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Ahmed H, Ismayl M, Palicherla A, May J, Goldsweig AM, Thirumalareddy J. A case report of vaping-associated sudden cardiac arrest in a young healthy patient. Ann Med Surg (Lond) 2024; 86:3042-3046. [PMID: 38694286 PMCID: PMC11060229 DOI: 10.1097/ms9.0000000000001907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/25/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction and importance While vaping has increased significantly among young individuals, the effects of vape aerosol constituents on cardiac electrophysiological dynamics remain unknown. Case presentation A 22-year-old female with a history of energy vaping presented with cardiac arrest. Found to have no pulse, CPR was started and an initial rhythm of ventricular tachycardia was obtained. Shock was administered with a follow-up rhythm of ventricular fibrillation. She was emergently defibrillated and entered atrial fibrillation with rapid ventricular response. Toxicology and troponins were all negative. Left heart catheterization and cardiac MRI were unremarkable. She was discharged with an external defibrillation vest and a tentative plan for outpatient electrophysiology study in the setting of negative work-up for cardiopulmonary arrest. Clinical discussion Vaping-induced sudden cardiac arrest may be attributed to a reduction in cardiac repolarization reserve. Exposure to vegetable glycerin and propylene glycol, substances present in nearly all vape products, have been found to incite arrhythmias and disrupt cardiac conduction in animals. Acrolein, an aldehyde byproduct of glycerin, has also been found to induce arrhythmias due to autonomic dysfunction. Increased intracellular calcium concentration and free radical damage, which occur as a result of inhaling particulate matter generated from e-cigarettes, further propagates the risk of arrhythmia. Conclusion The effects of inhaling vape aerosols remain not fully understood. While there is a perceived notion that nicotine-free aerosols may be harmless, that remains unclear. Further studies are needed to evaluate proarrhythmogenic effects and autonomic dysfunction from the various chemical substances present in vape aerosols.
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Affiliation(s)
- Hasaan Ahmed
- Department of Medicine, Division of Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska
| | - Mahmoud Ismayl
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Anirudh Palicherla
- Department of Medicine, Division of Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska
| | - Joshua May
- Department of Medicine, Division of Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska
| | - Andrew M. Goldsweig
- Department of Cardiovascular Medicine, Baystate Medical Center, Springfield, Massachusetts, USA
| | - Joseph Thirumalareddy
- Department of Medicine, Division of Internal Medicine, Creighton University School of Medicine, Omaha, Nebraska
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Bandara NA, Burgos-Blasco B, Zhou XR, Khaira A, Iovieno A, Matsubara JA, Yeung SN. The Impact of Vaping on the Ocular Surface: A Systematic Review of the Literature. J Clin Med 2024; 13:2619. [PMID: 38731149 PMCID: PMC11084645 DOI: 10.3390/jcm13092619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/20/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
Background: The use of electronic cigarettes has become increasingly popular in recent years. However, the impact that electronic cigarettes have on the ocular surface is not well known. Therefore, the aim of this review is to explore the current literature on the acute and chronic sequelae of electronic cigarettes on the ocular surface. Methods: A systematic review of the literature was undertaken by keyword searching on the Embase, Medline, and Web of Science databases. Articles identified through the search underwent title/abstract screening, full-text screening, and data extraction. Results: A total of 18 studies were included in this review. Non-intended ocular surface exposures and intended exposures on the ocular surface were found to be associated with the use of electronic cigarettes. Conclusions: The impact of vaping on the ocular surface is not benign. There are significant risks that vaping can pose to the ocular surface. Hence, it is necessary to develop appropriate risk communication tools given the increasing popularity of this activity. Additionally, future long-term studies are needed to better understand the long-term impacts of vaping on the ocular surface given the lack of current data.
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Affiliation(s)
- Nilanga Aki Bandara
- UBC Faculty of Medicine, Department of Medicine, Vancouver, BC V6T 1Z3, Canada
| | - Barbara Burgos-Blasco
- UBC Faculty of Medicine, Department of Ophthalmology and Visual Sciences, Vancouver, BC V5Z 3N9, Canada; (B.B.-B.)
| | - Xuan Randy Zhou
- Vagelos School of Physicians & Surgeons, Columbia University, New York City, NY 10027, USA;
| | - Amar Khaira
- UBC Faculty of Medicine, Department of Ophthalmology and Visual Sciences, Vancouver, BC V5Z 3N9, Canada; (B.B.-B.)
| | - Alfonso Iovieno
- UBC Faculty of Medicine, Department of Ophthalmology and Visual Sciences, Vancouver, BC V5Z 3N9, Canada; (B.B.-B.)
| | - Joanne A. Matsubara
- UBC Faculty of Medicine, Department of Ophthalmology and Visual Sciences, Vancouver, BC V5Z 3N9, Canada; (B.B.-B.)
| | - Sonia N. Yeung
- UBC Faculty of Medicine, Department of Ophthalmology and Visual Sciences, Vancouver, BC V5Z 3N9, Canada; (B.B.-B.)
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El-Hellani A, Adeniji A, Erythropel HC, Wang Q, Lamb T, Mikheev VB, Rahman I, Stepanov I, Strongin RM, Wagener TL, Brinkman MC. Comparison of emissions across tobacco products: A slippery slope in tobacco control. Tob Induc Dis 2024; 22:TID-22-57. [PMID: 38560551 PMCID: PMC10980913 DOI: 10.18332/tid/183797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/07/2024] [Accepted: 02/10/2024] [Indexed: 04/04/2024] Open
Abstract
In this narrative review, we highlight the challenges of comparing emissions from different tobacco products under controlled laboratory settings (using smoking/vaping machines). We focus on tobacco products that generate inhalable smoke or aerosol, such as cigarettes, cigars, hookah, electronic cigarettes, and heated tobacco products. We discuss challenges associated with sample generation including variability of smoking/vaping machines, lack of standardized adaptors that connect smoking/vaping machines to different tobacco products, puffing protocols that are not representative of actual use, and sample generation session length (minutes or number of puffs) that depends on product characteristics. We also discuss the challenges of physically characterizing and trapping emissions from products with different aerosol characteristics. Challenges to analytical method development are also covered, highlighting matrix effects, order of magnitude differences in analyte levels, and the necessity of tailored quality control/quality assurance measures. The review highlights two approaches in selecting emissions to monitor across products, one focusing on toxicants that were detected and quantified with optimized methods for combustible cigarettes, and the other looking for product-specific toxicants using non-targeted analysis. The challenges of data reporting and statistical analysis that allow meaningful comparison across products are also discussed. We end the review by highlighting that even if the technical challenges are overcome, emission comparison may obscure the absolute exposure from novel products if we only focus on relative exposure compared to combustible products.
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Affiliation(s)
- Ahmad El-Hellani
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, United States
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, United States
| | - Ayomipo Adeniji
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, United States
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, United States
| | - Hanno C. Erythropel
- Department of Chemical and Environmental Engineering, School of Engineering & Applied Science, Yale University, New Haven, United States
- Yale Center for the Study of Tobacco Product Use and Addiction (YCSTP), Department of Psychiatry, Yale School of Medicine, New Haven, United States
| | - Qixin Wang
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, United States
| | - Thomas Lamb
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, United States
| | - Vladimir B. Mikheev
- Battelle Public Health Center for Tobacco Research, Battelle Memorial Institute, Columbus, United States
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, United States
| | - Irina Stepanov
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota Twin Cities, Minneapolis, United States
- Masonic Cancer Center, University of Minnesota Twin Cities, Minneapolis, United States
| | - Robert M. Strongin
- Department of Chemistry, Portland State University, Portland, United States
| | - Theodore L. Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, United States
- Department of Internal Medicine, The Ohio State University, Columbus, United States
| | - Marielle C. Brinkman
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, United States
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, United States
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Yingst J, Midya V, White A, Foulds J, Cobb CO, Veldheer S, Yen MS, Eissenberg T. Effects of liquid nicotine concentration and flavour on the acceptability of electronic nicotine delivery systems (ENDS) among people who smoke participating in a randomised controlled trial to reduce cigarette consumption. Tob Control 2024:tc-2023-058282. [PMID: 38471776 DOI: 10.1136/tc-2023-058282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Research is needed to understand the acceptability of electronic nicotine delivery systems (ENDS) as a smoking reduction aid. This study examines the acceptability of ENDS by liquid nicotine concentration and flavour among people who smoke using ENDS to reduce their smoking. METHODS People who smoke cigarettes but were naïve to ENDS participated in a double-blind randomised controlled trial to reduce conventional cigarette smoking. Participants were randomised to either a control cigarette substitute (CS) or one of three ENDS groups; 0 mg/mL, 8 mg/mL or 36 mg/mL nicotine concentration. ENDS flavour was chosen by the participant (tobacco or menthol). Participants reported their CS, ENDS and cigarettes per day (CPD) from the past 7 days at 1-month, 3-month and 6-month follow-up visits. Participants also reported side effects and measures of satisfaction, psychological reward, aversion and craving relief. Outcome variables were modelled using linear mixed effects by the following groups: liquid nicotine concentration, flavour and a flavour-nicotine concentration interaction. RESULTS Participants (n=520) were 41.2% male, 67.3% white, had a mean age of 46.2 years and smoked a mean of 18.6 CPD (SD=7.74) at baseline. All flavour and concentration groups decreased CPD from baseline to all follow-up visits with the 36 mg/mL experiencing the greatest reduction, compared with the 0 mg/mL and 8 mg/mL groups. All groups except the 36 mg/mL group decreased their product use over time. The use of menthol flavour was associated with fewer side effects at 3 months (p=0.02) and lesser aversion at 1 month (p=0.03) compared with tobacco-flavoured ENDS. The 36 mg/mL group experienced the greatest craving relief and greatest aversion compared with other groups. CONCLUSIONS Both nicotine concentration and flavour appear to have independent, as well as interactive, effects that influence ENDS acceptability among people who use cigarettes.
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Affiliation(s)
- Jessica Yingst
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Vishal Midya
- Department of Environmental Medicine and Public Health, Icahn School of Medicine, New York, New York, USA
| | - Augustus White
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jonathan Foulds
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Susan Veldheer
- Departmanrt of Family and Community Medicine, Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Miao-Shan Yen
- Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Thomas Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
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Dai Y, Yang W, Song H, He X, Guan R, Wu Z, Jiang X, Li M, Liu P, Chen J. Long-term effects of chronic exposure to electronic cigarette aerosol on the cardiovascular and pulmonary system in mice: A comparative study to cigarette smoke. Environ Int 2024; 185:108521. [PMID: 38508052 DOI: 10.1016/j.envint.2024.108521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/03/2024] [Accepted: 02/19/2024] [Indexed: 03/22/2024]
Abstract
Electronic cigarettes (e-cigarettes) have rapidly gained popularity as alternatives to traditional combustible cigarettes. However, their long-term health impact remains uncertain. This study aimed to investigate the effects of chronic exposure to e-cigarette aerosol (ECA) in mice compared to conventional cigarette smoke (CS) exposure. The mice were exposed to air (control), low, medium, or high doses of ECA, or a reference CS dose orally and nasally for eight months. Various cardiovascular and pulmonary assessments have been conducted to determine the biological and prosthetic effects. Histopathological analysis was used to determine structural changes in the heart and lungs. Biological markers associated with fibrosis, inflammation, and oxidative stress were investigated. Cardiac proteomic analysis was applied to reveal the shared and unique protein expression changes in ECA and CS groups, which related to processes such as immune activation, lipid metabolism, and intracellular transport. Overall, chronic exposure to ECA led to adverse cardiovascular and pulmonary effects in mice, although they were less pronounced than those of CS exposure. This study provides evidence that e-cigarettes may be less harmful than combustible cigarettes for the long-term health of the cardiovascular and respiratory systems in mice. However, further human studies are needed to clarify the long-term health risks associated with e-cigarette use.
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Affiliation(s)
- Yuxing Dai
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Wanchun Yang
- Jieyang Medical Research Center, Jieyang People's Hospital, Jieyang, Guangdong, China
| | - Hongjia Song
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Xiangjun He
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Ruoqing Guan
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China
| | - Zehong Wu
- RELX Science Center, Shenzhen RELX Tech. Co. Ltd., Shenzhen 518101, China
| | - Xingtao Jiang
- RELX Science Center, Shenzhen RELX Tech. Co. Ltd., Shenzhen 518101, China
| | - Min Li
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China; National and Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China.
| | - Peiqing Liu
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China; National and Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China.
| | - Jianwen Chen
- Department of Pharmacology and Toxicology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China; National and Local Joint Engineering Laboratory of Druggability and New Drugs Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou 510006, China.
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6
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Monzon J, Barnoya J, Mus S, Davila G, Vidaña-Pérez D, Thrasher JF. Changes in substance use among adolescents before and during the COVID-19 pandemic in Guatemala. Front Psychiatry 2024; 15:1331962. [PMID: 38487580 PMCID: PMC10937547 DOI: 10.3389/fpsyt.2024.1331962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/25/2024] [Indexed: 03/17/2024] Open
Abstract
Objectives Due to the COVID-19 pandemic, on March 16th, schools had to be closed in Guatemala and went to online teaching. We sought to analyze the change in substance use among high school students in Guatemala associated with the lockdown. Methods Data from two surveys (2019, n=2096, and 2020, n=1606) of a student cohort in private high schools in Guatemala City was used. Logistic models for past 30-day cigarette, e-cigarette, marijuana, and alcohol (including binge drinking) were used, regressing these on survey wave, while adjusting for sex, scholastic performance, high school year of student, parental education, substance use, and household member tobacco use. Results Prevalence declined for smoking (10% to 3%, p<0.001), e-cigarette (31% to 14%, p<0.001), marijuana (4.3% to 1.9%, p<0.001), and alcohol use (47% to 38.5%, p<0.001), and binge drinking (24% to 13%, p<0.001). Adjusted models showed wave 2 associated with lower odds of using cigarettes (AOR=0.44, 95%CI=0.32-0.62), e-cigarettes (AOR=0.41, 95% CI=0.35-0.49, p<0.001), and binge drinking (AOR=0.73, 95%CI=0.59-0.89; p=0.002). Conclusion Among Guatemalan adolescents, COVID-19 restrictions were associated with a significant decrease in smoking, e-cigarette use, and binge drinking.
