1
|
Mat Salleh R, Baharom N, Siau CS, Chan CMH, Amit N, Sia PY, Wee LH. E-Cigarette Users' Profiles and Their Association with Identified Impacts of COVID-19 on Vaping among Young Adults in Malaysia. Healthcare (Basel) 2023; 11:healthcare11030434. [PMID: 36767009 PMCID: PMC9914650 DOI: 10.3390/healthcare11030434] [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: 12/12/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Electronic cigarettes (ECs) users' profiles and behaviors during the COVID-19 pandemic remain unclear. This cross-sectional study aimed to explore Malaysian EC users' profiles and their associations with related behaviors during the pandemic. The EC users (N = 351) were recruited from an official national vape entity. Respondents were predominantly of Malay ethnicity (90.6%), aged 31 to 35 years (27.6%), males (97.7%), married (68.7%), from Malaysia's west region states (63.5%) and tertiary educated (69.2%). The majority (80.3%) were non-dual users, and most purchased their vaping products online (77.2%), liked that they can vape while working at home (83.8%) and vaped more because of boredom (55.3%), had low and moderate nicotine addiction levels (94.9%), had low motivation level to quit EC use (92.6%) and were more likely to perceive that vaping did not increase the chances of complications from COVID-19. Respondents with moderate to high addiction levels had twice the odds of checking on their current EC supplies, whilst respondents with low motivation to quit had higher odds of using their tank/pod until the last drop and distancing from others when vaping. EC users should be encouraged to quit EC use, especially during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Rawaida Mat Salleh
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Nizam Baharom
- Primer Care Health Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Bandar Baru Nilai, Nilai 71800, Negeri Sembilan, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Caryn Mei Hsien Chan
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Noh Amit
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Pei Yin Sia
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Lei Hum Wee
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
- Faculty of Health and Medical Sciences, Taylors University Lakeside Campus, No. 1 Jalan Taylor’s, Subang Jaya 47500, Selangor, Malaysia
- Correspondence: or
| |
Collapse
|
2
|
Soo J, Easwaran M, Erickson‐DiRenzo E. Impact of Electronic Cigarettes on the Upper Aerodigestive Tract: A Comprehensive Review for Otolaryngology Providers. OTO Open 2023; 7:e25. [PMID: 36998560 PMCID: PMC10046796 DOI: 10.1002/oto2.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/18/2022] [Accepted: 12/02/2022] [Indexed: 02/19/2023] Open
Abstract
Objective The use and effects of electronic (e)-cigarettes (e-cigs) are particularly relevant for otolaryngology providers as tobacco plays a major role in benign and malignant diseases of the upper aerodigestive tract. This review aims to (1) summarize the recent policies regarding e-cigs and important patterns of use and (2) serve as a comprehensive resource for clinical providers on the known biologic and clinical effects of e-cigs on the upper aerodigestive tract. Data Sources PubMed/MEDLINE. Review Methods We conducted a narrative review on (1) general information on e-cig use and informative findings in the lower respiratory system and a comprehensive review on (2) the effects of e-cigs on cell and animal models and the clinical implications of these products on human health as is relevant to otolaryngology. Conclusions Although e-cigs are likely less harmful than conventional cigarettes, preliminary research on e-cigs suggest several deleterious effects including in the upper aerodigestive tract. Due to this, there has been increased interest in restricting e-cig usage, particularly among the adolescent population, and caution in recommending e-cigs to current smokers. Implications for Practice Chronic e-cig use is likely to have clinical implications. It is critical for otolaryngology providers to be aware of the rapidly changing regulations and use patterns regarding e-cigs and how e-cigs influence human health, particularly with regards to the upper aerodigestive tract, to accurately council patients regarding potential risks and benefits of use.
