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Besaratinia A, Tommasi S. The Untapped Biomarker Potential of MicroRNAs for Health Risk-Benefit Analysis of Vaping vs. Smoking. Cells 2024; 13:1330. [PMID: 39195220 DOI: 10.3390/cells13161330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 08/29/2024] Open
Abstract
Despite the popularity of electronic cigarettes (e-cigs) among adolescent never-smokers and adult smokers seeking a less pernicious substitute for tobacco cigarettes, the long-term health impact of vaping is largely unknown. Like cigarette smoke, e-cig vapor contains harmful and potentially harmful compounds, although in fewer numbers and at substantially lower concentrations. Many of the same constituents of e-cig vapor and cigarette smoke induce epigenetic changes that can lead to the dysregulation of disease-related genes. MicroRNAs (MiRNAs) are key regulators of gene expression in health and disease states. Extensive research has shown that miRNAs play a prominent role in the regulation of genes involved in the pathogenesis of smoking-related diseases. However, the use of miRNAs for investigating the disease-causing potential of vaping has not been fully explored. This review article provides an overview of e-cigs as a highly consequential electronic nicotine delivery system, describes trends in e-cig use among adolescents and adults, and discusses the ongoing debate on the public health impact of vaping. Highlighting the significance of miRNAs in cell biology and disease, it summarizes the published and ongoing research on miRNAs in relation to gene regulation and disease pathogenesis in e-cig users and in vitro experimental settings. It identifies gaps in knowledge and priorities for future research while underscoring the need for empirical evidence that can inform the regulation of tobacco products to protect youth and promote public health.
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Affiliation(s)
- Ahmad Besaratinia
- Department of Population & Public Health Sciences, USC Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA 90033, USA
| | - Stella Tommasi
- Department of Population & Public Health Sciences, USC Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA 90033, USA
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Besaratinia A, Blumenfeld H, Tommasi S. Exploring the Utility of Long Non-Coding RNAs for Assessing the Health Consequences of Vaping. Int J Mol Sci 2024; 25:8554. [PMID: 39126120 PMCID: PMC11313266 DOI: 10.3390/ijms25158554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024] Open
Abstract
Electronic cigarette (e-cig) use, otherwise known as "vaping", is widespread among adolescent never-smokers and adult smokers seeking a less-harmful alternative to combustible tobacco products. To date, however, the long-term health consequences of vaping are largely unknown. Many toxicants and carcinogens present in e-cig vapor and tobacco smoke exert their biological effects through epigenetic changes that can cause dysregulation of disease-related genes. Long non-coding RNAs (lncRNAs) have emerged as prime regulators of gene expression in health and disease states. A large body of research has shown that lncRNAs regulate genes involved in the pathogenesis of smoking-associated diseases; however, the utility of lncRNAs for assessing the disease-causing potential of vaping remains to be fully determined. A limited but growing number of studies has shown that lncRNAs mediate dysregulation of disease-related genes in cells and tissues of vapers as well as cells treated in vitro with e-cig aerosol extract. This review article provides an overview of the evolution of e-cig technology, trends in use, and controversies on the safety, efficacy, and health risks or potential benefits of vaping relative to smoking. While highlighting the importance of lncRNAs in cell biology and disease, it summarizes the current and ongoing research on the modulatory effects of lncRNAs on gene regulation and disease pathogenesis in e-cig users and in vitro experimental settings. The gaps in knowledge are identified, priorities for future research are highlighted, and the importance of empirical data for tobacco products regulation and public health is underscored.
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Affiliation(s)
- Ahmad Besaratinia
- Department of Population & Public Health Sciences, USC Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA 90033, USA; (H.B.); (S.T.)
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Hartono R, Yan C, Chen Y, Ma B, Deng Y, Sun Y, Li P, Dao Y, Deng R. Knowledge, attitude, and practice of e-cigarette use among undergraduate students: A comparative study between China and Indonesia. Tob Induc Dis 2024; 22:TID-22-131. [PMID: 39015939 PMCID: PMC11249499 DOI: 10.18332/tid/190636] [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: 05/16/2024] [Revised: 06/18/2024] [Accepted: 06/30/2024] [Indexed: 07/18/2024] Open
Abstract
INTRODUCTION The health risks associated with e-cigarettes are currently the focus of tobacco control efforts and public health initiatives. Given that China and Indonesia have the highest rates of adult smoking worldwide, it is imperative to gain a comprehensive understanding of e-cigarette prevalence among college students in these two nations. METHODS From May to June 2023, a cross-sectional study was employed to conduct an online questionnaire survey among college students in three universities located in Kunming (China) and Jakarta (Indonesia), respectively. The chi-squared test was utilized to compare the rates/ratios, while binary logistic regression analysis was applied to examine the factors influencing e-cigarette knowledge, attitude, and practice. RESULTS A total of 1327 individuals were included in the investigation. The proportion of Indonesian students (75.6%) with a high level of e-cigarette knowledge was lower than that observed among Chinese students (87.4%) (χ2=29.7, p<0.001). Additionally, the prevalence of e-cigarette use among Indonesian students (9.4%) was higher compared to their Chinese counterparts (3.0%) (χ2=22.32, p<0.001). Binary logistic regression analysis revealed that age, place of residence, studies, gender, and e-cigarette use by friends and family, significantly influenced knowledge levels and attitudes toward e-cigarettes in both countries (p<0.05). CONCLUSIONS Despite the positive knowledge, attitudes, and practices towards e-cigarettes among undergraduate students in both countries, a notable knowledge gap exists concerning the harmful effects of e-cigarettes. Chinese students had better e-cigarette knowledge and demonstrated lower usage rates, suggesting that heightened awareness plays a favorable role in preventing e-cigarette use. Furthermore, it becomes imperative for policymakers and health educators to focus on specific factors, such as the influence of close friends and family members, as well as the area of residence.
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Affiliation(s)
| | | | - Ying Chen
- Kunming Medical University, Kunming, China
| | - Boting Ma
- Kunming Medical University, Kunming, China
| | - Yaqi Deng
- Kunming Medical University, Kunming, China
| | - Yijia Sun
- Kunming Medical University, Kunming, China
| | - Pan Li
- Kunming Medical University, Kunming, China
| | - Yuye Dao
- Kunming Medical University, Kunming, China
| | - Rui Deng
- Kunming Medical University, Kunming, China
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Al-Otaibi HM, Baqasi AMS, Alhadrami HA. Genotoxicity and mutagenicity assessment of electronic cigarette liquids. Ann Thorac Med 2024; 19:222-227. [PMID: 39144536 PMCID: PMC11321532 DOI: 10.4103/atm.atm_59_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 08/16/2024] Open
Abstract
INTRODUCTION Electronic cigarettes (e-cigarettes) are often advertised as a safer alternative to traditional smoking. However, recent data suggest they may not be as safe as previously believed. This study aims to evaluate the genotoxicity and mutagenicity of e-cigarette liquids. METHODS We randomly selected eight varieties of e-cigarette liquids from the local market in Jeddah, Saudi Arabia. We evaluated their genotoxicity using the Genotoxicity SOS-Chromo Test™ Kit. In this investigation, a rat liver S9 fraction was utilized to emulate liver metabolic function to measure any chemical substance's mutagenic potential. The SOS-Chromo Test was performed by recording the β-galactosidase and alkaline phosphatase activity with and without the metabolic activation enzyme (S-9). RESULTS All samples, except for the first two dilutions of sample 2, were nongenotoxic in the absence of the S9 activation enzyme, according to the genotoxicity analysis. However, when tested in the presence of the S9 enzyme, samples 2, 4, and 7 exhibited mutagenic activity at varying concentrations. CONCLUSION Contrary to common belief, e-cigarettes are not safe. The present investigation confirms the presence of both toxicants and carcinogens in some e-cigarette liquids. This exposure could increase users' risk of various health complications.
