidative stress and inflammation in the animals exposed to E-vapor aerosols. Conversely, animals exposed to conventional cigarette smoke had high urinary levels of these markers. When compared with conventional cigarette smoke, E-vapor aerosols induced smaller atherosclerotic plaque surface area and volume. Systolic and diastolic cardiac function, as well as endothelial function, were further significantly less affected by electronic cigarette aerosols than conventional cigarette smoke. Molecular analysis demonstrated that E-vapor aerosols induce significantly smaller transcriptomic dysregulation in the heart and aorta compared with conventional cigarette smoke.
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Affiliation(s)
- Justyna Szostak
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
| | - Ee Tsin Wong
- Philip Morris International Research and development, Philip Morris International Research Laboratories, Singapore
| | - Bjoern Titz
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
| | - Tom Lee
- Philip Morris International Research and development, Philip Morris International Research Laboratories, Singapore
| | - Sin Kei Wong
- Philip Morris International Research and development, Philip Morris International Research Laboratories, Singapore
| | - Tiffany Low
- Philip Morris International Research and development, Philip Morris International Research Laboratories, Singapore
| | | | | | | | | | - Emmanuel Guedj
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
| | - Blaine Phillips
- Philip Morris International Research and development, Philip Morris International Research Laboratories, Singapore
| | - Patrice Leroy
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
| | | | - Yang Xiang
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
| | - Florian Martin
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
| | - Alain Sewer
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
| | - Arkadiusz Kuczaj
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
| | - Nikolai V Ivanov
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
| | - Karsta Luettich
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
| | - Patrick Vanscheeuwijck
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
| | - Manuel C Peitsch
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
| | - Julia Hoeng
- Philip Morris International Research and Development, Philip Morris Products, Neuchâtel, Switzerland
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154
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Li L, Lee ES, Nguyen C, Zhu Y. Effects of propylene glycol, vegetable glycerin, and nicotine on emissions and dynamics of electronic cigarette aerosols. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2020; 54:1270-1281. [PMID: 33116348 PMCID: PMC7590927 DOI: 10.1080/02786826.2020.1771270] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 05/17/2023]
Abstract
An electronic cigarette (e-cig) generates aerosols by vaporizing the e-liquid, which mainly consists of propylene glycol (PG), vegetable glycerin (VG), and nicotine. Understanding the effects of e-liquid main compositions on e-cig aerosols is important for exposure assessment. This study investigated how the PG/VG ratio and nicotine content affect e-cig aerosol emissions and dynamics. A tank-based e-cig device with 10 different flavorless e-liquid mixtures (e.g., PG/VG ratios of 0/100, 10/90, 30/70, 50/50, and 100/0 with 0.0% or 2.4% nicotine) was used to puff aerosols into a 0.46 m3 stainless steel chamber for 0.5 h. Real-time measurements of particle number concentration (PNC), fine particulate matter (PM2.5), and particle size distributions were conducted continuously throughout the puffing and the following 2-h decay period. During the decay period, particle loss rates were determined by a first-order log-linear regression and used to calculate the emission factor. The addition of nicotine in the e-liquid significantly decreased the particle number emission factor by 33%. The PM2.5 emission factor significantly decreased with greater PG content in the e-liquid. For nicotine-free e-liquids, increasing the PG/VG ratio resulted in increased particle loss rates measured by PNC and PM2.5. This pattern was not observed with nicotine in the e-liquids. The particle loss rates, however, were significantly different with and without nicotine especially when the PG/VG ratios were greater than 30/70. Compared with nonvolatile diethyl-hexyl subacute (DEHS) aerosols, e-cig particle concentration decayed faster inside the chamber, presumably due to evaporation. These results have potential implications for assessing human exposure to e-cig aerosols.
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Affiliation(s)
- Liqiao Li
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Eon S Lee
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Charlene Nguyen
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Yifang Zhu
- Department of Environmental Health Sciences, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California, USA
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155
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Boué S, Goedertier D, Hoeng J, Iskandar A, Kuczaj AK, Marescotti D, Mathis C, May A, Phillips B, Peitsch MC, Schlage WK, Sciuscio D, Tan WT, Vanscheeuwijck P. State-of-the-art methods and devices for generation, exposure, and collection of aerosols from e-vapor products. TOXICOLOGY RESEARCH AND APPLICATION 2020. [DOI: 10.1177/2397847320979751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
E-vapor products (EVP) have become popular alternatives for cigarette smokers who would otherwise continue to smoke. EVP research is challenging and complex, mostly because of the numerous and rapidly evolving technologies and designs as well as the multiplicity of e-liquid flavors and solvents available on the market. There is an urgent need to standardize all stages of EVP assessment, from the production of a reference product to e-vapor generation methods and from physicochemical characterization methods to nonclinical and clinical exposure studies. The objective of this review is to provide a detailed description of selected experimental setups and methods for EVP aerosol generation and collection and exposure systems for their in vitro and in vivo assessment. The focus is on the specificities of the product that constitute challenges and require development of ad hoc assessment frameworks, equipment, and methods. In so doing, this review aims to support further studies, objective evaluation, comparison, and verification of existing evidence, and, ultimately, formulation of standardized methods for testing EVPs.
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Affiliation(s)
- Stéphanie Boué
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Didier Goedertier
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Julia Hoeng
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Anita Iskandar
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Arkadiusz K Kuczaj
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Diego Marescotti
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Carole Mathis
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Anne May
- Consultants in Science, Epalinges, Switzerland
| | - Blaine Phillips
- Philip Morris International (PMI) Research & Development, Philip Morris International Research Laboratories Pte. Ltd, Science Park II, Singapore
| | - Manuel C Peitsch
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | | | - Davide Sciuscio
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
| | - Wei Teck Tan
- Philip Morris International (PMI) Research & Development, Philip Morris International Research Laboratories Pte. Ltd, Science Park II, Singapore
| | - Patrick Vanscheeuwijck
- Philip Morris International (PMI) Research & Development, Philip Morris Products S.A., Neuchâtel, Switzerland
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156
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Nicksic NE, Do EK, Barnes AJ. Cannabis legalization, tobacco prevention policies, and Cannabis use in E-cigarettes among youth. Drug Alcohol Depend 2020; 206:107730. [PMID: 31759233 PMCID: PMC6980691 DOI: 10.1016/j.drugalcdep.2019.107730] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND E-cigarettes are the most popular tobacco product among youth. As more states adopt cannabis legalization policies, youth cannabis use in e-cigarettes is a mounting concern. METHODS Data were from the 2016 and 2017 National Youth Tobacco Survey, a nationally-representative repeated cross-sectional survey administered to US middle and high school students. Ever use groups were categorized into e-cigarette ever users, cannabis in e-cigarette ever users, other tobacco ever users, and never users. Weighted multinomial logistic regression compared ever use groups, while controlling for state-level cannabis legalization and tobacco prevention polices, tobacco perceptions and exposures, and sociodemographic variables. Weighted prevalence of ever and current, or past 30 day, tobacco product use was determined by ever use groups. RESULTS Compared to e-cigarette ever users, cannabis in e-cigarette ever users increased (Adjusted Relative Risk Ratio (ARRR) = 1.65; p < 0.01) from 2016 to 2017. Medical-only and medical and recreational cannabis laws, and no e-cigarette minimum legal sales age (MLSA) and increased e-cigarette MLSA at 19 or 21 were positively associated with cannabis in e-cigarette ever users (ARRR = 1.34-1.85; p < 0.01, each). Ever and current use of all individual tobacco products was highest among cannabis in e-cigarette ever users compared to e-cigarette and other tobacco ever users. CONCLUSIONS Cannabis use in e-cigarettes has increased among youth, and these trends will likely continue as e-cigarettes continue to gain popularity and cannabis legalization policies proliferate. Targeted tobacco and cannabis prevention strategies are needed for youth, especially in states that have implemented cannabis 'medical and recreational laws.
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Affiliation(s)
- Nicole E Nicksic
- Department of Health Behavior and Policy, Virginia Commonwealth University, One Capitol Square, 830 East Main St, Richmond, VA 23219, USA.
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157
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Pericot-Valverde I, Yoon JH, Gaalema DE. Single- and cross-commodity delay discounting of money and e-cigarette liquid in experienced e-cigarette users. Drug Alcohol Depend 2020; 206:107740. [PMID: 31778948 PMCID: PMC7250042 DOI: 10.1016/j.drugalcdep.2019.107740] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 11/05/2019] [Accepted: 11/11/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Delay discounting (DD) research has improved our understanding of important behavioral processes associated with tobacco use. Little research has explored DD among e-cigarette users, and these studies have exclusively examined money as the only available commodity. This secondary analysis of a laboratory study explored discounting for money and e-liquid among e-cigarette users using two single-commodity discounting (SCD) tasks and one cross-commodity discounting (CCD) task. A secondary goal was to explore the extent to which results from the SCD and CCD tasks were correlated to each other and with measures of e-cigarette use. METHODS E-cigarette users (N = 27) completed two SCD tasks and one CCD task. The SCD tasks assessed choices between various amounts of either money now versus money later (M-M) or e-liquid now versus e-liquid later (mL-mL). The CCD task assessed choices between e-liquid now versus money later (mL-M). Discounting results were compared using logk and AUClog. RESULTS Discounting was greatest in the mL-mL task, followed by the M-M task, and then the mL-M task. AUClog and logk were significantly correlated across all discounting tasks. Attempts to quit vaping was positively associated with logk and negatively associated with AUClog and in both SCD tasks. CONCLUSIONS E-cigarette users discount e-liquid more than money in a SCD task. However, when the two commodities, money and e-liquid (CCD), are compared the substance of abuse is discounted to a lesser extent. Interventions that provide alternative reinforcers to compete with the reinforcing effects of nicotine intake may be especially indicated for treating e-cigarette dependence.
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Affiliation(s)
- Irene Pericot-Valverde
- School of Health Research, Clemson University, 605 Grove Road, Greenville, SC 29605, United States; Prisma Health-Upstate, Department of Internal Medicine, 701 Grove Road, Greenville, SC 29605, United States.
| | - Jin H Yoon
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1941 East Road, Houston, TX 77054, United States
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, 1 South Prospect Street, University of Vermont, Burlington, VT 05401, United States; Departments of Psychology and Psychiatry, 1 South Prospect Street, University of Vermont, Burlington, VT 05401, United States
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158
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Kalsi AS, Bomfim DI, Hussain Z. Factors affecting decision making at reassessment of periodontitis. Part 2: interpretation of clinical findings - systemic factors. Br Dent J 2019; 227:797-801. [PMID: 31705095 DOI: 10.1038/s41415-019-0893-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This paper is the second in a four-part series outlining treatment planning at periodontal reassessment. The first article focussed on the information that should be gathered at the reassessment appointment. Treatment can involve a range of non-surgical and surgical approaches. A variety of general, practical and local site factors can affect the choice of one option over another in choosing the most predictable treatment option. Residual periodontal probing depths can be associated with both systemic and local factors. This article (part 2) outlines systemic factors that need to be assessed when faced with residual periodontal probing depths.
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Affiliation(s)
- Amardip S Kalsi
- Speciality Trainee Registrar in Restorative Dentistry, Eastman Dental Hospital, 47-49 Huntley Street, London, WC1E 6DG, UK.
| | - Deborah I Bomfim
- Consultant in Restorative Dentistry, Eastman Dental Hospital, 47-49 Huntley Street, London, WC1E 6DG, UK
| | - Zahra Hussain
- Consultant in Restorative Dentistry, Eastman Dental Hospital, 47-49 Huntley Street, London, WC1E 6DG, UK
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159
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Yingst J, Foulds J, Zurlo J, Steinberg MB, Eissenberg T, Du P. Acceptability of electronic nicotine delivery systems (ENDS) among HIV positive smokers. AIDS Care 2019; 32:1224-1228. [PMID: 31698920 DOI: 10.1080/09540121.2019.1687835] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Electronic nicotine delivery systems (ENDS) have the potential to help smokers living with HIV/AIDS (PLWHA) to reduce harms from tobacco use. However, little is known about ENDS use among PLWHA. This study's aim was to evaluate the acceptability of two types of ENDS among PLWHA not planning to quit smoking. The study utilized a cross-over design where participants used two ENDS in a random order as smoking substitutes during two use periods separated by 7 days. Exhaled carbon monoxide (CO) was analyzed and participants reported daily cigarette and ENDS use and completed ratings on ENDS acceptability. Participants (n = 17) were a mean age of 49.1 years (SD = 8.8), were 53% white, and 59% male. All participants had controlled HIV disease status. Participants smoked a mean of 16.9 (SD = 7.9) CPD at baseline. Overall, CPD significantly decreased during both ENDS use periods (p < .01) but there were no differences in reduction between the different devices. CO decreased from baseline to follow-up only during the button-activated ENDS use period (p = .03), but there were no differences between ENDS devices. There were no significant differences in ratings of acceptability between ENDS devices. These results suggest that ENDS could be a harm reduction tool for smokers with HIV.
