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Zulkiewicz BA, Winickoff JP, Gottlieb MA, Emmons KM, Tan AS. "Tobacco-free nicotine" electronic cigarette perceptions and use among adolescents and adults in five New England states. Addict Behav Rep 2024; 19:100524. [PMID: 38226008 PMCID: PMC10788778 DOI: 10.1016/j.abrep.2024.100524] [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: 06/21/2023] [Revised: 09/08/2023] [Accepted: 01/02/2024] [Indexed: 01/17/2024] Open
Abstract
Introduction More brands are using tobacco-free nicotine (TFN) in electronic cigarettes (e-cigarettes) and these products are becoming increasingly popular. The term TFN and claims about its properties can mislead consumers about the harms and addictiveness of TFN e-cigarettes, which may increase initiation of these products among non-smokers or influence current smokers' decisions to adopt TFN e-cigarettes as a harm reduction measure. Methods We conducted an observational, cross-sectional survey of 777 adolesc aged 13-17 and 655 current adult cigarette smokers residing in Massachusetts, Connecticut, New Hampshire, Rhode Island, or Vermont about their TFN e-cigarette awareness, use, perceptions, and susceptibility. We examined the association between prior awareness of TFN and use, perceptions, and susceptibility. Results One-third of adolescents and adults reported being aware of TFN. TFN e-cigarette use was less common than tobacco-derived nicotine (TDN) e-cigarette use among adolescents (8.9 % vs. 30.5 %) and adults (21.1 % vs. 79.4 %). Compared to unaware adolescents, adolescents who were aware of TFN more frequently reported being more likely to use TFN compared to TDN e-cigarettes and that TFN e-cigarettes are more addictive than those containing TDN. Aware adult smokers more frequently reported that TFN e-cigarettes are more addictive than TDN e-cigarettes, TFN e-cigarettes cause some harm, TDN e-cigarettes cause little harm, and that TFN and TDN e-cigarettes are equally harmful than those who were unaware previously. Conclusion Public health education campaigns are needed to educate consumers about the harms and addictiveness of TFN e-cigarettes.
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Affiliation(s)
- Brittany A. Zulkiewicz
- University of Pennsylvania Annenberg School for Communication, 3620 Walnut St, Philadelphia, PA 19104, United States
| | - Jonathan P. Winickoff
- Massachusetts General Hospital, Division of General Academic Pediatrics, Harvard Medical School, 55 Fruit St, Boston, MA 02114, United States
| | - Mark A. Gottlieb
- Northeastern University School of Law, Public Health Advocacy Institute, 360 Huntington Ave, Suit 1170CU, Boston, MA 02115, United States
| | - Karen M. Emmons
- Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, United States
| | - Andy S.L. Tan
- University of Pennsylvania Annenberg School for Communication, 3620 Walnut St, Philadelphia, PA 19104, United States
- University of Pennsylvania Leonard Davis Institute of Health Economics, 3641 Locust Walk #210, Philadelphia, PA 19104, United States
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2
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Hanewinkel R, Hansen J. Regional socioeconomic deprivation in Germany and nicotine use among children and adolescents. Int J Environ Health Res 2024; 34:1023-1033. [PMID: 36966513 DOI: 10.1080/09603123.2023.2195155] [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: 02/15/2023] [Accepted: 03/21/2023] [Indexed: 06/18/2023]
Abstract
To assess the association of regional socioeconomic deprivation and nicotine use, survey data from 17,877 pupils aged 9-17 years were analysed. Lifetime use of combustible, e-cigarettes, and both products were the outcome variables. The German Index of Socioeconomic Deprivation was the exposure variable. Logistic regression models controlling for age, gender, school type, and sensation seeking were used to examine associations between regional socioeconomic deprivation and nicotine use. Ever use of combustible cigarettes was 17.8%, of e-cigarettes 19.6%, and of both products 13.4%. Compared to the most affluent area, the adjusted odds ratio of combustible cigarette use in the most deprived area was 2.24 (95% CI: 1.67-3.00), of e-cigarette use 1.56 (95% CI: 1.20-2.03), and of poly use 1.91 (95% CI: 1.36-2.69). Nicotine use among young people across ages and especially in socioeconomic-deprived areas was widespread. Nicotine control measures are urgently needed to reduce smoking and vaping in German adolescents.
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Affiliation(s)
| | - Julia Hansen
- Institute for Therapy and Health Research, Kiel, Germany
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Chen YC, Rindner DJ, Fowler JP, Lallai V, Mogul A, Demuro A, Lur G, Fowler CD. Extracellular ATP Neurotransmission and Nicotine Sex-Specifically Modulate Habenular Neuronal Activity in Adolescence. J Neurosci 2023; 43:8259-8270. [PMID: 37821229 PMCID: PMC10697394 DOI: 10.1523/jneurosci.1290-23.2023] [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: 06/26/2023] [Revised: 09/20/2023] [Accepted: 09/29/2023] [Indexed: 10/13/2023] Open
Abstract
The recent increase in the use of nicotine products by teenagers has revealed an urgent need to better understand the impact of nicotine on the adolescent brain. Here, we sought to examine the actions of extracellular ATP as a neurotransmitter and to investigate whether ATP and nicotinic signaling interact during adolescence. With the GRABATP (G-protein-coupled receptor activation-based ATP sensor), we first demonstrated that nicotine induces extracellular ATP release in the medial habenula, a brain region involved in nicotine aversion and withdrawal. Using patch-clamp electrophysiology, we then demonstrated that activation of the ATP receptors P2X or P2Y1 increases the neuronal firing of cholinergic neurons. Surprisingly, contrasting interactive effects were observed with nicotine exposure. For the P2X receptor, activation had no observable effect on acute nicotine-mediated activity, but during abstinence after 10 d of nicotine exposure, coexposure to nicotine and the P2X agonist potentiated neuronal activity in female, but not male, neurons. For P2Y1 signaling, a potentiated effect of the agonist and nicotine was observed with acute exposure, but not following extended nicotine exposure. These data reveal a complex interactive effect between nicotinic and ATP signaling in the adolescent brain and provide mechanistic insights into extracellular ATP signaling with sex-specific alterations of neuronal responses based on prior drug exposure.SIGNIFICANCE STATEMENT In these studies, it was discovered that nicotine induces extracellular ATP release in the medial habenula and subsequent activation of the ATP purinergic receptors increases habenular cholinergic neuronal firing in the adolescent brain. Interestingly, following extended nicotine exposure, nicotine was found to alter the interplay between purinergic and nicotinic signaling in a sex-specific manner. Together, these studies provide a novel understanding for the role of extracellular ATP in mediating habenular activity and reveal how nicotine exposure during adolescence alters these signaling mechanisms, which has important implications given the high incidence of e-cigarette/vape use by youth.
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Affiliation(s)
- Yen-Chu Chen
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, California 92697
| | - Daniel Jun Rindner
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, California 92697
| | - James P Fowler
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, California 92697
| | - Valeria Lallai
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, California 92697
| | - Allison Mogul
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, California 92697
| | - Angelo Demuro
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, California 92697
| | - Gyorgy Lur
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, California 92697
| | - Christie D Fowler
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, California 92697
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Cheng YJ, Cornelius ME, Wang TW, Homa DM. Trends and Demographic Differences in the Incidence and Mean Age of Starting to Smoke Cigarettes Regularly, National Health Interview Survey, 1997-2018. Public Health Rep 2023; 138:908-915. [PMID: 36514968 PMCID: PMC10576484 DOI: 10.1177/00333549221138295] [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: 12/15/2022] Open
Abstract
OBJECTIVES Surveillance of cigarette smoking behavior provides evidence for evaluating the impact of current tobacco control measures. We examined temporal changes and demographic differences in the incidence and mean age of starting to smoke cigarettes regularly in the United States. METHODS We conducted retrospective birth-cohort and cross-sectional analyses using self-reported data from the 1997-2018 National Health Interview Survey to evaluate trends and demographic differences in the incidence and mean age of starting to smoke cigarettes regularly among participants aged 18-84 years. We estimated the incidence and mean age of starting to smoke cigarettes regularly by using Poisson and linear regression. RESULTS Among adults born during 1950-1999, the incidence of starting to smoke cigarettes regularly before age 35 years decreased by 18.8% (95% CI, 17.0%-20.7%) per 10 years, with a peak incidence at age about age 18 years. Male, non-Hispanic White, and US-born people had a higher incidence of starting to smoke cigarettes regularly than female, other racial and ethnic, and non-US-born people, respectively (P < .001 for all). From 1997 to 2018, the mean age of starting to smoke cigarettes regularly decreased by 0.4% (95% CI, 0.2%-0.6%) per 10 years among adults who ever smoked. CONCLUSION The incidence of starting to smoke cigarettes regularly decreased dramatically at all ages during the study period, which suggests a positive impact of current tobacco control measures. For evaluating trends in starting to smoke cigarettes regularly, incidence can be a more sensitive indicator of temporal change than mean age. Differences in smoking incidence by demographic subgroup suggest that additional opportunities exist to further reduce the incidence of starting to smoke cigarettes regularly.
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Affiliation(s)
- Yiling J. Cheng
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Monica E. Cornelius
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Teresa W. Wang
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - David M. Homa
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Danielsson M, Lammi A, Siitonen S, Ollgren J, Pylkkänen L, Vasankari T. Factors predicting willingness to quit snus and cigarette use among young males. Sci Rep 2023; 13:15126. [PMID: 37704673 PMCID: PMC10499985 DOI: 10.1038/s41598-023-42233-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/07/2023] [Indexed: 09/15/2023] Open
Abstract
The health hazards of smoking are well recognised and recently knowledge about the harmful effects of nicotine and snus is accumulating. We investigated the factors increasing the willingness of young Finnish males to quit snus and cigarette smoking. We conducted a questionnaire study conducted in 3 out of 16 Finnish Defence Forces units which included 6508 male conscripts, of whom 4706 responded (response rate 72%, mean age 19.4 years). Factors related to the willingness to quit use were analysed by ordinal regression models. Backward selection following the Akaike information criterion (AIC) was used for the model. The prevalence figures of daily snus use and smoking were 17% and 25%, respectively. 16% of the daily snus users were also daily smokers and 29% were occasional smokers. Multivariate analysis showed that the willingness to quit snus use was associated with the perception of health hazards (OR 3.09, 95% CI 1.94-4.93) and with ≥ 2 quit attempts (OR 3.63, 95% CI 2.44-5.40). The willingness to quit smoking was associated with ≥ 2 quit attempts (OR 3.22, 95% CI 2.32-4.49), and with advice to quit smoking (OR 1.65, 95% CI 1.17-2.32). We created a brief two-question assessment model for snus dependence. With this model, nicotine dependence of daily snus users was congruent with that of nicotine dependence of smokers. A direct comparison with serum cotinine levels is necessary before our assessment model can be used as a proxy for dependence. Regular snus use predisposes to nicotine addiction and accumulated health hazards. Our findings underscore the importance of health promotion efforts in early adolescence and of active support for quitting snus use. Easily applicable tools to estimate nicotine addiction are needed for everyday clinical use.
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Affiliation(s)
- Maria Danielsson
- The Finnish Defence Forces, Kasarminkatu 17, 00130, Helsinki, Finland.