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Affiliation(s)
- Jose Monzon
- Health Sciences School, Rafael Landívar University, Guatemala City, Guatemala
- Research Department, Cardiovascular Surgery Unit of Guatemala (UNICAR), Guatemala City, Guatemala
| | - Joaquin Barnoya
- Research Department, Cardiovascular Surgery Unit of Guatemala (UNICAR), Guatemala City, Guatemala
- Research Department, Integra Cancer Institute, Guatemala City, Guatemala
| | - Sophia Mus
- Research Department, Cardiovascular Surgery Unit of Guatemala (UNICAR), Guatemala City, Guatemala
| | - Gustavo Davila
- Research Department, Cardiovascular Surgery Unit of Guatemala (UNICAR), Guatemala City, Guatemala
| | - Desirée Vidaña-Pérez
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - James F. Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Center for Population Health Research, National Institute of Public Health (Mexico), Cuernavaca, Mexico
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7
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Granata S, Vivarelli F, Morosini C, Canistro D, Paolini M, Fairclough LC. Toxicological Aspects Associated with Consumption from Electronic Nicotine Delivery System (ENDS): Focus on Heavy Metals Exposure and Cancer Risk. Int J Mol Sci 2024; 25:2737. [PMID: 38473984 DOI: 10.3390/ijms25052737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Tobacco smoking remains one of the leading causes of premature death worldwide. Electronic Nicotine Delivery Systems (ENDSs) are proposed as a tool for smoking cessation. In the last few years, a growing number of different types of ENDSs were launched onto the market. Despite the manufacturing differences, ENDSs can be classified as "liquid e-cigarettes" (e-cigs) equipped with an atomizer that vaporizes a liquid composed of vegetable glycerin (VG), polypropylene glycol (PG), and nicotine, with the possible addition of flavorings; otherwise, the "heated tobacco products" (HTPs) heat tobacco sticks through contact with an electronic heating metal element. The presence of some metals in the heating systems, as well as in solder joints, involves the possibility that heavy metal ions can move from these components to the liquid, or they can be adsorbed into the tobacco stick from the heating blade in the case of HTPs. Recent evidence has indicated the presence of heavy metals in the refill liquids and in the mainstream such as arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni), copper (Cu), and lead (Pb). The present review discusses the toxicological aspects associated with the exposition of heavy metals by consumption from ENDSs, focusing on metal carcinogenesis risk.
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Affiliation(s)
- Silvia Granata
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Fabio Vivarelli
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Camilla Morosini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Donatella Canistro
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Moreno Paolini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Lucy C Fairclough
- School of Life Sciences, University of Nottingham, East Dr, Nottingham NG7 2TQ, UK
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8
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Soule EK, Mayne S, Snipes W, Guy MC, Breland A, Fagan P. Reactions to a Hypothetical Ban of Open-System Electronic Cigarettes Among People Who Currently Use Electronic Cigarettes. Nicotine Tob Res 2024:ntae020. [PMID: 38408200 DOI: 10.1093/ntr/ntae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/13/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Policies limiting electronic cigarette (ECIG) device and liquid characteristics have been considered to prevent dependence potential and youth product appeal. "Open-system" ECIGs allow people to adjust device and liquid characteristics, which may undermine these policies. This study examined anticipated reactions to a policy prohibiting the sale of open-system ECIG devices in the United States using concept mapping. METHODS In 2020, adults who reported ECIG use in the past 30 days (n = 70; 45.1% women; mean age = 33.0, SD = 10.6) recruited from a research registry of individuals from across the United States provided statements into a shared list that completed a prompt: "If open-system vaping devices were no longer sold in the US and only closed-system vaping devices were available, what is a specific reaction or response you would have?" at a study website. Participants rated statements (1-7) on how true the statements were for them. Multidimensional scaling and hierarchical cluster analyses were used to identify thematic clusters. Mean ratings of statements were calculated and compared based on the type of ECIG used and current cigarette smoking status. RESULTS Participants generated 85 unique statements. The analysis identified eight themes that were organized into two broad groups. The first group of five clusters described behavioral responses to the hypothetical policy (Loopholes, Switch to Closed-System ECIGs, Legal Approaches to Use Open-System ECIGs, ECIG Use Cessation, Switch to non-ECIG Products). The second group of three clusters described psychological responses to the hypothetical policy (Closed-System ECIG Cons, Psychological Responses, Policy Outcome Concerns). CONCLUSIONS While a ban on open-system ECIG devices may have positive impacts on public health, policy loopholes, and consumer behaviors may undermine the policy. Efforts to support policy enforcement could increase policy effectiveness. IMPLICATIONS Open-system electronic cigarettes (ECIGs) that allow people who use ECIGs to modify ECIG device and liquid characteristics may limit the effectiveness of policies that establish product standards which attempt to limit nicotine delivery and flavor content in ECIG liquids. This study identified predicted reactions to a hypothetical policy prohibiting the sale of open-system ECIGs in the United States. Results suggest that people who use ECIGs may view a policy prohibiting open-system ECIGs unfavorably, but would be willing to use closed-system ECIGs. However, many ECIG users may attempt to find loopholes in the policy or alternative sources to purchase open-system ECIGs if open-systems were banned. Future research should identify strategies for tobacco regulatory policy enforcement to increase effectiveness.
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Affiliation(s)
- Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Shannon Mayne
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - William Snipes
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Mignonne C Guy
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Department of African American Studies, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - Alison Breland
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychology, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - Pebbles Fagan
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, Center for the Study of Tobacco, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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9
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Becker TD. A clinical overview of adolescent e-cigarette use (vaping). Minerva Pediatr (Torino) 2024; 76:108-118. [PMID: 37427959 DOI: 10.23736/s2724-5276.23.07131-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
E-cigarette use (also known as "vaping") has become increasingly popular among adolescents over the past decade and grown into a significant public health concern in North America, the United Kingdom, and other countries. Concerns about this new trend have generated numerous new research studies. This aim of this study was to summarize recent scientific findings, with a focus on their relevance to clinicians working with adolescents. The first half covers epidemiology, risk factors for e-cigarette use, characteristics of e-cigarette use, youth perceptions of e-cigarettes, physical health risks of e-cigarettes, evidence for "gateway effects" of e-cigarette exposure on subsequent substance use, and the relationship between e-cigarette use and mental health. The review concludes with a clinical focus on assessment of youth who vape, psychoeducation for youth and families, clinical management of vaping, and regulatory considerations.
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Affiliation(s)
- Timothy D Becker
- Department of Psychiatry, New York-Presbyterian Hospital, New York, NY, USA -
- Division of Child and Adolescent Psychiatry, Weill Cornell Medicine, New York, NY, USA -
- Division of Child and Adolescent Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA -
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10
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Manna VJ, Dwyer S, Pizutelli V, Caradonna SJ. Utilizing primary human airway mucociliary tissue cultures to model ramifications of chronic E-cigarette usage. Toxicol In Vitro 2024; 94:105725. [PMID: 37884163 DOI: 10.1016/j.tiv.2023.105725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/27/2023] [Accepted: 10/22/2023] [Indexed: 10/28/2023]
Abstract
Electronic cigarettes are battery powered devices that use a vape-liquid to produce a vapor that is inhaled. A consequence of the rise in e-cigarette usage was the 2019 emergence of a vaping-induced respiratory disease denoted as 'e-cigarette or vaping use-associated lung injury' (EVALI). One of the suspected causes of EVALI is Vitamin E Acetate (VEA), which was found to be a diluent in certain illicit vape-pens, whereas nicotine is commonly diluted in equal parts propylene glycol and vegetable glycerin (PG:VG). The prevalent use of e-cigarettes and the emergence of a novel illness has made understanding how e-cigarette vapors affect our respiratory tissues a public health concern. We have designed and produced a simple device that can operate e-cigarettes and deliver the vapor to a chamber containing a standard cell culture multi-well plate. Here we utilize our device to model the response of human airway mucociliary tissue after chronic exposure to vapors produced from either PG:VG or VEA. We note several differences between how PG:VG and VEA vapors interact with and alter airway tissue cultures and suggest potential mechanisms for how VEA-vapors can exacerbate EVALI symptoms. Our device combined with primary human airway tissue cultures make an economical and compact model system that allows for animal-free investigations into the acute and chronic consequences of e-cigarette vapors on primary respiratory cells.
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Affiliation(s)
- Vincent J Manna
- Department of Molecular Biology, Graduate School of Biomedical Sciences and School of Osteopathic Medicine, Rowan University, Stratford, NJ, United States.
| | - Shannon Dwyer
- Department of Molecular Biology, Graduate School of Biomedical Sciences and School of Osteopathic Medicine, Rowan University, Stratford, NJ, United States
| | - Vanessa Pizutelli
- Department of Molecular Biology, Graduate School of Biomedical Sciences and School of Osteopathic Medicine, Rowan University, Stratford, NJ, United States
| | - Salvatore J Caradonna
- Department of Molecular Biology, Graduate School of Biomedical Sciences and School of Osteopathic Medicine, Rowan University, Stratford, NJ, United States
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Wang S, Nandy RR, Rossheim ME. Associations between e-cigarette use and sleep health among adults in the United States, NHANES 2015-2018. Sleep Med 2024; 114:220-228. [PMID: 38232605 DOI: 10.1016/j.sleep.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/01/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Abstract
OBJECTIVE To examine the associations between e-cigarette use or dual (e-cigarette and combustible cigarette) use and short sleep duration and trouble sleeping among U.S. adults. METHODS We used 2015-2018 data from the National Health and Nutrition Examination Survey (NHANES) (n = 11,659). E-cigarette use and dual use were categorized as current, former, and never use. Short sleep duration was defined as sleep duration ≤6 h. Trouble sleeping was self-reported. Weighted logistic regression analyses were performed. RESULTS Among those with current e-cigarette use, 53.9 % were with current dual use and 23.8 % were with former dual use. Compared to never e-cigarette use, current e-cigarette use was associated with significantly higher odds of trouble sleeping (OR = 2.16, 95 % CI: 1.49-3.13), adjusting for potential confounders. Significant associations were also observed for former e-cigarette use versus never use with trouble sleeping (OR = 1.54, 95 % CI: 1.15-2.07) after full adjustment. Current cigarette use was associated with both short sleep duration (OR = 1.65, 95 % CI: 1.28-2.14) and trouble sleeping (OR = 1.36, 95 % CI: 1.03-1.79) after full adjustment. Additionally, the fully adjusted ORs for short sleep duration and trouble sleeping were 1.64 (95 % CI: 1.06-2.54) and 2.14 (95 % CI: 1.34-3.42) among those with current dual use, and 1.46 (95 % CI: 1.17-1.81) and 2.11 (95 % CI: 1.66-2.67) among those with former dual use, compared to those without dual use. CONCLUSIONS Current cigarette use or dual use is associated with significantly higher odds of short sleep duration and trouble sleeping. Moreover, former e-cigarette use or dual use is associated with increased odds of trouble sleeping.
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Affiliation(s)
- Shanshan Wang
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Rajesh R Nandy
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Matthew E Rossheim
- Department of Health Administration & Health Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
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Alhalafi A. The Use of Electronic Cigarettes in Saudi Arabia: A Narrative Review. Cureus 2024; 16:e54167. [PMID: 38496178 PMCID: PMC10941232 DOI: 10.7759/cureus.54167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
The use of electronic cigarettes (or "e-cigarettes") is spreading throughout the world. Population-level data from a number of countries indicate that e-cigarettes are used more by children and young adults than by the overall population. Although extensive research has been conducted in Western nations to better understand many aspects of e-cigarette usage among children and young adults, Middle Eastern nations have little data on this topic. The use of tobacco is detrimental to the health, finances, and national spirit of Saudi Arabia. More than 7,000 of its citizens die each year from diseases caused by tobacco use. Nevertheless, more than 20,000 youngsters and 3,352,000 adults smoke cigarettes each day. Similarly, the use of electronic cigarettes is on the rise, possibly as a result of aggressive publicity and marketing campaigns by manufacturers that appeal to the younger demographic. This review was undertaken through literature research to ascertain the usage and attitudes toward e-cigarette use among the Saudi population.
