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Andreas S, Chen DTH, Grigg J, Filippidis FT. [European Respiratory Society statement on novel nicotine and tobacco products, their role in tobacco control and "harm reduction"]. Pneumologie 2024. [PMID: 38670147 DOI: 10.1055/a-2298-8015] [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] [Indexed: 04/28/2024]
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Zervas EN, Matsouki NΕ, Tsipa CF, Katsaounou PA. Particle emissions from heated tobacco products. Tob Prev Cessat 2024; 10:TPC-10-15. [PMID: 38566785 PMCID: PMC10986040 DOI: 10.18332/tpc/185870] [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: 11/22/2023] [Revised: 02/20/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION This study determines the particle emissions from five heated tobacco products (HTPs). METHODS An aethalometer is used for the determination of black carbon (BC) and an aerosol monitor for total particulate matter (PM) concentration and also PM fractions (1, 2.5, 4, and 10 μm) in the mainstream emissions of 5 HTPs: IQOS, LIL, PULZE, ILUMA, and GLO. Fifteen different flavors were used, five sticks per flavor, which were smoked using a peristaltic pump under both ISO and Canadian smoking regimes. The method repeatability was determined using 15 sticks of one flavor for each brand for each smoking regime. RESULTS All HTPs emit particles, and more than 99.7% of the particles emitted are smaller than 1 μm. Both BC and PM emissions show quite low repeatability. Particle emissions increase in relation to the heating temperature and the intensity smoking regime, and are depending on the flavor used. BC corresponds to a small percentage of total PM. CONCLUSIONS Although HTPs are promoted as products of reduced risk compared to conventional cigarettes, high particle concentrations are detected in their emissions, depending on the smoking regime, the flavor used, and the operation parameters. PM emissions vary significantly between different brands under the ISO smoking regime, probably due to the heating temperature. In contrast, PM emissions under the Canadian smoking regime do not vary significantly between different brands. This could probably be attributed to the fact that increased puff frequency does not allow the device to cool down between puffs, resulting in an increase in PM emissions for all the brands, but not dependent on the maximum heating temperature of the device. BC emissions only consist of a very small fraction of PM and do not vary significantly between different brands under both smoking regimes.
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Blank ML, Hoek J. Smoking, vaping and drinking: A qualitative analysis of Aotearoa New Zealand young adults who tried e-cigarettes to stop smoking tobacco. Addiction 2024; 119:686-695. [PMID: 38114132 DOI: 10.1111/add.16413] [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: 04/11/2023] [Accepted: 11/01/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND AND AIM Social practices such as smoking-drinking co-use often go 'hand-in-hand', linked by the coordination of materials, skills and meanings. However, the experience of using e-cigarettes while drinking among people who smoke (and drink) remains underexplored. We used social practice theory to show how smoking, vaping and drinking intersect and to explain how vaping created two new social practices among people who tried e-cigarettes to stop smoking: 'vaping-drinking' co-use and 'smoking-vaping-drinking' poly-use. METHODS We conducted five in-depth interviews over 18-24 weeks during 2018-19, with each of nine Aotearoa New Zealand young adults aged 20-29 years. Participants smoked daily, did not regularly use e-cigarettes at entry and wished to try vaping to stop smoking. We analysed participants' reports of smoking or vaping while drinking using thematic analysis. RESULTS Individual participants reported both co-use and poly-use occasions throughout the study. Vaping-drinking co-use arose from practice 'replacement' processes, where vaping fully substituted smoking. Smoking-vaping-drinking poly-use arose from 'adjacency' processes where vaping complemented smoking. Participants used both processes flexibly over time, which required new skills in material, temporal, pleasure and social coordination to try to recreate valued meanings of comfort, security and communality associated with well-established smoking-drinking practices. Unsuccessful coordination attempts maintained smoking-drinking co-use. CONCLUSION Among Aotearoa New Zealand young adult smokers who want to use vaping to stop smoking, drinking occasions may help to maintain existing smoking-drinking practices and facilitate the development of vaping-drinking co-use and smoking-vaping-drinking poly-use practices, potentially prolonging individuals' exposure to smoking.
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Affiliation(s)
- Mei-Ling Blank
- Department of Preventive and Social Medicine, University of Otago, Ōtepoti Dunedin, Aotearoa, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Te Whanganui-a-Tara Pōneke, Wellington, Aotearoa, New Zealand
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Raspe M, Lo K, Sommer N, Andreas S. [Tobacco cessation: one of the most effective medical measures]. Inn Med (Heidelb) 2024; 65:365-375. [PMID: 38446181 DOI: 10.1007/s00108-024-01683-6] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/07/2024]
Abstract
Tobacco smoking is widespread in Germany. An increase in the number of teenagers and young adults that smoke has recently been a cause for concern. The high prevalence in Germany is contrasted by inadequate preventive measures compared to international standards. Smoking behavior should always be inquired about and documented in the same way as vital signs. All smokers, regardless of the reason for contact and motivation, should receive short, low-threshold advice, e.g. using the ABC approach (ask, brief advice, cessation). In addition to repeated advice and referral to further services, the use of nicotine replacement or drug therapy is essential for the success of quitting. The combination of long- and short-acting nicotine replacement products doubles the success rate. Electronic nicotine delivery systems are not recommended for smoking cessation.