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Affiliation(s)
- Hajed M. Al-Otaibi
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Respiratory Therapy Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Aisha MS. Baqasi
- Department of Laboratory Medicine, College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hani A. Alhadrami
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- DNA Forensic Unit, King Fahad Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
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Walker-Franklin I, Onyenwoke RU, Leung T, Huang X, Shipman JG, Kovach A, Sivaraman V. GC/HRMS Analysis of E-Liquids Complements In Vivo Modeling Methods and can Help to Predict Toxicity. ACS OMEGA 2024; 9:26641-26650. [PMID: 38911720 PMCID: PMC11191570 DOI: 10.1021/acsomega.4c03416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 06/25/2024]
Abstract
Tobacco smoking is a major risk factor for disease development, with the user inhaling various chemicals known to be toxic. However, many of these chemicals are absent before tobacco is "burned". Similar, detailed data have only more recently being reported for the e-cigarette with regards to chemicals present before and after the e-liquid is "vaped." Here, zebrafish were dosed with vaped e-liquids, while C57-BL/6J mice were vaped using nose-cone only administration. Preliminary assessments were made using e-liquids and GC/HRMS to identify chemical signatures that differ between unvaped/vaped and flavored/unflavored samples. Oxidative stress and inflammatory immune cell response assays were then performed using our in vivo models. Chemical signatures differed, e.g., between unvaped/vaped samples and also between unflavored/flavored e-liquids, with known chemical irritants upregulated in vaped and unvaped flavored e-liquids compared with unflavored e-liquids. However, when possible respiratory irritants were evaluated, these agents were predominantly present in only the vaped e-liquid. Both oxidative stress and inflammatory responses were induced by a menthol-flavored but not a tobacco-flavored e-liquid. Thus, chemical signatures differ between unvaped versus vaped e-liquid samples and also between unflavored versus flavored e-liquids. These flavors also likely play a significant role in the variability of e-liquid characteristics, e.g., pro-inflammatory and/or cytotoxic responses.
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Affiliation(s)
| | - Rob U. Onyenwoke
- Department
of Biological & Biomedical Sciences, North Carolina Central University, Durham, North Carolina 27707, United States
- Biomanufacturing
Research Institute and Technology Enterprise (BRITE), North Carolina Central University, Durham, North Carolina 27707, United States
| | - TinChung Leung
- Department
of Biological & Biomedical Sciences, North Carolina Central University, Durham, North Carolina 27707, United States
- The
Julius L. Chambers Biomedical/Biotechnology Research Institute, North Carolina Central University, North Carolina
Research Campus, Kannapolis, North Carolina 28081, United States
| | - Xiaoyan Huang
- The
Julius L. Chambers Biomedical/Biotechnology Research Institute, North Carolina Central University, North Carolina
Research Campus, Kannapolis, North Carolina 28081, United States
| | - Jeffrey G. Shipman
- Department
of Biological & Biomedical Sciences, North Carolina Central University, Durham, North Carolina 27707, United States
| | - Alex Kovach
- RTI
International, Research
Triangle Park, North Carolina 27704, United States
| | - Vijay Sivaraman
- Department
of Biological & Biomedical Sciences, North Carolina Central University, Durham, North Carolina 27707, United States
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Muthumalage T, Noel A, Thanavala Y, Alcheva A, Rahman I. Challenges in current inhalable tobacco toxicity assessment models: A narrative review. Tob Induc Dis 2024; 22:TID-22-102. [PMID: 38860150 PMCID: PMC11163881 DOI: 10.18332/tid/188197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/17/2024] [Accepted: 05/01/2024] [Indexed: 06/12/2024] Open
Abstract
Emerging tobacco products such as electronic nicotine delivery systems (ENDS) and heated tobacco products (HTPs) have a dynamic landscape and are becoming widely popular as they claim to offer a low-risk alternative to conventional smoking. Most pre-clinical laboratories currently exploit in vitro, ex vivo, and in vivo experimental models to assess toxicological outcomes as well as to develop risk-estimation models. While most laboratories have produced a wide range of cell culture and mouse model data utilizing current smoke/aerosol generators and standardized puffing profiles, much variation still exists between research studies, hindering the generation of usable data appropriate for the standardization of these tobacco products. In this review, we discuss current state-of-the-art in vitro and in vivo models and their challenges, as well as insights into risk estimation of novel products and recommendations for toxicological parameters for reporting, allowing comparability of the research studies between laboratories, resulting in usable data for regulation of these products before approval by regulatory authorities.
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Affiliation(s)
| | - Alexandra Noel
- School of Veterinary Medicine Louisiana State University, Baton Rouge, United States
| | - Yasmin Thanavala
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, United States
| | - Aleksandra Alcheva
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, United States
- Masonic Cancer Center, University of Minnesota, Minneapolis, United States
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, United States
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Greene CM, Abdulkadir M. Global respiratory health priorities at the beginning of the 21st century. Eur Respir Rev 2024; 33:230205. [PMID: 38599674 PMCID: PMC11004770 DOI: 10.1183/16000617.0205-2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/11/2024] [Indexed: 04/12/2024] Open
Abstract
Respiratory health has become a prevailing priority amid the diverse global health challenges that the 21st century brings, due to its substantial impact on individuals and communities on a global scale. Due to rapid advances in medicine, emerging knowledge gaps appear along with new challenges and ethical considerations. While breakthroughs in medical science can bring about encouraging possibilities for better treatments and interventions, they also lead to unanswered questions and areas where further research is warranted. A PubMed search on the topic "global respiratory health priorities" between the years 2000 and 2023 was conducted, which returned 236 articles. Of these, 55 were relevant and selected for inclusion in this article. The selection process took into account literature reviews, opinions from expert groups and careful analysis of existing gaps and challenges within the field; our selection encompasses specific infectious and noninfectious respiratory conditions in both adults and children. The global respiratory health priorities identified were selected on the basis that they have been recognised as critical areas of investigation and potential advancement and they span across clinical, translational, epidemiological and population health domains. Implementing these priorities will require a commitment to fostering collaboration and knowledge-sharing among experts in different fields with the ultimate aim to improve respiratory health outcomes for individuals and communities alike.