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Affiliation(s)
- Abdullah Alhalafi
- Department of Family and Community Medicine, College of Medicine, University of Bisha, Bisha, SAU
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13
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Deng R, Yang C, Yuan Y, Liang L, Yang X, Wang X, Tian J, Zhang Y, Wu X, Dai H. A cross-sectional survey of medical and other groups' awareness, perceptions, and willingness to use e-cigarettes during the COVID-19 pandemic. Front Public Health 2024; 11:1323804. [PMID: 38259797 PMCID: PMC10800479 DOI: 10.3389/fpubh.2023.1323804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Background In China, people's perceptions towards electronic cigarettes during Corona Virus Disease 2019 (COVID-19) pandemic compared with pre-pandemic conditions have not been explored. Exploring the perceptions of medical workers regarding e-cigarettes is crucial, as they serve as a trusted source of information and providers of smoking cessation counselling for smokers. This cross-sectional study was designed to explore the awareness and perceptions of e-cigarettes among Chinese medical and other groups in the context of the COVID-19 pandemic. Methods A cross-sectional survey was performed using an online, anonymous, and self-administered questionnaire. The questionnaire contained sections for collecting participants' general information and Likert scale questions regarding smoking status, perceptions of e-smoking, attitude, and willingness to use e-cigarettes. The respondents included medical students, clinical doctors, and other occupations. Data analysis was performed using tools such as descriptive analysis, binary logistic regression, and multivariate regression. Results A total of 952 people completed the questionnaire, and 96.54% of them reported to have heard about e-cigarettes. The most common source of information about e-cigarettes was advertising. Notably, 28 of the 116 smokers reported that they had used e-cigarettes. Independent-samples T-tests results showed that medical groups believed e-cigarettes contained tar (p = 0.03). Most of the medical and non-medical participants maintained neutral attitudes towards e-cigarette policies (38.3%) and prices (49.2%) but their views were significantly different (p < 0.001). Multivariate logistic regression indicated that highly educated people had higher knowledge about e-cigarettes relative to those with lower education (undergraduate, OR = 1.848, 95CI% = 1.305-2.616, p = 0.001; master's degree or doctoral degree, OR = 1.920, 95CI% = 1.230-2.997, p = 0.004). The medical group used fewer e-cigarettes compared to non-medical group (OR = 1.866, 95CI% = 1.185-2.938, p = 0.007), the non-traditional cigarette users showed lower utilization compared to traditional cigarette users (18-40, OR = 4.797, 95CI% = 0.930-24.744, p = 0.061; > 40, OR = 9.794, 95CI% = 1.683-56.989, p = 0.011) and the older adult used fewer than the young (18-40, OR = 4.797, 95CI% = 0.930-24.744, p = 0.061; > 40, OR = 9.794, 95CI% = 1.683-56.989, p = 0.011). Conclusion This study found that individuals tend to hold negative attitudes towards the awareness, perceptions, and willingness to use e-cigarettes. Medical groups are less likely to use e-cigarettes, but misperceptions are still prevalent among them. This calls for additional training for such medical personnel to improve their capacity to provide necessary counselling to smokers. E-cigarettes advertisements were the main source of information for young individuals to learn about e-cigarettes, and hence measures should be taken to restrict exposure of young individuals to e-cigarettes.
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Affiliation(s)
- Ruihang Deng
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Chuang Yang
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Yifang Yuan
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Lifang Liang
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Xin Yang
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Xinyu Wang
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Jiao Tian
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Yuxin Zhang
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Xuekai Wu
- First Clinical Medical College, Chongqing Medical University, Chongqing, China
| | - Haiyun Dai
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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14
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Qi H, Chang X, Wang K, Xu Q, Liu M, Han B. Comparative analyses of transcriptome sequencing and carcinogenic exposure toxicity of nicotine and 6-methyl nicotine in human bronchial epithelial cells. Toxicol In Vitro 2023; 93:105661. [PMID: 37586650 DOI: 10.1016/j.tiv.2023.105661] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/01/2023] [Accepted: 08/14/2023] [Indexed: 08/18/2023]
Abstract
Electronic cigarettes have become a purported safer alternative to the conventional cigarettes in recent years. Nicotine is the main component of electronic cigarettes, and other nicotinic compounds are synthesized as alternatives to nicotine. However, scientific data on the potential health effects of electronic cigarettes are scarce. Herein, we evaluated the cytotoxicity of nicotine and its analog 6-methyl nicotine (6-MN) on human bronchial epithelial cells (BEAS-2B cells) in vitro. Furthermore, we performed transcriptome sequencing to systematically assess the effects of nicotine and 6-MN on BEAS-2B cells. The cytotoxicity assay revealed that BEAS-2B cells were more sensitive to 6-MN than to nicotine. Transcriptome sequencing revealed 1208 differentially expressed cancer-related proteins (CRP) in the 6-MN groups relative to that with CRP in the control group. In addition, 6-MN had a greater negative effect on the CRP expression than nicotine. Bioinformatic analysis revealed that the differentially expressed genes and proteins in the 6-MN group were significantly enriched in the cancer-related pathways, unlike those in the nicotine group. Further validations of some lung cancer-related proteins, such as NF-κB p65, EGFR, and MET, were conducted by immunoblotting and real-time PCR, which revealed that 6-MN may have a greater negative effect on tumor development and metastasis than nicotine. Taken together, our findings suggest that new electronic cigarettes with 6-MN might offer some advantages over conventional electronic cigarettes containing nicotine.
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Affiliation(s)
| | - Xia Chang
- Guangdong Pharmaceutical University, China
| | - Ke Wang
- Guangdong Pharmaceutical University, China
| | - Qiaoxin Xu
- Guangdong Pharmaceutical University, China
| | - Meisen Liu
- Shenzhen Zinwi Bio-Tech Co., LTD., China.
| | - Bin Han
- Guangdong Pharmaceutical University, China.
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Adeniji A, El-Hage R, Brinkman MC, El-Hellani A. Nontargeted Analysis in Tobacco Research: Challenges and Opportunities. Chem Res Toxicol 2023; 36:1656-1665. [PMID: 37903095 DOI: 10.1021/acs.chemrestox.3c00150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Tobacco products are evolving at a pace that has outstripped tobacco control, leading to a high prevalence of tobacco use in the population. Researchers have been tirelessly developing suitable techniques to assess these products' emissions, toxicity, and public health impact. The nonclinical testing of tobacco products to assess the chemical profile of emissions is needed for evidence-based regulations. This testing has largely relied on targeted analytical methods that focus on constituent lists that may fall short in determining the toxicity of newly designed tobacco products. Nontargeted analysis (NTA), or the process of identifying and quantifying compounds within a complex matrix without prior knowledge of its chemical composition, is a promising technique for tobacco regulation, but it is not without challenges. The lack of standardized methods for sample generation, sample preparation, chromatographic separation, compound identification, and data analysis and reporting must be addressed so that the quality and reproducibility of the data generated by NTA can be benchmarked. This review discusses the challenges and highlights the opportunities of NTA in studying tobacco product constituents and emissions.
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Affiliation(s)
- Ayomipo Adeniji
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio 43210, United States
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio 43214, United States
| | - Rachel El-Hage
- Department of Chemistry, Faculty of Arts and Sciences, American University of Beirut, Beirut 1107 2020, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia 23220, United States
| | - Marielle C Brinkman
- Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio 43210, United States
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio 43214, United States
| | - Ahmad El-Hellani
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio 43210, United States
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio 43214, United States
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Olaniyan AC, Nabors LA, King KA, Merianos AL. Adverse Childhood Experiences and Electronic Cigarette Use among U.S. Young Adults. Toxics 2023; 11:907. [PMID: 37999559 PMCID: PMC10675573 DOI: 10.3390/toxics11110907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023]
Abstract
(1) Background: Adverse childhood experiences (ACEs), which are potentially traumatic childhood events, have been associated with increased tobacco product use. Less is known about electronic cigarette (e-cigarette) use during young adulthood. This study explored the associations between ACEs and current e-cigarette use among U.S. young adults. (2) Methods: This study was a secondary analysis of 2021 Behavioral Risk Factor Surveillance System data including 2537 young adults aged 18-24 years. Unadjusted and adjusted logistic regression analyses were conducted. (3) Results: Of the participants, 19.2% currently used e-cigarettes, and 22.1% reported 1 ACE, 13.0% reported 2 ACEs, 10.7% reported 3 ACEs, and 30.6% reported ≥4 ACEs. Unadjusted results indicated that participants who experienced 1 ACE (odds ratio (OR) = 1.76, 95% confidence interval (CI) = 1.01-3.07), 2 ACEs (OR = 2.18, 95%CI = 1.24-3.83), 3 ACEs (OR = 2.63, 95%CI = 1.41-4.90), and ≥4 ACEs (OR = 3.69, 95%CI = 2.23-6.09) were at increased odds of reporting current e-cigarette use than participants who experienced 0 ACEs. Adjusted results indicated that participants who experienced 3 ACEs were at 2.20 times higher odds (95%CI = 1.15-4.23) and participants who experienced ≥4 ACEs were at 2.73 times higher odds (95%CI = 1.58-4.71) of reporting current e-cigarette use than participants who experienced 0 ACEs. (4) Conclusions: Young adults exposed to ACEs are at risk of using e-cigarettes.
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Affiliation(s)
- Afolakemi C. Olaniyan
- School of Population & Health Sciences, Dillard University, New Orleans, LA 70122, USA;
| | - Laura A. Nabors
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Keith A. King
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Ashley L. Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA
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Sousan S, Mooring R, Fresquez S, Park YM, Coombs V, Bertges N, Thomas L, Gold E, Gogineni A, Tiet A, Pender J, Soule EK. Use of real-time monitors to evaluate the potential exposure of secondhand electronic cigarette particulate matter inside vehicles. Environ Pollut 2023; 336:122480. [PMID: 37657722 PMCID: PMC10591990 DOI: 10.1016/j.envpol.2023.122480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/03/2023]
Abstract
Electronic cigarette (ECIG) use continues to be highly prevalent, especially among youth and young adults. Potential exposure from secondhand ECIG particulate matter (PM) places bystanders in danger of inhaling harmful substances, especially in confined spaces. This study was conducted to measure the potential exposure from secondhand ECIG PM exposure in vehicles, with participants completing a 30-min ECIG use session in their own vehicle with their preferred ECIG device. Sessions included a 5-min, 10-puff directed bout (30-s interpuff interval), followed by a 25-min ad libitum bout in which participants could take as many puffs as desired. Real-time PM1, PM2.5, and PM10 (the 50% efficiency mass cut-off of that passes through a size-selective inlet at 1 μm, 2.5 μm, and 10 μm aerodynamic diameters, respectively) measurements were captured during the sessions using portable PM monitors (MiniWRAS, pDR, SidePak, and GeoAir2 low-cost monitors). A total of 56 participants with valid measurements were included in the study, with a total of 13 unique ECIG device brands, including Vuse Alto, Box Air Bar, ElfBar, Esco Bar, Aegis Legend, Hyde Edge, JUUL, Kang Onee Stick, Kang Onee Stick Plus, Nord X, Nord 2, Nord 3, and Vaporesso. During the 5-min directed bout, the highest real-time PM2.5 mean concentrations were 175 μg/m3 for the MiniWRAS, 1050 μg/m3 for pDR and 3314 μg/m3 for SidePak. The filter measurements were not detectable in most experiments, except for two participants, with one taking 205 puffs and the other taking 285 puffs, approximately 10 times the mean (30) puffs of all participants. The evaluation of GeoAir2 with the MiniWRAS showed a wide range of Pearson correlation coefficient (r) values, ranging from -0.03 to 1.00, for the 13 ECIG brands. The mass median diameter (0.31 μm-3.42 μm) and geometric standard deviation (2.47-8.21) were different based on the participants for the same ECIG brand.
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Affiliation(s)
- Sinan Sousan
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, 27858, USA; North Carolina Agromedicine Institute, Greenville, NC, 27858, USA.
| | - Ronald Mooring
- Department of Chemistry, Thomas Harriot College of Arts & Sciences, East Carolina University, Greenville, NC, 27858, USA
| | - Sarah Fresquez
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, 27858, USA
| | - Yoo Min Park
- Department of Geography, University of Connecticut, Storrs, CT, 06269, USA
| | - Vivien Coombs
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, 27858, USA
| | - Nicole Bertges
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC, 27858, USA
| | - Luke Thomas
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, 27858, USA
| | - Emily Gold
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, 27858, USA
| | - Anish Gogineni
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, 27858, USA
| | - Alex Tiet
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, 27858, USA
| | - Jack Pender
- Department of Chemistry, Thomas Harriot College of Arts & Sciences, East Carolina University, Greenville, NC, 27858, USA
| | - Eric K Soule
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC, 27858, USA; Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, 27858, USA
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Jones CA, Wallace MJ, Bandaru P, Woodbury ED, Mohler PJ, Wold LE. E-cigarettes and arrhythmogenesis: a comprehensive review of pre-clinical studies and their clinical implications. Cardiovasc Res 2023; 119:2157-2164. [PMID: 37517059 PMCID: PMC10578912 DOI: 10.1093/cvr/cvad113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/21/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Electronic cigarette use has grown exponentially in recent years, and while their popularity has increased, the long-term effects on the heart are yet to be fully studied and understood. Originally designed as devices to assist with those trying to quit traditional combustible cigarette use, their popularity has attracted use by teens and adolescents who traditionally have not smoked combustible cigarettes. Acute effects on the heart have been shown to be similar to traditional combustible cigarettes, including increased heart rate and blood pressure. The main components of electronic cigarettes that contribute to these arrhythmic effects are found in the e-liquid that is aerosolized and inhaled, comprised of nicotine, flavourings, and a combination of vegetable glycerin (VG) and propylene glycol (PG). Nicotine can potentially induce both ventricular and atrial arrhythmogenesis, with both the atrial and ventricular effects resulting from the interactions of nicotine and the catecholamines they release via potassium channels. Atrial arrhythmogenesis, more specifically atrial fibrillation, can also occur due to structural alterations, which happens because of nicotine downregulating microRNAs 133 and 590, both post-transcriptional growth factor repressors. Liquid flavourings and the combination of PG and VG can possibly lead to arrhythmic events by exposing users to acrolein, an aldehyde that stimulates TRPA1 that in turn causes a change towards sympathetic activation and autonomic imbalance. The design of these electronic delivery devices is constantly changing; therefore, it has proven extremely difficult to study the long-term effects on the heart caused by electronic cigarettes but will be important to understand given their rising popularity. The arrhythmic effects of electronic cigarettes appear similar to traditional cigarettes as well; however, a comprehensive review has not been compiled and is the focus of this article.
