1
|
Leal WE, Moscrop-Blake K. The many forms of cannabis use: Prevalence and correlates of routes of administration among nationally representative samples of U.S. adult and adolescent cannabis users. Addict Behav 2024; 159:108146. [PMID: 39222559 DOI: 10.1016/j.addbeh.2024.108146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 08/21/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Cannabis legalization has made cannabis accessible via dispensaries which sell a wide variety of cannabis products. Importantly, the various routes of administration are associated with differing consequences. As such, it's crucial to understand the prevalence and correlates of different cannabis products. Unfortunately, research has yet to examine the prevalence of certain forms of cannabis use, and little is known about the prevalence of using multiple forms of cannabis, and whether individual-level factors are associated with using different forms of cannabis. METHODS The current study uses data from the 2022 National Survey on Drug Use and Health (NSDUH) to examine the prevalence and correlates of eight different types of cannabis use (smoking, vaping, eating/drinking, dabbing, drops/lozenges, topical, pills, and other), as well as a cannabis variety scale, on samples of adult and adolescent cannabis users. RESULTS The results suggest that certain routes of administration are more prevalent than others and that these patterns are fairly consistent between adults and adolescents. Similarly, for both adults and adolescents, the majority of users used more than one cannabis product. Lastly, several individual-level factors are associated with the various forms of cannabis use and many of these associations vary by the route of administration examined. CONCLUSIONS The results of the current study demonstrate that there are differences among cannabis users. If we can develop an understanding of who uses the various forms of cannabis, we could identify the users of the more dangerous forms and provide these individuals with more resources.
Collapse
Affiliation(s)
- Wanda E Leal
- Department of Criminal Justice and Criminology, Sam Houston State University, 816 17th St, Huntsville, TX 77340, United States of America.
| | - Kelsi Moscrop-Blake
- Department of Criminal Justice and Criminology, Sam Houston State University, 816 17th St, Huntsville, TX 77340, United States of America.
| |
Collapse
|
2
|
Singh R, Burke M, Towns S, Rahman MA, Bittoun R, Shah S, Liu A, Bhurawala H. Exploring General Practitioners' Knowledge, Attitudes, and Practices towards E-Cigarette Use/Vaping in Children and Adolescents: A Pilot Cross-Sectional Study in Sydney. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1215. [PMID: 39338099 PMCID: PMC11444199 DOI: 10.3390/ijerph21091215] [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: 07/15/2024] [Revised: 08/25/2024] [Accepted: 09/15/2024] [Indexed: 09/30/2024]
Abstract
(1) Background: The increasing use of e-cigarettes/vaping in children and adolescents has been recognised as a global health concern. We aim to explore the Knowledge, Attitude, and Practice of General Practitioners (GPs) in Sydney regarding the use of e-cigarettes in children and adolescents and identify the barriers to addressing this issue. (2) Methods: This pilot study was a cross-sectional study conducted using an electronic questionnaire with a Likert scale and free-text responses. (3) Results: Fifty-three GPs participated in the study (male = 24 and female = 29) with a mean age of 50 ± 5.5 years. There was strong agreement (mean 4.5) about respiratory adverse effects and addictive potential. However, there was less awareness of cardiac side effects and the occurrence of burns. There is a lack of conversation about e-cigarettes in GP practice and a deficit of confidence in GPs regarding managing e-cigarette use in children and adolescents. (4) Conclusions: Our pilot study has shown that GPs are somewhat knowledgeable about the potential adverse effects of the use of e-cigarettes in children and adolescents, though there is a lack of knowledge of the complete spectrum of adverse effects and more importantly, there is a paucity of a structured approach to discuss the use of e-cigarettes with children and adolescents, and there is a low level of confidence in addressing these issues. There is a need for educational interventions for GPs to increase awareness of the potential adverse effects of using e-cigarettes and build confidence in providing management to children and adolescents regarding the use of e-cigarettes.
Collapse
Affiliation(s)
- Rajiv Singh
- Department of Paediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Michael Burke
- Department of General Practice at the University of Western Sydney, Sydney, NSW 2560, Australia
| | - Susan Towns
- Department of Adolescent Medicine Unit, The Children’s Hospital at Westmead, Sydney, NSW 2145, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia (A.L.)
| | - Muhammad Aziz Rahman
- Institute of Health and Wellbeing, Federation University Australia, Berwick, VIC 3806, Australia
| | - Renee Bittoun
- Lifestyle Medicine, Nicotine Addiction Unit, Avondale University, Sydney, NSW 2265, Australia, Australia
- Faculty of Medicine, The University of Notre Dame, Sydney, NSW 2007, Australia
| | - Smita Shah
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia (A.L.)
| | - Anthony Liu
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia (A.L.)
- Department of Paediatrics, Nepean Hospital, Kingswood, NSW 2747, Australia
| | - Habib Bhurawala
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia (A.L.)
