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Schilling L, Spallek J, Maul H, Tallarek M, Schneider S. Active and Passive Exposure to Tobacco and e-Cigarettes During Pregnancy. Matern Child Health J 2021; 25:656-665. [PMID: 33211261 PMCID: PMC8032614 DOI: 10.1007/s10995-020-03037-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Active and passive exposure to tobacco cigarettes during pregnancy is associated with multiple negative health outcomes for the fetus. In addition, exposure to e-cigarettes has been progressively discussed as a new threat to fetal health. Until now, there has been a lack of studies examining active and passive exposure to tobacco and e-cigarettes among pregnant women. The objective of our current STudy on E-cigarettes and Pregnancy (STEP) was to advance and complement the current knowledge regarding active and passive exposure to tobacco and e-cigarettes before pregnancy and during early and late pregnancy. METHODS One element of the STEP study was a quantitative cross-sectional design: A sample of 540 pregnant women recruited at an obstetrician clinic in Hamburg from April 2018 to January 2019 were surveyed once via a standardized questionnaire and provided complete information regarding their consumption of tobacco and e-cigarettes. We performed a descriptive analysis of tobacco and e-cigarette use before pregnancy and during early and late pregnancy, as well as bivariate analysis of these variables with sociodemographic determinants. Passive exposure was assessed by asking the participating pregnant women about the consumption of tobacco and e-cigarettes by their partners, in general, and in their homes. RESULTS Before pregnancy, 20.0% of the participants used tobacco cigarettes exclusively, 1.3% used e-cigarettes exclusively, and 6.5% were dual users. Educational level was significantly associated with tobacco cigarette use (p < 0.001) and dual use (p = 0.047) before pregnancy. During early (late) pregnancy, 8.7% (2.8%) used tobacco cigarettes and 0.4% (0.0%) used e-cigarettes exclusively. Twenty-point nine percent of women's partners consumed tobacco cigarettes exclusively, 2.7% consumed e-cigarettes exclusively, and 2.7% consumed both. A total of 8.5% (16.7%) of the partners who consumed tobacco cigarettes exclusively (e-cigarettes exclusively) did so in the women's homes. CONCLUSIONS FOR PRACTICE Among pregnant women, the use of tobacco cigarettes remains prominent before and during pregnancy, while e-cigarette use predominately occurs before pregnancy. Our study shows that pregnant women are frequently exposed to their partners' tobacco and e-cigarette use within their homes. Strategies to reduce such exposure should be further intensified.
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Affiliation(s)
- Laura Schilling
- Department of Public Health, Brandenburg University of Technology, Universitätsplatz 1, 01968 Senftenberg, Germany
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany
| | | | - Marie Tallarek
- Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany
| | - Sven Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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El-Merhie N, Krüger A, Uliczka K, Papenmeier S, Roeder T, Rabe KF, Wagner C, Angstmann H, Krauss-Etschmann S. Sex dependent effect of maternal e-nicotine on F1 Drosophila development and airways. Sci Rep 2021; 11:4441. [PMID: 33627715 PMCID: PMC7904947 DOI: 10.1038/s41598-021-81607-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 01/01/2021] [Indexed: 01/03/2023] Open
Abstract
E-cigarettes are heavily advertised as healthier alternative to common tobacco cigarettes, leading more and more women to switch from regular cigarettes to ENDS (electronic nicotine delivery system) during pregnancy. While the noxious consequences of tobacco smoking during pregnancy on the offspring health are well-described, information on the long-term consequences due to maternal use of e-cigarettes do not exist so far. Therefore, we aimed to investigate how maternal e-nicotine influences offspring development from earliest life until adulthood. To this end, virgin female Drosophila melanogaster flies were exposed to nicotine vapor (8 µg nicotine) once per hour for a total of eight times. Following the last exposure, e-nicotine or sham exposed females were mated with non-exposed males. The F1-generation was then analyzed for viability, growth and airway structure. We demonstrate that maternal exposure to e-nicotine not only leads to reduced maternal fertility, but also negatively affects size and weight, as well as tracheal development of the F1-generation, lasting from embryonic stage until adulthood. These results not only underline the need for studies investigating the effects of maternal vaping on offspring health, but also propose our established model for analyzing molecular mechanisms and signaling pathways mediating these intergenerational changes.
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Affiliation(s)
- Natalia El-Merhie
- Division of Experimental Asthma Research, Early Life Origins of Chronic Lung Disease, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL) and the Airway Research Center North (ARCN), Borstel, Germany
| | - Arne Krüger
- Division of Experimental Asthma Research, Early Life Origins of Chronic Lung Disease, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL) and the Airway Research Center North (ARCN), Borstel, Germany
| | - Karin Uliczka
- Division of Experimental Asthma Research, Early Life Origins of Chronic Lung Disease, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL) and the Airway Research Center North (ARCN), Borstel, Germany
- Invertebrate Models, Priority Area Asthma & Allergy, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Stephanie Papenmeier
- Division of Experimental Asthma Research, Early Life Origins of Chronic Lung Disease, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL) and the Airway Research Center North (ARCN), Borstel, Germany
- Invertebrate Models, Priority Area Asthma & Allergy, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Thomas Roeder
- Department of Molecular Physiology and Zoology, Christian Albrechts University, German Center for Lung Research (DZL) and the Airway Research Center North (ARCN), Kiel, Germany
| | - Klaus F Rabe
- Department of Pneumology, LungenClinic, German Center for Lung Research (DZL) and the Airway Research Center North (ARCN), Grosshansdorf, Germany
- Department of Medicine, Christian Albrechts University, German Center for Lung Research (DZL) and the Airway Research Center North (ARCN), Kiel, Germany
| | - Christina Wagner
- Invertebrate Models, Priority Area Asthma & Allergy, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Hanna Angstmann
- Division of Experimental Asthma Research, Early Life Origins of Chronic Lung Disease, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL) and the Airway Research Center North (ARCN), Borstel, Germany
| | - Susanne Krauss-Etschmann
- Division of Experimental Asthma Research, Early Life Origins of Chronic Lung Disease, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL) and the Airway Research Center North (ARCN), Borstel, Germany.
- Institute for Experimental Medicine, Christian Albrechts University, German Center for Lung Research (DZL) and the Airway Research Center North (ARCN), Kiel, Germany.
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53
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Parekh T, Owens C, Fay K, Phillips J, Kitsantas P. Use of e-Cigarettes and Development of Respiratory Conditions in Women of Childbearing Age. South Med J 2021; 113:488-494. [PMID: 33005962 DOI: 10.14423/smj.0000000000001158] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Women of childbearing age are encouraged not to smoke because of well-documented adverse health outcomes. This study examines the association between e-cigarette use and respiratory conditions (asthma and chronic obstructive pulmonary disease [COPD]) among women of childbearing age. METHODS The study used data from the Behavioral Risk Factor Surveillance System 2016-2017. The sample consisted of 131,965 women of childbearing age (18-44 years old). The main independent variable was smoking status and the primary outcomes were self-reported respiratory conditions such as asthma and COPD. Data were analyzed using descriptive statistics and multivariate logistic regression to assess the effects of e-cigarettes on asthma and COPD. RESULTS In this sample of childbearing-age women, 2.79% were current e-cigarettes users with or without a history of combustible cigarette smoking and 3.02% were current dual users. Compared with nonsmokers, current e-cigarette users without a history of combustible cigarette smoking were associated with 74% higher odds of having asthma (adjusted odds ratio [AOR] 1.74, 95% confidence interval [CI] 1.29-2.35), whereas results were not significant for COPD. The odds of having COPD, however, were 3 times higher (AOR 3.28, 95% CI 2.62-4.12) for current e-cigarette users with a history of cigarette smoking, whereas current dual users showed 5 times higher odds (AOR 5.07, 95% CI 3.91-6.56) of COPD compared with nonsmokers. CONCLUSION Policies related to e-cigarettes need to be reevaluated and clearly communicated to improve prevention efforts for women of childbearing age.
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Affiliation(s)
- Tarang Parekh
- From the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Constance Owens
- From the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Kathryn Fay
- From the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Joseph Phillips
- From the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Panagiota Kitsantas
- From the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
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54
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Schilling L, Spallek J, Maul H, Schneider S. Study on E-Cigarettes and Pregnancy (STEP) - Results of a Mixed Methods Study on Risk Perception of E-Cigarette Use During Pregnancy. Geburtshilfe Frauenheilkd 2021; 81:214-223. [PMID: 33574625 PMCID: PMC7870285 DOI: 10.1055/a-1308-2376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 11/08/2020] [Indexed: 01/06/2023] Open
Abstract
Introduction
E-cigarette use during pregnancy is a risk factor for maternal and fetal health. Early studies on animals showed that in utero exposure to e-cigarettes can have negative health outcomes for the fetus. There has been only limited research into the risk perceptions of e-cigarette use during pregnancy. This study was conducted to comprehensively characterize the constructs of risk perceptions with regard to e-cigarette use during pregnancy using an
I
ntegrated
H
ealth
B
elief
M
odel (IHBM).
Methods
Our
ST
udy on
E
-cigarettes and
P
regnancy (STEP) used a mixed methods approach, with the study divided into an initial qualitative part and a quantitative part. A netnographic approach was used for the first part, which consisted of the analysis of 1552 posts from 25 German-language online discussion threads on e-cigarette use during pregnancy. Using these qualitative results, a quantitative questionnaire was developed to explore risk perception constructs about e-cigarette use during pregnancy. This questionnaire was subsequently administered to pregnant women (n = 575) in one hospital in Hamburg, Germany. Descriptive and bivariate analysis was used to examine differences in risk perception according to participantsʼ tobacco and e-cigarette user status before and during pregnancy. While the study design, methods and sample have been extensively described in our recently published study protocol in the January 2020 issue of
Geburtshilfe und Frauenheilkunde
, this paper is devoted to a presentation of the results of our mixed methods study.
Results
Themes related to perceived threats identified in the qualitative study part were
nicotine-related health risks
and
potential health risks of additional ingredients
. Perceived benefits were
possibility and facilitation of smoking cessation
and a presumed
potential to reduce harm
. The subsequent quantitative part showed that nearly all participants (99.3%) perceived e-cigarettes which contained nicotine as constituting a threat to the health of the unborn child. The most commonly perceived barrier was health-related (96.6%), while the most commonly perceived benefit was a reduction in the amount of tobacco cigarettes consumed (31.8%). We found that particularly perceived benefits varied depending on the participantʼs tobacco and e-cigarette user status.
Conclusion
When considering future prevention strategies, the potential health risks and disputed effectiveness of e-cigarettes as a tool for smoking cessation need to be taken into account and critically discussed.
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Affiliation(s)
- Laura Schilling
- Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany.,Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany
| | | | - Sven Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Abstract
PURPOSE OF REVIEW Electronic cigarettes have quickly risen to be the leading alternative nicotine source to tobacco. E-cigarette use is hard to research and regulate because of the novelty and rapid evolution of the devices and E-liquids. Epidemiological data on long-term usage is currently lacking, but in smaller cohort studies we are starting to understand the usage patterns and demographics of users, which differ depending on where the study takes place and the regulatory environment. The present review describes the current knowledge of the effects of E-cigarettes on the pulmonary system and knowledge of their usage patterns worldwide. RECENT FINDINGS E-cigarette use is continuing to rise in young adults in United States and Canada, but not in United Kingdom. These suggest that regulation is influencing uptake in young adults. If E-cigarettes are to be considered as a harm minimisation smoking cessation product, use in young never smokers must be factored into the risk assessment. A recent surge in cases of lung injury associated with vaping in America has resulted in the definition of vaping associated pulmonary injury, although the exact cause remains unknown. SUMMARY It is our opinion that E-cigarettes can no longer be defined as harmless. Further studies are needed to determine the risks for all populations as it is evident that a large proportion of E-cigarette users are never-smokers, meaning they cannot only be considered from a harm reduction perspective.
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56
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Jafari A, Rajabi A, Gholian-Aval M, Peyman N, Mahdizadeh M, Tehrani H. National, regional, and global prevalence of cigarette smoking among women/females in the general population: a systematic review and meta-analysis. Environ Health Prev Med 2021; 26:5. [PMID: 33419408 PMCID: PMC7796590 DOI: 10.1186/s12199-020-00924-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/20/2020] [Indexed: 02/07/2023] Open
Abstract
Background This systematic and meta-analysis review aimed to provide an updated estimate of the prevalence of ever and current cigarette smoking in women, in geographic areas worldwide, and demonstrate a trend of the prevalence of smoking over time by using a cumulative meta-analysis. Methods Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of ever and current cigarette smoking in women. We searched PubMed, Web of Science (ISI), Scopus, and Ovid from January 2010 to April 2020. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence of ever and current cigarette smoking in women. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression. Results The pooled prevalence of ever and current cigarette smoking in women was 28% and 17%, respectively. The pooled prevalence of ever cigarette smoking in adolescent girls/students of the school, adult women, pregnant women, and women with the disease was 23%, 27%, 32%, and 38%, respectively. The pooled prevalence of ever cigarette smoking in the continents of Oceania, Asia, Europe, America, and Africa was 36%, 14%, 38%, 31%, and 32%, respectively. Conclusions The prevalence of cigarette smoking among women is very high, which is significant in all subgroups of adolescents, adults, and pregnant women. Therefore, it is necessary to design and implement appropriate educational programs for them, especially in schools, to reduce the side effects and prevalence of smoking among women. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-020-00924-y.