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Affiliation(s)
- Matthias Raspe
- Fächerverbund für Infektiologie, Pneumologie und Intensivmedizin, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - Kevin Lo
- Department für Pneumologie, Medizinische Klinik II, Excellence Cluster Cardio Pulmonary Institute (CPI), Universitätsklinikum Gießen und Marburg (UKGM), Justus-Liebig-Universität Gießen, Aulweg 130, 35392, Gießen, Deutschland
- Mitglied des Deutschen Zentrums für Lungenforschung (DZL), Gießen, Deutschland
| | - Natascha Sommer
- Department für Pneumologie, Medizinische Klinik II, Excellence Cluster Cardio Pulmonary Institute (CPI), Universitätsklinikum Gießen und Marburg (UKGM), Justus-Liebig-Universität Gießen, Aulweg 130, 35392, Gießen, Deutschland
- Mitglied des Deutschen Zentrums für Lungenforschung (DZL), Gießen, Deutschland
| | - Stefan Andreas
- Mitglied des Deutschen Zentrums für Lungenforschung (DZL), Gießen, Deutschland
- Lungenfachklinik Immenhausen, Robert-Koch-Straße 3, 34376, Immenhausen, Deutschland
- Abteilung Kardiologie und Pneumologie, Universitätsmedizin Göttingen, Göttingen, Deutschland
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Chen DTH, Grigg J, Filippidis FT. European Respiratory Society statement on novel nicotine and tobacco products, their role in tobacco control and "harm reduction". Eur Respir J 2024; 63:2301808. [PMID: 38316440 DOI: 10.1183/13993003.01808-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/27/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Daniel Tzu-Hsuan Chen
- Nuffield Department of Primary Care Health Science, University of Oxford, Radcliffe Observatory Quarter, Oxford, UK
| | - Jonathan Grigg
- Centre for Child Health, Blizard Institute, Queen Mary University of London, London, UK
| | - Filippos T Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
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Husari A, El-Harakeh M, Shihadeh A, Daou MAZ, Bitar H, Karaoghlanian N, Zaatari G, El-Sabban M. The Substitution of Fifty Percent of Combustible Tobacco Smoke Exposure With Either Electronic Cigarettes or Heated tobacco Products Did Not Attenuate Acute Lung Injury in an Animal Model. Nicotine Tob Res 2023; 25:1361-1368. [PMID: 36943313 PMCID: PMC10256882 DOI: 10.1093/ntr/ntad045] [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: 11/14/2021] [Revised: 12/08/2022] [Accepted: 03/16/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND To reduce the harmful health effects of combustible cigarette smoke (CS), some (CS) users attempt to substitute CS with electronic cigarettes (ECIG) and/or heated tobacco products (HTP). In this animal study, we evaluated the acute effects of substituting CS consumption with ECIG or HTP thus mimicking the dual users' approach, on the lungs of a mouse model. METHODS C57BL/6 mice were divided into Control, ECIG, HTP, CS, ECIG + CS, HTP + CS, and HTP + ECIG groups. Animals were exposed for 3 hours in AM and PM sessions to either air, CS, ECIG, or HTP for seven days. Lung injury was assessed by: wet to dry (W/D) ratio, albumin concentration in bronchoalveolar lavage fluid, expression of IL-1β, IL-6, and TNF-α, histopathology examination, reactive oxygen species (ROS) production, and assessment of cellular apoptosis. RESULTS W/D ratio was significantly increased in mice exposed to CS only. Albumin leak and expression of IL-1β, IL-6, and TNF-a were elevated in CS, ECIG + CS, and HTP + CS. Histological examination revealed significant inflammatory cells infiltration, as well as collagen deposit in CS, ECIG + CS, HTP + CS. ROS production was significantly increased in CS, ECIG + CS, HTP + CS. Finally, cell death was also significantly increased in CS, ECIG + CS, and HTP + CS. CONCLUSION In this animal model, substituting 50% of daily CS exposure by either ECIG or HTP exposure did not result in significant attenuation of acute lung injury.
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Affiliation(s)
- Ahmad Husari
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine; American University of Beirut, Beirut, Lebanon
| | - Mohammad El-Harakeh
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine; American University of Beirut, Beirut, Lebanon
| | - Alan Shihadeh
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Michella Abi Zeid Daou
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine; American University of Beirut, Beirut, Lebanon
| | - Hala Bitar
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine; American University of Beirut, Beirut, Lebanon
| | - Nareg Karaoghlanian
- Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Ghazi Zaatari
- Department of Pathology & Laboratory Medicine, American University of Beirut, Beirut, Lebanon
| | - Marwan El-Sabban
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
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Cox DW, Rodriguez L, Grigg J. Statement on Tobacco 21 from the European Respiratory Society Tobacco Control Committee. Eur Respir J 2023; 61:61/3/2300134. [PMID: 36958744 DOI: 10.1183/13993003.00134-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/22/2023] [Indexed: 03/25/2023]
Affiliation(s)
- Des W Cox
- Respiratory Department, Children's Health Ireland, Dublin, Ireland
- University College Dublin, Dublin, Ireland
| | | | - Jonathan Grigg
- Centre for Child Health, Blizard Institute, Queen Mary University of London, London, UK
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Grigg J. Smoking, nicotine, and COVID-19. The Lancet Respiratory Medicine 2022; 10:818-819. [PMID: 35985355 PMCID: PMC9381020 DOI: 10.1016/s2213-2600(22)00258-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 11/20/2022]
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Gille T, Sivapalan P, Kaltsakas G, Kolekar SB, Armstrong M, Tuffnell R, Evans RA, Vagheggini G, Degani-Costa LH, Vicente C, Das N, Poberezhets V, Rolland-Debord C, Bayat S, Vogiatzis I, Franssen FME, Pinnock H, Vanfleteren LEGW. ERS International Congress 2021: highlights from the Respiratory Clinical Care and Physiology Assembly. ERJ Open Res 2022; 8:00710-2021. [PMID: 35615417 PMCID: PMC9125042 DOI: 10.1183/23120541.00710-2021] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/06/2022] [Indexed: 11/05/2022] Open
Abstract
It is a challenge to keep abreast of all the clinical and scientific advances in the field of respiratory medicine. This article contains an overview of laboratory-based science, randomised controlled trials and qualitative research that were presented during the 2021 European Respiratory Society International Congress within the sessions from the five groups of the Assembly 1 - Respiratory clinical care and physiology. Selected presentations are summarised from a wide range of topics: clinical problems, rehabilitation and chronic care, general practice and primary care, electronic/mobile health (e-health/m-health), clinical respiratory physiology, exercise and functional imaging.