- Faculty of Medicine, The University of Notre Dame, Sydney, NSW 2007, Australia
- Department of Paediatrics, Nepean Hospital, Kingswood, NSW 2747, Australia
| |
Collapse
|
3
|
Jung S, Murthy D, Bateineh BS, Loukas A, Wilkinson AV. The Normalization of Vaping on TikTok Using Computer Vision, Natural Language Processing, and Qualitative Thematic Analysis: Mixed Methods Study. J Med Internet Res 2024; 26:e55591. [PMID: 39259963 PMCID: PMC11425021 DOI: 10.2196/55591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/07/2024] [Accepted: 05/20/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Social media posts that portray vaping in positive social contexts shape people's perceptions and serve to normalize vaping. Despite restrictions on depicting or promoting controlled substances, vape-related content is easily accessible on TikTok. There is a need to understand strategies used in promoting vaping on TikTok, especially among susceptible youth audiences. OBJECTIVE This study seeks to comprehensively describe direct (ie, explicit promotional efforts) and indirect (ie, subtler strategies) themes promoting vaping on TikTok using a mixture of computational and qualitative thematic analyses of social media posts. In addition, we aim to describe how these themes might play a role in normalizing vaping behavior on TikTok for youth audiences, thereby informing public health communication and regulatory policies regarding vaping endorsements on TikTok. METHODS We collected 14,002 unique TikTok posts using 50 vape-related hashtags (eg, #vapetok and #boxmod). Using the k-means unsupervised machine learning algorithm, we identified clusters and then categorized posts qualitatively based on themes. Next, we organized all videos from the posts thematically and extracted the visual features of each theme using 3 machine learning-based model architectures: residual network (ResNet) with 50 layers (ResNet50), Visual Geometry Group model with 16 layers, and vision transformer. We chose the best-performing model, ResNet50, to thoroughly analyze the image clustering output. To assess clustering accuracy, we examined 4.01% (441/10,990) of the samples from each video cluster. Finally, we randomly selected 50 videos (5% of the total videos) from each theme, which were qualitatively coded and compared with the machine-derived classification for validation. RESULTS We successfully identified 5 major themes from the TikTok posts. Vape product marketing (1160/10,990, 8.28%) reflected direct marketing, while the other 4 themes reflected indirect marketing: TikTok influencer (3775/14,002, 26.96%), general vape (2741/14,002, 19.58%), vape brands (2042/14,002, 14.58%), and vaping cessation (1272/14,002, 9.08%). The ResNet50 model successfully classified clusters based on image features, achieving an average F1-score of 0.97, the highest among the 3 models. Qualitative content analyses indicated that vaping was depicted as a normal, routine part of daily life, with TikTok influencers subtly incorporating vaping into popular culture (eg, gaming, skateboarding, and tattooing) and social practices (eg, shopping sprees, driving, and grocery shopping). CONCLUSIONS The results from both computational and qualitative analyses of text and visual data reveal that vaping is normalized on TikTok. Our identified themes underscore how everyday conversations, promotional content, and the influence of popular figures collectively contribute to depicting vaping as a normal and accepted aspect of daily life on TikTok. Our study provides valuable insights for regulatory policies and public health initiatives aimed at tackling the normalization of vaping on social media platforms.
Collapse
Affiliation(s)
- Sungwon Jung
- School of Journalism and Media, University of Texas at Austin, Austin, TX, United States
| | - Dhiraj Murthy
- School of Journalism and Media, University of Texas at Austin, Austin, TX, United States
| | - Bara S Bateineh
- University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX, United States
| | - Anna V Wilkinson
- University of Texas Health Science Center at Houston School of Public Health, Houston, TX, United States
| |
Collapse
|
4
|
Zvolensky MJ, Shepherd JM, Clausen BK, Redmond BY, De Dios M, Cano MÁ. Combustible cigarette smokers versus dual combustible and electronic users: Evaluation of differences in anxiety, depression, and transdiagnostic constructs among Latinx adults. J Ethn Subst Abuse 2024:1-18. [PMID: 39145994 DOI: 10.1080/15332640.2024.2391309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Research on dual combustible and electronic nicotine use among Latinx persons is needed to better understand patterns of use because this group is an established tobacco disparities population. Negative emotional symptoms and related processes (e.g., reactive transdiagnostic vulnerabilities) have been among the most prominent factors linked to the onset, maintenance, and relapse of smoking. As such, the current study sought to compare levels of mental health symptoms among combustible users compared to dual combustible and electronic users among Latinx persons who smoke. The current sample consisted of 297 adult Latinx daily cigarette smokers (Mage = 35.90 years; SD = 8.87; age range 18-61; 36.4% female), of which 92 reported current dual use of an e-cigarette (Mage = 33.34 years; SD = 7.75; age range 19-60; 28.3% female). Differences in anxiety, depression, anxiety sensitivity, emotion dysregulation, and distress tolerance were examined, and we hypothesized that dual users would showcase higher mental health problems. Results indicated that adult Latinx dual users evidenced greater levels of anxiety, depression, emotional dysregulation, anxiety sensitivity, and lower levels of distress tolerance compared to combustible users. The current study sheds light on the clinical importance of affective differences among dual versus combustible Latinx smokers.
Collapse
Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- HEALTH Institute, University of Houston, Houston, Texas, USA
| | - Justin M Shepherd
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Bryce K Clausen
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Brooke Y Redmond
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Marcel De Dios
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas, USA
| | - Miguel Ángel Cano
- Peter O'Donnell Jr. School of Public Health, The University of Texas Southwestern Medical Center, Houston, Texas, USA
| |
Collapse
|
5
|
Klubertanz GC, Matulle MJ, Li JS, Abraham O. Adolescent Perspectives on the Pharmacy-Based T-EVER (Teen E-Cigarette and Vaping Educational Resource) and Its Potential Impact on Youth Vaping. PHARMACY 2024; 12:101. [PMID: 39051385 PMCID: PMC11270414 DOI: 10.3390/pharmacy12040101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND While public health efforts have made tobacco smoking near obsolete among adolescents, vaping products are quickly taking their place. With the negative health consequences looming ahead of young vapers, there is a desperate need to curb youth vaping. Adolescents want to be actively engaged in their health which creates space to educate on vaping in this population segment. METHODS From January to May 2023, 35 adolescents aged 11-18 participated in interviews to assess the investigator-developed Teen E-cigarette and Vaping Educational Resource (T-EVER). All the interviews were recorded and transcribed for independent analysis by two study team members. RESULTS The participants liked the T-EVER, indicating they were engaged in the content. However, some participants wanted more information. The participants wanted health professionals to educate them on vaping but were worried about the potential barriers facing the implementation in community pharmacy settings. CONCLUSIONS Adolescents want to learn about vaping, but there are limited opportunities to do so. The T-EVER is designed to educate youth about vaping. This tool was well received and has the potential to be used by pharmacists as a vaping prevention and cessation intervention. More research is required to discern the true scope of the pharmacist's role in using an educational tool to address adolescent vaping.