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Affiliation(s)
- Alireza Jafari
- Department of Health Education and Health Promotion, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abdolhalim Rajabi
- Biostatistics and Epidemiology Department, Faculty of Health, Environmental Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahdi Gholian-Aval
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Peyman
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrsadat Mahdizadeh
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Tehrani
- Department of Health Education and Health Promotion, Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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57
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Ford A, Uny I, Lowes J, Naughton F, Cooper S, Coleman T, Hajek P, Przulj D, Myers Smith K, Bauld L, Sinclair L, Walton R, Clark M, Ussher M. A Qualitative Study of Factors Influencing Adherence among Pregnant Women Taking Part in a Trial of E-Cigarettes for Smoking Cessation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E430. [PMID: 33430407 PMCID: PMC7827544 DOI: 10.3390/ijerph18020430] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/16/2020] [Accepted: 12/23/2020] [Indexed: 12/13/2022]
Abstract
Use of e-cigarettes (vaping) has potential to help pregnant women stop smoking. This study explored factors influencing adherence among participants in the vaping arm of the first trial of vaping for smoking cessation in pregnancy. We conducted semi-structured telephone interviews (n = 28) with women at three-months postpartum. Interviews were analysed using thematic analysis, informed by the Theoretical-Domains Framework, Necessity-Concerns Framework and Perceptions and Practicalities Approach. Interviewees generally reported high levels of vaping. We found that: (1) intervention adherence was driven by four necessity beliefs-stopping smoking for the baby, and vaping for harm reduction, smoking cessation or as a last resort; (2) necessity beliefs outweighed vaping concerns, such as dependence and safety; (3) adherence was linked to four practicalities themes, acting as barriers and facilitators to vaping-device and e-liquid perceptions, resources and support, whether vaping became habitual, and social and environmental factors; and (4) intentional non-adherence was rare; unintentional non-adherence was due to device failures, forgetting to vape, and personal circumstances and stress. Pregnant smokers provided with e-cigarettes, and with generally high levels of vaping, had positive beliefs about the necessity of vaping for smoking cessation which outweighed concerns about vaping. Non-adherence was mainly due to unintentional factors.
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Affiliation(s)
- Allison Ford
- Institute for Social Marketing and Health, University of Stirling, Stirling FK9 4LA, UK; (I.U.); (J.L.); (M.U.)
| | - Isabelle Uny
- Institute for Social Marketing and Health, University of Stirling, Stirling FK9 4LA, UK; (I.U.); (J.L.); (M.U.)
| | - Judith Lowes
- Institute for Social Marketing and Health, University of Stirling, Stirling FK9 4LA, UK; (I.U.); (J.L.); (M.U.)
| | - Felix Naughton
- Behavioural and Implementation Science Group, School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK;
| | - Sue Cooper
- Division of Primary Care, University of Nottingham, Nottingham NG7 2RD, UK; (S.C.); (T.C.); (M.C.)
| | - Tim Coleman
- Division of Primary Care, University of Nottingham, Nottingham NG7 2RD, UK; (S.C.); (T.C.); (M.C.)
| | - Peter Hajek
- Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (P.H.); (D.P.); (K.M.S.); (R.W.)
| | - Dunja Przulj
- Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (P.H.); (D.P.); (K.M.S.); (R.W.)
| | - Katie Myers Smith
- Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (P.H.); (D.P.); (K.M.S.); (R.W.)
| | - Linda Bauld
- Usher Institute and SPECTRUM Consortium, College of Medicine and Veterinary Medicine, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh EH8 9AG, UK; (L.B.); (L.S.)
| | - Lesley Sinclair
- Usher Institute and SPECTRUM Consortium, College of Medicine and Veterinary Medicine, University of Edinburgh, Old Medical School, Teviot Place, Edinburgh EH8 9AG, UK; (L.B.); (L.S.)
| | - Robert Walton
- Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AT, UK; (P.H.); (D.P.); (K.M.S.); (R.W.)
| | - Miranda Clark
- Division of Primary Care, University of Nottingham, Nottingham NG7 2RD, UK; (S.C.); (T.C.); (M.C.)
| | - Michael Ussher
- Institute for Social Marketing and Health, University of Stirling, Stirling FK9 4LA, UK; (I.U.); (J.L.); (M.U.)
- Population Health Research Institute, St George’s University of London, London SW17 ORE, UK
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58
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Froggatt S, Reissland N, Covey J. Risk perception of cigarette and e-cigarette use during pregnancy: A qualitative postpartum perspective. Midwifery 2020; 94:102917. [PMID: 33387740 DOI: 10.1016/j.midw.2020.102917] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 11/26/2020] [Accepted: 12/17/2020] [Indexed: 11/30/2022]
Abstract
AIM The aim of this exploratory qualitative analysis is to assess the perceptions of risks of cigarette and e-cigarette use during pregnancy. BACKGROUND An important public health aim is a reduction of smoking at time of delivery (SATOD) from 10.6% to less than 6% by 2022 in the United Kingdom (UK). In order to successfully meet this target, we need to have a better understanding of the perceived risks associated with cigarette smoking. Additionally, the use of e-cigarettes is increasing in the general population, with pregnant women being supported to use such products if it helps them remain smoke free. However, in contrast to cigarette smoking, there is little definitive research assessing the safety of e-cigarette use during pregnancy, with most information disregarding the health of the growing fetus. E-cigarettes are of special interest, given they are an unlicensed product for use during pregnancy, yet women are being supported to use them as a method of harm reduction. A better understanding of perceived risks is essential. METHOD Fourteen interviews were conducted one month postpartum with women who smoked during pregnancy and continued to smoke after the birth. Thematic analysis was conducted. FINDINGS Two themes emerged for cigarette smoking; health and justifications. Six themes were identified for e-cigarette use; the unknown, experience, comparison to cigarettes, the product, advice and healthier option. A range of subthemes are discussed. CONCLUSION Women provided a range of justifications for continuing to smoke during pregnancy. Women felt e-cigarettes were a riskier option than continuing to smoke.
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Affiliation(s)
- Suzanne Froggatt
- Psychology Department, Durham University, Science Site, South Road, Durham DH1 3LE, England.
| | - Nadja Reissland
- Psychology Department, Durham University, Science Site, South Road, Durham DH1 3LE, England.
| | - Judith Covey
- Psychology Department, Durham University, Science Site, South Road, Durham DH1 3LE, England.
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59
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Raterman ST, Metz JR, Wagener FADTG, Von den Hoff JW. Zebrafish Models of Craniofacial Malformations: Interactions of Environmental Factors. Front Cell Dev Biol 2020; 8:600926. [PMID: 33304906 PMCID: PMC7701217 DOI: 10.3389/fcell.2020.600926] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/23/2020] [Indexed: 11/13/2022] Open
Abstract
The zebrafish is an appealing model organism for investigating the genetic (G) and environmental (E) factors, as well as their interactions (GxE), which contribute to craniofacial malformations. Here, we review zebrafish studies on environmental factors involved in the etiology of craniofacial malformations in humans including maternal smoking, alcohol consumption, nutrition and drug use. As an example, we focus on the (cleft) palate, for which the zebrafish ethmoid plate is a good model. This review highlights the importance of investigating ExE interactions and discusses the variable effects of exposure to environmental factors on craniofacial development depending on dosage, exposure time and developmental stage. Zebrafish also promise to be a good tool to study novel craniofacial teratogens and toxin mixtures. Lastly, we discuss the handful of studies on gene–alcohol interactions using mutant sensitivity screens and reverse genetic techniques. We expect that studies addressing complex interactions (ExE and GxE) in craniofacial malformations will increase in the coming years. These are likely to uncover currently unknown mechanisms with implications for the prevention of craniofacial malformations. The zebrafish appears to be an excellent complementary model with high translational value to study these complex interactions.
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Affiliation(s)
- S T Raterman
- Radboud Institute of Molecular Life Sciences, Nijmegen, Netherlands.,Department of Dentistry-Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, Netherlands.,Department of Animal Ecology and Physiology, Institute for Water and Wetland Research, Radboud University, Nijmegen, Netherlands
| | - J R Metz
- Department of Animal Ecology and Physiology, Institute for Water and Wetland Research, Radboud University, Nijmegen, Netherlands
| | - Frank A D T G Wagener
- Radboud Institute of Molecular Life Sciences, Nijmegen, Netherlands.,Department of Dentistry-Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, Netherlands
| | - Johannes W Von den Hoff
- Radboud Institute of Molecular Life Sciences, Nijmegen, Netherlands.,Department of Dentistry-Orthodontics and Craniofacial Biology, Radboud University Medical Center, Nijmegen, Netherlands
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60
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Dobbs PD, Lu Y, Maness S, Coleman L, Johnson A, Metz S, Vidal C, Cheney MK. Gestational Women's Perceptions About the Harms of Cigarette and E-Cigarette Use During Pregnancy. Matern Child Health J 2020; 25:1209-1220. [PMID: 33190194 DOI: 10.1007/s10995-020-03085-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The purpose of this study was to examine differences between perceived harm of cigarette and electronic cigarette (e-cigarette) use while pregnant and differences between healthcare providers' communication about these products during pregnancy. METHODS A convenience sample of gestational women (n = 218; ages 18-45) living in the US completed an online survey between May and December 2017. Participants reported perceived likelihood of adverse health outcomes (e.g., low birth weight, sudden infant death syndrome) among infants/children born to mothers who used cigarettes/e-cigarettes. T-tests and two-way ANOVAs examined differences between risk perceptions of using cigarettes/e-cigarettes while pregnant based on pregnancy status (previously pregnant, currently pregnant, future pregnant). Chi-square analyses examined differences between healthcare provider communication about cigarette/e-cigarette use during pregnancy. RESULTS Overall, participants believed adverse health outcomes were significantly more likely to be caused by maternal use of cigarettes than e-cigarettes. Participants who planned to be pregnant reported higher endorsement that smoking combustible cigarettes would cause a miscarriage (p < .05) or increased blood pressure (p < .05) for a child than currently pregnant participants. Participants reported healthcare providers asked about (p < .05), advised them not to use (p < .001), and talked to them about health effects of smoking combustible cigarettes while pregnant (p < .001) significantly more than e-cigarettes. CONCLUSIONS FOR PRACTICE Healthcare providers working with pregnant women should perform the 5As behavioral intervention method to provide pregnant women with tobacco cessation care. They should also discuss the absolute harm nicotine exposure (via cigarettes or e-cigarettes) can have on fetal health and development.
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Affiliation(s)
- Page D Dobbs
- Health, Human Performance and Recreation Department, University of Arkansas, Fayetteville, AR, USA. .,Department of Health and Exercise Science, University of Arkansas, 308 HPER Building, Fayetteville, AR, 72701, USA.
| | - Yu Lu
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Ave, Norman, OK, 73019, USA
| | - Sarah Maness
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Ave, Norman, OK, 73019, USA
| | - Lois Coleman
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Ave, Norman, OK, 73019, USA
| | - Aleyah Johnson
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Ave, Norman, OK, 73019, USA
| | - Samantha Metz
- Seven Valley Health Coalition, 10 Kennedy Parkway, Cortland, NY, 13045, USA
| | - Charlie Vidal
- Puerto Rico Public Health Association, New York, USA
| | - Marshall K Cheney
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Ave, Norman, OK, 73019, USA
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Nagpal TS, Green CR, Cook JL. Vaping During Pregnancy: What Are the Potential Health Outcomes and Perceptions Pregnant Women Have? JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 43:219-226. [PMID: 33187893 DOI: 10.1016/j.jogc.2020.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/29/2020] [Accepted: 05/29/2020] [Indexed: 10/23/2022]
Abstract
The prevalence of electronic nicotine delivery systems, such as vaping, is a growing public health concern, and there is limited information on the use of these devices during pregnancy. The objective of this rapid review was to summarize the available literature on human studies of the potential maternal or fetal health effects of vaping or women's perceptions of vaping during pregnancy. A systematic search was completed in the following databases: Medline, EMBASE, Scopus, Web of Science, and CINAHL. A search strategy was developed combining the terms pregnancy and vaping. Findings were divided into two groups and summarized as: 1) Health outcomes following vaping during pregnancy; and 2) Perceptions pregnant women have related to vaping during pregnancy. A total of 760 articles were retrieved and, after applying the inclusion/exclusion criteria and screening, 19 studies were included. Five included studies provided evidence on potential health outcomes and 14 were focused on perceptions. There is emerging evidence that vaping during pregnancy may increase the risk of small for gestational age newborns. Pregnant women generally report that they used vaping products during pregnancy for smoking cessation and perceived that this was a healthier alternative to traditional cigarettes. Overall, there was consensus that there is a lack of information on maternal and fetal health outcomes following vaping during pregnancy. Based on the findings of this rapid review, there is an urgent need for high-quality studies in pregnant women to evaluate the potential in utero and long-term effects of exposure to prenatal vaping.
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Affiliation(s)
- Taniya S Nagpal
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON; Department of Human Kinetics, University of Ottawa, Ottawa, ON.
| | - Courtney R Green
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON
| | - Jocelynn L Cook
- The Society of Obstetricians and Gynaecologists of Canada, Ottawa, ON; Department of Obstetrics and Gynaecology, University of Ottawa, Ottawa, ON
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Garland MA, Reynolds K, Zhou CJ. Environmental mechanisms of orofacial clefts. Birth Defects Res 2020; 112:1660-1698. [PMID: 33125192 PMCID: PMC7902093 DOI: 10.1002/bdr2.1830] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 12/11/2022]
Abstract
Orofacial clefts (OFCs) are among the most common birth defects and impart a significant burden on afflicted individuals and their families. It is increasingly understood that many nonsyndromic OFCs are a consequence of extrinsic factors, genetic susceptibilities, and interactions of the two. Therefore, understanding the environmental mechanisms of OFCs is important in the prevention of future cases. This review examines the molecular mechanisms associated with environmental factors that either protect against or increase the risk of OFCs. We focus on essential metabolic pathways, environmental signaling mechanisms, detoxification pathways, behavioral risk factors, and biological hazards that may disrupt orofacial development.