Collapse
Affiliation(s)
- Joanne Soo
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
| | - Meena Easwaran
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
| | - Elizabeth Erickson‐DiRenzo
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
| |
Collapse
|
3
|
Vivarelli F, Granata S, Rullo L, Mussoni M, Candeletti S, Romualdi P, Fimognari C, Cruz-Chamorro I, Carrillo-Vico A, Paolini M, Canistro D. On the toxicity of e-cigarettes consumption: Focus on pathological cellular mechanisms. Pharmacol Res 2022; 182:106315. [PMID: 35724819 DOI: 10.1016/j.phrs.2022.106315] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 10/18/2022]
Abstract
Tobacco smoking remains without a doubt one of the leading causes of premature death worldwide. In combination with conventional protocols for smoking cessation, e-cigarettes have been proposed as a useful tool to quit smoking. Advertised as almost free of toxic effects, e-cigarettes have rapidly increased their popularity, becoming a sought-after device, especially among young people. Recently some health concerns about e-cigarette consumption are being raised. It is well known that they can release several toxic compounds, some of which are carcinogenic to humans, and emerging results are now outlining the risks related to the onset of respiratory and cardiovascular diseases and even cancer. The present review shows the emerging evidence about the role of technical components of the devices, the e-liquid composition as well as customization by consumers. The primary topics we discuss are the main toxicological aspects associated with e-cigarette consumption, focusing on the molecular pathways involved. Here it will be shown how exposure to e-cigarette aerosol induces stress/mitochondrial toxicity, DNA breaks/fragmentation following the same pathological pathways triggered by tobacco smoke, including the deregulation of molecular signalling axis associated with cancer progression and cell migration. Risk to fertility and pregnancy, as well as cardiovascular risk associated with e-cigarette use, have also been reported.
Collapse
Affiliation(s)
- Fabio Vivarelli
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy.
| | - Silvia Granata
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; Department of Medicine and Surgery - University of Milano - Bicocca
| | - Laura Rullo
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Matilde Mussoni
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Sanzio Candeletti
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Patrizia Romualdi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Carmela Fimognari
- Department for Life Quality Studies, Alma Mater Studiorum-University of Bologna, Corso d'Augusto 237, 47921 Rimini, Italy
| | - Ivan Cruz-Chamorro
- Instituto de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), 41013 Seville, Spain; Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Universidad de Sevilla, 41009 Seville, Spain
| | - Antonio Carrillo-Vico
- Instituto de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), 41013 Seville, Spain; Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Universidad de Sevilla, 41009 Seville, Spain
| | - Moreno Paolini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy.
| | - Donatella Canistro
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| |
Collapse
|
4
|
Tang MS, Lee HW, Weng MW, Wang HT, Hu Y, Chen LC, Park SH, Chan HW, Xu J, Wu XR, Wang H, Yang R, Galdane K, Jackson K, Chu A, Halzack E. DNA damage, DNA repair and carcinogenicity: Tobacco smoke versus electronic cigarette aerosol. MUTATION RESEARCH. REVIEWS IN MUTATION RESEARCH 2022; 789:108409. [PMID: 35690412 PMCID: PMC9208310 DOI: 10.1016/j.mrrev.2021.108409] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 01/03/2023]
Abstract
The allure of tobacco smoking is linked to the instant gratification provided by inhaled nicotine. Unfortunately, tobacco curing and burning generates many mutagens including more than 70 carcinogens. There are two types of mutagens and carcinogens in tobacco smoke (TS): direct DNA damaging carcinogens and procarcinogens, which require metabolic activation to become DNA damaging. Recent studies provide three new insights on TS-induced DNA damage. First, two major types of TS DNA damage are induced by direct carcinogen aldehydes, cyclic-1,N2-hydroxy-deoxyguanosine (γ-OH-PdG) and α-methyl-1, N2-γ-OH-PdG, rather than by the procarcinogens, polycyclic aromatic hydrocarbons and aromatic amines. Second, TS reduces DNA repair proteins and activity levels. TS aldehydes also prevent procarcinogen activation. Based on these findings, we propose that aldehydes are major sources of TS induce DNA damage and a driving force for carcinogenesis. E-cigarettes (E-cigs) are designed to deliver nicotine in an aerosol state, without burning tobacco. E-cigarette aerosols (ECAs) contain nicotine, propylene glycol and vegetable glycerin. ECAs induce O6-methyl-deoxyguanosines (O6-medG) and cyclic γ-hydroxy-1,N2--propano-dG (γ-OH-PdG) in mouse lung, heart and bladder tissues and causes a reduction of DNA repair proteins and activity in lungs. Nicotine and nicotine-derived nitrosamine ketone (NNK) induce the same types of DNA adducts and cause DNA repair inhibition in human cells. After long-term exposure, ECAs induce lung adenocarcinoma and bladder urothelial hyperplasia in mice. We propose that E-cig nicotine can be nitrosated in mouse and human cells becoming nitrosamines, thereby causing two carcinogenic effects, induction of DNA damage and inhibition of DNA repair, and that ECA is carcinogenic in mice. Thus, this article reviews the newest literature on DNA adducts and DNA repair inhibition induced by nicotine and ECAs in mice and cultured human cells, and provides insights into ECA carcinogenicity in mice.