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Affiliation(s)
- Catherine M Greene
- Lung Biology Group, Department of Clinical Microbiology, RCSI University of Medicine and Heath Sciences, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
| | - Mohamed Abdulkadir
- Lung Biology Group, Department of Clinical Microbiology, RCSI University of Medicine and Heath Sciences, Education and Research Centre, Beaumont Hospital, Dublin, Ireland
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Nazzal Z, Maraqa B, Azizeh R, Darawsha B, AbuAlrub I, Hmeidat M, Al-Jabari F. Exploring the prevalence, knowledge, attitudes and influencing factors of e-cigarette use among university students in Palestine: a cross-sectional study. BMJ Open 2024; 14:e080881. [PMID: 38367977 PMCID: PMC10875484 DOI: 10.1136/bmjopen-2023-080881] [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: 10/13/2023] [Accepted: 01/31/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVES E-cigarettes have gained popularity, especially among young adults. This study aims to determine the prevalence of e-cigarette smoking, assess knowledge and attitudes and identify associated factors among Palestinian university students. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS The study was conducted among Palestinian university students in early 2023.A self-administered questionnaire was used to survey 1792 students from six Palestine universities in the West Bank. The questionnaire covered various aspects, including sociodemographic information, daily habits, exposure to smoking, attitudes and knowledge about e-cigarettes. Data were analysed using descriptive statistics, χ2 tests and multivariate regression analysis. RESULTS The study revealed a high prevalence of tobacco use (41.2%), with e-cigarette use prevalent among 19.7% of participants. Knowledge about e-cigarettes was suboptimal, with misconceptions regarding their safety and health effects. Negative attitudes towards e-cigarettes were common, and students with negative attitudes were more likely to use e-cigarettes (aOR=2.6, 95% CI: 1.9 to 3.6). Gender (aOR=2.1, 95% CI: 1.4 to 3.0), waterpipe smoking (aOR=4.5, 95% CI: 3.2 to 6.3), physical inactivity (aOR=1.4, 95% CI: 1.1 to 1.9), high coffee consumption (aOR=1.6, 95% CI: 1.1 to 2.3), spending time with friends (aOR=2.4, 95% CI: 1.5 to 3.7), having a mother who is a smoker (aOR=1.5, 95% CI: 1.1 to 2.2) and having a friend who uses e-cigarettes (aOR=1.5, 95% CI: 1.1 to 2.1) were significantly associated with e-cigarettes use. CONCLUSIONS E-cigarette use is a growing concern among Palestinian university students. Combating this trend should include educational initiatives, social interventions and policy measures to promote informed decision-making and discourage e-cigarette use. Comprehensive tobacco control programs considering various tobacco and nicotine products and involving multiple stakeholders are warranted.
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Affiliation(s)
- Zaher Nazzal
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Beesan Maraqa
- Department of Family and Community Medicine, Faculty of Medicine, Hebron University, Hebron, Palestine
- Primary Health Care, Ministry of Health, Hebron, Palestine
| | - Razan Azizeh
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Bara' Darawsha
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ibraheem AbuAlrub
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Mousa Hmeidat
- Department of Medicine, Faculty of Medicine, Hebron University, Hebron, Palestine
| | - Fadel Al-Jabari
- Department of Medicine, Faculty of Medicine, Hebron University, Hebron, Palestine
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Chen G, Rahman S, Lutfy K. E-cigarettes may serve as a gateway to conventional cigarettes and other addictive drugs. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11345. [PMID: 38389821 PMCID: PMC10880776 DOI: 10.3389/adar.2023.11345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/14/2023] [Indexed: 02/24/2024]
Abstract
Electronic cigarettes (e-cigarettes) are devices that allow the user to inhale nicotine in a vapor, and are primarily marketed as a means of quitting smoking and a less harmful replacement for traditional cigarette smoking. However, further research is needed to determine if vaping nicotine via e-cigarettes can be effective. Conversely, nicotine has been considered a gateway drug to alcohol and other addictive drugs and e-cigarettes containing nicotine may have the same effects. Previous reports have shown that e-cigarette use may open the gate for the use of other drugs including conventional cigarettes, cannabis, opioids, etc. The increasing prevalence of e-cigarettes, particularly among youth and adolescents in the last decade have led to an increase in the dual use of e-cigarettes with alcohol, cannabis, and other illicit drug use like heroin and 3-4-methylenedioxymethamphetamine (MDMA). The advent of e-cigarettes as a device to self-administer addictive agents such as cocaine and synthetic cathinones may bring about additional adverse health effects associated with their concurrent use. This review aims to briefly describe e-cigarettes and their different generations, and their co-use with other addictive drugs as well as the use of the device as a tool to self-administer addictive drugs, such as cocaine, etc.
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Affiliation(s)
- Grace Chen
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, United States
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, College of Pharmacy, South Dakota State University, Brookings, SD, United States
| | - Kabirullah Lutfy
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States
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Tommasi S, Blumenfeld H, Besaratinia A. Vaping Dose, Device Type, and E-Liquid Flavor are Determinants of DNA Damage in Electronic Cigarette Users. Nicotine Tob Res 2023; 25:1145-1154. [PMID: 36780924 PMCID: PMC10202635 DOI: 10.1093/ntr/ntad003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/26/2022] [Accepted: 01/05/2023] [Indexed: 02/15/2023]
Abstract
INTRODUCTION Despite the widespread use of electronic cigarettes, the long-term health consequences of vaping are largely unknown. AIMS AND METHODS We investigated the DNA-damaging effects of vaping as compared to smoking in healthy adults, including "exclusive" vapers (never smokers), cigarette smokers only, and nonusers, matched for age, gender, and race (N = 72). Following biochemical verification of vaping or smoking status, we quantified DNA damage in oral epithelial cells of our study subjects, using a long-amplicon quantitative polymerase chain reaction assay. RESULTS We detected significantly increased levels of DNA damage in both vapers and smokers as compared to nonusers (p = .005 and p = .020, respectively). While the mean levels of DNA damage did not differ significantly between vapers and smokers (p = .522), damage levels increased dose-dependently, from light users to heavy users, in both vapers and smokers as compared to nonusers. Among vapers, pod users followed by mod users, and those who used sweet-, mint or menthol-, and fruit-flavored e-liquids, respectively, showed the highest levels of DNA damage. The nicotine content of e-liquid was not a predictor of DNA damage in vapers. CONCLUSIONS This is the first demonstration of a dose-dependent formation of DNA damage in vapers who had never smoked cigarettes. Our data support a role for product characteristics, specifically device type and e-liquid flavor, in the induction of DNA damage in vapers. Given the popularity of pod and mod devices and the preferability of sweet-, mint or menthol-, and fruit-flavored e-liquids by both adult- and youth vapers, our findings can have significant implications for public health and tobacco products regulation. IMPLICATIONS We demonstrate a dose-dependent formation of DNA damage in oral cells from vapers who had never smoked tobacco cigarettes as well as exclusive cigarette smokers. Device type and e-liquid flavor determine the extent of DNA damage detected in vapers. Users of pod devices followed by mod users, and those who use sweet-, mint or menthol-, and fruit-flavored e-liquids, respectively, show the highest levels of DNA damage when compared to nonusers. Given the popularity of pod and mod devices and the preferability of these same flavors of e-liquid by both adult- and youth vapers, our findings can have significant implications for public health and tobacco products regulation.