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Affiliation(s)
- Carson A Jones
- Dorothy M. Davis Heart and Lung Research Institute, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Columbus, OH 43210, USA
| | - Michael J Wallace
- Dorothy M. Davis Heart and Lung Research Institute, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Columbus, OH 43210, USA
| | - Priya Bandaru
- Dorothy M. Davis Heart and Lung Research Institute, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Columbus, OH 43210, USA
| | - Emerson D Woodbury
- Dorothy M. Davis Heart and Lung Research Institute, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Columbus, OH 43210, USA
| | - Peter J Mohler
- Dorothy M. Davis Heart and Lung Research Institute, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Columbus, OH 43210, USA
- Department of Internal Medicine, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Loren E Wold
- Dorothy M. Davis Heart and Lung Research Institute, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Columbus, OH 43210, USA
- Division of Cardiac Surgery, Department of Surgery, Wexner Medical Center, The Ohio State University, 473 W 12th Avenue, Room 603, Columbus, OH 43210, USA
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Kolaczyk K, Jiang H. Photometric Monitoring of Electronic Cigarette Puff Topography. Sensors (Basel) 2023; 23:8220. [PMID: 37837050 PMCID: PMC10575377 DOI: 10.3390/s23198220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/15/2023]
Abstract
To study and monitor the adverse health consequences of using electronic cigarettes, a user's puff topography, which are quantification parameters of the user's vaping habits, plays a central role. In this work, we introduce a topography sensor to measure the mass of total particulate matter generated in every puff and to estimate the nicotine yield. The sensor is compact and low-cost, and is integrated into the electronic cigarette device to promptly and conveniently monitor the user's daily puff topography. The topography sensor is comprised of a photometric sensor and a pressure sensor. The photometric sensor measures the mass concentration of the aerosol, based on scattering of near-infrared light from airborne particles, while the pressure sensor measures the flow rate. The topography sensor was tested under various conditions including a wide range of atomizer power, puff duration, and inhalation pressure. The sensor's accuracy was validated by comparing the sensor's readings with reference measurements, and the results matched closely with the trends reported by existing studies on electronic cigarettes. An example application for tracking a user's puff topography was also demonstrated. Our topography sensor holds great promise in mitigating the health risks of vaping, and in promoting quality control of electronic cigarette products.
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Close A, Blackerby J, Tunnell H, Pender J, Soule E, Sousan S. Effects of E-Cigarette Liquid Ratios on the Gravimetric Filter Correction Factors and Real-Time Measurements. Aerosol Air Qual Res 2023; 23:230011. [PMID: 38500670 PMCID: PMC10947168 DOI: 10.4209/aaqr.230011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Electronic cigarettes (ECIGs) generate high concentrations of particulate matter (PM), impacting the air quality inhaled by humans through secondhand exposure. ECIG liquids are available commercially and some users create their own "do-it-yourself" liquids, and these liquids often vary in the amounts of their chemical ingredients, including propylene glycol (PG) and vegetable glycerin (VG). Previous studies have quantified PM concentrations in ECIG aerosol generated from liquids containing different PG/VG ratios. However, the effects of these ratios on aerosol instrument filter correction factors needed to measure PM concentrations accurately have not been assessed. Thus, ECIG aerosol filter correction factors for multiple aerosol instruments (SMPS + APS, MiniWRAS, pDR, and SidePak) were determined for five different PG/VG ratios 1) 0PG/100VG, 2) 15PG/85VG, 3) 50PG/50VG, 4) 72PG/28VG, and 5) 90PG/10VG and two different PM sizes, PM1 (1 μm and smaller) and PM2.5 (2.5 μm and smaller). ECIG aerosols were generated inside a controlled exposure chamber using a diaphragm pump and a refillable ECIG device for all the ratios. In addition, the aerosol size distribution and mass median diameter were measured for all five ECIG ratios. PM2.5 correction factors (5-7.6) for ratios 1, 2, 3, and 4 were similar for the SMPS + APS combined data, and ratios 1, 2, 3 were similar for the MiniWRAS (~2), pDR (~0.5), and SidePak (~0.24). These data suggest different correction factors may need to be developed for aerosol generated from ECIGs with high PG content. The higher correction factor values for the 90PG/10VG ratio may have resulted from greater PG volatility relative to VG and sensor losses. The correction factors (ratios 1-4) for PM2.5 were SMPS + APS data (4.96-7.62), MiniWRAS (2.02-3.64), pDR (0.50-1.07), and SidePak (0.22-0.40). These data can help improve ECIG aerosol measurement accuracy for different ECIG mixture ratios.
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Affiliation(s)
- Austin Close
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
| | - Jane Blackerby
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
| | - Heather Tunnell
- Department of Chemistry, East Carolina University, Greenville, NC 27858, USA
| | - Jack Pender
- Department of Chemistry, East Carolina University, Greenville, NC 27858, USA
| | - Eric Soule
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC 27858
| | - Sinan Sousan
- Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA
- North Carolina Agromedicine Institute, Greenville, NC 27834, USA
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21
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Wadkin R, Allen C, Fearon IM. E-cigarette puffing topography: The importance of assessing user behaviour to inform emissions testing. Drug Test Anal 2023; 15:1222-1232. [PMID: 36574584 DOI: 10.1002/dta.3322] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/12/2022] [Accepted: 05/15/2022] [Indexed: 12/29/2022]
Abstract
Analysis of the chemical composition of e-cigarette emissions is an important step in determining whether e-cigarettes offer both individual and population-level harm reduction potential. Commonly, e-cigarette emissions for chemical analysis are collected when using e-cigarettes according to standardised puffing regimens, such as those recommended by the International Organization for Standardization (ISO) or the Cooperation Centre for Scientific Research Relative to Tobacco (CORESTA). While the use of such standard puffing regimens affords a degree of uniformity between studies and are also recommended by regulatory authorities who require the submission of e-cigarette emissions data to make decisions regarding allowing a product to be commercially marketed, the standardised regimens do not necessarily reflect human puffing behaviour. This can lead to under- or over-estimating real-world emissions from e-cigarettes and inaccuracy in determining their harm reduction potential. In this review, we describe how human puffing behaviour (topography) information can be collected both in the clinical laboratory and in the real world using a variety of different methodologies. We further discuss how this information can be used to dictate e-cigarette puffing regimens for collecting emissions for chemical analyses and how this may lead to better predictions both of human yields of e-cigarette emissions constituents and of risk assessments to predict e-cigarette tobacco harm reduction potential.
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Affiliation(s)
- Rhys Wadkin
- Scientific Affairs, Broughton Life Sciences, Earby, UK
| | - Chris Allen
- Scientific Affairs, Broughton Life Sciences, Earby, UK
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22
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Fearon IM, Seltzer RGN, Houser TL, Tope A, Cahours X, Verron T, Malt L, Nahde T, O'Connell G, Nides M. Examination of the impact of myblu electronic nicotine delivery system e-liquid nicotine strength on self-reported measures of dependence. Drug Test Anal 2023; 15:1270-1280. [PMID: 35712897 DOI: 10.1002/dta.3335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/31/2022] [Accepted: 06/15/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Greater nicotine delivery is associated with higher nicotine concentrations in electronic nicotine delivery system (ENDS) liquids. However, there is a current debate as to whether this leads to increased dependence and mitigates ENDS public health potential. METHODS Self-reported dependence among users of myblu ENDS containing different nicotine concentrations was examined with data from a multiwave cross-sectional survey of US young adults and adults. Questions examined responses related to dependence measures and participants' most often used myblu ENDS nicotine concentration (low: 0%, 1% and 1.2%; medium: 2%, 2.4% and 2.5%; or high: 3.6% and 4%). RESULTS A global general linear model using nicotine concentration, age and days myblu that was used in the past 30 revealed a significant difference in PROMIS scores among nicotine concentration groups (F = 4.07, p = 0.02). However, pairwise comparisons to examine which specific groups differed significantly from others showed no significant differences. Logistic regression demonstrated that strong past 30-day cravings to use myblu among participants using high or medium nicotine concentrations were not significantly different from those using a low concentration (ORs 0.66 [0.42, 1.03], p = 0.07 and 0.95 [0.49, 1.82], p = 0.98, respectively). Time to daily first use for high or medium nicotine concentration users was not significantly different from those using a low concentration (ORs 0.89 [0.70, 1.14], p = 0.35 and 0.84 [0.57, 1.25], p = 0.40, respectively). CONCLUSIONS Use of myblu ENDS with different nicotine concentrations is not associated with differing levels of dependence. Our findings contradict the notion that high ENDS e-liquid nicotine levels generate increased dependence.
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Affiliation(s)
| | | | - Trisha L Houser
- Houser Clinical Research Writing and Consulting, LLC, Durham, North Carolina, USA
| | | | | | | | | | - Thomas Nahde
- Reemtsma Cigarettenfabriken GmbH, Hamburg, Germany
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23
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Lin SY, Cheng X, Rossheim ME, Gress D, Cuellar AE, Cheskin L, Xue H. Associations between use of specific social media sites and electronic cigarette use among college students. J Am Coll Health 2023; 71:2217-2224. [PMID: 34469259 DOI: 10.1080/07448481.2021.1965149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To examine dose-response associations between use of specific social media sites and the use of electronic cigarettes (e-cigarettes) and traditional cigarettes. METHODS This was a cross-sectional study of 298 first-year college students enrolled in the fall 2019 semester at a large state university. Heckman selection and Probit model were used to estimate associations between use of specific social media sites and e-cigarette/traditional cigarette use. RESULTS Each additional hour per day spent on Snapchat was associated with a 4.61% increase in the probability of lifetime e-cigarette use. In addition, among current e-cigarette users, more time spent on Snapchat was associated with more frequent e-cigarette use (marginal effects: 0.13, p = 0.001). Facebook, Twitter, Snapchat and Instagram were not associated with traditional cigarette smoking. CONCLUSION Snapchat was the only major social media platform associated with both lifetime and current e-cigarette use.
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Affiliation(s)
- Shuo-Yu Lin
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Xiaolu Cheng
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Matthew E Rossheim
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Dustin Gress
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Alison Evans Cuellar
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Lawrence Cheskin
- Department of Nutrition and Food Studies, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Hong Xue
- Department of Health Administration and Policy, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
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24
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Wölkart G, Kollau A, Russwurm M, Koesling D, Schrammel A, Mayer B. Varied effects of tobacco smoke and e-cigarette vapor suggest that nicotine does not affect endothelium-dependent relaxation and nitric oxide signaling. Sci Rep 2023; 13:15833. [PMID: 37739972 PMCID: PMC10517138 DOI: 10.1038/s41598-023-42750-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/14/2023] [Indexed: 09/24/2023] Open
Abstract
Chronic smoking causes dysfunction of vascular endothelial cells, evident as a reduction of flow-mediated dilation in smokers, but the role of nicotine is still controversial. Given the increasing use of e-cigarettes and other nicotine products, it appears essential to clarify this issue. We studied extracts from cigarette smoke (CSE) and vapor from e-cigarettes (EVE) and heated tobacco (HTE) for their effects on vascular relaxation, endothelial nitric oxide signaling, and the activity of soluble guanylyl cyclase. The average nicotine concentrations of CSE, EVE, and HTE were 164, 800, and 85 µM, respectively. At a dilution of 1:3, CSE almost entirely inhibited the relaxation of rat aortas and porcine coronary arteries to acetylcholine and bradykinin, respectively, while undiluted EVE, with a 15-fold higher nicotine concentration, had no significant effect. With about 50% inhibition at 1:2 dilution, the effect of HTE was between CSE and EVE. Neither extract affected endothelium-independent relaxation to an NO donor. At the dilutions tested, CSE was not toxic to cultured endothelial cells but, in contrast to EVE, impaired NO signaling and inhibited NO stimulation of soluble guanylyl cyclase. Our results demonstrate that nicotine does not mediate the impaired endothelium-dependent vascular relaxation caused by smoking.
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Affiliation(s)
- Gerald Wölkart
- Department of Pharmacology and Toxicology, Institute of Pharmaceutical Sciences, Universität Graz, Humboldtstraße 46, 8010, Graz, Austria
| | - Alexander Kollau
- Department of Pharmacology and Toxicology, Institute of Pharmaceutical Sciences, Universität Graz, Humboldtstraße 46, 8010, Graz, Austria
| | - Michael Russwurm
- Department of Pharmacology and Toxicology, Ruhr-Universität Bochum, MA N1-39, 44780, Bochum, Germany
| | - Doris Koesling
- Department of Pharmacology and Toxicology, Ruhr-Universität Bochum, MA N1-39, 44780, Bochum, Germany
| | - Astrid Schrammel
- Department of Pharmacology and Toxicology, Institute of Pharmaceutical Sciences, Universität Graz, Humboldtstraße 46, 8010, Graz, Austria
| | - Bernd Mayer
- Department of Pharmacology and Toxicology, Institute of Pharmaceutical Sciences, Universität Graz, Humboldtstraße 46, 8010, Graz, Austria.
