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Tobacco use and risk of COVID-19 infection in the Finnish general population. Sci Rep 2022; 12:20335. [PMID: 36434073 PMCID: PMC9700668 DOI: 10.1038/s41598-022-24148-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
Empirical evidence, primarily based on hospital-based or voluntary samples, suggests that current smokers have a lower risk of COVID-19 infection than never smokers. In this study, we used nationally representative data to examine the association between tobacco use and the risk of having a confirmed COVID-19 case. We explored several forms of tobacco use, contributing to separate the role of nicotine from smoking. We used data from 44,199 participants from three pooled national health surveys in Finland (FinSote 2018-2020). The primary outcome was a confirmed COVID-19 case. We examined current smoking, moist smokeless tobacco (snus), e-cigarettes with and without nicotine and nicotine replacement therapy products. Current daily smokers had a relative risk of 1.12 of a confirmed COVID-19 case (95% CI 0.65; 1.94) in fully adjusted models compared with never smokers. Current snus use was associated with a 68% higher risk of a confirmed COVID-19 case (RR 1.68, 95% CI 1.02; 2.75) than never users. We did not find conclusive evidence of associations between e-cigarettes with and without nicotine and nicotine replacement therapy products and the risk of confirmed COVID-19 cases. Our findings suggest that nicotine might not have a protective role in the risk of COVID-19 as previously hypothesized.
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Ando W, Horii T, Jimbo M, Uematsu T, Atsuda K, Hanaki H, Otori K. Smoking cessation in the elderly as a sign of susceptibility to symptomatic COVID-19 reinfection in the United States. Front Public Health 2022; 10:985494. [PMID: 36504971 PMCID: PMC9733529 DOI: 10.3389/fpubh.2022.985494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
Background We aimed to clarify the relationship between coronavirus disease 2019 (COVID-19) reinfection and basic disease and smoking status. Methods The electronic health records of 165,320 patients with COVID-19 from January 1, 2020, to August 27, 2021, were analyzed. Data on age, race, sex, smoking status (never, current, former), and basic disease were analyzed using Cox proportional hazard models. Results In total, 6,133 patients (3.7%) were reinfected. The overall reinfection rate for never, current, and former smokers was 4.2, 3.5, and 5.7%, respectively. Although the risk of reinfection was highest among former smokers aged ≥65 years (7.7% [422/5,460]), the reinfection rate among current smokers aged ≥65 years was 6.2% (341/5,543). Among reinfected patients, the number of basic diseases was higher in former smokers (2.41 ± 1.16) than in current (2.28 ± 1.07, P = 0.07) and never smokers (2.07 ± 1.05, P < 0.001). Former smokers who are older may have been exposed to factors that increase their risk of symptomatic COVID-19 reinfection.
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Affiliation(s)
- Wataru Ando
- Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, Kitasato University School of Pharmacy, Shirokane, Japan,Department of Pharmacy, Kitasato University Medical Center, Kitamoto, Japan,*Correspondence: Wataru Ando
| | - Takeshi Horii
- Laboratory of Pharmacy Practice and Science 1, Division of Clinical Pharmacy, Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, Sagamihara, Japan
| | - Mitsuki Jimbo
- Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, Kitasato University School of Pharmacy, Shirokane, Japan
| | - Takayuki Uematsu
- Biomedical Laboratory, Division of Biomedical Research, Kitasato University Medical Center, Kitamoto, Japan
| | - Koichiro Atsuda
- Laboratory of Pharmacy Practice and Science 1, Division of Clinical Pharmacy, Research and Education Center for Clinical Pharmacy, Kitasato University School of Pharmacy, Sagamihara, Japan
| | - Hideaki Hanaki
- Infection Control Research Center, Omura Satoshi Memorial Institute, Kitasato University, Shirokane, Japan
| | - Katsuya Otori
- Department of Clinical Pharmacy, Center for Clinical Pharmacy and Sciences, Kitasato University School of Pharmacy, Shirokane, Japan,Department of Pharmacy, Kitasato University Medical Center, Kitamoto, Japan
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Adzrago D, Sulley S, Mamudu L, Ormiston CK, Williams F. The Influence of COVID-19 Pandemic on the Frequent Use of E-Cigarettes and Its Association with Substance Use and Mental Health Symptoms. Behav Sci (Basel) 2022; 12:453. [PMID: 36421749 PMCID: PMC9687156 DOI: 10.3390/bs12110453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/27/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although several studies examined the association between e-cigarettes, substance use, and mental health conditions, there is limited research on whether COVID-19-related stress and health outcomes, mental health symptoms, and substance use differ by the frequency of e-cigarette use during the COVID-19 pandemic. We assessed the association of past 30-day frequent use of e-cigarettes with alcohol, cannabis, anxiety/depression, and COVID-19 impact. METHODS We conducted a national online cross-sectional survey among a random sample of US adults aged 18 years or older (N = 5065) between 13 May 2021, and 9 January 2022. A multinomial logistic regression analysis was performed to assess the study aims. RESULTS Of the participants, 7.17% reported once to several times per month (OSTPM), 6.95% reported once to several times per week (OSTPW), and 6.57% reported every day to several times per day (ESTPD) use of e-cigarettes in the past month. Alcohol and cannabis use ESTPD and once to several times per week/month (OSTPW/M) were associated with a higher likelihood of e-cigarette use ESTPD and OSTPW/M, respectively. Anxiety/depression was associated with e-cigarette use ESTPD and OSTPW. Individuals who considered social distancing to be stressful were more likely to use e-cigarettes ESTPD and OSTPW/M compared to those that considered social distancing as not stressful. CONCLUSION Individuals who engaged in the frequent use of alcohol or cannabis, had depression/anxiety, and considered social distancing to be stressful were more likely to engage in frequent e-cigarette use. Improving efforts geared toward reducing the use of substances may help decrease the health risks associated with e-cigarette use.
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Affiliation(s)
- David Adzrago
- Center for Health Promotion and Prevention Research, The University of Texas School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Saanie Sulley
- National Healthy Start Association, 1325 G Street, Washington, DC 20005, USA
| | - Lohuwa Mamudu
- Department of Public Health, California State University, Fullerton, 800 N. State College Boulevard, Fullerton, CA 92831, USA
| | - Cameron K. Ormiston
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Two White Flint North, Rockville, MD 20852, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Two White Flint North, Rockville, MD 20852, USA
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Maldonado Viasús D, Perdomo G, García Duran M, Pulido A, Lüchau Hernandez M, Borrero Roldan E, Botero MC, Moreno S. ENDS consumption in students of higher education:
Phenomenon on the rise during the COVID-19 pandemic. Tob Induc Dis 2022; 20:100. [DOI: 10.18332/tid/154970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/27/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
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Factors affecting tobacco, nicotine, and cannabis product use among California young adults during the COVID-19 pandemic: A qualitative study. Addict Behav Rep 2022; 16:100470. [PMCID: PMC9661417 DOI: 10.1016/j.abrep.2022.100470] [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: 06/13/2022] [Revised: 10/15/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022] Open
Abstract
The effects of COVID-19 on tobacco use and cannabis has been variable, and it is unclear the extent to which factors affecting changes in tobacco and cannabis use differ. The purpose of this study was to identify the COVID-19-related factors that affect changes in tobacco and cannabis use during the pandemic. Focus groups with 114 young adults in California in April 2021 were held to discuss tobacco and cannabis use patterns, adverse events, and the effect of COVID-19 on tobacco and cannabis product use. Factors affecting changes in use were largely similar between tobacco products and cannabis products. Drivers of increased cannabis use distinct from tobacco or nicotine product use included feeling greater freedom to disengage and perceptions of less harm. Increases in product use were a result of changing social environment, coping with emotional and psychological distress, and product related factors. Decreases in product use were a result of social isolation, COVID-19-related health concerns, disruptions in daily patterns of living, and reduced access. Improved understanding of how the pandemic has affected tobacco and cannabis use can inform tailored interventions to both support those who have decreases or quit and assist those who have increased use during the pandemic to reduce or cease their consumption.
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Hamon R, Ween MP. E-Cigarette Vapour Increases ACE2 and TMPRSS2 Expression in a Flavour- and Nicotine-Dependent Manner. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14955. [PMID: 36429673 PMCID: PMC9691196 DOI: 10.3390/ijerph192214955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
COVID-19 infects via the respiratory system, but it can affect multiple systems and lead to multi system failure. There is growing evidence that smoking may be associated with higher rates of COVID-19 infections and worse outcomes due to increased levels of ACE2 in lung epithelial cells, but it is unknown whether E-cigarette use may lead to increased risk of COVID-19 infection from the SARS-CoV-2 virus. In this study, healthy donor bronchial epithelial cells (NHBE) and monocyte-derived macrophages (MDM) were exposed to cigarette smoke extract (CSE) or nicotine or flavoured E-cigarette vapour extract (EVE) before the assessment of SARS-CoV-2 recognition receptors ACE2 and TMPRSS2 genes. MDMs exposed to CSE and Tobacco EVE showed increased ACE2 expression; however, no treatment altered the TMPRSS2 expression. ACE2 was found to be upregulated by >2-fold in NHBE cells exposed to CSE, as well as nicotine, banana, or chocolate EVE, while TMPRSS2 was only upregulated by CSE or nicotine EVE exposure. These findings suggesting that flavourings can increase ACE2 expression in multiple cell types, while TMPRSS2 expression increases are limited to the epithelial cells in airways and may be limited to nicotine and/or cigarette smoke exposure. Therefore, increased risk of COVID-19 infection cannot be ruled out for vapers.
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Affiliation(s)
- Rhys Hamon
- School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide 5000, Australia
- Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide 5000, Australia
| | - Miranda P. Ween
- School of Medicine, Faculty of Health Sciences, University of Adelaide, Adelaide 5000, Australia
- Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide 5000, Australia
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Giovacchini CX, Crotty Alexander LE, Que LG. Electronic Cigarettes: A Pro-Con Review of the Current Literature. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2843-2851. [PMID: 35872217 DOI: 10.1016/j.jaip.2022.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/27/2022] [Accepted: 07/08/2022] [Indexed: 05/11/2023]
Abstract
Electronic cigarettes (e-cigarettes, e-cigs, or electronic nicotine delivery systems) are battery-operated devices typically containing glycerol and/or propylene glycol-based solutions with varying nicotine content, known as e-liquids. Although e-cigarettes were originally developed as a potentially less harmful alternative to traditional combustible tobacco cigarette smokers, several factors have driven their popularity among smokers and nonsmokers alike, including their sleek product designs, innumerable appealing flavors, lack of combustible smoke and odor, and high potential nicotine concentrations. Furthermore, many advocates have promoted the idea that e-cigarettes are safe to use, or at least safer than conventional tobacco, despite limited longitudinal data to support these claims. Here, we examine what is known about the impacts of e-cigarette use on traditional cigarette smoking cessation, lung health, and youth and young adult tobacco product exposure. Upon review of the currently available literature, the negative effects of e-cigarette use seem to outweigh any potential benefit, because the available evidence does not confirm the use of e-cigarettes as an effective strategy for supporting traditional combustible tobacco cigarette smoking cessation, particularly given the emerging adverse effects on lung health and the potential future public health effects of e-cigarette adoption among a burgeoning new generation of tobacco product users.
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Affiliation(s)
- Coral X Giovacchini
- Division of Pulmonary, Allergy, and Critical Care, Duke University Health System, Durham, NC
| | - Laura E Crotty Alexander
- Pulmonary Critical Care Section, VA San Diego Healthcare System, San Diego, Calif; Division of Pulmonary, Critical Care, Sleep, and Physiology, University of California San Diego, San Diego, Calif.
| | - Loretta G Que
- Division of Pulmonary, Allergy, and Critical Care, Duke University Health System, Durham, NC.