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Affiliation(s)
- Stella Tommasi
- Department of Population and Public Health Sciences, USC Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA 90033, USA
| | - Hannah Blumenfeld
- Department of Population and Public Health Sciences, USC Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA 90033, USA
| | - Ahmad Besaratinia
- Department of Population and Public Health Sciences, USC Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA 90033, USA
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Besaratinia A. The State of Research and Weight of Evidence on the Epigenetic Effects of Bisphenol A. Int J Mol Sci 2023; 24:ijms24097951. [PMID: 37175656 PMCID: PMC10178030 DOI: 10.3390/ijms24097951] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Bisphenol A (BPA) is a high-production-volume chemical with numerous industrial and consumer applications. BPA is extensively used in the manufacture of polycarbonate plastics and epoxy resins. The widespread utilities of BPA include its use as internal coating for food and beverage cans, bottles, and food-packaging materials, and as a building block for countless goods of common use. BPA can be released into the environment and enter the human body at any stage during its production, or in the process of manufacture, use, or disposal of materials made from this chemical. While the general population is predominantly exposed to BPA through contaminated food and drinking water, non-dietary exposures through the respiratory system, integumentary system, and vertical transmission, as well as other routes of exposure, also exist. BPA is often classified as an endocrine-disrupting chemical as it can act as a xenoestrogen. Exposure to BPA has been associated with developmental, reproductive, cardiovascular, neurological, metabolic, or immune effects, as well as oncogenic effects. BPA can disrupt the synthesis or clearance of hormones by binding and interfering with biological receptors. BPA can also interact with key transcription factors to modulate regulation of gene expression. Over the past 17 years, an epigenetic mechanism of action for BPA has emerged. This article summarizes the current state of research on the epigenetic effects of BPA by analyzing the findings from various studies in model systems and human populations. It evaluates the weight of evidence on the ability of BPA to alter the epigenome, while also discussing the direction of future research.
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Affiliation(s)
- Ahmad Besaratinia
- Department of Population and Public Health Sciences, USC Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA 90033, USA
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Al Rajeh AM, Mahmud I, Al Imam MH, Rahman MA, Al Shehri F, Alomayrin S, Alfazae N, Elmosaad YM, Alasqah I. E-Cigarette Use among Male Smokers in Al-Ahsa, Kingdom of Saudi Arabia: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:143. [PMID: 36612462 PMCID: PMC9819296 DOI: 10.3390/ijerph20010143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
E-cigarette use is increasing globally. Recent evidence suggests that e-cigarettes contain harmful substances that could cause adverse health outcomes. This study investigated the prevalence and associated factors of e-cigarette use among male current smokers in Saudi Arabia. We conducted a cross-sectional survey of adult male current smokers in the Al-Ahsa province of Saudi Arabia. Data were collected using a structured questionnaire. We performed logistic regression analyses to investigate the factors associated with e-cigarette use among adult male current smokers. 325 current smokers participated in the study. A third of them (33.5%) were e-cigarette users. Almost all the study participants (97.0%) had heard about e-cigarettes. Participants who were occasional smokers (Odds Ratio (OR): 2.28; 95% Confidence Interval (CI): 1.17-4.41) and had good knowledge perception of e-cigarettes (OR 3.49; 95% CI: 2.07-5.90) had higher odds of using e-cigarettes when compared to regular smokers of conventional cigarettes and current smokers with poor knowledge perception of e-cigarettes, respectively. In contrast, private employees (OR: 0.25, 95% CI: 0.07-0.85), and business owners (OR: 0.09, 95% CI: 0.01-0.63) had lower odds of using e-cigarettes compared to unemployed individuals. Compared with non-e-cigarette users, the rate of conventional cigarette smoking per day was significantly lower among e-cigarette users. Use of e-cigarette (OR: 3.57, 95% CI: 2.14-5.98), believing that e-cigarette quitting is hard (OR: 2.02, 95% CI: 1.17-3.49) and trying to quit e-cigarettes (OR: 2.17, 95% CI: 1.1-4.25) were found to be significant predictors of good knowledge perception of e-cigarettes among the current smokers. The use and knowledge perception of e-cigarettes were higher among occasional conventional male cigarette smokers than regular male smokers in Al-Ahsa province. The use of e-cigarettes as smoking cessation aids should be examined further in the Saudi Arabian setting.
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Affiliation(s)
- Ahmed M. Al Rajeh
- Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Ilias Mahmud
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al-Bukairiyah 52741, Saudi Arabia
| | - Mahmudul Hassan Al Imam
- School of Health, Medical, and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, QLD 4701, Australia
| | - Muhammad Aziz Rahman
- Institute of Health and Wellbeing, Federation University Australia, Berwick, VIC 3350, Australia
- Australian Institute for Primary Care & Ageing (AIPCA), La Trobe University, Melbourne, VIC 3086, Australia
| | - Fariss Al Shehri
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Salman Alomayrin
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Nawaf Alfazae
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Yousif Mohammed Elmosaad
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
| | - Ibrahim Alasqah
- Department of Public Health, College of Public Health and Health Informatics, Qassim University, Al-Bukairiyah 52741, Saudi Arabia
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13
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Alhadyan SK, Sivaraman V, Onyenwoke RU. E-cigarette Flavors, Sensory Perception, and Evoked Responses. Chem Res Toxicol 2022; 35:2194-2209. [PMID: 36480683 DOI: 10.1021/acs.chemrestox.2c00268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The chemosensory experiences evoked by flavors encompass a number of unique sensations that include olfactory stimuli (smell), gustatory stimuli (taste, i.e., salty, sweet, sour, bitter, and umami (also known as "savoriness")), and chemesthesis (touch). As such, the responses evoked by flavors are complex and, as briefly stated above, involve multiple perceptive mechanisms. The practice of adding flavorings to tobacco products dates back to the 17th century but is likely much older. More recently, the electronic cigarette or "e-cigarette" and its accompanying flavored e-liquids emerged on to the global market. These new products contain no combustible tobacco but often contain large concentrations (reported from 0 to more than 50 mg/mL) of nicotine as well as numerous flavorings and/or flavor chemicals. At present, there are more than 400 e-cigarette brands available along with potentially >15,000 different/unique flavored products. However, surprisingly little is known about the flavors/flavor chemicals added to these products, which can account for >1% by weight of some e-liquids, and their resultant chemosensory experiences, and the US FDA has done relatively little, until recently, to regulate these products. This article will discuss e-cigarette flavors and flavor chemicals, their elicited responses, and their sensory effects in some detail.
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Affiliation(s)
- Shatha K Alhadyan
- Department of Pharmaceutical Sciences, North Carolina Central University, Durham, North Carolina 27707, United States
| | - Vijay Sivaraman
- Department of Biological and Biomedical Sciences, North Carolina Central University, Durham, North Carolina 27707, United States
| | - Rob U Onyenwoke
- Department of Pharmaceutical Sciences, North Carolina Central University, Durham, North Carolina 27707, United States.,Biomanufacturing Research Institute and Technology Enterprise (BRITE), North Carolina Central University, Durham, North Carolina 27707, United States
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14
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Fang J, Ren J, Ren L, Max W, Yao T, Zhao F. Electronic cigarette knowledge, attitudes and use among
students at a university in Hangzhou, China. Tob Induc Dis 2022; 20:09. [PMID: 35125992 PMCID: PMC8796848 DOI: 10.18332/tid/144230] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/24/2021] [Accepted: 11/24/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Electronic cigarettes are increasingly popular worldwide, especially among youth. There is growing evidence of the negative health consequences of vaping. Our objective was to assess university students’ knowledge and attitudes regarding electronic cigarettes (e-cigarettes), their use, as well as the associated influencing factors for their use. METHODS The study involved an online cross-sectional survey conducted between November 2019 and March 2020 in a university in Hangzhou, China. A total of 563 students completed the questionnaire. Descriptive statistics were used to assess characteristics, knowledge, and attitudes; t-tests, χ2-tests and logistic regression models were used to identify factors associated with ever e-cigarette use. RESULTS In all, 59.9% of respondents were female and the average age was 20.38 years (SD=1.32). Only 42.6% of the respondents thought that e-cigarettes contain nicotine, 31.1% thought e-cigarettes are tobacco products, and 8.2% of the students reported being ever e-cigarettes users. In regard to attitude, the average score of the students in the Safety dimension was 3.34 (SD=0.64), followed by the Restriction dimension (Mean=2.66, SD=0.83). Correlates of ever use included regions, friends’ and roommates’ ever e-cigarette use, and higher attitude score in the Supervision dimension. CONCLUSIONS The university students’ level of knowledge regarding e-cigarettes was not high, and their attitudes regarding e-cigarettes were not that supportive. Students’ ever use of e-cigarettes at a university in Hangzhou was higher than for university students in other cities in China, but lower than for those in foreign countries.