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25
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Soule EK, Sousan S, Pender J, Thomas L, Gold E, Fresquez S, Mooring R, Coombs V, Gogineni A, Tiet A. Secondhand electronic cigarette aerosol in vehicles impacts indoor air quality. Drug Alcohol Depend 2023; 250:110889. [PMID: 37478503 PMCID: PMC10528711 DOI: 10.1016/j.drugalcdep.2023.110889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/26/2023] [Accepted: 07/04/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Electronic cigarette (ECIG) use in vehicles represents a public health concern due to the potential for exposure to high concentrations of particulate matter (PM) and other toxicants. This study examined the impact of ECIG use on air quality in vehicles. METHODS People who reported current ECIG use (n=60; mean age=20.5, SD=2.3) completed a brief survey and a 30-min ECIG use session in their own vehicle. Using a protocol similar to clinical laboratory studies involving tobacco use, participants took 10 directed puffs (i.e., a directed bout with one puff every 30s for 5min) followed by a 25-min ad libitum period in which participants took as many puffs as desired. PM 2.5µm in diameter or smaller (PM2.5) were measured using aerosol monitors set up to sample air from the breathing zone of the passenger seat and total puffs were recorded. The association between peak PM2.5 concentration and puff count was examined. RESULTS Participants took a median 18 total puffs during the sessions. Median PM2.5 concentrations increased from 4.78µg/m3 at baseline to 107.40µg/m3 after the directed bout. Median peak PM2.5 concentration was 464.48µg/m3 and ranged from 9.56µg/m3 to 143,503.91µg/m3 (IQR=132.72-1604.68). After removing two extreme outliers for puff count and PM2.5 concentrations, puff count was significantly correlated with peak PM2.5 concentration during the ad libitum bout (r=0.32, p=0.015). CONCLUSIONS ECIG use in vehicles impacts air quality negatively and may pose health risks to those present in vehicles when ECIG use is occurring.
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Affiliation(s)
- Eric K Soule
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA; Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA27858, USA.
| | - Sinan Sousan
- Department of Public Health, Brody School of Medicine, East Carolina UniversityGreenville, NC27858, USA; North Carolina Agromedicine Institute, Greenville, NC27858, USA
| | - Jack Pender
- Department of Chemistry, Thomas Harriot College of Arts & Sciences, East Carolina University, Greenville, NC27858, USA
| | - Luke Thomas
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Emily Gold
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Sarah Fresquez
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Ronald Mooring
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Vivien Coombs
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Anish Gogineni
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Alex Tiet
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
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26
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Yassine A, Antossian C, El-Hage R, Saliba NA. A Quick Method for the Determination of the Fraction of Freebase Nicotine in Electronic Cigarettes. Chem Res Toxicol 2023. [PMID: 37406365 DOI: 10.1021/acs.chemrestox.2c00371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Recently, many electronic cigarettes (ECIGs) manufacturers have begun offering e-liquids, known as "nicotine salts". These salts that have started gaining big popularity among users can be formed by adding weak acid to e-liquid mixtures consisting of propylene glycol (PG), vegetable glycerin (VG), flavors, and nicotine. The latter can exist in two forms: monoprotonated (mp) and freebase (fb) based on the pH of the matrix. Over the years, the determination of the fraction of fb was found important to policymakers as the prevalence of this form in ECIGs has been associated with the harshness sensory of inhalable aerosols. Liquid-liquid extraction (LLE), 1H NMR, and Henderson-Hasselback have been developed to deduce the fraction of fb; however, these methods were found to be time-consuming and have shown some challenges mainly due to the presence of a non-aqueous matrix consisting of PG and VG. This paper presents a quick non-aqueous pH measurement-based method that allows a quick determination of the fraction fb by just measuring the pH and the dielectric constant of the e-liquid. Then, by inputting these values into an established mathematical relationship, the fraction fb can be deduced. The relationship between pH, dielectric constant, and fb relies on knowing the values of the acidity dissociation constants of nicotine, which were determined for the first time in various PG/VG mixtures using a non-aqueous potentiometric titration. To validate the proposed method, the fraction fb was determined for commercials and lab-made nicotine salts utilizing the pH and LLE methods. The variation between the two methods was (<8.0%) for commercial e-liquids and lab-made nicotine salts containing lactic acid and salicylic acid. A larger discrepancy of up to 22% was observed for lab-made nicotine salts containing benzoic acid, which can be attributed to the stronger affinity of benzoic acid to toluene in the LLE method.
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Affiliation(s)
- Amira Yassine
- Department of Chemistry, Faculty of Arts and Sciences, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon
| | - Cynthia Antossian
- Department of Chemistry, Faculty of Arts and Sciences, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon
| | - Rachel El-Hage
- Department of Chemistry, Faculty of Arts and Sciences, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 100 W. Franklin St. Suite 200, Richmond, Virginia 23220, United States
| | - Najat A Saliba
- Department of Chemistry, Faculty of Arts and Sciences, American University of Beirut, Riad El Solh, Beirut 1107 2020, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, 100 W. Franklin St. Suite 200, Richmond, Virginia 23220, United States
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27
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Frosina J, McEwan M, Ebajemito J, Thissen J, Taluskie K, Baxter-Wright S, Hardie G. Assessing the impact of protonating acid combinations in e-cigarette liquids: a randomised, crossover study on nicotine pharmacokinetics. Sci Rep 2023; 13:10563. [PMID: 37386281 PMCID: PMC10310785 DOI: 10.1038/s41598-023-37539-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 06/23/2023] [Indexed: 07/01/2023] Open
Abstract
The addition of protonating acids to e-cigarette liquid formulations (e-liquids) enhances nicotine bioavailability in e-cigarette use. However, little is known about the impact of different combinations of protonating acid on nicotine pharmacokinetics. The objectives of this study were to compare pharmacokinetics of nicotine absorption following use of a closed-system e-cigarette, containing e-liquids with two different nicotine levels and with different ratios of three common protonating acids-lactic, benzoic and levulinic. In a randomised, controlled, crossover study, nicotine pharmacokinetics and product liking were assessed for prototype e-liquids used in a Vuse e-cigarette containing either 3.5% or 5% nicotine and varying ratios of lactic, benzoic and/or levulinic acid. During an 8-day confinement period, 32 healthy adult current cigarette smokers/e-cigarette dual users used a single study e-liquid each day during 10-min fixed and ad libitum use periods after overnight nicotine abstinence. For most comparisons, Cmax and AUC0-60 following both fixed and ad libitum puffing were significantly higher for e-liquids containing 5% nicotine compared with 3.5% nicotine. However, Cmax and AUC0-60 were not statistically different for 5% nicotine e-liquids containing varying ratios of lactic, levulinic and benzoic acid when compared to an e-liquid containing lactic acid only. Mean scores for product liking were similar for all e-liquid formulations assessed, regardless of nicotine concentration, acid content, and whether the product was used in a fixed or ad libitum puffing regimen. While e-liquid nicotine concentration significantly affected users' nicotine uptake, the different combinations of benzoic, levulinic and lactic acid in the e-liquids assessed had limited impact on nicotine pharmacokinetics and product liking scores.
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Affiliation(s)
- Justin Frosina
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK.
| | - Michael McEwan
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | - James Ebajemito
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | - Jesse Thissen
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | | | | | - George Hardie
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
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28
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Wells MB. Tobacco Use in Adolescents With Disabilities: A Literature Review. Subst Abuse 2023; 17:11782218231179599. [PMID: 37426876 PMCID: PMC10326458 DOI: 10.1177/11782218231179599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 05/16/2023] [Indexed: 07/11/2023]
Abstract
The use of tobacco products by adolescents has greatly increased in recent years. Adolescents with disabilities have demonstrated higher instances of e-cigarette and tobacco use in relation to their peers without disabilities. Repercussions for e-cigarette and tobacco use increase negative physical and health implications and financial which ultimately will further the gap for individuals with disabilities over time. It is argued that adolescents with disabilities are more susceptible to begin using tobacco and remain using tobacco which can lead to further use of addictive substances. In this paper, the researcher explained the use of tobacco within the adolescent population, specifically for individuals with disabilities, the impact of tobacco use for individuals with disabilities, reviewed previous studies on tobacco use for adolescents with disabilities, points to the need for educational policy reform, and stated certain recommendations for mitigating tobacco use in adolescents with disabilities, which may result in positive future outcomes. The literature review indicated that the targeted interventions in schools or peer groups reduces tobacco use in adolescents with disabilities.
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Affiliation(s)
- Melissa Beck Wells
- Melissa Beck Wells, Department of Educational
Studies, Empire State University, 1200 South Avenue, Staten Island, NY 10308, USA.
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29
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Addicott MA, Sutfin EL, Reynolds LM, Donny E, Matich EK, Hsu PC. Biochemical validation of self-reported electronic nicotine delivery system and tobacco heaviness of use. Exp Clin Psychopharmacol 2023; 31:715-723. [PMID: 36107700 PMCID: PMC10184506 DOI: 10.1037/pha0000604] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Research on tobacco use disorder relies on a combination of self-reported use (e.g., cigarettes per day) and biochemical validation to quantify heaviness of use. However, electronic nicotine delivery system (ENDS) users may be unaware of how much they have vaped per day. The aim of this study was to test the relationship between self-reported heaviness of ENDS/tobacco use and nicotine biomarkers. Young adults (n = 30) who currently use ENDS and other tobacco products completed a detailed tobacco use history, timeline follow-back, and an ENDS topography session. We evaluated the self-reports of own-brand ENDS use and tested correlations to determine which self-report measures of own-brand use, and which self-reported measures of puff topography, had the strongest correlations with urine and/or blood biomarkers of nicotine use. Participants reported using a variety of different ENDS devices and had a range of usage. The sum of the self-reported number of occasions or hours of ENDS use, along with the number of cigarettes and other tobacco products used, over the past 24 hr was significantly correlated with plasma cotinine levels. Puff topography measures correlated with increased nicotine concentrations, although participants underestimated the number of puffs they took during the topography session. This study provides preliminary evidence that summing together the hours of ENDS use, or the number of occasions of ENDS use, in addition to the number of other tobacco products used (i.e., cigarettes) based on self-report may be an accurate method of quantification. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Merideth A. Addicott
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Erin L. Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
| | - Lindsay M. Reynolds
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | - Eric Donny
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Eryn K. Matich
- Department of Environmental and Occupational Health, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Ping-Ching Hsu
- Department of Environmental and Occupational Health, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR
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30
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Hosseini S, Gholap V, Halquist MS, Golshahi L. Effects of Device Settings and E-Liquid Characteristics on Mouth-Throat Losses of Nicotine Delivered with Electronic Nicotine Delivery Systems (ENDS). J Aerosol Sci 2023; 171:106178. [PMID: 37092025 PMCID: PMC10121190 DOI: 10.1016/j.jaerosci.2023.106178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Currently it is not fully understood how the device settings and electronic liquid (e-liquid) composition, including their form of nicotine content, impact mouth and throat losses, and potentially lead to the variations in total nicotine delivery to the human lungs. An in situ size assessment method was developed for real-time measurements at the mouthpiece and outlet of a biorelevant mouth-throat to account for the dynamic nature of the aerosol. The aerosol size, temperature, and delivery through the mouth-throat replica and the exhaled aerosol between the puff intervals were measured at different wattages using various e-liquid compositions. The effects of body temperature and humidity on aerosol size and nicotine delivery were also explored to evaluate the importance of considering realistic in vivo conditions in in vitro measurements. Notably, in vitro tests with body temperature and humidity in mouth-throat model vs room conditions, resulted in larger aerosol size at the end of the throat (Dv50=5.83±0.33 μm vs 3.05±0.15 μm), significantly higher thoracic nicotine delivery (>90% vs 50-85%) potentially due to the lower exhaled amount (<10% vs 15-50%). Besides, higher VG/PG ratios resulted in significantly lower exhaled amount and higher mouth-throat nicotine deposition. One of the main outcomes of the study was finding significantly lower exhaled amount and higher thoracic nicotine delivery with nicotine salt form vs free-base. Considering body temperature and humidity also showed significant enhancement in nicotine delivery, so it is essential to account for biorelevant experimental conditions in benchtop testing.
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Affiliation(s)
- Sana Hosseini
- Department of Mechanical and Nuclear Engineering, VCU, Richmond, VA, USA
| | - Vinit Gholap
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia
| | - Matthew S Halquist
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia
| | - Laleh Golshahi
- Department of Mechanical and Nuclear Engineering, VCU, Richmond, VA, USA
- Corresponding Author: 800 E Leigh Street, Room 1083, Richmond, VA, 23298, Tel: (804) 827-3742, Fax: (804) 827-7030,
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Ma S, Jiang S, Wagener T, Mays D, Chen J, Shang C. The associations between e-liquid characteristics and its pricing: Evidence from online vape shops. PLoS One 2023; 18:e0286258. [PMID: 37235576 DOI: 10.1371/journal.pone.0286258] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Given the increase in electronic cigarette use during the past decade, the objectives of this study are to obtain comprehensive product-level information from online vape shops, which are one of the most common outlets for e-cigarette users to purchase vaping products, especially e-liquid products, and to examine the appeal of various e-liquid product attributes to consumers. We used web scraping and estimation of generalized estimating equation (GEE) models to obtain and analyze data from five popular online vape shops that sell nationwide across the US. The outcome measures are e-liquid pricing for the following e-liquid product attributes: nicotine concentration (in mg/ml), nicotine form (nicotine-free, freebase, or salt), vegetable glycerin/propylene glycol (VG/PG) ratio, and a variety of flavors. We find that the pricing for freebase nicotine and nicotine salt products are 1% (p<0.001) lower and 12% higher (p<0.001), respectively, than that for products that do not contain nicotine. For nicotine salt-based e-liquid products specifically, the pricing for a 50/50 VG/PG ratio is 10% (p<0.001) higher than the pricing for a more common 70/30 VG/PG ratio, and the pricing for fruity flavors is 2% (p<0.05) higher than that for tobacco/unflavored products. Regulating the nicotine form in all e-liquid products and fruity flavor in nicotine salt-based products will have a great impact on the market and consumers. The preference for VG/PG ratio varies by product nicotine form. More evidence on typical user patterns of a certain nicotine form (i.e., freebase or salt nicotine) is needed to assess the public health consequences of these regulations.