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Harrell MB, Mantey DS, Chen B, Kelder SH, Barrington-Trimis J. Impact of the e-cigarette era on cigarette smoking among youth in the United States: A population-level study. Prev Med 2022; 164:107265. [PMID: 36152819 PMCID: PMC10381788 DOI: 10.1016/j.ypmed.2022.107265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/28/2022] [Accepted: 09/17/2022] [Indexed: 11/19/2022]
Abstract
To examine and compare trends in past 30-day cigarette smoking among adolescents in the US from 2002 to 2019, before and after the onset of the "e-cigarette era" in 2014. Using National Youth Tobacco Survey (NYTS) data from 2002 to 2019, we modeled the prevalence of past 30-day cigarette smoking over time. A total of n = 274,551 (weighted N = 340,403,754) middle and high school students were included in this study. Interrupted time series analyses were used to examine changes in cigarette smoking over time and compare trends in cigarette smoking pre- and post-2014. Models were applied to the full sample and stratified by middle (6th-8th grade) and high school (9th-12th grade). The observed number of current adolescent cigarette smokers post-2014 was compared to the predicted number, given trends in cigarette smoking prevalence observed pre-2014. Among all students, past 30-day cigarette smoking declined by approximately 0.75% per year from 2002 to 2013 (p < 0.001). Following a significant drop in prevalence from 2013 to 2014 (1.64%; p < 0.001), the decline in past 30-day cigarette smoking slowed significantly to approximately 0.37% per year (p < 0.001), from 2015 to 2019. We estimate that the onset of the "e-cigarette era" in 2014 corresponded to over 1.66 million (95% CI: 1.57 m - 1.75 m) more past 30-day cigarette smokers from 2015 to 2019, cumulatively. The rate of decline in past 30-day cigarette smoking prevalence among adolescents observed since 2002 slowed with the onset of the "e-cigarette era" in 2014, providing evidence at a population-level for the "gateway effect."
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Affiliation(s)
- Melissa B Harrell
- University of Texas School of Public Health, Austin, TX, United States of America; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA
| | - Dale S Mantey
- University of Texas School of Public Health, Austin, TX, United States of America; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA.
| | - Baojiang Chen
- University of Texas School of Public Health, Austin, TX, United States of America; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA
| | - Steven H Kelder
- University of Texas School of Public Health, Austin, TX, United States of America; Michael & Susan Dell Center for Healthy Living, UTHealth School of Public Health Austin Campus, Austin, Texas, USA
| | - Jessica Barrington-Trimis
- University of Southern California, Keck School of Medicine, Los Angeles, CA, United States of America
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Glantz S, Jeffers A, Winickoff JP. Nicotine Addiction and Intensity of e-Cigarette Use by Adolescents in the US, 2014 to 2021. JAMA Netw Open 2022; 5:e2240671. [PMID: 36342713 PMCID: PMC9641541 DOI: 10.1001/jamanetworkopen.2022.40671] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
IMPORTANCE As e-cigarettes have become more effective at delivering the addictive drug nicotine, they have become the dominant form of tobacco use by US adolescents. OBJECTIVE To measure intensity of use of e-cigarettes, cigarettes, and other tobacco products among US adolescents and their dependence level over time. DESIGN, SETTING, AND PARTICIPANTS This survey study analyzed the cross-sectional National Youth Tobacco Surveys from 2014 to 2021. Confirmatory analysis was conducted using Youth Behavioral Risk Factor Surveillance System from 2015 to 2019. The surveys were administered to national probability samples of US students in grades 6 to 12. EXPOSURES Use of e-cigarettes and other tobacco products before and after the introduction of e-cigarettes delivering high levels of nicotine. MAIN OUTCOMES AND MEASURES First tobacco product used, age at initiation of use, intensity of use (days per month), and nicotine addiction (measured as time after waking to first use of any tobacco product). RESULTS A total of 151 573 respondents were included in the analysis (51.1% male and 48.9% female; mean [SEM] age, 14.57 [0.03] years). Prevalence of e-cigarette use peaked in 2019 and then declined. Between 2014 and 2021, the age at initiation of e-cigarette use decreased, and intensity of use and addiction increased. By 2017, e-cigarettes became the most common first product used (77.0%). Age at initiation of use did not change for cigarettes or other tobacco products, and changes in intensity of use were minimal. By 2019, more e-cigarette users were using their first tobacco product within 5 minutes of waking than for cigarettes and all other products combined. Median e-cigarette use also increased from 3 to 5 d/mo in 2014 to 2018 to 6 to 9 d/mo in 2019 to 2020 and 10 to 19 d/mo in 2021. CONCLUSIONS AND RELEVANCE The changes detected in this survey study may reflect the higher levels of nicotine delivery and addiction liability of modern e-cigarettes that use protonated nicotine to make nicotine easier to inhale. The increasing intensity of use of modern e-cigarettes highlights the clinical need to address youth addiction to these new high-nicotine products over the course of many clinical encounters. In addition, stronger regulation, including comprehensive bans on the sale of flavored tobacco products, should be implemented.
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Affiliation(s)
| | - Abra Jeffers
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston
| | - Jonathan P. Winickoff
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston
- Julius B. Richmond Center, American Academy of Pediatrics, Itasca, Illinois
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Pisinger C, Rasmussen SKB. The Health Effects of Real-World Dual Use of Electronic and Conventional Cigarettes versus the Health Effects of Exclusive Smoking of Conventional Cigarettes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013687. [PMID: 36294263 PMCID: PMC9603628 DOI: 10.3390/ijerph192013687] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND A high prevalence of dual use of e-cigarettes and conventional cigarettes has been reported across the world. METHODS A systematic search was carried out. We included original articles on any topic relevant to health, excluding mental health, in all languages. The PRISMA guidelines were followed. Both reviewers independently screened and read all publications. We compared dual use with exclusive smoking of conventional cigarettes (ESCC). RESULTS Fifty-two publications (49 studies) were included. Thirteen papers/10 studies were prospective. There was great heterogeneity across studies. Many methodological weaknesses, such as inaccurate exposure measurement, lack of adjustment for former tobacco consumption, and lack of significance testing were identified. Most prospective studies found dual use to be at least as harmful as ESCC. The longest follow-up was six years. Most of the best available cross-sectional studies found dual use associated with the same and, in several studies, significantly higher risk of self-reported symptoms/disease than in ESCC. The intensity of cigarette smoking seems associated with worse health. CONCLUSION Existing studies indicate that dual use is at least as, or probably even more, harmful than ESCC. Due to the predominance of cross-sectional studies and the methodological weaknesses we judged the overall certainty of the evidence as "low certainty".
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Affiliation(s)
- Charlotta Pisinger
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, 2400 Copenhagen, Denmark
- Danish Heart Foundation, 1120 Copenhagen, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Sofie K. Bergman Rasmussen
- Center for Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Capital Region of Denmark, 2400 Copenhagen, Denmark
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Bluestein MA, Harrell MB, Hébert ET, Chen B, Kuk AE, Spells CE, Pérez A. Associations Between Perceptions of e-Cigarette Harmfulness and Addictiveness and the Age of E-Cigarette Initiation Among the Population Assessment of Tobacco and Health (PATH) Youth. Tob Use Insights 2022; 15:1179173X221133645. [PMID: 36276166 PMCID: PMC9585561 DOI: 10.1177/1179173x221133645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Youth perceptions of harmfulness and addictiveness of e-cigarettes may impact the age that they initiate e-cigarette use, but this has not been investigated previously. Methods Youth (12-17 years old) never e-cigarette users at their first wave of PATH participation (waves 1-3, 2013-2016) were included. PATH questions on absolute perceptions of e-cigarette harmfulness and addictiveness were used as exposures. Interval-censored Cox proportional hazards models were used to estimate the impact of perceptions of harmfulness, and perceptions of addictiveness on (i) the age of initiation of e-cigarette use and (ii) age of first reporting past 30-day e-cigarette use, while controlling for covariates. Results Youth who perceive e-cigarettes as having no/little harm had increased risk of initiating both ever e-cigarette use (AHR = 2.04; 95%CI = 1.74-2.40) and past 30-day e-cigarette use (AHR = 2.64; 95%CI = 2.07-3.37) at earlier ages compared to youth who perceive e-cigarettes as having a lot of harm. Youth who perceive the likelihood of becoming addicted to e-cigarettes to be very/somewhat unlikely had increased risk of an earlier age of both ever (AHR = 1.28; 95%CI = 1.07-1.52) and past 30-day (AHR = 1.36; 95%CI = 1.04-1.79) e-cigarette initiation compared to youth who perceived the likelihood of becoming addicted to e-cigarettes to be somewhat/very likely. Conclusion These results highlight the importance of communicating to youth the potential for health harms and addiction from e-cigarette use in prevention and intervention campaigns, as those with the lowest perceptions of harmfulness and addictiveness had the earliest ages of e-cigarette initiation.
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Affiliation(s)
- Meagan A. Bluestein
- Michael & Susan Dell Center for Healthy Living, School of Public Health, the University of Texas Health Science Center at Houston (UTHealth), Austin Campus, Austin, TX, USA
| | - Melissa B. Harrell
- Michael & Susan Dell Center for Healthy Living, School of Public Health, the University of Texas Health Science Center at Houston (UTHealth), Austin Campus, Austin, TX, USA,Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, the University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
| | - Emily T. Hébert
- Michael & Susan Dell Center for Healthy Living, School of Public Health, the University of Texas Health Science Center at Houston (UTHealth), Austin Campus, Austin, TX, USA,Department of Health Promotion and Behavioral Sciences, School of Public Health, the University of Texas Health Science Center at Houston (UTHealth), Austin, TX, USA
| | - Baojiang Chen
- Michael & Susan Dell Center for Healthy Living, School of Public Health, the University of Texas Health Science Center at Houston (UTHealth), Austin Campus, Austin, TX, USA,Department of Biostatistics and Data Science, School of Public Health, the University of Texas Health Science Center at Houston (UTHealth), Austin Campus, Austin, TX, USA
| | - Arnold E. Kuk
- Michael & Susan Dell Center for Healthy Living, School of Public Health, the University of Texas Health Science Center at Houston (UTHealth), Austin Campus, Austin, TX, USA
| | - Charles E. Spells
- Michael & Susan Dell Center for Healthy Living, School of Public Health, the University of Texas Health Science Center at Houston (UTHealth), Austin Campus, Austin, TX, USA
| | - Adriana Pérez
- Michael & Susan Dell Center for Healthy Living, School of Public Health, the University of Texas Health Science Center at Houston (UTHealth), Austin Campus, Austin, TX, USA,Department of Biostatistics and Data Science, School of Public Health, the University of Texas Health Science Center at Houston (UTHealth), Austin Campus, Austin, TX, USA,Adriana Pérez, Department of Biostatistics and Data Science, School of Public Health, the University of Texas Health Science Center at Houston (UTHealth), Austin Campus, Austin, TX 78701, USA.
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Estimating the changing disease burden attributable to smoking in South Africa for 2000, 2006 and 2012. S Afr Med J 2022; 112:649-661. [DOI: 10.7196/samj.2022.v112i8b.16492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Indexed: 11/08/2022] Open
Abstract
Background. Ongoing quantification of the disease burden attributable to smoking is important to monitor and strengthen tobacco control policies.Objectives. To estimate the attributable burden due to smoking in South Africa for 2000, 2006 and 2012.Methods. We estimated attributable burden due to smoking for selected causes of death in South African (SA) adults aged ≥35 years for 2000, 2006 and 2012. We combined smoking prevalence results from 15 national surveys (1998 - 2017) and smoking impact ratios using national mortality rates. Relative risks between smoking and select causes of death were derived from local and international data. Results. Smoking prevalence declined from 25.0% in 1998 (40.5% in males, 10.9% in females) to 19.4% in 2012 (31.9% in males, 7.9% in females), but plateaued after 2010. In 2012 tobacco smoking caused an estimated 31 078 deaths (23 444 in males and 7 634 in females), accounting for 6.9% of total deaths of all ages (17.3% of deaths in adults aged ≥35 years), a 10.5% decline overall since 2000 (7% in males; 18% in females). Age-standardised mortality rates (and disability-adjusted life years (DALYs)) similarly declined in all population groups but remained high in the coloured population. Chronic obstructive pulmonary disease accounted for most tobacco-attributed deaths (6 373), followed by lung cancer (4 923), ischaemic heart disease (4 216), tuberculosis (2 326) and lower respiratory infections (1 950). The distribution of major causes of smoking-attributable deaths shows a middle- to high-income pattern in whites and Asians, and a middle- to low-income pattern in coloureds and black Africans. The role of infectious lung disease (TB and LRIs) has been underappreciated. These diseases comprised 21.0% of deaths among black Africans compared with only 4.3% among whites. It is concerning that smoking rates have plateaued since 2010. Conclusion. The gains achieved in reducing smoking prevalence in SA have been eroded since 2010. An increase in excise taxes is the most effective measure for reducing smoking prevalence. The advent of serious respiratory pandemics such as COVID-19 has increased the urgency of considering the role that smoking cessation/abstinence can play in the prevention of, and post-hospital recovery from, any condition.