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Affiliation(s)
- Thomas Gille
- Service de Physiologie et Explorations Fonctionnelles, Centre Hospitalier Universitaire Avicenne, Hôpitaux Universitaires de Paris Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris, Bobigny, France.,Inserm U1272 "Hypoxia and the Lung", UFR Santé - Médecine - Biologie Humaine Léonard de Vinci, Université Sorbonne Paris Nord, Bobigny, France
| | - Pradeesh Sivapalan
- Section of Respiratory Medicine, Herlev-Gentofte University Hospital, Hellerup, Denmark
| | - Georgios Kaltsakas
- Lane Fox Respiratory Service, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Centre of Human and Applied Physiological Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.,1st Respiratory Medicine Dept, "Sotiria" Hospital for Diseases of the Chest, National and Kapodistrian University of Athens, Athens, Greece
| | - Shailesh B Kolekar
- Dept of Internal Medicine, Zealand University Hospital, Roskilde, Denmark.,Dept of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Matthew Armstrong
- Dept of Rehabilitation and Sport Sciences, Bournemouth University, Poole, UK
| | - Rachel Tuffnell
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rachael A Evans
- NIHR Leicester Biomedical Research Centre - Respiratory, University Hospitals of Leicester NHS Trust, Leicester, UK.,Dept of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Guido Vagheggini
- Dept of Medical Specialties, Chronic Respiratory Failure Care Pathway, Azienda USL Toscana Nordovest, Volterra, Italy.,Fondazione Volterra Ricerche Onlus, Volterra, Italy
| | | | | | - Nilakash Das
- Laboratory of Respiratory Diseases and Thoracic Surgery, Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Vitalii Poberezhets
- Dept of Propedeutics of Internal Medicine, National Pirogov Memorial Medical University, Vinnytsya, Ukraine
| | - Camille Rolland-Debord
- Service de Pneumologie, Hôpital Gabriel Montpied, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Sam Bayat
- Service de Pneumologie et de Physiologie, CS10217, CHU Grenoble, Grenoble, France.,Univ. Grenoble Alpes, Inserm UA07 STROBE, Grenoble, France
| | - Ioannis Vogiatzis
- Dept of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, UK
| | - Frits M E Franssen
- Dept of Research and Development, Ciro, Horn, the Netherlands.,Dept of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.,NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
| | - Hilary Pinnock
- Allergy and Respiratory Research Group, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Lowie E G W Vanfleteren
- COPD Center, Dept of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Dept of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Saller FS, Agaku IT, Filippidis FT. Association between e-cigarette use initiated after cigarette smoking and smoking abstinence: a cross-sectional study among adolescent established smokers in the USA. Tob Control 2022; 31:416-423. [PMID: 33414265 DOI: 10.1136/tobaccocontrol-2020-055943] [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: 05/19/2020] [Revised: 10/30/2020] [Accepted: 11/17/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Recent years have seen a rapid increase in the popularity of electronic cigarettes (e-cigarettes) among adolescents in the USA. Evidence on their role in the continuation of or abstinence from cigarette smoking among young smokers remains scarce. OBJECTIVE To examine the relationship between e-cigarette use initiated after cigarette smoking and abstinence from cigarette smoking among US adolescent established smokers. METHODS The data were drawn from the 2015-2018 National Youth Tobacco Survey-a nationally representative survey of US middle and high school students. Multivariable logistic regression was used to assess the association between ever e-cigarette use and past 30-day abstinence from cigarette smoking. The analytical sample comprised ever established cigarette smokers with or without a history of e-cigarette use after smoking initiation. RESULTS Neither experimental (adjusted OR 0.67, 95% CI 0.39-1.14) nor prior established (adjusted OR 1.56, 95% CI 0.96-2.56) nor current established (adjusted OR 0.65, 95% CI 0.41-1.03) e-cigarette use was statistically significantly associated with subsequent abstinence from cigarette smoking among adolescent ever established smokers. These findings were largely consistent across sensitivity analyses using alternative key definitions, although experimental and current established e-cigarette use was significantly negatively associated with past 6-month abstinence. CONCLUSIONS We found no evidence that e-cigarette use among US adolescents already smoking cigarettes is associated with subsequent abstinence from cigarette smoking; there was some evidence of an inverse association among experimental and current established e-cigarette users. These findings could inform future regulatory and public health efforts regarding youth e-cigarette use and the reduction of youth cigarette smoking in the USA.
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Affiliation(s)
- Franziska S Saller
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
| | - Israel T Agaku
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Filippos T Filippidis
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK
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El Asmar ML, Laverty AA, Vardavas CI, Filippidis FT. How do Europeans quit using tobacco, e-cigarettes and heated tobacco products? A cross-sectional analysis in 28 European countries. BMJ Open 2022; 12:e059068. [PMID: 35487758 PMCID: PMC9058771 DOI: 10.1136/bmjopen-2021-059068] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/06/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES While smoking tobacco remains a substantial cause of harm in Europe, novel products such as electronic cigarettes or e-cigarettes (ECs) and heated tobacco products (HTPs) have entered the market recently. While debate still persists over the role of these novel products, they are now in widespread use. This study aimed to explore the prevalence and methods of attempts to quit EC and HTP. SETTING We analysed the 2020 Eurobarometer survey, which collected data in 28 European countries. PARTICIPANTS A representative sample of individuals residing in these countries aged ≥15 years. PRIMARY AND SECONDARY OUTCOME MEASURES Multilevel regression analyses were performed to assess differences in quit attempts and cessation methods among tobacco smokers and exclusive EC/HTP users separately. RESULTS 51.1% of current tobacco smokers and 27.1% of exclusive EC or HTP users reported having ever made a quit attempt. The majority of former and current smokers (75.8%) who made a quit attempt did so unassisted, with 28.8% reporting at least one attempt using a cessation aid. The most popular cessation aids were nicotine replacement therapy or other medication (13.4%) and ECs (11.3%). 58.8% of exclusive EC or HTP users who had made a quit attempt did so unassisted, with 39.5% reporting the use of a cessation aid. CONCLUSION Most EC and HTP users in Europe try to quit unassisted, although more of them report the use of a cessation aid compared with tobacco smokers. Cessation support services should take into consideration the increasing numbers of users of EC and HTP who may be trying to quit.
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Affiliation(s)
- Marie Line El Asmar
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Constantine I Vardavas
- School of Medicine, University of Crete, Crete, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Filippos T Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
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Jiménez-ruiz CA, Solano-reina S, de Higes -Martínez E, Cabrera-césar E, Sandoval-contreras R, Granda-orive JID, Riesco-miranda JA, Signes-costa Miñana J, Lorza-blasco JJ, Martínez-muñiz MÁ, Rábade-castedo C. Documento de posicionamiento de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) ante las estrategias de reducción del daño del tabaco. Open Respiratory Archives 2022. [PMID: 37497325 PMCID: PMC10369613 DOI: 10.1016/j.opresp.2022.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In the last decade, the appearance of electronic cigarettes and new tobacco products (heated tobacco or smokeless tobacco) has generated a growing interest in harm reduction methods that are defined as mechanisms that seek to reduce the harmful consequences of tobacco without give up the pleasant effects of it by replacing it with these new electronic devices. However, these products are addictive and not safe as they contain nicotine. Harm reduction is a false solution as it represents a commercial strategy of the tobacco industry to increase its sales, making it difficult to control smoking, since it keeps smokers from consuming tobacco and prevents them from making serious attempts to quit. In addition, these products are a gateway to adolescents in tobacco.