- Doctoral Programme in Population Health, University of Helsinki, P.O. BOX 3, 00014, Helsinki, Finland.
| | - Anelma Lammi
- Finnish Lung Health Association (FILHA), Filha Ry, Sibeliuksenkatu 11 A 1, 00250, Helsinki, Finland
| | - Simo Siitonen
- The Finnish Defence Forces, Kasarminkatu 17, 00130, Helsinki, Finland
| | - Jukka Ollgren
- National Institute for Health and Welfare, P.O. BOX 30, 00271, Helsinki, Finland
| | - Liisa Pylkkänen
- Finnish Medicines Agency Fimea, Helsinki, Finland
- Division of Medicine, Department of Oncology, Turku University Hospital and University of Turku, P.O. BOX 52, 20521, Turku, Finland
| | - Tuula Vasankari
- Finnish Lung Health Association (FILHA), Filha Ry, Sibeliuksenkatu 11 A 1, 00250, Helsinki, Finland
- Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, P.O. BOX 52, 20521, Turku, Finland
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Heinly A, Walley S. The nicotine and tobacco epidemic among adolescents: new products are addicting our youth. Curr Opin Pediatr 2023; 35:513-521. [PMID: 37335268 DOI: 10.1097/mop.0000000000001271] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
PURPOSE OF REVIEW New nicotine and tobacco products such as electronic cigarettes and oral nicotine products have increased in use and threaten to addict a new generation of youth. This review summarizes current literature on nicotine and tobacco products used by youth, epidemiology, health effects, prevention and treatment of nicotine dependence, and current policies and regulations. RECENT FINDINGS Electronic cigarettes and oral nicotine products are popular among youth, attracting adolescents through exposure to deceptive marketing and fruit, candy and dessert flavors. Electronic cigarettes and oral nicotine product use can lead to nicotine addiction and is associated with respiratory, cardiovascular, and oral health problems, although long-term health effects are not fully known. The Food and Drug Administration (FDA) has authority to regulate nicotine and tobacco products; however, thousands of unregulated and unauthorized products remain on the market. SUMMARY Millions of adolescents continue to use nicotine and tobacco products, which puts them at risk for health problems, including nicotine addiction. Pediatric providers can provide prevention messages, screen youth for tobacco and nicotine use, and offer appropriate treatment options. Regulation of tobacco and nicotine products by the FDA is critical to reverse this public health epidemic of youth nicotine and tobacco use.
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Affiliation(s)
- Allison Heinly
- Hasbro Children's Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Susan Walley
- Children's National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Fountoulakis P, Theofilis P, Tsalamandris S, Antonopoulos AS, Tsioufis P, Toutouzas K, Oikonomou E, Tsioufis K, Tousoulis D. The cardiovascular consequences of electronic cigarette smoking: a narrative review. Expert Rev Cardiovasc Ther 2023; 21:651-661. [PMID: 37755116 DOI: 10.1080/14779072.2023.2264179] [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: 03/10/2023] [Accepted: 09/25/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION E-cigarettes have emerged as a popular alternative to traditional tobacco smoking in recent years. Despite their growing popularity, concerns have arisen regarding the cardiovascular implications of e-cigarette use. AREAS COVERED This narrative review aims to highlight the latest evidence on the impact of e-cigarettes on cardiovascular health. EXPERT OPINION Numerous studies have demonstrated that e-cigarette use can lead to acute adverse cardiovascular effects. Inhalation of e-cigarette aerosols exposes users to a wide range of potentially harmful substances that have been implicated in critical pathophysiologic pathways of cardiovascular disease, namely endothelial dysfunction, oxidative stress, inflammation, sympathetic overdrive, and arterial stiffness. While long-term epidemiological studies specifically focusing on the cardiovascular effects of e-cigarettes are still relatively scarce, early evidence suggests a potential association between e-cigarette use and an increased risk of adverse cardiovascular events. However, it is essential to recognize that e-cigarettes are relatively new products, and the full extent of their long-term cardiovascular impact has not been fully elucidated. In the meantime, promoting tobacco cessation strategies that are evidence-based and regulated, along with rigorous monitoring of e-cigarette use patterns and associated health outcomes, are essential steps in safeguarding cardiovascular health in the face of this emerging public health challenge.
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Affiliation(s)
- Petros Fountoulakis
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Panagiotis Theofilis
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Sotiris Tsalamandris
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Alexios S Antonopoulos
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Panagiotis Tsioufis
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Konstantinos Toutouzas
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Evangelos Oikonomou
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
- Cardiology Department, Sotiria Chest Diseases Hospital, University of Athens Medical School, Athens, Greece
| | - Konstantinos Tsioufis
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
| | - Dimitris Tousoulis
- Cardiology Department, Hippokration General Hospital, University of Athens Medical School, Athens, Greece
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8
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Park JH, Kim MJ, Lee HJ. A Study on the Factors Influencing Smoking in Multicultural Youths in Korea. Healthcare (Basel) 2023; 11:healthcare11101437. [PMID: 37239723 DOI: 10.3390/healthcare11101437] [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: 04/07/2023] [Revised: 04/29/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Based on the ecological integration model, this study examined the factors affecting smoking in adolescents from multicultural families by dividing them into two levels: microsystem and social network factors. The data were from the Korea Youth Risk Behavior Web-Based Survey (KYRBS) from 2016 to 2020. It included 4577 respondents whose fathers, mothers, or both, were not born in Korea. The factors affecting smoking among multicultural teenagers were determined by a composite-sample multiple logistic regression analysis. Male smoking rates among multicultural adolescents were 2.49 times higher than female rates in the microsystem. When the father was "Korean" rather than a "Foreigner", smoking was 0.55 times lower in family factors in terms of social network. In social factors of social networks, multicultural adolescents' smoking was 12.02 times greater when they were drinking than when they were not, and 3.62 times higher when the answer to the question of whether they had experienced violence was "yes" than "no." Based on the ecological model in this study, social factors such as drinking, and violence were highly related to smoking. Since multicultural adolescents were closely influenced by the surrounding environment, such as family, school, and social relationship, it was necessary to let parents and schoolteachers be involved in the intervention of smoking of multicultural adolescents so that they can help multicultural adolescents adjust better to school and perform better academically while decreasing risky behaviors for their health, such as drinking and, ultimately, smoking.
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Affiliation(s)
- Jin-Hee Park
- Department of Nursing, Changshin University, 262 Palyongro, MasanHoewon-gu, Changwon 51352, Gyeongsangnam-do, Republic of Korea
| | - Mi-Jin Kim
- Department of Nursing, Daegu Haany University, Hanuidae-ro, Gyeongsan-si 38610, Gyeongsangbuk-do, Republic of Korea
| | - Hee-Joo Lee
- Department of Nursing, Sangmyung University, 31 Sangmyungdae-gil, Dongnam-gu, Cheonan 31066, Chungnam, Republic of Korea
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Wang Z, Shi H, Peng L, Zhou Y, Wang Y, Jiang F. Gender differences in the association between biomarkers of environmental smoke exposure and developmental disorders in children and adolescents. Environ Sci Pollut Res Int 2022; 29:84629-84639. [PMID: 35781659 DOI: 10.1007/s11356-022-21767-w] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Effects of environmental tobacco smoke (ETS) exposure on children and adolescent health outcomes have been attracted more and more attention. In the present study, we seek to examine the gender-specific difference association of environmental smoke exposure biomarkers and developmental disorders in children and adolescents aged 6-15 years. US nationally representative sample collected from the National Health and Nutrition Examination Survey (NHANES) 2007-2014 was enrolled (N = 4428). Developmental disorders (DDs) are defined as a positive answer to the question, "Does your child receive special education or early intervention services?" Serum cotinine and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) were utilized as acute and chronic exposure biomarkers of ETS, respectively. Participants with serum cotinine >0.015 ng/mL were considered as with acute ETS exposure, and participants with creatinine-adjusted NNAL >0.0006 ng/mL were considered as with chronic ETS exposure. A survey logistic regression model was used to estimate the association between ETS exposure biomarkers and DDs. Additive interaction was utilized to examine the interaction of gender and biomarkers of ETS. Overall, approximately 9% of children were defined as DDs, and 65% of children had serum cotinine and urinary NNAL levels above the limit of detection. In the adjusted models, the association of ETS exposure biomarkers with DDs was only observed in girls. Girls with low cotinine levels and high urinary NNAL levels had 2.074 (95% CI: 1.012-4.247) and 1.851 (95% CI: 1.049-3.265) times higher odds of being DDs than those without ETS exposure, respectively. However, the effects of boys and NNAL exposure on DDs have additively interacted. Our findings first provided strong evidence for gender differences in the association between two tobacco metabolites and DDs in children, disclosing the public health implications and economic burdens of environmental tobacco smoke exposure.
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Affiliation(s)
- Zixuan Wang
- Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, Jiangsu, China
| | - Hui Shi
- Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, Jiangsu, China
| | - Ling Peng
- Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, Jiangsu, China
| | - Yue Zhou
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, PR China
| | - Ying Wang
- Suzhou Center for Disease Prevention and Control, 72 Sanxiang Road, Suzhou, Jiangsu, China
| | - Fei Jiang
- School of public health, Medical College of Soochow University, 199 Renai Road, Suzhou, 215123, Jiangsu, China.
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Yang JS, Lim P, Ojeda K, Cuomo RE, Purushothaman V, Mackey T. Inductive Characterization of ENDS-Associated Adverse Events Among California Young Adults. AJPM Focus 2022; 1:100040. [PMID: 37791243 PMCID: PMC10546498 DOI: 10.1016/j.focus.2022.100040] [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] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Previous studies have identified numerous adverse events experienced with the use of ENDS or E-cigarettes. However, much remains unknown about adverse event frequency, duration, and response experienced by users. The purpose of this study was to inductively characterize ENDS-attributed adverse events among young adults. Methods Sixteen focus groups were held with 114 young adults (aged 18-29 years) who have reported lifetime ENDS use in April 2021. Discussion topics included current and previous tobacco, nicotine, and cannabis use; specific symptoms and frequency and duration of and response to symptoms of ENDS-attributed adverse events; and the impact of other conditions such as COVID-19 on ENDS use. Data were inductively analyzed using a team-based approach. Results More than 40 ENDS-attributed adverse events were reported in focus groups among approximately three quarters of all study participants, with headache, coughing, lightheadedness, nausea, dry or sore throat, and dizziness the most common. In general, adverse events were transient, with most resolving in a few hours, although some tended to last for longer. The frequency of adverse events varied most between every time ENDS were used and when someone vaped excessively. Finally, behavioral responses varied by adverse events, with difficulty in breathing, chest pain, and lung discomfort more likely to result in quitting permanently. Conclusions Overall, the results of this study show that not only do adverse events vary greatly, but they also vary across multiple dimensions of user experience.