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Affiliation(s)
- Michael A. Garland
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, CA 95817
| | - Kurt Reynolds
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Biochemistry, Molecular, Cellular, and Developmental Biology (BMCDB) graduate group, University of California, Davis, CA 95616
| | - Chengji J. Zhou
- Department of Biochemistry and Molecular Medicine, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Institute for Pediatric Regenerative Medicine of Shriners Hospitals for Children, University of California at Davis, School of Medicine, Sacramento, CA 95817
- Biochemistry, Molecular, Cellular, and Developmental Biology (BMCDB) graduate group, University of California, Davis, CA 95616
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63
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Reddy KD, Oliver BGG. Sex-specific effects of in utero and adult tobacco smoke exposure. Am J Physiol Lung Cell Mol Physiol 2020; 320:L63-L72. [PMID: 33084360 DOI: 10.1152/ajplung.00273.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Tobacco smoke has harmful effects on a multiorgan level. Exposure to smoke, whether in utero or environmental, significantly increases susceptibility. This susceptibility has been identified to be divergent between males and females. However, there remains a distinct lack of thorough research into the relationship between sex and exposure to tobacco. Females tend to generate a more significant response than males during adulthood exposure. The intrauterine environment is meticulously controlled, and exposure to tobacco presents a significant factor that contributes to poor health outcomes and susceptibility later in life. Analysis of these effects in relation to the sex of the offspring is yet to be holistically reviewed and summarized. In this review, we will delineate the time-dependent relationship between tobacco smoke exposure and sex-specific disease susceptibility. We further outline possible biological mechanisms that may contribute to the identified pattern.
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Affiliation(s)
- Karosham D Reddy
- School of Life Sciences, University of Technology Sydney, Sydney, New South Wales, Australia.,Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Brian G G Oliver
- School of Life Sciences, University of Technology Sydney, Sydney, New South Wales, Australia.,Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
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Kurti AN. Reducing tobacco use among women of childbearing age: Contributions of tobacco regulatory science and tobacco control. Exp Clin Psychopharmacol 2020; 28:501-516. [PMID: 31855002 PMCID: PMC8168442 DOI: 10.1037/pha0000342] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Tobacco use has unique, adverse health consequences for reproductive-aged women, particularly should these women become pregnant. Thus, successful efforts to reduce tobacco use among this population have strong potential to improve public health and reduce health disparities. The present review examines contributions to reducing tobacco use among women of childbearing age spanning the domains of tobacco regulatory science and tobacco control from the passage of the Family Smoking Prevention and Tobacco Control Act in 2009 through September 2019. In the domain of tobacco regulatory science, such efforts include research conducted by various National Institutes of Health/Food and Drug Administration (FDA)-supported Tobacco Centers of Regulatory Science, epidemiological surveillance studies, as well as studies examining the potential impact of tobacco regulatory policies currently under consideration by the FDA (e.g., reduced nicotine content cigarettes, health warning labels). Tobacco control efforts within this same 10-year timeframe include developments in pharmacological and psychosocial approaches to promoting tobacco cessation, mHealth interventions, and tobacco control policy. Emerging issues pertinent to ongoing efforts to reduce tobacco use within the domains of both tobacco regulatory science and tobacco control are also reviewed, including e-cigarettes, comorbid health conditions, course of tobacco and other drugs of abuse, and obstacles to the dissemination and implementation of evidence-based treatment and policy. Although the past decade has seen numerous important contributions to reducing tobacco use among reproductive-aged women within both domains, existing obstacles must be surmounted to continue reducing tobacco use and protecting health among this population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Vohra F, Bukhari IA, Sheikh SA, Albaijan R, Naseem M. Comparison of self-rated oral symptoms and periodontal status among cigarette smokers and individuals using electronic nicotine delivery systems. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:788-793. [PMID: 31995451 DOI: 10.1080/07448481.2019.1709476] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/15/2019] [Accepted: 12/22/2019] [Indexed: 06/10/2023]
Abstract
Objective: The aim was to compare the self-rated oral symptoms (OS) and clinical and radiographic periodontal status among cigarette smokers and electronic nicotine delivery systems (ENDS) users.Participants: Self-reported cigarette smokers and electronic cigarette and JUUL users were included.Methods: Self-rated OS and demographic data were recorded. Clinical attachment loss (AL), plaque index (PI), probing depth (PD), number of missing teeth, and bleeding on probing (BOP) were determined. p Values<.05 were deemed significant.Results: Bad breath (p<.001) and pain in gums (p<.001) were more often reported by cigarette-smokers than ENDS users. Compared with never-smokers, pain in teeth (p<.001), bad-breath (p<.001), and pain in gums (p<.001) were higher among cigarette smokers. There was no significant difference in pain in teeth, bleeding gums, bad breath, and pain in gums when JUUL users were compared with never-smokers and electronic cigarette users. PI (p<.05) and PD (p<.05) were increased in cigarette smokers than ENDS users and never-smokers.Conclusions: Pain in teeth and gums are more often perceived by cigarette smokers than electronic cigarette and JUUL users and never-smokers.
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Affiliation(s)
- Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ishfaq A Bukhari
- Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saeed A Sheikh
- Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Refal Albaijan
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mustafa Naseem
- Department of Research, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Schmidt S. E-Cigarette Aerosols and the Brain: Behavioral and Neuroinflammatory Changes in Prenatally Exposed Adult Mice. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:104005. [PMID: 33104447 PMCID: PMC7587668 DOI: 10.1289/ehp7315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 04/29/2020] [Indexed: 06/11/2023]
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Kim S. Changes in Multiple and Different Tobacco Product Use Behaviors in Women Before and During Pregnancy: An Analysis of Longitudinal Population Assessment of Tobacco and Health Data. Am J Prev Med 2020; 59:588-592. [PMID: 32828586 PMCID: PMC7508803 DOI: 10.1016/j.amepre.2020.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/01/2020] [Accepted: 05/05/2020] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Changes in tobacco use behaviors among women with respect to pregnancy are expected to be significant and dynamic, with a strong desire for smoking cessation, diversification of tobacco products, and perceived relative safety on noncigarette tobacco products. This study aims to illustrate how multiple and different tobacco use behaviors change before and during pregnancy. METHODS Data were extracted from 864 pregnant, nationally representative U.S. women, who were prospectively followed with the Population Assessment of Tobacco and Health study between 2013 and 2017. Smoking statuses were defined on the basis of the number and type of 7 different tobacco products under current use. Differences in maternal characteristics were investigated in relation to tobacco cessation statuses during pregnancy. Weighted percentages and 95% CIs were calculated. RESULTS Only 50.4% of prepregnancy tobacco users achieved complete abstinence with varying rates of cessation, depending on the number and type of products used prepregnancy. The lowest cessation rates were observed among prepregnancy poly-tobacco users (23.3%) and conventional cigarette smokers (45.5%). During pregnancy, 11.3% and 2.8% of women reported smoking cigarettes and e-cigarettes, respectively. Persistent tobacco users during pregnancy were more likely to be white, be older, and have nonprivate or no medical insurance (all p<0.05). CONCLUSIONS This study demonstrates a widespread prenatal tobacco use and low rates of complete cessation in major subgroups of tobacco users. Current findings on the concurrent use of multiple products and noncigarette tobacco products highlight the urgent need for further research and comprehensive public health intervention for smoking cessation during pregnancy.
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Affiliation(s)
- Sooyong Kim
- Behavioral Sciences Group, Sanford Research, Sioux Falls, South Dakota.
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68
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Kim S, Oancea SC. Electronic cigarettes may not be a "safer alternative" of conventional cigarettes during pregnancy: evidence from the nationally representative PRAMS data. BMC Pregnancy Childbirth 2020; 20:557. [PMID: 32967660 PMCID: PMC7510270 DOI: 10.1186/s12884-020-03247-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/14/2020] [Indexed: 12/16/2022] Open
Abstract
Background Conventional cigarette (CC) smoking is one of the most preventable causes of adverse birth outcomes. Although electronic cigarettes (ECs) are considered to be safer than CCs during pregnancy, the evidence is yet to be presented. This study examines the effects of prenatal EC use on neonatal birth outcomes compared to those of CC smokers and complete tobacco abstainers. Methods Data was extracted from 55,251 pregnant women who participated in the Phase 8 survey of the Pregnancy Risk Assessment Monitoring System between 2016 and 2018. Participants were classified into three groups based on their smoking behaviors in the third trimester: complete tobacco abstinence, exclusive CC smoking, or exclusive EC use. Adverse outcomes included infants being small-for-gestational-age (SGA), having low birthweight (LBW), and being born at preterm. EC users were matched to complete abstainers and CC smokers who share the same baseline characteristics in race/ethnicity, age, educational attainment, income, prenatal care adequacy, and first- and second-trimester CC smoking statuses. The association between EC use and adverse birth outcomes were examined by survey-weighted logistic regression analyses in the matched population. Results Among participants, 1.0% of women reported having used ECs during the third trimester, 60% of which reported using ECs exclusively. Neonates of EC users were significantly more likely to be SGA (OR 1.76; 95% CI 1.04, 2.96), have LBW (OR 1.53; 95% CI 1.06, 2.22), or be born preterm (OR 1.86; 95% CI 1.11, 3.12) compared to tobacco abstainers. However, odds of EC users’ pregnancies resulting in SGA (OR 0.67; 95% CI 0.30, 1.47), LBW (OR 0.71; 95% CI 0.37, 1.37), or preterm birth (OR 1.06; 95% CI 0.46, 2.48) were not significantly lower than those of CC smokers. Conclusions Even after accounting for shared risk factors between prenatal tobacco use and adverse birth outcomes, EC use remains an independent risk factor for neonatal complications and is not a safer alternative to CC smoking during pregnancy. Until further research is completed, all pregnant women are encouraged to abstain from all tobacco products including ECs.
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Affiliation(s)
- Sooyong Kim
- Behavioral Sciences Group, Sanford Research, 2301 East 60th St N, Sioux Falls, SD, 57104, USA. .,Present address: Pinney Associates, Inc, 201 North Craig Street, Suite 320, Pittsburgh, PA, 15213, USA.
| | - Sanda Cristina Oancea
- Department of Population Health , University of North Dakota School of Medicine & Health Sciences, Grand Forks , ND, 58202, USA
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69
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Abdel-Qader DH, Al Meslamani AZ. Knowledge and Beliefs of Jordanian Community Toward E-cigarettes: A National Survey. J Community Health 2020; 46:577-586. [PMID: 32772206 DOI: 10.1007/s10900-020-00896-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Electronic nicotine delivery systems were promoted publically as a healthier replacement for conventional cigarettes. Knowledge and beliefs of the public can drive their behaviours to adapt or reject the new habit. No previous research was conducted in Jordan to assess electronic cigarettes (e-cigarettes) prevalence, and limited data are available on public opinions and orientation toward this new habit. To assess prevalence of, knowledge, attitude and beliefs about e-cigarettes, and examine factors associated with plans of quitting or initiating e-cigarettes among adults in Jordan. A large cross-sectional face-to-face survey on a random sample of adult population aged ≥ 18 years was conducted over two months to include 1820 adults in Jordan. A representative sample was collected using proportionate random sampling technique, which enabled us to geographically categorise the study population. Reliability and validity measures were taken to ensure a comprehensive and appropriate study tool. The Statistical Package for Social Science (SPSS®) version 24 was used to conduct descriptive analysis, logistic regression, and Rao-Scott chi-square. Findings were considered statistically significant at p value < 0.05 (with a confidence limit at 95%). Of 2164 adults approached, 1820 completed the questionnaire (84.1% response rate). The prevalence of current e-cigarette smokers and dual smokers were 11.7% and 4.0%, respectively. Quitting conventional smoking (38.8%) and enjoying the flavour (32.5%) were the most common reasons to start vaping. Friends were the major source of information about e-cigarettes. There was evidence that adults aged 45-59 years were less likely to be dual smokers (OR 0.51; 95%CI 0.29-0.66; p = 0.03). Poor knowledge about the content (23.7%) and types of e-cigarettes (14.5%) was reported. Plans to reduce or quit e-cigarettes were significantly associated with three factors: smokers' knowledge about its content, social impression, smokers' satisfaction with e-cigarettes. Social impression was also associated with plans of initiating e-cigarettes. Most participants thought vaping cannot be harmful to children and pregnant women (73.1%) and cannot be addictive (58.2%). Electronic cigarettes were considered helpful in smoking cessation by 69.1% of participants. The proportions of adults who were currently electronic cigarette and dual smokers were 11.7% and 4.0%, respectively. Our research may provide insight to product and individual factors that were associated with plans to sustain, quit or initiate electronic smoking.
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70
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Li G, Chan YL, Wang B, Saad S, Oliver BG, Chen H. Replacing smoking with vaping during pregnancy: Impacts on metabolic health in mice. Reprod Toxicol 2020; 96:293-299. [PMID: 32750443 DOI: 10.1016/j.reprotox.2020.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/25/2020] [Accepted: 07/27/2020] [Indexed: 01/02/2023]
Abstract
Smoking is a significant risk factor for the development of metabolic diseases. Due to social pressures to quit smoking, many pregnant women are vaping as an alternative nicotine source. However, the metabolic consequences of replacing tobacco cigarettes with e-cigarettes during pregnancy are unknown. Therefore, in the mothers and their offspring, we investigated the metabolic and hepatic impacts of replacing cigarette smoke with e-vapour during pregnancy. Female BALB/c mice were either air-exposed or cigarette smoke-exposed (SE) from six weeks before pregnancy until lactation. At mating, a subset of the SE mice were instead exposed to e-vapour. Markers of glucose and lipid metabolism were measured in the livers and plasma, from the mothers and their male offspring (13 weeks). In the SE mothers, plasma insulin levels were reduced, leading to downstream increases in hepatic gluconeogenesis and plasma non-esterified fatty acids (NEFA). In the e-vapour replacement mothers, these changes were not as significant. In the SE offspring, there was impaired glucose tolerance, and increased plasma NEFA and liver triglyceride concentrations. E-vapour replacement restored lipid homeostasis but did not improve glucose tolerance. Therefore, in a murine model, low dose e-cigarette replacement during pregnancy is less toxic than cigarette smoke.