Collapse
Affiliation(s)
- Moon-Shong Tang
- Department of Environmental Medicine, Pathology and Medicine, United States.
| | - Hyun-Wook Lee
- Department of Environmental Medicine, Pathology and Medicine, United States
| | - Mao-Wen Weng
- Department of Environmental Medicine, Pathology and Medicine, United States
| | - Hsiang-Tsui Wang
- Department of Environmental Medicine, Pathology and Medicine, United States
| | - Yu Hu
- Department of Environmental Medicine, Pathology and Medicine, United States
| | - Lung-Chi Chen
- Department of Environmental Medicine, Pathology and Medicine, United States
| | - Sung-Hyun Park
- Department of Environmental Medicine, Pathology and Medicine, United States
| | - Huei-Wei Chan
- Department of Environmental Medicine, Pathology and Medicine, United States
| | - Jiheng Xu
- Department of Environmental Medicine, Pathology and Medicine, United States
| | - Xue-Ru Wu
- Departmemt of Urology, New York University School of Medicine, New York, NY10016, United States
| | - He Wang
- Department of Pathology and Laboratory Medicine, Robert Wood Johnson MedicalSchool, Rutgers University, Piscataway, NJ 08854, United States
| | - Rui Yang
- Department of Environmental Medicine, Pathology and Medicine, United States
| | - Karen Galdane
- Department of Environmental Medicine, Pathology and Medicine, United States
| | - Kathryn Jackson
- Department of Environmental Medicine, Pathology and Medicine, United States
| | - Annie Chu
- Department of Environmental Medicine, Pathology and Medicine, United States
| | - Elizabeth Halzack
- Department of Environmental Medicine, Pathology and Medicine, United States
| |
Collapse
|
5
|
Kotoulas SC, Katsaounou P, Riha R, Grigoriou I, Papakosta D, Spyratos D, Porpodis K, Domvri K, Pataka A. Electronic Cigarettes and Asthma: What Do We Know So Far? J Pers Med 2021; 11:jpm11080723. [PMID: 34442368 PMCID: PMC8399607 DOI: 10.3390/jpm11080723] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/19/2021] [Accepted: 07/23/2021] [Indexed: 12/20/2022] Open
Abstract
Electronic cigarettes (EC) are a novel product, marketed as an alternative to tobacco cigarette. Its effects on human health have not been investigated widely yet, especially in specific populations such as patients with asthma. With this review, we use the existing literature in order to answer four crucial questions concerning: (1) ECs' role in the pathogenesis of asthma; (2) ECs' effects on lung function and airway inflammation in patients with asthma; (3) ECs' effects on asthma clinical characteristics in asthmatics who use it regularly; and (4) ECs' effectiveness as a smoking cessation tool in these patients. Evidence suggests that many EC compounds might contribute to the pathogenesis of asthma. Lung function seems to deteriorate by the use of EC in this population, while airway inflammation alters, with the aggravation of T-helper-type-2 (Th2) inflammation being the most prominent but not the exclusive effect. EC also seems to worsen asthma symptoms and the rate and severity of exacerbations in asthmatics who are current vapers, whilst evidence suggests that its effectiveness as a smoking cessation tool might be limited. Asthmatic patients should avoid using EC.
Collapse
Affiliation(s)
- Serafeim-Chrysovalantis Kotoulas
- Clinic of Respiratory Failure, General Hospital of Thessaloniki Georgios Papanikolaou, Aristotle University of Thessaloniki, Leoforos Papanikolaou, 57010 Thessaloniki, Greece; (I.G.); (A.P.)