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Affiliation(s)
- Joshua S. Yang
- Department of Public Health, College of Health and Human Development, California State University, Fullerton, Fullerton, California
| | - Pauline Lim
- Department of Public Health, College of Health and Human Development, California State University, Fullerton, Fullerton, California
| | - Kristen Ojeda
- Department of Public Health, College of Health and Human Development, California State University, Fullerton, Fullerton, California
| | - Raphael E. Cuomo
- Department of Anesthesiology, School of Medicine, University of California, San Diego, San Diego, California
| | - Vidya Purushothaman
- San Diego Supercomputer Center, University of California, San Diego, San Diego, California
| | - Tim Mackey
- San Diego Supercomputer Center, University of California, San Diego, San Diego, California
- Global Health Program, University of California, San Diego, San Diego, California
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Di X, Liu S, Xie H, Zeng X, Meng Z, Xiao L. Cigarette availability and affordability among Chinese youth smokers: Findings from the 2019 China Youth Tobacco Survey. Tob Induc Dis 2022; 20:89. [PMID: 36330276 PMCID: PMC9580065 DOI: 10.18332/tid/152511] [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: 05/23/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Preventing youth from tobacco use is a priority for tobacco control in China, and the government has taken many measures such as introducing tobacco control in the health education curriculum, banning smoking in school, promoting smoke-free household, and advocacy campaigns. The objective of this study was to understand the availability and affordability of cigarettes for middle school (MS) and high school (HS) students in China. METHODS The data were extracted from the 2019 China National Youth Tobacco Survey, which was a school-based cross-sectional survey with a nationally representative sample of 288192 MS and HS students. The survey employed a randomized multistage stratified cluster sampling design with probability proportional to size sampling method and used an anonymous self-administrated questionnaire to collect data. The availability and affordability of cigarettes were analyzed, and all parameter estimates were weighted to account for the complex sampling design. RESULTS In 2019, an estimated 80.5% of current smokers who were aged <18 years bought cigarettes in the past 30 days. Among them, 83.3% (83.0% of males and 85.2% of females; and 76.5% in MS and 87.6% in HS) had not been refused purchase of cigarettes because they were underage, with 84.1% in urban and 82.9% in rural areas, and 87.3% in central, 83.4% in eastern, and 80.5% in western regions of China. Among current smokers who bought cigarettes in the past 30 days, 77.3% had bought a pack of cigarettes (20 cigarettes) costing >10 RMB and at least 61.4% had more pocket money per week than the cost of a pack of cigarettes. Although 84.2% of current smokers bought cigarettes by the pack, 9.2% of current smokers reported that they bought cigarettes as sticks. CONCLUSIONS Although the youth smoking rate dropped down from 2014 to 2019, the proportion of youth smokers that bought cigarettes was still high in China. Due to the high amount of pocket money, the current cigarette price was not an effective price barrier to prevent youth smoking. Selling cigarettes by the stick worsens the situation. Strengthening the enforcement of the 2021 Law on the Protection of Minors, increasing tobacco taxes and prices, and forbidding the selling of cigarette sticks, might assist the progress in youth tobacco control.
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Affiliation(s)
- Xinbo Di
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shiwei Liu
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huiyu Xie
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xinying Zeng
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zida Meng
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lin Xiao
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
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12
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Gakkhar A, Mehendale A, Mehendale S. Tobacco Cessation Intervention for Young People. Cureus 2022; 14:e30308. [PMID: 36407239 PMCID: PMC9659423 DOI: 10.7759/cureus.30308] [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: 09/10/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023] Open
Abstract
Most adolescent tobacco control programs focus on preventing consumption, but teen smoking persists. It is uncertain whether adult-specific therapies can assist adolescents in quitting smoking. The rising incidence of smoking in low and middle-socioeconomic countries and the challenges of conducting tobacco cessation programs in these settings (due to increasing population, poor lifestyle, lack of awareness and education, professional stress, and non-compliance) need an emphasis on the scope of trials to conduct tobacco cessation in these settings. In the 11th Five Year Plan, the Indian government introduced a new National Tobacco Control Program, which currently spans 108 districts in 31 states across the country. The objective is to review the randomized control trials of selected individuals held in India and assess and evaluate the effectiveness of the steps taken by the government to help people quit tobacco consumption. These programs are important because of the hazards and impact they have on the public health indices of the nation. The government has taken steps like prohibiting smoking in public areas and banning sources. Several programs, particularly those that employed group counselling, included a range of approaches that proved beneficial in helping young people quit smoking. The RCTs mentioned are psychosocially followed by behavioral and pharmacological therapies. The challenges faced are not having participatory health care, motivating tobacco users to quit even in the short-term, adequate coverage; barriers at a different level of implementation (at a regional, state, or national level); and interference by the tobacco industry should be eliminated. The currently functioning programs in India are the National Tobacco Control Program, the National and three Regional Quitlines and mCessation.
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Affiliation(s)
- Avni Gakkhar
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Ashok Mehendale
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Shivansh Mehendale
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Insititute of Medical Sciences, Wardha, IND
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Li Y, Wu F, Mu Q, Xu K, Yang S, Wang P, Wu Y, Wu J, Wang W, Li H, Chen L, Wang F, Liu Y. Metal ions in cerebrospinal fluid: Associations with anxiety, depression, and insomnia among cigarette smokers. CNS Neurosci Ther 2022; 28:2141-2147. [PMID: 36168907 PMCID: PMC9627395 DOI: 10.1111/cns.13955] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 08/03/2022] [Accepted: 08/11/2022] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The study aimed to investigate the relationship between cerebrospinal fluid (CSF) metal ions and anxiety, depression, and insomnia among cigarette smokers. METHODS We measured CSF levels of various metal ions from 178 Chinese male subjects. Apart from sociodemographic and clinical characteristics data, the Fagerstrom Test for Nicotine Dependence (FTND), Beck Depression Inventory (BDI), Self-Rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI) were applied. RESULTS BDI and PSQI scores (all p < 0.001) were significantly higher in active smokers than nonsmokers. Active smokers have significantly higher CSF levels of magnesium, zinc, iron, lead, lithium, and aluminum (all p ≤ 0.002). Some metal ions, including zinc, iron, lead, and aluminum, were found to have a significant correlation with BDI scores, whereas metal ions, including zinc and lead, were found to have a significant correlation with PSQI scores in the general group. More interesting, mediation analysis showed that aluminum mediated the relationship between smoking and depression. CONCLUSIONS Cigarette smoking was indeed associated with depression and insomnia. Active smokers had significantly higher CSF levels of magnesium, zinc, iron, lead, lithium, and aluminum. Furthermore, CSF aluminum played a mediating role in the relationship between smoking and depression, which further confirmed its neurotoxicity.
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Affiliation(s)
- Yuying Li
- Ruian People's HospitalWenzhou Medical College Affiliated Third HospitalWenzhouChina
| | - Fenzan Wu
- Laboratory of Translational MedicineAffiliated Cixi Hospital, Wenzhou Medical UniversityNingboChina,School of PharmacyWenzhou Medical UniversityWenzhouChina
| | - Qingshuang Mu
- Xinjiang Key Laboratory of Neurological Disorder ResearchThe Second Affiliated Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Kewei Xu
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Shizhuo Yang
- School of PharmacyWenzhou Medical UniversityWenzhouChina
| | - Ping Wang
- School of PharmacyWenzhou Medical UniversityWenzhouChina
| | - Yuyu Wu
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Junnan Wu
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Wei Wang
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Hui Li
- Psychosomatic Medicine Research DivisionInner Mongolia Medical UniversityHuhhotChina,Department of Biomedical EngineeringCollege of Engineering, Peking UniversityBeijingChina
| | - Li Chen
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Fan Wang
- Beijing Hui‐Long‐Guan HospitalPeking UniversityBeijingChina
| | - Yanlong Liu
- The Affiliated Kangning HospitalWenzhou Medical UniversityWenzhouChina
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14
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Akbayram HT, Dogru S. Smoking and smoking addiction in future physicians during the COVID-19 pandemic; an example of a medical school in Turkey. Journal of Substance Use 2022. [DOI: 10.1080/14659891.2022.2124547] [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] [Indexed: 10/14/2022]
Affiliation(s)
- Hatice Tuba Akbayram
- Department of Family Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Turkiye
| | - Sibel Dogru
- Department of Pulmonary Disease, Gaziantep University Faculty of Medicine, Gaziantep, Turkiye
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15
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McBrayer K, Ouyang F, Adams Z, Hulvershorn L, Aalsma MC. Rates of Tobacco Use Disorder, Pharmacologic Treatment, and Associated Mental Health Disorders in a Medicaid Claim Review Among Youth in Indiana, USA. Tob Use Insights 2022; 15:1179173X221119133. [PMID: 36052177 PMCID: PMC9424880 DOI: 10.1177/1179173x221119133] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose This study delineates a number of Medicaid youth with tobacco use disorder (TUD), prescribing habits for treatment, and associated externalizing disorders. Methods Youth Medicaid claims from 2007-2017 processed in a large Midwestern city were analyzed for a diagnosis of TUD, related pharmacotherapy, and externalizing mental health and substance use disorders. Results Claims connected 6541 patients with 42 890 visits. Mean age was 16.4 with 40% female. 1232 of the 6541 charts contained a TUD diagnosis equating to 1848 visits. A comorbid diagnosis of ADHD, cannabis use, and conduct disorder were more common in males (3.9% vs 1.3% in females; 3.4% vs .8%; and 2.8% vs .8%; P < .05). 808 scripts were provided to 152 of the 1232 youths, with 4.7% of those scripts a nicotine replacement product. Conclusions Pharmacotherapy is underutilized in this Medicaid claims data set. Certain externalizing factors were associated with males with TUD more than females.
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Affiliation(s)
- Kimberly McBrayer
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Fangqian Ouyang
- Department of Biostatistics, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA
| | - Zachary Adams
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Leslie Hulvershorn
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Matthew C Aalsma
- Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
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López-Gil JF, Cavero-Redondo I, Tárraga López PJ, Jiménez-López E, González AD, Sequí-Domínguez I, Mesas AE. Anxiety-Induced Sleep Disturbance and Associated Lifestyle Behaviors According to Sex in Argentine Adolescents. Front Behav Neurosci 2022; 16:860241. [PMID: 35548694 PMCID: PMC9084278 DOI: 10.3389/fnbeh.2022.860241] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/15/2022] [Indexed: 12/01/2022] Open
Abstract
Purpose The aim of the current study was twofold: first, to determine the prevalence of anxiety-induced sleep disturbances among Argentine adolescents according to sex, and second, to identify the association between these sleep disturbances and lifestyle behaviors in this population. Methods This is a cross-sectional study with data from the Global School-based Student Health Survey (GSHS) in Argentina (2018). A total of 32,393 adolescents (aged 12–17 years; 53.4% girls) were included in the final analysis. Anxiety-induced sleep disturbances were assessed with the question “During the past 12 months, how often have you been so worried about something that you could not sleep at night?” Results The prevalence of anxiety-induced sleep disturbances was higher in girls (17.4%) than in boys (7.9%) (p < 0.001). In boys, results indicated that those who used marijuana (cannabis) (odds ratio [OR] = 1.46, 95% confidence interval [CI] 1.08–1.98), used amphetamine or methamphetamine (OR = 2.19, 95% CI 1.28–3.77), walked or biked to or from school (OR = 1.53, 95% CI 1.19–1.96), and spent 3 h or more in sedentary behaviors (OR = 1.35, 95% CI 1.05–1.74) were more likely to report anxiety-induced sleep disturbances. In girls, those who ate from a fast-food restaurant (OR = 1.24, 95% CI 1.05–1.47), consumed alcoholic beverages (OR = 1.45, 95% CI 1.19–1.75), smoked cigarettes (OR = 2.09, 95%CI 1.05–4.14), consumed any tobacco product (OR = 1.47, 95% CI 1.19–1.82), used amphetamine or methamphetamine (OR = 2.08, 95% CI 1.33–3.26), and those who spent 3 h or more in sedentary behaviors (OR = 1.32, 95% CI 1.11–1.57) were more likely to report frequent anxiety-induced sleep disturbances. Conclusion In conclusion, considerable sex differences were observed with respect to the prevalence of anxiety-related sleep disturbances and associated lifestyle aspects.