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Affiliation(s)
- Shaoying Ma
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States of America
| | - Shuning Jiang
- Department of Computer Science and Engineering, The Ohio State University, Columbus, Ohio, United States of America
| | - Theodore Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States of America
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
| | - Darren Mays
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States of America
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
| | - Jian Chen
- Department of Computer Science and Engineering, The Ohio State University, Columbus, Ohio, United States of America
| | - Ce Shang
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States of America
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
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Do EK, Aarvig K, Donovan EM, Barrington-Trimis JL, Vallone DM, Hair EC. E-cigarette Device Type, Source, and Use Behaviors of Youth and Young Adults: Findings from the Truth Longitudinal Cohort (2020-2021). Subst Use Misuse 2023; 58:796-803. [PMID: 36924188 PMCID: PMC10361006 DOI: 10.1080/10826084.2023.2188555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Background: E-cigarette device types vary in the amount of nicotine delivered to users. Given that youth and young adults are using pod-based and disposable e-cigarettes with high nicotine concentrations, it is important to determine how e-cigarette use behaviors associated with nicotine dependence may differ across e-cigarette device type. Methods: Baseline information was collected from September 2020 to March 2021 and follow-up information was collected from July to October 2021 from the Truth Longitudinal Cohort. The final analytic sample included respondents (aged 15-24) who reported current use of e-cigarettes at either baseline or follow-up and provided information on the 4-item E-cigarette Dependence Scale (EDS). Differences in endorsement of items from the EDS by e-cigarette device type (pod-based, disposable, or tank) were assessed using chi-square tests. Results: Participants (N = 308) were evenly split on age (15-20, 21+) and gender. Most 15-20-year-olds used disposable e-cigarettes, while those 21+ years primarily used tank devices. Although EDS score did not differ by e-cigarette device type, positive endorsement of two items from the EDS significantly differed by e-cigarette device type. More tank users endorsed reaching for a device without thinking about it (tank: 92.6%; pod-based: 79.0%; disposables: 79.9%, p = 0.04) and vaping more before going into a situation where vaping is not allowed (tank: 92.9%; pod-based: 71.0%; disposables: 73.0%, p < 0.01). Conclusions: Findings have the potential to inform policy implementation by providing evidence for specific targets for regulatory action that can help to reduce the burdens of e-cigarette use among youth and young adults, as results suggest that tank device users are more likely to endorse use behaviors associated with nicotine dependence.
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Affiliation(s)
- Elizabeth K Do
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | | | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Donna M Vallone
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.,School of Global Public Health, New York University, New York, New York, USA
| | - Elizabeth C Hair
- Schroeder Institute, Truth Initiative, Washington, DC, USA.,Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.,School of Global Public Health, New York University, New York, New York, USA
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Soule EK, Mayne S, Snipes W, Do EK, Theall T, Höchsmann C, Talih S, Martin CK, Eissenberg T, Fuemmeler BF. Electronic Cigarette Nicotine Flux, Nicotine Yield, and Particulate Matter Emissions: Impact of Device and Liquid Heterogeneity. Nicotine Tob Res 2023; 25:412-420. [PMID: 35965260 PMCID: PMC9910146 DOI: 10.1093/ntr/ntac196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 07/29/2022] [Accepted: 08/10/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Electronic cigarettes (ECIGs) heat a nicotine-containing liquid to produce an inhalable aerosol. ECIG power (wattage) and liquid nicotine concentration are two factors that predict nicotine emission rate ("flux"). These factors can vary greatly across devices and users. AIMS AND METHODS The purpose of this study was to examine ECIG device and liquid heterogeneity in "real world" settings and the association with predicted nicotine flux, nicotine yield, and total particulate matter (TPM) emissions. Past 30-day ECIG users (n = 84; mean age = 23.8 years [SD = 9.6]) reported device and liquid characteristics. Device power was measured via multimeter, device display screens, or obtained via labeling. Liquid nicotine concentration was obtained via labeling or through chemical analysis. Predicted nicotine flux, nicotine yield, and TPM associated with 10 4-second puffs were calculated for participants' primary devices. RESULTS Participants' primary devices were box mods (42.9%), disposable vapes (20.2%), and pod mods (36.9%). Most participants (65.5%) reported not knowing their primary device wattage. Rebuildable/box mods had the greatest power range (11.1-120.0 W); pod mod power also varied considerably (4.1-21.7 W). Unlike device wattage, most participants (95.2%) reported knowing their liquid nicotine concentration, which ranged from 3.0 to 86.9 mg/ml (M = 36.0, SD = 29.3). Predicted nicotine flux varied greatly across products (range =12.0-160.1 μg/s, M = 85.6 μg/s, SD = 34.3). Box mods had the greatest variability in wattage and predicted nicotine flux, nicotine yield, and TPM yield. CONCLUSIONS ECIG device and liquid heterogeneity influence nicotine and other toxicant emissions. Better measurement of ECIG device and liquid characteristics is needed to understand nicotine and toxicant emissions and to inform regulatory policy. IMPLICATIONS ECIG device and liquid heterogeneity cause great variability in nicotine flux and toxicants emitted. These data demonstrate the need to examine device and liquid characteristics to develop empirically informed, health-promoting regulatory policies. Policies may include setting product standards such that ECIG products cannot (1) have nicotine fluxes much greater than that of a cigarette to decrease the risk of dependence, (2) have nicotine fluxes that are very low and thus would have minimal appeal to cigarette smokers and may serve as starter products for youth or nontobacco users, and (3) emit large amounts of particulate matter and other toxicants.
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Affiliation(s)
- Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Shannon Mayne
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - William Snipes
- Department of Health Education and Promotion, East Carolina University, Greenville, NC, USA
| | - Elizabeth K Do
- Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
- Schroeder Institute, Truth Initiative, Washington, DC, USA
| | - Travis Theall
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Christoph Höchsmann
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Soha Talih
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
- Mechanical Engineering Department, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
| | - Corby K Martin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Bernard F Fuemmeler
- Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
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Yingst J, Wang X, Lopez AA, Breland A, Soule E, Barnes A, Cohen J, Underwood M, Crabtree M, Foulds J. Changes in Nicotine Dependence Among Smokers Using Electronic Cigarettes to Reduce Cigarette Smoking in a Randomized Controlled Trial. Nicotine Tob Res 2023; 25:372-378. [PMID: 35752091 PMCID: PMC9910150 DOI: 10.1093/ntr/ntac153] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 05/09/2022] [Accepted: 06/23/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION How nicotine dependence will be affected when current smokers initiate electronic cigarette (e-cigarette) use to reduce cigarette smoking is unknown. This study evaluated cigarette, e-cigarette, and total nicotine dependence more than 6 months among smokers reducing cigarette consumption by replacing with e-cigarettes. AIMS AND METHODS Adult cigarette smokers were randomized to one of four conditions (36 mg/ml e-cigarette, 8 mg/ml e-cigarette, 0 mg/ml e-cigarette, or cigarette-substitute [CS] [provided at no cost]) and instructed to reduce their cigarette smoking by 75% at 1 month. Participants completed follow-up at 1, 3, and 6 months. The Penn State Nicotine Dependence Index (PSNDI) measured dependence on cigarettes (PSCDI) and e-cigarettes (PSECDI). Urine cotinine measured total nicotine exposure. Linear mixed effects models for each outcome were conducted and included interaction terms between visit and condition. RESULTS Participants (n = 520) were 58.8% female, 67.3% White, and 48.0 years old. At baseline, the median number of cigarettes smoked per day was 17.3 and the mean PSCDI score was 13.4, with no significant differences between conditions. Participants in the e-cigarette conditions reported significantly lower PSCDI scores, compared with baseline, and with the CS condition at all follow-up visits. Those in the 36 mg/ml e-cigarette condition reported greater PSECDI scores at 6 months, compared with baseline and the 0 mg/ml and 8 mg/ml conditions. At all follow-up visits, there were no differences in total nicotine exposure compared to baseline, nor between any conditions. CONCLUSIONS E-cigarette use was associated with reduced cigarette dependence, compared to the CS, without significant increases in total nicotine exposure. IMPLICATIONS Initiation of electronic cigarette use while continuing to smoke could potentially increase nicotine dependence. In this randomized trial aimed at helping smokers to reduce their cigarette intake, we found that use of an e-cigarette was associated with a reduction in cigarette dependence and an increase in e-cigarette dependence (in the condition with the highest nicotine concentration only), with no long term increase in total nicotine dependence or nicotine exposure.
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Affiliation(s)
- Jessica Yingst
- Department of Public Health Sciences, Penn State College of Medicine, Center for Research on Tobacco and Health, Hershey, PA 17033, USA
| | - Xi Wang
- Department of Public Health Sciences, Penn State College of Medicine, Center for Research on Tobacco and Health, Hershey, PA 17033, USA
| | - Alexa A Lopez
- College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Alison Breland
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Eric Soule
- Department of Health Education and Promotion, College of Health and Human Performance East Carolina University, Greenville, NC 27858, USA
| | - Andrew Barnes
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA 23219, USA
| | - Joanna Cohen
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Megan Underwood
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Melanie Crabtree
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Jonathan Foulds
- Department of Public Health Sciences, Penn State College of Medicine, Center for Research on Tobacco and Health, Hershey, PA 17033, USA
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Braß SM, Wagenhäuser MU, Simon F, Schelzig H, Mulorz J. Elektrische Zigaretten – Stand der Forschung aus gefäßmedizinischer Sicht. Gefässchirurgie 2023. [DOI: 10.1007/s00772-023-00974-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Bigwanto M, Arumsari I, Fauzi R. The portrayal of electronic cigarettes in Indonesia: a content analysis of news media. BMC Public Health 2023; 23:52. [PMID: 36611150 PMCID: PMC9824992 DOI: 10.1186/s12889-022-14886-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 12/16/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The news media play an essential role in shaping public opinion. Analyzing a specific issue reported in the news media provides insight and considerations for a government to form a policy. This study aimed to assess the portrayal of electronic cigarettes (e-cigarettes) in Indonesian news media, including the variety of arguments being presented and the actors behind them. METHODS We used a paid service database from eBdesk to collect Indonesian news articles from 2020 to 2021 using the keywords 'rokok elektronik' (electronic cigarette), 'rokok elektrik' (electric cigarette), 'e-rokok' (e-cigarette), 'vape', and 'vaping'. Content analysis of 551 full-text news articles was conducted to identify the concepts, topics, and frames of quoted arguments and to examine whether any frames were presented by different types of organizations and the origin of actors. RESULTS News articles related to e-cigarettes were mostly published in the national newspaper and in the non-health section of the newspaper desk. A total of 891 arguments from 393 persons representing 212 institutions were identified. Twenty-eight concepts were further categorized into 12 topics. Health impact was the most frequently reported topic, followed by regulation, tax/price, and e-cigarettes as smoking cessation tools. Overall, the articles and arguments with positive tones toward e-cigarettes outnumbered negative articles and arguments. The industry, university, and research-based institutions were the most involved types of organizations in the news articles. There were more neutral frames toward e-cigarettes among government, even though the frame within the non-health government sector was reported to be more positive toward e-cigarettes. CONCLUSIONS Although health impact is the most reported topic, the actors involved in delivering arguments were mainly from the non-health sector, including when the news articles were published by the newspaper desk. The e-cigarette issue in Indonesia was mainly played by the non-health sector, which is more inclined toward economic interest than health.
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Affiliation(s)
- Mouhamad Bigwanto
- grid.5591.80000 0001 2294 6276Doctoral School of Psychology, Eötvös Loránd University, Izabella U. 46, Budapest, 1064 Hungary ,grid.5591.80000 0001 2294 6276Institute of Psychology, Eötvös Loránd University, Izabella U. 46, Budapest, 1064 Hungary ,grid.443454.60000 0001 0177 9026Faculty of Health Sciences, Universitas Muhammadiyah Prof. Dr. HAMKA, Jl. Limau II, Jakarta, 12210 Indonesia
| | - Imas Arumsari
- grid.443454.60000 0001 0177 9026Faculty of Health Sciences, Universitas Muhammadiyah Prof. Dr. HAMKA, Jl. Limau II, Jakarta, 12210 Indonesia
| | - Ridhwan Fauzi
- grid.443452.00000 0004 0380 9286Faculty of Public Health, Universitas Muhammadiyah Jakarta, Jl. KH Ahmad Dahlan, Jakarta, 15419 Indonesia
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Ardati O, Adeniji A, El Hage R, Salman R, El-Kaassamani M, Yassine A, Talih S, Hourani M, Karaoghlanian N, Breland A, Eissenberg T, Saliba N, Shihadeh A, El-Hellani A. Impact of smoking intensity and device cleaning on IQOS emissions: comparison with an array of cigarettes. Tob Control 2023:tc-2022-057802. [PMID: 36609493 PMCID: PMC10323035 DOI: 10.1136/tc-2022-057802] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/26/2022] [Indexed: 01/09/2023]
Abstract
SIGNIFICANCE IQOS is a heated tobacco product that has been widely advertised by Philip Morris International (PMI) as a reduced-exposure product compared with cigarettes. Reduced exposure results from reduced emission of toxicants which could be influenced by product constituents and user behaviour. This study aims to assess the influence of user behaviour, including device cleaning and puffing parameters, on toxicant emissions from IQOS. METHODS IQOS aerosols were generated by a smoking machine using the combination of two cleaning protocols (after 1 stick vs 20 sticks) and five puffing regimes (including standard cigarette puffing regimes and IQOS-tailored regimes). The generated aerosols were analysed by targeted methods for phenol and carbonyl quantification, and by chemical screening for the identification of unknown compounds. RESULTS Puffing parameters significantly affected phenol and carbonyl emissions while device cleaning had no effect. Harsher puffing conditions like more, longer, and larger puffs yielded higher levels for most toxicant emissions. Comparing the obtained data with data reported by PMI on 50 cigarette brands smoked under different puffing regimes showed various trends for phenol and carbonyl emissions, with IQOS emissions sometimes higher than cigarettes. Also, the chemical screening resulted in the tentative identification of ~100 compounds in the IQOS aerosols (most of limited toxicity data). CONCLUSION This study showed that puffing parameters, but not device cleaning, have significant effects on carbonyl, phenol and other emissions. Data analysis highlighted the importance of comparing IQOS emissions with an array of commercial cigarettes tested under different puffing regimes before accepting reduced exposure claims.