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Islam S, Thompson K, Abadi M, Wharton K, Lipperman-Kreda S. "I don't know whose mouth has been on this": youth nicotine and cannabis vaping practices in the context of the COVID-19 pandemic. BMC Public Health 2022; 22:1808. [PMID: 36151523 PMCID: PMC9502587 DOI: 10.1186/s12889-022-14201-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/14/2022] [Indexed: 11/10/2022] Open
Abstract
Early COVID-19 safety protocols urged physical and social distancing, resulting in minimal contact with others. As social contexts are central to vaping among youth, we used semi-structured interviews to describe how youth who vape are making sense of their use practices and adaptations. The qualitative analyses revealed changes in vaping frequency and access, social isolation shaping substance- and product-specific use, and motivations and outcomes of dual use of nicotine and cannabis which were closely linked to the pandemic. The findings indicate variation of youth vaping experiences within the early stages of the pandemic that should be attended to in future studies.
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Affiliation(s)
- Sabrina Islam
- School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA, 94704, USA. .,Prevention Research Center, Pacific Institute for Research and Evaluation, 2030 Addison Street, Suite 410, CA, 94704, Berkeley, USA.
| | - Kirsten Thompson
- Louisville Center, Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, KY, 40202, Louisville, USA
| | - Melissa Abadi
- Louisville Center, Pacific Institute for Research and Evaluation, 401 West Main Street, Suite 2100, KY, 40202, Louisville, USA
| | - Kristina Wharton
- School of Public Health, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA, 94704, USA.,Prevention Research Center, Pacific Institute for Research and Evaluation, 2030 Addison Street, Suite 410, CA, 94704, Berkeley, USA
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, 2030 Addison Street, Suite 410, CA, 94704, Berkeley, USA
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Lin CY, Su SB, Chen KT. An overview of gastrointestinal diseases in patients with COVID-19: A narrative review. Medicine (Baltimore) 2022; 101:e30297. [PMID: 36086768 PMCID: PMC10980500 DOI: 10.1097/md.0000000000030297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/01/2022] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has emerged as a global health concern. This study aimed to review the epidemiology and pathophysiology of COVID-19 and provide evidence for the implementation of control measures. We utilized several online databases, including MEDLINE (National Library of Medicine, Bethesda, Maryland, USA), PubMed, EMBASE, Web of Science, and Google Scholar, to collect relevant published papers using a combination of the following keywords: "COVID-19," "SARS-CoV-2," "novel coronavirus," "epidemiology," and "pathophysiology." The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used in this study. Globally, approximately 3-46% of patients with SARS-CoV-2 infection experience gastrointestinal symptoms. The clinical spectrum of COVID-19 is wide, ranging from mild to severe, and even fatal. COVID-19 was initially reported as a respiratory tract disease; however, gastrointestinal symptoms have only recently been reported. COVID-19 Patients with gastrointestinal symptoms may have more severe clinical manifestations and poor prognosis. This study highlights the need to better understand the mechanisms involved in the development of gastrointestinal symptoms in patients with COVID-19 to prevent the further spread of this pathogen.
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Affiliation(s)
- Cheng-Yao Lin
- Division of Hematology-Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Liouying, Taiwan
- Department of Senior Welfare and Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
| | - Shih-Bin Su
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Kow-Tong Chen
- Department of Occupational Medicine, Tainan Municipal Hospital, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Benowitz NL, Goniewicz ML, Halpern-Felsher B, Krishnan-Sarin S, Ling PM, O'Connor RJ, Pentz MA, Robertson RM, Bhatnagar A. Tobacco product use and the risks of SARS-CoV-2 infection and COVID-19: current understanding and recommendations for future research. THE LANCET. RESPIRATORY MEDICINE 2022; 10:900-915. [PMID: 35985357 PMCID: PMC9381032 DOI: 10.1016/s2213-2600(22)00182-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 01/27/2022] [Accepted: 05/03/2022] [Indexed: 01/11/2023]
Abstract
Heterogeneity in the clinical presentation of SARS-CoV-2 infection and COVID-19 progression underscores the urgent need to identify individual-level susceptibility factors that affect infection vulnerability and disease severity. Tobacco product use is a potential susceptibility factor. In this Personal View, we provide an overview of the findings of peer-reviewed, published studies relating tobacco product use to SARS-CoV-2 infection and COVID-19 outcomes, with most studies focusing on cigarette smoking in adults. Findings pertaining to the effects of tobacco product use on the incidence of SARS-CoV-2 infection are inconsistent. However, evidence supports a role for cigarette smoking in increasing the risk of poor COVID-19 outcomes, including hospital admission, progression in disease severity, and COVID-19-related mortality. We discuss the potential effects of tobacco use behaviour on SARS-CoV-2 transmission and infection, and highlight the pathophysiological changes associated with cigarette smoking that could promote SARS-CoV-2 infection and increased disease severity. We consider the biological mechanisms by which nicotine and other tobacco product constituents might affect immune and inflammatory responses to SARS-CoV-2 infection. Finally, we identify current knowledge gaps and suggest priorities for research to address acute and post-acute health outcomes of COVID-19 during and after the pandemic.
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Affiliation(s)
- Neal L Benowitz
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | | | | | - Pamela M Ling
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Mary Ann Pentz
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Rose Marie Robertson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Aruni Bhatnagar
- Department of Medicine, University of Louisville, Louisville, KY, USA.
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Folayan MO, Alade O, Adeyemo Y, Sabbagh HJ, Oyapero A, Oziegbe EO, Popoola BO, Quritum M, El Tantawi M. Differences in risk indicators associated with electronic cigarette use and tobacco smoking among adolescents and young people in Nigeria. BMJ Open Respir Res 2022; 9:9/1/e001285. [PMID: 36109086 PMCID: PMC9478830 DOI: 10.1136/bmjresp-2022-001285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/24/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction The study determined the proportion of adolescents and young persons (AYP) in Nigeria who use e-cigarettes and smoke tobacco; and identified factors associated with the use of e-cigarettes and tobacco smoking. Methods AYP aged 11–23 years were recruited to participate in an online survey. The independent variables were respondents’ health, HIV and COVID-19 status and their level of anxiety. The dependent variables were tobacco smoking and use of e-cigarettes. Binary logistic regression was used to determine the associations between the dependent and independent variables after adjusting for confounders (age, sex, educational level and vulnerability status). Results There were 2206 respondents of which 568 (19.8%) used e-cigarettes and 787 (27.4%) smoked tobacco. Individual (18–23 years, having a health condition, high anxiety and being vulnerable) and familial (having father, mother, siblings or friends who used e-cigarettes) factors were associated with both the use of e-cigarettes and tobacco smoking. Tobacco smoking was a significant risk indicator for e-cigarettes use and vice versa. COVID-19 infection (adjusted OR, AOR: 3.602) and living with HIV (AOR: 1.898) were associated with higher odds of using e-cigarettes. Males (AOR: 1.577), 15–17 years (AOR: 6.621) and moderate anxiety (AOR: 2.500) were associated with higher odds of tobacco smoking. AYP with health conditions had higher odds of using e-cigarettes (AOR: 1.514) while AYP with moderate anxiety had lower odds of using e-cigarettes (AOR: 0.627). Conclusion The proportion of AYP in Nigeria who used e-cigarettes and smoked tobacco is high. Public health interventions that target the common risk factors for e-cigarettes use and tobacco smoking among AYP in Nigeria are urgently needed.
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Affiliation(s)
| | - Omolola Alade
- Department of Peventive and Community Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Yewande Adeyemo
- Department of Child Dental Health, Bayero University Kano, Kano, Nigeria
| | - Heba Jafar Sabbagh
- Preventive Dental Sciences, King Abdulaziz University, Jeddah, Saudi Arabia, Jeddah, Saudi Arabia.,Dental School, Dundee University, UK
| | - Afolabi Oyapero
- Department of Preventive Dentistry, Lagos State University College of Medicine, Ojo, Nigeria
| | - Elizabeth O Oziegbe
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Maryam Quritum
- Department of Peventive and Community Dentistry, Alexandria University, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Alexandria University, Alexandria, Egypt
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67
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Young-Wolff KC, Slama NE, Alexeeff SE, Prochaska JJ, Fogelberg R, Sakoda LC. Electronic cigarette use and risk of COVID-19 among young adults without a history of cigarette smoking. Prev Med 2022; 162:107151. [PMID: 35809821 PMCID: PMC9259067 DOI: 10.1016/j.ypmed.2022.107151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/11/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022]
Abstract
It is unknown whether use of e-cigarettes increases susceptibility to COVID-19. In a large clinical sample of young adults, we evaluated whether current or ever e-cigarette use was associated with polymerase chain reaction (PCR)-confirmed COVID-19. To address the confounding of combustible smoking, the sample was restricted to never smokers. This retrospective cohort study analyzed data from the electronic health records of 74,853 young adults (aged 18-35 years), without a history of cigarette smoking, who were screened for e-cigarette use (current, former, never) in the Kaiser Permanente Northern California (KPNC) healthcare system from 3/5/2020 (baseline) to 11/30/2020 (pre-vaccine). COVID-19 risk was estimated in time-to-event analyses using multivariable Cox proportional hazard regression models, adjusted for socio-demographics and medical comorbidities. E-cigarette status in the cohort was: 1.6% current, 1.2% former, and 97.2% never. During follow-up, 1965 (2.6%) patients acquired COVID-19. We did not find evidence that current (vs never) e-cigarette use was associated with risk of COVID-19 (aHR = 1.12 95%CI:0.77-1.62). However, we did find suggestive evidence that former (versus never) e-cigarette use may be associated with greater risk of COVID-19 (aHR = 1.39 95%CI:0.98-1.96). While e-cigarette use is associated with health risks for young adults, results from this study suggest that current use of e-cigarettes may not increase susceptibility for COVID-19 among young adults who have never smoked cigarettes.
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Affiliation(s)
- Kelly C Young-Wolff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
| | - Natalie E Slama
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Stacey E Alexeeff
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Stanford University, Stanford, CA, USA
| | - Renee Fogelberg
- Richmond Medical Center, Kaiser Permanente Northern California, Richmond, CA, USA
| | - Lori C Sakoda
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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68
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Cabral P. E-cigarette use and intentions related to psychological distress among cigarette, e-cigarette, and cannabis vape users during the start of the COVID-19 pandemic. BMC Psychol 2022; 10:201. [PMID: 35971158 PMCID: PMC9376900 DOI: 10.1186/s40359-022-00910-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study examines associations between psychological distress, intentions to use e-cigarettes, and cigarette smoking, e-cigarette use, and cannabis consumption through e-cigarette use among a diverse sample of U.S. young adults. Procedures Young adults (N = 314; 72.5% female) were recruited to complete an online survey during the first few months of the COVID-19 pandemic. Results Associations between psychological distress and cigarette smoking, e-cigarette use, cannabis vaping, and intentions to use e-cigarettes were found. Current e-cigarette use (OR = 1.23, 95% CI 1.17, 1.28, p < .001; 7.5%) and cannabis vaping (OR = 2.03, 95% CI 1.88, 2.18, p < .001; 10%) was higher among female, possibly due to the significantly higher psychological distress reported among females. Interactions between intentions to use e-cigarettes and psychological distress variables were found for all smoking and vaping behaviors. Conclusions Public health efforts should increase focus on providing psychological services for young adults to improve coping strategies that are alternative to smoking and vaping behaviors.
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Affiliation(s)
- Patricia Cabral
- Department of Psychology, Occidental College, 1600 Campus Road, Los Angeles, CA, 90041, USA.
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69
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Rohde JA, Noar SM, Sheldon JM, Hall MG, Kieu T, Brewer NT. Identifying Promising Themes for Adolescent Vaping Warnings: A National Experiment. Nicotine Tob Res 2022; 24:1379-1385. [PMID: 35397474 PMCID: PMC9356688 DOI: 10.1093/ntr/ntac093] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 03/26/2022] [Accepted: 04/05/2022] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Adolescent vaping remains a problem in the United States, yet little is known about what health warning themes most discourage vaping among adolescents. We sought to identify the most compelling themes for vaping warnings for US adolescents. METHODS Participants were a national probability sample of 623 US adolescents aged 13-17 years, recruited in the summer of 2020. Adolescents were randomized to one of the five warning message themes about the potential health effects of vaping: 1. chemical harms, 2. lung harms, 3. Coronavirus Disease 2019 (COVID-19) harms, 4. nicotine addiction, or 5. control (messages about vape litter). The primary outcome was perceived message effectiveness (PME; 3-item scale). Secondary outcomes were negative affect (fear), attention, anticipated social interactions, and message novelty. RESULTS Adolescents rated the chemical, lung, and COVID-19 harms warning messages higher on PME than nicotine addiction and control (all p < .05), while nicotine addiction was rated higher than control (p < .05). The chemical, lung, and COVID-19 harms warning themes also elicited greater negative affect than nicotine addiction and control (all p < .05). For all other secondary outcomes, the COVID-19 harms warning message theme was rated higher than nicotine addiction and control (all p < .05). CONCLUSION Adolescents perceived warning message themes about lung, chemical and COVID-19 health effects of vaping as more effective than nicotine addiction. To discourage vaping, the FDA and others should communicate to youth about the health effects of vaping beyond nicotine addiction. IMPLICATIONS Adolescents rated warning message themes about the lung, chemical, and COVID-19 health effects of vaping as more effective than nicotine addiction, while nicotine addiction was rated as more effective than control themes about vaping litter. To discourage vaping among adolescents, health messaging should expand message themes to communicate about a broader set of health effects of vaping beyond nicotine addiction.