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Affiliation(s)
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Pedro J. Tárraga López
- Department of Medical Sciences, Faculty of Medicine, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Estela Jiménez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Department of Psychiatry, Hospital Virgen de La Luz, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Cuenca, Spain
- *Correspondence: Estela Jiménez-López,
| | - Alberto Durán González
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
| | | | - Arthur Eumann Mesas
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil
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Di Cicco M, Sepich M, Beni A, Comberiati P, Peroni DG. How E-cigarettes and vaping can affect asthma in children and adolescents. Curr Opin Allergy Clin Immunol 2022; 22:86-94. [PMID: 35197429 DOI: 10.1097/ACI.0000000000000807] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Electronic nicotine delivery systems such as e-cigarettes are commonly felt to be harmless devices when compared to traditional cigarettes. However, an increasing number of studies support the biological plausibility for the potential detrimental effects of vaping on the respiratory mucosa. To date, few human studies have been carried out on adult vapers showing a reduction in lung function testing, especially in those with asthma, whereas the effects of vaping on children and adolescents have not been elucidated so far. RECENT FINDINGS Several cross-sectional, national, population-based studies on large groups of adolescents have been carried out showing an association between vape exposure and self-reported asthma diagnosis and/or respiratory symptoms in this age group. The effects of second and third-hand exposure together with those of active and passive exposure in pregnancy, are almost completely unknown. SUMMARY This review outlines recent data on the potential effects of vaping on asthma, focusing on vape composition, reported effects on the respiratory mucosa, available data in adolescents, and reasons behind the current vaping epidemic. The evidence so far available both in animals and humans suggests that vaping is not harmless, and its exposure should be limited in children and adolescents, especially when affected by asthma.
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18
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Gill VS, Chaudhary N, Randhawa A, Verma M, Rai GK, Mishra S. A Prospective Study to Assess the Outcome of Motivational Interviewing Among Male Students of Haryana, India: A Strive Towards Smoking Cessation in the Youth. Cureus 2022; 14:e22642. [PMID: 35371670 PMCID: PMC8964476 DOI: 10.7759/cureus.22642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2022] [Indexed: 12/03/2022] Open
Abstract
Background The brown plague is a classic example of the modern-day epidemic.Motivational interviewing has been found to increase smokers' readiness to quit, attempts to quit, and reduce smoking levels.Thus, this study, attempts to find out the prevalence of smoking and assess the impact of motivational interviewing on male smoker students (18-30 years). Methodology The study was conducted among the male students of educational institutes in Maharishi Markandeshwar University in Haryana. A cross-sectional study to estimate the prevalence of smoking was carried out. With motivational interviewing of the smokers a prospective cohort study was conducted following the smokers for six months. The probability proportionate to size (PPS) sampling method was applied to recruit 830 participants in the study. A self-designed, semi-structured proforma was used to collect data on smoking behavior, level of dependence, and level of motivation to quit. A modified Fagerstrom questionnaire was used to assess the nicotine dependence level. The motivation to quit smoking was measured by the 10 point scale of Contemplation Ladder, Prochaska, and DiClemente transtheoretical model was used to categorize smokers into stages of readiness to change. Statistical analysis was done using SPSS version 16.0 (IBM Inc., Armonk, New York). Results The prevalence of smoking was 20.4%. Following motivational interview on the first contact, more than half of the current smokers (66.2%) had high motivation which further increased to 88.13% on the third visit at six months (p < 0.001). Likewise, at first contact, 47% had low nicotine dependence; this increased to 52.5 % at two weeks, and finally, at six months, 53.4% had low nicotine dependence. But this finding was statistically insignificant (p=0.23). It was noted that 21 (16.5%) smokers out of 127 quit smoking. A high degree of motivation, support from family and friends, and a low degree of nicotine dependence were identified as significant independent predictors for smoking cessation. Conclusion A satisfying proportion of smokers could attain a high level of motivation for quitting smoking, but less than one-fourth of the current smokers were able to abstain from smoking at the end of the study period. However, the impact of motivational interviewing was not very promising and calls for multi-pronged approach for discouraging smoking.
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Bagdas D, Kebede N, Zepei AM, Harris L, Minanov K, Picciotto MR, Addy NA. Animal Models to Investigate the Impact of Flavors on Nicotine Addiction and Dependence. Curr Neuropharmacol 2022; 20:2175-2201. [PMID: 35611777 PMCID: PMC9886843 DOI: 10.2174/1570159x20666220524120231] [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: 12/26/2021] [Revised: 04/17/2022] [Accepted: 05/22/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Tobacco use in humans is a long-standing public health concern. Flavors are common additives in tobacco and alternative tobacco products, added to mask nicotine's harsh orosensory effects and increase the appeal of these products. Animal models are integral for investigating nicotine use and addiction and are helpful for understanding the effects of flavor additives on the use of nicotine delivery products. OBJECTIVE This review focuses on preclinical models to evaluate the contribution of flavor additives to nicotine addiction. MATERIALS AND METHODS An electronic literature search was conducted by authors up to May 2022. Original articles were selected. RESULTS The behavioral models of rodents described here capture multiple dimensions of human flavored nicotine use behaviors, including advantages and disadvantages. CONCLUSION The consensus of the literature search was that human research on nicotine use behavior has not caught up with fast-changing product innovations, marketing practices, and federal regulations. Animal models are therefore needed to investigate mechanisms underlying nicotine use and addiction. This review provides a comprehensive overvie.
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Affiliation(s)
- Deniz Bagdas
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Yale Tobacco Center of Regulatory Science, Yale School of Medicine, New Haven, CT, USA
| | - Nardos Kebede
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Andy Ma Zepei
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Lilley Harris
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Karina Minanov
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Marina R. Picciotto
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Yale Tobacco Center of Regulatory Science, Yale School of Medicine, New Haven, CT, USA
| | - Nii A. Addy
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Yale Tobacco Center of Regulatory Science, Yale School of Medicine, New Haven, CT, USA
- Department of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, USA
- Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA
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Danielsson M, Tanner T, Patinen P, Birkhed D, Anttonen V, Lammi A, Siitonen S, Ollgren J, Pylkkänen L, Vasankari T. Prevalence, duration of exposure and predicting factors for snus use among young Finnish men: a cross-sectional study. BMJ Open 2021; 11:e050502. [PMID: 34521671 PMCID: PMC8442068 DOI: 10.1136/bmjopen-2021-050502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The health hazards of tobacco products depend on the level of exposure, but little is known about the characteristics of snus use. The aim of this study was to investigate the duration of daily exposure to snus among occasional and daily users and its associated predictive factors among young Finnish men. DESIGN Cross-sectional questionnaire study. SETTING Three out of 16 Finnish Defence Forces units. PARTICIPANTS 1280 young Finnish male conscripts starting their military service in 2016 chosen by simple random sampling. PRIMARY AND SECONDARY MEASURES The prevalence, duration of use and the amount of daily usage of snus and cigarettes were investigated. The attitudes towards perceived harmfulness of snus and the predictive factors affecting the total time of snus consumption were examined. RESULTS Almost a fifth (19.5%) of the conscripts reported daily snus use, and a further 16% reported occasional use. Daily snus use was associated with an earlier starting age, longer duration of use and higher daily exposure time compared with occasional use. On average, daily snus users consumed 10 portions and occasional users three portions per day (p<0.001). The daily total exposure time for daily users was 372 min (95% CI 344 to 401) and for occasional users 139 min (95% CI 106 to 171). Respondents with an upper secondary education had significantly less daily total exposure than those with basic comprehensive education (p=0.036). Perceptions of snus as a harmful substance resulted in a significantly lower duration of exposure. CONCLUSION Snus use was very common among young Finnish men. High snus exposure duration was associated with an earlier starting age, a longer history of use and a careless attitude to its health hazards. A higher education level was a protective factor for total exposure time. Studies of the long-term health effects and dependency profile of snus use are needed.
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Affiliation(s)
- Maria Danielsson
- Center for Military Medicine, Finnish Defence Forces, Helsinki, Uusimaa, Finland
- Doctoral Programme in Population Health, University of Helsinki, Helsinki, Uusimaa, Finland
| | - Tarja Tanner
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, University Hospital and University of Oulu, Oulu, Finland
| | - Pertti Patinen
- Center for Military Medicine, Finnish Defence Forces, Helsinki, Uusimaa, Finland
| | - Dowen Birkhed
- Former: Department of Cariology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Vuokko Anttonen
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, University Hospital and University of Oulu, Oulu, Finland
| | - Anelma Lammi
- Finnish Lung Health Association, Helsinki, Uusimaa, Finland
| | - Simo Siitonen
- The Defence Command, Finnish Defence Forces, Helsinki, Uusimaa, Finland
| | - Jukka Ollgren
- Department of Infectious Disease Surveillance and Control, Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
| | - Liisa Pylkkänen
- Finnish Medicines Agency Fimea, Helsinki, Uusimaa, Finland
- Division of Medicine, Department of Oncology, University of Turku, Turku, Varsinais-Suomi, Finland
| | - Tuula Vasankari
- Finnish Lung Health Association, Helsinki, Uusimaa, Finland
- Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Varsinais-Suomi, Finland
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Rehman K, Haider K, Akash MSH. Cigarette smoking and nicotine exposure contributes for aberrant insulin signaling and cardiometabolic disorders. Eur J Pharmacol 2021; 909:174410. [PMID: 34375672 DOI: 10.1016/j.ejphar.2021.174410] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/22/2021] [Revised: 08/06/2021] [Accepted: 08/06/2021] [Indexed: 01/06/2023]
Abstract
Cigarette smoking- and nicotine-mediated dysregulation in insulin-signaling pathways are becoming leading health issues associated with morbidity and mortality worldwide. Many cardiometabolic disorders particularly insulin resistance, polycystic ovary syndrome (PCOS), central obesity and cardiovascular diseases are initiated from exposure of exogenous substances which augment by disturbances in insulin signaling cascade. Among these exogenous substances, nicotine and cigarette smoking are potential triggers for impairment of insulin-signaling pathways. Further, this aberrant insulin signaling is associated with many metabolic complications, which consequently give rise to initiation as well as progression of these metabolic syndromes. Hence, understanding the underlying molecular mechanisms responsible for cigarette smoking- and nicotine-induced altered insulin signaling pathways and subsequent participation in several health hazards are quite essential for prophylaxis and combating these complications. In this article, we have focused on the role of nicotine and cigarette smoking mediated pathological signaling; for instance, nicotine-mediated inhibition of nuclear factor erythroid 2-related factor 2 and oxidative damage, elevated cortisol that may promote central obesity, association PCOS and oxidative stress via diminished nitric oxide which may lead to endothelial dysfunction and vascular inflammation. Pathological underlying molecular mechanisms involved in mediating these metabolic syndromes via alteration of insulin signaling cascade and possible molecular mechanism responsible for these consequences on nicotine exposure have also been discussed.