Collapse
Affiliation(s)
| | | | | | - Olufunmilola Abraham
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53705, USA; (G.C.K.); (M.J.M.); (J.S.L.)
| |
Collapse
|
6
|
Allbright K, Villandre J, Crotty Alexander LE, Zhang M, Benam KH, Evankovich J, Königshoff M, Chandra D. The paradox of the safer cigarette: understanding the pulmonary effects of electronic cigarettes. Eur Respir J 2024; 63:2301494. [PMID: 38609098 DOI: 10.1183/13993003.01494-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 03/16/2024] [Indexed: 04/14/2024]
Abstract
Electronic cigarette (e-cigarette) use continues to rise globally. E-cigarettes have been presented as safer alternatives to combustion cigarettes that can mitigate the harm associated with tobacco products; however, the degree to which e-cigarette use itself can lead to morbidity and mortality is not fully defined. Herein we describe how e-cigarettes function; discuss the current knowledge of the effects of e-cigarette aerosol on lung cell cytotoxicity, inflammation, antipathogen immune response, mucociliary clearance, oxidative stress, DNA damage, carcinogenesis, matrix remodelling and airway hyperresponsiveness; and summarise the impact on lung diseases, including COPD, respiratory infection, lung cancer and asthma. We highlight how the inclusion of nicotine or flavouring compounds in e-liquids can impact lung toxicity. Finally, we consider the paradox of the safer cigarette: the toxicities of e-cigarettes that can mitigate their potential to serve as a harm reduction tool in the fight against traditional cigarettes, and we summarise the research needed in this underinvestigated area.
Collapse
Affiliation(s)
- Kassandra Allbright
- Department of Medicine and the Electronic Cigarette Research Initiative, University of Pittsburgh, Pittsburgh, PA, USA
| | - John Villandre
- Department of Medicine and the Electronic Cigarette Research Initiative, University of Pittsburgh, Pittsburgh, PA, USA
| | - Laura E Crotty Alexander
- VA San Diego Healthcare System, San Diego, CA, USA
- Department of Medicine, University of California San Diego, San Diego, CA, USA
| | - Michael Zhang
- Department of Medicine and the Electronic Cigarette Research Initiative, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kambez H Benam
- Department of Medicine and the Electronic Cigarette Research Initiative, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - John Evankovich
- Department of Medicine and the Electronic Cigarette Research Initiative, University of Pittsburgh, Pittsburgh, PA, USA
| | - Melanie Königshoff
- Department of Medicine and the Electronic Cigarette Research Initiative, University of Pittsburgh, Pittsburgh, PA, USA
| | - Divay Chandra
- Department of Medicine and the Electronic Cigarette Research Initiative, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
7
|
Ogburn T, Chaudhry I, Knight LD. When Vaping Isn't Actually Safer: A Death From Toxic Alcohol Contaminated Vape Juice. Am J Forensic Med Pathol 2024:00000433-990000000-00190. [PMID: 38833354 DOI: 10.1097/paf.0000000000000951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
ABSTRACT Vape juice is a diluent for e-cigarette active ingredients, nicotine or tetrahydrocannabinol (THC). Lack of strict regulation in vape juice production is a concern as ingredients and their concentrations may vary widely from the labeling.A 43-year-old woman was transported via ambulance to the hospital after ingesting homemade vape juice, presenting unresponsive with decerebrate posturing. She reportedly made a tincture combining a vape juice purchased online (containing "ethylene glycol") and THC for "endometriosis-related pain relief." Laboratory evaluation revealed anion gap metabolic acidosis, elevated serum lactate, and high serum osmolality. Urine fluoresced under Wood's lamp, and fomepizole was administered as an ethylene glycol antidote, but she expired the following afternoon. Clinical serum toxicology results returned after death revealed 235 mg/dL of methanol, and no ethylene glycol.Autopsy findings included ischemic changes of the gastrointestinal tract and cerebral edema with herniation. Postmortem toxicology performed on hospital admission blood revealed methanol (220 mg/dL), propylene glycol (59 mg/dL), Δ-9 THC and metabolites, and medications administered during hospitalization. The medical examiner determined the cause of death to be methanol and propylene glycol toxicity.To our knowledge, this is the first report of accidental death from ingestion of vape juice contaminated with toxic alcohol.