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Affiliation(s)
- Jacob A Rohde
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer Mendel Sheldon
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marissa G Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health at Chapel Hill, University of North Carolina, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Talia Kieu
- Department of Health Behavior, Gillings School of Global Public Health at Chapel Hill, University of North Carolina, Chapel Hill, NC, USA
| | - Noel T Brewer
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Health Behavior, Gillings School of Global Public Health at Chapel Hill, University of North Carolina, Chapel Hill, NC, USA
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Coronavirus disease pandemic and adolescent substance use. Curr Opin Pediatr 2022; 34:334-340. [PMID: 35836392 DOI: 10.1097/mop.0000000000001125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Substance use is common in adolescence and has distinct developmental, cognitive, and health consequences. Over the last 2 years, the coronavirus disease 2019 pandemic has isolated adolescents, disrupted typical developmental milestones, and caused pervasive stress and anxiety. Healthcare providers can help by recognizing and addressing these effects on adolescent mental health and substance use. This update reviews the immediate effects of the pandemic on adolescent substance use, potential future implications, and opportunities to use new strategies to improve care for adolescents with problematic use. RECENT FINDINGS Initial findings suggest that fewer teens started using substances during the pandemic. This was likely influenced by stay at home orders that reduced opportunities for social use. However, increased time at home was not beneficial for all adolescents. Furthermore, adolescents who used substances prepandemic, experienced material hardship, or reported higher pandemic-related stress tended to intensify substance use during this time. SUMMARY The adverse effects of pandemic isolation, anxiety, and developmental disruption will likely have consequences for adolescent substance use for many years to come. To comprehensively address adolescent health, healthcare providers can be sensitive to these realities and use existing screening and brief intervention strategies to address use. Innovative telehealth strategies that allow for the expansion of substance use treatment offer promising opportunities to improve care for adolescents with substance use disorder.
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Hollis A, Downey E, Standing S, Leahy J, Ebbert K, Ganesh A. A vaping risks education program for school students: Evaluation of the solve mystery toolkit. Prev Med Rep 2022; 28:101852. [PMID: 35785407 PMCID: PMC9243163 DOI: 10.1016/j.pmedr.2022.101852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 11/18/2022] Open
Abstract
One in three grade 7 to 12 students in Canada report trying vaping or e-cigarettes. Despite consequences like nicotine addiction, impaired brain development, increased respiratory symptoms, and association with an increased risk of COVID-19 diagnosis, 48% of youth believe occasional vaping has little to no risk. There is a clear need for youth to learn about vaping consequences. We developed and piloted a novel free interactive educational program on vaping risks which has been used by over 800 grade 7 to 9 students. In post-program surveys, students reported a subjective increase in knowledge about the health consequences of vaping.
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Affiliation(s)
- Asha Hollis
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Corresponding author at: 2500 University Drive NW, Calgary, AB T2N1N4, Canada.
| | - Emily Downey
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shaelene Standing
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Janet Leahy
- Department of Computer Science, University of Calgary, Calgary, AB, Canada
| | - Kirsten Ebbert
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary AB, Canada
| | - Aravind Ganesh
- Departments of Clinical Neurosciences and Community Health Sciences, and the Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Rastian B, Wilbur C, Curtis DB. Transfer of Metals to the Aerosol Generated by an Electronic Cigarette: Influence of Number of Puffs and Power. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159334. [PMID: 35954690 PMCID: PMC9368615 DOI: 10.3390/ijerph19159334] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 07/26/2022] [Accepted: 07/26/2022] [Indexed: 02/05/2023]
Abstract
Electronic cigarettes (e-cigarettes) are increasing in popularity despite uncertainties about their health hazards. Literature studies have shown that e-cigarettes may be a source of toxic heavy metal exposure to the user, but the mechanism by which metals are transferred from the e-cigarette parts into the aerosol plume that is inhaled by the user is poorly understood. The goal of this study was to quantify the potentially harmful heavy metals chromium, nickel, copper, and lead systematically during the simulated use of a mod-type e-cigarette in order to better understand the mechanism of metal transfer from the e-cigarette parts into the aerosol plume and into the liquid in the storage tank. Aerosol was collected and aliquots of the remaining liquid in the storage tank were collected from 0 to 40 puffs in 10 puff increments and analyzed with atomic absorption spectroscopy. It was found that the concentration of metals increased in both the aerosol and tank liquid the more times the e-cigarette was puffed, but at varying rates for each element and depending on the power applied to the heating coil. For copper, lead, and nickel, the concentrations of metals in the aerosol and tank increased with increasing power but for chromium, the concentration varied with power. Additionally, it was observed that chromium and nickel concentrations were greater in the aerosol than in tank liquid, consistent with the direct transfer of those metals to the aerosol from heating of the nichrome coil element used in this study. For copper and lead, the concentrations were similar or greater in the tank compared to the aerosol, consistent with transfer first into the storage tank liquid, followed by vaporization into the aerosol.
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Depression with Chronic Disease Is Associated with Increased Use of Medical Services and Medical Expenses in Hardcore Smokers. Healthcare (Basel) 2022; 10:healthcare10081405. [PMID: 36011061 PMCID: PMC9407839 DOI: 10.3390/healthcare10081405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/11/2022] [Accepted: 07/19/2022] [Indexed: 11/17/2022] Open
Abstract
We aimed to investigate the association of chronic disease and depression with medical service use and expenses in hardcore smokers and provide basic data for health management system of hardcore smokers. This was a secondary data study involving 1735 smokers. Propensity score matching (PSM) was conducted to match hardcore smokers with regular smokers, and a two part model (TPM) was used based on the matched groups. In the case of general smokers, subjects with both depression and chronic disease had a significant relation to medical service use. In the case of hardcore smokers, subjects without depression and with chronic disease or with both depression and chronic disease had increased the use of medical services. The depression and chronic disease of general smokers did not affect the use of medical services. In the case of hardcore smokers, subjects who do not have depression and have only chronic disease (β = 0.20, p = 0.002) or with depression and chronic disease (β = 0.20, p = 0.014) significantly related the use of medical services. Conclusion: It is necessary to establish a health management system that considers both emotional states and chronic disease for hardcore smokers.
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Sabbagh HJ, Abdelaziz W, Quritum M, AlKhateeb NA, Abourdan J, Qureshi N, Qureshi S, Hamoud AHN, Mahmoud N, Odeh R, Al-Khanati NM, Jaber R, Balkhoyor AL, Shabi M, Folayan MO, Alade O, Gomaa N, Alnahdi R, Mahmoud NA, El Wazziki H, Alnaas M, Samodien B, Mahmoud RA, Abu Assab N, Saad S, Alhachim SG, El Tantawi M. Cigarettes' use and capabilities-opportunities-motivation-for-behavior model: a multi-country survey of adolescents and young adults. Front Public Health 2022; 10:875801. [PMID: 35937229 PMCID: PMC9353685 DOI: 10.3389/fpubh.2022.875801] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/27/2022] [Indexed: 01/08/2023] Open
Abstract
The use of cigarettes among adolescents and young adults (AYA) is an important issue. This study assessed the association between regular and electronic-cigarettes use among AYA and factors of the Capability-Motivation-Opportunity-for-Behavior-change (COM-B) model. A multi-country survey was conducted between August-2020 and January-2021, Data was collected using the Global-Youth-Tobacco-Survey and Generalized-Anxiety-Disorder-7-item-scale. Multi-level logistic-regression-models were used. Use of regular and electronic-cigarettes were dependent variables. The explanatory variables were capability-factors (COVID-19 status, general anxiety), motivation-factors (attitude score) and opportunity-factors (country-level affordability scores, tobacco promotion-bans, and smoke free-zones) controlling for age and sex. Responses of 6,989-participants from 25-countries were used. Those who reported that they were infected with COVID-19 had significantly higher odds of electronic-cigarettes use (AOR = 1.81, P = 0.02). Normal or mild levels of general anxiety and negative attitudes toward smoking were associated with significantly lower odds of using regular-cigarettes (AOR = 0.34, 0.52, and 0.75, P < 0.001) and electronic-cigarettes (AOR = 0.28, 0.45, and 0.78, P < 0.001). Higher affordability-score was associated with lower odds of using electronic-cigarettes (AOR = 0.90, P = 0.004). Country-level-smoking-control policies and regulations need to focus on reducing cigarette affordability. Capability, motivation and opportunity factors of the COM-B model were associated with using regular or electronic cigarettes.
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Affiliation(s)
- Heba Jafar Sabbagh
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- *Correspondence: Heba Jafar Sabbagh
| | - Wafaa Abdelaziz
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Maryam Quritum
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Joud Abourdan
- Medical Faculty, Istanbul Medipol University, Istanbul, Turkey
| | - Nafeesa Qureshi
- City Quay Dental Practice and Implant Centre, Dundee, Scotland
| | - Shabnum Qureshi
- Department of Education, University of Kashmir, Srinagar, India
| | | | - Nada Mahmoud
- Faculty of Dentistry, National Ribat University, Khartoum, Sudan
| | - Ruba Odeh
- College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Nuraldeen Maher Al-Khanati
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Rawiah Jaber
- General Courses, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Mohammed Shabi
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Omolola Alade
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Noha Gomaa
- Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Raqiya Alnahdi
- Department of Dental Surgery, Oman Dental College, Muscat, Oman
| | | | - Hanane El Wazziki
- Laboratory of Cereal Plant Pathology, National Institute for Argonomic Research, Settat, Morocco
| | - Manal Alnaas
- Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, Scotland
| | - Bahia Samodien
- Western Cape Education Department, Cape Town, South Africa
| | | | | | | | | | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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75
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Abstract
Widespread uptake of vaping has signaled a sea change in the future of nicotine consumption. Vaping has grown in popularity over the past decade, in part propelled by innovations in vape pen design and nicotine flavoring. Teens and young adults have seen the biggest uptake in use of vape pens, which have superseded conventional cigarettes as the preferred modality of nicotine consumption. Relatively little is known, however, about the potential effects of chronic vaping on the respiratory system. Further, the role of vaping as a tool of smoking cessation and tobacco harm reduction remains controversial. The 2019 E-cigarette or Vaping Use-Associated Lung Injury (EVALI) outbreak highlighted the potential harms of vaping, and the consequences of long term use remain unknown. Here, we review the growing body of literature investigating the impacts of vaping on respiratory health. We review the clinical manifestations of vaping related lung injury, including the EVALI outbreak, as well as the effects of chronic vaping on respiratory health and covid-19 outcomes. We conclude that vaping is not without risk, and that further investigation is required to establish clear public policy guidance and regulation.
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Affiliation(s)
- Andrea Jonas
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Stanford University, Stanford, CA, USA
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76
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Silver N, Kierstead E, Tran B, Sparrock L, Vallone D, Schillo B. Belief and Recall of Nicotine as Therapeutic for COVID-19 May Undermine E-Cigarette Quitting Behavior. HEALTH EDUCATION & BEHAVIOR 2022; 49:929-933. [PMID: 35848331 DOI: 10.1177/10901981221109127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We examine the proposition that misinformation about the therapeutic potential of nicotine to prevent or treat COVID-19 may lead to relapse among attempted e-cigarette quitters. A sample of N = 507 e-cigarette ever-users who reported at least one quit attempt in the past year were surveyed in June of 2021 for recall and belief in several claims about COVID-19 and nicotine. Participants who recalled and believed at least one misinformation claim were significantly more likely to have relapsed than those who did not recall or believe such claims. These differences remained robust to regression analysis adding demographic covariates and accounting for continuous measurement of recall and belief. Misinformation about e-cigarette use is reaching young adult e-cigarette users who are trying to quit. The implications of these findings merit further research to characterize potential barriers to successful e-cigarette cessation.