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Affiliation(s)
- Jessica Yingst
- Department of Public Health Sciences, Penn State University College of Medicine, Hershey, PA, USA
| | - Jonathan Foulds
- Department of Public Health Sciences, Penn State University College of Medicine, Hershey, PA, USA
| | - John Zurlo
- Department of Medicine, Penn State University College of Medicine, Hershey, PA USA
| | - Michael B Steinberg
- Division of General Internal Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Thomas Eissenberg
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Ping Du
- Department of Public Health Sciences, Penn State University College of Medicine, Hershey, PA, USA.,Department of Medicine, Penn State University College of Medicine, Hershey, PA USA
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160
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Chung S, Baumlin N, Dennis JS, Moore R, Salathe SF, Whitney PL, Sabater J, Abraham WM, Kim MD, Salathe M. Electronic Cigarette Vapor with Nicotine Causes Airway Mucociliary Dysfunction Preferentially via TRPA1 Receptors. Am J Respir Crit Care Med 2019; 200:1134-1145. [PMID: 31170808 PMCID: PMC6888648 DOI: 10.1164/rccm.201811-2087oc] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 06/05/2019] [Indexed: 12/11/2022] Open
Abstract
Rationale: Electronic cigarette (e-cig) use has been widely adopted under the perception of safety. However, possibly adverse effects of e-cig vapor in never-smokers are not well understood.Objectives: To test the effects of nicotine-containing e-cig vapors on airway mucociliary function in differentiated human bronchial epithelial cells isolated from never-smokers and in the airways of a novel, ovine large animal model.Methods: Mucociliary parameters were measured in human bronchial epithelial cells and in sheep. Systemic nicotine delivery to sheep was quantified using plasma cotinine levels, measured by ELISA.Measurements and Main Results:In vitro, exposure to e-cig vapor reduced airway surface liquid hydration and increased mucus viscosity of human bronchial epithelial cells in a nicotine-dependent manner. Acute nicotine exposure increased intracellular calcium levels, an effect primarily dependent on TRPA1 (transient receptor potential ankyrin 1). TRPA1 inhibition with A967079 restored nicotine-mediated impairment of mucociliary parameters including mucus transport in vitro. Sheep tracheal mucus velocity, an in vivo measure of mucociliary clearance, was also reduced by e-cig vapor. Nebulized e-cig liquid containing nicotine also reduced tracheal mucus velocity in a dose-dependent manner and elevated plasma cotinine levels. Importantly, nebulized A967079 reversed the effects of e-cig liquid on sheep tracheal mucus velocity.Conclusions: Our findings show that inhalation of e-cig vapor causes airway mucociliary dysfunction in vitro and in vivo. Furthermore, they suggest that the main nicotine effect on mucociliary function is mediated by TRPA1 and not nicotinic acetylcholine receptors.
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Affiliation(s)
- Samuel Chung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami School of Medicine, Miami, Florida; and
| | - Nathalie Baumlin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami School of Medicine, Miami, Florida; and
| | - John S. Dennis
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami School of Medicine, Miami, Florida; and
| | - Robert Moore
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami School of Medicine, Miami, Florida; and
| | - Sebastian F. Salathe
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami School of Medicine, Miami, Florida; and
| | - Phillip L. Whitney
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami School of Medicine, Miami, Florida; and
| | - Juan Sabater
- Department of Research, Mount Sinai Medical Center, Miami Beach, Florida
| | - William M. Abraham
- Department of Research, Mount Sinai Medical Center, Miami Beach, Florida
| | - Michael D. Kim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami School of Medicine, Miami, Florida; and
| | - Matthias Salathe
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami School of Medicine, Miami, Florida; and
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161
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Affiliation(s)
- Julia Kastner
- University of Maryland School of Medicine, Baltimore, MD
| | - Rydhwana Hossain
- University of Maryland School of Medicine, Cardiothoracic Imaging, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Center, Baltimore, MD
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162
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Nanco CR, Poklis JL, Hiler MM, Breland AB, Eissenberg T, Wolf CE. An Ultra-High-Pressure Liquid Chromatographic Tandem Mass Spectrometry Method for the Analysis of Benzoyl Ester Derivatized Glycols and Glycerol. J Anal Toxicol 2019; 43:720-725. [PMID: 31436292 PMCID: PMC6921292 DOI: 10.1093/jat/bkz071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/01/2019] [Accepted: 06/09/2019] [Indexed: 01/02/2023] Open
Abstract
Presented is an ultra-high-pressure liquid chromatographic tandem mass spectrometry (UPLC-MS/MS) method developed for the detection of propylene glycol, glycerol, ethylene glycol and diethylene glycol using isotopically labeled standards in urine as part of ongoing studies to evaluate whether urinary propylene glycol and/or vegetable glycerin concentration are indicators of recent use. Propylene glycol and vegetable glycerol are found in many products that are consumed and used including electronic cigarettes (e-cigarettes). E-cigarettes are battery-powered devices used as an alternative to traditional cigarettes. The liquid formulations aerosolized in these devices largely consist of propylene glycol and/or vegetable glycerol. Published reports regarding the ratio of propylene glycol to glycerol content in these formulations ranged from 50:50 to 100 percent of either. For the analysis of urine specimens from both users and non-users of e-cigarettes, calibrators, controls and specimens were derivatized using benzoyl chloride prior to analysis. They were analyzed using a Waters AcQuity Xevo TQ-S Micro UPLC-MS/MS. Chromatographic separation was performed on an AcQuity UPLC BEH C18 1.7 um, 2.1 × 50 mm, column using a 20 mM ammonium formate in water and 20 mM ammonium formate in methanol as the mobile phase. The method was validated using SWGTOX guidelines for linearity, precision and accuracy, stability, carryover and limit of detection. The linear range was determined using a seven-point calibration curve ranging between 0.5 and 100 mcg/mL. The bias for all validation controls was determined to be ±20% of the expected concentrations with CVs of <15%. A total of 124 urine specimens analyzed collected with 50 specimens collected from self-reported non-smokers (cigarettes/e-cigarettes) confirmed cotinine free using the DRI® Cotinine Assay (Thermo Scientific, Waltham, MA) and 74 specimens collected before and after 12 hours self-reported e-cigarettes abstinence e-cigarette users. Propylene glycol and glycerol were determined to have concentration ranges of "none detected" to 1470 and "none detected" to 2950 mcg/mL, respectively.
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Affiliation(s)
| | - Justin L Poklis
- Department of Pharmacology & Toxicology,Richmond, VA, 23298-0613
| | - Marzena M Hiler
- Department of Psychology, Virginia Commonwealth University, Richmond, VA VA 23298-0710
- Center for the Study of Tobacco Products, VA 23220
| | - Alison B Breland
- Department of Psychology, Virginia Commonwealth University, Richmond, VA VA 23298-0710
- Center for the Study of Tobacco Products, VA 23220
| | - Thomas Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA VA 23298-0710
- Center for the Study of Tobacco Products, VA 23220
| | - Carl E Wolf
- Virginia Commonwealth University
- Pathology at Virginia Commonwealth University, Richmond, VA 23298-0165, USA
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163
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Meernik C, Baker HM, Kowitt SD, Ranney LM, Goldstein AO. Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review. BMJ Open 2019; 9:e031598. [PMID: 31619431 PMCID: PMC6797351 DOI: 10.1136/bmjopen-2019-031598] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Given the exponential increase in the use of e-cigarettes among younger age groups and in the growth in research on e-cigarette flavours, we conducted a systematic review examining the impact of non-menthol flavoured e-cigarettes on e-cigarette perceptions and use among youth and adults. DESIGN PubMed, Embase, PyscINFO and CINAHL were systematically searched for studies published and indexed through March 2018. ELIGIBILITY CRITERIA Quantitative observational and experimental studies that assessed the effect of non-menthol flavours in e-cigarettes on perceptions and use behaviours were included. Specific outcome measures assessed are appeal, reasons for use, risk perceptions, susceptibility, intention to try, initiation, preference, current use, quit intentions and cessation. DATA EXTRACTION AND SYNTHESIS Three authors independently extracted data related to the impact of flavours in tobacco products. Data from a previous review were then combined with those from the updated review for final analysis. Results were then grouped and analysed by outcome measure. RESULTS The review included 51 articles for synthesis, including 17 published up to 2016 and an additional 34 published between 2016 and 2018. Results indicate that non-menthol flavours in e-cigarettes decrease harm perceptions (five studies) and increase willingness to try and initiation of e-cigarettes (six studies). Among adults, e-cigarette flavours increase product appeal (seven studies) and are a primary reason many adults use the product (five studies). The role of flavoured e-cigarettes on smoking cessation remains unclear (six studies). CONCLUSION This review provides summary data on the role of non-menthol flavours in e-cigarette perceptions and use. Consistent evidence shows that flavours attract both youth and adults to use e-cigarettes. Given the clear findings that such flavours increase product appeal, willingness to try and initiation among youth, banning non-menthol flavours in e-cigarettes may reduce youth e-cigarette use. Longitudinal research is needed to examine any role flavours may play in quit behaviours among adults.
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Affiliation(s)
- Clare Meernik
- Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hannah M Baker
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah D Kowitt
- Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Leah M Ranney
- Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Adam O Goldstein
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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164
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Mravec B, Tibensky M, Horvathova L, Babal P. E-Cigarettes and Cancer Risk. Cancer Prev Res (Phila) 2019; 13:137-144. [PMID: 31619443 DOI: 10.1158/1940-6207.capr-19-0346] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/28/2019] [Accepted: 10/08/2019] [Indexed: 11/16/2022]
Abstract
From the time of their introduction, the popularity of e-cigarettes (electronic nicotine-delivery systems) has been rising. This trend may reflect the general belief that e-cigarettes are a less hazardous alternative to combustible cigarettes. However, the potential cancer-related effects of increased activation of the sympathoadrenal system induced by the inhalation of nicotine, the primary component of the e-cigarettes, are completely overlooked. Therefore, the aim of this review is to describe mechanisms that may connect the use of e-cigarettes and an increased risk for cancer development, as well as their stimulatory effect on cancer progression. Available preclinical data indicate that activation of the sympathetic nervous system by nicotine inhaled from e-cigarettes may stimulate cancer development and growth by several mechanisms. This issue might be especially important for oncological patients as they may have the misconception that compared with combustible cigarettes, e-cigarettes represent a risk-free alternative.
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Affiliation(s)
- Boris Mravec
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, Slovakia. .,Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Miroslav Tibensky
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, Slovakia.,Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Lubica Horvathova
- Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Pavel Babal
- Institute of Pathology, Faculty of Medicine, Comenius University in Bratislava, Slovakia
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165
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Breland A, McCubbin A, Ashford K. Electronic nicotine delivery systems and pregnancy: Recent research on perceptions, cessation, and toxicant delivery. Birth Defects Res 2019; 111:1284-1293. [PMID: 31364280 PMCID: PMC7121906 DOI: 10.1002/bdr2.1561] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/15/2019] [Accepted: 07/16/2019] [Indexed: 01/09/2023]
Abstract
Electronic nicotine delivery systems (ENDS), which includes e-cigarettes (ECIGs), are a rapidly-expanding class of products that heat a liquid (which may or may not contain nicotine) to produce an aerosol. The variation of ECIG components is extensive as are their effects on users. Epidemiological data show that while both adults and youth use ECIGs, use among youth has increased dramatically in recent years. Other epidemiological data show that women of reproductive age and some pregnant women are also using ECIGs. The goal of this article is to provide readers with background information about ECIGs, with a focus on recent findings about ECIG use in pregnancy and potential implications. Among pregnant women, correlates of ECIG use include current cigarette smoking, among other factors. Regarding pregnant women's perceptions of ECIG use in pregnancy, two themes emerge from the literature: many pregnant women perceive ECIGs to be safer than conventional cigarettes, and that ECIGs can aid with smoking cessation. In contrast to these perceptions, there is little concrete evidence that ECIGs help smokers quit. In addition, there are concerns about ECIG nicotine and other toxicant delivery. Nicotine is a toxicant of particular concern for pregnant women, as nicotine is known to harm a developing fetus. There are many limitations to existing research, and the literature is scant in this area. Further, new "pod mod"-style ECIGs such as JUUL present new challenges. Overall, with limited evidence of their effectiveness, and concerns about developmental toxicology, the authors do not recommend that pregnant women use ECIGs.