Collapse
Affiliation(s)
- Timothy Ogburn
- From the University of Nevada-Reno School of Medicine, Reno, NV
| | - Irfan Chaudhry
- Washoe County Regional Medical Examiner's Office, and Department of Pathology, University of Nevada-Reno School of Medicine, Reno, NV
| | - Laura D Knight
- Washoe County Regional Medical Examiner's Office, and Departments of Pathology and Pediatrics, University of Nevada-Reno School of Medicine, Reno, NV
| |
Collapse
|
8
|
Roeder NM, Mihalkovic A, Richardson BJ, Penman SL, Novalen M, Hammond N, Eiden R, Khokhar JY, Tyndale RF, Thanos PK. Behavioral and Pharmacokinetic Assessment of Nicotine e-Cigarette Inhalation in Female Rats. Nicotine Tob Res 2024; 26:724-732. [PMID: 38092656 PMCID: PMC11109488 DOI: 10.1093/ntr/ntad240] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/13/2023] [Accepted: 11/23/2023] [Indexed: 05/23/2024]
Abstract
INTRODUCTION Nicotine and tobacco use remain high both globally and in the United States, contributing to large health care expenditures. With a rise in e-cigarette use, it is important to have clinically relevant models of inhaled nicotine exposure. AIMS AND METHODS This study aims to extend prior preclinical nicotine inhalation animal data to females and provide both behavior and serum pharmacokinetics. We tested two inhalation doses of nicotine (24 mg/mL and 59 mg/ mL) and compared these to injected doses (0.4 mg/kg and 1 mg/kg). In addition, we assessed locomotor behavior after the same doses. Blood was collected at 10- and 120-minutes post-administration. We assessed nicotine and cotinine serum concentrations by LC-MS/MS. RESULTS Showed that while nicotine serum concentrations for the respective high and low-dose administrations were similar between both routes of administration, the route had differential effects on locomotor behavior. Inhaled nicotine showed a dose-dependent decrease in locomotor activity while injected doses showed the opposite trend. CONCLUSIONS Our results indicate that the route of administration is an important factor when establishing preclinical models of nicotine exposures. Given that the overall use of e-cigarettes in vulnerable populations is on the rise, our study provides important behavioral and pharmacokinetic information to advance our currently limited understanding of the effects of nicotine vapor exposure. IMPLICATIONS This study highlights behavioral differences between different routes of administration of similar doses of nicotine. Using a low and high dose of nicotine, we found that nicotine serum concentrations were similar between the different routes of administration. Our results indicate that different routes of administration have opposing effects on locomotor activity. These findings provide important implications for future behavioral models.
Collapse
Affiliation(s)
- Nicole M Roeder
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Psychology, University at Buffalo, Buffalo, NY, USA
| | - Abrianna Mihalkovic
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Psychology, University at Buffalo, Buffalo, NY, USA
| | - Brittany J Richardson
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Psychology, University at Buffalo, Buffalo, NY, USA
| | - Samantha L Penman
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Maria Novalen
- Center for Addiction and Mental Health and Departments of Pharmacology and Toxicology, and Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nikki Hammond
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
| | - Rina Eiden
- Department of Psychology, Social Science Research Institute, Pennsylvania State University, University Park, PA, USA
| | - Jibran Y Khokhar
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Rachel F Tyndale
- Center for Addiction and Mental Health and Departments of Pharmacology and Toxicology, and Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Panayotis K Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA
- Department of Psychology, University at Buffalo, Buffalo, NY, USA
| |
Collapse
|
9
|
DeGregorio MW, Kao CJ, Wurz GT. Complexity of Translating Analytics to Recent Cannabis Use and Impairment. J AOAC Int 2024; 107:493-505. [PMID: 38410076 DOI: 10.1093/jaoacint/qsae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 01/31/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
While current analytical methodologies can readily identify cannabis use, definitively establishing recent use within the impairment window has proven to be far more complex, requiring a new approach. Recent studies have shown no direct relationship between impairment and Δ9-tetra-hydrocannabinol (Δ9-THC) concentrations in blood or saliva, making legal "per se" Δ9-THC limits scientifically unjustified. Current methods that focus on Δ9-THC and/or metabolite concentrations in blood, saliva, urine, or exhaled breath can lead to false-positive results for recent use due to the persistence of Δ9-THC well outside of the typical 3-4 h window of potential impairment following cannabis inhalation. There is also the issue of impairment due to other intoxicating substances-just because a subject exhibits signs of impairment and cannabis use is detected does not rule out the involvement of other drugs. Compounding the matter is the increasing popularity of hemp-derived cannabidiol (CBD) products following passage of the 2018 Farm Bill, which legalized industrial hemp in the United States. Many of these products contain varying levels of Δ9-THC, which can lead to false-positive tests for cannabis use. Furthermore, hemp-derived CBD is used to synthesize Δ8-THC, which possesses psychoactive properties similar to Δ9-THC and is surrounded by legal controversy. For accuracy, analytical methods must be able to distinguish the various THC isomers, which have identical masses and exhibit immunological cross-reactivity. A new testing approach has been developed based on exhaled breath and blood sampling that incorporates kinetic changes and the presence of key cannabinoids to detect recent cannabis use within the impairment window without the false-positive results seen with other methods. The complexity of determining recent cannabis use that may lead to impairment demands such a comprehensive method so that irresponsible users can be accurately detected without falsely accusing responsible users who may unjustly suffer harsh, life-changing consequences.