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Affiliation(s)
- Nathan Silver
- Truth Initiative Schroeder Institute, Washington, DC, USA
| | | | - Bianca Tran
- Truth Initiative Schroeder Institute, Washington, DC, USA
| | - Lindsey Sparrock
- Truth Initiative Schroeder Institute, Washington, DC, USA.,American University, Washington, DC, USA
| | - Donna Vallone
- Truth Initiative Schroeder Institute, Washington, DC, USA.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,New York University, New York City, NY, USA
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77
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El Tantawi M, Sabbagh HJ, Alkhateeb NA, Quritum M, Abourdan J, Qureshi N, Qureshi S, Hamoud A, Mahmoud N, Odeh R, Al-Khanati NM, Jaber R, Balkhoyor AL, Shabi M, Folayan MO, Gomaa N, Al_Nahdi R, Mahmoud N, El Wazziki H, Alnaas M, Samodien B, Mahmoud R, Abu Assab N, Saad S, Al-Hachim S, Alshaikh A, Abdelaziz W. Oral manifestations in young adults infected with COVID-19 and impact of smoking: a multi-country cross-sectional study. PeerJ 2022; 10:e13555. [PMID: 35860046 PMCID: PMC9291069 DOI: 10.7717/peerj.13555] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/17/2022] [Indexed: 01/17/2023] Open
Abstract
Background Oral manifestations and lesions could adversely impact the quality of people's lives. COVID-19 infection may interact with smoking and the impact on oral manifestations is yet to be discovered. Objectives The aim of this study was to assess the self-reported presence of oral lesions by COVID-19-infected young adults and the differences in the association between oral lesions and COVID-19 infection in smokers and non-smokers. Methods This cross-sectional multi-country study recruited 18-to-23-year-old adults. A validated questionnaire was used to collect data on COVID-19-infection status, smoking and the presence of oral lesions (dry mouth, change in taste, and others) using an online platform. Multi-level logistic regression was used to assess the associations between the oral lesions and COVID-19 infection; the modifying effect of smoking on the associations. Results Data was available from 5,342 respondents from 43 countries. Of these, 8.1% reported COVID-19-infection, 42.7% had oral manifestations and 12.3% were smokers. A significantly greater percentage of participants with COVID-19-infection reported dry mouth and change in taste than non-infected participants. Dry mouth (AOR=, 9=xxx) and changed taste (AOR=, 9=xxx) were associated with COVID-19- infection. The association between COVID-19-infection and dry mouth was stronger among smokers than non-smokers (AOR = 1.26 and 1.03, p = 0.09) while the association with change in taste was stronger among non-smokers (AOR = 1.22 and 1.13, p = 0.86). Conclusion Dry mouth and changed taste may be used as an indicator for COVID-19 infection in low COVID-19-testing environments. Smoking may modify the association between some oral lesions and COVID-19-infection.
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Affiliation(s)
- Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Heba Jafar Sabbagh
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Maryam Quritum
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Joud Abourdan
- Medical Faculty, Istanbul Medipol University, Istanbul, Turkey
| | - Nafeesa Qureshi
- City Quay Dental Practice and Implant Centre, Dundee, Scotland, United Kingdom
| | - Shabnum Qureshi
- Department of Education, University of Kashmir, Srinagar, Kashmir, India
| | - Ahmed Hamoud
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Nada Mahmoud
- Faculty of Dentistry, National Ribat University, Khartoum, Sudan
| | - Ruba Odeh
- College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Nuraldeen Maher Al-Khanati
- Department of Oral and Maxillofacial Surgery/Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Rawiah Jaber
- General Courses, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Mohammed Shabi
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Noha Gomaa
- Schulich School of Medicine and Dentistry, University of Western Ontario, Ontario, Canada
| | - Raqiya Al_Nahdi
- Department of Dental Surgery, Oman Dental College, Muscat, Oman
| | | | - Hanane El Wazziki
- Department of Cereal Plant Pathology, National Institute of Aricultural Research, Settat, Morocco
| | - Manal Alnaas
- Division of Imaging Science and Technology, School of Medicine, University of Dundee, Dundee, Scotland, United Kingdom
| | - Bahia Samodien
- Western Cape Education Department, Western Cape, South Africa
| | - Rawa Mahmoud
- International Medical Center, Jeddah, Saudi Arabia
| | - Nour Abu Assab
- Schools of Awqaf, Directorate of Education, Jerusalem, Palestine
| | | | - Sondos Al-Hachim
- Health Education Services, Ingham County, Lansing, Michigan, United States of America
| | - Ali Alshaikh
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wafaa Abdelaziz
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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78
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Liu J, Reynolds MJ, Hartman L, Gottlieb M, Coogan JM, Winickoff JP. The First State Tobacco Flavor Ban: High School Tobacco Control Needs in a Changing Landscape. THE JOURNAL OF SCHOOL HEALTH 2022; 92:720-727. [PMID: 35304758 DOI: 10.1111/josh.13171] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/24/2021] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Despite recent tobacco control efforts, adolescent vaping remains an epidemic in the United States. The purpose of our study was to understand high school student vaping behaviors using the perceptions of Massachusetts school personnel during the critical window from when the Massachusetts statewide flavor ban legislation was passed in November 2019 through the first year of the COVID-19 pandemic. METHODS High school personnel throughout Massachusetts were invited to complete a cross-sectional survey. Analysis of survey responses was conducted in R. RESULTS A total of 162 respondents completed the survey representing 137 schools that draw enrollments from 216 (61%) of the 352 cities and towns in Massachusetts. The most popular products that respondents believed their students were using were JUULs (95.7%), other e-cigarettes (85.3%), and disposable vapes (79.6%). Following the flavor ban, the majority (90.7%) did not report an increase in combusted tobacco product use. All participants (100%) reported wanting more access to prevention and treatment resources. CONCLUSIONS Our findings suggest that a comprehensive flavor ban may be an effective tobacco control policy that does not appear to promote student switching from vaping products to combusted tobacco products. These data also indicate that schools report needing additional resources to address the vaping epidemic.
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Affiliation(s)
- Jessica Liu
- Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115
| | | | - Lester Hartman
- Westwood-Mansfield Pediatric Associates, 541 High Street, Westwood, MA, 02090
| | - Mark Gottlieb
- Public Health Advocacy Institute, Northeastern University School of Law, 416 Huntington Avenue, Boston, MA, 02115
| | - Jacqueline M Coogan
- Massachusetts Parent Teachers Association, 405 Waltham Street #147, Lexington, MA, 02421
| | - Jonathan P Winickoff
- Division of General Academic Pediatrics, MassGeneral Hospital for Children, 55 Fruit Street, Yawkey 6D, Boston, MA, 02114
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79
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Abbasi Y, Hout MCV, Faragalla M, Itani L. Knowledge and Use of Electronic Cigarettes in Young Adults in the United Arab Emirates, Particularly during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137828. [PMID: 35805487 PMCID: PMC9265798 DOI: 10.3390/ijerph19137828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 02/04/2023]
Abstract
(1) Background: The popularity of electronic cigarettes (e-cigarettes) has recently increased. Although they are less harmful than regular cigarettes, they still cause health consequences and their use for smoking cessation is inconclusive. The objective of this study was to evaluate patterns of use, knowledge about, and attitude towards e-cigarettes among youth in the United Arab Emirates (UAE) while also researching the impact of the COVID-19 pandemic on smoking behavior. (2) Methods: An online cross-sectional survey was distributed across three major universities in the UAE (n = 240) between March and November 2021. Descriptive analysis, comparison across gender and nationality groups, and correlates between 30-day e-cigarette use and self-reported increases in nicotine consumption during the pandemic were studied. (3) Results: About 37% of students had used an e-cigarette in their lifetime, and 23% had smoked e-cigarettes in the past month. During the pandemic, 52% of university students self-reported no change in nicotine consumption, while only 17.5% had reported an increase. The current smoking of regular cigarettes, waterpipe, and medwakh increased the odds of having an increase in smoking during the pandemic by 5.3 times. (4) Conclusions: The findings inform about youth behavior and knowledge about vaping in the UAE and could also support the development of awareness interventions.
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Affiliation(s)
- Yasir Abbasi
- Maudsley Health, Dubai 1853, United Arab Emirates;
| | - Marie-Claire Van Hout
- International Public Health Policy and Practice, Research and Knowledge Exchange, Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool L2 2QP, UK;
| | - Mohamed Faragalla
- Al Amal Psychiatric Hospital, Emirates Health Services, Dubai 1853, United Arab Emirates;
| | - Lynn Itani
- Maudsley Health, Dubai 1853, United Arab Emirates;
- Correspondence: ; Tel.: +971-52-880-5227
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80
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Jun J, Fitzpatrick MA, Zain A, Zhang N. Have E-cigarette Risk Perception and Cessation Intent of Young Adult Users Changed During the Pandemic? Am J Health Behav 2022; 46:304-314. [PMID: 35794763 DOI: 10.5993/ajhb.46.3.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: Emerging evidence indicates that young adults who use e-cigarettes can withhold greater exposure to COVID-19 risk. We examine how young e-cigarette users perceive COVID-19 related threat of e-cigarette use and benefit of cessation as compared to traditional ones, applying the health belief model. We investigate changes of such perceptions during the pandemic and their associations with past attempt and future intent to quit e-cigarette use. Methods: We collected responses from US young adults (aged 18-25) who have used e-cigarettes in the past month by conducting 2 waves of online surveys in 2020 (wave 1, N=165) and 2021 (wave 2, N=347). Results: Young e-cigarette users in wave 2 reported greater estimates of COVID-19 and traditional threat as well as COVID-19 and traditional benefit of quitting than wave 1. However, we also found significant increases of e-cig dependence, perceived barriers of quitting, and the percentage of young e-cigarette users (33%) who had never attempted to quit in the past month. Importantly, a COVID-19 benefit of cessation and efficacy of quitting were significantly associated with cessation intent. Conclusions: Ongoing efforts are required to track post-pandemic e-cigarette risk perceptions and behaviors, as well as to identify strategies to mitigate increased dependence and usage of e-cigarettes.
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Affiliation(s)
- Jungmi Jun
- Jungmi Jun, School of Journalism and Mass Communications, College of Information and Communications, University of South Carolina, Columbia, SC, United States;,
| | - Mary Anne Fitzpatrick
- Mary Anne Fitzpatrick, School of Journalism and Mass Communications, College of Information and Communications, University of South Carolina, Columbia, SC, United States
| | - Ali Zain
- Ali Zain, School of Journalism and Mass Communications, College of Information and Communications University of South Carolina, Columbia, SC, United States
| | - Nanlan Zhang
- Nanlan Zhang, School of Journalism and Communication, Chongqing University, Chongqing, China
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81
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Virgili F, Nenna R, Ben David S, Mancino E, Di Mattia G, Matera L, Petrarca L, Midulla F. E-cigarettes and youth: an unresolved Public Health concern. Ital J Pediatr 2022; 48:97. [PMID: 35701844 PMCID: PMC9194784 DOI: 10.1186/s13052-022-01286-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/25/2022] [Indexed: 11/11/2022] Open
Abstract
The use of electronic cigarettes (e-cigarette) and vaping devices started as a potential aid for cessation and reducing the harmful consequences of cigarette smoking, mainly in the adult population. Today e-cigarette use is highly increasing in vulnerable populations, especially young and pregnant women, due to the misconception of its harmless use. Despite the growing acknowledgment in e-cigarette as a potential harmful device, and due to mixed information found concerning its beneficial aid for smokers, along with an insufficient clinical study done in human models, it is important to further evaluate the possible benefits and risks of non-combusting, vaping nicotine or non-nicotine delivery devices. In this review we tried to summarize the latest updated information found in the literature, concentrating mainly in the variety of adverse effects of e-cigarette use and its contribution for recent and future health concerns.