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Affiliation(s)
- Gerard Li
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW 2007, Australia.
| | - Yik L Chan
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW 2007, Australia; Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW 2037, Australia
| | - Baoming Wang
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW 2007, Australia; Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW 2037, Australia
| | - Sonia Saad
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW 2007, Australia; Kolling Institute of Medical Research, Royal North Shore Hospital, The University of Sydney, Sydney, New South Wales 2065, Australia
| | - Brian G Oliver
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW 2007, Australia; Respiratory Cellular and Molecular Biology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW 2037, Australia
| | - Hui Chen
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW 2007, Australia
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Obisesan OH, Osei AD, Uddin SMI, Dzaye O, Cainzos-Achirica M, Mirbolouk M, Orimoloye OA, Sharma G, Al Rifai M, Stokes A, Bhatnagar A, El Shahawy O, Benjamin EJ, DeFilippis AP, Blaha MJ. E-Cigarette Use Patterns and High-Risk Behaviors in Pregnancy: Behavioral Risk Factor Surveillance System, 2016-2018. Am J Prev Med 2020; 59:187-195. [PMID: 32362509 PMCID: PMC8349302 DOI: 10.1016/j.amepre.2020.02.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The prevalence of e-cigarette use has increased dramatically in the last decade in the U.S. Understanding the prevalence, patterns of use, and risk factor associations of e-cigarette use in pregnant women is particularly important, as this could have potential health implications for the mother and the developing child. METHODS Using Behavioral Risk Factor Surveillance System Survey data from 2016 to 2018, adult women of reproductive age (18-49 years) who reported being pregnant (n=7,434) were studied. Self-reported current e-cigarette use was the main exposure. Other measures included combustible cigarette smoking status and high-risk behaviors (including other tobacco, marijuana, or heavy alcohol use; binge drinking; and others). All analyses were done in 2019. RESULTS Approximately 2.2% of pregnant women reported current e-cigarette use, of whom 0.6% reported daily use. The highest prevalence of e-cigarette use was observed in the youngest age group of pregnant women (3.2%), with 41.7% of all pregnant current e-cigarette users being aged 18-24 years. There was a marked increase in the prevalence of current use of e-cigarettes among pregnant women from 1.9% in 2016 to 3.8% in 2018. Approximately 46% of pregnant current e-cigarette users reported concomitant cigarette smoking. Compared with pregnant never e-cigarette users, pregnant current e-cigarette users had a higher prevalence of other tobacco product use, marijuana use, heavy alcohol intake, binge drinking, and other high-risk behaviors. CONCLUSIONS These findings underscore the need to strengthen prevention and policy efforts, specifically in the vulnerable subgroup of pregnant women.
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Affiliation(s)
- Olufunmilayo H Obisesan
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland; American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
| | - Albert D Osei
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland; American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
| | - S M Iftekhar Uddin
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland; American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
| | - Omar Dzaye
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland; Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Radiology and Neuroradiology, Charité, Berlin, Germany
| | - Miguel Cainzos-Achirica
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland
| | | | - Olusola A Orimoloye
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Garima Sharma
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland
| | - Mahmoud Al Rifai
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Andrew Stokes
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas; Department of Global Health, Boston University, Boston, Massachusetts
| | - Aruni Bhatnagar
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas; Department of Medicine, University of Louisville, Louisville, Kentucky
| | - Omar El Shahawy
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas; Section on Tobacco, Alcohol and Drug Use, Department of Population Health, School of Medicine, New York University, New York, New York; Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Emelia J Benjamin
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas; Department of Medicine, Boston University, Boston, Massachusetts
| | - Andrew P DeFilippis
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas; Department of Medicine, University of Louisville, Louisville, Kentucky
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland; American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas.
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Garabedian C, Berveiller P, Guerby P. [Other Methods of Consumption: Electronic Cigarette, Heated Tobacco, Shisha and Snus - CNGOF-SFT Expert Report and Guidelines on the management for Smoking Management During Pregnancy]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2020; 48:583-586. [PMID: 32247094 DOI: 10.1016/j.gofs.2020.03.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Other methods of cigarette consumption include a variety of electronic products, as well as heated tobacco, snus and shisha. The questions in this chapter are: what other methods of consumption are used during pregnancy (either electronic or containing tobacco) and what is their prevalence? What is their benefit/risk balance? Can their use during pregnancy be proposed? Although the fetus is not exposed to the combustible toxins of tobacco, e-cigarette products may contain nicotine, which maintains the exposure of the fetus. Further research is needed on the other components of the electronic cigarette, such as flavorings and propylene glycol and/or glycerol, in order to assess the benefit/risk balance. In addition, some solvents contain ethanol. In the current state of knowledge, the precautionary principle should be respected and not recommend the initiation or continuation of the electronic cigarette during pregnancy (professional agreement). For smoking cessation or electronic cigarette cessation, it is recommended to provide the same advice and to use methods that have already been evaluated (professional agreement). For the JUUL, there are currently no data on obstetrical outcome when used. The use of shisha during pregnancy is associated with decreased fetal growth. It is recommended not to use shisha during pregnancy (GradeC). There are currently no data on the use of heated tobacco and obstetrical outcome.
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Affiliation(s)
- C Garabedian
- CHU Lille, clinique d'obstétrique, 1, avenue Eugène-Avinée, 59000 Lille, France; Univ. Lille, ULR 2694 - METRICS : évaluation des technologies de santé et des pratiques médicales, 59000 Lille, France.
| | - P Berveiller
- Service de gynécologie-obstétrique, CHI de Poissy St-Germain, 78300 Poissy, France
| | - P Guerby
- Service de gynécologie-obstétrique, CHU de Toulouse, 31300, Toulouse, France
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Aldakheel FM, Alduraywish SA, Jhugroo P, Jhugroo C, Divakar DD. Quantification of pathogenic bacteria in the subgingival oral biofilm samples collected from cigarette-smokers, individuals using electronic nicotine delivery systems and non-smokers with and without periodontitis. Arch Oral Biol 2020; 117:104793. [PMID: 32544646 DOI: 10.1016/j.archoralbio.2020.104793] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 05/30/2020] [Accepted: 05/31/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of the present study was to quantify pathogenic bacteria isolated from the subgingival oral-biofilm samples collected from cigarette-smokers and ENDS-users with periodontitis, when compared to non-smokers with and without periodontitis. METHODS Demographic data was collected using a questionnaire. Periodontal parameters (plaque [PI] and gingival [GI] indices, clinical attachment loss [CAL], probing depth [PD] and marginal bone loss [MBL]) were measured. Subgingival oral bio-film samples were collected and assessed for periodontopathogenic bacteria (Aggregatibacter actinomycetemcomitans [A. actinomycetemcomitans], Prevotella intermedia [P. intermedia], Porphyromonas gingivalis [P. gingivalis], Tannerella forsythia [T. forsythia] and Treponema denticola [T. denticola]). Group-comparisons were performed; and P < 0.01 were considered statistically significant. RESULTS All cigarette-smokers, ENDS-users and non-smokers with periodontitis had Grade-B periodontitis. The CFU/mL of A. actinomycetemcomitans (P < 0.001) and P. gingivalis (P < 0.001) were significantly higher among cigarette-smokers (P < 0.01) and ENDS-users (P < 0.01) than non-smokers with periodontitis. The CFU/mL of T. denticola were significantly higher among cigarette-smokers (P < 0.001), ENDS-users (P < 0.001) and non-smokers with periodontitis (P < 0.001) compared with non-smokers without periodontitis. There was no statistically significant difference in the CFU/mL of P. intermedia and T. denticola among cigarette-smokers, ENDS-users and non-smokers with periodontitis. CONCLUSION Counts of periodontopathogenic bacteria in the subgingival oral-biofilm are comparable among cigarette-smokers and individuals using ENDS.
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Affiliation(s)
- Fahad M Aldakheel
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Shatha A Alduraywish
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Prince Sattam Research Chair for Epidemiology and Public Health, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Poojdev Jhugroo
- CAP Research Ltd., 2nd Floor, Orbis Court, 132 St. Jean Road, 72218, Quatre Bornes, Mauritius
| | - Chitra Jhugroo
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Darshan Devang Divakar
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
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Rollins L, Sokol NA, McCallum M, England L, Matteson K, Werner E, Stroud LR. Electronic Cigarette Use During Preconception and/or Pregnancy: Prevalence, Characteristics, and Concurrent Mental Health Conditions. J Womens Health (Larchmt) 2020; 29:780-788. [PMID: 32109175 PMCID: PMC7307667 DOI: 10.1089/jwh.2019.8089] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: Electronic cigarettes (e-cigarettes) are increasing in popularity in the United States. Prior prevalence estimates of e-cigarette use in pregnancy range from 1% to 15%. Materials and Methods: We assessed prevalence of e-cigarette and conventional cigarette use during preconception or pregnancy in a large sample of racially/ethnically diverse, low-income pregnant women via telephone survey (2015-2018) and compared sociodemographic characteristics and mental health conditions. Results: Of 1365 pregnant women surveyed, 54 (4.0%) reported e-cigarette use (regardless of other tobacco use), 372 (27.3%) reported conventional cigarette use without e-cigarette use (conventional cigarette use), and 939 (68.8%) reported no tobacco or nicotine replacement therapy (NRT) product use during the preconception period and/or pregnancy. Seventy-four percent of women using e-cigarettes reported also using conventional cigarettes. Women who used e-cigarettes were more likely to report high school education or greater, income <$30,000, White race, and non-Hispanic ethnicity than women who used conventional cigarettes. Women who used e-cigarettes were more likely than women who used conventional cigarettes or no tobacco/NRT to report symptoms of depression. Women who used e-cigarettes and women who used conventional cigarettes were more likely than women who used no tobacco/NRT to report a history of severe mental health conditions, alcohol use during pregnancy, and marijuana or other drug use during preconception. Conclusions: In this sample, 4% of women used e-cigarettes during preconception and/or pregnancy and most also used conventional cigarettes. Increased efforts by providers to screen for tobacco (including use of e-cigarette) and polysubstance use and to provide cessation services could improve outcomes of mothers and children.
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Affiliation(s)
- L.G. Rollins
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Natasha A. Sokol
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, Rhode Island
| | - Meaghan McCallum
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
| | - Lucinda England
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristen Matteson
- Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
- Department of Obstetrics and Gynecology, Brown University School of Medicine, Providence, Rhode Island
| | - Erika Werner
- Department of Obstetrics and Gynecology, Brown University School of Medicine, Providence, Rhode Island
- Department of Obstetrics and Gynecology, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Laura R. Stroud
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, Rhode Island
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
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75
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Perceptions, Characteristics, and Behaviors of Cigarette and Electronic Cigarette Use among Pregnant Smokers. Womens Health Issues 2020; 30:221-229. [PMID: 32376187 DOI: 10.1016/j.whi.2020.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 02/27/2020] [Accepted: 03/20/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Smoking during pregnancy is a primary risk factor for adverse perinatal outcomes. Although electronic cigarette (e-cigarette) use has increased, reasons for and behaviors of use are not fully understood. The purpose of this study, composed exclusively of pregnant current smokers, was to describe perceptions of health risks associated with e-cigarette use among pregnant women, describe the use patterns of pregnant dual users (defined as those who simultaneously use conventional/combustible cigarettes and e-cigarettes), and examine smoking-related behaviors between conventional-only (defined as those smoking combustible cigarettes but not e-cigarettes) and dual users. METHODS Cross-sectional data from a larger study of pregnant conventional-only and dual users were analyzed. A brief survey measured perceptions of prenatal e-cigarette use and smoking behaviors. Analysis included descriptive statistics, bivariate analysis, and logistic and linear regression analysis. RESULTS Among 176 pregnant smokers (38% dual users), more than one-half of participants believed e-cigarettes were harmful to women (56%) and posed harm to the fetus (53%). Among dual users, 41% used their e-cigarette daily, on average eight times per day. Eleven percent of dual users smoked a pack of cigarettes per day, compared with 5% of conventional-only smokers, and dual users scored significantly higher (p = .026) on the Penn State Cigarette Dependence Index. The most common e-cigarette liquid flavor was fruit (64%), and the most frequently reported e-cigarette nicotine concentration was 1-6 mg. CONCLUSIONS Characterizing perceptions and behaviors of e-cigarette use during pregnancy is foundational for future research to explore the association between product use and maternal and infant outcomes.