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Affiliation(s)
- Kanwal Rehman
- Department of Pharmacy, University of Agriculture, Faisalabad, Pakistan
| | - Kamran Haider
- Department of Pharmacy, University of Agriculture, Faisalabad, Pakistan
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Rapp JL, Alpert N, Wilson KM, Flores RM, Taioli E. Changes in E-Cigarette Perceptions Over Time: A National Youth Tobacco Survey Analysis. Am J Prev Med 2021; 61:174-181. [PMID: 34052076 DOI: 10.1016/j.amepre.2021.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/23/2021] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This multiyear, cross-sectional study explores the changes over time in how U.S. middle- and high-school students perceive the harm and addiction risk of E-cigarettes. METHODS This study analyzed 83,779 participants in the National Youth Tobacco Survey from 2015 to 2019. Associations of survey year with perceived harm and addiction risk of E-cigarettes were assessed using multivariable multinomial logistic regression models, adjusted for sociodemographic characteristics. RESULTS Smoking decreased over the 5 years (-1.85 percentage points, p=0.07); vaping increased (9.03 percentage points, p<0.01). Perceived harm of both combustible cigarettes and E-cigarettes increased with time. Male, older, and non-White students perceived less harm from smoking or vaping. Perceptions of the addictiveness of E-cigarettes increased over time: 26.31% of students considered E-cigarettes to be more addictive than combustible cigarettes in 2019, compared with 7.26% in 2016. Female and non-White students were more likely to think that E-cigarettes were at least as addictive as combustible cigarettes but also reported less knowledge about them. CONCLUSIONS The perceptions of both harm and addictiveness of E-cigarettes have increased over time, independent of current use. Perceptions vary on the basis of age, sex, race/ethnicity, and current use. Efforts should be made to further educate adolescents about E-cigarettes and to regulate their sale and advertisement. Efforts to reduce the uptake of combustible cigarettes among adolescents have been successful and should be duplicated for E-cigarettes.
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Affiliation(s)
- Joseph L Rapp
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Naomi Alpert
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Karen M Wilson
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Division of General Pediatrics, Icahn School of Medicine at Mount Sinai and Mount Sinai Kravis Children's Hospital, New York, New York
| | - Raja M Flores
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Emanuela Taioli
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York; The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York; Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
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Mahajan SD, Homish GG, Quisenberry A. Multifactorial Etiology of Adolescent Nicotine Addiction: A Review of the Neurobiology of Nicotine Addiction and Its Implications for Smoking Cessation Pharmacotherapy. Front Public Health 2021; 9:664748. [PMID: 34291026 PMCID: PMC8287334 DOI: 10.3389/fpubh.2021.664748] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 02/05/2021] [Accepted: 05/24/2021] [Indexed: 12/14/2022] Open
Abstract
Nicotine is the primary pharmacologic component of tobacco, and its highly addictive nature is responsible for its widespread use and significant withdrawal effects that result in challenges to smoking cessation therapeutics. Nicotine addiction often begins in adolescence and this is at least partially attributed to the fact that adolescent brain is most susceptible to the neuro-inflammatory effects of nicotine. There is increasing evidence for the involvement of microglial cells, which are the brain's primary homeostatic sensor, in drug dependence and its associated behavioral manifestations particularly in the adolescent brain. A hallmark of neuro-inflammation is microglial activation and activation of microglia by nicotine during adolescent development, which may result in long-term addiction to nicotine. This non-systematic review examines multifactorial etiology of adolescent nicotine addiction, neurobiology of nicotine addiction and the potential mechanisms that underlie the effects of nicotine on inflammatory signaling in the microglia, understanding how nicotine affects the adolescent brain. We speculate, that modulating homeostatic balance in microglia, could have promising therapeutic potential in withdrawal, tolerance, and abstinence-related neural adaptations in nicotine addiction, in the adolescent brain. Further, we discuss nicotine addiction in the context of the sensitization-homeostasis model which provides a theoretical framework for addressing the potential role of microglial homeostasis in neural adaptations underlying nicotine abuse.
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Affiliation(s)
- Supriya D. Mahajan
- Department of Community Health and Health Behavior, School of Public Health, University at Buffalo, Buffalo, NY, United States
| | - Gregory G. Homish
- Department of Community Health and Health Behavior, School of Public Health, University at Buffalo, Buffalo, NY, United States
| | - Amanda Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
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Fahrizal Y, Risdiana N, Rustyawati F. The Correlation between Nicotine Dependence Level and Anxiety in Indonesian Adolescent Smokers. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5862] [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: 11/05/2022] Open
Abstract
BACKGROUND: Smoking behavior in Indonesia increases from year to year. The adverse effects of smoking do not appear directly after the cigarette use, but they will be seen in a few months or even in several years. The adverse effects of smoking include nicotine dependence, and anxiety disorder felt as a part of withdrawal symptoms.
AIM: This research aims to identify if there is a correlation between nicotine dependence level and anxiety level in adolescents.
METHODS: This study is non-experiment research with a quantitative method and a cross-sectional approach. The sample of the study was 44 people. Fagerstrom Test for Nicotine Dependence was used as the instrument to measure the nicotine dependence level, while the instrument for anxiety level was carried out using the Taylor Manifest Anxiety Scale.
RESULTS: The correlation analysis between the level of nicotine dependence and anxiety conducted using Spearman rho non-parametric correlation analysis obtained a significant value of 0.0001 (p > 0.05). The value of r = 0.979 showed a positive and robust correlation between nicotine dependence and anxiety level.
CONCLUSION: It is concluded that there is a strong and positive correlation between the nicotine dependence level and the anxiety level in adolescents.
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Abstract
Electronic cigarettes are the most common form of nicotine delivery used by youth and young adults, and in 2018, the US Surgeon General declared this to be an epidemic. The developing adolescent brain is vulnerable to nicotine exposure, which can lead to long-lasting cognitive and mood disorders. Screening rates for vaping are low and lack of knowledge by adolescents, clinicians, parents, and caregivers is high. This article reviews the components of vaping, prevalence, adverse reactions, regulation, treatment, and prevention strategies related to vaping in youth and young adults.
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Zhu H, Abdullah AS, He J, Xi J, Mao Y, Feng Y, Xiao Q, Zheng P. Untargeted Urinary Metabolomics and Children's Exposure to Secondhand Smoke: The Influence of Individual Differences. Int J Environ Res Public Health 2021; 18:E710. [PMID: 33467557 DOI: 10.3390/ijerph18020710] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/30/2020] [Accepted: 01/09/2021] [Indexed: 12/26/2022]
Abstract
Children’s exposure to secondhand smoke (SHS) is a severe public health problem. There is still a lack of evidence regarding panoramic changes in children’s urinary metabolites induced by their involuntary exposure to SHS, and few studies have considered individual differences. This study aims to clarify the SHS-induced changes in urinary metabolites in preschool children by using cross-sectional and longitudinal metabolomics analyses. Urinary metabolites were quantified by using untargeted ultra high-performance liquid chromatography-mass spectrometry (UPLC(c)-MS/MS). Urine cotinine-measured SHS exposure was examined to determine the exposure level. A cross-sectional study including 17 children in a low-exposure group, 17 in a medium-exposure group, and 17 in a high-exposure group was first conducted. Then, a before–after study in the cohort of children was carried out before and two months after smoking-cessation intervention for family smokers. A total of 43 metabolites were discovered to be related to SHS exposure in children in the cross-sectional analysis (false discovery rate (FDR) corrected p < 0.05, variable importance in the projection (VIP) > 1.0). Only three metabolites were confirmed to be positively associated with children’s exposure to SHS (FDR corrected p < 0.05) in a follow-up longitudinal analysis, including kynurenine, tyrosyl-tryptophan, and 1-(3-pyridinyl)-1,4-butanediol, the latter of which belongs to carbonyl compounds, peptides, and pyridines. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis indicated that 1-(3-pyridinyl)-1,4-butanediol and kynurenine were significantly enriched in xenobiotic metabolism by cytochrome P450 (p = 0.040) and tryptophan metabolism (p = 0.030), respectively. These findings provide new insights into the pathophysiological mechanism of SHS and indicate the influence of individual differences in SHS-induced changes in urinary metabolites in children.
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Dinh QP, Novirsa R, Jeong H, Nugraha WC, Addai-Arhin S, Viet PH, Tominaga N, Ishibashi Y, Arizono K. Mercury, cadmium, and lead in cigarettes from international markets: concentrations, distributions and absorption ability of filters. J Toxicol Sci 2021; 46:401-411. [PMID: 34470992 DOI: 10.2131/jts.46.401] [Citation(s) in RCA: 3] [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] [Indexed: 11/02/2022]
Abstract
Mercury (Hg), cadmium (Cd), and lead (Pb) concentrations in marketed cigarettes from South Korea, Vietnam, Japan, Indonesia, Taiwan, Thailand, the United Kingdom (UK), Belgium, Italy, Finland, and France were investigated. The cigarettes from Vietnam and Thailand had the highest trend of Hg. Meanwhile, Cd was found higher in cigarettes from Thailand, the UK, and Belgium. Pb concentrations in cigarettes from Belgium, the UK, and Korea were higher than others. The average of these heavy metals concentrated in cigarettes was in the order of Pb > Cd > Hg. Furthermore, the contents of these heavy metals in cigarette leaves were much higher than in filter and rolling paper. There was a significant positive correlation between Hg and Cd, but no correlation between Cd and Pb and between Hg and Pb. Significant positive correlations of nicotine with Hg and Cd but not Pb in the cigarette were observed. Activated carbon filters (Ce-C) absorb Cd and Pb from cigarette leaves and rolling paper indicated a higher trapping trend than cellulose acetate filter without activated carbon (Ce). The trapping ratios of Ce-C (Cd: 5.53%, Pb:5.41%) were higher than Ce (Cd:3.09%, Pb:5.49%). On the other hand, Hg had lower absorption by both types of filters (Ce:0.15%, Ce-C:0.02%). This revealed that Hg, Cd and Pb absorption ability by both filters was relatively lower to the total concentration of these metals in tobacco leaves and rolling paper. The concern was that the higher concentrations of metals such as Hg, Cd and Pb in cigarettes might exist in mainstream smoke.