- Correspondence: ; Tel.: +30-6977-705450
| | - Paraskevi Katsaounou
- 1st ICU “Evangelismos Hospital”, School of Medicine, National and Kapodistrian University of Athens, Ypsilantou 45-47, 10676 Athens, Greece;
| | - Renata Riha
- Sleep Research Unit, Department of Sleep Medicine, The University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK;
| | - Ioanna Grigoriou
- Clinic of Respiratory Failure, General Hospital of Thessaloniki Georgios Papanikolaou, Aristotle University of Thessaloniki, Leoforos Papanikolaou, 57010 Thessaloniki, Greece; (I.G.); (A.P.)
| | - Despoina Papakosta
- Department of Pulmonary Medicine, General Hospital of Thessaloniki “Georgios Papanikolaou”, Aristotle University of Thessaloniki, Leoforos Papanikolaou, 57010 Thessaloniki, Greece; (D.P.); (D.S.); (K.P.); (K.D.)
| | - Dionysios Spyratos
- Department of Pulmonary Medicine, General Hospital of Thessaloniki “Georgios Papanikolaou”, Aristotle University of Thessaloniki, Leoforos Papanikolaou, 57010 Thessaloniki, Greece; (D.P.); (D.S.); (K.P.); (K.D.)
| | - Konstantinos Porpodis
- Department of Pulmonary Medicine, General Hospital of Thessaloniki “Georgios Papanikolaou”, Aristotle University of Thessaloniki, Leoforos Papanikolaou, 57010 Thessaloniki, Greece; (D.P.); (D.S.); (K.P.); (K.D.)
| | - Kalliopi Domvri
- Department of Pulmonary Medicine, General Hospital of Thessaloniki “Georgios Papanikolaou”, Aristotle University of Thessaloniki, Leoforos Papanikolaou, 57010 Thessaloniki, Greece; (D.P.); (D.S.); (K.P.); (K.D.)
| | - Athanasia Pataka
- Clinic of Respiratory Failure, General Hospital of Thessaloniki Georgios Papanikolaou, Aristotle University of Thessaloniki, Leoforos Papanikolaou, 57010 Thessaloniki, Greece; (I.G.); (A.P.)
| |
Collapse
|
6
|
Gale N, McEwan M, Camacho OM, Hardie G, Murphy J, Proctor CJ. Changes in Biomarkers of Exposure on Switching From a Conventional Cigarette to the glo Tobacco Heating Product: A Randomized, Controlled Ambulatory Study. Nicotine Tob Res 2021; 23:584-591. [PMID: 32776101 PMCID: PMC7885769 DOI: 10.1093/ntr/ntaa135] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/29/2020] [Indexed: 12/11/2022]
Abstract
Introduction Tobacco heating products (THPs) generate lower machine yields of toxicants compared to those found in conventional cigarette smoke. During use, these products are likely to expose users to lower levels of particulate matter and harmful and potentially harmful compounds compared with smoking cigarettes. Aims and Methods This randomized, controlled study is investigating whether biomarkers of exposure (BoE) to smoke toxicants are reduced when smokers switch from smoking cigarettes to using the glo THP in a naturalistic, ambulatory setting. Control groups include smokers who are abstaining from cigarette smoking and never-smokers. At a baseline study visit, 24-hour urine samples and spot blood samples were taken for BoE analysis, and exhaled carbon monoxide was also measured. N-(2-cyanoethyl) valine (CEVal) was used as a marker of compliance in subjects asked to refrain from combustible cigarette smoking. Subjects are being followed up at periodic intervals for 360 days; this article presents data following a planned interim analysis at day 90. Results In continuing smokers, BoE remained stable between baseline (day 1) and day 90. In both per-protocol and CEVal-compliant analysis populations, reductions in BoE were observed in subjects switching to using glo or undergoing smoking cessation. These reductions were statistically significant for a number of BoE when switching to glo was compared with continued smoking. Furthermore, in both populations, reductions observed in subjects switching to using glo were comparable to those seen with smoking cessation and were also to levels similar to those seen in never-smokers. Conclusion glo is a reduced-exposure tobacco product. Implications This clinical study builds on a previous 5-day confinement study and demonstrates that when smokers switched from smoking combustible cigarettes to using the glo THP in a naturalistic, ambulatory setting, their exposure to tobacco smoke toxicants was significantly decreased. For most BoE examined, this was to the same extent as that seen when a control group of smokers ceased cigarette smoking, or even to levels seen in never-smoker controls. This indicates that glo is a reduced-exposure product with the potential to be a reduced-risk tobacco product, when used by smokers whose cigarette consumption is displaced completely. Clinical trial registration ISRCTN81075760.