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Hanewinkel R, Niederberger K, Pedersen A, Unger JB, Galimov A. E-cigarettes and nicotine abstinence: a meta-analysis of randomised controlled trials. Eur Respir Rev 2022; 31:31/163/210215. [PMID: 35321930 PMCID: PMC9488503 DOI: 10.1183/16000617.0215-2021] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/17/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives To determine the effects of electronic cigarettes (e-cigarettes) as a therapeutic intervention compared to nicotine replacement therapy (NRT) on nicotine abstinence. Methods Two authors independently searched the PubMed, Embase, PsycInfo and Cochrane Central Register of Controlled Trials databases for articles published up to and including 10 July 2021. We included randomised controlled trials (RCTs) in which nicotine e-cigarettes were compared to NRT among current cigarette users. The primary outcome was abstaining from all nicotine-delivery devices. Secondary outcomes were 1) allocated product use (e-cigarettes or NRT) among successful cigarette quitters and 2) quitting cigarettes at the end of the trial using fixed-effect Mantel–Haenszel models. Results We included four RCTs representing 1598 adult participants (51.0% females). The mean age of participants in these studies ranged from 41 to 54 years, while average baseline smoking ranged from 14 to 21 cigarettes per day. Compared to NRT, e-cigarette use was associated with lower nicotine abstinence rates at the longest follow-up (risk ratio 0.50 (95% CI 0.32–0.77)). Among successful cigarette quitters, the risk of allocated product use by the end of the observational time was higher for e-cigarette users compared to NRT (risk ratio 8.94 (95% CI 3.98–20.07)). E-cigarette users had higher cigarette smoking cessation rates compared to NRT users (risk ratio 1.58 (95% CI 1.20–2.08)). Conclusions The use of e-cigarettes as a therapeutic intervention for smoking cessation may lead to permanent nicotine dependence. Clinicians should not recommend e-cigarettes for smoking cessation due to the risk of permanent nicotine dependencehttps://bit.ly/358oToy
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Affiliation(s)
| | - Kathrin Niederberger
- Clinical Psychology and Psychotherapy, Dept of Psychology, Kiel University, Kiel, Germany.,Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Anya Pedersen
- Clinical Psychology and Psychotherapy, Dept of Psychology, Kiel University, Kiel, Germany
| | - Jennifer B Unger
- Institute for Health Promotion and Disease Prevention Research, Dept of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Artur Galimov
- Institute for Health Promotion and Disease Prevention Research, Dept of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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15
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Somayaji R, Chalmers JD. Just breathe: a review of sex and gender in chronic lung disease. Eur Respir Rev 2022; 31:31/163/210111. [PMID: 35022256 DOI: 10.1183/16000617.0111-2021] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 08/20/2021] [Indexed: 01/08/2023] Open
Abstract
Chronic lung diseases are the third leading cause of death worldwide and are increasing in prevalence over time. Although much of our traditional understanding of health and disease is derived from study of the male of the species - be it animal or human - there is increasing evidence that sex and gender contribute to differences in disease risk, prevalence, presentation, severity, treatment approach, response and outcomes. Chronic obstructive pulmonary disease, asthma and bronchiectasis represent the most prevalent and studied chronic lung diseases and have key sex- and gender-based differences which are critical to consider and incorporate into clinical and research approaches. Mechanistic differences present opportunities for therapeutic development whereas behavioural and clinical differences on the part of patients and providers present opportunities for greater education and understanding at multiple levels. In this review, we seek to summarise the sex- and gender-based differences in key chronic lung diseases and outline the clinical and research implications for stakeholders.
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Affiliation(s)
- Ranjani Somayaji
- Dept of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada .,Dept of Microbiology, Immunology and Infectious Disease, University of Calgary, Calgary, Canada.,Dept of Community Health Sciences, University of Calgary, Calgary, Canada
| | - James D Chalmers
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
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16
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Affiliation(s)
| | | | - Andrew Bush
- National Heart and Lung Institute, Imperial College London
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17
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Hedman L, Galanti MR, Ryk L, Gilljam H, Adermark L. Electronic cigarette use and smoking cessation in cohort studies and randomized trials: A systematic review and meta-analysis. Tob Prev Cessat 2021; 7:62. [PMID: 34712864 PMCID: PMC8508281 DOI: 10.18332/tpc/142320] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 05/20/2021] [Revised: 09/01/2021] [Accepted: 09/15/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The aim of this systematic review and meta-analysis was to assess the association between e-cigarette use and subsequent smoking cessation in cohort studies and randomized controlled trials (RCT). METHODS A systematic literature search was finalized 11 November 2019 using EMBASE, Cochrane Library, Scopus, PubMed Health, NICE evidence search, PROSPERO, CRD, PsycInfo, and PubMed including Medline. Inclusion criteria were: reporting empirical results; longitudinal observational design with a minimum of 3 months of follow-up; including general population samples; and allowing for comparison between users and non-users of e-cigarettes. Studies rated as having high risk of bias were excluded. The procedures described by PRISMA were followed, and the quality of evidence was rated using GRADE. RESULTS Twenty-eight longitudinal, peer-reviewed publications from 26 cohort studies, and eight publications from seven RCTs assessing the association between e-cigarette use and smoking cessation were included in this review. A random-effects meta-analysis based on 39147 participants in cohort studies showed a pooled unadjusted odds ratio (OR) for smoking cessation among baseline e-cigarette users compared with baseline non-users of 0.97 (95% CI: 0.67-1.40), while the adjusted OR was 0.90 (95% CI: 0.63-1.27). The pooled odds ratio for smoking cessation in RCTs was 1.78 (95% CI: 1.41-2.25). The evidence for cohort studies was graded as very low and for RCTs as low. CONCLUSIONS We did not find quality evidence for an association between e-cigarette use and smoking cessation. Although RCTs tended to support a more positive association between e-cigarette use and smoking cessation than the cohort studies, the grading of evidence was consistently low.