Collapse
Affiliation(s)
- Michael W DeGregorio
- RCU Labs, Inc., 408 Sunrise Ave, Roseville, CA 95661-4123, United States
- Professor Emeritus, University of California, Davis, One Shields Avenue, Davis, CA 95616, United States
| | - Chiao-Jung Kao
- RCU Labs, Inc., 408 Sunrise Ave, Roseville, CA 95661-4123, United States
| | - Gregory T Wurz
- RCU Labs, Inc., 408 Sunrise Ave, Roseville, CA 95661-4123, United States
| |
Collapse
|
10
|
Andrus MR. E-Cigarette, or Vaping, Product Use-Associated Lung Injury (EVALI) Continues: An Opportunity for Pharmacist Intervention. Ann Pharmacother 2024; 58:549-554. [PMID: 37605427 DOI: 10.1177/10600280231193770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023] Open
Abstract
Electronic cigarette (e-cigarette), or vaping, product use-associated lung injury (EVALI) was first identified and reported in 2019, but media coverage and reporting of cases drastically decreased when the COVID-19 pandemic started in early 2020. The syndrome has continued to occur since that time and it is critical that pharmacists are aware of how EVALI presents, and when it should be considered as a potential diagnosis. Inpatient and outpatient pharmacists play a vital role in the treatment of EVALI, and should be knowledgeable of the utility of corticosteroids, even though data are extremely limited. Pharmacists should understand the importance of collecting detailed and accurate information about vaping from patient interviews. Pharmacists also play a leading role in cessation counseling and treatment, selecting medications that can be used to treat nicotine addiction from vaping, and assisting with transitions of care and follow-up.
Collapse
Affiliation(s)
- Miranda R Andrus
- Department of Pharmacy Practice, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
- Department of Family Medicine, Huntsville Regional Medical Campus, The University of Alabama at Birmingham, Huntsville, AL, USA
| |
Collapse
|
11
|
Zvolensky MJ, Shepherd JM, Clausen BK, Redmond BY, Correa-Fernández V, Ditre JW. Combustible cigarette smokers versus e-cigarette dual users among Latinx individuals: Differences in alcohol and drug use severity. Exp Clin Psychopharmacol 2024; 32:197-206. [PMID: 37470998 PMCID: PMC10799193 DOI: 10.1037/pha0000673] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
The Latinx population in the United States (U.S.) experiences significant tobacco and other substance use-related health disparities. Yet, little is known about the couse of combustible cigarettes and e-cigarettes (dual use) in relation to substance use behavior among Latinx smokers. The present investigation compared English-speaking Latinx adults living in the United States who exclusively smoke combustible cigarettes versus dual users in terms of alcohol use and other drug use problem severity. Participants were 297 Hispanic/Latinx daily cigarette smokers (36.4% female, Mage = 35.9 years, SD = 8.87) recruited nationally across the United States using Qualtrics Panels to complete self-report measures of behavioral health outcomes. Five analysis of covariance models were conducted to evaluate differences in overall alcohol consumption, dependence, related problems, hazardous drinking, and drug use problem severity between exclusive combustible cigarette smokers (N = 205) and dual users (N = 92). Results indicated that dual users evinced greater levels of alcohol consumption, dependence, alcohol-related problems, and hazardous drinking compared to exclusive combustible cigarette smokers (ps < .001). Dual users also reported greater levels of drug use problems relative to exclusive combustible cigarette smokers (p < .001). The current findings are among the first to document that dual cigarette and e-cigarette use status (compared to exclusive combustible cigarette smoking) may serve as a clinically relevant risk indicator for a range of deleterious substance use problems among Latinx individuals. Future research is needed to corroborate these findings and examine dual-use status as a longitudinal predictor of alcohol and other substance-related problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Collapse
Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center
- HEALTH Institute, University of Houston
| | | | | | | | | | | |
Collapse
|
12
|
Wang S, Nandy RR, Rossheim ME. Associations between e-cigarette use and sleep health among adults in the United States, NHANES 2015-2018. Sleep Med 2024; 114:220-228. [PMID: 38232605 DOI: 10.1016/j.sleep.2024.01.005] [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: 05/11/2023] [Revised: 08/01/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Abstract
OBJECTIVE To examine the associations between e-cigarette use or dual (e-cigarette and combustible cigarette) use and short sleep duration and trouble sleeping among U.S. adults. METHODS We used 2015-2018 data from the National Health and Nutrition Examination Survey (NHANES) (n = 11,659). E-cigarette use and dual use were categorized as current, former, and never use. Short sleep duration was defined as sleep duration ≤6 h. Trouble sleeping was self-reported. Weighted logistic regression analyses were performed. RESULTS Among those with current e-cigarette use, 53.9 % were with current dual use and 23.8 % were with former dual use. Compared to never e-cigarette use, current e-cigarette use was associated with significantly higher odds of trouble sleeping (OR = 2.16, 95 % CI: 1.49-3.13), adjusting for potential confounders. Significant associations were also observed for former e-cigarette use versus never use with trouble sleeping (OR = 1.54, 95 % CI: 1.15-2.07) after full adjustment. Current cigarette use was associated with both short sleep duration (OR = 1.65, 95 % CI: 1.28-2.14) and trouble sleeping (OR = 1.36, 95 % CI: 1.03-1.79) after full adjustment. Additionally, the fully adjusted ORs for short sleep duration and trouble sleeping were 1.64 (95 % CI: 1.06-2.54) and 2.14 (95 % CI: 1.34-3.42) among those with current dual use, and 1.46 (95 % CI: 1.17-1.81) and 2.11 (95 % CI: 1.66-2.67) among those with former dual use, compared to those without dual use. CONCLUSIONS Current cigarette use or dual use is associated with significantly higher odds of short sleep duration and trouble sleeping. Moreover, former e-cigarette use or dual use is associated with increased odds of trouble sleeping.