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76
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Wang X, Lee NL, Burstyn I. Smoking and use of electronic cigarettes (vaping) in relation to preterm birth and small-for-gestational-age in a 2016 U.S. national sample. Prev Med 2020; 134:106041. [PMID: 32105682 DOI: 10.1016/j.ypmed.2020.106041] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/03/2020] [Accepted: 02/22/2020] [Indexed: 11/18/2022]
Abstract
Women who smoke may be motivated to switch to vaping (use electronic cigarettes, e-cigs) around pregnancy in seeking to alleviate known hazards of smoking. E-cigs typically contain nicotine but either eliminates or greatly reduces exposure to the combustion products of tobacco. We studied a U.S.-wide representative sample of 31,973 live singleton births in 2016. In the three months before pregnancy, 5029 (14%) mothers exclusively smoked tobacco ("sole smokers") and 976 (3%) used both tobacco and e-cigs ("dual-users"). Among pre-pregnancy sole smokers, 44% continued to only smoke while 1% became dual-users in late pregnancy. Logistic regression models were used to assess the adjusted odds ratios (aOR) for preterm and small-for-gestational-age (SGA) by reported smoking or vaping in late pregnancy. Compared to women who used neither product ("non-users"), late-pregnancy sole smokers had increased risks for preterm birth (aOR 1.6, 95% CI 1.2-2.0) and SGA (aOR 2.4, 95% CI 1.8-2.9), after adjusting for their pre-pregnancy smoking or vaping status and other confounders. The adjusted models also showed that late-pregnancy sole vapers had similar risk of preterm birth as non-users (aOR 1.2, 95% CI 0.5-2.7). Late-pregnancy dual-users also had similar risk of preterm birth as non-users (aOR 1.3, 95% CI 0.8-2.3). However, late-pregnancy sole vapers and dual-users had increased risk of SGA compared to non-users (aOR 2.4, 95% CI 1.0-5.7 for sole vapers, and aOR 2.3 95% CI 1.3-4.1 for dual-users). These findings suggest that vapers during pregnancy had similar risk of preterm as non-users but still had elevated risk for restricted fetal growth.
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Affiliation(s)
- Xi Wang
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America.
| | - Nora L Lee
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, United States of America
| | - Igor Burstyn
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, United States of America; Department of Environmental and Occupational Health, Drexel University, Philadelphia, PA, United States of America
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77
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Effect of electronic cigarette aerosol exposure during gestation and lactation on learning and memory of adult male offspring rats. Physiol Behav 2020; 221:112911. [PMID: 32289318 DOI: 10.1016/j.physbeh.2020.112911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/14/2020] [Accepted: 04/03/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Electronic cigarette (ECIG) use has increased worldwide, including among pregnant and breastfeeding women. In this study, we examined the effect of ECIG aerosol exposure during gestation and lactation on learning and memory of adult male offspring rats. METHODS Rats were exposed to either fresh air or ECIG aerosol for one hour daily during gestational period as well as days 4-21 of lactation. Male offspring were followed through 19 weeks and then spatial learning and memory were tested by radial arm water maze (RAWM). The hippocampus was examined for biomarkers of harm, including oxidative stress, superoxide dismutase, catalase, glutathione peroxidase and thiobarbituric acid reactive substances and brain derived neurotrophic factor (BDNF). RESULTS Relative to exposure to fresh air, exposure to ECIG aerosol during gestation/lactation impaired long-term memory in adult offspring (P < 0.05). This impairment was associated with increased activity of superoxide dismutase in the hippocampus (P < 0.05). BDNF and the other tested oxidative stress biomarkers were not affected by ECIG aerosol exposure (p > 0.05). CONCLUSIONS In conclusion, ECIG aerosol exposure during gestation and lactation impaired long-term memory and increased the activity of superoxide dismutase in the hippocampus of offspring adult rats. These results support the development of strategies to enhance ECIG cessation during pregnancy and breastfeeding.
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78
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Ruszkiewicz JA, Zhang Z, Gonçalves FM, Tizabi Y, Zelikoff JT, Aschner M. Neurotoxicity of e-cigarettes. Food Chem Toxicol 2020; 138:111245. [PMID: 32145355 PMCID: PMC7089837 DOI: 10.1016/j.fct.2020.111245] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 02/29/2020] [Accepted: 03/03/2020] [Indexed: 02/07/2023]
Abstract
It appears that electronic cigarettes (EC) are a less harmful alternative to conventional cigarette (CC) smoking, as they generate substantially lower levels of harmful carcinogens and other toxic compounds. Thus, switching from CC to EC may be beneficial for smokers. However, recent accounts of EC- or vaping-associated lung injury (EVALI) has raised concerns regarding their adverse health effects. Additionally, the increasing popularity of EC among vulnerable populations, such as adolescents and pregnant women, calls for further EC safety evaluation. In this state-of-the-art review, we provide an update on recent findings regarding the neurological effects induced by EC exposure. Moreover, we discuss possible neurotoxic effects of nicotine and numerous other chemicals which are inherent both to e-liquids and EC aerosols. We conclude that in recognizing pertinent issues associated with EC usage, both government and scientific researchers must address this public health issue with utmost urgency.
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Affiliation(s)
- Joanna A Ruszkiewicz
- Molecular Toxicology Group, Department of Biology, University of Konstanz, Konstanz, Germany
| | - Ziyan Zhang
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Filipe Marques Gonçalves
- Biochemistry Graduate Program, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Yousef Tizabi
- Department of Pharmacology, Howard University College of Medicine, Washington DC, United States
| | - Judith T Zelikoff
- Department of Environmental Medicine, New York University School of Medicine, Manhattan, NY, United States
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, United States.
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79
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Church JS, Chace-Donahue F, Blum JL, Ratner JR, Zelikoff JT, Schwartzer JJ. Neuroinflammatory and Behavioral Outcomes Measured in Adult Offspring of Mice Exposed Prenatally to E-Cigarette Aerosols. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:47006. [PMID: 32293200 PMCID: PMC7228099 DOI: 10.1289/ehp6067] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND In an effort to decrease the rates of smoking conventional tobacco cigarettes, electronic cigarettes (e-cigarettes) have been proposed as an effective smoking cessation tool. However, little is known about their toxicological impacts. This is concerning given that e-cigarette use is perceived as less harmful than conventional tobacco cigarettes during pregnancy for both the mother and fetus. OBJECTIVE The goal of this study was to test the neurodevelopmental consequences of maternal e-cigarette use on adult offspring behavior and neuroimmune outcomes. METHODS Pregnant female CD-1 mice were randomly assigned to one of three treatment groups (n=8-10 per group) and exposed daily to either filtered air, propylene glycol and vegetable glycerol (50:50 PG/VG vehicle), or to PG/VG with 16mg/mL nicotine (+Nic). Whole-body exposures were carried out for 3 h/d, 7 d/week, from gestational day (GD)0.5 until GD17.5. Adult male and female offspring (8 weeks old) were assessed across a battery of behavioral assessments followed by region-specific quantification of brain cytokines using multiplex immunoassays. RESULTS Adult offspring of both sexes exposed to +Nic exhibited elevated locomotor activity in the elevated plus maze and altered stress-coping strategies in the forced swim task. Moreover, male and female offspring exposed to PG/VG with and without nicotine had a 5.2% lower object discrimination score in the novel object recognition task. In addition to differences in offspring behavior, maternal e-cigarette exposure with nicotine led to a reduction in interleukin (IL)-4 and interferon-gamma (IFNγ) in the diencephalon, as well as lower levels of hippocampal IFNγ (females only). E-cigarette exposure without nicotine resulted in a 2-fold increase of IL-6 in the cerebellum. DISCUSSION These findings support previous adverse findings of e-cigarette exposure on neurodevelopment in a mouse model and provide substantial evidence of persistent adverse behavioral and neuroimmunological consequences to adult offspring following maternal e-cigarette exposure during pregnancy. https://doi.org/10.1289/EHP6067.
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Affiliation(s)
- Jamie S. Church
- Program in Neuroscience and Behavior, Department of Psychology and Education, Mount Holyoke College, South Hadley, Massachusetts, USA
| | - Fiona Chace-Donahue
- Program in Neuroscience and Behavior, Department of Psychology and Education, Mount Holyoke College, South Hadley, Massachusetts, USA
| | - Jason L. Blum
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Jill R. Ratner
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Judith T. Zelikoff
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Jared J. Schwartzer
- Program in Neuroscience and Behavior, Department of Psychology and Education, Mount Holyoke College, South Hadley, Massachusetts, USA
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80
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E-cigarette use in reproductive-aged women and pregnancy: a rising health concern. Fertil Steril 2020; 113:1133-1134. [PMID: 32222252 DOI: 10.1016/j.fertnstert.2020.01.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 11/21/2022]
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Buck JM, O'Neill HC, Stitzel JA. Developmental nicotine exposure engenders intergenerational downregulation and aberrant posttranslational modification of cardinal epigenetic factors in the frontal cortices, striata, and hippocampi of adolescent mice. Epigenetics Chromatin 2020; 13:13. [PMID: 32138755 PMCID: PMC7059320 DOI: 10.1186/s13072-020-00332-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 02/19/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Maternal smoking of traditional or electronic cigarettes during pregnancy, which constitutes developmental nicotine exposure (DNE), heightens the risk of neurodevelopmental disorders including ADHD, autism, and schizophrenia in children. Modeling the intergenerationally transmissible impacts of smoking during pregnancy, we previously demonstrated that both the first- and second-generation adolescent offspring of nicotine-exposed female mice exhibit enhanced nicotine preference, hyperactivity and risk-taking behaviors, aberrant rhythmicity of home cage activity, nicotinic acetylcholine receptor and dopamine transporter dysfunction, impaired furin-mediated proBDNF proteolysis, hypocorticosteronemia-related glucocorticoid receptor hypoactivity, and global DNA hypomethylation in the frontal cortices and striata. This ensemble of multigenerational DNE-induced behavioral, neuropharmacological, neurotrophic, neuroendocrine, and DNA methylomic anomalies recapitulates the pathosymptomatology of neurodevelopmental disorders such as ADHD, autism, and schizophrenia. Further probing the epigenetic bases of DNE-induced multigenerational phenotypic aberrations, the present study examined the expression and phosphorylation of key epigenetic factors via an array of immunoblot experiments. RESULTS Data indicate that DNE confers intergenerational deficits in corticostriatal DNA methyltransferase 3A (DNMT3A) expression accompanied by downregulation of methyl-CpG-binding protein 2 (MeCP2) and histone deacetylase 2 (HDAC2) in the frontal cortices and hippocampi, while the expression of ten-eleven translocase methylcytosine dioxygenase 2 (TET2) is unaltered. Moreover, DNE evokes multigenerational abnormalities in HDAC2 (Ser394) but not MeCP2 (Ser421) phosphorylation in the frontal cortices, striata, and hippocampi. CONCLUSIONS In light of the extensive gene regulatory roles of DNMT3A, MeCP2, and HDAC2, the findings of this study that DNE elicits downregulation and aberrant posttranslational modification of these factors in both first- and second-generation DNE mice suggest that epigenetic perturbations may constitute a mechanistic hub for the intergenerational transmission of DNE-induced neurodevelopmental disorder-like phenotypes.
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Affiliation(s)
- Jordan M Buck
- Institute for Behavioral Genetics, University of Colorado, 1480 30th Street, Boulder, CO, 80309-0447, USA.
- Department of Integrative Physiology, University of Colorado, Boulder, USA.
| | - Heidi C O'Neill
- Institute for Behavioral Genetics, University of Colorado, 1480 30th Street, Boulder, CO, 80309-0447, USA
| | - Jerry A Stitzel
- Institute for Behavioral Genetics, University of Colorado, 1480 30th Street, Boulder, CO, 80309-0447, USA
- Department of Integrative Physiology, University of Colorado, Boulder, USA
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82
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Noël A, Hansen S, Zaman A, Perveen Z, Pinkston R, Hossain E, Xiao R, Penn A. In utero exposures to electronic-cigarette aerosols impair the Wnt signaling during mouse lung development. Am J Physiol Lung Cell Mol Physiol 2020; 318:L705-L722. [PMID: 32083945 DOI: 10.1152/ajplung.00408.2019] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Currently, more than 9 million American adults, including women of childbearing age, use electronic-cigarettes (e-cigs). Further, the prevalence of maternal vaping now approaching 10% is similar to that of maternal smoking. Little, however, is known about the effects of fetal exposures to nicotine-rich e-cig aerosols on lung development. In this study, we assessed whether in utero exposures to e-cig aerosols compromised lung development in mice. A third-generation e-cig device was used to expose pregnant BALB/c mice by inhalation to 36 mg/mL of nicotine cinnamon-flavored e-cig aerosols for 14-31 days. This included exposures for either 12 days before mating plus during gestation (preconception groups) or only during gestation (prenatal groups). Respective control mice were exposed to filtered air. Subgroups of offspring were euthanized at birth or at 4 wk of age. Compared with respective air-exposed controls, both preconception and prenatal exposures to e-cig aerosols significantly decreased the offspring birth weight and body length. In the preconception group, 7 inflammation-related genes were downregulated, including 4 genes common to both dams and fetuses, denoting an e-cig immunosuppressive effect. Lung morphometry assessments of preconception e-cig-exposed offspring showed a significantly increased tissue fraction at birth. This result was supported by the downregulation of 75 lung genes involved in the Wnt signaling, which is essential to lung organogenesis. Thus, our data indicate that maternal vaping impairs pregnancy outcomes, alters fetal lung structure, and dysregulates the Wnt signaling. This study provides experimental evidence for future regulations of e-cig products for pregnant women and developmentally vulnerable populations.