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Affiliation(s)
- Linnea Hedman
- Department of Public Health and Clinical Medicine, Division Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden.,Department of Health Sciences, Division of Nursing, Luleå University of Technology, Luleå, Sweden
| | - Maria R Galanti
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Centre of Epidemiology and Community Medicine, Stockholm, Sweden
| | - Lotta Ryk
- Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden
| | - Hans Gilljam
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Louise Adermark
- Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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18
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Farber HJ, Conrado Pacheco Gallego M, Galiatsatos P, Folan P, Lamphere T, Pakhale S. Harms of Electronic Cigarettes: What the Healthcare Provider Needs to Know. Ann Am Thorac Soc 2021; 18:567-72. [PMID: 33284731 DOI: 10.1513/AnnalsATS.202009-1113CME] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Electronic cigarettes (e-cigarettes) reached the market without either extensive preclinical toxicology testing or long-term safety trials that would be required of conventional therapeutics or medical devices. E-cigarettes are considered a tobacco product and as such have no manufacturing quality or safety standards. A growing body of evidence documents severe harms from e-cigarette use, including injuries from product explosions, nicotine poisoning, and severe lung diseases. Commonly used e-cigarette components have significant inhalation toxicity. Emerging evidence from laboratory studies suggests substantial reason for concern for long-term harms, including risk for cardiovascular disease, chronic obstructive lung disease, and cancer. Rather than helping people stop smoking, e-cigarette use is associated with reduced rates of smoking cessation among current smokers and an increased risk of relapse to smoking among former smokers. The World Health Organization advises, "Unlike the tried and tested nicotine and non-nicotine pharmacotherapies that are known to help people quit tobacco use, WHO does not endorse e-cigarettes as cessation aids." Careful evaluation of all the available research justifies a strong recommendation that healthcare providers should neither prescribe nor recommend e-cigarettes for persons who are tobacco dependent. If a patient is dependent on e-cigarettes, the healthcare provider should provide counseling and treatment (of nicotine dependence) to help the patient to stop their e-cigarette use.
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19
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Katzenberg G, Deacon A, Aigbirior J, Vestbo J. Management of chronic obstructive pulmonary disease. Br J Hosp Med (Lond) 2021; 82:1-10. [PMID: 34338012 DOI: 10.12968/hmed.2020.0561] [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] [Indexed: 11/11/2022]
Abstract
Chronic obstructive pulmonary disease is a prevalent condition in the UK, associated with high morbidity and mortality. Hospital physicians manage a significant portion of acute chronic obstructive pulmonary disease admissions to hospital and readmissions after discharge. Optimal management of exacerbations requires controlled oxygen therapy and ventilatory support where necessary, and careful administration of bronchodilators, steroids and antibiotics. Holistic care for these patients includes nutritional supplementation and palliative support for those with advanced disease. To reduce the chance of readmission, chronic obstructive pulmonary disease care bundles can be used, along with a review of inhaled and oral therapies. Where available, hospital-at-home discharge schemes can safely facilitate early discharge. Most importantly, high quality evidence-based smoking cessation support must be offered to smokers. Exercise improves the physiological and psychological condition of people with chronic obstructive pulmonary disease and should be encouraged, with referral to a pulmonary rehabilitation service if available.
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Affiliation(s)
- Gideon Katzenberg
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester Academic Science Centre, Manchester, UK
| | - Andrew Deacon
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester Academic Science Centre, Manchester, UK
| | - Joshua Aigbirior
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester Academic Science Centre, Manchester, UK
| | - Jørgen Vestbo
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester Academic Science Centre, Manchester, UK.,Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK
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20
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Glynn TJ, Hays JT, Kemper K. E-Cigarettes, Harm Reduction, and Tobacco Control: A Path Forward? Mayo Clin Proc 2021; 96:856-862. [PMID: 33494956 DOI: 10.1016/j.mayocp.2020.11.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/22/2020] [Accepted: 11/25/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Thomas J Glynn
- Prevention Research Center, School of Medicine, Stanford University, CA
| | - J Taylor Hays
- Mayo Clinic Nicotine Dependence Center, Mayo Clinic, Rochester, MN
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21
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Affiliation(s)
- Jonathan Grigg
- Centre for Child Health, Blizard Institute, Queen Mary University of London, London, UK
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22
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Rosenkilde Laursen K, Bønløkke JH, Bendstrup E, Bilde M, Glasius M, Heitmann Gutzke V, Puthukkadan Moosakutty S, Olin AC, Ravn P, Østergaard K, Sigsgaard T. An RCT of acute health effects in COPD-patients after passive vape exposure from e-cigarettes. Eur Clin Respir J 2020; 8:1861580. [PMID: 33456728 PMCID: PMC7781946 DOI: 10.1080/20018525.2020.1861580] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/06/2020] [Indexed: 12/30/2022] Open
Abstract
Background: E-cigarette use has been shown to have short-term acute effects among active users but less is known of the acute passive effects, particularly among individuals with existing respiratory diseases. Objective: To investigate local and systemic effects of short-term passive vape exposure among patients with mild or moderate chronic obstructive pulmonary disease (COPD). Methods: In a double-blinded crossover study 16 non-smoking COPD-patients (mean age 68) were randomly exposed for 4 h to passive vape (median PM2.5: 18 µg/m3 (range: 8-333)) and clean air (PM2.5 < 6 µg/m3) separated by 14 days. Particles were measured using an ultrafine particle counter (P-TRAK) and a scanning mobility particle sizer (SMPS). Health effects including Surfactant Protein-A (SP-A) and albumin in exhaled air, spirometry, FeNO, and plasma proteins were evaluated before, right after, and 24 hours after exposure. Participants reported symptoms throughout exposure sessions. Data were analyzed using mixed models. Results: SP-A in exhaled air was negatively affected by exposure to vape and several plasma proteins increased significantly. Throat irritation was more pronounced during passive vape exposure, while FVC and FEV1 decreased, however, not significantly. Conclusions: SP-A in exhaled air and some plasma proteins were affected by passive vape in patients with COPD indicating inflammation, showing that passive vape exposure is potentially harmful.