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Affiliation(s)
- Fabrizio Virgili
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Shira Ben David
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Greta Di Mattia
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Luigi Matera
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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82
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Cummings KJ, Clarkberg M, Busche J, Travis AJ, Meredith GR, Weisfuse I, Cazer CL, Koretzky GA, Warnick LD. Case-control study to identify risk factors for SARS-CoV-2 infection among university students in the northeastern USA. Transbound Emerg Dis 2022; 69:e2688-e2693. [PMID: 35687478 PMCID: PMC9348057 DOI: 10.1111/tbed.14619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
Curbing the coronavirus disease 2019 (COVID-19) pandemic requires a thorough understanding of risk factors for transmission of SARS-CoV-2, the etiologic agent. Institutions of higher education present unique challenges for controlling disease spread because of features inherent to these settings. Our objective was to determine risk factors for SARS-CoV-2 infection among a university student population in the northeastern USA during the spring and fall 2021 semesters, using the case-control study design. Cases were defined as students with a newly diagnosed SARS-CoV-2 infection detected either through the robust PCR-based surveillance testing program on campus or through healthcare testing if symptoms compatible with COVID-19 were present. Controls were defined as students with negative SARS-CoV-2 status, based on consistently negative PCR results at the time of selection. A comprehensive questionnaire was administered to each student enrolled in the study, covering a broad range of campus life activities. A total of 446 cases and 1,185 controls were included in this study. Multivariable logistic regression analysis showed that recent party attendance (adjusted OR = 2.3, p < .0001), recently visiting a bar (aOR = 1.6, p = .007), living in a campus residence hall (aOR = 1.6, p = .001), fraternity/sorority membership (aOR = 1.8, p = .002), and recent travel (aOR = 1.3, p = .04) were associated with being a COVID-19 case. Having an on-campus job was negatively associated with being a COVID-19 case (aOR = 0.6, p = .0003). Among cases, the most commonly reported symptoms were cough (43.9%), fatigue (38.1%) and sore throat (30.3%). These findings can be used to inform the development of COVID-19 mitigation strategies and public health outreach efforts in university settings, thus reducing SARS-CoV-2 transmission among students and helping to preserve the vital education and research missions of these institutions.
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83
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E Culbreth R, J Brandenberger K, Battey-Muse CM, Gardenhire DS. 2021 Year in Review: E-Cigarettes, Hookah Use, and Vaping Lung Injuries During the COVID-19 Pandemic. Respir Care 2022; 67:709-714. [PMID: 35606003 PMCID: PMC9994204 DOI: 10.4187/respcare.09919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Electronic cigarettes (e-cigarettes) and hookah smoking have gained tremendous popularity over the past decade. With the constantly evolving e-cigarette market and potential impact of the COVID-19 pandemic on users of these tobacco products, research is needed to assess the prevalence and safety of these devices as well as potential public health implications and cessation tools. For this year in review, PubMed was searched from January 2021-December 14, 2021, for articles related to e-cigarettes, vaping-related lung injury, and hookah smoking. Relevant articles addressing the objectives were included in this review. This review focused primarily on articles based on United States populations. Gray literature and nonpublished articles were not included in this review. The 2020 pandemic resulted in a decline in e-cigarette usage among youth (potentially due to the COVID-19 pandemic); however, recent research in 2021 suggests that e-cigarette usage is increasing again among youth. Conflicting evidence exists for e-cigarettes and the risk of COVID-19 infection, but biological plausibility suggests that e-cigarette users are more susceptible to COVID-19 infection and more severe COVID-19 infection compared to non-e-cigarette users. Hookah smoking has remained stable across the past several years and remains a primarily social activity among youth. New e-cigarette devices are constantly emerging, resulting in an increased demand to understand the safety of these devices. Additionally, hookah smoking continues to be a concerning public health issue with the increase in hookah bars and venues coupled with lack of policy regulations for hookah smoking.
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Affiliation(s)
- Rachel E Culbreth
- Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia.
| | - Kyle J Brandenberger
- Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia
| | - Corinne M Battey-Muse
- Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia
| | - Douglas S Gardenhire
- Department of Respiratory Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, Georgia
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84
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Gaiha SM, Epperson AE, Halpern-Felsher B. Youth perceptions of e-cigarette-related risk of lung issues and association with e-cigarette use. Health Psychol 2022; 41:417-422. [PMID: 35157478 PMCID: PMC9133038 DOI: 10.1037/hea0001146] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
OBJECTIVE E-cigarette use is associated with increased risk of negative health outcomes, including respiratory problems such as Coronavirus Disease 2019 (COVID-19). Nevertheless, adolescents and young adults (AYAs) continue to use e-cigarettes at alarming rates. We examined AYA's perceptions of the health harms of e-cigarettes in relation to respiratory problems and the associations between these perceptions and e-cigarette use. METHOD In May 2020, we conducted an online, national cross-sectional survey of AYAs aged 13 to 24 years old (N = 4,315; 65% female; 50% ever-users, 50% never-users) to assess e-cigarette use and perceptions of the risk of respiratory problems, COVID-19, and severe lung disease for AYAs with different levels of e-cigarette use. RESULTS In comparisons between AYAs with different levels of e-cigarette use, e-cigarette-related health risk perceptions were lower among ever-users compared to never-users and among ever-users who used e-cigarettes in the past 30 days compared to ever-users who did not use in the past 30 days. After controlling for demographics, AYAs were less likely to have used in the past 30 days if they agreed that young people are at risk of respiratory problems due to e-cigarette use (adjusted Odds Ratio [aOR] = .68, 95% confidence interval [CI; .59, .78]) and e-cigarettes are harmful for their health (aOR = .52, 95% CI [.30, .90]). AYAs were more likely to have used in the past 30 days if they believed that there is no hard evidence that e-cigarette use with nicotine increases risk of severe lung disease (aOR = 1.61, 95% CI [1.42, 1.82]) and that e-cigarette use is safer than smoking cigarettes (aOR = 1.26, 95% CI [1.11, 1.42]). CONCLUSIONS Among AYAs who had ever used e-cigarettes, those who did not believe that e-cigarette use increases the risks of respiratory problems were more likely to have used e-cigarettes in the past month. To bridge the gap between youth perceptions and emerging scientific evidence on e-cigarette-related health risks, prevention messaging should seek to explain how e-cigarette use is linked to respiratory problems and could affect COVID-19 outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Shivani M. Gaiha
- Reach lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University
| | - Anna E. Epperson
- Department of Psychological Sciences, School of Social Sciences, Humanities and Arts, University of California, Merced
| | - Bonnie Halpern-Felsher
- Reach lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University
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85
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Robertson L, Hoek J, Blank ML. A qualitative analysis of electronic nicotine delivery systems (ENDS) uptake and use among young adult never-smokers in New Zealand. PLoS One 2022; 17:e0268449. [PMID: 35622846 PMCID: PMC9140280 DOI: 10.1371/journal.pone.0268449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 04/29/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Electronic nicotine delivery systems (ENDS) likely pose fewer health risks than smoking. Yet ENDS uptake has increased among never-smoking young adults, who likely face greater health risks relative to non-users of ENDS. To date, few qualitative studies have explored ENDS uptake and use by never-smokers. METHODS We conducted in-depth, semi-structured interviews with 16 current ENDS users from New Zealand aged 18 to 24 years old who reported never having smoked cigarettes regularly. We explored participants' experimentation with conventional tobacco products, trial, uptake and patterns of ENDS use, and their future intentions regarding both ENDS and conventional tobacco products. We managed the data using NVivo12 and used thematic analysis to interpret the transcripts. RESULTS ENDS use enhanced connection and belonging by providing communal experiences and facilitating social interactions. Participants' mastery of tricks generated social cachet within friendship groups and counteracted the ENDS-related stigma they experienced. Flavours, clouds and devices' physical attributes provided stimulation and engagement, and some used ENDS for stress or appetite management. Lastly, participants rationalised ENDS uptake by referencing the far greater risks smoking posed. CONCLUSIONS ENDS uptake by young adult never-smokers is driven by both psycho-social and functional factors. ENDS provided shared hedonic experiences and physical pleasures, and generated both bonding and bridging social capital, although many participants had also experienced judgement from others for using ENDS. Policies that denormalise ENDS as recreational devices could discourage uptake by never-smokers, though measures will require careful nuancing to avoid deterring smokers from switching to ENDS.
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Affiliation(s)
- Lindsay Robertson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Mei-Ling Blank
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
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Bennett M, Speer J, Taylor N, Alexander T. Changes in E-cigarette Use Among Youth and Young Adults During the COVID-19 Pandemic: Insights Into Risk Perceptions and Reasons for Changing Use Behavior. Nicotine Tob Res 2022; 25:350-355. [PMID: 35639822 PMCID: PMC9384103 DOI: 10.1093/ntr/ntac136] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/03/2022] [Accepted: 05/24/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION This study assessed changes in e-cigarette use since the COVID-19 pandemic began and reasons for these changes among US youth and young adults. AIMS AND METHODS We combined data from two cross-sectional samples of youth and young adult (15-24 years) participants of a monthly surveillance study (data collected in April and June 2021). Analyses were restricted to past-year e-cigarette users who reported using e-cigarettes before the pandemic (n = 1762). Participants reported changes in e-cigarette use since the pandemic began, reasons for changing their behavior, and their perceptions around COVID-19 risk related to e-cigarette use. Multinomial logistic regression models assessed associations between demographics and COVID vaping risk perceptions and changes in e-cigarette use. RESULTS Over a third of the sample (37.9%) reported increasing e-cigarette use, while 28.9% reported decreasing use, and 33.1% reported no change. Analyses revealed associations between change in e-cigarette use and age, race and ethnicity, e-cigarette use status, and COVID vaping risk perceptions. The most common reason for increasing use was managing stress (36%); the most common reasons for decreasing use included fewer social interactions (22%) and concerns over general health (18%). Results also indicated differences in reasons for decreasing use by race and ethnicity, and differences in reasons for both increasing and decreasing use by age. CONCLUSIONS This study provides recent data on how the ongoing and evolving COVID-19 pandemic has impacted youth and young adults' e-cigarette use. Findings identify subpopulations that may benefit from e-cigarette prevention interventions, as well as insights that may inform the content and delivery of such interventions. IMPLICATIONS This study provides recent insights into if and why the ongoing COVID-19 pandemic has impacted e-cigarette use behavior among youth and young adults. Findings contribute to the understanding of the role e-cigarettes play in young people's lives-insights that can inform youth and young adult prevention efforts.
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Affiliation(s)
- Morgane Bennett
- Corresponding Author: Morgane Bennett, DrPH, 10903 New Hampshire Ave, Silver Spring, MD 20993, USA. Telephone: 240 750 5996; E-mail:
| | - Jessica Speer
- Center for Health Analytics, Media, and Policy, RTI International, Research Triangle Park, NC, USA
| | - Nathaniel Taylor
- Center for Health Analytics, Media, and Policy, RTI International, Research Triangle Park, NC, USA
| | - Tesfa Alexander
- Department of Research and Evaluation, Office of Health Communication and Education, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
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Bennett B, Romm KF, Berg CJ. Changes in cigarette and e-cigarette use among US young adults from before to during the COVID-19 pandemic: News exposure and risk perceptions as potential predictors. Tob Prev Cessat 2022; 8:18. [PMID: 35601562 PMCID: PMC9074834 DOI: 10.18332/tpc/148245] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/09/2022] [Accepted: 04/12/2022] [Indexed: 01/28/2023]
Abstract
INTRODUCTION COVID-19 impacted cigarette and e-cigarette use behaviors among some individuals. This study examined COVID-19 factors and prior substance use as predictors of cigarette and e-cigarette cessation and initiation among US young adults from before to during the COVID-19 pandemic. METHODS We analyzed data from Wave 3 (Sept-Dec 2019) and Wave 5 (Sept-Dec 2020) of a 2-year, 5-wave longitudinal study of young adults across six US metropolitan areas. We examined COVID-19 news exposure, perceived smoking and e-cigarette use risk, and prior substance use, as predictors of cigarette and e-cigarette cessation and initiation, respectively. RESULTS Of W3 cigarette users (n=516), 37.8% (n=195) quit cigarettes at W5; predictors of cessation included younger age, fewer days of W3 past-month cigarette use, and no W3 e-cigarette use. Of W3 e-cigarette users (n=687), 38.7% (n=266) quit e-cigarettes at W5; predictors included greater COVID-19 news exposure, fewer days of W3 past-month e-cigarette use, and no W3 cigarette use. Of W3 cigarette non-users (n=1693), 5.0% (n=85) initiated cigarettes at W5; predictors of initiation included younger age, lower perceived smoking risk, lifetime cigarette and e-cigarette use, and W3 e-cigarette use. Of W3 e-cigarette non-users (n=1522), 6.3% (n=96) initiated e-cigarettes at W5; predictors included younger age, less news exposure, lifetime cigarette and e-cigarette use, and W3 cigarette use. CONCLUSIONS These findings underscore the need to address cigarette and e-cigarette co-use and related risk perceptions in prevention and cessation interventions.