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Affiliation(s)
- Alison Breland
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Andrea McCubbin
- Perinatal Research and Wellness Center, College of Nursing, University of Kentucky, Lexington, Kentucky
| | - Kristin Ashford
- Perinatal Research and Wellness Center, College of Nursing, University of Kentucky, Lexington, Kentucky
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166
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Modeling drug exposure in rodents using e-cigarettes and other electronic nicotine delivery systems. J Neurosci Methods 2019; 330:108458. [PMID: 31614162 DOI: 10.1016/j.jneumeth.2019.108458] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 10/05/2019] [Accepted: 10/06/2019] [Indexed: 12/25/2022]
Abstract
Smoking tobacco products is the leading cause of preventable death worldwide. Coordinated efforts have successfully reduced tobacco cigarette smoking in the United States; however, electronic cigarettes (e-cigarette) and other electronic nicotine delivery systems (ENDS) recently have replaced traditional cigarettes for many users. While the clinical risks associated with long-term ENDS use remain unclear, advancements in preclinical rodent models will enhance our understanding of their overall health effects. This review examines the peripheral and central effects of ENDS-mediated exposure to nicotine and other drugs of abuse in rodents and evaluates current techniques for implementing ENDS in preclinical research.
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167
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Maloney SF, Breland A, Soule EK, Hiler M, Ramôa C, Lipato T, Eissenberg T. Abuse liability assessment of an electronic cigarette in combustible cigarette smokers. Exp Clin Psychopharmacol 2019; 27:443-454. [PMID: 30777773 PMCID: PMC6754311 DOI: 10.1037/pha0000261] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Under certain conditions, electronic cigarettes (e-cigs) can deliver nicotine to and suppress tobacco abstinence symptoms in cigarette smokers. Growing popularity of e-cigs raises abuse liability concerns. This study's purpose was to compare the abuse liability of an e-cig (1.5 Ohm, 3.3 V) filled with 36 mg/mL or 0 mg/mL nicotine to an Food and Drug Administration (FDA)-approved nicotine inhaler (IN) and participants' own brand (OB) of cigarettes. Smokers (N = 24) completed four sessions in which they completed the multiple-choice procedure, and plasma nicotine concentration and subjective effects were measured. Mean (SD) multiple-choice procedure crossover point was $0.87 (1.0) for the 36-mg/mL nicotine e-cig and $0.96 (1.2) for the 0-mg/mL e-cig, significantly higher than the IN mean of $0.32 (0.6) but significantly lower than the OB cigarette mean of $1.42 (1.4). Ten puffs from an own-brand cigarette increased mean plasma nicotine concentration from 3.55 (2.8) to 13.64 (9.8) ng/mL, as compared to an increase from 3.16 (1.8) to 8.51 (5.4) ng/mL for the 36-mg/mL e-cig. The 36-mg/mL e-cig reduced nicotine abstinence symptoms more than the 0-mg/mL e-cig, and both e-cigs were rated as more reinforcing than the inhaler but less reinforcing than participants' OB cigarettes (ps < .05). Results suggest that the e-cig examined had higher abuse liability than the IN but lower than combustible cigarettes. These data and methods may be useful for policymakers by revealing how e-cig abuse liability compares to tobacco/nicotine products with abuse liability profiles that are well established. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Sarah F Maloney
- Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University
| | - Alison Breland
- Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University
| | - Eric K Soule
- Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University
| | - Marzena Hiler
- Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University
| | - Carolina Ramôa
- Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University
| | - Thokozeni Lipato
- Department of Internal Medicine, Division of General Internal Medicine, Virginia Commonwealth University
| | - Thomas Eissenberg
- Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University
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168
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Cobb CO, Lopez AA, Soule EK, Yen MS, Rumsey H, Lester-Schotles R, Rudy AK, Lipato T, Guy M, Eissenberg T. Influence of electronic cigarette liquid flavors and nicotine concentration on subjective measures of abuse liability in young adult cigarette smokers. Drug Alcohol Depend 2019; 203:27-34. [PMID: 31401532 PMCID: PMC9307062 DOI: 10.1016/j.drugalcdep.2019.05.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/17/2019] [Accepted: 05/21/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND A rapidly evolving tobacco marketplace highlights the timeliness of the FDA's authority to regulate tobacco, specifically the role that flavorings in nicotine-containing electronic cigarette (ECIG) liquids have on public health. This study aimed to evaluate the extent to which ECIG liquid flavor and nicotine concentration influenced subjective measures of abuse liability among young adult cigarette (cig) smokers. METHODS Young adult (18-21 y.o.) smokers (M = 10.1 cig/day, no regular ECIG use history) completed 7 Latin-square ordered conditions each preceded by 12 h. nicotine/tobacco abstinence. Conditions were own brand cig (OB) and eGo-style ECIG paired with three liquid flavors (cream, tropical fruit, tobacco/menthol) varying in nicotine concentration (0 or 36 mg/ml). Products were administered in two 10-puff bouts in each condition. Heart rate/blood pressure (HR/BP) and tobacco/nicotine abstinence symptoms, nicotine/general drug effects, and acceptability measures were assessed repeatedly throughout sessions. Mixed linear models were followed-up with Tukey's HSD t-tests. RESULTS HR/BP indicated nicotine exposure during nicotine-containing conditions. OB and tobacco/menthol 36 mg/ml conditions produced significant decreases in ratings of cig smoking urges. Nicotine/drug effects were elevated significantly for OB and 36 mg/ml ECIG conditions with one exception noted for the tobacco/menthol 0 mg/ml condition. OB had the highest acceptability ratings, and ECIG condition results varied by acceptability item. CONCLUSIONS Among young adult smokers, ECIG conditions containing nicotine were positively associated with several subjective measures of abuse liability but not all. Flavors did not consistently mask/enhance effects observed. Results reinforce continued examination of ECIG-delivered nicotine and liquid flavors in relationship to abuse liability.
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Affiliation(s)
- Caroline O. Cobb
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA,Correspondence: Caroline O. Cobb, Virginia Commonwealth University, 808 W Franklin, Room 304, P.O. Box 842018, Richmond, VA 23284-2018 Phone: 804-828-8687
| | - Alexa A. Lopez
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Eric K. Soule
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Miao-Shan Yen
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA
| | - Hannah Rumsey
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Rebecca Lester-Schotles
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Alyssa K. Rudy
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Thokozeni Lipato
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Mignonne Guy
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of African American Studies, Virginia Commonwealth University, Richmond, VA, USA
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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169
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Berman ML, Bickel WK, Harris AC, LeSage MG, O'Connor RJ, Stepanov I, Shields PG, Hatsukami DK. Consortium on Methods Evaluating Tobacco: Research Tools to Inform US Food and Drug Administration Regulation of Snus. Nicotine Tob Res 2019; 20:1292-1300. [PMID: 29059363 DOI: 10.1093/ntr/ntx228] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 09/28/2017] [Indexed: 11/13/2022]
Abstract
Introduction The US Food and Drug Administration (FDA) has purview over tobacco products. To set policy, the FDA must rely on sound science, yet most existing tobacco research methods have not been designed to specifically inform regulation. The NCI and FDA-funded Consortium on Methods Evaluating Tobacco (COMET) was established to develop and assess valid and reliable methods for tobacco product evaluation. The goal of this article is to describe these assessment methods using a US manufactured "snus" as the test product. Methods In designing studies that could inform FDA regulation, COMET has taken a multidisciplinary approach that includes experimental animal models and a range of human studies that examine tobacco product appeal, addictiveness, and toxicity. This article integrates COMET's findings over the last 4 years. Results Consistency in results was observed across the various studies, lending validity to our methods. Studies showed low abuse liability for snus and low levels of consumer demand. Toxicity was less than cigarettes on some biomarkers but higher than medicinal nicotine. Conclusions Using our study methods and the convergence of results, the snus that we tested as a potential modified risk tobacco product is likely to neither result in substantial public health harm nor benefit. Implications This review describes methods that were used to assess the appeal, abuse liability, and toxicity of snus. These methods included animal, behavioral economics, consumer perception studies, and clinical trials. Across these varied methods, study results showed low abuse-liability and appeal of the snus product we tested. In several studies, demand for snus was lower than for less toxic nicotine gum. The consistency and convergence of results across a range of multi-disciplinary studies lends validity to our methods and suggests that promotion of snus as a modified risk tobacco products is unlikely to produce substantial public health benefit or harm.
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Affiliation(s)
- Micah L Berman
- College of Public Health, Ohio State University, Columbus, OH.,Moritz College of Law, Ohio State University, Columbus, OH
| | | | - Andrew C Harris
- Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Medicine, University of Minnesota, Minneapolis, MN.,Department of Psychology, University of Minnesota, Minneapolis, MN
| | - Mark G LeSage
- Minneapolis Medical Research Foundation, Minneapolis, MN.,Department of Medicine, University of Minnesota, Minneapolis, MN.,Department of Psychology, University of Minnesota, Minneapolis, MN
| | | | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Peter G Shields
- Comprehensive Cancer Center, Ohio State University, Columbus, OH
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170
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Voos N, Goniewicz ML, Eissenberg T. What is the nicotine delivery profile of electronic cigarettes? Expert Opin Drug Deliv 2019; 16:1193-1203. [PMID: 31495244 DOI: 10.1080/17425247.2019.1665647] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Introduction: Electronic cigarettes (e-cigarettes) are a rapidly evolving class of tobacco products intended to deliver nicotine to users. There are many types of e-cigarettes available and the most popular type today in the United States are 'pod' based devices that use high nicotine concentration liquids. Understanding the nicotine delivery capabilities of e-cigarettes is imperative for understanding their addictive potential and safety profile, informing regulation, and revealing their potential use as smoking cessation aids. Areas covered: This review discusses nicotine content of e-cigarettes, effectiveness of nicotine aerosolization by devices, delivery of nicotine to users, and user and device characteristics that impact each of these. Expert opinion: Modern e-cigarettes have the potential to deliver equal or more nicotine compared to a tobacco cigarette. Future research needs to identify the nicotine delivery profiles likely to benefit public health and the means to regulate them appropriately while also identifying those that are likely to cause harm. Public health benefit accrues if e-cigarettes help smokers quit combustible cigarettes completely. Harm is possible if inadequate nicotine delivery undermines cessation attempts, e-cigarettes facilitate continued combustible cigarette use, long-term e-cigarette use is associated with substantial morbidity/mortality, and/or e-cigarettes increase the initiation of combustible cigarette use among never smokers.
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Affiliation(s)
- Natalie Voos
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center , Buffalo , NY , USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center , Buffalo , NY , USA
| | - Thomas Eissenberg
- Department of Psychology, Virginia Commonwealth University , Richmond , VA , USA.,Center for the Study of Tobacco Products, Virginia Commonwealth University , Richmond , VA , USA
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171
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Design Features in Multiple Generations of Electronic Cigarette Atomizers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162904. [PMID: 31416115 PMCID: PMC6720609 DOI: 10.3390/ijerph16162904] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/05/2019] [Accepted: 08/09/2019] [Indexed: 12/25/2022]
Abstract
The design of electronic cigarette (EC) atomizing units has evolved since their introduction over 10 years ago. The purpose of this study was to evaluate atomizer design in ECs sold between 2011–2017. Atomizers from 34 brands representing three generations of ECs were dissected and photographed using a stereoscopic microscope. Five distinct atomizer design categories were identified in first generation products (cig-a-like/cartomizer) and three categories were found in the third generation. Atomizers in most cig-a-like ECs contained a filament, thick wire, wire joints, air-tube, wick, sheath, and fibers, while some later models lacked some of these components. Over time design changes included an increase in atomizer size; removal of solder joints between wires; removal of Polyfil fibers; and removal of the microprocessor from Vuse. In second and third generation ECs, the reservoirs and batteries were larger, and the atomizing units generally lacked a thick wire, fibers, and sheath. These data contribute to an understanding of atomizer design and show that there is no single design for ECs, which are continually evolving. The design of the atomizer is particularly important as it affects the performance of ECs and what transfers into the aerosol.