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Affiliation(s)
| | - Jakob Hjort Bønløkke
- Environment, Work and Health, Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Occupational and Environmental Medicine, Aalborg University Hospital, Danish Ramazzini Centre, Aalborg, Denmark
| | - Elisabeth Bendstrup
- Center for Rare Lung Diseases, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Merete Bilde
- Department of Chemistry, Aarhus University, Aarhus, Denmark
| | | | - Vibeke Heitmann Gutzke
- Environment, Work and Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | | | - Anna-Carin Olin
- Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Peter Ravn
- Environment, Work and Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Kirsten Østergaard
- Environment, Work and Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Torben Sigsgaard
- Environment, Work and Health, Department of Public Health, Aarhus University, Aarhus, Denmark
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23
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Duru Çetinkaya P, Turan A, Deniz PP. Effectiveness of Behavioral and Pharmacological Smoking Cessation Treatment in Patients with Failed Attempt at Quitting with E-cigarettes. Turk Thorac J 2020; 21:404-408. [PMID: 33352096 DOI: 10.5152/turkthoracj.2020.20181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/21/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The tobacco industry has introduced electronic cigarettes (e-cigarettes) as a less harmful substitute to cigarettes and as an aid to smoking cessation. This study aimed to evaluate the success of evidence-based pharmacological treatments and behavioral/cognitive training in patients who failed to quit smoking with e-cigarettes. MATERIAL AND METHODS A total of 109 consecutive patients with failed attempts at smoking cessation by e-cigarettes were admitted. A questionnaire was administered to evaluate the demographic characteristics and smoking habits. Nicotine dependence scores of the smokers were obtained using the Fagerström addiction test. Appropriate pharmacological therapy and behavioral/cognitive training were given to each patient who failed to quit smoking with e-cigarettes. RESULTS The mean age of the participants was 35.2±10.4 years, and 89 (81.7%) were men. Education level was high school or university for 92 (84.4%) patients; only 17 (15.6%) graduated from middle school. The mean number of cigarettes smoked per day was 25.8±10.8, and the mean nicotine dependence score was 6.7±1.9. Only 6 (5.5%) individuals quit smoking temporarily after using e-cigarettes, with a mean restarting time of 3.3±2.0 months in all 6 patients. The smoking cessation rate in our study was 43.1% (47 patients) with medical treatment. The remaining individuals were unable to quit smoking with pharmacological treatment, and the mean restarting time for these patients was 10.4±2.2 months. CONCLUSION It has been shown that the success rate of smoking cessation increases with pharmacological treatment and behavioral/cognitive training in individuals who failed to quit smoking with e-cigarettes.
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Affiliation(s)
- Pelin Duru Çetinkaya
- Department of Chest Diseases, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Ayşe Turan
- Clinic of Smoking Cessation, Adana Seyhan Hospital, Adana, Turkey
| | - Pelin Pınar Deniz
- Department of Chest Diseases, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
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24
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Abstract
E-cigarettes are electronic nicotine delivery systems (ENDS) which mimic tobacco smoking without the combustion of tobacco. These devices have been misleadingly marketed as "less harmful" alternatives to conventional smoking tobacco products. The e-liquid in e-cigarettes include nicotine, a humectant and other additives including flavourings, colourants, or adulterants such as bacterial and fungal products. In this review, we discuss the contrasting views of the tobacco lobby and most professional societies. We describe the epidemiology of the use of these devices, with a widespread and significant rise in youth e-cigarette use seen in both the USA and Europe. We also describe what is known about the toxicity and mechanisms of EVALI (e-cigarette or vaping associated lung injury). This characterised by respiratory failure with an intense inflammatory response. The presentations are diverse and clinicians should consider vaping as a possible cause of any unusual respiratory illness in patients who have a history of vaping or other use of e-cigarette-related products. Second hand exposure to e-cigarettes is also harmful through respiration and transdermal absorption. E-cigarettes have a worse acute toxicity than tobacco and their long-term toxicity is unknown, and we advocate for the immediate, most vigorous anti-vaping legislation possible.
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Affiliation(s)
- Jayesh Mahendra Bhatt
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, United Kingdom.
| | - Manisha Ramphul
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, United Kingdom.
| | - Andrew Bush
- Paediatrics and Paediatric Respirology, National Heart and Lung Institute, United Kingdom; Paediatric Chest Physician, Royal Brompton & Harefield NHS Foundation Trust, United Kingdom; Imperial Centre for Paediatrics and Child Health, United Kingdom; Royal Brompton Hospital, Sydney Street, London SW3 6NP, United Kingdom.
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25
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Katsaounou PA. Electronic cigarettes for smoking cessation: an opportunity to readdress smoking cessation treatment. Eur Respir J 2020; 56:56/4/2000098. [PMID: 33122291 DOI: 10.1183/13993003.00098-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 07/08/2020] [Indexed: 12/23/2022]
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26
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Abstract
Governments could help prevent chronic obstructive pulmonary disease (COPD) by reducing smoking rates; for example, through tobacco sale restriction, increasing tobacco prices, reducing nicotine content, and banning smoking in public areas and workplaces. Smoking cessation in general, and in particular among patients with COPD, could be achieved through specific programs, including behavior modification and the use of nicotine replacement therapy, bupropion, or varenicline. Prevention and/or slowed COPD progression could be achieved by occupational exposure prevention; improved indoor/outdoor air quality; reduced cooking and heating pollutants; use of better stoves and chimneys, and alternative energy sources; and influenza and pneumococcal vaccination.