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Affiliation(s)
- Breesa Bennett
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Katelyn F. Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
- George Washington Cancer Center, George Washington University, Washington, United States
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88
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Payton AD, Perryman AN, Hoffman JR, Avula V, Wells H, Robinette C, Alexis NE, Jaspers I, Rager JE, Rebuli ME. Cytokine signature clusters as a tool to compare changes associated with tobacco product use in upper and lower airway samples. Am J Physiol Lung Cell Mol Physiol 2022; 322:L722-L736. [PMID: 35318855 PMCID: PMC9054348 DOI: 10.1152/ajplung.00299.2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/22/2022] Open
Abstract
Inhalation exposure to cigarette smoke and e-cigarette aerosol is known to alter the respiratory immune system, particularly cytokine signaling. In assessments of health impacts of tobacco product use, cytokines are often measured using a variety of sample types, from serum to airway mucosa. However, it is currently unclear whether and how well cytokine levels from different sample types and the airway locations they represent are correlated, making comparing studies that utilize differing sample types challenging. To address this challenge, we compared baseline cytokine signatures in upper and lower airways and systemic samples and evaluated how groups of coexpressed cytokines change with tobacco product use. Matched nasal lavage fluid (NLF), nasal epithelial lining fluid (NELF), sputum, and circulating serum samples were collected from 14 nonsmokers, 13 cigarette smokers, and 17 e-cigarette users and analyzed for levels of 22 cytokines. Individual cytokine signatures were first compared across each sample type, followed by identification of cytokine clusters within each sample type. Identified clusters were then evaluated for potential alterations following tobacco product use using eigenvector analyses. Individual cytokine signatures in the respiratory tract were significantly correlated (NLF, NELF, and sputum) compared with randomly permutated signatures, whereas serum was not significantly different from random permutations. Cytokine clusters that were similar across airway sample types were modified by tobacco product use, particularly e-cigarettes, indicating a degree of uniformity in terms of how cytokine host defense and immune cell recruitment responses cooperate in the upper and lower airways. Overall, cluster-based analyses were found to be especially useful in small cohort assessments, providing higher sensitivity than individual signatures to detect biologically meaningful differences between tobacco use groups. This novel cluster analysis approach revealed that eigencytokine patterns in noninvasive upper airway samples simulate cytokine patterns in lower airways.
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Affiliation(s)
- Alexis D Payton
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- The Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alexia N Perryman
- Curriculum in Toxicology and Environmental Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jessica R Hoffman
- Curriculum for the Environment and Ecology, College of Arts and Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Vennela Avula
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- The Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Heather Wells
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Carole Robinette
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Neil E Alexis
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Ilona Jaspers
- Curriculum in Toxicology and Environmental Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- The Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Julia E Rager
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Curriculum in Toxicology and Environmental Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- The Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Meghan E Rebuli
- Curriculum in Toxicology and Environmental Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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89
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Sznitman SR, Lewis N. Israeli news media coverage of COVID-19 and use of cannabis and tobacco: A case study of inconsistent risk communication. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 103:103648. [PMID: 35325638 PMCID: PMC8898739 DOI: 10.1016/j.drugpo.2022.103648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 02/24/2022] [Accepted: 03/02/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND There is continued scientific debate regarding the link between risk of COVID-19 infection and increased disease severity and tobacco and cannabis use. The way this topic is presented in news media coverage may influence public attitudes and behavior and is thus an important topic of investigation. This study examines (1) the extent to which Israeli news media reported a positive (i.e., protective/therapeutic), negative (i.e., harmful), or inconclusive association between three types of substance use (tobacco, medical cannabis, recreational cannabis) and risk of COVID-19 infection and/or increased disease severity, and (2) the extent that this media coverage refers to scientific research. METHODS A quantitative content analysis of news articles related to tobacco and cannabis use and COVID-19 (N = 113) from eleven of the highest circulation newspapers in Israel. RESULTS News items were significantly more likely to mention increased COVID-19 risk for tobacco use, compared to cannabis use. All medical cannabis news items reported that medical cannabis use was associated with reduced COVID-19 risk. In contrast, news items about recreational cannabis use were more likely to describe a balanced or inconclusive risk for COVID-19, or increased risk. The majority of articles referred to scientific research. CONCLUSION While Israeli news media reported a relatively consistent message about the increased risk of COVID-19 in relation to tobacco use, messages about cannabis use were less consistent in communicating risk information. Research should examine effects of media coverage of tobacco and cannabis use and COVID-19 on public perceptions and behaviors.
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Affiliation(s)
- Sharon R Sznitman
- School of Public Health, University of Haifa, Eshkol Tower room 705 Mt, Carmel, 3190501, Haifa, Israel.
| | - Nehama Lewis
- Communication Department, University of Haifa, Rabin Complex 8032 Mt, Carmel, 3190501, Haifa, Israel
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90
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Ross JA, Malone PK, Levy S. The Impact of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic on Substance Use in the United States. Clin Infect Dis 2022; 75:S81-S85. [PMID: 35476024 PMCID: PMC9129126 DOI: 10.1093/cid/ciac311] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The SARS-CoV-2 pandemic has been associated with dramatic increases in substance use, as marked by increased alcohol, nicotine, and cannabis sales. Lethal opioid overdoses also increased dramatically, especially during the initial phases of the epidemic when lockdowns and social isolation combined with increasing fentanyl contamination of the illicit drug supply resulted in more overdoses and fewer opportunities for rescue. Substance use, and especially inhalational drug use, increases the likelihood of both transmission and severe infection. Youth are especially vulnerable to substance use and have increased risk of long-term problems. These outcomes highlight the need for greater access to substance use treatment. Virtual treatment, which emerged as a promising format during the pandemic, may reduce access barriers. This article reviews trends in substance use during the pandemic, explores root causes of increased use and overdose, and examines the potential to increase treatment through virtual care, especially during future periods of disruption.
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Affiliation(s)
- Jennifer A. Ross
- Adolescent Substance Use and Addiction Program, Boston Children’s Hospital, Boston, MA 02115,Corresponding author: Jennifer A. Ross, 300 Longwood Avenue, Mailstop 3393, Boston, MA 02115
| | - Patrice K. Malone
- Department of Psychiatry, Columbia University Irving Medical Center, New York City, New York, 10032
| | - Sharon Levy
- Adolescent Substance Use and Addiction Program, Boston Children’s Hospital, Boston, MA 02115; Harvard Medical School, Boston, MA, 02115
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91
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Burnett-Hartman AN, Goldberg Scott S, Powers JD, Clennin MN, Lyons JA, Gray M, Feigelson HS. The Association of Electronic Cigarette Use With SARS-CoV-2 Infection and COVID-19 Disease Severity. Tob Use Insights 2022; 15:1179173X221096638. [PMID: 35492220 PMCID: PMC9044777 DOI: 10.1177/1179173x221096638] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/06/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Although combustible cigarette use is an established risk factor for severe
COVID-19 disease, there is conflicting evidence for the association of
electronic cigarette use with SARS-CoV-2 infection and COVID-19 disease
severity. METHODS Study participants were from the Kaiser Permanente Research Bank (KPRB), a
biorepository that includes adult Kaiser Permanente members from across the
United States. Starting in April 2020, electronic surveys were sent to KPRB
members to assess the impact of the COVID-19 pandemic. These surveys
collected information on self-report of SARS-CoV-2 infection and
COVID-related risk factors, including electronic cigarette and combustible
cigarette smoking history. We also used electronic health records data to
assess COVID-19 diagnoses, positive PCR lab tests, hospitalizations, and
death. We used multivariable Cox proportional hazards regression to
calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs)
comparing the risk of SARS-CoV-2 infection between individuals by
e-cigarette use categories (never, former, and current). Among those with
SARS-CoV-2 infection, we used multivariable logistic regression to estimate
adjusted odds ratios (ORs) and 95% CIs comparing the odds of hospitalization
or death within 30 days of infection between individuals by e-cigarette use
categories. RESULTS There were 126,475 individuals who responded to the survey and completed
questions on e-cigarette and combustible cigarette use (48% response rate).
Among survey respondents, 819 (1%) currently used e-cigarettes, 3,691 (3%)
formerly used e-cigarettes, and 121,965 (96%) had never used e-cigarettes.
After adjustment for demographic, behavioral, and clinical factors, there
was no association with SARS-CoV-2 infection and former e-cigarette use
(hazard ratio (HR) = 0.99; CI: 0.83–1.18) or current e-cigarette use (HR =
1.08; CI: 0.76–1.52). Among those with SARS-CoV-2 infection, there was no
association with hospitalization or death within 30 days of infection and
former e-cigarette use (odds ratio (OR) = 1.19; CI: 0.59–2.43) or current
e-cigarette use (OR = 1.02; CI: 0.22–4.74). CONCLUSIONS Our results suggest that e-cigarette use is not associated with an increased
risk of SARS-CoV-2 infection or severe COVID-19 illness.
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Affiliation(s)
- Andrea N Burnett-Hartman
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | | | - J David Powers
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA
| | - Morgan N Clennin
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA
| | - Jason A Lyons
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA
| | - Mark Gray
- Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA
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Sidani JE, Hoffman B, Colditz JB, Wolynn R, Hsiao L, Chu KH, Rose JJ, Shensa A, Davis E, Primack B. Discussions and Misinformation About Electronic Nicotine Delivery Systems and COVID-19: Qualitative Analysis of Twitter Content. JMIR Form Res 2022; 6:e26335. [PMID: 35311684 PMCID: PMC9009382 DOI: 10.2196/26335] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 05/14/2021] [Accepted: 03/14/2022] [Indexed: 01/19/2023] Open
Abstract
Background Misinformation and conspiracy theories related to COVID-19 and electronic nicotine delivery systems (ENDS) are increasing. Some of this may stem from early reports suggesting a lower risk of severe COVID-19 in nicotine users. Additionally, a common conspiracy is that the e-cigarette or vaping product use–associated lung injury (EVALI) outbreak of 2019 was actually an early presentation of COVID-19. This may have important public health ramifications for both COVID-19 control and ENDS use. Objective Twitter is an ideal tool for analyzing real-time public discussions related to both ENDS and COVID-19. This study seeks to collect and classify Twitter messages (“tweets”) related to ENDS and COVID-19 to inform public health messaging. Methods Approximately 2.1 million tweets matching ENDS-related keywords were collected from March 1, 2020, through June 30, 2020, and were then filtered for COVID-19–related keywords, resulting in 67,321 original tweets. A 5% (n=3366) subsample was obtained for human coding using a systematically developed codebook. Tweets were coded for relevance to the topic and four overarching categories. Results A total of 1930 (57.3%) tweets were coded as relevant to the research topic. Half (n=1008, 52.2%) of these discussed a perceived association between ENDS use and COVID-19 susceptibility or severity, with 42.4% (n=818) suggesting that ENDS use is associated with worse COVID-19 symptoms. One-quarter (n=479, 24.8%) of tweets discussed the perceived similarity/dissimilarity of COVID-19 and EVALI, and 13.8% (n=266) discussed ENDS use behavior. Misinformation and conspiracy theories were present throughout all coding categories. Conclusions Discussions about ENDS use and COVID-19 on Twitter frequently highlight concerns about the susceptibility and severity of COVID-19 for ENDS users; however, many contain misinformation and conspiracy theories. Public health messaging should capitalize on these concerns and amplify accurate Twitter messaging.
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Affiliation(s)
- Jaime E Sidani
- Center for Social Dynamics and Community Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States
| | - Beth Hoffman
- Center for Social Dynamics and Community Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States
| | - Jason B Colditz
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Riley Wolynn
- Kenneth P Dietrich School of Arts & Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lily Hsiao
- Kenneth P Dietrich School of Arts & Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kar-Hai Chu
- Center for Social Dynamics and Community Health, Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, United States
| | - Jason J Rose
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Ariel Shensa
- Department of Health Administration and Public Health, John G Rangos Sr School of Health Sciences, Duquesne University, Pittsburgh, PA, United States
| | - Esa Davis
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Brian Primack
- College of Education and Health Professions, University of Arkansas, Fayetteville, AZ, United States
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93
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Lyzwinski LN, Naslund JA, Miller CJ, Eisenberg MJ. Global youth vaping and respiratory health: epidemiology, interventions, and policies. NPJ Prim Care Respir Med 2022; 32:14. [PMID: 35410990 PMCID: PMC9001701 DOI: 10.1038/s41533-022-00277-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 02/17/2022] [Indexed: 01/02/2023] Open
Abstract
AbstractE-cigarette usage (also known as e-cigarettes or vaping products) has increasingly been recognized as a global public health problem. One challenge in particular involves their marketing to minors (teenagers and children) and the rising prevalence of use in this population. E-cigarettes unnecessarily expose minors to health risks, these include respiratory health problems, such as exacerbations of asthma, bronchitis, and respiratory-tract irritation. Nicotine, commonly found in e-cigarettes, is also associated with cognitive impairment and neurodevelopmental problems. E-cigarettes are also risk factors for downstream substance use, including cigarettes and cannabis initiation (the gateway hypothesis), which compounds health risks in dual users. Current public health preventative and intervention studies are limited, and there is a clear need for more interventions that may prevent usage and assist with cessation in this vulnerable population. Physician education and screening uptake should also be enhanced. Stricter public health policy and protection measures are also needed on a global scale to limit e-cigarette exposure in minors.