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172
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El-Hellani A, Salman R, El-Hage R, Talih S, Malek N, Baalbaki R, Karaoghlanian N, Nakkash R, Shihadeh A, Saliba NA. Nicotine and Carbonyl Emissions From Popular Electronic Cigarette Products: Correlation to Liquid Composition and Design Characteristics. Nicotine Tob Res 2019; 20:215-223. [PMID: 27798087 DOI: 10.1093/ntr/ntw280] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 10/05/2016] [Indexed: 01/01/2023]
Abstract
Introduction Available in hundreds of device designs and thousands of flavors, electronic cigarette (ECIG) may have differing toxicant emission characteristics. This study assesses nicotine and carbonyl yields in the most popular brands in the U.S. market. These products included disposable, prefilled cartridge, and tank-based ECIGs. Methods Twenty-seven ECIG products of 10 brands were procured and their power outputs were measured. The e-liquids were characterized for pH, nicotine concentration, propylene glycol/vegetable glycerin (PG/VG) ratio, and water content. Aerosols were generated using a puffing machine and nicotine and carbonyls were, respectively, quantified using gas chromatograph and high-performance liquid chromatography. A multiregression model was used to interpret the data. Results Nicotine yields varied from 0.27 to 2.91 mg/15 puffs, a range corresponding to the nicotine yield of less than 1 to more than 3 combustible cigarettes. Nicotine yield was highly correlated with ECIG type and brand, liquid nicotine concentration, and PG/VG ratio, and to a lower significance with electrical power, but not with pH and water content. Carbonyls, including the carcinogen formaldehyde, were detected in all ECIG aerosols, with total carbonyl concentrations ranging from 3.72 to 48.85 µg/15 puffs. Unlike nicotine, carbonyl concentrations were mainly correlated with power. Conclusion In 15 puffs, some ECIG devices emit nicotine quantities that exceed those of tobacco cigarettes. Nicotine emissions vary widely across products but carbonyl emissions showed little variations. In spite of that ECIG users are exposed to toxicologically significant levels of carbonyl compounds, especially formaldehyde. Regression analysis showed the importance of design and e-liquid characteristics as determinants of nicotine and carbonyl emissions. Implications Periodic surveying of characteristics of ECIG products available in the marketplace is valuable for understanding population-wide changes in ECIG use patterns over time.
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Affiliation(s)
- Ahmad El-Hellani
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | - Rola Salman
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA.,Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Rachel El-Hage
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | - Soha Talih
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA.,Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Nathalie Malek
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA.,Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
| | - Rima Baalbaki
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | - Nareg Karaoghlanian
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA.,Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Rima Nakkash
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA.,Department of Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
| | - Alan Shihadeh
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA.,Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Najat A Saliba
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon.,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
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Yingst JM, Foulds J, Veldheer S, Hrabovsky S, Trushin N, Eissenberg TT, Williams J, Richie JP, Nichols TT, Wilson SJ, Hobkirk AL. Nicotine absorption during electronic cigarette use among regular users. PLoS One 2019; 14:e0220300. [PMID: 31344110 PMCID: PMC6657878 DOI: 10.1371/journal.pone.0220300] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/01/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The capability of electronic cigarette devices (e-cigs) to deliver nicotine is key to their potential to replace combustible cigarettes. We compared nicotine delivery and subjective effects associated with the use of two classes of e-cigarettes and cigarettes. METHODS 14 e-cigarette users were instructed to vape their own e-cigarette device every 20 seconds for 10 minutes while blood was drawn at 1, 2, 4, 6, 8, 10,12, and 15 minutes after initiating vaping. Users rated withdrawal symptoms and side effects before and after vaping. E-cigarette devices were classified as first-generation (same size as cigarette, no activation button) or advanced (larger than cigarette with an activation button). Separately, 10 cigarette smokers completed a similar protocol. Fisher's Exact Test and two-sided t-tests were used as appropriate to determine differences in outcomes between first-generation e-cigarette users, advanced e-cigarette users, and smokers. RESULTS Compared to first-generation devices, advanced devices were associated with greater serum nicotine Cmax (ng/ml) (11.5 v. 2.8, p = 0.0231) and greater nicotine boost (ng/ml) (10.8 v. 1.8, p = 0.0177). Overall, e-cigarettes users experienced a significant reduction in withdrawal and craving, although there were no significant differences between users of first-generation and advanced devices. Comparing e-cigarettes overall to cigarettes, cigarettes were associated with greater Cmax (25.9 v. 9.0, p = 0.0043) and greater nicotine boost (21.0 v. 8.2, p = 0.0128). CONCLUSIONS Advanced e-cigarettes delivered significantly more nicotine than first-generation devices but less than combustible cigarettes. Overall, e-cigarette use was associated with a reduction in withdrawal and craving with no reported side effects. The wide variation in nicotine absorption from different e-cigarette devices should be considered in studies of e-cigarettes for smoking cessation.
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Affiliation(s)
- Jessica M. Yingst
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Jonathan Foulds
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Susan Veldheer
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Shari Hrabovsky
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Neil Trushin
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Thomas T. Eissenberg
- Department of Psychology, Center for the Study on Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Jill Williams
- Division of Addiction Psychiatry, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United States of America
| | - John P. Richie
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
| | - Travis T. Nichols
- Department of Psychology, Pennsylvania State University, University Park, PA, United States of America
| | - Stephen J. Wilson
- Department of Psychology, Pennsylvania State University, University Park, PA, United States of America
| | - Andrea L. Hobkirk
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, Pennsylvania State University, College of Medicine, Hershey, PA, United States of America
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174
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Mulder HA, Patterson JL, Halquist MS, Kosmider L, Turner JBM, Poklis JL, Poklis A, Peace MR. The Effect of Electronic Cigarette User Modifications and E-liquid Adulteration on the Particle Size Profile of an Aerosolized Product. Sci Rep 2019; 9:10221. [PMID: 31308389 PMCID: PMC6629610 DOI: 10.1038/s41598-019-46387-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 06/06/2019] [Indexed: 12/28/2022] Open
Abstract
Electronic cigarettes (e-cigarettes) are an alternate nicotine delivery system that generate a condensation aerosol to be inhaled by the user. The size of the droplets formed in the aerosol can vary and contributes to drug deposition and ultimate bioavailability in the lung. The growing popularity of e-cigarette products has caused an increase in internet sources promoting the use of drugs other than nicotine (DOTNs) in e-cigarettes. The purpose of this study was to determine the effect of various e-cigarette and e-liquid modifications, such as coil resistance, battery voltage, and glycol and drug formulation, on the aerosol particle size. E-liquids containing 12 mg/mL nicotine prepared in glycol compositions of 100% propylene glycol (PG), 100% vegetable glycerin (VG), or 50:50 PG:VG were aerosolized at three voltages and three coil resistances. Methamphetamine and methadone e-liquids were prepared at 60 mg/mL in 50:50 PG:VG and all e-liquids were aerosolized onto a 10 stage Micro-Orifice Uniform Deposit Impactor. Glycol deposition correlated with drug deposition, and the majority of particles centered between 0.172–0.5 μm in diameter, representing pulmonary deposition. The 100% PG e-liquid produced the largest aerosol particles and the 100% VG and 50:50 PG:VG e-liquids produced ultra-fine particles <0.3 μm. The presence of ultrafine particles indicates that drugs can be aerosolized and reach the pulmonary alveolar regions, highlighting a potential for abuse and risk of overdose with DOTNs aerosolized in an e-cigarette system.
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Affiliation(s)
- Haley A Mulder
- Department of Forensic Science, Virginia Commonwealth University, Richmond, USA
| | - Jesse L Patterson
- Department of Forensic Science, Virginia Commonwealth University, Richmond, USA
| | - Matthew S Halquist
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, USA
| | - Leon Kosmider
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, USA
| | | | - Justin L Poklis
- Department of Pharmacology & Toxicology, Virginia Commonwealth University, Richmond, USA
| | - Alphonse Poklis
- Department of Forensic Science, Virginia Commonwealth University, Richmond, USA.,Department of Pharmacology & Toxicology, Virginia Commonwealth University, Richmond, USA.,Department of Pathology, Virginia Commonwealth University, Richmond, USA
| | - Michelle R Peace
- Department of Forensic Science, Virginia Commonwealth University, Richmond, USA.
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175
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Coleman B, Chang JT, Rostron BL, Johnson SE, Das B, Del Valle-Pinero AY. An Examination of Device Types and Features Used by Adult Electronic Nicotine Delivery System (ENDS) Users in the PATH Study, 2015-2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132329. [PMID: 31269633 PMCID: PMC6651074 DOI: 10.3390/ijerph16132329] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 06/27/2019] [Accepted: 06/29/2019] [Indexed: 11/16/2022]
Abstract
To date no study has reported U.S. nationally representative estimates of current ENDS users by device category (“open” vs. “closed” systems) nor their detailed use behaviors. We examined the proportion of current adult ENDS users (unweighted n = 2671) using either “closed” or “open” systems during Wave 3 (2015–2016) of the Population Assessment of Tobacco and Health (PATH) Study. Demographic characteristics, use patterns, and device characteristics were examined overall and by device type. Among the 5.0% of current users at Wave 3, 43.9% used closed systems and 53.7% used open systems. Compared to closed system users, open system users were more likely to be male (60.7% vs. 48.4%), aged 18–24 (30.4% vs. 21.4%), and non-Hispanic White (76.2% vs. 65.4%), recent former (9.9% vs. 5.6%) or long-term former (20.2% vs. 10.9%) smokers, and use ENDS daily (44.1% vs. 22.5%); they were less likely to be to be current daily smokers (31.7% vs. 48.0%) or never smokers (15.2% vs. 19.5%). Adult ENDS users were nearly evenly split on their use of closed versus open systems; however, several group differences were observed. Disentangling the relationship between device selection and subsequent use patterns remains a public health priority.
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Affiliation(s)
- Blair Coleman
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, MD 20705, USA.
| | - Joanne T Chang
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, MD 20705, USA
| | - Brian L Rostron
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, MD 20705, USA
| | - Sarah E Johnson
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, MD 20705, USA
| | - Babita Das
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, MD 20705, USA
| | - Arseima Y Del Valle-Pinero
- Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Beltsville, MD 20705, USA
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176
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Determined and declared nicotine content in refill liquids for electronic cigarettes marketed in North Macedonia. Arh Hig Rada Toksikol 2019; 70:130-133. [DOI: 10.2478/aiht-2019-70-3191] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 03/01/2019] [Indexed: 11/21/2022] Open
Abstract
Abstract
The use of electronic cigarettes or vaping has been gaining momentum among Macedonian smokers but has also raised great many concerns about the toxicity of liquid refills and its aerosols, especially as the nicotine levels in refill liquids (e-liquids) are not required to be declared accurately or at all by current regulations. The aim of this study was therefore to determine nicotine levels in fifteen samples of e-liquids purchased in specialised shops in Macedonia using gas chromatography. Nicotine concentrations deviated from manufacturer’s declarations in nine of the twelve samples: in five they were higher and in four lower than declared, ranging from −16.7 % to +30.0 %. These significant discrepancies between the actual and declared nicotine concentrations in the analysed e-liquids call for closer attention of the healthcare and the regulating authorities.