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Affiliation(s)
- Quang Phan Dinh
- Graduate School of Environmental and Symbiotic Sciences, Prefectural University of Kumamoto
- VNU University of Science, Vietnam National University, Vietnam
| | - Randy Novirsa
- Graduate School of Environmental and Symbiotic Sciences, Prefectural University of Kumamoto
| | - Huiho Jeong
- Graduate School of Environmental and Symbiotic Sciences, Prefectural University of Kumamoto
| | - Willy Cahya Nugraha
- Graduate School of Environmental and Symbiotic Sciences, Prefectural University of Kumamoto
| | - Sylvester Addai-Arhin
- Graduate School of Environmental and Symbiotic Sciences, Prefectural University of Kumamoto
| | - Pham Hung Viet
- VNU University of Science, Vietnam National University, Vietnam
| | - Nobuaki Tominaga
- Department of Creative Engineering, National Institute of Technology, Ariake College
| | - Yasuhiro Ishibashi
- Faculty of Environmental and Symbiotic Sciences, Prefectural University of Kumamoto
| | - Koji Arizono
- Faculty of Environmental and Symbiotic Sciences, Prefectural University of Kumamoto
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Lee YT, Huang YH, Tsai FJ, Liu HC, Sun FJ, Tsai YJ, Liu SI. Prevalence and psychosocial risk factors associated with current cigarette smoking and hazardous alcohol drinking among adolescents in Taiwan. J Formos Med Assoc 2021; 120:265-274. [DOI: 10.1016/j.jfma.2020.05.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/23/2020] [Accepted: 05/04/2020] [Indexed: 10/24/2022] Open
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Abstract
OBJECTIVES The aim was to identify predictors of electronic cigarette (e-cigarette) use among teenagers. DESIGN AND SETTING A prospective population-based cohort study of schoolchildren in northern Sweden. PARTICIPANTS In 2006, a cohort study about asthma and allergic diseases among schoolchildren started within the Obstructive Lung Disease in Northern Sweden studies. The study sample (n=2185) was recruited at age 7-8 years, and participated in questionnaire surveys at age 14-15 and 19 years. The questionnaire included questions about respiratory symptoms, living conditions, upper secondary education, physical activity, diet, health-related quality of life, parental smoking and parental occupation. Questions about tobacco use were included at age 14-15 and 19 years. PRIMARY OUTCOME E-cigarette use at age 19 years. RESULTS At age 19 years, 21.4% had ever tried e-cigarettes and 4.2% were current users. Among those who were daily tobacco smokers at age 14-15 years, 60.9% had tried e-cigarettes at age 19 years compared with 19.1% of never-smokers and 34.0% of occasional smokers (p<0.001). Among those who had tried e-cigarettes, 28.1% were never smokers both at age 14-15 and 19 years, and 14.4% were never smokers among the current e-cigarette users. In unadjusted analyses, e-cigarette use was associated with daily smoking, use of snus and having a smoking father at age 14-15 years, as well as with attending vocational education, physical inactivity and unhealthy diet. In adjusted analyses, current e-cigarette use was associated with daily tobacco smoking at age 14-15 years (OR 6.27; 95% CI 3.12 to 12.58), attending a vocational art programme (OR 2.22; 95% CI 1.04 to 4.77) and inversely associated with eating a healthy diet (OR 0.74; 95% CI 0.59 to 0.92). CONCLUSIONS E-cigarette use was associated with personal and parental tobacco use, as well as with physical inactivity, unhealthy diet and attending vocational upper secondary education. Importantly, almost one-third of those who had tried e-cigarettes at age 19 years had never been tobacco smokers.
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Affiliation(s)
- Linnea Hedman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University Faculty of Medicine, Umeå, Sweden
- Department of Health Science, Division of Nursing, Luleå University of Technology, Luleå, Sweden
| | - Helena Backman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University Faculty of Medicine, Umeå, Sweden
- Department of Health Science, Division of Nursing, Luleå University of Technology, Luleå, Sweden
| | - Caroline Stridsman
- Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University Faculty of Medicine, Umeå, Sweden
| | - Magnus Lundbäck
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, Stockholm, Sweden
| | - Martin Andersson
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University Faculty of Medicine, Umeå, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University Faculty of Medicine, Umeå, Sweden
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Graham SU, Temples HS. E-Cigarettes Versus Adolescent Health: The Rise of Vaping. J Pediatr Health Care 2020; 34:442-445. [PMID: 32565149 DOI: 10.1016/j.pedhc.2020.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/11/2020] [Accepted: 04/20/2020] [Indexed: 11/29/2022]
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Abstract
Over the past 10 - 15 years, there has been a significant increase in the use of electronic cigarettes. These devices are generally used to deliver nicotine through inhalation by aerosolization. While the long-term risk of lung cancer is yet to be known, the chemicals and impurities in the solutions may have other acute and chronic effects on the respiratory system including respiratory failure from adult respiratory distress syndrome. Recent concerns have been raised regarding the potential for significant acute and chronic health care risks of these devices including pneumonitis, airway reactivity and respiratory failure. Given that many of the acute effects are related to the respiratory system, anesthetic care may be required during diagnostic procedures including bronchoscopy to investigate the etiology of acute respiratory symptomatology. We present an adolescent who presented to the operating room for bronchoscopy and bronchoalveolar lavage to investigate the etiology of respiratory involvement following an episode of vaping. The healthcare and end-organ effects of nicotine, tobacco smoke and vaping are discussed, and potential anesthetic implications are presented.
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Affiliation(s)
- Amogha Krishna
- Heritage College of Osteopathic Medicine, Dublin, OH, USA
| | - Wana Mathieu
- The Ohio State University School of Medicine, Columbus, OH, USA
| | - Eric Mull
- Division of Pediatric Pulmonology and Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Joseph D Tobias
- Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA
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Abstract
Electronic nicotine delivery systems and vaping devices are now the most commonly used forms of tobacco consumed by youth and young adults. A variety of chemicals and toxicants released during inhalation have harmful systemic effects and effects on the lung. The known and potential health consequences are particularly alarming. There is concern that use of these devices will create a new generation of life-long smokers with nicotine and polysubstance addiction. Beyond the concerning chronic health effects of regular use, there is a recent epidemic of severe, acute lung disease termed e-cigarette, or vaping product use-associated lung injury, (EVALI), associated with high morbidity and mortality. These issues demand immediate public health attention. Healthcare providers play key roles in limiting the exposure of youth and young adults to these products by providing evidence-based counseling to patients and families, and by advocating for regulations to protect against childhood initiation and continuation of use.
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Affiliation(s)
- Amy Brown
- Division of Pediatric Pulmonology, Allergy, Immunology, and Sleep Medicine, Boston Children's Health Physicians, Hawthorne, NY, USA; Division of Pediatric Pulmonology, Maria Fareri Children's Hospital at Westchester Medical Center, 40 Sunshine Cottage, Skyline 1NE-29, Valhalla, NY 10595, USA; Department of Pediatrics, New York Medical College, Valhalla, NY, USA.
| | - Sophie J Balk
- Pediatric Academic Associates, Children's Hospital at Montefiore, 1621 Eastchester Road, Bronx, NY 10461, USA; Albert Einstein College of Medicine, Bronx, NY, United States.
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Affiliation(s)
- Scott E. Hadland
- Grayken Center for Addiction / Department of Pediatrics, Boston Medical Center, One Boston Medical Center Place, Boston, MA, USA, 02118,Boston University School of Medicine, Division of General Pediatrics, Department of Pediatrics, 88 East Newton Street, Vose Hall Room 322, Boston, MA, USA, 02118
| | - Nicholas Chadi
- Division of Adolescent Medicine, Department of Pediatrics, Sainte-Justine University Hospital Centre / University of Montreal, 3175 Ch de la Cote Ste Catherine, Montreal, QC, Canada, H3T 1C5
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Shaik FB, Nagajothi G, Swarnalatha K, Kumar CS, Maddu N. Quantification of Nicotine and Cotinine in Plasma, Saliva, and Urine by HPLC Method in Chewing Tobacco Users. Asian Pac J Cancer Prev 2019; 20:3617-3623. [PMID: 31870102 PMCID: PMC7173387 DOI: 10.31557/apjcp.2019.20.12.3617] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 04/16/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Nicotine acts as major alkaloid of all tobacco products including smokeless tobacco (SLT) forms. The mode of SLT consumption is in the form of chewing under the cheek or lip and induced biochemical alterations in the plasma, saliva, and urine. MATERIALS AND METHODS The smokeless tobacco products like Raja or blue bull tobacco brands are widely consumed by human male volunteers under the age of 18-30 years for the period of 3 years consisting of 30g per day. The concentrations of nicotine and cotinine in samples of plasma, saliva, and urine are quantified by the method of HPLC. The remaining variables of plasma are evaluated by auto analyzer and spectrophotometric methods. RESULTS The analysis of results presented that significant increase in the levels of nicotine and cotinine in plasma, saliva, and urine of chewing tobacco users. The lipid profile (Cholesterol, triglycerides, HDL-C, and LDL-C), liver marker enzymes (SGOT, SGPT, and ALP), kidney markers (Creatinine, urea, and uric acid), glucose, and the remaining variables are present within normal range observed in SLT users. The lipid peroxidation (LPO), nitric oxide (NO) (NO2 and NO3), protein carbonyls (PCO), and peroxynitrites (ONOO-) are reported to be higher levels in the plasma of experimental subjects in comparison with normal controls. The various brands of tobacco varieties (Raja, madhu chhap, hans chhap, miraj, badshah, blue bull, and swagat gold tobacco) are presented. CONCLUSION The chewing tobacco users exhibited greater amounts of nicotine and cotinine are at risk of cardiovascular due to nicotine has cardiovascular effects, and oral cancer disease complications in the future for chronic consumption of smokeless tobacco products due to the presence of carcinogens of tobacco-specific N-nitrosamines.
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Affiliation(s)
- Fareeda Begum Shaik
- Department of Biochemistry, Sri Krishnadevaraya University, Ananthapuramu, Andhra Pradesh, India
| | - G Nagajothi
- Department of Corporate Secretary ship, Queen Mary's College (Autonomous), Chennai, Tamil Nadu, India
| | - K Swarnalatha
- Department of Biochemistry, Sri Krishnadevaraya University, Ananthapuramu, Andhra Pradesh, India
| | - C Suresh Kumar
- Department of Biochemistry, Sri Krishnadevaraya University, Ananthapuramu, Andhra Pradesh, India
| | - Narendra Maddu
- Department of Biochemistry, Sri Krishnadevaraya University, Ananthapuramu, Andhra Pradesh, India
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Silva MR, Gattás GJF, De Antonio J, Firigato I, Curioni OA, Gonçalves FDT. Polymorphisms of CHRNA3 and CHRNA5: Head and neck cancer and cigarette consumption intensity in a Brazilian population. Mol Genet Genomic Med 2019; 7:e998. [PMID: 31599127 PMCID: PMC6900374 DOI: 10.1002/mgg3.998] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 02/14/2019] [Revised: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 12/21/2022] Open
Abstract
Background Cigarette consumption has been identified as the main non‐etiological factor in head and neck cancer (HNC) development. One of the main compounds in cigarettes is nicotine, which binds directly to nicotine acetylcholine receptors (nAchRs) in the body, which are encoded by different genes of the CHRNA family. Polymorphisms in some of these genes have been studied in relation to the risk of HNC and cigarette consumption intensity. The aim of this study was to evaluate whether there were associations between the CHRNA3 (rs578776) and CHRNA5 (rs16969968) polymorphisms and HNC risk and between the polymorphisms and the intensity of cigarette consumption. Methods A total of 1,067 individuals from Heliopolis Hospital in São Paulo were investigated, including 619 patients with HNC and 448 patients without diagnosed tumors. All participants answered a questionnaire about sociodemographic information and cigarette consumption data. The polymorphisms were determined by TaqMan genotyping by real‐time PCR. Results The polymorphisms studied, rs578776 (CHRNA3) and rs16969968 (CHRNA5), did not have an association with HNC risk, but the rs16969968 homozygous genotype was associated with increased cigarette consumption intensity (OR 1.93, 95% CI 1.05–3.58). Conclusion The polymorphism CHRNA5 can be considered an indirect risk factor for neoplasms in these Brazilian samples when cigarette consumption increased.