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Affiliation(s)
- Juan Fang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Jianping Ren
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Lixian Ren
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Wendy Max
- Institute for Health and Aging, School of Nursing, University of California San Francisco, San Francisco, United States
| | - Tingting Yao
- Institute for Health and Aging, School of Nursing, University of California San Francisco, San Francisco, United States
| | - Falin Zhao
- School of Public Health, Hangzhou Normal University, Hangzhou, China
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15
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Besaratinia A. From Tobacco Cigarettes to Electronic Cigarettes: The Two Sides of a Nicotine Coin. FRONTIERS IN ORAL HEALTH 2022; 2:790634. [PMID: 35048076 PMCID: PMC8757837 DOI: 10.3389/froh.2021.790634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 11/04/2021] [Indexed: 01/31/2023] Open
Abstract
Tobacco smoking-related diseases, including cardiovascular disease, pulmonary disease, stroke, and cancer in multiple organ sites, are the leading causes of preventable death, worldwide. Youth electronic cigarette use (vaping) is an evolving public health problem in the United States and around the world. Many of the same toxicants and carcinogens present in tobacco smoke are also found in electronic cigarette vapor, although mostly at substantially lower levels. The reduced concentrations of these chemicals in electronic cigarette vapor may imply lower health risk; however, they cannot equate to no risk. To date, the long-term health consequences of vaping are largely unknown. This “Perspective” provides a concise chronology of events leading up to an unprecedented global challenge, namely the convergence of global tobacco epidemic and youth vaping epidemic. Current state of knowledge, outstanding questions in the field, present challenges, and future directions in research are highlighted. The existing data show a continued and dynamic evolution of the converged epidemics. The goal should be to prevent youth vaping while improving smoking cessation strategies. In smokers who are unable or unwilling to quit smoking, the objective should be to provide “provably” safe or less-harmful alternatives, which should “completely” or “substantially” substitute tobacco cigarettes.
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Affiliation(s)
- Ahmad Besaratinia
- Department of Population and Public Health Sciences, USC Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
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16
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Snoderly HT, Nurkiewicz TR, Bowdridge EC, Bennewitz MF. E-Cigarette Use: Device Market, Study Design, and Emerging Evidence of Biological Consequences. Int J Mol Sci 2021; 22:12452. [PMID: 34830344 PMCID: PMC8619996 DOI: 10.3390/ijms222212452] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 12/12/2022] Open
Abstract
Electronic cigarettes are frequently viewed as a safer alternative to conventional cigarettes; however, evidence to support this perspective has not materialized. Indeed, the current literature reports that electronic cigarette use is associated with both acute lung injury and subclinical dysfunction to the lung and vasculature that may result in pathology following chronic use. E-cigarettes can alter vascular dynamics, polarize innate immune populations towards a proinflammatory state, compromise barrier function in the pulmonary endothelium and epithelium, and promote pre-oncogenic phenomena. This review will summarize the variety of e-cigarette products available to users, discuss current challenges in e-cigarette study design, outline the range of pathologies occurring in cases of e-cigarette associated acute lung injury, highlight disease supporting tissue- and cellular-level changes resulting from e-cigarette exposure, and briefly examine how these changes may promote tumorigenesis. Continued research of the mechanisms by which e-cigarettes induce pathology benefit users and clinicians by resulting in increased regulation of vaping devices, informing treatments for emerging diseases e-cigarettes produce, and increasing public awareness to reduce e-cigarette use and the onset of preventable disease.
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Affiliation(s)
- Hunter T. Snoderly
- Department of Chemical and Biomedical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV 26506, USA;
- Center for Inhalation Toxicology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA; (T.R.N.); (E.C.B.)
| | - Timothy R. Nurkiewicz
- Center for Inhalation Toxicology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA; (T.R.N.); (E.C.B.)
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Elizabeth C. Bowdridge
- Center for Inhalation Toxicology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA; (T.R.N.); (E.C.B.)
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Margaret F. Bennewitz
- Department of Chemical and Biomedical Engineering, Benjamin M. Statler College of Engineering and Mineral Resources, West Virginia University, Morgantown, WV 26506, USA;
- Center for Inhalation Toxicology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA; (T.R.N.); (E.C.B.)
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17
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Sharma H, Verma S. “Vaping”- a Trojan Horse Against Fight Toward Tobacco Use and Cancer: A Systematic Review of the Existing Evidence. Indian J Med Paediatr Oncol 2021. [DOI: 10.4103/ijmpo.ijmpo_11_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AbstractThe purpose of this systematic review is to understand many aspects of vaping, like what is vaping, why it is more enticing to adolescents and young adults, what makes it more harmful than regular smoked tobacco products, subsequent health consequences, and what measures are currently being taken against this activity. A literature search was conducted in online database PubMed using search string “(((((Lung injury*[Title/Abstract]) AND Vaping[Title/Abstract]) OR electronic nicotine delivery device[Title/Abstract]) OR electronic cigarette*[Title/Abstract]) AND e-cigarettes liquid) AND electronic cigars and search filter used were “published in the last 5 years” and “Human Studies.” Similar search terms were used to search EMBASE, Web of Science, Google Scholar, and the CENTRAL database of the Cochrane Library with the help of Boolean terms. Thirty-six articles were included for a final systematic review. Many of the known brands use additives such as flavoring and thickening agents that, when used even for the short term, can cause toxicity to human lung tissues. This toxicity depends not only on the extent of the habit, but also on the variable susceptibility to lung damage, dual use with cigarettes, variability in the product design of different brands, and the liquid content used in them. Vaping may be linked with significant health issues, including respiratory diseases such as asthma, very severe forms of bronchitis such as popcorn lung, or E-cigarette, or vaping, product use-associated lung injury, and cardiovascular illnesses such as atherosclerotic plaque and myocardial ischemia. From the current systematic review, we would like to emphasize that no long-term toxicological and health studies have been carried out in humans using these vaping products and their constituents to date. Although cessation should be strongly encouraged in smokers for better quality of life, it is uncertain whether it is a universally safer option to replace cigarettes with these vaping devices.