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177
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Dai H, Leventhal AM. Association of electronic cigarette vaping and subsequent smoking relapse among former smokers. Drug Alcohol Depend 2019; 199:10-17. [PMID: 30978519 PMCID: PMC6743978 DOI: 10.1016/j.drugalcdep.2019.01.043] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 01/11/2019] [Accepted: 01/15/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Former combustible cigarette smokers who vape e-cigarettes after quitting smoking may experience health benefits if post-quit vaping prevents smoking relapse. METHODS Former combustible cigarette smokers aged >18 that were recent (quit ≤ 12 months) or long-term (quit > 12 months) quitters at baseline were re-surveyed at 1-year follow-up in the Population Assessment of Tobacco and Health (PATH) U.S. nationally-representative longitudinal study. Associations of baseline e-cigarette vaping status (never use, prior use, current occasional use, and current regular use) and smoking relapse (vs. abstinence) at follow-up were estimated. RESULTS Among recent quitters (N = 884), the prevalence of follow-up smoking relapse was 31.6%, 39.0%, 51.6%, and 31.9% among never (N = 233), prior (N = 399), current occasional (N = 56), and current regular (N = 196) baseline e-cigarette users, respectively. Baseline e-cigarette use was not associated with smoking relapse at follow-up after covariate adjustment. In long-term quitters (n = 3210), follow-up smoking relapse was 1.8%, 10.4%, 9.6%, and 15.0% among never (N = 2479), prior (N = 588), current occasional (N = 45), and current regular (N = 98) baseline e-cigarette users, respectively. Both prior use (AOR = 2.00, CI [1.25-3.20]) and current regular use of e-cigarettes (AOR = 3.77, CI [1.48-9.65]) had higher odds of subsequent smoking relapse as compared to never e-cigarette users after covariate adjustment. Among relapsers, baseline e-cigarette vaping was not associated with smoking frequency or intensity at follow-up. CONCLUSIONS Vaping more than one year after quitting smoking was associated with smoking relapse at 12-month follow-up in a nationally-representative sample. Further studies are needed to evaluate whether this association is causal.
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Affiliation(s)
- Hongying Dai
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, 984375 Nebraska Medical Center, Omaha, NE, 68198-4375, United States.
| | - Adam M. Leventhal
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles, United States,Department of Psychology, University of Southern California, Los Angeles, United States,USC Norris Comprehensive Cancer Center, Los Angeles, United States,Corresponding author at: Health, Emotion, and Addiction Laboratory, University of Southern California, 2250 Alcazar St., CSC 271, Los Angeles, CA, 90033, United States. (A.M. Leventhal)
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178
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Influence of Electronic Cigarette Characteristics on Susceptibility, Perceptions, and Abuse Liability Indices among Combustible Tobacco Cigarette Smokers and Non-Smokers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101825. [PMID: 31126016 PMCID: PMC6572235 DOI: 10.3390/ijerph16101825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 11/26/2022]
Abstract
This study assessed how electronic cigarette (ECIG) characteristics amenable to regulation—namely nicotine content, flavor, and modified risk messages—impact ECIG use susceptibility, harm/addiction perceptions, and abuse liability indices among combustible tobacco cigarette (CTC) smokers and non-smokers. CTC smokers and non-smokers varying in ECIG use recruited via Amazon Mechanical Turk (MTurk) completed an online survey in 2016 (analytic n = 706). Participants were randomly assigned to one of eight conditions differing in ECIG characteristics: nicotine content (no, low, high), flavor (menthol, tobacco, fruit), or modified risk message (reduced harm, reduced carcinogen exposure). Regressions assessed ECIG susceptibility, harm/addiction perceptions, and abuse liability indices (purchase task measures of breakpoint/intensity) within each regulatory domain (nicotine content, flavor, message) and their interactions with CTC/ECIG status. Differential effects on ECIG susceptibility, harm/addiction perceptions, and abuse liability indices were observed by regulatory domain with many effects moderated by CTC/ECIG status. ECIG nicotine content and flavor conditions were the most influential across outcomes. Greater nicotine content, tobacco-flavored and reduced carcinogen exposure ECIGs were more highly preferred by CTC smokers with some differing preferences for non-users. Findings reinforce consideration of discrete ECIG preferences across tobacco use status to improve regulatory efficacy.
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179
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Czoli CD, Goniewicz ML, Palumbo M, Leigh N, White CM, Hammond D. Identification of flavouring chemicals and potential toxicants in e-cigarette products in Ontario, Canada. Canadian Journal of Public Health 2019; 110:542-550. [PMID: 31025300 DOI: 10.17269/s41997-019-00208-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 03/25/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The current study examined constituents of e-cigarette products on the Canadian market, with a focus on the province of Ontario. METHODS E-cigarettes were systematically purchased at 80 retail outlets across 4 cities in Ontario, Canada, in January-February 2015. Product constituents were identified using gas chromatography and mass spectrometry. Additionally, tobacco-specific nitrosamines (TSNAs) were quantified in tested products using liquid chromatography with tandem mass spectrometry. RESULTS A total of 166 e-cigarette products were purchased, including disposable products (33%), refillable products (14%), and e-liquids (53%). Overall, e-cigarette products had an average of 6.2 (SD = 3.6) flavouring chemicals. E-cigarettes with sweet flavours (e.g., desserts, alcoholic drinks) had a significantly greater number of flavouring chemicals when compared with tobacco- and menthol-flavoured products (p < 0.05). Approximately one fifth (21%) of products contained flavouring chemicals with potential risk of inhalation toxicity (benzyl alcohol, benzaldehyde, vanillin). An additional 8 toxicants (e.g., acrolein, diacetyl) were detected in a total of 14 e-cigarette products. Measurable levels of TSNAs were detected in 70% of tested products. CONCLUSION E-cigarettes purchased in Ontario, Canada, contained several constituents that may present excess risk, including some flavouring chemicals and carcinogenic nitrosamines. Further research is needed to determine whether the levels of these constituents have implications for the magnitude of risk to users. The findings reveal several policy gaps that may be addressed by developing regulatory product standards and labelling practices for e-cigarettes.
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Affiliation(s)
- Christine D Czoli
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - Maciej L Goniewicz
- Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA
| | - Mary Palumbo
- Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA
| | - Noel Leigh
- Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14263, USA
| | - Christine M White
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
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180
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Breland A, Balster RL, Cobb C, Fagan P, Foulds J, Koch JR, Lipato T, Saliba N, Shihadeh A, Sun S, Eissenberg T. Answering questions about electronic cigarettes using a multidisciplinary model. ACTA ACUST UNITED AC 2019; 74:368-379. [PMID: 30945898 DOI: 10.1037/amp0000426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Electronic cigarettes (ECIGs) are a relatively new class of tobacco products and a subject of much debate for scientists and policymakers worldwide. Objective data that address the ECIG risk-benefit ratio for individual and public health are needed, and addressing this need requires a multidisciplinary approach that spans several areas of psychology as well as chemistry, toxicant inhalation, and physiology. This multidisciplinary approach would benefit from methods that are reliable, valid, and swift. For this reason, we formed a multidisciplinary team to develop methods that could answer questions about ECIGs and other potential modified risk tobacco products. Our team includes scientists with expertise in psychology (clinical, community, and experimental) and other disciplines, including aerosol research, analytical chemistry, biostatistics, engineering, internal medicine, and public health. The psychologists on our team keep other members focused on factors that influence individual behavior, and other team members keep the psychologists aware of other issues, such as product design. Critically, all team members are willing to extend their interests beyond the boundaries of their discipline to collaborate effectively with the shared goal of producing the rigorous science needed to inform empirically based tobacco policy. In addition, our trainees gain valuable knowledge from these collaborations and learn that other disciplines are accessible, exciting, and can enhance their own research. Multidisciplinary work presents challenges: learning other scientists' languages and staying focused on our core mission. Overall, our multidisciplinary team has led to several major findings that inform the scientific, regulatory, and public health communities about ECIGs and their effects. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Shumei Sun
- Center for the Study of Tobacco Products
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181
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Yingst J, Foulds J, Veldheer S, Du P. Device characteristics of long term electronic cigarette users: A follow-up study. Addict Behav 2019; 91:238-243. [PMID: 30270024 PMCID: PMC11067426 DOI: 10.1016/j.addbeh.2018.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 07/25/2018] [Accepted: 08/01/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Electronic cigarette (e-cig) device characteristics affect use but few studies have evaluated the types of devices commonly used or how users transition between devices. This study examines e-cig device usage patterns and explores the relationship between device transitions and continued use. METHODS E-cig users completed an online survey from 2012 to 2015 about their e-cig use, preferred device, and preferences and were followed-up via an emailed survey in January 2017. Continuing users were those reporting any e-cig use in the past 30 days at both time points while stoppers reported no use at follow-up. Means, frequencies, and Chi-square tests were used as appropriate to describe the sample, the transition between devices, and differences between groups. RESULTS The sample was 83.6% (n = 511) continuers and 16.3% (n = 100) stoppers. At follow-up, most continuers had transitioned to using more advanced devices like mods (62.6%) with variable voltage (67.7%) and/or wattage (76.8%) and with a tank system (78.6%). Nicotine concentration decreased by half from baseline to follow-up (p < .01). Baseline cigalike users were the most likely to report stopping e-cig use (p < .01) and the most likely to return to other tobacco use (p = .02). CONCLUSION The majority of e-cig users continued exclusive e-cig use over 3+ years and were likely to transition to devices with more advanced characteristics like variable voltage and to reduce the nicotine concentration of their liquid. Baseline cigalike users were the most likely to stop e-cig use at follow-up.
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Affiliation(s)
- Jessica Yingst
- Penn State University College of Medicine, Department of Public Health Sciences, Tobacco Center of Regulatory Science, Hershey, PA 17033, United States.
| | - Jonathan Foulds
- Penn State University College of Medicine, Department of Public Health Sciences, Tobacco Center of Regulatory Science, Hershey, PA 17033, United States
| | - Susan Veldheer
- Penn State University College of Medicine, Department of Public Health Sciences, Tobacco Center of Regulatory Science, Hershey, PA 17033, United States
| | - Ping Du
- Penn State University College of Medicine, Department of Public Health Sciences, Tobacco Center of Regulatory Science, Hershey, PA 17033, United States; Penn State University College of Medicine, Department of Medicine, Hershey, PA 17033, United States
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182
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Wiernik E, Airagnes G, Lequy E, Gomajee R, Melchior M, Le Faou AL, Limosin F, Goldberg M, Zins M, Lemogne C. Electronic cigarette use is associated with depressive symptoms among smokers and former smokers: Cross-sectional and longitudinal findings from the Constances cohort. Addict Behav 2019; 90:85-91. [PMID: 30368023 DOI: 10.1016/j.addbeh.2018.10.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/21/2018] [Accepted: 10/15/2018] [Indexed: 12/21/2022]
Abstract
AIMS To examine the cross-sectional and longitudinal associations between depressive symptoms and electronic cigarette (e-cig) use in a large population-based sample while taking into account smoking status and sociodemographic confounders. METHODS Participants from the French Constances cohort were included from February 2012 to December 2016. Smoking status, e-cig use (never/ever/current) and nicotine concentration were self-reported. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression (CES-D) scale. Logistic regressions were used to provide odds ratios (ORs) and 95% confidence intervals (95%CI) of e-cig use according to depressive symptoms, adjusting for age, sex and education. RESULTS In cross-sectional analyses (n = 35,337), depressive symptoms (i.e. a CES-D score ≥ 19) were associated with both ever (OR [95%CI]: 1.67 [1.53-1.82]) and current (1.73 [1.53-1.96]) e-cig use with a dose-dependent relationship (p-trend<0.001). In longitudinal analyses (n = 30,818), depressive symptoms at baseline were associated with current e-cig use at follow-up (2.02 [1.72-2.37]) with a similar dose-dependent relationship. These associations were mainly significant among smokers or former smokers at baseline. Furthermore, among smokers at baseline, depressive symptoms were associated with dual consumption at follow-up (1.58 [1.41-1.77]), whereas among former smokers, they were associated with either smoking only (1.52 [1.34-1.73]) or e-cig use only (2.02 [1.64-2.49]), but not with dual consumption (1.11 [0.73-1.68]) at follow-up. Finally, depressive symptoms were positively associated with nicotine concentration among e-cig users at baseline. CONCLUSIONS Depressive symptoms were positively associated with e-cig use in both cross-sectional and longitudinal analyses with a dose-dependent relationship. In addition, nicotine concentration and depressive symptoms were positively associated.