Collapse
Affiliation(s)
- Shanshan Wang
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
| | - Rajesh R Nandy
- Department of Population & Community Health, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Matthew E Rossheim
- Department of Health Administration & Health Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| |
Collapse
|
13
|
Graham R, Bharthi K, Williams J, Sharifi V, Pedram P, Fahim M, Bulloch A, Patten SB. Trends in vaping and smoking behavior before and during the COVID-19 pandemic in Canada: Beneficial and potentially detrimental changes. Addict Behav 2024; 149:107839. [PMID: 37839145 DOI: 10.1016/j.addbeh.2023.107839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 08/12/2023] [Accepted: 08/22/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION E-cigarette and cigarette use may have changed during the COVID-19 pandemic, however, there is no consensus in existing literature, and current Canadian studies have not used representative samples. Thus, there is a need for robust national estimates. OBJECTIVE AND METHODS The primary objective was to describe the 30-day period prevalence of smoking and vaping before and during the COVID-19 pandemic in Canada. This study analyzed three years of the cross-sectional Canadian Tobacco and Nicotine Survey: 2019 (pre-pandemic), 2020 (9 months into the pandemic) and 2021 (21 months into pandemic). RESULTS Thirty-day period prevalence of vaping over the 2019, 2020, and 2021 study periods were 4.8 (95%CI: 4.2-5.3), 4.6% (95%CI: 4.1-5.2), and 5.2% (95%CI: 4.7-5.7), respectively. The 30-day period prevalence of smoking over the 2019, 2020, and 2021 study periods were 11.9% (95%CI: 10.9-12.7), 10.3% (95%CI: 9.4-11.2), and 10.3% (95%CI: 9.4-11.1), respectively. Notably, estimates of smoking for females decreased considerably from 2019 (11.0%; 95%CI: 9.9--12.2%) to 2020 (8.6%; 95%CI: 7.5-9.7). Estimates of vaping in those aged 20-24 increased substantially from 2020 (13.0%; 95%CI: 10.9-15.1) to 2021 (17.2%; 95%CI: 15.4-18.9). CONCLUSIONS Changes to smoking and vaping were restricted to subsets within the population. In those aged 20-24, there was a modest increase in vaping from 2020 to 2021. In females, there was a decrease in smoking from 2019 to 2020, which persisted in 2021.
Collapse
Affiliation(s)
- Robert Graham
- Departments of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.
| | - Kanika Bharthi
- Department of Biological Sciences, University of Calgary, Canada.
| | - Jeanne Williams
- Departments of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.
| | - Vandad Sharifi
- Departments of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada; Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Iran.
| | - Pardis Pedram
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Canada.
| | - Mina Fahim
- Departments of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.
| | - Andrew Bulloch
- Departments of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada; Mathison Centre for Mental Health Research & Education, Cumming School of Medicine, University of Calgary, Canada.
| | - Scott B Patten
- Departments of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada; Department of Psychiatry, Cumming School of Medicine, University of Calgary, Canada.
| |
Collapse
|
14
|
Hofmann JJ, Poulos VC, Zhou J, Sharma M, Parraga G, McIntosh MJ. Review of quantitative and functional lung imaging evidence of vaping-related lung injury. Front Med (Lausanne) 2024; 11:1285361. [PMID: 38327710 PMCID: PMC10847544 DOI: 10.3389/fmed.2024.1285361] [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: 08/29/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
Introduction The pulmonary effects of e-cigarette use (or vaping) became a healthcare concern in 2019, following the rapid increase of e-cigarette-related or vaping-associated lung injury (EVALI) in young people, which resulted in the critical care admission of thousands of teenagers and young adults. Pulmonary functional imaging is well-positioned to provide information about the acute and chronic effects of vaping. We generated a systematic review to retrieve relevant imaging studies that describe the acute and chronic imaging findings that underly vaping-related lung structure-function abnormalities. Methods A systematic review was undertaken on June 13th, 2023 using PubMed to search for published manuscripts using the following criteria: [("Vaping" OR "e-cigarette" OR "EVALI") AND ("MRI" OR "CT" OR "Imaging")]. We included only studies involving human participants, vaping/e-cigarette use, and MRI, CT and/or PET. Results The search identified 445 manuscripts, of which 110 (668 unique participants) specifically mentioned MRI, PET or CT imaging in cases or retrospective case series of patients who vaped. This included 105 manuscripts specific to CT (626 participants), three manuscripts which mainly used MRI (23 participants), and two manuscripts which described PET findings (20 participants). Most studies were conducted in North America (n = 90), with the remaining studies conducted in Europe (n = 15), Asia (n = 4) and South America (n = 1). The vast majority of publications described case studies (n = 93) and a few described larger retrospective or prospective studies (n = 17). In e-cigarette users and patients with EVALI, key CT findings included ground-glass opacities, consolidations and subpleural sparing, MRI revealed abnormal ventilation, perfusion and ventilation/perfusion matching, while PET showed evidence of pulmonary inflammation. Discussion and conclusion Pulmonary structural and functional imaging abnormalities were common in patients with EVALI and in e-cigarette users with or without respiratory symptoms, which suggests that functional MRI may be helpful in the investigation of the pulmonary health effects associated with e-cigarette use.