Collapse
Affiliation(s)
- Nathan Gale
- British American Tobacco (Investments) Limited, Research and Development, Southampton, UK
| | - Michael McEwan
- British American Tobacco (Investments) Limited, Research and Development, Southampton, UK
| | - Oscar M Camacho
- British American Tobacco (Investments) Limited, Research and Development, Southampton, UK
| | - George Hardie
- British American Tobacco (Investments) Limited, Research and Development, Southampton, UK
| | - James Murphy
- British American Tobacco (Investments) Limited, Research and Development, Southampton, UK
| | - Christopher J Proctor
- British American Tobacco (Investments) Limited, Research and Development, Southampton, UK
| |
Collapse
|
7
|
Atherosclerosis inflammation and burden in young adult smokers and vapers measured by PET/MR. Atherosclerosis 2021; 325:110-116. [PMID: 33896592 DOI: 10.1016/j.atherosclerosis.2021.03.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 02/25/2021] [Accepted: 03/18/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Electronic cigarette (EC) use is popular among youth, touted as a safer alternative to smoking and promoted as a tool to aid in smoking cessation. EC cardiovascular safety however is not well established. The aim of this study was to examine cardiovascular consequences of EC use by evaluating their effect on the entire atherosclerotic cascade in young adults using noninvasive combined positron emission tomography (PET)/magnetic resonance imaging (MR) and comparing EC use with age matched smokers of traditional cigarettes and nonsmoking controls. METHODS Carotid PET/MR was applied to look at vascular inflammation (18-fluorodeoxyglucose (FDG)-PET) and plaque burden (multi-contrast MR of vessel wall) from 60 18-30 year-old subjects (20 electronic cigarette users, 20 traditional smokers and 20 nonsmokers). RESULTS Groups were reasonably well balanced in terms of age, gender, demographics, cardiovascular risk and most biomarkers. There were no differences in vascular inflammation as measured by 18-FDG-PET target to background ratios (TBR) between EC users, traditional cigarette smokers and nonsmokers. However, measures of carotid plaque burden - wall area, normalized wall index, and wall thickness - measured from MR were significantly higher in both traditional smokers and EC users than in nonsmokers. CONCLUSIONS Young adult EC users, smokers and nonsmokers in our study did not exhibit vascular inflammation as defined by 18-F-FDG-PET TBR max, but smokers and EC users had significantly more carotid plaque burden compared to matched nonsmokers. Results could indicate that vaping does not cause an increase in vascular inflammation as measured by FDG-PET.