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183
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Haddad C, Salman R, El-Hellani A, Talih S, Shihadeh A, Saliba NA. Reactive Oxygen Species Emissions from Supra- and Sub-Ohm Electronic Cigarettes. J Anal Toxicol 2019; 43:45-50. [PMID: 30192935 PMCID: PMC6376456 DOI: 10.1093/jat/bky065] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 06/25/2018] [Indexed: 12/24/2022] Open
Abstract
Electronic cigarettes (ECIGs) are battery-powered devices that heat and vaporize solutions containing propylene glycol (PG) and/or vegetable glycerin (VG), nicotine and possible trace flavorants to produce an inhalable aerosol. The heating process can lead to the formation of reactive oxygen species (ROS), which are linked to various oxidative damage-initiated diseases. Several studies in the literature have addressed ROS emissions in ECIG aerosols, but the effects of power, ECIG device design and liquid composition on ROS are relatively unknown. In addition, ROS emissions have not been examined in the emerging high power, sub-Ohm device (SOD) category. In this study, an acellular 2',7'-dichlorofluorescin (DCFH) probe technique was optimized to measure ROS in ECIG aerosols. The technique was deployed to measure ROS emissions in SOD and supra-Ohm ECIGs while varying power, heater coil head design and liquid composition (PG/VG ratio and nicotine concentration). Liquids were made from analytical standards of PG, VG and nicotine and contained no flavorants. At high powers, ROS emissions in ECIGs and combustible cigarettes were similar. Across device designs, ROS emissions were uncorrelated with power (R2 = 0.261) but were highly correlated with power per unit area (R2 = 0.78). It was noticed that an increase in the VG percentage in the liquid yielded higher ROS flux, and nicotine did not affect ROS emissions. ROS emissions are a function of device design and liquid composition at a given power. For a given liquid composition, a promising metric for predicting ROS emissions across device designs and operating conditions is power per unit area of the heating coil. Importantly, ROS formation is significant even when the ECIG liquid consists of pure analytical solutions of PG and VG; it can therefore be viewed as intrinsic to ECIG operation and not solely a by-product of particular flavorants, contaminants or additives.
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Affiliation(s)
- Christina Haddad
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rola Salman
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Ahmad El-Hellani
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Soha Talih
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Alan Shihadeh
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Mechanical Engineering Department, Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Najat Aoun Saliba
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
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El-Hage R, El-Hellani A, Haddad C, Salman R, Talih S, Shihadeh A, Eissenberg T, Saliba NA. Toxic emissions resulting from sucralose added to electronic cigarette liquids. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2019; 53:1197-1203. [PMID: 36506805 PMCID: PMC9733909 DOI: 10.1080/02786826.2019.1645294] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Electronic cigarettes (ECIGs) are appealing in part because of the many flavors of the liquids used in them. Concerns have been raised that some ECIG liquid flavors, especially those that are sweet, are attracting otherwise nicotine-naïve youth to ECIGs. Sucralose is an artificial, non-caloric sweetener that is added to some ECIG liquids. In this study, we evaluated the toxicants, namely isomers of chloropropanols that can be produced when sucralose-containing ECIG liquid is aerosolized. An analytical separation method relying on solid-phase extraction (SPE) to isolate chloropropanols from the propylene glycol/glycerol matrix was developed. Chloropropanols were then derivatized by silylation before they were analyzed on GC-MS. The influence of different ECIG operating conditions on the generation of chloropropanols was studied by varying ECIG device design and power output and also the sucralose concentration of the liquid. Heated sucralose-containing ECIG liquids produce two toxic compounds that can be found in the resulting aerosols. The two chloropropanols, 3-monochloro-1,2-propanediol (3-MCPD) and 1,3-dichloropropanol (1,3-DCP) that were detected under all conditions were found to be correlated significantly with liquid sucralose content. Effective regulation of ECIGs will minimize user and bystander exposure to these and other ECIG toxicants.
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Affiliation(s)
- Rachel El-Hage
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ahmad El-Hellani
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Christina Haddad
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rola Salman
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Soha Talih
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Alan Shihadeh
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Thomas Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Najat Aoun Saliba
- Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Corresponding Author: Najat A. Saliba, Tel: +961 1 350000/3992.
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185
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Lopez AA, Redner R, Kurti AN, Keith DR, Villanti AC, Stanton CA, Gaalema DE, Bunn JY, Doogan NJ, Cepeda-Benito A, Roberts ME, Higgins ST. Tobacco and nicotine delivery product use in a U.S. national sample of women of reproductive age. Prev Med 2018; 117:61-68. [PMID: 29559222 PMCID: PMC6141351 DOI: 10.1016/j.ypmed.2018.03.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 03/01/2018] [Accepted: 03/09/2018] [Indexed: 01/07/2023]
Abstract
This study examined prevalence and correlates of using cigarettes, e-cigarettes, and other tobacco/nicotine delivery products in a U.S. national sample of women of reproductive age. Weighted data were obtained from women aged 15-44 years who were not currently pregnant in the first wave of the Population Assessment of Health and Tobacco (PATH, 2013-2014) study (N = 12,848). 20.1% of women were current cigarette smokers, 5.9% current e-cigarette users, 4.9% current cigar smokers, and 6.5% current hookah users. Prevalence of current use of other tobacco products was <1.0%. Current cigarette smoking was the strongest correlate of current e-cigarette use (OR = 65.7, 95% CI = 44.8-96.5), cigar smoking (OR = 19.2, 95% CI = 14.1-26.1), and hookah use (OR = 6.6, 95% CI = 5.1-8.5). Among former cigarette smokers, 3.8%, 6.9%, and 3.2% were also currently using e-cigarettes, hookah, and cigars, respectively. Use of other tobacco and nicotine delivery products was low among those who never smoked tobacco cigarettes: 2.5% used hookah and <1.0% used other products. Cigarette smoking prevalence remains relatively high among women of reproductive age and strongly correlated with use of other tobacco products. Monitoring tobacco and nicotine use in this population is important due to the additional risk of adverse health impacts should they become pregnant. Clinicians working with cigarette smokers should assess for use of other tobacco products. Among women of reproductive age, use of emerging tobacco and nicotine products appears to be largely, although not exclusively, restricted to current cigarette smokers.
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Affiliation(s)
- Alexa A Lopez
- Vermont Center on Behavior and Health, University of Vermont, United States
| | - Ryan Redner
- Vermont Center on Behavior and Health, University of Vermont, United States; Rehabilitation Institute, Southern Illinois University, United States.
| | - Allison N Kurti
- Vermont Center on Behavior and Health, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - Diana R Keith
- Vermont Center on Behavior and Health, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - Andrea C Villanti
- Vermont Center on Behavior and Health, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - Cassandra A Stanton
- Westat, Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science, Department of Oncology, Georgetown University Medical Center, United States
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | | | - Nathan J Doogan
- College of Public Health, The Ohio State University, United States
| | | | - Megan E Roberts
- College of Public Health, The Ohio State University, United States
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States; Department of Psychological Science, University of Vermont, United States
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186
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Peace MR, Mulder HA, Baird TR, Butler KE, Friedrich AK, Stone JW, Turner JBM, Poklis A, Poklis JL. Evaluation of Nicotine and the Components of e-Liquids Generated from e-Cigarette Aerosols. J Anal Toxicol 2018; 42:537-543. [PMID: 30371842 PMCID: PMC6203128 DOI: 10.1093/jat/bky056] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/01/2018] [Accepted: 07/16/2018] [Indexed: 12/11/2022] Open
Abstract
Electronic cigarettes (e-cigs) deliver nicotine in an aerosol to the user that simulates the smoke of traditional cigarettes purportedly without the pathology of inhaling tobacco smoke due to the absence of combustion. Advanced versions of e-cigs enable the user to potentially moderate the concentration of drug in the aerosol by selecting from a range of voltages on the power supply. A method was developed to trap the aerosol produced by a KangerTech AeroTank, 1.8 Ω preassembled atomizer in order to analyze the concentration of nicotine and to evaluate the constituents of the aerosol at various voltages on the power supply. A 12-mg/mL formulation of nicotine in 50:50 propylene glycol (PG):vegetable glycerin (VG) was used to produce aerosol at 3.9, 4.3 and 4.7 V. The aerosol was trapped in a simple glass assemblage and analyzed by a 3200 Q Trap HPLC-MS-MS. The dose of nicotine delivered in the aerosol at 3.9, 4.3 and 4.7 V was determined to be 88 ± 12 μg, 91 ± 15 μg and 125 ± 22 μg. The average recovery of nicotine in the trap across the voltages was 99.8%. The glass trap system was an effective device for collecting the aerosol for analysis and an increase in drug yield was observed with increasing voltage from the power supply on the e-cig. The glass trap system was also used in combination with a 100-μm solid-phase microextraction fiber to capture the aerosol and analyze it via DART-MS and GC-MS. Four commercial e-liquids labeled to contain nicotine were aerosolized at 4.3 V. The pharmacologically active ingredient, nicotine, as well as PG, VG and a number of flavoring agents found in these formulations were identified.
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Affiliation(s)
- Michelle R Peace
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA
| | - Haley A Mulder
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA
| | - Tyson R Baird
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA
| | - Karen E Butler
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA
| | - Alaina K Friedrich
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA
| | - Joseph W Stone
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Alphonse Poklis
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA
- Department of Pathology, Virginia Commonwealth University, Richmond, VA, USA
| | - Justin L Poklis
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA
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187
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Cigarette smoke condensate may disturb immune function with apoptotic cell death by impairing function of organelles in alveolar macrophages. Toxicol In Vitro 2018; 52:351-364. [DOI: 10.1016/j.tiv.2018.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 01/24/2023]
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188
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Rossheim ME, Livingston MD, Soule EK, Zeraye HA, Thombs DL. Electronic cigarette explosion and burn injuries, US Emergency Departments 2015-2017. Tob Control 2018; 28:472-474. [PMID: 30219795 DOI: 10.1136/tobaccocontrol-2018-054518] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 07/25/2018] [Accepted: 08/17/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Electronic cigarette (e-cigarette) battery failure can result in explosions and burn injuries. Previous attempts to quantify these events has been limited to compilations of case studies, federal agency reports and media reports. Although e-cigarette explosions and burn injuries are thought to be rare, current surveillance methods likely underestimate actual occurrences. METHODS Analyses were conducted on cross-sectional data from the US Consumer Product Safety Commission's (CPSC) National Electronic Injury Surveillance System (NEISS). A keyword search of case narrative text was used to identify e-cigarette-related explosion and burn injuries presenting to US emergency departments from 2015 to 2017. Sampling weights were applied to make conservative national incidence estimates. RESULTS From 2015 to 2017, there were an estimated 2035 e-cigarette explosion and burn injuries presenting to US hospital emergency departments (95% CI 1107 to 2964). CONCLUSIONS There are more e-cigarette explosion and burn injuries in the USA than estimated in the past reports. Improved surveillance of e-cigarette injuries and regulation of e-cigarette devices is urgently needed. NEISS could be a valuable resource for e-cigarette injury surveillance.
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Affiliation(s)
- Matthew E Rossheim
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA
| | - Melvin D Livingston
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Eric K Soule
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Helen A Zeraye
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA
| | - Dennis L Thombs
- Health Behavior and Health Systems, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
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189
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E-cigarette nicotine content and labelling practices in a restricted market: Findings from Ontario, Canada. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 58:9-12. [DOI: 10.1016/j.drugpo.2018.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/28/2018] [Accepted: 04/04/2018] [Indexed: 11/19/2022]
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190
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Anderson P, Gual A, Rehm J. Reducing the health risks derived from exposure to addictive substances. Curr Opin Psychiatry 2018; 31:333-341. [PMID: 29746421 DOI: 10.1097/yco.0000000000000432] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW To discuss the health risks due to exposure to alcohol, illegal drugs and nicotine and how these risks might be reduced. RECENT FINDINGS In 2016, worldwide, alcohol, illegal drugs and nicotine were responsible for some 10 million deaths. There is evolutionary and biological evidence that humans are predisposed to consuming alcohol, illegal drugs and nicotine - present-day problems are caused by high levels of potency, exposure and drug delivery systems. The two priority substances for action are alcohol and smoked cigarettes; their exposure can be reduced by price increases, setting minimum prices per product, regulating a shift form smoked cigarettes to electronic nicotine delivery devices and, theoretically, reducing the ethanol content of existing beverages. Legalization of cannabis requires a strict regulatory framework. SUMMARY Purposeful policy can reduce the harm done by alcohol, illegal drugs and nicotine. In particular, policy to reduce exposure to alcohol requires considerable strengthening.