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Affiliation(s)
- Ola Ardati
- Department of Chemistry, American University of Beirut Faculty of Arts and Sciences, Beirut, Lebanon
| | - Ayomipo Adeniji
- Division of Environmental Health Sciences, The Ohio State University College of Public Health, Columbus, Ohio, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Rachel El Hage
- Department of Chemistry, American University of Beirut Faculty of Arts and Sciences, 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
- Department of Mechanical Engineering, American University of Beirut Faculty of Engineering and Architecture, Beirut, Lebanon
| | - Malak El-Kaassamani
- Department of Physical and Environmental Sciences, University of Toronto Faculty of Arts & Science, Toronto, Ontario, Canada
| | - Amira Yassine
- Department of Environmental Health and Engineering, Johns Hopkins University Whiting School of Engineering, Baltimore, Maryland, USA
| | - Soha Talih
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Mechanical Engineering, American University of Beirut Faculty of Engineering and Architecture, Beirut, Lebanon
| | - Mario Hourani
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Mechanical Engineering, American University of Beirut Faculty of Engineering and Architecture, Beirut, Lebanon
| | - Nareg Karaoghlanian
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Mechanical Engineering, American University of Beirut Faculty of Engineering and Architecture, Beirut, Lebanon
| | - Alison Breland
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Najat Saliba
- Department of Chemistry, American University of Beirut Faculty of Arts and Sciences, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Alan Shihadeh
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Mechanical Engineering, American University of Beirut Faculty of Engineering and Architecture, Beirut, Lebanon
| | - Ahmad El-Hellani
- Division of Environmental Health Sciences, The Ohio State University College of Public Health, Columbus, Ohio, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
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Mus S, Monzon J, Islam F, Thrasher JF, Barnoya J. First tobacco product tried and current use of cigarettes and electronic cigarettes among adolescents from Guatemala City. Salud Publica Mex 2023; 65:46-53. [PMID: 36750072 PMCID: PMC11091932 DOI: 10.21149/13972] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/13/2022] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To assess how first experimenting with ciga-rettes or e-cigarettes is associated with current use in Gua-temala, a middle-income country with weak tobacco control and no e-cigarette regulations. MATERIALS AND METHODS We surveyed students from private schools in Guatemala City, limiting analyses to ever users (n=1 026). Multinomial logistic models regressed current product use on first product used, adjusting for sociodemographics and friends and family use. RESULTS The most common first product used was e-cigarettes (56%), followed by flavored cigarettes (24%) and regular cigarettes (20%). At the time of the survey, 4% were exclusive smokers, 37% were exclusive e-cigarette users, 18% dual users, and 40% had ever tried either but were not current users. Compared to those who first tried cigarettes, students who first tried e-cigarettes were less likely to be current smokers (RR=0.19 [CI: 0.11,0.31]) or dual users (RR=0.26 [CI: 0.14,0.49]) and students who first tried flavored cigarettes were more likely to be current smokers (RR=1.66 [CI=1.13,2.42]). CONCLUSIONS In our sample, Guatemalan adolescents from private schools more frequently experiment and continue to use e-cigarettes than cigarettes. There is urgent need to implement e-cigarette restrictions in addition to tobacco control policy implementation.
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Affiliation(s)
- Sophia Mus
- Departamento de Investigación, Unidad de Cirugía Cardiovascular de Guatemala. Guatemala City, Guatemala.
| | - Jose Monzon
- Departamento de Investigación, Unidad de Cirugía Cardiovascular de Guatemala. Guatemala City, Guatemala.
| | - Farahnaz Islam
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina. Columbia, South Carolina, USA.
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina. Columbia, South Carolina, USA/Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, Mexico.
| | - Joaquin Barnoya
- Departamento de Investigación, Unidad de Cirugía Cardiovascular de Guatemala/Integra Cancer Institute. Guatemala City, Guatemala.
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Alzoubi KH, Halboup AM, Khabour OF, Alomari MA. The Protective Effects of the Combination of Vitamin E and Swimming Exercise on Memory Impairment Induced by Exposure to Waterpipe Smoke. CNS Neurol Disord Drug Targets 2023; 22:304-312. [PMID: 35306997 DOI: 10.2174/1871527321666220318113635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/12/2021] [Accepted: 12/29/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Waterpipe smoking (WP) exposure involves a negative health impact, including memory deficit, which is attributed to the elevation of oxidative stress. Vitamin E (VitE) in combination with swimming exercise exerts protective effects that prevent memory impairment. In the current study, the modulation of WP-induced memory impairment by the combined effect of VitE and swimming exercise (SE) was investigated. METHODS Animals were exposed to WP one hour/day, five days per week for four weeks. Simultaneously, VitE (100 mg/kg, six days/week for four weeks) was administered via oral gavage, and the rats were made to swim one hour/day, five days/week for four weeks. Changes in memory were evaluated using radial arm water maze (RAWM), and oxidative stress biomarkers were examined in the hippocampus. RESULTS WP exposure induced short-term/long-term memory impairment (p<0.05). This impairment was prevented by a combination of VitE with SE (p<0.05). Additionally, this combination normalized the hippocampal catalase, GPx, and GSH/GSSG ratios that were modulated by WP (p<0.05). The combination further reduced TBARs levels below those of the control group (p<0.05). CONCLUSION WP-induced memory impairments were prevented by the combination of VitE with SE. This could be attributed to preserving the hippocampal oxidative mechanism by combining VitE and SE during WP exposure.
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Affiliation(s)
- Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdulsalam M Halboup
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Science and Technology, Sana\'a, Yemen
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Jordan
| | - Mahmoud A Alomari
- Department of Rehabilitation Sciences, Division of Physical Therapy, Jordan University of Science and Technology, Irbid, Jordan
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Lin E, Fuentes AL, Patel A, Crotty Alexander LE. E-Cigarette: Friend or Foe? Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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Soule E, Bansal-Travers M, Grana R, McIntosh S, Price S, Unger JB, Walton K. Electronic cigarette use intensity measurement challenges and regulatory implications. Tob Control 2023; 32:124-129. [PMID: 34059553 PMCID: PMC8630087 DOI: 10.1136/tobaccocontrol-2021-056483] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/04/2022]
Abstract
Assessing tobacco use intensity allows researchers to examine tobacco use in greater detail than assessing ever or current use only. Tobacco use intensity measures have been developed that are specific to tobacco products, such as asking smokers to report number of cigarettes smoked per day. However, consensus on electronic cigarette use intensity measures that can be used for survey research has yet to be established due to electronic cigarette product and user behavior heterogeneity. While some survey measures that attempt to assess electronic cigarette use intensity exist, such as examining number of 'times' using an electronic cigarette per day, number of puffs taken from an electronic cigarette per day, volume of electronic cigarette liquid consumed per day, or nicotine concentration of electronic cigarette liquid, most measures have limitations. Challenges in electronic cigarette measurement often stem from variations across electronic cigarette device and liquid characteristics as well as the difficulty that many electronic cigarette users have regarding answering questions about their electronic cigarette device, liquid, or behavior. The inability for researchers to measure electronic cigarette use intensity accurately has important implications such as failing to detect unintended consequences of regulatory policies. Development of electronic cigarette use intensity measures, though not without its challenges, can improve understanding of electronic cigarette use behaviors and associated health outcomes and inform development of regulatory policies.
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Affiliation(s)
- Eric Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA
| | | | - Rachel Grana
- Tobacco Control Research Branch, National Cancer Institute, Rockville, Maryland, USA
| | - Scott McIntosh
- Public Health Sciences, University of Rochester, Rochester, New York, USA
| | - Simani Price
- Public Health and Epidemiology Practice, Westat, Center for Coordination of Analytics, Science, Enhancement, and Logistics, Rockville, Maryland, USA
| | - Jennifer B Unger
- Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Kevin Walton
- Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, Bethesda, Maryland, USA
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Rebuli ME, Rose JJ, Noël A, Croft DP, Benowitz NL, Cohen AH, Goniewicz ML, Larsen BT, Leigh N, McGraw MD, Melzer AC, Penn AL, Rahman I, Upson D, Crotty Alexander LE, Ewart G, Jaspers I, Jordt SE, Kligerman S, Loughlin CE, McConnell R, Neptune ER, Nguyen TB, Pinkerton KE, Witek TJ. The E-cigarette or Vaping Product Use-Associated Lung Injury Epidemic: Pathogenesis, Management, and Future Directions: An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2023; 20:1-17. [PMID: 36584985 PMCID: PMC9819258 DOI: 10.1513/annalsats.202209-796st] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
E-cigarette or vaping product use-associated lung injury (EVALI) is a severe pulmonary illness associated with the use of e-cigarettes or vaping products that was officially identified and named in 2019. This American Thoracic Society workshop was convened in 2021 to identify and prioritize research and regulatory needs to adequately respond to the EVALI outbreak and to prevent similar instances of disease associated with e-cigarette or vaping product use. An interdisciplinary group of 26 experts in adult and pediatric clinical care, public health, regulatory oversight, and toxicology were convened for the workshop. Four major topics were examined: 1) the public health and regulatory response to EVALI; 2) EVALI clinical care; 3) mechanisms contributing to EVALI; and 4) needed actions to address the health effects of EVALI. Oral presentations and group discussion were the primary modes used to identify top priorities for addressing EVALI. Initiatives including a national EVALI case registry and biorepository, integrated electronic medical record coding system, U.S. Food and Drug Administration regulation and enforcement of nicotine e-cigarette standards, regulatory authority over nontobacco-derived e-cigarettes, training in evaluating exogenous exposures, prospective clinical studies, standardized clinical follow-up assessments, ability to more readily study effects of cannabinoid e-cigarettes, and research to identify biomarkers of exposure and disease were identified as critical needs. These initiatives will require substantial federal investment as well as changes to regulatory policy. Overall, the workshop identified the need to address the root causes of EVALI to prevent future outbreaks. An integrated approach from multiple perspectives is required, including public health; clinical, basic, and translational research; regulators; and users of e-cigarettes. Improving the public health response to reduce the risk of another substantial disease-inducing event depends on coordinated actions to better understand the inhalational toxicity of these products, informing the public of the risks, and developing and enforcing regulatory standards for all e-cigarettes.
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Hoetger C, Bono RS, White AM, Barnes AJ, Cobb CO. The interaction of nicotine concentration and device power on electronic nicotine delivery system (ENDS) abuse liability among exclusive ENDS users and dual users of ENDS and combustible cigarettes. Exp Clin Psychopharmacol 2022; 30:973-982. [PMID: 34647773 PMCID: PMC9284402 DOI: 10.1037/pha0000523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Open-system electronic nicotine delivery systems (ENDS) permit modifications to device characteristics such as power, potentially increasing nicotine and toxicant delivery. Limiting liquid nicotine concentration may carry unintended consequences by prompting users to increase device power to increase nicotine delivery. This study examined the abuse liability of ENDS across nicotine concentration and power settings. In a clinical laboratory study, n = 19 exclusive ENDS users and n = 13 dual ENDS/cigarette users, aged 21-55 completed four Latin-square ordered conditions that varied by liquid nicotine concentration (10 mg/ml [low], 30 mg/ml [high]) and device power (15 watts [low], 30 watts [high]), that were followed by a fifth own brand (OB) condition. A progressive ratio task (PRT) using bar presses to earn ENDS puffs was used to assess abuse liability and compare between conditions using mixed effects linear regressions. The low nicotine/high watt condition was associated with a significantly higher number of bar presses and puffs earned relative to the OB ENDS, high nicotine/high watt, and high nicotine/low watt conditions (p < .05). Findings appeared to be driven largely by exclusive ENDS users; most comparisons were not significant among dual users. Participants worked significantly harder for puffs of low nicotine/high watt ENDS, highlighting previous findings that suggest limiting liquid nicotine concentration without addressing power settings may be insufficient to reduce the abuse liability of ENDS. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Cosima Hoetger
- Department of Psychology, Virginia Commonwealth University, Center for the Study of Tobacco Products, Virginia Commonwealth University
| | - Rose S. Bono
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Department of Health Behavior and Policy, Virginia Commonwealth University
| | - Augustus M. White
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Department of Health Behavior and Policy, Virginia Commonwealth University
| | - Andrew J. Barnes
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Department of Health Behavior and Policy, Virginia Commonwealth University
| | - Caroline O. Cobb
- Department of Psychology, Virginia Commonwealth University, Center for the Study of Tobacco Products, Virginia Commonwealth University
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El-Hellani A, Soule EK, Daoud M, Salman R, El Hage R, Ardati O, El-Kaassamani M, Yassine A, Karaoghlanian N, Talih S, Saliba N, Shihadeh A. Assessing toxicant emissions from e-liquids with DIY additives used in response to a potential flavour ban in e-cigarettes. Tob Control 2022; 31:s245-s248. [PMID: 36328456 PMCID: PMC9664124 DOI: 10.1136/tc-2022-057505] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/15/2022] [Indexed: 11/22/2022]
Abstract
SIGNIFICANCE Electronic cigarettes (e-cigarettes) aerosolise liquids that contain nicotine, propylene glycol, glycerol and appealing flavours. In the USA, regulations have limited the availability of flavoured e-cigarettes in pod-based systems, and further tightening is expected. In response, some e-cigarette users may attempt to make their e-liquids (do-it-yourself, DIY). This study examined toxicant emissions from several aerosolised DIY e-liquids. METHODS DIY additives were identified by reviewing users' responses to a hypothetical flavour ban, e-cigarette internet forums and DIY mixing internet websites. They include essential oils, cannabidiol, sucralose and ethyl maltol. E-liquids with varying concentrations and combinations of additives and tobacco and menthol flavours were prepared and were used to assess reactive oxygen species (ROS), carbonyl and phenol emissions in machine-generated aerosols. RESULTS Data showed that adding DIY additives to unflavoured, menthol-flavoured or tobacco-flavoured e-liquids increases toxicant emissions to levels comparable with those from commercial flavoured e-liquids. Varying additive concentrations in e-liquids did not have a consistently significant effect on the tested emissions, yet increasing power yielded significantly higher ROS, carbonyl and phenol emissions for the same additive concentration. Adding nicotine to DIY e-liquids with sucralose yielded increase in some emissions and decrease in others, with freebase nicotine-containing e-liquid giving higher ROS emissions than that with nicotine salt. CONCLUSION This study showed that DIY additives can impact aerosol toxicant emissions from e-cigarettes and should be considered by policymakers when restricting commercially available flavoured e-liquids.