Collapse
|
8
|
Fischman JS, Sista S, Lee D, Cuadra GA, Palazzolo DL. Flavorless vs. Flavored Electronic Cigarette-Generated Aerosol and E-Liquid on the Growth of Common Oral Commensal Streptococci. Front Physiol 2020; 11:585416. [PMID: 33329035 PMCID: PMC7732452 DOI: 10.3389/fphys.2020.585416] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction Electronic cigarette (ECIG) use or vaping has become popular globally. While the question “Is vaping safer than smoking?” continues, it is becoming clearer that one of the most dangerous components of E-liquids are the flavorings. Since the oral cavity is the first anatomical site to be assaulted by ECIG aerosol, the aim of this study is to test the hypothesis that flavored ECIG aerosols or E-liquids pose a more detrimental effect on the growth of commensal oral streptococcal bacteria compared to flavorless aerosols or E-liquids. Methods Kirby Bauer assays and 24-h planktonic growth curves were used to compare the effects of flavorless vs. flavored (tobacco, menthol, cinnamon, strawberry and blueberry) ECIG-generated aerosols and E-liquids on the growth of four common strains of oral commensal bacteria (Streptococcus gordonii, Streptococcus intermedius, Streptococcus mitis and Streptococcus oralis). Results Kirby Bauer assays revealed inhibition of growth for all bacteria tested when exposed to 100% menthol, cinnamon or strawberry flavors. In contrast, 5% flavor in E-liquid had no effect. When exposed to 100 puffs of ECIG-generated aerosol ± flavors (≈ 0.05% flavor in brain heart infusion media) or an equivalent amount of E-liquid ± flavors, twenty-four hour planktonic growth curves indicated no effect on growth for all streptococci tested. Subsequent twenty-four hour planktonic growth curves testing the effects of E-liquid ± flavors (0.0625, 0.125, 0.25, 0.3125, 0.625, and 1.25% flavor in brain heart infusion media) revealed dose-dependent inhibition of growth, particularly for menthol, cinnamon and strawberry), for all bacteria tested. Conclusion These results support the hypothesis that flavored E-liquids are more detrimental to the growth of oral commensal bacteria than unflavored E-liquids. The streptococci tested in this study are early colonizers and part of the foundation of oral biofilms and dental plaque. Disturbances in the composition and growth of these primary colonizers is crucial to the development of a healthy dental plaque and host-bacteria interactions. E-liquids and their aerosols containing flavoring agents alter the growth of these bacteria. Such perturbations of pioneering oral communities pose a potential risk to the health of the oral cavity and, ultimately, health in general.
Collapse
Affiliation(s)
- Jacob S Fischman
- Department of Biology, Muhlenberg College, Allentown, PA, United States
| | - Swapna Sista
- Department of Physiology, DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, United States
| | - DongKeun Lee
- Department of Physiology, DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, United States
| | | | - Dominic L Palazzolo
- Department of Physiology, DeBusk College of Osteopathic Medicine, Lincoln Memorial University, Harrogate, TN, United States
| |
Collapse
|
9
|
Szukalska M, Szyfter K, Florek E, Rodrigo JP, Rinaldo A, Mäkitie AA, Strojan P, Takes RP, Suárez C, Saba NF, Braakhuis BJ, Ferlito A. Electronic Cigarettes and Head and Neck Cancer Risk-Current State of Art. Cancers (Basel) 2020; 12:E3274. [PMID: 33167393 PMCID: PMC7694366 DOI: 10.3390/cancers12113274] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 11/03/2020] [Indexed: 01/11/2023] Open
Abstract
E-cigarettes have become increasingly popular in the last decade and are considered less harmful than traditional tobacco products due to the lower content of toxic and carcinogenic compounds. However, this is still a controversial issue. This paper contains a review of previous reports on the composition of e-cigarettes and their impact on the pathogenesis and risk of head and neck cancer (HNC). The objective of the review was to compare the molecular and health effects of e-cigarette use in relation to the effects of traditional cigarette smoking in the upper respiratory tract, and to assess the safety and effect of e-cigarettes on HNC risk. A review for English language articles published until 31 August 2020 was made, using a PubMed (including MEDLINE), CINAHL Plus, Embase, Cochrane Library and Web of Science data. The authors reviewed articles on both toxic and carcinogenic compounds contained in e-cigarettes and their molecular and health effects on the upper respiratory tract in comparison to tobacco cigarettes. The risk of developing head and neck squamous cell carcinoma (HNSCC) remains lower in users of e-cigarettes compared with tobacco smokers. However, more long-term studies are needed to better address the safety of e-cigarettes.