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Affiliation(s)
- Peter Anderson
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK.,Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Antoni Gual
- Addictions Unit, Psychiatry Department, Neurosciences Institute, Hospital Clinic.,Institut d'Investigacions Biomèdiques.,August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia.,Red de Trastornos Adictivos (RTA - RETICS), Instituto de Salud Carlos III, Madrid, Spain
| | - Jürgen Rehm
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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191
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Spindle TR, Talih S, Hiler MM, Karaoghlanian N, Halquist MS, Breland AB, Shihadeh A, Eissenberg T. Effects of electronic cigarette liquid solvents propylene glycol and vegetable glycerin on user nicotine delivery, heart rate, subjective effects, and puff topography. Drug Alcohol Depend 2018; 188:193-199. [PMID: 29778773 PMCID: PMC7193252 DOI: 10.1016/j.drugalcdep.2018.03.042] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/18/2018] [Accepted: 03/23/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Electronic cigarettes (ECIGs) are a class of tobacco products that produce different effects (e.g., nicotine delivery), depending on the device, liquid, and behavioral factors. However, the influence of the two primary ECIG liquid solvents, propylene glycol (PG) and vegetable glycerin (VG), on ECIG acute effects is unknown. METHODS Thirty ECIG-experienced, ≥12-h nicotine- abstinent participants completed four conditions consisting of two ECIG-use bouts (10 puffs, 30 s interpuff-interval) differing only by liquid PG:VG ratio (2PG:98VG, 20PG:80VG, 55PG:45VG, 100PG). Device power (7.3 W) and liquid nicotine concentration (18 mg/ml) remained constant. Nicotine delivery, subjective effects, heart rate (HR), and puff topography were assessed. RESULTS In the 100PG condition, participants took shorter and smaller puffs but obtained significantly more nicotine relative to the two VG-based conditions. Total nicotine exposure (i.e., area under the curve) was also significantly higher during use of the two PG-based liquids. However, participants reported that the 100 PG liquid was significantly less "pleasant" and "satisfying" relative to the other liquids (all ps < .05). Increases in HR and decreases in abstinence symptoms (e.g., "craving") did not differ across conditions. CONCLUSIONS PG:VG ratio influenced nicotine delivery, some subjective effects, and puff topography. Lower overall product satisfaction associated with the 100PG liquid suggests factors other than nicotine delivery (e.g., aerosol visibility) may play a role in maintaining ECIG use. Regulating ECIG acute effects such as nicotine delivery and subjective effects may require simultaneous attention to liquid PG:VG ratio as well as device, liquid, and behavioral factors known to influence these outcomes.
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Affiliation(s)
- Tory R Spindle
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States
| | - Soha Talih
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States; Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Marzena M Hiler
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States
| | - Nareg Karaoghlanian
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States; Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Matthew S Halquist
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA, United States
| | - Alison B Breland
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States
| | - Alan Shihadeh
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States; Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Thomas Eissenberg
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States.
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192
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Kosmider L, Spindle TR, Gawron M, Sobczak A, Goniewicz ML. Nicotine emissions from electronic cigarettes: Individual and interactive effects of propylene glycol to vegetable glycerin composition and device power output. Food Chem Toxicol 2018; 115:302-305. [PMID: 29572013 PMCID: PMC6363104 DOI: 10.1016/j.fct.2018.03.025] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/27/2018] [Accepted: 03/19/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The power output of e-cigarettes varies considerably, as does the composition of liquids used with these products. Most e-cigarette liquids contain two primary solvents: propylene glycol (PG) and vegetable glycerin (VG). The primary aim of this study was to examine the extent to which PG and VG composition and device power interact with each other to influence e-cigarette nicotine emissions. METHODS Aerosols were generated using a 2nd generation e-cigarette and an automatic smoking machine. Nicotine was measured in aerosols, via gas chromatography, produced from three solutions containing pure PG, pure VG, or a mixture of both solvents (50:50) across three different power settings (4.3, 6.7, and 9.6 W). RESULTS At the lowest power setting, nicotine yield increased significantly as more PG was added to the solution. However, as device power was increased, differences in nicotine yield across liquids became less pronounced. At the highest power setting (9.6 W), nicotine yields did not differ across the three liquids examined. CONCLUSIONS The present study demonstrated that the extent to which e-cigarette liquid PG and VG composition influences nicotine emissions is dependent on device power. Thus, device power may influence e-cigarette nicotine emissions to a greater degree relative to solvent concentrations.
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Affiliation(s)
- Leon Kosmider
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University and Affiliated with Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA; School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Department of General and Analytical Chemistry, Jagiellońska 4, 41-200 Sosnowiec, Poland.
| | - Tory R Spindle
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Michal Gawron
- School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Department of General and Analytical Chemistry, Jagiellońska 4, 41-200 Sosnowiec, Poland
| | - Andrzej Sobczak
- School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Department of General and Analytical Chemistry, Jagiellońska 4, 41-200 Sosnowiec, Poland; Institute of Occupational Medicine and Environmental Health, Kościelna 13, 41-200 Sosnowiec, Poland
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193
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Guerrero-Cignarella A, Luna Diaz LV, Balestrini K, Holt G, Mirsaeidi M, Calderon-Candelario R, Whitney P, Salathe M, Campos MA. Differences in vaping topography in relation to adherence to exclusive electronic cigarette use in veterans. PLoS One 2018; 13:e0195896. [PMID: 29694428 PMCID: PMC5919012 DOI: 10.1371/journal.pone.0195896] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/26/2018] [Indexed: 11/18/2022] Open
Abstract
Background Understanding vaping patterns of electronic cigarette (EC) use is important to understand the real-life exposure to EC vapor. Long term information on vaping topography in relation to tobacco cigarette (TC) smoking cessation success has not been explored. Methods Observational non-blinded study where active TC smokers were asked to replace TC with EC over 4 weeks (replacement phase, RP) followed by exclusive EC use for an additional 12 weeks (maintenance phase, MP). TC use and EC compliance was monitored weekly. Subjects were classified as success or failure whether or not they completed the protocol. Vaping information was stored and downloaded directly from the EC device and averaged per calendar day for analysis. Results From 25 subjects that followed the protocol, sixteen succeeded in completing the RP and 8 the MP (32%). No significant differences in baseline characteristics were noted between subjects in the success and failure groups including markers of nicotine addiction, plasma cotinine levels or smoking history. Success subjects showed significantly longer puff duration (seconds per vape) and total overall vapor exposure (number of vapes x average vape duration or vape-seconds) in both study phases. Furthermore, subjects in the success group continued to increase the number of vapes, device voltage and wattage significantly as they transitioned into the MP. After an initial drop, subjects in the success group were able to regain plasma cotinine levels comparable to their TC use while subjects in the failure group could not. Cotinine levels significantly correlated with the average number of daily vapes and vapes-seconds, but not with other vaping parameters. Conclusion The topography of smokers who adhere to exclusive EC use reflects a progressive and dynamic device adaptation over weeks to maintain baseline cotinine levels. The higher inhaled volume over time should be considered when addressing the potential toxic effects of EC and the variable EC adherence when addressing public health policies regarding their use.
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Affiliation(s)
- Andrea Guerrero-Cignarella
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- Miami Veterans Affairs Medical Center, Miami, Florida, United States of America
| | - Landy V. Luna Diaz
- Miami Veterans Affairs Medical Center, Miami, Florida, United States of America
| | - Kira Balestrini
- Miami Veterans Affairs Medical Center, Miami, Florida, United States of America
| | - Gregory Holt
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- Miami Veterans Affairs Medical Center, Miami, Florida, United States of America
| | - Mehdi Mirsaeidi
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- Miami Veterans Affairs Medical Center, Miami, Florida, United States of America
| | - Rafael Calderon-Candelario
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- Miami Veterans Affairs Medical Center, Miami, Florida, United States of America
| | - Philip Whitney
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Matthias Salathe
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States of America
| | - Michael A. Campos
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Miami Miller School of Medicine, Miami, Florida, United States of America
- Miami Veterans Affairs Medical Center, Miami, Florida, United States of America
- * E-mail:
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194
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Abstract
This article reviews the literature that supports routine expectations for smoking cessation; weight loss; diabetic, nutritional, or metabolic optimization; and decolonization techniques before ventral hernia repair. These methods diminish postoperative complications. In an era of value-centric care, an upfront investment in patient optimization can improve the quality of the repair by reducing wound morbidity and hernia recurrence, naturally translating to a reduction in cost. The adoption of these practices and further study aimed at identifying other effective optimization techniques are encouraged.
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Affiliation(s)
- Clayton C Petro
- Department of Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - Ajita S Prabhu
- Department of Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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195
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Hobkirk AL, Nichols TT, Foulds J, Yingst JM, Veldheer S, Hrabovsky S, Richie J, Eissenberg T, Wilson SJ. Changes in resting state functional brain connectivity and withdrawal symptoms are associated with acute electronic cigarette use. Brain Res Bull 2018; 138:56-63. [PMID: 28528203 PMCID: PMC5693791 DOI: 10.1016/j.brainresbull.2017.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 05/12/2017] [Indexed: 11/25/2022]
Abstract
Resting state functional brain connectivity (rsFC) may be an important neuromarker of smoking behavior. Prior research has shown, among cigarette smokers, that nicotine administration alters rsFC within frontal and parietal cortices involved in executive control, as well as striatal regions that drive reward processing. These changes in rsFC have been associated with reductions in withdrawal symptom severity. We currently have a limited understanding of how rsFC is affected by the use of electronic cigarettes (ecigs), an increasingly popular class of products, the members of which deliver nicotine with varying effectiveness. The current study used fMRI to determine the effects of ecig use on rsFC and withdrawal symptoms. Independent component, dual regression, and permutation analyses were conducted on rsFC collected from ecig users before and after an ecig use episode (n=9) that occurred after 14h of nicotine abstinence. Similar to the known effects of nicotine administration, ecig use decreased rsFC of two clusters in the right frontal pole and frontal medial cortex with an attentional control salience network, and decreased rsFC of five clusters in the left thalamus, insula, and brain stem with a reward network encompassing the striatum. Ecig use increased inverse coupling between the prefrontal reward network and the right frontoparietal executive control network. Reductions in craving and difficulty with concentration were correlated with decreases in coupling strength between reward and executive control networks. These preliminary results suggest that the effects of ecig use on rsFC are similar to those seen with nicotine administration in other forms. In order to gain insight into the addictive potential of ecigs, further research is needed to understand the neural influence of ecigs across the range of nicotine delivery within this class of products.
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Affiliation(s)
- Andréa L Hobkirk
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2812 Erwin Rd, Durham, NC 27708, USA.
| | - Travis T Nichols
- VA North Texas Health Care System, 4500 S. Lancaster Rd, Dallas, TX 75216, USA.
| | - Jonathan Foulds
- Department of Public Health Sciences, Pennsylvania State University, College of Medicine, Cancer Institute, 500 University Drive, PO Box 850, Hershey, PA 17033, USA.
| | - Jessica M Yingst
- Department of Public Health Sciences, Pennsylvania State University, College of Medicine, Cancer Institute, 500 University Drive, PO Box 850, Hershey, PA 17033, USA.
| | - Susan Veldheer
- Department of Public Health Sciences, Pennsylvania State University, College of Medicine, Cancer Institute, 500 University Drive, PO Box 850, Hershey, PA 17033, USA.
| | - Shari Hrabovsky
- Department of Public Health Sciences, Pennsylvania State University, College of Medicine, Cancer Institute, 500 University Drive, PO Box 850, Hershey, PA 17033, USA.
| | - John Richie
- Department of Public Health Sciences, Pennsylvania State University, College of Medicine, Cancer Institute, 500 University Drive, PO Box 850, Hershey, PA 17033, USA.
| | - Thomas Eissenberg
- Department of Psychology (Health Program) and Center for the Study of Tobacco Products, Virginia Commonwealth University, Box 980205, Richmond, VA 23298, USA.
| | - Stephen J Wilson
- Pennsylvania State University, Department of Psychology, University Park, PA 16802, USA.