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Affiliation(s)
- Hunny Sharma
- Department of Public Health Dentistry, Triveni Institute of Dental Sciences, Hospital and Research Centre, Bilaspur, Chhattisgarh, India
| | - Swati Verma
- Department of Public Health Dentistry, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
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18
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Besaratinia A, Tommasi S. The consequential impact of JUUL on youth vaping and the landscape of tobacco products: The state of play in the COVID-19 era. Prev Med Rep 2021; 22:101374. [PMID: 34168950 PMCID: PMC8207461 DOI: 10.1016/j.pmedr.2021.101374] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 12/23/2022] Open
Abstract
JUUL is a groundbreaking electronic cigarette (e-cig) and the preeminent vaping product on the market. We present an overview of the rapid and spectacular rise of JUUL and its remarkable fall within the timespan of 2015 - 2020. We highlight JUUL's entering the market in June 2015, becoming the industry leader in mid 2017, and experiencing a litany of setbacks by late 2019 through to early 2020. We address the role played by JUUL in the ongoing epidemic of youth vaping. We also feature competing views on the public health impact of JUUL use (in particular), and e-cig vaping (in general). We further highlight the latest trends in youth vaping and sales records for JUUL and tobacco cigarettes. In view of the ongoing pandemic of COVID-19, we briefly summarize the existing evidence on the relationship between vaping and smoking and the prevalence, disease course, and clinical outcomes of COVID-19.
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Key Words
- ACE2, angiotensin converting enzyme 2
- Adolescents
- CDC, Centers for Disease Control and Prevention
- COVID-19
- COVID-19, coronavirus disease 2019
- EVALI, e-cig, or vaping, product use-associated lung injury
- Electronic cigarettes
- Epidemic
- FDA, Food and Drug Administration
- FTC, Federal Trade Commission
- ITC, International Trade Commission
- JUUL
- NASEM, National Academy of Sciences, Engineering and Medicine NYTS, National Youth Tobacco Survey
- NRT, nicotine replacement therapy
- Nicotine
- PHE, Public Health England
- Pandemic
- Public health
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- Tobacco
- Youth vaping
- e-cig, electronic cigarette
- nAChR, nicotinic acetylcholine receptor
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Affiliation(s)
- Ahmad Besaratinia
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA 90033, USA
| | - Stella Tommasi
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA 90033, USA
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19
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De Martin S, Gabbia D, Bogialli S, Biasioli F, Boschetti A, Gstir R, Rainer D, Cappellin L. Refill liquids for electronic cigarettes display peculiar toxicity on human endothelial cells. Toxicol Rep 2021; 8:456-462. [PMID: 33717998 PMCID: PMC7933715 DOI: 10.1016/j.toxrep.2021.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/21/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023] Open
Abstract
The electronic cigarettes mimic combustible cigarettes through a heating technology that vaporizes a refill liquid consisting of solvents, flavors, and nicotine. E-cigarettes are sometimes still used as a support for smoking cessation, even if in 2019 an acute lung injury outbreak occurred in the USA, affecting mainly adolescents and young adults, and was correlated to eCigs. Therefore, due to the lack of a definite knowledge about the mechanism(s) of refill liquid toxicity and considering that previous investigations gave controversial results, the aim of the present study was the cytotoxicity assessment of different refill liquids on human endothelial cells, evaluated by means of two different in vitro approaches, i.e. the resazurin and the LDH release assays. Our results clearly demonstrated that different refill liquids (6 samples) display different levels of cytotoxicity in our cellular model, although their cytotoxicity was always lower than that observed for the condensate obtained from traditional cigarettes (3 samples). These results suggest that accurate evaluations should be provided for refill liquids, in particular to correlate their toxicity to their chemical composition, with the final aim of obtaining useful information for the agencies involved in the regulation of their components.
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Affiliation(s)
- Sara De Martin
- Department of Pharmaceutical and Pharmacological Sciences, Università degli Studi di Padova, Padova, Italy
| | - Daniela Gabbia
- Department of Pharmaceutical and Pharmacological Sciences, Università degli Studi di Padova, Padova, Italy
| | - Sara Bogialli
- Department of Chemical Sciences, Università degli Studi di Padova, Padova, Italy
| | - Franco Biasioli
- Research and Innovation Centre, Fondazione Edmund Mach, S. Michele a/A, Italy
| | | | - Ronald Gstir
- Austrian Drug Screening Institute GmbH, Innsbruck, Austria
| | - Daniela Rainer
- Austrian Drug Screening Institute GmbH, Innsbruck, Austria
| | - Luca Cappellin
- Department of Chemical Sciences, Università degli Studi di Padova, Padova, Italy.,Research and Innovation Centre, Fondazione Edmund Mach, S. Michele a/A, Italy
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20
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Zhang R, Jones MM, Dornsife RE, Wu T, Sivaraman V, Tarran R, Onyenwoke RU. JUUL e-liquid exposure elicits cytoplasmic Ca 2+ responses and leads to cytotoxicity in cultured airway epithelial cells. Toxicol Lett 2021; 337:46-56. [PMID: 33253780 PMCID: PMC7772262 DOI: 10.1016/j.toxlet.2020.11.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 10/27/2020] [Accepted: 11/18/2020] [Indexed: 12/15/2022]
Abstract
RATIONALE The popularity of new and emerging tobacco products such as E-cigarettes (E-cigs) is rapidly expanding worldwide. However, uncertainties surrounding the potential health consequences due to the use of such products exist and warrant further study. METHODS Cultured A549 and Calu-3 airway epithelia were exposed to three out of the eight types of JUUL brand e-liquids ("Mint", "Virginia Tobacco" and "Menthol", all containing 3% nicotine at 1% and 3% (vol/vol) dilutions) and assessed for viability using a resazurin-based assay. Intracellular Ca2+ levels were measured using fluorescent indicators and pro-inflammatory cytokine levels were monitored by quantitative PCR (qPCR). Cultures were also analyzed by flow cytometry to evaluate apoptotic markers and cell viability. RESULTS Exposing the airway epithelial cells to the flavored JUUL e-liquids led to significant cytotoxicity, with the "Mint" flavor being the overall most cytotoxic. The "Mint" flavored e-liquid also led to significant elevations in intracellular Ca2+ and upregulation of the pro-inflammatory cytokine IL-6 and early apoptotic marker Annexin V. CONCLUSIONS JUUL e-liquid challenge resulted in a loss of airway epithelial cell viability, induced pro-inflammatory responses and eventually caused apoptosis.
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Affiliation(s)
- Rui Zhang
- Department of Respiratory and Critical Care Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, PR China; Biomanufacturing Research Institute and Technology Enterprise (BRITE), Durham, NC, United States
| | - Myles M Jones
- Department of Biological and Biomedical Sciences, Durham, NC, United States
| | - Ronna E Dornsife
- Biomanufacturing Research Institute and Technology Enterprise (BRITE), Durham, NC, United States
| | - Tongde Wu
- Biomanufacturing Research Institute and Technology Enterprise (BRITE), Durham, NC, United States; Department of Pharmaceutical Sciences, North Carolina Central University, Durham, NC, United States
| | - Vijay Sivaraman
- Department of Biological and Biomedical Sciences, Durham, NC, United States
| | - Robert Tarran
- Department of Cell Biology & Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Rob U Onyenwoke
- Biomanufacturing Research Institute and Technology Enterprise (BRITE), Durham, NC, United States; Department of Pharmaceutical Sciences, North Carolina Central University, Durham, NC, United States.