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Affiliation(s)
- Mariana R Silva
- Departamento de Medicina Legal e Ética Médica, Medicina Social e do Trabalho, Instituto Oscar Freire, LIM-40, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Gilka J F Gattás
- Departamento de Medicina Legal e Ética Médica, Medicina Social e do Trabalho, Instituto Oscar Freire, LIM-40, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Juliana De Antonio
- Departamento de Medicina Legal e Ética Médica, Medicina Social e do Trabalho, Instituto Oscar Freire, LIM-40, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Isabela Firigato
- Departamento de Medicina Legal e Ética Médica, Medicina Social e do Trabalho, Instituto Oscar Freire, LIM-40, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Otávio A Curioni
- Departamento de Cirurgia de Cabeça e Pescoço e Otorrinolaringologia, Hospital Heliópolis, São Paulo, Brazil
| | - Fernanda de Toledo Gonçalves
- Departamento de Medicina Legal e Ética Médica, Medicina Social e do Trabalho, Instituto Oscar Freire, LIM-40, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
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Abstract
Abstract Tobacco continues to kill about 0.48 million Americans per year and there are currently 34.3 million smokers in the USA. As a consequence of the First Surgeon General’s Report on Tobacco in 1964, tobacco control interventions on part of the government led to a significant decline in conventional tobacco product usage over the last few decades. However, more recently, a new entity in the form of electronic cigarettes has risen rapidly and has exposed a younger population to a plethora of dangerous consequences. Looking at e-cigarettes from the perspective of tobacco control however raises a lot of challenges. There is little doubt that existing smokers of combustible cigarettes who switch to e-cigarettes will be switching to a less harmful product. However, if the younger generation begins using e-cigarettes as a result of targeted marketing, appealing flavors and ‘safer alternative’ perception, decades of progress made in conventional tobacco control will be negated. Governments at the federal, state, and local levels have a mandate to once again implement new public health policies to ensure that non-conventional tobacco products like e-cigarettes are available as smoking cessation tools for existing smokers but at the same time do not play a role in ruining the health of future generations through addiction and disease. Purpose of Review To review the present scenario of regulations and policies impacting public health with respect to electronic nicotine delivery systems (ENDS) with the objective of providing a meaningful and balanced view of the challenges at hand with plausible recommendations. Recent Findings Nicotine in tobacco is known to cause addiction and dependence. It is particularly potent in children and young adults. E-cigarettes can deliver high concentrations of nicotine, and these concentrations can vary depending on the numerous constituents within the e-cigarette which vary greatly from one another. Use of e-cigarettes is implicated as a risk factor for future cigarette use in young adults. Moreover, e-cigarette usage patterns also depend on several sociodemographic factors. Banning tobacco products has shown to reduce smoking risk in youth and as such, strong e-cigarette regulation measures are needed for prevention. Summary Effective regulation of ENDS faces a multitude of challenges. One such challenge is to prevent youth and non-smokers from getting habituated to nicotine through e-cigarettes. The intention of tobacco companies to sustain sales through harmful marketing strategies that tone down the risks and highlight e-cigarettes as a “much safer alternative” while promoting flavors appealing to children should be immediately prohibited. Another hazard is the endorsement of ENDS as devices meant for enhancing social interaction which opens a path for youth to make erroneous choices under peer pressure. On the other hand, several studies have reported that e-cigarettes significantly reduce an existing smoker’s risk of being exposed to toxic tobacco smoke constituents that are normally present in cigarette smoke. This leads to the conclusions that e-cigarettes can be a tool for smoking cessation for current smokers. Public policy must take a multi-dimensional approach to balance these two extremes.
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Morgenstern M, Nies A, Goecke M, Hanewinkel R. E-Cigarettes and the Use of Conventional Cigarettes. Dtsch Arztebl Int 2019; 115:243-248. [PMID: 29716689 DOI: 10.3238/arztebl.2018.0243] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 11/02/2017] [Accepted: 01/23/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND In 2015, 12.1% of 12- to 17-year-olds in Germany had reportedly already tried e-cigarette smoking at least once. We carried out a study of the "gateway" hypothesis, according to which the use of e-cigarettes can motivate adolescents to start smoking conventional cigarettes. METHODS During the 2015/2016 school year, 2186 tenth-graders in the German states of Lower Saxony and Schleswig-Holstein who had never smoked conventional cigarettes before took part in a survey over a 6-month period (mean age 15.5 years, standard deviation 0.65; 53.6% female). RESULTS 14.3% of the survey population (313 adolescents) said at the start of the survey period that they had already tried e-cigarettes at least once. By the end of the survey period, 12.3% (268) of those who had never smoked before had begun to experiment with conventional cigarettes. The risk of beginning such experimentation was 2.2 times higher among e-cigarette users. This association remained (relative risk = 2.18 [1.65; 2.83]) after statistical control for age, sex, state, immigrant background, type of school, socioeconomic status, various personality traits (sensation-seeking, impulsivity, anxiety, hopelessness, extraversion, agreeableness, conscientiousness, neuroticism, openness), and the use of alcohol, cannabis, and other illicit drugs. Further analysis revealed that the association between the use of e-cigarettes and the onset of conventional cigarette smoking was stronger among adolescents with low sensation-seeking scores and without any experience of alcohol intoxication. CONCLUSION Among adolescents who have never smoked, experimentation with conventional cigarettes is more common in those who have used e-cigarettes. This effect seems to be stronger among adolescents who, in general, have a lower risk of starting to smoke. The 6-month observation period of this study is too short to allow any inference regarding a connection between e-cigarette use and the development of tobacco dependence.
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Affiliation(s)
- Matthis Morgenstern
- Institute for Therapy and Health Research, IFT-Nord gGmbH, Kiel, Germany; Federal Center for Health Education, Cologne, Germany
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Abstract
Electronic cigarettes (e-cigarettes) and vape devices have rapidly become the most common tobacco products used by youth, driven in large part by marketing and advertising by e-cigarette companies. There is substantial evidence that adolescent e-cigarette use leads to use of combustible tobacco products. E-cigarette companies commonly advertise that e-cigarettes contain nicotine, flavoring chemicals, and humectants (propylene glycol and/or vegetable glycerin), but toxicants, ultrafine particles, and carcinogens have also been found in e-cigarette solutions and emissions, many of which are known to cause adverse health effects. Most major e-cigarette brands are owned by big tobacco companies that use similar marketing and advertising strategies to attract youth users as they did with traditional tobacco products. In this review, we provide an overview of e-cigarettes and vape devices with an emphasis on the impact for the pediatric population. We describe the vast array of e-cigarette devices and solutions, concern for nicotine addiction, and the scientific background on the known health harms. There are accompanying visual depictions to assist in identifying these products, including newer e-cigarette products and JUUL. Because current federal regulations are insufficient to protect youth from e-cigarette use, exposure, and nicotine addiction, there are recommendations for pediatricians and pediatric health care providers to counsel and advocate for a tobacco-free lifestyle for patients and families.
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Affiliation(s)
- Susan C Walley
- Division of Pediatric Hospital Medicine, The University of Alabama at Birmingham and Children's of Alabama, Birmingham, Alabama;
| | - Karen M Wilson
- Division of General Pediatrics, Icahn School of Medicine at Mount Sinai and Mount Sinai Kravis Children's Hospital, New York, New York
| | - Jonathan P Winickoff
- Division of General Academic Pediatrics, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts; and
| | - Judith Groner
- Division of Primary Care, College of Medicine, The Ohio State University and Nationwide Children's Hospital, Columbus, Ohio
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40
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Han MA. The price of tobacco and its effects on smoking behaviors in Korea: The 2015 Korea Community Health Survey. Prev Med 2019; 120:71-77. [PMID: 30659910 DOI: 10.1016/j.ypmed.2019.01.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 07/23/2018] [Revised: 01/09/2019] [Accepted: 01/15/2019] [Indexed: 01/23/2023]
Abstract
This study investigated the effects of the price of tobacco on smoking behaviors in Korean adult smokers using a population-based survey. Current smokers or former smokers who quit smoking <1 year prior to the survey were selected from the data of 2015 Korea Community Health Survey (N = 45,686). The effects of the price of tobacco on smoking behaviors were measured. The major effects were defined as quitting, reducing smoking and using electronic cigarettes (e-cigarettes). Chi-square tests and multiple logistic regression analyses were performed. After tobacco prices increased, 3.8%, 22.8% and 5.4% of subjects quit, reduced smoking and switched to e-cigarettes. The adjusted odds ratio (aOR) for reducing smoking was significantly higher in subjects with a lower household income and lower education level than in those with a greater income and higher education level among current smokers. Subjects who started smoking at an older age, who smoked a smaller number of cigarettes smoked per day and who had been exposed to anti-smoking campaigns and anti-smoking information were more likely to reduce smoking after the price of tobacco increased. Younger subjects were less likely to reduce smoking, but they were more likely to use e-cigarettes after the price of tobacco increased. Low-income subjects were sensitive to increases in the price of tobacco. Additional strategies are required to change the smoking behaviors of heavy smokers. Future studies should investigate the long-term effects of increasing the price of tobacco, especially on younger adults, on smoking behaviors.
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Affiliation(s)
- Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 61452, Republic of Korea.
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41
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Abstract
Nicotine, one of the more than 4700 ingredients in tobacco smoke, is a neurotoxin and once used as pesticides in agriculture. Although its use in agriculture is prohibited in many countries, nicotine intoxication is still a problem among the workers in tobacco farms, and young children as well as adults due to the accidental or suicidal ingestions of nicotine products. Understanding the mechanism of nicotine intoxication is important not only for the prevention and treatment but also for the appropriate regulatory approaches. Here, we review pharmacokinetics of nicotine and the molecular mechanisms for acute and chronic intoxication from nicotine that might be relevant to the central and the peripheral nervous system. We include green tobacco sickness, acute intoxication from popular nicotine products, circadian rhythm changes, chronic intoxication from nicotine through prenatal nicotine exposure, newborn behaviors, and sudden infant death syndrome.
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Affiliation(s)
- Tursun Alkam
- Japanese Drug Organization of Appropriate Use and Research, Nagoya, Japan; Department of Basic Medical Sciences, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, USA.
| | - Toshitaka Nabeshima
- Japanese Drug Organization of Appropriate Use and Research, Nagoya, Japan; Advanced Diagnostic System Research Laboratory, Graduate School of Health Sciences, Fujita Health University, Toyoake, Japan.