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196
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Gibson LA, Creamer MR, Breland AB, Giachello AL, Kaufman A, Kong G, Pechacek TF, Pepper JK, Soule EK, Halpern-Felsher B. Measuring perceptions related to e-cigarettes: Important principles and next steps to enhance study validity. Addict Behav 2018; 79:219-225. [PMID: 29175027 DOI: 10.1016/j.addbeh.2017.11.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 09/26/2017] [Accepted: 11/09/2017] [Indexed: 12/28/2022]
Abstract
Measuring perceptions associated with e-cigarette use can provide valuable information to help explain why youth and adults initiate and continue to use e-cigarettes. However, given the complexity of e-cigarette devices and their continuing evolution, measures of perceptions of this product have varied greatly. Our goal, as members of the working group on e-cigarette measurement within the Tobacco Centers of Regulatory Science (TCORS) network, is to provide guidance to researchers developing surveys concerning e-cigarette perceptions. We surveyed the 14 TCORS sites and received and reviewed 371 e-cigarette perception items from seven sites. We categorized the items based on types of perceptions asked, and identified measurement approaches that could enhance data validity and approaches that researchers may consider avoiding. The committee provides suggestions in four areas: (1) perceptions of benefits, (2) harm perceptions, (3) addiction perceptions, and (4) perceptions of social norms. Across these 4 areas, the most appropriate way to assess e-cigarette perceptions depends largely on study aims. The type and number of items used to examine e-cigarette perceptions will also vary depending on respondents' e-cigarette experience (i.e., user vs. non-user), level of experience (e.g., experimental vs. established), type of e-cigarette device (e.g., cig-a-like, mod), and age. Continuous formative work is critical to adequately capture perceptions in response to the rapidly changing e-cigarette landscape. Most important, it is imperative to consider the unique perceptual aspects of e-cigarettes, building on the conventional cigarette literature as appropriate, but not relying on existing conventional cigarette perception items without adjustment.
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Affiliation(s)
| | - MeLisa R Creamer
- University of Texas Health Science Center, Houston School of Public Health, Austin, Regional Campus, TX, USA
| | | | | | - Annette Kaufman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Grace Kong
- Yale University School of Medicine, New Haven, CT, USA
| | | | - Jessica K Pepper
- University of North Carolina at Chapel Hill, NC, USA; RTI International, Research Triangle Park, NC, USA
| | - Eric K Soule
- Virginia Commonwealth University, Richmond, VA, USA
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197
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Soule EK, Maloney SF, Guy MC, Eissenberg T, Fagan P. User-identified electronic cigarette behavioral strategies and device characteristics for cigarette smoking reduction. Addict Behav 2018; 79:93-101. [PMID: 29272713 DOI: 10.1016/j.addbeh.2017.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/01/2017] [Accepted: 12/07/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is limited evidence on how cigarette smokers use electronic cigarettes (ECIGs) for smoking cessation and reduction. This study used concept mapping, a participatory mixed-methods research approach, to identify ECIG use behaviors and device characteristics perceived to be associated with cigarette smoking cessation or reduction. METHODS Current ECIG users aged 18-64 were recruited from seven cities selected randomly from U.S. census tract regions. Participants were invited to complete concept mapping tasks: brainstorming, sorting and rating (n=72). During brainstorming, participants generated statements in response to a focus prompt ("A SPECIFIC WAY I HAVE USED electronic cigarettes to reduce my cigarette smoking or a SPECIFIC WAY electronic cigarettes help me reduce my cigarette smoking is…") and then sorted and rated the statements. Multidimensional scaling and hierarchical cluster analyses were used to generate a cluster map that was interpreted by the research team. RESULTS Eight thematic clusters were identified: Convenience, Perceived Health Effects, Ease of Use, Versatility and Variety, Advantages of ECIGs over Cigarettes, Cigarette Substitutability, Reducing Harms to Self and Others, and Social Benefits. Participants generated several statements that related to specific behavioral strategies used when using ECIGs for smoking reduction/complete switching behaviors such as making rapid transitions from smoking to ECIG use or using certain ECIG liquids or devices. Former smokers rated the Perceived Health Effects cluster and several behavioral strategy statements higher than current smokers. CONCLUSIONS These results help to identify ECIG use behaviors and characteristics perceived by ECIG users to aid in cigarette smoking cessation or reduction.
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Affiliation(s)
- Eric K Soule
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; Virginia Commonwealth University, Department of Psychology, PO Box 980205, Richmond, VA 23298, United States.
| | - Sarah F Maloney
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; Virginia Commonwealth University, Department of Psychology, PO Box 980205, Richmond, VA 23298, United States.
| | - Mignonne C Guy
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; Virginia Commonwealth University, Department of African American Studies, PO Box 842509, Richmond, VA 23284, United States.
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; Virginia Commonwealth University, Department of Psychology, PO Box 980205, Richmond, VA 23298, United States.
| | - Pebbles Fagan
- Center for the Study of Tobacco Products, Virginia Commonwealth University, United States; University of Arkansas for Medical Sciences, Fay W. Boozman College of Public Health, Department of Health Behavior and Health Education, 4301 West Markham Street #820, Little Rock, AR 72205, United States.
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198
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Sassano MF, Davis ES, Keating JE, Zorn BT, Kochar TK, Wolfgang MC, Glish GL, Tarran R. Evaluation of e-liquid toxicity using an open-source high-throughput screening assay. PLoS Biol 2018; 16:e2003904. [PMID: 29584716 PMCID: PMC5870948 DOI: 10.1371/journal.pbio.2003904] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 02/21/2018] [Indexed: 01/08/2023] Open
Abstract
The e-liquids used in electronic cigarettes (E-cigs) consist of propylene glycol (PG), vegetable glycerin (VG), nicotine, and chemical additives for flavoring. There are currently over 7,700 e-liquid flavors available, and while some have been tested for toxicity in the laboratory, most have not. Here, we developed a 3-phase, 384-well, plate-based, high-throughput screening (HTS) assay to rapidly triage and validate the toxicity of multiple e-liquids. Our data demonstrated that the PG/VG vehicle adversely affected cell viability and that a large number of e-liquids were more toxic than PG/VG. We also performed gas chromatography-mass spectrometry (GC-MS) analysis on all tested e-liquids. Subsequent nonmetric multidimensional scaling (NMDS) analysis revealed that e-liquids are an extremely heterogeneous group. Furthermore, these data indicated that (i) the more chemicals contained in an e-liquid, the more toxic it was likely to be and (ii) the presence of vanillin was associated with higher toxicity values. Further analysis of common constituents by electron ionization revealed that the concentration of cinnamaldehyde and vanillin, but not triacetin, correlated with toxicity. We have also developed a publicly available searchable website (www.eliquidinfo.org). Given the large numbers of available e-liquids, this website will serve as a resource to facilitate dissemination of this information. Our data suggest that an HTS approach to evaluate the toxicity of multiple e-liquids is feasible. Such an approach may serve as a roadmap to enable bodies such as the Food and Drug Administration (FDA) to better regulate e-liquid composition.
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Affiliation(s)
- M. Flori Sassano
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Eric S. Davis
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - James E. Keating
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Bryan T. Zorn
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Tavleen K. Kochar
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Matthew C. Wolfgang
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gary L. Glish
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Robert Tarran
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Cell Biology & Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- * E-mail:
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199
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Baldassarri SR, Hillmer AT, Anderson JM, Jatlow P, Nabulsi N, Labaree D, Cosgrove KP, O’Malley SS, Eissenberg T, Krishnan-Sarin S, Esterlis I. Use of Electronic Cigarettes Leads to Significant Beta2-Nicotinic Acetylcholine Receptor Occupancy: Evidence From a PET Imaging Study. Nicotine Tob Res 2018; 20:425-433. [PMID: 28460123 PMCID: PMC5896427 DOI: 10.1093/ntr/ntx091] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 04/21/2017] [Indexed: 12/13/2022]
Abstract
Background Electronic cigarettes (ECs) can influence nicotine addiction by delivering aerosolized nicotine. We investigated if nicotine from ECs is delivered to the brain β2*-nicotinic acetylcholine receptors (β2*-nAChR) and how this relates to the behavioral effects and nicotine delivery from cigarettes. Methods Seven nicotine users participated in positron emission tomography (PET) studies with (-)-[18F]Flubatine before and after nicotine challenge with 0, 8, and 36 mg/ml nicotine in a 3.3 Volt, 1.5 Ohm EC or a standard tobacco cigarette. Craving was evaluated before and after product use. Results Average β2*-nAChR occupancy was higher after 36 mg/ml EC challenge compared to 8 mg/ml EC at trend level. Average β2*-nAChR occupancy after tobacco cigarette smoking was 68 ± 18% and was not different compared with 8 mg/ml (64 ± 17%,) or 36 mg/ml (84 ± 3%) nicotine in EC users. Area under the curve (AUC) of blood nicotine level was higher in the cigarette smoking group compared with the 8mg/ml group (p = 0.03), but similar compared with the 36 mg/ml EC (p = 0.29). Drug craving was reduced after use of the tobacco cigarette, 8 mg/ml EC, and 36 mg/ml EC. Conclusions In this novel investigation of EC effects at β2*-nAChRs, we show that average β2*-nAChR occupancy was higher after 36 mg/ml EC challenge compared with 8 mg/ml EC. Receptor occupancy and arterial blood nicotine levels after cigarette smoking were similar to 36 mg/ml EC use under controlled conditions. These findings suggest that the ECs studied here have abuse liability and may provide an adequate alternative nicotine delivery system for cigarette smokers. Implications This is the first study to directly determine the neurologic effects of electronic cigarettes on human brain beta-2 nicotinic acetylcholine receptors using PET neuroimaging with (-)-[18F]Flubatine, a novel radiotracer. Our findings suggest that the e-cigarettes studied here have abuse liability and may provide an adequate alternative nicotine delivery system for cigarette smokers.
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Affiliation(s)
- Stephen R Baldassarri
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT
| | - Ansel T Hillmer
- PET center, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | | | - Peter Jatlow
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT
| | - Nabeel Nabulsi
- PET center, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
| | - David Labaree
- PET center, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
| | - Kelly P Cosgrove
- PET center, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | | | - Thomas Eissenberg
- Department of Psychology (Health Program) and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
| | | | - Irina Esterlis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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200
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Lisdahl KM, Sher KJ, Conway KP, Gonzalez R, Feldstein Ewing SW, Nixon SJ, Tapert S, Bartsch H, Goldstein RZ, Heitzeg M. Adolescent brain cognitive development (ABCD) study: Overview of substance use assessment methods. Dev Cogn Neurosci 2018; 32:80-96. [PMID: 29559216 PMCID: PMC6375310 DOI: 10.1016/j.dcn.2018.02.007] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 02/01/2018] [Accepted: 02/16/2018] [Indexed: 12/21/2022] Open
Abstract
One of the objectives of the Adolescent Brain Cognitive Development (ABCD) Study (https://abcdstudy.org/) is to establish a national longitudinal cohort of 9 and 10 year olds that will be followed for 10 years in order to prospectively study the risk and protective factors influencing substance use and its consequences, examine the impact of substance use on neurocognitive, health and psychosocial outcomes, and to understand the relationship between substance use and psychopathology. This article provides an overview of the ABCD Study Substance Use Workgroup, provides the goals for the workgroup, rationale for the substance use battery, and includes details on the substance use module methods and measurement tools used during baseline, 6-month and 1-year follow-up assessment time-points. Prospective, longitudinal assessment of these substance use domains over a period of ten years in a nationwide sample of youth presents an unprecedented opportunity to further understand the timing and interactive relationships between substance use and neurocognitive, health, and psychopathology outcomes in youth living in the United States.
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Affiliation(s)
- Krista M Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, 2441 East Hartford Ave, 224 Garland Hall, Milwaukee, WI, 53211, United States.
| | - Kenneth J Sher
- Curators' Professor of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO 65211, United States
| | - Kevin P Conway
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse,6001 Executive Boulevard, Bethesda, MD 20892, United States
| | - Raul Gonzalez
- Department of Psychology, Florida International University,11200 SW 8th Street AHC-4, 461, Miami, FL 33199, United States
| | - Sarah W Feldstein Ewing
- Department of Child & Adolescent Psychiatry, Oregon Health & Science University, Mail code: DC7P, 3181 SW Sam Jackson Park Rd, Portland OR 97239, United States
| | - Sara Jo Nixon
- Department of Psychiatry, P.O. Box 100256, University of Florida, Gainesville, FL 32610, United States
| | - Susan Tapert
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, United States
| | - Hauke Bartsch
- Center for Multimodal Imaging and Genetics, Department of Radiology, University of California, San Diego,9452 Medical Center Drive, La Jolla, CA, 92037, United States
| | - Rita Z Goldstein
- Department of Psychiatry (primary) and Department of Neuroscience, Friedman Brain Institute (secondary), Chief, Brain Imaging Center (BIC), Icahn School of Medicine at Mount Sinai, The Leon and Norma Hess Center for Science and Medicine, 1470 Madison Ave, New York, NY 10029, United States
| | - Mary Heitzeg
- Department of Psychiatry, University of Michigan,4250 Plymouth Road, Ann Arbor, MI 48109, United States
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