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21
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BEYAZÇİÇEK Ö, BEYAZÇİÇEK E, ÖZMERDİVENLİ R, DEMİR S. E-sigaralar: Yeni Bir Fenomen. DÜZCE ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2020. [DOI: 10.33631/duzcesbed.748056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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22
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Besaratinia A, Tommasi S. Vaping epidemic: challenges and opportunities. Cancer Causes Control 2020; 31:663-667. [PMID: 32363571 DOI: 10.1007/s10552-020-01307-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/27/2020] [Indexed: 01/09/2023]
Abstract
This article is a timely, concise, and unbiased analysis of the national and international responses to the spate of vaping-related lung illnesses and deaths and the epidemic of teen vaping. In view of the recent outbreak of vaping-related lung injuries and deaths in the USA and the epidemic of teen vaping, the viewpoints and recommendations presented in this article have immediate policy implications in the USA and around the world. The perspectives and recommendations are expected to assist medical communities, public health professionals, and regulatory authorities in addressing complex issues related to vaping regulation, which are intertwined with public health, economy, and politics of nations, worldwide.
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Affiliation(s)
- Ahmad Besaratinia
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA, 90033, USA.
| | - Stella Tommasi
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA, 90033, USA
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23
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Gómez AC, Rodríguez-Fernández P, Villar-Hernández R, Gibert I, Muriel-Moreno B, Lacoma A, Prat-Aymerich C, Domínguez J. E-cigarettes: Effects in phagocytosis and cytokines response against Mycobacterium tuberculosis. PLoS One 2020; 15:e0228919. [PMID: 32040536 PMCID: PMC7010305 DOI: 10.1371/journal.pone.0228919] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/22/2020] [Indexed: 01/17/2023] Open
Abstract
Cigarette smoking and tuberculosis are a significant cause of death worldwide. Several epidemiological studies have demonstrated cigarette smoking is a risk factor for tuberculosis. Electronic cigarettes have recently appeared as a healthier alternative to conventional smoking, although their impact in tuberculosis is not well understood. The aim of this study was to explore the effect of electronic cigarettes in phagocytosis of Mycobacterium tuberculosis and cytokines production. In vitro infection was carried out by exposing THP-1 macrophages to four electronic vapor extracts and the intracellular burden of M. tuberculosis was determined. The percentage of infection was evaluated by confocal microscopy and the cytokine production by Luminex. A reduction of intracellular M. tuberculosis burden in THP-1 macrophages was found after its exposure to electronic vapor extract; the same trend was observed by confocal microscopy when Mycobacterium bovis BCG-GFP strain was used. Electronic cigarettes stimulate a pro-inflammatory cytokine response. We conclude that electronic cigarettes impair the phagocytic function and the cytokine response to M. tuberculosis.
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Affiliation(s)
- Andromeda-Celeste Gómez
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, CIBER Enfermedades Respiratorias (CIBERES), Badalona, Catalonia, Spain
- Institut de Biotecnologia i de Biomedicina (IBB), Universitat Autònoma de Barcelona (UAB), Bellaterra (Cerdanyola del Vallès), Barcelona, Catalonia, Spain
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Catalonia, Spain
| | - Pablo Rodríguez-Fernández
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, CIBER Enfermedades Respiratorias (CIBERES), Badalona, Catalonia, Spain
- Institut de Biotecnologia i de Biomedicina (IBB), Universitat Autònoma de Barcelona (UAB), Bellaterra (Cerdanyola del Vallès), Barcelona, Catalonia, Spain
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Catalonia, Spain
| | - Raquel Villar-Hernández
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, CIBER Enfermedades Respiratorias (CIBERES), Badalona, Catalonia, Spain
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Catalonia, Spain
| | - Isidre Gibert
- Institut de Biotecnologia i de Biomedicina (IBB), Universitat Autònoma de Barcelona (UAB), Bellaterra (Cerdanyola del Vallès), Barcelona, Catalonia, Spain
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Catalonia, Spain
| | - Beatriz Muriel-Moreno
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, CIBER Enfermedades Respiratorias (CIBERES), Badalona, Catalonia, Spain
| | - Alicia Lacoma
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, CIBER Enfermedades Respiratorias (CIBERES), Badalona, Catalonia, Spain
| | - Cristina Prat-Aymerich
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, CIBER Enfermedades Respiratorias (CIBERES), Badalona, Catalonia, Spain
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Catalonia, Spain
| | - Jose Domínguez
- Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, CIBER Enfermedades Respiratorias (CIBERES), Badalona, Catalonia, Spain
- Departament de Genètica i de Microbiologia, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Barcelona, Catalonia, Spain
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Caliri AW, Caceres A, Tommasi S, Besaratinia A. Hypomethylation of LINE-1 repeat elements and global loss of DNA hydroxymethylation in vapers and smokers. Epigenetics 2020; 15:816-829. [PMID: 31996072 DOI: 10.1080/15592294.2020.1724401] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The outbreak of vaping-related severe lung injuries and deaths and the epidemic of teen vaping in the U.S. underscore the urgent need for determining the biological consequences of electronic cigarette (e-cig) use. We have investigated the association between vaping and epigenetic changes by quantifying DNA methylation levels in Long Interspersed Nucleotide Element 1 (LINE-1) and global DNA hydroxymethylation (5-hmC) levels and measuring the expression level of enzymes catalysing the respective processes in peripheral blood of exclusive vapers, smokers, and controls, matched for age, gender, and race (n = 45). Both vapers and smokers showed significant loss of methylation in LINE-1 repeat elements in comparison to controls (P = 0.00854 and P = 0.03078, respectively). Similarly, vapers and smokers had significant reductions in 5-hmC levels relative to controls (P = 0.04884 and P = 0.0035, respectively). Neither the LINE-1 methylation levels nor the global 5-hmC levels were different between vapers and smokers. There was a direct correlation between methylation levels in the LINE-1 elements and global 5-hmC levels in the study subjects (r = 0.31696, P = 0.03389). Inverse and statistically significant correlations were found between both the LINE-1 methylation levels and the global 5-hmC levels and various vaping/smoking metrics in the study subjects. There were modest but not statistically significant changes in transcription of DNA methyltransferases and ten-eleven translocation enzymes in both vapers and smokers relative to controls. Our findings support follow-up genome-wide investigations into the epigenetic effects of vaping, which may further clarify the health consequences of e-cig use. ABBREVIATIONS 5-mC: 5-methylcytosine; 5-hmC: 5-hydroxymethylcytosine; 8-OHdG: 8-hydroxy-2'-deoxyguanosine; ACTIN: actin beta; ANOVA: Analysis of Variance; BER: base excision repair; BMI: body mass index; CO: carbon monoxide; COHb: carboxyhaemoglobin; COBRA: combined bisulphite restriction analysis; COPD: chronic obstructive pulmonary disease; DNMT1: DNA methyltransferase 1; DNMT3A: DNA methyltransferase 3A; DNMT3B: DNA methyltransferase 3B; e-cigs: electronic cigarettes; ELISA: enzyme-linked immunosorbent assay; ENDS: electronic nicotine delivery systems; FDA: Food and Drug Administration; GAPDH; glyceraldehyde-3-phosphate dehydrogenase; HPLC: high-performance liquid chromatography; LINE-1: Long Interspersed Nucleotide Element 1; PBS: phosphate-buffered saline; RFU: relative fluorescence units; RT-qPCR: quantitative reverse-transcription polymerase chain reaction; ROS: reactive oxygen species; SAM, S-adenosylmethionine; SE: standard error; TET1: ten-eleven translocation 1; TET2: ten-eleven translocation 2; TET3: ten-eleven translocation 3.