Collapse
Affiliation(s)
- Marta Szukalska
- Laboratory of Environmental Research, Department of Toxicology, Poznan University of Medical Sciences, 60-631 Poznan, Poland
| | - Krzysztof Szyfter
- Institute of Human Genetics, Polish Academy of Sciences, 60-479 Poznan, Poland;
| | - Ewa Florek
- Laboratory of Environmental Research, Department of Toxicology, Poznan University of Medical Sciences, 60-631 Poznan, Poland
| | - Juan P. Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias-University of Oviedo, 33011 Oviedo, Spain;
- Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, CIBERONC, 33011 Oviedo, Spain;
| | | | - Antti A. Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, 00029 HUS Helsinki, Finland;
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska Hospital, 141 86 Stockholm, Sweden
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, 1000 Ljubljana, Slovenia;
| | - Robert P. Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Carlos Suárez
- Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, CIBERONC, 33011 Oviedo, Spain;
| | - Nabil F. Saba
- Department of Hematology and Medical Oncology, Emory University, Atlanta, GA 30322, USA;
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, 35100 Padua, Italy;
| |
Collapse
|
10
|
Kuga K, Ito K, Chen W, Wang P, Kumagai K. A numerical investigation of the potential effects of e-cigarette smoking on local tissue dosimetry and the deterioration of indoor air quality. INDOOR AIR 2020; 30:1018-1038. [PMID: 32159877 DOI: 10.1111/ina.12666] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/19/2020] [Accepted: 03/09/2020] [Indexed: 05/28/2023]
Abstract
Electronic (e)-cigarette smoking is considered to be less harmful than traditional tobacco smoking because of the lack of a combustion process. However, e-cigarettes have the potential to release harmful chemicals depending on the constituents of the vapor. To date, there has been significant evidence on the adverse health effects of e-cigarette usage. However, what is less known are the impacts of the chemicals contained in exhaled air from an e-cigarette smoker on indoor air quality, the second-hand passive smoking of residents, and the toxicity of the exhaled air. In this study, we develop a comprehensive numerical model and computer-simulated person to investigate the potential effects of e-cigarette smoking on local tissue dosimetry and the deterioration of indoor air quality. We also conducted demonstrative numerical analyses for first-hand and second-hand e-cigarette smoking in an indoor environment. To investigate local tissue dosimetry, we used newly developed physiologically based pharmacokinetic/toxicokinetic models that reproduce inhalation exposure by way of the respiratory tract and dermal exposure through the human skin surface. These models were integrated into the computer-simulated person. Our numerical simulation results quantitatively demonstrated the potential impacts of e-cigarette smoking in enclosed spaces on indoor air quality.
Collapse
Affiliation(s)
- Kazuki Kuga
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga, Japan
| | - Kazuhide Ito
- Faculty of Engineering Sciences, Kyushu University, Kasuga, Japan
| | - Wenhao Chen
- Indoor Air Quality Program, Environmental Health Laboratory, California Department of Public Health, Richmond, CA, USA
| | - Ping Wang
- Indoor Air Quality Program, Environmental Health Laboratory, California Department of Public Health, Richmond, CA, USA
| | - Kazukiyo Kumagai
- Indoor Air Quality Program, Environmental Health Laboratory, California Department of Public Health, Richmond, CA, USA
| |
Collapse
|
11
|
Jayasuriya NA, Kjaergaard AD, Pedersen KM, Sørensen AL, Bak M, Larsen MK, Nordestgaard BG, Bojesen SE, Çolak Y, Skov V, Kjaer L, Tolstrup JS, Hasselbalch HC, Ellervik C. Smoking, blood cells and myeloproliferative neoplasms: meta-analysis and Mendelian randomization of 2·3 million people. Br J Haematol 2019; 189:323-334. [PMID: 31875952 DOI: 10.1111/bjh.16321] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 09/19/2019] [Indexed: 12/19/2022]
Abstract
Meta-analyses and Mendelian randomization (MR) may clarify the associations of smoking, blood cells and myeloproliferative neoplasms (MPN). We investigated the association of smoking with blood cells in the Danish General Suburban Population Study (GESUS, n = 11 083), by meta-analyses (including GESUS) of 92 studies (n = 531 741) and MR of smoking variant CHRNA3 (rs1051730[A]) in UK Biobank, and with MPN in a meta-analysis of six studies (n (total/cases):1 425 529/2187), totalling 2 307 745 participants. In the meta-analysis the random-effects standardized mean difference (SMD) in current smokers versus non-smokers was 0·82 (0·75-0·89, P = 2·0 * 10-108 ) for leukocytes, 0·09 (-0·02 to 0·21, P = 0·12) for erythrocytes, 0·53 (0·42-0·64, P = 8·0 * 10-22 ) for haematocrit, 0·42 (0·34-0·51, P = 7·1 * 10-21 ) for haemoglobin, 0·19 (0·08-0·31, P = 1·2 * 10-3 ) for mean corpuscular haemoglobin (MCH), 0·29 (0·19-0·39, P = 1·6 * 10-8 ) for mean corpuscular volume (MCV), and 0·04 (-0·04 to 0·13, P = 0·34) for platelets with trends for ever/ex-/current smokers, light/heavy smokers and female/male smokers. Analyses presented high heterogeneity but low publication bias. Per allele in CHRNA3, cigarettes per day in current smokers was associated with increased blood cell counts (leukocytes, neutrophils), MCH, red cell distribution width (RDW) and MCV. The pooled fixed-effects odds ratio for MPN was 1·44 [95% confidence interval (CI): 1·33-1·56; P = 1·8 * 10-19 ; I2 = 0%] in current smokers, 1·29 (1·15-1·44; P = 8·0 * 10-6 ; I2 = 0%) in ex-smokers, 1·49 (1·26-1·77; P = 4·4 * 10-6 ; I2 = 0%) in light smokers and 2·04 (1·74-2·39, P = 2·3 * 10-18 ; I2 = 51%) in heavy smokers compared with non-smokers. Smoking is observationally and genetically associated with increased leukocyte counts and red blood cell indices (MCH, MCV, RDW) and observationally with risk of MPN in current and ex-smokers versus non/never-smokers.
Collapse
Affiliation(s)
- Nimesh A Jayasuriya
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA, USA.,School of Medicine, University of Glasgow, Glasgow, UK
| | - Alisa D Kjaergaard
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA, USA.,Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - Kasper M Pedersen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Hematology, Zealand University Hospital, Roskilde, Denmark.,Department of Clinical Biochemistry, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Anders L Sørensen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Marie Bak
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Morten K Larsen
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark.,Department of Science and Environment, Roskilde University, Roskilde, Denmark
| | - Børge G Nordestgaard
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Biochemistry and the Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Stig E Bojesen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Biochemistry and the Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Yunus Çolak
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Biochemistry and the Copenhagen General Population Study, Copenhagen University Hospital, Herlev and Gentofte Hospital, Herlev, Denmark
| | - Vibe Skov
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Lasse Kjaer
- Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Janne S Tolstrup
- Faculty of Health and Medical Sciences, University of Southern Denmark, Odense, Denmark.,National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Hans C Hasselbalch
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Hematology, Zealand University Hospital, Roskilde, Denmark
| | - Christina Ellervik
- Department of Laboratory Medicine, Boston Children's Hospital, Boston, MA, USA.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Production, Research, and Innovation; Region Zealand, Sorø, Denmark.,Division of Pathology, Faculty of Medicine, Harvard Medical School, Boston, USA
| |
Collapse
|
12
|
Mravec B, Tibensky M, Horvathova L, Babal P. E-Cigarettes and Cancer Risk. Cancer Prev Res (Phila) 2019; 13:137-144. [PMID: 31619443 DOI: 10.1158/1940-6207.capr-19-0346] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/28/2019] [Accepted: 10/08/2019] [Indexed: 11/16/2022]
Abstract
From the time of their introduction, the popularity of e-cigarettes (electronic nicotine-delivery systems) has been rising. This trend may reflect the general belief that e-cigarettes are a less hazardous alternative to combustible cigarettes. However, the potential cancer-related effects of increased activation of the sympathoadrenal system induced by the inhalation of nicotine, the primary component of the e-cigarettes, are completely overlooked. Therefore, the aim of this review is to describe mechanisms that may connect the use of e-cigarettes and an increased risk for cancer development, as well as their stimulatory effect on cancer progression. Available preclinical data indicate that activation of the sympathetic nervous system by nicotine inhaled from e-cigarettes may stimulate cancer development and growth by several mechanisms. This issue might be especially important for oncological patients as they may have the misconception that compared with combustible cigarettes, e-cigarettes represent a risk-free alternative.
Collapse
Affiliation(s)
- Boris Mravec
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, Slovakia. .,Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Miroslav Tibensky
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, Slovakia.,Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Lubica Horvathova
- Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Pavel Babal
- Institute of Pathology, Faculty of Medicine, Comenius University in Bratislava, Slovakia
| |
Collapse
|