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42
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Abstract
Electronic cigarettes (e-cigarettes) are the most commonly used tobacco product among youth. The 2016 US Surgeon General's Report on e-cigarette use among youth and young adults concluded that e-cigarettes are unsafe for children and adolescents. Furthermore, strong and consistent evidence finds that children and adolescents who use e-cigarettes are significantly more likely to go on to use traditional cigarettes-a product that kills half its long-term users. E-cigarette manufacturers target children with enticing candy and fruit flavors and use marketing strategies that have been previously successful with traditional cigarettes to attract youth to these products. Numerous toxicants and carcinogens have been found in e-cigarette solutions. Nonusers are involuntarily exposed to the emissions of these devices with secondhand and thirdhand aerosol. To prevent children, adolescents, and young adults from transitioning from e-cigarettes to traditional cigarettes and minimize the potential public health harm from e-cigarette use, there is a critical need for e-cigarette regulation, legislative action, and counterpromotion to protect youth.
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Affiliation(s)
- Brian P. Jenssen
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania and PolicyLab, Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Susan C. Walley
- Department of Pediatrics, The University of Alabama at Birmingham and Children’s of Alabama, Birmingham, Alabama
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Abstract
Electronic cigarettes (E-cig), also referred to as Electronic Nicotine Delivery System (ENDS), were initially developed in 2003 to reduce the harmful effects of tobacco smoking. Since then, E-cig have become widely available in many countries and are used by many young people who would be unlikely to take up cigarette smoking. However, the adverse effects on child health remain largely unknown. E-cigs are available through regulated sale in many countries, but easily accessible by the internet in others. Adverse effects may be ascribed to the nicotine itself, to the accompanying substances in the aerosol (often referred to as vapour) or to temperature modifications of the content. There is a lack of human studies to assess respiratory effects of nicotine exposure to the unborn or young child. Also assessing the effects of the vaping content apart from nicotine is challenging, with the huge variety of exposure by frequency, duration and content, but experimental studies are on the way that may indicate the level of harm by such products. This article will summarize what is currently known about the use of E-cigs in children and in pregnancy, and discuss adverse effects of direct or in utero exposure to E-cig on the respiratory health of children. We thereby hope to provide a background for discussing potential harms to the respiratory system of children by E-cig exposure in pregnancy and early post-natal life, in a setting where an increasing proportion of adolescent and young adults use E-cigs, marketed to be 95% less harmful than conventional cigarettes.
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Affiliation(s)
- Karin C Lødrup Carlsen
- Department of Paediatric Allergy and Pulmonology, Division of Child and Adolescent Medicine, Oslo University Hospital, Norway; The Faculty of Medicine, University of Oslo, Norway.
| | - Håvard O Skjerven
- Department of Paediatric Allergy and Pulmonology, Division of Child and Adolescent Medicine, Oslo University Hospital, Norway
| | - Kai-Håkon Carlsen
- Department of Paediatric Allergy and Pulmonology, Division of Child and Adolescent Medicine, Oslo University Hospital, Norway; The Faculty of Medicine, University of Oslo, Norway
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Egbe CO, Parry CDH, Myers B. Electronic cigarettes: the solution or yet another phase of the tobacco epidemic? South African Journal of Psychology 2018. [DOI: 10.1177/0081246318794828] [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: 11/15/2022]
Abstract
Tobacco use is the single largest preventable cause of death globally. For years, the tobacco industry sought to create a tobacco product that is less controversial than conventional cigarettes. Electronic cigarettes were created out of the supposed need to supply consumers of tobacco products with a less harmful tobacco product. The question remains, is it really less harmful for consumers of traditional cigarettes and other tobacco products to switch to electronic cigarettes? This article takes a closer look at the overall harm in relation to benefits of using electronic cigarettes for the individual and public health and the unintended negative consequences the introduction of electronic cigarette has had on overall public health. Given the evidence that the use of electronic cigarettes is a gateway to the use of other tobacco products especially among adolescents, we view electronic cigarettes as having the potential to cause a rebound of the tobacco use glut which the global public health community has been succeeding in reversing. We therefore support the World Health Organization’s suggestion that electronic cigarettes should be regulated as other tobacco products since there is, as yet, no harmless tobacco product. In the same vein, we view the new Tobacco Products and Electronic Delivery Systems Bill seeking to regulate electronic cigarettes in South Africa as other tobacco products as a step in the right direction.
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Affiliation(s)
- Catherine O Egbe
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, South Africa
| | - Charles DH Parry
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, South Africa
- Department of Psychiatry, Stellenbosch University, South Africa
| | - Bronwyn Myers
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
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Hu H, Zhao X, Ma J, Shangguan Y, Pan Z, Chen L, Zhang X, Wang H. Prenatal nicotine exposure retards osteoclastogenesis and endochondral ossification in fetal long bones in rats. Toxicol Lett 2018; 295:249-255. [PMID: 29981921 DOI: 10.1016/j.toxlet.2018.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 11/14/2017] [Revised: 06/06/2018] [Accepted: 07/04/2018] [Indexed: 12/21/2022]
Abstract
This study investigated the mechanisms underlying the retarded development of long bone in fetus by prenatal nicotine exposure (PNE) which had been demonstrated by our previous work. Nicotine (2.0 mg/kg.d) or saline was injected subcutaneously into pregnant rats every morning from gestational day (GD) 9 to 20. Fetal femurs or tibias were harvested for analysis on GD 20. We found massive accumulation of hypertrophic chondrocytes and a delayed formation of primary ossification center (POC) in the fetal femur or tibia of rat fetus after PNE, which was accompanied by a decreased amount of osteoclasts in the POC and up-regulated expression of osteoprotegerin (OPG) but by no obvious change in the expression of receptor activator of NF-κB ligand (RANKL). In primary osteoblastic cells, both nicotine (0, 162, 1620, 16,200 ng/ml) and corticosterone (0, 50, 250, 1250 nM) promoted the mRNA expression of OPG but concentration-dependently suppressed that of RANKL. Furthermore, blocking α4β2-nicotinic acetylcholine receptor (α4β2-nAChR) or glucocorticoid receptor rescued the above effects of nicotine and corticosterone, respectively. In conclusion, retarded osteoclastogenesis may contribute to delayed endochondral ossification in long bone in fetal rats with PNE. The adverse effects of PNE may be mediated via the direct effect of nicotine and indirect effect of maternal corticosterone on osteoblastic cells.
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Affiliation(s)
- Hang Hu
- Department of Pharmacology, Basic Medical School of Wuhan University, Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China; Department of Physiology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Xin Zhao
- Department of Physiology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Jing Ma
- Department of Pharmacology, Basic Medical School of Wuhan University, Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China; Department of Physiology, Basic Medical School of Wuhan University, Wuhan 430071, China
| | - Yangfan Shangguan
- Department of Pharmacology, Basic Medical School of Wuhan University, Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China; Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Zhengqi Pan
- Department of Pharmacology, Basic Medical School of Wuhan University, Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China; Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Liaobin Chen
- Department of Orthopaedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China
| | - Xianrong Zhang
- Department of Orthopaedics and Traumatology, Nanfang Hospital, Southern Medical University, Guangdong Provincial Key Laboratory of Bone and Cartilage Regenerative Medicine, Nanfang Hospital, Southern Medical University, No.1838 North of Guangzhou Avenue, Guangzhou, 510515, China.
| | - Hui Wang
- Department of Pharmacology, Basic Medical School of Wuhan University, Hubei Provincial Key Laboratory of Developmentally Originated Disease, Wuhan 430071, China.
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Ferkol TW, Farber HJ, La Grutta S, Leone FT, Marshall HM, Neptune E, Pisinger C, Vanker A, Wisotzky M, Zabert GE, Schraufnagel DE. Electronic cigarette use in youths: a position statement of the Forum of International Respiratory Societies. Eur Respir J 2018; 51:13993003.00278-2018. [PMID: 29848575 DOI: 10.1183/13993003.00278-2018] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 04/23/2018] [Indexed: 12/12/2022]
Abstract
Children and adolescents are highly susceptible to nicotine addiction, which affects their brain development, even in those who smoke infrequently. Young people who become addicted to nicotine are at greater risk of becoming lifelong tobacco consumers. The use of nicotine-delivering electronic cigarettes has risen dramatically among youths worldwide. In addition to physical dependence, adolescents are susceptible to social and environmental influences to use electronic cigarettes. The product design, flavours, marketing, and perception of safety and acceptability have increased the appeal of electronic cigarettes to young people, thus leading to new generations addicted to nicotine. Moreover, there is growing evidence that electronic cigarettes in children and adolescents serve as a gateway to cigarette smoking. There can be no argument for harm reduction in children. To protect this vulnerable population from electronic cigarettes and other nicotine delivery devices, we recommend that electronic cigarettes be regulated as tobacco products and included in smoke-free policies. Sale of electronic cigarettes should be barred to youths worldwide. Flavouring should be prohibited in electronic cigarettes, and advertising accessible by youths and young adults be banned. Finally, we recommend greater research on the health effects of electronic cigarettes and surveillance of use across different countries.
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Affiliation(s)
- Thomas W Ferkol
- Depts of Pediatrics, Cell Biology and Physiology, Washington University in St Louis, St Louis, MO, USA
| | - Harold J Farber
- Dept of Pediatrics, Pulmonary Section, Baylor College of Medicine, Houston, TX, USA
| | - Stefania La Grutta
- Institute of Biomedicine and Molecular Immunology, National Research Council of Italy, Palermo, Italy
| | - Frank T Leone
- Dept of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Henry M Marshall
- University of Queensland Thoracic Research Centre, The Prince Charles Hospital, Brisbane, Australia
| | - Enid Neptune
- Dept of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Charlotta Pisinger
- Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Aneesa Vanker
- Dept of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Myra Wisotzky
- International Union Against Tuberculosis and Lung Disease, Federal Way, WA, USA
| | - Gustavo E Zabert
- Dept of Clinical Medicine, FACIMED, Universidad Nacional del Comahue, Neuquen, Argentina
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47
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Abstract
Electronic cigarettes (ECs) have been growing rapidly in popularity among youth and adults in the United States over the last decade. This increasing prevalence is driven partially by the ability to customize devices, flavors, and nicotine content and the general notion that ECs are harmless, particularly in comparison with conventional cigarettes. In vitro and in vivo murine models have demonstrated a number of harmful biological effects of e-liquids and their aerosols. However, limited clinical data exist on whether these effects translate into detrimental long-term outcomes in human subjects. The short-term harmful respiratory effects of EC use demonstrated in nonsmokers argue against their use. However, slightly more favorable data exist for the respiratory benefits of substituting conventional cigarettes with ECs and the short-term efficacy of ECs as smoking cessation tools. Nonetheless, available research is severely limited in regard to long-term outcomes and by study designs fraught with bias, pointing to the need for additional research efforts with well-designed longitudinal studies to guide US Food and Drug Administration regulatory efforts. The hurdle presented by diverse device designs and e-liquid permutations, which contribute to the inconsistency of available data, also highlights the need for legislative standardization of ECs.
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Affiliation(s)
- Amika K Sood
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Matthew J Kesic
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Michelle L Hernandez
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC
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48
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Jarlstrup NS, Juel K, Pisinger CH, Grønbæk M, Holm S, Andersen S. International Approaches to Tobacco Use Cessation Programs and Policy in Adolescents and Young Adults: Denmark. Curr Addict Rep 2018. [DOI: 10.1007/s40429-018-0187-x] [Citation(s) in RCA: 8] [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] [Indexed: 11/29/2022]
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