Collapse
Affiliation(s)
| | | | - Jiahai Zhou
- Robarts Research Institute, London, ON, Canada
| | - Maksym Sharma
- Robarts Research Institute, London, ON, Canada
- Department of Medical Biophysics, London, ON, Canada
| | - Grace Parraga
- Robarts Research Institute, London, ON, Canada
- Department of Medical Biophysics, London, ON, Canada
- Department of Medical Imaging, Western University, London, ON, Canada
| | - Marrissa J. McIntosh
- Robarts Research Institute, London, ON, Canada
- Department of Medical Biophysics, London, ON, Canada
| |
Collapse
|
15
|
Martin A, Tempra C, Yu Y, Liekkinen J, Thakker R, Lee H, de Santos Moreno B, Vattulainen I, Rossios C, Javanainen M, Bernardino de la Serna J. Exposure to Aldehyde Cherry e-Liquid Flavoring and Its Vaping Byproduct Disrupt Pulmonary Surfactant Biophysical Function. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:1495-1508. [PMID: 38186267 PMCID: PMC10809783 DOI: 10.1021/acs.est.3c07874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/09/2024]
Abstract
Over the past decade, there has been a significant rise in the use of vaping devices, particularly among adolescents, raising concerns for effects on respiratory health. Pressingly, many recent vaping-related lung injuries are unexplained by current knowledge, and the overall implications of vaping for respiratory health are poorly understood. This study investigates the effect of hydrophobic vaping liquid chemicals on the pulmonary surfactant biophysical function. We focus on the commonly used flavoring benzaldehyde and its vaping byproduct, benzaldehyde propylene glycol acetal. The study involves rigorous testing of the surfactant biophysical function in Langmuir trough and constrained sessile drop surfactometer experiments with both protein-free synthetic surfactant and hydrophobic protein-containing clinical surfactant models. The study reveals that exposure to these vaping chemicals significantly interferes with the synthetic and clinical surfactant biophysical function. Further atomistic simulations reveal preferential interactions with SP-B and SP-C surfactant proteins. Additionally, data show surfactant lipid-vaping chemical interactions and suggest significant transfer of vaping chemicals to the experimental subphase, indicating a toxicological mechanism for the alveolar epithelium. Our study, therefore, reveals novel mechanisms for the inhalational toxicity of vaping. This highlights the need to reassess the safety of vaping liquids for respiratory health, particularly the use of aldehyde chemicals as vaping flavorings.
Collapse
Affiliation(s)
- Alexia Martin
- National
Heart and Lung Institute, Imperial College
London, Sir Alexander Fleming Building, London SW7 2AZ, U.K.
| | - Carmelo Tempra
- Institute
of Organic Chemistry and Biochemistry, Czech Academy of Sciences, Prague 6 160 00, Czech Republic
| | - Yuefan Yu
- National
Heart and Lung Institute, Imperial College
London, Sir Alexander Fleming Building, London SW7 2AZ, U.K.
| | - Juho Liekkinen
- Department
of Physics, University of Helsinki, Helsinki 00560, Finland
| | - Roma Thakker
- National
Heart and Lung Institute, Imperial College
London, Sir Alexander Fleming Building, London SW7 2AZ, U.K.
| | - Hayoung Lee
- National
Heart and Lung Institute, Imperial College
London, Sir Alexander Fleming Building, London SW7 2AZ, U.K.
| | - Berta de Santos Moreno
- National
Heart and Lung Institute, Imperial College
London, Sir Alexander Fleming Building, London SW7 2AZ, U.K.
| | - Ilpo Vattulainen
- Department
of Physics, University of Helsinki, Helsinki 00560, Finland
| | - Christos Rossios
- National
Heart and Lung Institute, Imperial College
London, Sir Alexander Fleming Building, London SW7 2AZ, U.K.
| | - Matti Javanainen
- Institute
of Organic Chemistry and Biochemistry, Czech Academy of Sciences, Prague 6 160 00, Czech Republic
- Institute
of Biotechnology, University of Helsinki, Helsinki 00790, Finland
| | - Jorge Bernardino de la Serna
- National
Heart and Lung Institute, Imperial College
London, Sir Alexander Fleming Building, London SW7 2AZ, U.K.
| |
Collapse
|
16
|
Zhong Q, An K, Wu Z, Zhang H, Li S, Zhang L, Li C, Li H, Zhuo Ga QM, Yang Zong DJ, An Z. Knowledge and awareness of nicotine, nicotine replacement therapy, and electronic cigarettes among general practitioners with a special interest in respiratory medicine in China. Front Med (Lausanne) 2024; 10:1236453. [PMID: 38264047 PMCID: PMC10805112 DOI: 10.3389/fmed.2023.1236453] [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: 06/07/2023] [Accepted: 12/21/2023] [Indexed: 01/25/2024] Open
Abstract
Objectives This study aimed to assess the knowledge and awareness of nicotine, nicotine replacement therapy (NRT), and electronic cigarettes (e-cigarettes) among general practitioners with a special interest (GPwSIs) in respiratory medicine. Methods A cross-sectional study was conducted from October 2021 to February 2022. Knowledge and awareness were compared among smokers and non-smokers, as well as different age and gender groups. Results The study consisted of 102 GPwSIs from 21 cities in Sichuan Province, China. Most respondents would recommend NRT for long-term use. Only a few believed that e-cigarettes are an effective means of smoking cessation and 71.6% would not recommend e-cigarettes as a substitute for cigarettes to their patients. Additionally, the majority did not regularly provide extensive help to assist patients in quitting smoking and needed smoking cessation counseling training. Conclusion GPwSIs in respiratory medicine in China could have a relatively low level of knowledge and awareness regarding nicotine, NRT, and e-cigarettes. The study highlights the need for smoking cessation training among GPwSIs to improve their knowledge and provide better assistance to patients who want to quit smoking.