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Affiliation(s)
- Alberto Papi
- Section of Respiratory Diseases, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Cona General Hospital, Via Aldo Moro 8, Ferrara 44124, Italy.
| | - Luca Morandi
- Section of Respiratory Diseases, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Cona General Hospital, Via Aldo Moro 8, Ferrara 44124, Italy
| | - Leonardo M Fabbri
- Section of Respiratory Diseases, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Cona General Hospital, Via Aldo Moro 8, Ferrara 44124, Italy
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27
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Mozun R, Ardura-Garcia C, de Jong CCM, Goutaki M, Usemann J, Singer F, Latzin P, Kuehni CE, Moeller A. Cigarette, shisha, and electronic smoking and respiratory symptoms in Swiss children: The LUIS study. Pediatr Pulmonol 2020; 55:2806-2815. [PMID: 32716136 DOI: 10.1002/ppul.24985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Received: 05/29/2020] [Revised: 07/10/2020] [Accepted: 07/20/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Smoking habits in adolescents are changing. We assessed active smoking of conventional cigarettes, e-cigarettes and shishas in Swiss schoolchildren, studied risk factors and compared respiratory problems between smokers and non-smokers. METHODS We used data from LuftiBus in the school (LUIS), a school-based survey of respiratory health of children carried out 2013 to 2016 in the canton of Zurich, Switzerland. Participants were asked about use of cigarettes, shishas, and electronic smoking devices (ESD), and current respiratory symptoms. We studied associations between smoking and risk factors using logistic regression. RESULTS We included 3488 schoolchildren. Among 6 to 12-year-olds, 90/1905 (5%) had smoked occasionally (<once/week). Among 13 to 17-year-olds, 563/1583 (36%) had smoked occasionally of whom 414 smoked ESDs, 409 shishas, and 276 cigarettes. Among 13 to 17-year-olds who smoked frequently (≥once/week), 41/54 (76%) smoked cigarettes. A 22% of 15 to 17-year-olds (104/477) had used all three products. Smoking was more common in adolescents who were male (adjusted OR, 2.1; 95% CI, 1.7-2.6), lived in rural areas (1.8, 95% CI, 1.2-2.9 vs small urban), and whose mother (1.7, 95% CI, 1.3-2.3) or father (1.5, 95% CI, 1.2-1.9) smoked. Current respiratory symptoms like rhinitis, dyspnea, and wheeze were more common among frequent smokers (44%, 30%, 12%, respectively) and occasional smokers (32%, 22%, 13%) than in never smokers (29%,19%, 8%, P for trend <.05). CONCLUSION Smoking of shishas and ESDs is common among Swiss adolescents and often combined with smoking cigarettes. Adolescent smokers reported more respiratory symptoms than never smokers. We recommend smoking preventive strategies that include all forms of smoking.
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Affiliation(s)
- Rebeca Mozun
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Carmen C M de Jong
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Jakob Usemann
- Division of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, University of Zurich, Zurich, Switzerland.,University Children's Hospital Basel (UKBB), Basel, Switzerland
| | - Florian Singer
- Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland.,PEDNET, Paediatric Clinical Trial Unit, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Philipp Latzin
- Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Alexander Moeller
- Division of Respiratory Medicine, University Children's Hospital Zurich and Childhood Research Center, University of Zurich, Zurich, Switzerland
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28
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Suhling H, Welte T, Fuehner T. Three Patients With Acute Pulmonary Damage Following the Use of E-Cigarettes-A Case Series. Dtsch Arztebl Int 2020; 117:177-182. [PMID: 32327029 DOI: 10.3238/arztebl.2020.0177] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/07/2020] [Accepted: 01/19/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND The use of e-cigarettes is on the rise around the world. Many case reports of acute lung injury due to e-cigarette use have been published in recent months in the USA, but no comparable cases have emerged in Germany up to the present report. The use of e-cigarettes has risen very rapidly in the USA in recent years, simultaneously with the legalization of marijuana sale in many American states. Most of the cases described there involved the use, not only of nicotine, but of tetrahydrocannabinol (THC, the psychoactive ingredient in marijuana) as well, though some of the patients had indeed not used additives (e.g. THC). METHODS We report three cases in Germany of acute pulmonary illness that we consider to have been caused by the use of e-cigarettes. RESULTS All three patients were hospitalized for acute shortness of breath. Two displayed partial respiratory insufficiency and bilateral pulmonary infiltrates. All three stated that they had used ordinary, commercially available e-cigarettes every day for at least the past three months. In the first patient, a 48-year-old man, the complete blood count and bronchial lavage findings indicated eosinophilic inflammation. The second patient, a 22-year-old man, developed multiple episodes of hemoptysis, with computed tomography (CT) showing diffuse alveolar bleeding; his complete blood count also revealed eosinophilic inflammation. The third patient, a 34-year-old man, displayed acute ground-glass lung opacities as well as fibrosing changes on CT corresponding to pulmonary sarcoidosis. All three recovered on high-dose systemic corticosteroid treatment and were discharged from the hospital in 2 to 12 days. CONCLUSION In the first two cases, acute pulmonary injury was very likely due to e-cigarette consumption, as all other possible causes were ruled out. A possible link to e-cigarette use was present in the third case. We thus describe the first three suspected cases of acute lung disease due to e-cigarette use in Germany. These patients do not share any common, typical clinical picture; rather, their symptoms represent different components of the wide spectrum of interstitial lung disease. A uniform national registry should be established to improve our understanding of the adverse effects of e-cigarettes and the resulting acute and chronic changes in the lungs.
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Affiliation(s)
- Hendrik Suhling
- Department of Pneumology, Hannover Medical School(MHH); Department of Respiratory Medicine, Städtisches Klinikum Braunschweig
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29
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McAlinden KD, Eapen MS, Lu W, Sharma P, Sohal SS. The rise of electronic nicotine delivery systems and the emergence of electronic-cigarette-driven disease. Am J Physiol Lung Cell Mol Physiol 2020; 319:L585-L595. [PMID: 32726146 DOI: 10.1152/ajplung.00160.2020] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
In 2019, the United States experienced the emergence of the vaping-associated lung injury (VALI) epidemic. Vaping is now known to result in the development and progression of severe lung disease in the young and healthy. Lack of regulation on electronic cigarettes in the United States has resulted in over 2,000 patients and 68 deaths. We examine the clinical representation of VALI and the delve into the scientific evidence of how deadly exposure to electronic cigarettes can be. E-cigarette vapor is shown to affect numerous cellular processes, cellular metabolism, and cause DNA damage (which has implications for cancer). E-cigarette use is associated with a higher risk of developing crippling lung conditions such as chronic obstructive pulmonary disease (COPD), which would develop several years from now, increasing the already existent smoking-related burden. The role of vaping and virus susceptibility is yet to be determined; however, vaping can increase the virulence and inflammatory potential of several lung pathogens and is also linked to an increased risk of pneumonia. As it has emerged for cigarette smoking, great caution should also be given to vaping in relation to SARS-CoV-2 infection and the COVID-19 pandemic. Sadly, e-cigarettes are continually promoted and perceived as a safer alternative to cigarette smoking. E-cigarettes and their modifiable nature are harmful, as the lungs are not designed for the chronic inhalation of e-cigarette vapor. It is of interest that e-cigarettes have been shown to be of no help with smoking cessation. A true danger lies in vaping, which, if ignored, will lead to disastrous future costs.