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94
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Rai S, Hormozdyaran S, Burns J, Amodio JB, Quizon AI. Diagnosis of EVALI in Adolescents During the COVID-19 Pandemic: A Case Series. Hosp Pediatr 2022; 12:538-543. [PMID: 35388412 DOI: 10.1542/hpeds.2021-006110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Electronic-cigarette or vaping use-associated lung injury (EVALI) is an illness that requires further awareness for appropriate diagnosis and management. This series is a retrospective chart review of EVALI cases admitted from June to December 2020 at a large academic children's hospital in New York. METHODS Notably during this time, the coronavirus disease 2019 (COVID-19) global pandemic rendered the world under strict quarantine mandates. We discuss 7 patients, all of whom were seen in a clinic, urgent care, or emergency department before presentation to our hospital. RESULTS Patients presented with respiratory, gastroenterology, and constitutional complaints typically seen with EVALI and COVID-19. However, given their complex presentations in the setting of the COVID-19 pandemic, EVALI was not considered as pertinent history was not elicited. CONCLUSIONS With the COVID-19 pandemic as a setting for these cases, we emphasize the importance of eliciting a complete psychosocial history for all adolescents because without vaping disclosure, EVALI will go undiagnosed. It is also imperative to ensure consistent outpatient follow-up, although difficult because of limited access or hesitation and fear of acquiring COVID-19 in health care settings during the pandemic, and to stress vaping cessation, both of which are crucial in preventing further complications.
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Affiliation(s)
| | | | | | - John B Amodio
- Pediatric Radiology, Cohen Children's Medical Center, New Hyde Park, New York.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Annabelle I Quizon
- Departments of Pediatrics.,Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
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Kanakaraju K, Vanoli H, Rajenthrakumar H, Asokan A, Ranganathan RS. An Analytical Study to Determine the Severity of COVID-19 Among Smokers. Cureus 2022; 14:e23802. [PMID: 35530823 PMCID: PMC9067350 DOI: 10.7759/cureus.23802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 01/08/2023] Open
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Kumar N, Janmohamed K, Nyhan K, Martins SS, Cerda M, Hasin D, Scott J, Sarpong Frimpong A, Pates R, Ghandour LA, Wazaify M, Khoshnood K. Substance, use in relation to COVID-19: A scoping review. Addict Behav 2022; 127:107213. [PMID: 34959077 PMCID: PMC8684053 DOI: 10.1016/j.addbeh.2021.107213] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 10/24/2021] [Accepted: 12/11/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND We conducted a scoping review focused on various forms of substance use amid the pandemic, looking at both the impact of substance use on COVID-19 infection, severity, and vaccine uptake, as well as the impact that COVID-19 has had on substance use treatment and rates. METHODS A scoping review, compiling both peer-reviewed and grey literature, focusing on substance use and COVID-19 was conducted on September 15, 2020 and again in April 15, 2021 to capture any new studies. Three bibliographic databases (Web of Science Core Collection, Embase, PubMed) and several preprint servers (EuropePMC, bioRxiv, medRxiv, F1000, PeerJ Preprints, PsyArXiv, Research Square) were searched. We included English language original studies only. RESULTS Of 1564 articles screened in the abstract and title screening phase, we included 111 research studies (peer-reviewed: 98, grey literature: 13) that met inclusion criteria. There was limited research on substance use other than those involving tobacco or alcohol. We noted that individuals engaging in substance use had increased risk for COVID-19 severity, and Black Americans with COVID-19 and who engaged in substance use had worse outcomes than white Americans. There were issues with treatment provision earlier in the pandemic, but increased use of telehealth as the pandemic progressed. COVID-19 anxiety was associated with increased substance use. CONCLUSIONS Our scoping review of studies to date during COVID-19 uncovered notable research gaps namely the need for research efforts on vaccines, COVID-19 concerns such as anxiety and worry, and low- to middle-income countries (LMICs) and under-researched topics within substance use, and to explore the use of qualitative techniques and interventions where appropriate. We also noted that clinicians can screen and treat individuals exhibiting substance use to mitigate effects of the pandemic. FUNDING Study was funded by the Institution for Social and Policy Studies, Yale University and The Horowitz Foundation for Social Policy. DH was funded by a NIDA grant (R01DA048860). The funding body had no role in the design, analysis, or interpretation of the data in the study.
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Affiliation(s)
- Navin Kumar
- Human Nature Lab, Department of Sociology, Yale University, New Haven, CT, USA.
| | | | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, USA; Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Magdalena Cerda
- Center for Opioid Epidemiology and Policy, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Deborah Hasin
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Jenny Scott
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | | | - Richard Pates
- Institute of Health and Society, University of Worcester, Worcester, UK
| | - Lilian A Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Mayyada Wazaify
- Department of Biopharmaceuticals and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan
| | - Kaveh Khoshnood
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
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Collaco JM, McGrath-Morrow SA. Developmental Effects of Electronic Cigarette Use. Compr Physiol 2022; 12:3337-3346. [PMID: 35578965 DOI: 10.1002/cphy.c210018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Electronic cigarettes have gained widespread acceptance among adolescents and young adults. As a result of this popularity, there are concerns regarding the potential harm of primary, secondhand and thirdhand electronic cigarette exposures on fetal and postnatal development. In vitro studies have shown that constituents in electronic cigarette liquids, including nicotine, flavorings, and carrier agents can alter cellular processes and growth. Additionally, aerosolized electronic cigarette emissions have been shown to disrupt organ development and immune responses in preclinical studies. In clinical studies, an association between electronic cigarette use and frequent respiratory symptoms, greater asthma severity and impaired mucociliary clearance has been demonstrated with adolescent and young adult users of electronic cigarettes having twice the frequency of cough, mucus production, or bronchitis compared to nonusers. Along with the popularity of electronic cigarette use, secondhand electronic cigarette exposure has increased substantially; with almost one-fourth of middle and high school children reporting exposure to secondhand vapors. The health consequences of secondhand electronic cigarette exposure on children and other vulnerable populations are poorly understood but detectable levels of cotinine have been measured in nonusers. Pregnant women and their offspring are another vulnerable group at increased risk for health consequences from electronic cigarette exposure. Nicotine crosses the placenta and can disrupt brain and lung development in preclinical studies. This article will focus on the physiological and health effects associated with primary or secondhand exposure to electronic cigarettes. It is expected that with ongoing availability of electronic cigarettes as well as the accumulation of additional follow-up time for long-term outcomes, the risks associated with exposure will become better clarified. © 2022 American Physiological Society. Compr Physiol 12:3337-3346, 2022.
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Affiliation(s)
- Joseph M Collaco
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Sharon A McGrath-Morrow
- Division of Pediatric Pulmonology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Feeney S, Rossetti V, Terrien J. E-Cigarettes-a review of the evidence-harm versus harm reduction. Tob Use Insights 2022; 15:1179173X221087524. [PMID: 35370428 PMCID: PMC8968985 DOI: 10.1177/1179173x221087524] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 02/09/2022] [Indexed: 12/23/2022] Open
Abstract
The World Health Organization estimates there are 1.1 billion cigarette smokers across the globe and that tobacco related deaths number 7 million per year. Electronic nicotine delivery systems (ENDS) are available to contribute options for smoking cessation and include e-cigarettes, e-hookahs, vape pens, mods, and vaping. The growing use of ENDS, or e-cigarettes, in the US and globally across populations is dramatic. Although users may think that e-cigarettes are less harmful than combustible tobacco products, the evidence shows that there are known risks and harms for users. E-cigarettes have varying amounts of toxicants, nicotine, and carcinogens and put the user at risk for lung diseases and COVID-19 similar to smokers. Currently, most governing bodies have not approved e-cigarettes as a smoking cessation tool but do state if a person has failed conventional smoking cessation treatments that e-cigarettes used alone for the short term may help those to quit combustible tobacco and nicotine. A shared decision-making approach should be used when discussing e-cigarettes as a harm reduction tool. More studies and long-term data are needed to assess potential benefits and harms. What is known is that prevention efforts and policy are needed to avoid adolescents and other vulnerable populations from initiating tobacco or e-cigarette use.
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Affiliation(s)
- Susan Feeney
- Graduate School of Nursing, University of Massachusetts Medical SchoolUniversity, Worcester, MA, USA
| | - Victoria Rossetti
- Lamar Souter Library, University of Massachusetts Chan Medical SchoolUniversity, Worcester, MA, USA
| | - Jill Terrien
- Graduate School of Nursing, University of Massachusetts Medical School Graduate School of NursingUniversity, Worcester, MA, USA
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Risk Behaviors, Family Support, and Emotional Health among Adolescents during the COVID-19 Pandemic in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073850. [PMID: 35409535 PMCID: PMC8997377 DOI: 10.3390/ijerph19073850] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 12/23/2022]
Abstract
We investigated the prevalence of risk behaviors among Israeli adolescents (tobacco smoking, alcohol consumption, drug use) during the COVID-19 pandemic. Associations between different risk behaviors were examined and so was whether specific characteristics could predict risk behaviors in adolescents. The study consisted of 1020 Israeli adolescents aged 15-18. Study subjects completed an online survey between the first and second lockdowns in Israel (April 2020 to September 2020). Participants reported the frequency at which they engaged in four different risky behaviors: general risky behavior, tobacco smoking, alcohol consumption (binge drinking), and cannabis use. The most prevalent risky behavior in the sample was binge drinking (33.8%). The four measured risky behaviors were significantly correlated. Among participants who had previously engaged in a risky behavior assessed, most did not change the behavior frequency during the pandemic. All independent variables (sociodemographic characteristics, family support, and emotional, health excluding friends' support, physical activity volume, and coronavirus restrictions) were significantly different between participants engaging vs. not engaging in risky behaviors. Our findings suggest that family support is one of the most influential factors in preventing risky behavior during the pandemic, and they emphasize the importance of family-based interventions with children and adolescents from elementary to high school.
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Li M, Sun W, Wang Y, Qi C. Prevalence and Differences of Depression, Anxiety, and Substance Use Between Chinese College-Age Students Studying in China and America During the Coronavirus Disease 2019 Pandemic. Front Psychiatry 2022; 13:805120. [PMID: 35370855 PMCID: PMC8965811 DOI: 10.3389/fpsyt.2022.805120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/31/2022] [Indexed: 01/03/2023] Open
Abstract
Introduction The coronavirus disease (COVID-19) swept the globe and harmfully influenced the mental health and behaviors of the college student population. This study aims to examine the prevalence and difference of mental health and the substance use problems of the Chinese college-age students studying in China and America (CSA) during the COVID-19 pandemic. Methods One thousand five hundred four students participated in this study. A total of 42.12% of students are enrolled in Chinese colleges, and 57.78% of students are enrolled in American colleges, aged 17-23 years (x ¯ ± s = 19.90 ± 1.50). Binary logistic regression and independent t-test were used in this study to find the predictor variables and association among mental health, substance use problems, and student population. Results The two student groups had a statistical difference in General Anxiety Disorder-7 scale, alcohol, medicines, drinks, drugs and cigarettes (p < 0.01). The students suffering depression problems from the two groups have statistical significance with drinks (odds ratio = 0.89, 95% confidence interval = 0.81-0.97, p < 0.05; odds ratio = 1.11, 95% confidence interval = 1.04-1.19, p < 0.01). CSA experiencing anxiety problem had a significant association with alcohol, drinks, cigarette, and desserts (p < 0.05). Conclusion This is the first cross-sectional study focusing on the comparison of the Chinese college-age students' mental health and substance use problems who are studying in China and America during the pandemic. Our study revealed severe mental health and substance use problems in both student groups, particularly in the CSA during the COVID-19 pandemic. The findings of our study also highlight the evidence to find more interventions and preventions to solve the different mental health and substance use problems for college students.
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Affiliation(s)
- Mingsheng Li
- Department of Geriatric VIP No. 3 (Department of Clinical Psychology), Rehabilitation Medicine Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
- Psychology Department, Denison University, Granville, OH, United States
| | - Wangdi Sun
- Department of Geriatric VIP No. 3 (Department of Clinical Psychology), Rehabilitation Medicine Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
| | - Ye Wang
- Department of Geriatric VIP No. 3 (Department of Clinical Psychology), Rehabilitation Medicine Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
- Psychology Department, Air Force Health Care Center for Special Services Hangzhou, Hangzhou, China
| | - Chang Qi
- Department of Geriatric VIP No. 3 (Department of Clinical Psychology), Rehabilitation Medicine Center, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
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