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Affiliation(s)
- Andrew W Caliri
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California , Los Angeles, CA, USA
| | - Amanda Caceres
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California , Los Angeles, CA, USA
| | - Stella Tommasi
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California , Los Angeles, CA, USA
| | - Ahmad Besaratinia
- Department of Preventive Medicine, USC Keck School of Medicine, University of Southern California , Los Angeles, CA, USA
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Dwedar I, Ruby D, Mostafa A. A survey exploring knowledge and beliefs about electronic cigarettes between health care providers and the general population in Egypt. Int J Chron Obstruct Pulmon Dis 2019; 14:1943-1950. [PMID: 32021137 PMCID: PMC6719839 DOI: 10.2147/copd.s214389] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 08/01/2019] [Indexed: 11/23/2022] Open
Abstract
Background Electronic cigarettes are increasing in popularity, and they are easily accessible in a variety of locations. Despite increasing its popularity, little is known about its overall health effects. Physicians have rated the most trustful source of information about it and play also a role in disseminating information about it. Thus, this study identified the difference in knowledge and beliefs about electronic cigarettes between health care providers and the general population in Egypt. Methods A cross-sectional study using the self-administered questionnaire in the Arabic language was conducted between December 2018 and March 2019 in the Chest Department in Ain Shams University Hospital in Egypt. Study population (n=610) was divided into health care providers (n=260) and general population (n=350). Result A total of 593 respondents participated in this study and returned filled questionnaire with total response rate=97.2%, only 8.8% of all participates were smokers, none of the study population reported using electronic cigarettes, despite that, 79.3% of the participants have heard of electronic cigarettes, media advertisements were the main source of getting to know it and there was a statistically significant difference between both groups regarding most beliefs and attitudes toward electronic cigarettes. Conclusion There was high awareness about electronic cigarettes in Egypt and more negative attitude about it among health care providers than the general population, but still educational programs and guidelines for health care providers are needed to raise more the awareness which will aid in counseling general population appropriately.
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Affiliation(s)
- Ibrahim Dwedar
- Department of Chest, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Dina Ruby
- Department of Chest, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Aya Mostafa
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Kilibarda B, Krstev S, Milovanovic M, Foley K. E-cigarette use in Serbia: Prevalence, reasons for trying and perceptions. Addict Behav 2019; 91:61-67. [PMID: 30473245 DOI: 10.1016/j.addbeh.2018.11.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 11/15/2018] [Accepted: 11/16/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Biljana Kilibarda
- Institute of Public Health of Serbia, Office for Smoking Prevention, Dr Subotica 5, 11 000 Belgrade, Serbia.
| | - Srmena Krstev
- Association "Health Mission", Krunska 6a, 11000 Belgrade, Serbia
| | - Minja Milovanovic
- University of the Witwatersrand, Perinatal HIV Research Unit, Soweto, South Africa
| | - K Foley
- Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Medical Center Boulevard, Winston-Salem, NC 27157, United States
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Deregulation of Biologically Significant Genes and Associated Molecular Pathways in the Oral Epithelium of Electronic Cigarette Users. Int J Mol Sci 2019; 20:ijms20030738. [PMID: 30744164 PMCID: PMC6386888 DOI: 10.3390/ijms20030738] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 02/06/2019] [Accepted: 02/07/2019] [Indexed: 12/15/2022] Open
Abstract
We have investigated the regulation of genes and associated molecular pathways, genome-wide, in oral cells of electronic cigarette (e-cigs) users and cigarette smokers as compared to non-smokers. Interrogation of the oral transcriptome by RNA-sequencing (RNA-seq) analysis showed significant number of aberrantly expressed transcripts in both e-cig users (vapers) and smokers relative to non-smokers; however, smokers had ~50% more differentially expressed transcripts than vapers (1726 versus 1152). Whereas the deregulated transcripts in smokers were predominately from protein-coding genes (79% versus 53% in vapers), nearly 28% of the aberrantly expressed transcripts in vapers (versus 8% in smokers) belonged to regulatory non-coding RNAs, including long intergenic non-coding, antisense, small nucleolar and misc RNA (P < 0.0001). Molecular pathway and functional network analyses revealed that "cancer" was the top disease associated with the deregulated genes in both e-cig users and smokers (~62% versus 79%). Examination of the canonical pathways and networks modulated in either e-cig users or smokers identified the "Wnt/Ca⁺ pathway" in vapers and the "integrin signaling pathway" in smokers as the most affected pathways. Amongst the overlapping functional pathways impacted in both e-cig users and smokers, the "Rho family GTPases signaling pathway" was the top disrupted pathway, although the number of affected targets was three times higher in smokers than vapers. In conclusion, we observed deregulation of critically important genes and associated molecular pathways in the oral epithelium of vapers that bears both resemblances and differences with that of smokers. Our findings have significant implications for public health and tobacco regulatory science.
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Morgan J, Breitbarth AK, Jones AL. Risk versus regulation: an update on the state of e-cigarette control in Australia. Intern Med J 2019; 49:110-113. [DOI: 10.1111/imj.14176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/06/2018] [Accepted: 06/23/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Jody Morgan
- Faculty of Science, Medicine and Health; University of Wollongong; Wollongong New South Wales Australia
- Illawarra Health and Medical Research Institute; University of Wollongong; Wollongong New South Wales Australia
| | - Andreas K. Breitbarth
- Illawarra Shoalhaven Local Health District, NSW Health; Wollongong New South Wales Australia
| | - Alison L. Jones
- Faculty of Science, Medicine and Health; University of Wollongong; Wollongong New South Wales Australia
- Illawarra Health and Medical Research Institute; University of Wollongong; Wollongong New South Wales Australia
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Breitbarth AK, Morgan J, Jones AL. E-cigarettes-An unintended illicit drug delivery system. Drug Alcohol Depend 2018; 192:98-111. [PMID: 30245461 DOI: 10.1016/j.drugalcdep.2018.07.031] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/12/2018] [Accepted: 07/04/2018] [Indexed: 12/15/2022]
Abstract
Since the introduction of electronic cigarettes (e-cigarettes) in 2003, the technology has advanced allowing for greater user modifications, with users now able to control voltage, battery power, and constituents of the e-cigarette liquid. E-cigarettes have been the subject of a growing body of research with most research justifiably focused on the chemical makeup and risk analysis of chemicals, metals, and particulates found in e-cigarette liquids and vapor. Little research to date has focused on assessing the risks associated with the drug delivery unit itself and its potential for use as an illicit drug delivery system. In light of this, a range of illicit drugs was researched focusing on pharmacodynamics, usual method of administration, the dosage required for toxicity, toxic effects, and evidence of existing use in e-cigarettes in both literature and online illicit drug forums. A systematic literature search found evidence of current use of e-cigarettes to vape almost all illicit drug types analyzed. This presents both a potential population health risk and a management issue for clinicians. It also raises the issue of policing illicit drugs due to potential altered characteristic smells and storage within e-cigarette fluids. E-cigarettes are a viable illicit drug delivery system with evidence both inside and outside of the formal medical literature detailing their potential use for drug delivery of a wide range of illicit and legal drugs.
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Affiliation(s)
| | - Jody Morgan
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Alison L Jones
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, 2522, Australia
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