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Affiliation(s)
- Kielan Darcy McAlinden
- Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Mathew Suji Eapen
- Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Wenying Lu
- Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - Pawan Sharma
- Center for Translational Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Sukhwinder Singh Sohal
- Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, University of Tasmania, Launceston, Tasmania, Australia
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Giulietti F, Filipponi A, Rosettani G, Giordano P, Iacoacci C, Spannella F, Sarzani R. Pharmacological Approach to Smoking Cessation: An Updated Review for Daily Clinical Practice. High Blood Press Cardiovasc Prev 2020; 27:349-362. [PMID: 32578165 PMCID: PMC7309212 DOI: 10.1007/s40292-020-00396-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 06/13/2020] [Indexed: 01/29/2023] Open
Abstract
Tobacco use is one of the major public health concerns and it is the most preventable cause of morbidity and mortality worldwide. Smoking cessation reduces subsequent cardiovascular events and mortality. Smoking is a real chronic disorder characterized by the development of an addiction status mainly due to nicotine. This condition makes the smokers generally unable to quit smoking without help. Different strategies are available to treat smoking dependence that include both non-pharmacological (behavioral counselling) and pharmacological therapies. Currently, it is well accepted that smoking cessation drugs are effective and safe in real-world settings. Nicotine replacement therapy (NRT), varenicline, bupropion and cytisine are the main pharmacological strategies available for smoking cessation. Their efficacy and safety have been proved even in patients with chronic cardiovascular disease. Each of these drugs has peculiar characteristics and the clinician should customize the smoking cessation strategy based on currently available scientific evidence and patient's preference, paying particular attention to those patients having specific cardiovascular and psychiatric comorbidities. The present document aims to summarize the current viable pharmacological strategies for smoking cessation, also discussing the controversial issue regarding the use of alternative tobacco products, in order to provide useful practical indications to all physicians, mainly to those involved in cardiovascular prevention.
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Affiliation(s)
- Federico Giulietti
- Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Pulmonology and Respiratory Medicine Clinic, Centre for Smoking Cessation, IRCCS INRCA, Ancona, Italy
- Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Ancona, Italy
| | - Andrea Filipponi
- Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Pulmonology and Respiratory Medicine Clinic, Centre for Smoking Cessation, IRCCS INRCA, Ancona, Italy
- Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Ancona, Italy
| | - Giulia Rosettani
- Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Pulmonology and Respiratory Medicine Clinic, Centre for Smoking Cessation, IRCCS INRCA, Ancona, Italy
- Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Ancona, Italy
| | - Piero Giordano
- Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Pulmonology and Respiratory Medicine Clinic, Centre for Smoking Cessation, IRCCS INRCA, Ancona, Italy
| | - Corrado Iacoacci
- Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Pulmonology and Respiratory Medicine Clinic, Centre for Smoking Cessation, IRCCS INRCA, Ancona, Italy
| | - Francesco Spannella
- Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Pulmonology and Respiratory Medicine Clinic, Centre for Smoking Cessation, IRCCS INRCA, Ancona, Italy
- Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Ancona, Italy
| | - Riccardo Sarzani
- Internal Medicine and Geriatrics, "Hypertension Excellence Centre" of the European Society of Hypertension, Pulmonology and Respiratory Medicine Clinic, Centre for Smoking Cessation, IRCCS INRCA, Ancona, Italy.
- Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Ancona, Italy.
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31
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Vestbo J, Grigg J, Pisinger C, Bush A. World No Tobacco Day: smoking, nicotine and children. Eur Respir J 2020; 55:55/5/2001633. [DOI: 10.1183/13993003.01633-2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 11/05/2022]
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Britton J, George J, Bauld L, Agrawal S, Moxham J, Arnott D, McNeill A, Hopkinson NS. A rational approach to e-cigarettes: challenging ERS policy on tobacco harm reduction. Eur Respir J 2020; 55:2000166. [PMID: 32094209 DOI: 10.1183/13993003.00166-2020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 02/05/2020] [Indexed: 02/06/2023]
Affiliation(s)
- John Britton
- UK Centre for Tobacco and Alcohol Studies, University of Nottingham, London, UK
| | - Jacob George
- Molecular and Cellular Medicine, Dundee University, Dundee, UK
| | - Linda Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
| | - Sanjay Agrawal
- Institute for Lung Health, University of Leicester, Leicester, UK
| | - John Moxham
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | | | - Ann McNeill
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Affiliation(s)
- Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, The University of Manchester, Manchester, United Kingdom
- North West Lung Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Charlotta Pisinger
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Copenhagen, Denmark
- Danish Heart Association, Copenhagen, Denmark
- University of Copenhagen, Faculty of Health Sciences, Department of Public Health, Copenhagen, Denmark
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34
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Pisinger C, Vestbo J. A rational approach to e-cigarettes: challenging ERS policy on tobacco harm reduction. Eur Respir J 2020; 55:2000355. [PMID: 32094210 DOI: 10.1183/13993003.00355-2020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 02/18/2020] [Indexed: 11/05/2022]
Affiliation(s)
- Charlotta Pisinger
- Center for Clinical Research and Disease Prevention, Frederiksberg-Bispebjerg University Hospital, Copenhagen, Denmark
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
- North West Lung Centre, Manchester University NHS, Foundation Trust, Manchester, UK
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35
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Chalmers JD, Reeves EL, Bullen NJ, Kolb M. The evolution of the European Respiratory Journal: ready for the new decade! Eur Respir J 2020; 55:55/1/1902503. [PMID: 31974124 DOI: 10.1183/13993003.02503-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 01/06/2020] [Indexed: 11/05/2022]
Affiliation(s)
- James D Chalmers
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Elin L Reeves
- European Respiratory Society, Publications Office, Sheffield, UK
| | - Neil J Bullen
- European Respiratory Society, Publications Office, Sheffield, UK
| | - Martin Kolb
- Dept of Respiratory Medicine, Pathology and Molecular Medicine, McMaster University and St Joseph's Healthcare, Hamilton, ON, Canada
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