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Affiliation(s)
- Alexandra Noël
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - Shannon Hansen
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - Anusha Zaman
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - Zakia Perveen
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - Rakeysha Pinkston
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana.,Health Research Center, Department of Environmental Toxicology, Southern University and A&M College, Baton Rouge, Louisiana
| | - Ekhtear Hossain
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - Rui Xiao
- Department of Anesthesiology, Columbia University Medical Center, New York, New York
| | - Arthur Penn
- Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
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83
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Kurti AN, Bunn JY, Tang K, Nighbor T, Gaalema DE, Coleman-Cowger V, Coleman SRM, Higgins ST. Impact of electronic nicotine delivery systems and other respondent characteristics on tobacco use transitions among a U.S. national sample of women of reproductive age. Drug Alcohol Depend 2020; 207:107801. [PMID: 31855658 PMCID: PMC6981035 DOI: 10.1016/j.drugalcdep.2019.107801] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 11/26/2019] [Accepted: 11/26/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Identifying predictors of tobacco use patterns that differ in harm among reproductive-aged women may inform efforts to protect women and children against adverse health impacts of tobacco use. METHODS Changes in tobacco use patterns were examined among women (18-49 years) who completed Wave 1 (W1) and Wave 2 (W2), or W2 and Wave 3 (W3) of the U.S. Population Assessment of Tobacco and Health (PATH, 2013-2016) study, and were using cigarettes, filtered cigars and/or cigarillos in the first wave over which data were included for that respondent (Time 1; T1). We examined the proportion of respondents whose tobacco use transitions from T1 to Time 2 (T2) were harm-maintaining (continued using combusted tobacco), harm-reducing (transitioned to electronic nicotine delivery systems (ENDS), or harm-eliminating (quit tobacco). Multinomial logistic regressions (with harm-maintaining as the baseline category) were conducted to examine associations between ENDS use, demographic, and psychosocial characteristics with each transition. RESULTS A majority of women (83 %) exhibited harm-maintaining transitions, followed by harm-eliminating (14.7 %) and harm-reducing (2.3 %) transitions. Use of ENDS at T1 was associated with increased odds of harm reduction and decreased odds of harm elimination. Younger women were more likely to make both harm-reducing and harm-eliminating transitions. Increased educational attainment, identifying as Black or Hispanic, increased psychiatric symptoms, and pregnancy were associated with harm elimination, whereas living at or above poverty was associated with harm reduction. CONCLUSIONS Study results contribute new information on the impact of ENDS, sociodemographic characteristics, psychiatric symptoms, and pregnancy on tobacco use transitions among reproductive-aged women.
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Affiliation(s)
- Allison N Kurti
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA; Department of Psychological Science, University of Vermont, Burlington, VT, USA.
| | - Janice Y Bunn
- Department of Medical Biostatistics, University of Vermont, Burlington, VT, USA
| | - Katherine Tang
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Tyler Nighbor
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA; Department of Psychological Science, University of Vermont, Burlington, VT, USA
| | | | - Sulamunn R M Coleman
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, USA; Department of Psychiatry, University of Vermont, Burlington, VT, USA; Department of Psychological Science, University of Vermont, Burlington, VT, USA
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84
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Desai N. Smoking and pregnancy: The era of electronic nicotine delivery systems. Obstet Med 2020; 13:154-158. [PMID: 33343691 DOI: 10.1177/1753495x19893224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/12/2019] [Indexed: 11/16/2022] Open
Abstract
Electronic nicotine delivery systems have been commercially available in the United States since 2007. Despite a decrease in combustible cigarette use, electronic nicotine delivery systems use has dramatically increased among both adults and adolescents. These devices have been marketed as smoking cessation aids, although data on their efficacy are scarce. Pregnant women are an especially vulnerable population susceptible to claims of safety and efficacy, and the medical community remains inadequately informed on how to counsel these women. The purpose of this article is to review known literature regarding the use of electronic nicotine delivery systems in pregnancy, to understand the differences between cigarettes and electronic nicotine delivery systems use in pregnancy, and to further guide clinicians on how to advise the pregnant woman on their use.
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Affiliation(s)
- Nikita Desai
- Respiratory Institute, Pulmonary and Critical Care Medicine, Cleveland Clinic, Cleveland, OH, USA
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85
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Collins L, Glasser AM, Abudayyeh H, Pearson JL, Villanti AC. E-Cigarette Marketing and Communication: How E-Cigarette Companies Market E-Cigarettes and the Public Engages with E-cigarette Information. Nicotine Tob Res 2020; 21:14-24. [PMID: 29315420 DOI: 10.1093/ntr/ntx284] [Citation(s) in RCA: 179] [Impact Index Per Article: 44.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 12/28/2017] [Indexed: 12/26/2022]
Abstract
Introduction Given the lack of regulation on marketing of electronic cigarettes (e-cigarettes) in the United States and the increasing exchange of e-cigarette-related information online, it is critical to understand how e-cigarette companies market e-cigarettes and how the public engages with e-cigarette information. Methods Results are from a systematic review of peer-reviewed literature on e-cigarettes via a PubMed search through June 1, 2017. Search terms included: "e-cigarette*" or "electronic cigarette" or "electronic cigarettes" or "electronic nicotine delivery" or "vape" or "vaping." Experimental studies, quasi-experimental studies, observational studies, qualitative studies, and mixed methods studies providing empirical findings on e-cigarette marketing and communication (ie, nonmarketing communication in the public) were included. Results One hundred twenty-four publications on e-cigarette marketing and communication were identified. They covered topics including e-cigarette advertisement claims/promotions and exposure/receptivity, the effect of e-cigarette advertisements on e-cigarette and cigarette use, public engagement with e-cigarette information, and the public's portrayal of e-cigarettes. Studies show increases in e-cigarette marketing expenditures and online engagement through social media over time, that e-cigarettes are often framed as an alternative to combustible cigarettes, and that e-cigarette advertisement exposure may be associated with e-cigarette trial in adolescents and young adults. Discussion Few studies examine the effects of e-cigarette marketing on perceptions and e-cigarette and cigarette use. Evidence suggests that exposure to e-cigarette advertisements affects perceptions and trial of e-cigarettes, but there is no evidence that exposure affects cigarette use. No studies examined how exposure to e-cigarette communication, particularly misleading or inaccurate information, impacts e-cigarette, and tobacco use behaviors. Implications The present article provides a comprehensive review of e-cigarette marketing and how the public engages with e-cigarette information. Studies suggest an association between exposure to e-cigarette marketing and lower harm perceptions of e-cigarettes, intention to use e-cigarettes, and e-cigarette trial, highlighting the need to for advertising regulations that support public health goals. Findings from this review also present the methodological limitations of the existing research (primarily due to cross-sectional and correlational analyses) and underscore the need for timely, rigorous research to provide an accurate understanding of e-cigarette marketing and communication and its impact on e-cigarette and tobacco product use.
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Affiliation(s)
- Lauren Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Allison M Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Haneen Abudayyeh
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Jennifer L Pearson
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,School of Community Health Sciences, University of Nevada, Reno, NV
| | - Andrea C Villanti
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT
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86
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Hawkins SS, Wylie BJ, Hacker MR. Use of ENDS and Cigarettes During Pregnancy. Am J Prev Med 2020; 58:122-128. [PMID: 31862099 DOI: 10.1016/j.amepre.2019.08.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Although the use of alternative tobacco products has been increasing among women and adolescents, research on the use of ENDS during pregnancy has been limited. This study examines the prevalence and sociodemographic characteristics of ENDS and cigarette use during pregnancy. METHODS This cross-sectional analysis of the 2016 Pregnancy Risk Assessment Monitoring System used data on self-reported use of ENDS and cigarettes during the last 3 months of pregnancy among 33,964 women from 29 states and New York City. Data were analyzed in 2019. RESULTS The overall prevalence of prenatal ENDS use was 1.2% and cigarette use was 7.7%, varying from 0.6% and 1.8% in New York City to 4.4% and 22.7% in West Virginia. In adjusted models, white women were more likely to use ENDS (AOR=4.68, 95% CI=2.91, 7.54) than black women. Women with increasing years of education were also less likely to use ENDS. Women who used cigarettes during pregnancy were 11.05 times (95% CI=7.40, 16.48) more likely to also use ENDS prenatally. Associations between sociodemographic characteristics and cigarette use during pregnancy were consistent with the findings for ENDS. CONCLUSIONS Pregnant women across the U.S. are using ENDS and cigarettes. Surveillance is essential to continue monitoring trends in prenatal use of tobacco products and understand the implications on pregnancy and infant outcomes.
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Affiliation(s)
| | - Blair Johnson Wylie
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
| | - Michele R Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts
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87
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Schilling L, Schneider S, Maul H, Spallek J. STudy on E-Cigarettes and Pregnancy (STEP) - Study Protocol of a Mixed Methods Study on Risk Perception of E-Cigarette Use During Pregnancy and Sample Description. Geburtshilfe Frauenheilkd 2020; 80:66-75. [PMID: 31949321 PMCID: PMC6957352 DOI: 10.1055/a-1061-7288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 01/08/2023] Open
Abstract
Introduction During pregnancy, the mother's healthy lifestyle is crucial for the health of the fetus. Potential risk factors for maternal and child health should therefore be identified and reduced as early as possible. The consumption of e-cigarettes represents one of these potential risk factors. Exploring risk perceptions about e-cigarette use during pregnancy can provide early indications of possible user motives. Therefore, our mixed methods ST udy on E -cigarettes and P regnancy (STEP) aimed to comprehensively analyze risk perceptions about e-cigarette use during pregnancy based on an I ntegrated H ealth B elief M odel (IHBM). This paper describes the study design, methods, sample population and limitations of STEP. Methods Our sequential mixed methods study combined qualitative and quantitative approaches. In the qualitative section of the study which preceded the quantitative part of the study, we aimed to characterize risk perceptions about e-cigarette use during pregnancy. We used a netnographic research approach which analyzed discussion threads in online forums dealing with e-cigarette use during pregnancy. The analysis was based on an IHBM. Identified themes were incorporated in the questionnaire which was developed for the quantitative part of the study. The quantitative section aimed to quantify, among other things, perceived threats, barriers and benefits and to explore differences in risk perception according to sociodemographic characteristics and tobacco and e-cigarette usage. Results In the qualitative section, 1552 posts in 25 online discussion threads dealing, inter alia, with e-cigarette use during pregnancy were identified. The quantitative part looked at the responses in the questionnaires handed in by 575 pregnant women who attended a hospital in Hamburg (Germany) from April 2018 to January 2019 (response rate: 27.5%). Conclusion Data collection was successful for both the qualitative and quantitative parts of the study. When interpreting the results of STEP, different limitations should be taken into account. The results of STEP provide starting points for the development of tailored preventive measures for pregnant women.
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Affiliation(s)
- Laura Schilling
- Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sven Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany
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88
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Seelan RS, Greene RM, Pisano MM. MicroRNAs as Epigenetic Targets of Cigarette Smoke During Embryonic Development. Microrna 2020; 9:168-173. [PMID: 31556862 PMCID: PMC7365999 DOI: 10.2174/2211536608666190926114704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/26/2019] [Accepted: 09/03/2019] [Indexed: 02/07/2023]
Abstract
The adverse developmental effects of exposure to Cigarette Smoke (CS) during pregnancy are documented in this paper. These include low birth weight, congenital anomalies, preterm birth, fetal mortality and morbidity. The current biological thought now recognizes that epigenetics represents a fundamental contributing process in embryogenesis, and that the environment can have a profound effect on shaping the epigenome. It has become increasingly recognized that genes encoding microRNAs (miRNAs) might be potential loci for congenital disabilities. One means by which CS can cause developmental anomalies may be through epigenetic mechanisms involving altered miRNA expression. While several studies have focused on genes affected by CS during embryonic/ fetal development, there is a paucity of knowledge on the involvement of miRNAs in this process. This brief review summarizes the current state of knowledge in this area.
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Affiliation(s)
- Ratnam S. Seelan
- Department of Oral Immunology and Infectious Diseases, Division of Craniofacial Development and Anomalies,
University of Louisville School of Dentistry, Louisville, KY40202, USA
| | - Robert M. Greene
- Department of Oral Immunology and Infectious Diseases, Division of Craniofacial Development and Anomalies,
University of Louisville School of Dentistry, Louisville, KY40202, USA
| | - Michele M. Pisano
- Department of Oral Immunology and Infectious Diseases, Division of Craniofacial Development and Anomalies,
University of Louisville School of Dentistry, Louisville, KY40202, USA
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89
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Wanasinghe D, Shah S, Bamanikar A, Aboudi D, Mikkilineni S, Shyong O, Wu N, Lavan T, Brumberg HL. Lifestyle characteristics of parental electronic cigarette and marijuana users: healthy or not? J Perinat Med 2019; 48:59-66. [PMID: 31855571 DOI: 10.1515/jpm-2019-0392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/02/2019] [Indexed: 01/15/2023]
Abstract
Objective To assess lifestyle characteristics among parental electronic cigarette (e-cigarette), marijuana and tobacco users. Methods A total of 1214 parents (77% mothers and 23% fathers) were surveyed and categorized into five exposure groups: e-cigarette use only (1%), marijuana use only (3%), tobacco products only (10%), multi-exposed [11% (marijuana, e-cigarette and tobacco)], and non-users [75% (no e-cigarette, tobacco or marijuana)]. Results Similar to non-users, the e-cigarette group had no illicit drug use. Further, e-cigarette users were more likely, in adjusted models, to self-identify as non-smokers and exercise compared with tobacco and multi-exposed groups. Although marijuana users also had higher odds of self-identifying as non-smokers compared to tobacco and multi-exposed groups, they were more likely than non-users to drink alcohol. Conclusion E-cigarette and marijuana using parents were less likely to identify as smokers. E-cigarette users had healthier lifestyle characteristics than the other exposed groups. Clinicians should consider specifically screening for parental e-cigarette and marijuana use as assessing for only "smoking" may underrepresent first-and second-hand exposure. Additionally, clinicians should be aware that marijuana using parents are more likely to drink alcohol and should counsel accordingly.