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Affiliation(s)
- Ahmad El-Hellani
- Division of Environmental Health Sciences, The Ohio State University College of Public Health, Columbus, Ohio, USA
- Virginia Commonwealth University Center for the Study of Tobacco Products, Richmond, Virginia, USA
| | - Eric K Soule
- Virginia Commonwealth University Center for the Study of Tobacco Products, Richmond, Virginia, USA
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA
| | - Mohammad Daoud
- Department of Chemistry, American University of Beirut Faculty of Arts and Sciences, Beirut, Lebanon
| | - Rola Salman
- Virginia Commonwealth University Center for the Study of Tobacco Products, Richmond, Virginia, USA
- Department of Mechanical Engineering, American University of Beirut Faculty of Engineering and Architecture, Beirut, Lebanon
| | - Rachel El Hage
- Virginia Commonwealth University Center for the Study of Tobacco Products, Richmond, Virginia, USA
- Department of Chemistry, American University of Beirut Faculty of Arts and Sciences, Beirut, Lebanon
| | - Ola Ardati
- Department of Chemistry, American University of Beirut Faculty of Arts and Sciences, Beirut, Lebanon
| | - Malak El-Kaassamani
- Department of Chemistry, American University of Beirut Faculty of Arts and Sciences, Beirut, Lebanon
| | - Amira Yassine
- Department of Chemistry, American University of Beirut Faculty of Arts and Sciences, Beirut, Lebanon
| | - Nareg Karaoghlanian
- Virginia Commonwealth University Center for the Study of Tobacco Products, Richmond, Virginia, USA
- Department of Mechanical Engineering, American University of Beirut Faculty of Engineering and Architecture, Beirut, Lebanon
| | - Soha Talih
- Virginia Commonwealth University Center for the Study of Tobacco Products, Richmond, Virginia, USA
- Department of Mechanical Engineering, American University of Beirut Faculty of Engineering and Architecture, Beirut, Lebanon
| | - Najat Saliba
- Virginia Commonwealth University Center for the Study of Tobacco Products, Richmond, Virginia, USA
- Department of Chemistry, American University of Beirut Faculty of Arts and Sciences, Beirut, Lebanon
| | - Alan Shihadeh
- Virginia Commonwealth University Center for the Study of Tobacco Products, Richmond, Virginia, USA
- Department of Mechanical Engineering, American University of Beirut Faculty of Engineering and Architecture, Beirut, Lebanon
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45
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Wang W, Zeng R, Liu M, Chen M, Wei S, Li B, Yu S. Exosome proteomics study of the effects of traditional cigarettes and electronic cigarettes on human bronchial epithelial cells. Toxicol In Vitro 2022; 86:105516. [DOI: 10.1016/j.tiv.2022.105516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/25/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2022]
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46
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Soule EK, Mayne S, Snipes W, Thomas L, Guy MC, Breland A, Fagan P. Electronic cigarette users' reactions and responses to a hypothetical ban of flavoured electronic cigarette liquids. Tob Control 2022; 31:s197-s205. [PMID: 36328459 PMCID: PMC9661374 DOI: 10.1136/tc-2022-057454] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/27/2022] [Indexed: 11/22/2022]
Abstract
Regulations have been proposed to limit e-cigarette flavours, but limited research has examined potential impacts of such policies. This study examined adult e-cigarette users’ reactions to a hypothetical e-cigarette flavour ban.
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Affiliation(s)
- Eric K Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Shannon Mayne
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - William Snipes
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Luke Thomas
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA,Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Mignonne C Guy
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA,Department of African American Studies, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Alison Breland
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA,Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Pebbles Fagan
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, USA,Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Pinto MI, Thissen J, Hermes N, Cunningham A, Digard H, Murphy J. Chemical characterisation of the vapour emitted by an e-cigarette using a ceramic wick-based technology. Sci Rep 2022; 12:16497. [PMID: 36192548 DOI: 10.1038/s41598-022-19761-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 09/05/2022] [Indexed: 11/30/2022] Open
Abstract
Fourth-generation ‘pod’ e-cigarette devices have been driven by technological advances in electronic atomization of the e-liquid. Use of microporous ceramic as a wicking material improves heating efficiency, but how it affects the chemical emissions of these devices is unclear. We assessed the emissions of a pod e-cigarette with innovative ceramic wick-based technology and two flavoured e-liquids containing nicotine lactate and nicotine benzoate (57 and 18 mg mL−1 nicotine, respectively). Among the studied harmful and potentially harmful constituents (HPHCs) listed by the US FDA and/or WHO TobReg, only 5 (acetone, acetaldehyde, formaldehyde, naphthalene and nornicotine) were quantified at levels of 0.14 to 100 ng puff−1. In the combustible cigarette (Kentucky reference 1R6F), levels were from 0.131 to 168 µg puff−1. Nicotine levels ranged 0.10–0.32 mg puff−1 across the 3 study products. From the 19 proposed HPHCs specifically of concern in e-cigarettes, only 3 (glycerol, isoamyl acetate and propylene glycol) were quantified. The low/undetectable levels of HPHCs reflect not only the optimal operating conditions of the e-cigarette, including an efficient supply of e-liquid by the ceramic wick without overheating, but also the potential of the e-cigarettes to be used as an alternative to combustible cigarettes.
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48
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Yang W, Yang X, Jiang L, Song H, Huang G, Duan K, Jiang X, Li M, Liu P, Chen J. Combined biological effects and lung proteomics analysis in mice reveal different toxic impacts of electronic cigarette aerosol and combustible cigarette smoke on the respiratory system. Arch Toxicol 2022. [PMID: 36173423 DOI: 10.1007/s00204-022-03378-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022]
Abstract
Combustible cigarettes produce many toxic substances that have been linked to diseases, such as lung cancer and chronic obstructive pulmonary disease. For those smokers unable or unwilling to quit, electronic cigarettes (e-cigarettes) could be used as an alternative to cigarettes. However, the effects and mechanisms of e-cigarette aerosol (ECA) on respiratory function have not been fully elucidated, and in vivo studies of its safety are limited compared to cigarette smoke (CS). In this article, we chose nicotine levels as dosing references and C57BL/6 mice for a 10-week subchronic inhalation toxicity study. A comprehensive set of toxicological endpoints was used to study the effect of exposure. Both CS (6 mg/kg) and ECA (6 or 12 mg/kg) inhalation had decreased the animal’s lung function and increased levels of inflammation markers, along with pathological changes in the airways and lungs, with ECA displaying a relatively small effect at the same dose. Proteomic analysis of lung tissue showed greater overall protein changes by CS than that of ECA, with more severe inflammatory network perturbations. Compared with ECA, KEGG analysis of CS revealed upregulation of more inflammatory and virus-related pathways. Protein–protein interactions (PPI) showed that both ECA and CS significantly changed ribosome and complement system-related proteins in mouse lung tissue. The results support that e-cigarette aerosol is less harmful to the respiratory system than cigarette smoke at the same dose using this animal model, thus providing additional evidence for the relative safety of e-cigarettes.
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Hung M, Spencer A, Hon ES, Licari FW, Cheever VJ, Moffat R, Goh C, Raymond B, Lipsky MS. E-cigarette addiction and harm perception: Does initiation flavor choice matter? BMC Public Health 2022; 22:1780. [PMID: 36127670 PMCID: PMC9487027 DOI: 10.1186/s12889-022-14166-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/12/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction The 21st century was marked by a dramatic increase in adolescent e-cigarette use in the United States (US). The popularity of non-traditional flavor types, including fruit and pastry, is thought to contribute toward growing product use nationally, leading to a variety of federal and state regulations limiting the use of non-traditional flavors in the US. The relationship between flavor type and increased adolescent use suggests a possible link between flavor use and addiction and harm perception. This study assessed if the flavor type used when initiating e-cigarette use predicted addiction and harm perceptions. Methods The study utilized data from the multi-wave youth Population Assessment of Tobacco Health Study. It explored the impact initiating e-cigarette use with traditional versus non-traditional flavor types among cigarette users on the outcome variables: e-cigarette addiction and harm perception. Both e-cigarette addiction and harm perception were measured using self-report, Likert scale questionnaires. Descriptive statistics characterized the study variables and linear regression analyses performed to test whether flavor initiation type is associated with addiction and harm perception. Results The study sample consisted of 1,043 youth (weighted N = 1,873,617) aged 12 to 17 years who reported at least one instance of e-cigarette use. After adjusting for age, age of onset, sex, race and annual household income there was no statistically significant difference in addiction levels between those initiating with traditional versus non-traditional flavors (p = 0.294). Similarly, traditional versus non-traditional flavor initiation did not show a statistically significant difference in adolescent e-cigarette harm perceptions (p = 0.601). Conclusions Traditionally flavored e-cigarette initiation produces similar risk for addiction and harm perceptions as non-traditionally flavored initiation. These findings suggest that banning non-traditional flavors alone may be ineffective in curbing e-cigarette addiction and harm perception. Additional research is needed to better understand which e-cigarette product characteristics and behaviors may be associated with greater addiction and reduced harm perceptions.
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Affiliation(s)
- Man Hung
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA. .,University of Utah School of Medicine, Salt Lake City, UT, USA.
| | - Andrew Spencer
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA.,Emory University, Atlanta, GA, USA
| | - Eric S Hon
- University of Chicago Department of Economics, Chicago, IL, USA
| | - Frank W Licari
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA
| | - Val Joseph Cheever
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA
| | - Ryan Moffat
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA
| | - Clarissa Goh
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA.,Riverton High School, Riverton, UT, USA
| | - Ben Raymond
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA
| | - Martin S Lipsky
- Roseman University of Health Sciences College of Dental Medicine, 10894 S. River Front Parkway, South Jordan, Utah, 84905, USA.,Portland State University Institute on Aging, Portland, OR, USA
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50
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Saran SK, Salinas KZ, Foulds J, Kaynak Ö, Hoglen B, Houser KR, Krebs NM, Yingst JM, Allen SI, Bordner CR, Hobkirk AL. A Comparison of Vaping Behavior, Perceptions, and Dependence among Individuals Who Vape Nicotine, Cannabis, or Both. Int J Environ Res Public Health 2022; 19:10392. [PMID: 36012024 PMCID: PMC9408799 DOI: 10.3390/ijerph191610392] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
Background: Electronic delivery systems (e.g., vapes, e-cigarettes) are now popular modes of cannabis and nicotine administration that are often used by the same individuals; however, we still know little about dual nicotine and cannabis vaping. Materials & Methods: An online convenience sample of adult nicotine and/or cannabis vape users residing in the United States completed a 60 min survey on sociodemographic characteristics, cannabis and/or nicotine vape use behaviors and dependence, reasons for vape use, and perceptions of benefits and harms. After data cleaning, we compared dual vs. nicotine-only and cannabis-only vape users with univariate statistics and step-wise hierarchical linear regression analyses. Additionally, we assessed the factor structure, internal consistency, and criterion and convergent validity of the Penn State Cannabis Vaping Dependence Index (PSCVDI). Results: The final sample included 357 dual, 40 cannabis, and 106 nicotine vape users. Compared to nicotine- and cannabis-only vapers, dual vapers started using their nicotine and cannabis vapes at a younger age (p < 0.001), used them for more years (p < 0.001), and were less likely to use their nicotine vape to replace combustible cigarettes (p = 0.047). Dual users vs. single-substance users did not have significantly higher nicotine or cannabis vape dependence scores after controlling for sociodemographic and use behaviors. The PSCVDI showed adequate validity for measuring cannabis vape dependence. Conclusions: This survey is the first to highlight important differences in vape use behaviors and reasons for use between dual vs. cannabis- and nicotine-only vape users.
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Affiliation(s)
- Savreen K. Saran
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Kalin Z. Salinas
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Jonathan Foulds
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
- Department of Public Health Sciences & Penn State Center for Research on Tobacco and Health, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Övgϋ Kaynak
- School of Behavioral Sciences & Education, Penn State Harrisburg, 777 West Harrisburg Pike, Middletown, PA 17057, USA
| | - Brianna Hoglen
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Kenneth R. Houser
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Nicolle M. Krebs
- Department of Public Health Sciences & Penn State Center for Research on Tobacco and Health, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Jessica M. Yingst
- Department of Public Health Sciences & Penn State Center for Research on Tobacco and Health, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Sophia I. Allen
- Department of Public Health Sciences & Penn State Center for Research on Tobacco and Health, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Candace R. Bordner
- Department of Public Health Sciences & Penn State Center for Research on Tobacco and Health, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
| | - Andrea L. Hobkirk
- Department of Psychiatry and Behavioral Health, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
- Department of Public Health Sciences & Penn State Center for Research on Tobacco and Health, Penn State College of Medicine, 500 University Drive, Hershey, PA 17033, USA
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