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Affiliation(s)
- Dilani Wanasinghe
- The Regional Neonatal Center, Division of Newborn Medicine, New York Medical College, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY, USA
| | - Shetal Shah
- The Regional Neonatal Center, Division of Newborn Medicine, New York Medical College, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY, USA
| | - Amruta Bamanikar
- Jersey Shore University Medical Center - a University Level Affiliate of Rutgers Robert Wood Johnson, Neptune, NJ, USA
| | - David Aboudi
- The Regional Neonatal Center, Division of Newborn Medicine, New York Medical College, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY, USA
| | | | - Olivia Shyong
- Westchester Medical Center, New York Medical College, Valhalla, NY, USA
| | - Natasha Wu
- Geisinger School of Medicine, Wilkes-Barre, PA, USA
| | | | - Heather L Brumberg
- The Regional Neonatal Center, Division of Newborn Medicine, New York Medical College, Maria Fareri Children's Hospital at Westchester Medical Center, Valhalla, NY, USA.,Department of Pediatrics, Division of Newborn Medicine, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, 100 Woods Road, Valhalla, NY 10595, USA
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90
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Hilpert M, Ilievski V, Coady M, Andrade-Gutierrez M, Yan B, Chillrud SN, Navas-Acien A, Kleiman NJ. A custom-built low-cost chamber for exposing rodents to e-cigarette aerosol: practical considerations. Inhal Toxicol 2019; 31:399-408. [PMID: 31797690 DOI: 10.1080/08958378.2019.1698678] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: To (1) design and build a low-cost exposure chamber system for whole-body exposure of rodents to electronic cigarette aerosol, (2) provide detailed instructions with particular focus on automated e-cigarette activation, and (3) develop a simple mathematical model for aerosol levels in the exposure chamber.Methods: We built the system with standard laboratory equipment and an open-source electronics platform (Arduino) for e-cigarette activation. Arduino is used to control a solenoid, which pushes the activation button of so-called "Mod" e-cigarettes, and a pump to move the aerosol from the mouthpiece of the e-cigarette into the chamber. For "Pods" and "Cigalikes," the solenoid is not used as they are activated by the vacuum created by the pump. Aerosol concentrations were measured with a light-scattering laser photometer.Results: The system allows varying the air exchange rate, monitoring aerosol levels, and programing arbitrary puff topography. Aerosol concentrations observed for different chamber operating conditions (puff time and period, e-cigarette power output, air exchange rate) were consistent with the mathematical model.Conclusions: Our low-cost exposure chamber can be used in animal experimental studies of the health effects of e-cigarettes. Our model allows estimating design parameters such as chamber volume, air exchange rate, and puff period.
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Affiliation(s)
- Markus Hilpert
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Vesna Ilievski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Maxine Coady
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | | | - Beizhan Yan
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY, USA
| | - Steven N Chillrud
- Lamont-Doherty Earth Observatory, Columbia University, Palisades, NY, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Norman J Kleiman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
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91
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Dwyer JB, Cardenas A, Franke RM, Chen Y, Bai Y, Belluzzi JD, Lotfipour S, Leslie FM. Prenatal nicotine sex-dependently alters adolescent dopamine system development. Transl Psychiatry 2019; 9:304. [PMID: 31740669 PMCID: PMC6861272 DOI: 10.1038/s41398-019-0640-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 09/23/2019] [Accepted: 10/20/2019] [Indexed: 02/06/2023] Open
Abstract
Despite persistent public health initiatives, many women continue to smoke during pregnancy. Since maternal smoking has been linked to persisting sex-dependent neurobehavioral deficits in offspring, some consider nicotine to be a safer alternative to tobacco during pregnancy, and the use of electronic nicotine delivery systems is on the rise. We presently show, however, that sustained exposure to low doses of nicotine during fetal development, approximating plasma levels seen clinically with the nicotine patch, produces substantial changes in developing corticostriatal dopamine systems in adolescence. Briefly, pregnant dams were implanted on gestational day 4 with an osmotic minipump that delivered either saline (GS) or nicotine (3 mg/kg/day) (GN) for two weeks. At birth, pups were cross-fostered with treatment naïve dams and were handled daily. Biochemical analyses, signaling assays, and behavioral responses to cocaine were assessed on postnatal day 32, representative of adolescence in the rodent. GN treatment had both sex-dependent and sex-independent effects on prefrontal dopamine systems, altering Catechol-O-methyl transferase (COMT)-dependent dopamine turnover in males and norepinephrine transporter (NET) binding expression in both sexes. GN enhanced cocaine-induced locomotor activity in females, concomitant with GN-induced reductions in striatal dopamine transporter (DAT) binding. GN enhanced ventral striatal D2-like receptor expression and G-protein coupling, while altering the roles of D2 and D3 receptors in cocaine-induced behaviors. These data show that low-dose prenatal nicotine treatment sex-dependently alters corticostriatal dopamine system development, which may underlie clinical deficits seen in adolescents exposed to tobacco or nicotine in utero.
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Affiliation(s)
- Jennifer B. Dwyer
- 0000 0001 0668 7243grid.266093.8Department of Pharmacology, University of California, 360 Med Surge II, Irvine, CA 92697 USA
| | - Anjelica Cardenas
- 0000 0001 0668 7243grid.266093.8Department of Pharmacology, University of California, 360 Med Surge II, Irvine, CA 92697 USA
| | - Ryan M. Franke
- 0000 0001 0668 7243grid.266093.8Department of Pharmacology, University of California, 360 Med Surge II, Irvine, CA 92697 USA
| | - YiLing Chen
- 0000 0001 0668 7243grid.266093.8Department of Pharmacology, University of California, 360 Med Surge II, Irvine, CA 92697 USA
| | - Yu Bai
- 0000 0001 0668 7243grid.266093.8Department of Emergency Medicine, School of Medicine, University of California, Irvine, CA 92697 USA
| | - James D. Belluzzi
- 0000 0001 0668 7243grid.266093.8Department of Pharmacology, University of California, 360 Med Surge II, Irvine, CA 92697 USA
| | - Shahrdad Lotfipour
- 0000 0001 0668 7243grid.266093.8Department of Pharmacology, University of California, 360 Med Surge II, Irvine, CA 92697 USA ,0000 0001 0668 7243grid.266093.8Department of Emergency Medicine, School of Medicine, University of California, Irvine, CA 92697 USA
| | - Frances M. Leslie
- 0000 0001 0668 7243grid.266093.8Department of Pharmacology, University of California, 360 Med Surge II, Irvine, CA 92697 USA ,0000 0001 0668 7243grid.266093.8Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, CA 92697 USA
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92
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Hammer B, Wagner C, Divac Rankov A, Reuter S, Bartel S, Hylkema MN, Krüger A, Svanes C, Krauss-Etschmann S. In utero exposure to cigarette smoke and effects across generations: A conference of animals on asthma. Clin Exp Allergy 2019; 48:1378-1390. [PMID: 30244507 DOI: 10.1111/cea.13283] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 07/24/2018] [Accepted: 09/01/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND The prevalence of asthma and chronic obstructive pulmonary disease (COPD) has risen markedly over the last decades and is reaching epidemic proportions. However, underlying molecular mechanisms are not fully understood, hampering the urgently needed development of approaches to prevent these diseases. It is well established from epidemiological studies that prenatal exposure to cigarette smoke is one of the main risk factors for aberrant lung function development or reduced fetal growth, but also for the development of asthma and possibly COPD later in life. Of note, recent evidence suggests that the disease risk can be transferred across generations, that is, from grandparents to their grandchildren. While initial studies in mouse models on in utero smoke exposure have provided important mechanistic insights, there are still knowledge gaps that need to be filled. OBJECTIVE Thus, in this review, we summarize current knowledge on this topic derived from mouse models, while also introducing two other relevant animal models: the fruit fly Drosophila melanogaster and the zebrafish Danio rerio. METHODS This review is based on an intensive review of PubMed-listed transgenerational animal studies from 1902 to 2018 and focuses in detail on selected literature due to space limitations. RESULTS This review gives a comprehensive overview of mechanistic insights obtained in studies with the three species, while highlighting the remaining knowledge gaps. We will further discuss potential (dis)advantages of all three animal models. CONCLUSION/CLINICAL RELEVANCE Many studies have already addressed transgenerational inheritance of disease risk in mouse, zebrafish or fly models. We here propose a novel strategy for how these three model organisms can be synergistically combined to achieve a more detailed understanding of in utero cigarette smoke-induced transgenerational inheritance of disease risk.
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Affiliation(s)
- Barbara Hammer
- Early Life Origins of Chronic Lung Diseases, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL), Borstel, Germany
| | - Christina Wagner
- Invertebrate Models, Research Center Borstel, Leibniz Lung Center, Borstel, Germany
| | - Aleksandra Divac Rankov
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade, Serbia
| | - Sebastian Reuter
- Department of Pulmonary Medicine, University Hospital Essen - Ruhrlandklinik, Essen, Germany
| | - Sabine Bartel
- Early Life Origins of Chronic Lung Diseases, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL), Borstel, Germany
| | - Machteld N Hylkema
- GRIAC Research Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Pathology and Medical Biology, University Medical Center Groningen, Groningen, The Netherlands
| | - Arne Krüger
- Early Life Origins of Chronic Lung Diseases, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL), Borstel, Germany.,Institute for Life Science and Technology, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - Cecilie Svanes
- Centre for International Health, University of Bergen, Bergen, Norway.,Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Susanne Krauss-Etschmann
- Early Life Origins of Chronic Lung Diseases, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL), Borstel, Germany.,Institute for Experimental Medicine, Christian-Albrechts-Universitaet zu Kiel, Kiel, Germany
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93
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Breland A, McCubbin A, Ashford K. Electronic nicotine delivery systems and pregnancy: Recent research on perceptions, cessation, and toxicant delivery. Birth Defects Res 2019; 111:1284-1293. [PMID: 31364280 PMCID: PMC7121906 DOI: 10.1002/bdr2.1561] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/15/2019] [Accepted: 07/16/2019] [Indexed: 01/09/2023]
Abstract
Electronic nicotine delivery systems (ENDS), which includes e-cigarettes (ECIGs), are a rapidly-expanding class of products that heat a liquid (which may or may not contain nicotine) to produce an aerosol. The variation of ECIG components is extensive as are their effects on users. Epidemiological data show that while both adults and youth use ECIGs, use among youth has increased dramatically in recent years. Other epidemiological data show that women of reproductive age and some pregnant women are also using ECIGs. The goal of this article is to provide readers with background information about ECIGs, with a focus on recent findings about ECIG use in pregnancy and potential implications. Among pregnant women, correlates of ECIG use include current cigarette smoking, among other factors. Regarding pregnant women's perceptions of ECIG use in pregnancy, two themes emerge from the literature: many pregnant women perceive ECIGs to be safer than conventional cigarettes, and that ECIGs can aid with smoking cessation. In contrast to these perceptions, there is little concrete evidence that ECIGs help smokers quit. In addition, there are concerns about ECIG nicotine and other toxicant delivery. Nicotine is a toxicant of particular concern for pregnant women, as nicotine is known to harm a developing fetus. There are many limitations to existing research, and the literature is scant in this area. Further, new "pod mod"-style ECIGs such as JUUL present new challenges. Overall, with limited evidence of their effectiveness, and concerns about developmental toxicology, the authors do not recommend that pregnant women use ECIGs.
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Affiliation(s)
- Alison Breland
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Andrea McCubbin
- Perinatal Research and Wellness Center, College of Nursing, University of Kentucky, Lexington, Kentucky
| | - Kristin Ashford
- Perinatal Research and Wellness Center, College of Nursing, University of Kentucky, Lexington, Kentucky
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94
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Wetendorf M, Randall LT, Lemma MT, Hurr SH, Pawlak JB, Tarran R, Doerschuk CM, Caron KM. E-Cigarette Exposure Delays Implantation and Causes Reduced Weight Gain in Female Offspring Exposed In Utero. J Endocr Soc 2019; 3:1907-1916. [PMID: 31598571 PMCID: PMC6777403 DOI: 10.1210/js.2019-00216] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/15/2019] [Indexed: 12/25/2022] Open
Abstract
Electronic nicotine delivery system (e-cigarette) use is prevalent among pregnant women as a seemingly safe alternative to traditional tobacco use, known to result in fetal developmental abnormalities and impaired fertility of male offspring. However, little is known about the effects of e-cigarette use on fertility or pregnancy outcomes. A successful pregnancy is initiated by a multitude of dynamic molecular alterations in the uterus resulting in embryo implantation at day 4.5 in the mouse. We examined whether e-cigarette exposure impairs implantation and offspring health. Pregnant C57BL/6J mice were exposed five times a week to e-cigarette vapor or sham. After 4 months, e-cigarette exposed dams exhibited a significant delay in the onset of the first litter. Furthermore, exposure of new dams in early pregnancy significantly impaired embryo implantation, as evidenced by nearly complete absence of implantation sites in e-cigarette-exposed animals at day 5.5, despite exhibiting high levels of progesterone, an indicator of pregnancy. RNA microarray from day 4.5 pseudopregnant mice revealed significant changes in the integrin, chemokine, and JAK signaling pathways. Moreover, female offspring exposed to e-cigarettes in utero exhibited a significant weight reduction at 8.5 months, whereas males exhibited a slight but nonsignificant deficiency in fertility. Thus, e-cigarette exposure in mice impairs pregnancy initiation and fetal health, suggesting that e-cigarette use by reproductive-aged women or during pregnancy should be considered with caution.
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Affiliation(s)
- Margeaux Wetendorf
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina
| | - Lewis T Randall
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Mahlet T Lemma
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Sophia H Hurr
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina
| | - John B Pawlak
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina
| | - Robert Tarran
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina
| | - Claire M Doerschuk
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Kathleen M Caron
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina
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95
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Berkelhamer SK, Helman JM, Gugino SF, Leigh NJ, Lakshminrusimha S, Goniewicz ML. In Vitro Consequences of Electronic-Cigarette Flavoring Exposure on the Immature Lung. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193635. [PMID: 31569724 PMCID: PMC6801380 DOI: 10.3390/ijerph16193635] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 12/17/2022]
Abstract
Background: The developing lung is uniquely susceptible and may be at increased risk of injury with exposure to e-cigarette constituents. We hypothesize that cellular toxicity and airway and vascular responses with exposure to flavored refill solutions may be altered in the immature lung. Methods: Fetal, neonatal, and adult ovine pulmonary artery smooth muscle cells (PASMC) were exposed to popular flavored nicotine-free e-cigarette refill solutions (menthol, strawberry, tobacco, and vanilla) and unflavored solvents: propylene glycol (PG) or vegetable glycerin (VG). Viability was assessed by lactate dehydrogenase assay. Brochodilation and vasoreactivity were determined on isolated ovine bronchial rings (BR) and pulmonary arteries (PA). Results: Neither PG or VG impacted viability of immature or adult cells; however, exposure to menthol and strawberry flavored solutions increased cell death. Neonatal cells were uniquely susceptible to menthol flavoring-induced toxicity, and all four flavorings demonstrated lower lethal doses (LD50) in immature PASMC. Exposure to flavored solutions induced bronchodilation of neonatal BR, while only menthol induced airway relaxation in adults. In contrast, PG/VG and flavored solutions did not impact vasoreactivity with the exception of menthol-induced relaxation of adult PAs. Conclusion: The immature lung is uniquely susceptible to cellular toxicity and altered airway responses with exposure to common flavored e-cigarette solutions.
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Affiliation(s)
- Sara K Berkelhamer
- Department of Pediatrics, University at Buffalo, SUNY, Buffalo, NY 14203, USA.
| | - Justin M Helman
- Department of Pediatrics, University at Buffalo, SUNY, Buffalo, NY 14203, USA.
| | - Sylvia F Gugino
- Department of Pediatrics, University at Buffalo, SUNY, Buffalo, NY 14203, USA.
| | - Noel J Leigh
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
| | | | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
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96
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Nguyen T, Li GE, Chen H, Cranfield CG, McGrath KC, Gorrie CA. Neurological Effects in the Offspring After Switching From Tobacco Cigarettes to E-Cigarettes During Pregnancy in a Mouse Model. Toxicol Sci 2019; 172:191-200. [PMID: 31505003 DOI: 10.1093/toxsci/kfz194] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 07/25/2019] [Accepted: 08/17/2019] [Indexed: 12/17/2022] Open
Abstract
Abstract
Maternal smoking is currently a public health concern and has been associated with a number of complications in the offspring. E-cigarettes are gaining popularity as a “safer” alternative to tobacco cigarettes during pregnancy, however, there are a limited number of studies to suggest that it is actually “safe.” Balb/C female mice were exposed to ambient air (n = 8; Sham), or tobacco cigarette smoke (n = 8; SE) before gestation, during gestation and lactation. A third group was exposed to cigarette smoke before gestation followed by e-cigarette aerosols during gestation and lactation (n = 8; Switch). Male offspring (12-week old, n = 10–14/group) underwent behavioral assessments to investigate short-term memory, anxiety, and activity using the novel object recognition and elevated plus maze tests. Brains were collected at postnatal day (P)1, P20, and Week 13 for global DNA methylation, epigenetic gene expression, and neuronal cell counts. The offspring from mothers switching to e-cigarettes exhibited no change in exploration/activity but showed a decrease in global DNA methylation, Aurora Kinase (Aurk) A and AurkB gene expression and a reduction in neuronal cell numbers in the cornu ammonis 1 region of the dorsal hippocampus compared with the SE group. Continuous tobacco cigarette smoke exposure during pregnancy resulted in marked neurological deficits in the offspring. Switching to e-cigarettes during pregnancy reduced these neurological deficits compared with cigarette smoke exposure. However, neurological changes were still observed, so we therefore conclude that e-cigarette use during pregnancy is not advised.
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Affiliation(s)
- Tara Nguyen
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, New South Wales 2007, Australia
| | - Gerard E Li
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, New South Wales 2007, Australia
| | - Hui Chen
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, New South Wales 2007, Australia
| | - Charles G Cranfield
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, New South Wales 2007, Australia
| | - Kristine C McGrath
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, New South Wales 2007, Australia
| | - Catherine A Gorrie
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, New South Wales 2007, Australia
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97
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Buck JM, O'Neill HC, Stitzel JA. Developmental nicotine exposure elicits multigenerational disequilibria in proBDNF proteolysis and glucocorticoid signaling in the frontal cortices, striata, and hippocampi of adolescent mice. Biochem Pharmacol 2019; 168:438-451. [PMID: 31404529 DOI: 10.1016/j.bcp.2019.08.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/07/2019] [Indexed: 01/03/2023]
Abstract
Maternal smoking of conventional or vapor cigarettes during pregnancy, a form of developmental nicotine exposure (DNE), enhances the risk of neurodevelopmental disorders such as ADHD, autism, and schizophrenia in children. Modeling the multigenerational effects of smoking during pregnancy and nursing in the first- (F1) and second- (F2) generation adolescent offspring of oral nicotine-treated female C57BL/6J mice, we have previously reported that DNE precipitates intergenerational transmission of nicotine preference, hyperactivity and impulsivity-like behaviors, altered rhythmicity of home cage activity, corticostriatal nicotinic acetylcholine receptor and dopamine transporter dysfunction, and corticostriatal global DNA methylome deficits. In aggregate, these DNE-evoked behavioral, neuropharmacological, and epigenomic anomalies mirror fundamental etiological aspects of neurodevelopmental disorders including ADHD, autism, and schizophrenia. Expanding this line of research, the current study profiled the multigenerational neurotrophic and neuroendocrine consequences of DNE. Results reveal impaired proBDNF proteolysis as indicated by proBDNF-BDNF imbalance, downregulation of the proBDNF processing enzyme furin, atypical glucocorticoid receptor (GR) activity as implied by decreased relative nuclear GR localization, and deficient basal plasma corticosterone (CORT) levels in adolescent DNE offspring and grandoffspring. Collectively, these data recapitulate the BDNF deficits and HPA axis dysregulation characteristic of neurodevelopmental disorders such as ADHD, autism, and schizophrenia as well as the children of maternal smokers. Notably, as BDNF is a quintessential mediator of neurodevelopment, our prior findings of multigenerational DNE-induced behavioral and neuropharmacological abnormalities may stem from neurodevelopmental insults conferred by the proBDNF-BDNF imbalance detected in DNE mice. Similarly, our findings of multigenerational GR hypoactivity may contribute to the increased risk-taking behaviors and aberrant circadian rhythmicity of home cage activity that we previously documented in first- and second-generation DNE mice.
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Affiliation(s)
- Jordan M Buck
- Institute for Behavioral Genetics, University of Colorado, Boulder, United States; Department of Integrative Physiology, University of Colorado, Boulder, United States.
| | - Heidi C O'Neill
- Institute for Behavioral Genetics, University of Colorado, Boulder, United States
| | - Jerry A Stitzel
- Institute for Behavioral Genetics, University of Colorado, Boulder, United States; Department of Integrative Physiology, University of Colorado, Boulder, United States
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98
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Greene RM, Pisano MM. Developmental toxicity of e-cigarette aerosols. Birth Defects Res 2019; 111:1294-1301. [PMID: 31400084 DOI: 10.1002/bdr2.1571] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 07/07/2019] [Accepted: 07/19/2019] [Indexed: 12/21/2022]
Abstract
Maternal smoking during pregnancy represents a major public health concern increasing the risk for low birth weight, congenital anomalies, preterm birth, fetal mortality, and morbidity. In an effort to diminish adverse developmental effects of exposure to cigarette smoking, pregnant women, and women of reproductive age, are increasingly turning to electronic nicotine delivery systems (ENDS), such as e-cigarettes, as an alternative. Given that health risks associated with ENDS use during pregnancy are largely unknown, there is an acute need to determine risks vs. benefits of e-cigarette use by pregnant women. While the most recent Surgeon General's Report on the "Health Consequences of Smoking" states that "the evidence is sufficient to infer that nicotine adversely affects maternal and fetal health during pregnancy, contributing to multiple adverse outcomes," it remains unclear whether use of ENDS represents a "safer alternative" to tobacco smoking during pregnancy. This is due, in part, to the lack of sufficient and conclusive evidence concerning whether or not maternal e-cigarette use adversely affects embryonic/fetal development. While several recent developmental studies have challenged the safety of nicotine inhalation via ENDS, the true risks of smoking e-cigarettes during the first trimester of pregnancy-the period of organogenesis-are largely unknown. Moreover, evidence is emerging that even nicotine-free e-cigarette aerosols may harm the developing conceptus, suggesting that components of e-cigarette liquid, including flavorings, may be developmentally toxicity. Focused human epidemiological analyses, and carefully designed animal studies are critically needed to address the question of the safety of ENDS use during pregnancy.
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Affiliation(s)
- Robert M Greene
- Department of Oral Immunology and Infectious Diseases, Division of Craniofacial Development and Anomalies, School of Dentistry, University of Louisville, Louisville, Kentucky, 40202
| | - M Michele Pisano
- Department of Oral Immunology and Infectious Diseases, Division of Craniofacial Development and Anomalies, School of Dentistry, University of Louisville, Louisville, Kentucky, 40202
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99
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Chiang SC, Abroms LC, Cleary SD, Pant I, Doherty L, Krishnan N. E-cigarettes and smoking cessation: a prospective study of a national sample of pregnant smokers. BMC Public Health 2019; 19:964. [PMID: 31319846 PMCID: PMC6637539 DOI: 10.1186/s12889-019-7299-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/10/2019] [Indexed: 11/29/2022] Open
Abstract
Background Smoking during pregnancy has adverse health consequences for the mother and fetus. E-cigarettes could aid with smoking cessation but there is limited research on the prevalence and patterns of e-cigarette use, and their association with smoking cessation among pregnant smokers. Methods We conducted a secondary analysis of a randomized controlled trial of a text-messaging program for smoking cessation among a U.S. national cohort of pregnant smokers (n = 428). Outcomes assessed were trajectories of e-cigarettes use from baseline to one-month follow-up, and longitudinal association between e-cigarette use at baseline and smoking cessation at one-month follow-up. Results At baseline, 74 (17.29%) pregnant smokers used e-cigarettes in the past 30 days and 36 (8.41%) used e-cigarettes in the past 7 days. The primary reason stated for using e-cigarettes during pregnancy was for quitting. E-cigarette use between baseline and 1-month was inconsistent. Of 36 dual-users at baseline, 20 (55.56%) stopped using e-cigarettes by the 1-month follow-up and 14 initiated e-cigarette use. There was no evidence of an association between e-cigarette use at baseline and the primary smoking cessation outcome, 7-day point prevalence abstinence [adjusted odds ratio = 0.79, 95% confidence intervals = 0.33–1.92]. Conclusions A secondary analysis of a national sample of pregnant smokers indicates that use of e-cigarettes is inconsistent and is not associated with improved smoking cessation outcomes. There is an urgent need to further examine the risk and benefits of e-cigarette use, especially during pregnancy. Electronic supplementary material The online version of this article (10.1186/s12889-019-7299-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shawn C Chiang
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave. NW, Washington, DC, 20052, USA.
| | - Lorien C Abroms
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave. NW, Washington, DC, 20052, USA
| | - Sean D Cleary
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Ichhya Pant
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave. NW, Washington, DC, 20052, USA
| | - Lindsay Doherty
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Nandita Krishnan
- Department of Prevention and Community Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave. NW, Washington, DC, 20052, USA
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100
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Li G, Chan YL, Nguyen LT, Mak C, Zaky A, Anwer AG, Shi Y, Nguyen T, Pollock CA, Oliver BG, Saad S, Chen H. Impact of maternal e‐cigarette vapor exposure on renal health in the offspring. Ann N Y Acad Sci 2019; 1452:65-77. [DOI: 10.1111/nyas.14174] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/12/2019] [Accepted: 05/31/2019] [Indexed: 01/14/2023]
Affiliation(s)
- Gerard Li
- Faculty of Science, School of Life SciencesUniversity of Technology Sydney Sydney New South Wales Australia
| | - Yik L. Chan
- Faculty of Science, School of Life SciencesUniversity of Technology Sydney Sydney New South Wales Australia
- Respiratory Cellular and Molecular BiologyWoolcock Institute of Medical Research Sydney New South Wales Australia
| | - Long T. Nguyen
- Kolling Institute of Medical Research, Royal North Shore HospitalThe University of Sydney Sydney New South Wales Australia
| | - Crystal Mak
- Faculty of Science, School of Life SciencesUniversity of Technology Sydney Sydney New South Wales Australia
| | - Amgad Zaky
- Kolling Institute of Medical Research, Royal North Shore HospitalThe University of Sydney Sydney New South Wales Australia
| | - Ayad G. Anwer
- Graduate School of Biomedical EngineeringThe University of New South Wales Sydney New South Wales Australia
| | - Ying Shi
- Kolling Institute of Medical Research, Royal North Shore HospitalThe University of Sydney Sydney New South Wales Australia
| | - Tara Nguyen
- Faculty of Science, School of Life SciencesUniversity of Technology Sydney Sydney New South Wales Australia
| | - Carol A. Pollock
- Kolling Institute of Medical Research, Royal North Shore HospitalThe University of Sydney Sydney New South Wales Australia
| | - Brian G. Oliver
- Faculty of Science, School of Life SciencesUniversity of Technology Sydney Sydney New South Wales Australia
- Respiratory Cellular and Molecular BiologyWoolcock Institute of Medical Research Sydney New South Wales Australia
| | - Sonia Saad
- Faculty of Science, School of Life SciencesUniversity of Technology Sydney Sydney New South Wales Australia
- Kolling Institute of Medical Research, Royal North Shore HospitalThe University of Sydney Sydney New South Wales Australia
| | - Hui Chen
- Faculty of Science, School of Life SciencesUniversity of Technology Sydney Sydney New South Wales Australia
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