Collapse
Affiliation(s)
- Qian Zhong
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kang An
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, Multimorbidity Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zengxiang Wu
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, Multimorbidity Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Haijun Zhang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, Multimorbidity Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shengxi Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lin Zhang
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, Multimorbidity Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Caizheng Li
- General Practice Ward/International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, Multimorbidity Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Heting Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qi Mei Zhuo Ga
- Department of General Practice, People’s Hospital of Lhasa, Lhasa, Tibet, China
| | - De Ji Yang Zong
- Department of General Practice, People’s Hospital of Lhasa, Lhasa, Tibet, China
| | - Zhenmei An
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
17
|
Tituana NY, Clavijo CG, Espinoza EF, Tituana VA. E-cigarette use-associated lung injury (EVALI). Pneumologie 2024; 78:58-69. [PMID: 37857323 PMCID: PMC10791482 DOI: 10.1055/a-2161-0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/13/2023] [Indexed: 10/21/2023]
Abstract
The prevalence of vaping has overtaken conventional cigarettes as the most frequent form of nicotine consumption among 15-24-year olds. There are currently a large number of both legitimate and illegitimate products and suppliers offering more than 8000 different flavors of vape on the market, whose additives are not tested, studied or regulated and whose safety and toxicity profile remains unknown. In vitro studies have demonstrated a dose-dependent decrease in the viability of normal human bronchial epithelial cells after exposure to vapor from electronic vape devices.Short- and medium-term studies to date indicate that vapor-induced pulmonary lesions are the most serious and commonly reported side effect; such lesions include bilateral ground glass opacities in lung bases with subpleural preservation, bilateral infiltrates, pleural effusion, pneumomediastinum and nodular opacities. Cases of EVALI have been described in patients with daily exposure, as well as in users who reported having been exposed to these substances at least once a month. The most frequently inhaled substances are THC, flavored liquids of unknown content, and nicotine.The clinical manifestations of dyspnea and cough are the most frequent respiratory symptomatology, in addition to constitutional manifestations such as fever and chills, and gastrointestinal manifestations such as vomiting, nausea, abdominal pain and diarrhea. To these can be added the presence of tachypnea, tachycardia, elevated blood pressure, hypoxia, leukocytosis with neutrophilia and elevated ESR.
Collapse
Affiliation(s)
- Nathaly Yessenia Tituana
- Medicina, Universidad Catolica de Cuenca Unidad Academica de Medicina y Ciencias de la Salud, Cuenca, Ecuador
| | - Claudia Gabriela Clavijo
- Medicina, Universidad Catolica de Cuenca Unidad Academica de Medicina y Ciencias de la Salud, Cuenca, Ecuador
| | - Evelyn Fernanda Espinoza
- Medicina, Universidad Catolica de Cuenca Unidad Academica de Medicina y Ciencias de la Salud, Cuenca, Ecuador
| | | |
Collapse
|
18
|
Zvolensky MJ, Shepherd JM, Clausen BK, Ditre JW, Smit T, Redmond B. Differences in Pain Severity and Interference between Latinx Combustible Cigarette Smokers and Dual Users with Current Pain. Behav Med 2023:1-11. [PMID: 38112190 PMCID: PMC11218863 DOI: 10.1080/08964289.2023.2290480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023]
Abstract
Latinx individuals who smoke represent a tobacco health disparities group. Yet, limited research has focused on examining dual combustible and electronic cigarette use among Latinx populations. Importantly, Latinx persons who smoke also evince elevated rates of pain problems and symptoms and prior research has consistently linked pain problems and severity to smoking prevalence, maintenance, and behavior. Accordingly, the current study sought to build from the limited work that exists among dual combustible cigarette and electronic cigarette Latinx users comparing levels of pain severity and interference. The current sample consists of 196 adult Latinx daily cigarette smokers (35.48 years old; 39.4% female), of which 72 reported current daily dual use of an e-cigarette. Results indicated that Latinx dual users reported greater levels of pain severity (ηp2 = .12) and pain interference (ηp2 = .10) than exclusive combustible cigarette users. The study adds uniquely to the limited literature on the clinical importance of dual cigarette use in relation to pain severity and interference in that pain may serve as an important risk factor for the initiation and maintenance of dual use for increased analgesic nicotine effects.
Collapse
Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
| | | | - Bryce K. Clausen
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Joseph W. Ditre
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Brooke Redmond
- Department of Psychology, University of Houston, Houston, TX, USA
| |
Collapse
|
19
|
Osman A, Petrescu GS, Tuculină MJ, Dascălu IT, Popescu C, Enescu AȘ, Dăguci C, Cucu AP, Nistor C, Carsote M. Metabolic and Other Endocrine Elements with Regard to Lifestyle Choices: Focus on E-Cigarettes. Metabolites 2023; 13:1192. [PMID: 38132874 PMCID: PMC10745117 DOI: 10.3390/metabo13121192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/22/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023] Open
Abstract
Our objective was to overview recent data on metabolic/endocrine disorders with respect to e-cigarette (e-cig) use. This is a narrative review; we researched English, full-length, original articles on PubMed (between January 2020 and August 2023) by using different keywords in the area of metabolic/endocrine issues. We only included original clinical studies (n = 22) and excluded case reports and experimental studies. 3 studies (N1 = 22,385; N2 = 600,046; N3 = 5101) addressed prediabetes risk; N1 showed a 1.57-fold increased risk of dual vs. never smokers, a higher risk that was not confirmed in N2 (based on self-reported assessments). Current non-smokers (N1) who were dual smokers still have an increased odd of prediabetes (a 1.27-fold risk increase). N3 and another 2 studies addressed type 2 diabetes mellitus (DM): a lower prevalence of DM among dual users (3.3%) vs. cigarette smoking (5.9%) was identified. 6 studies investigated obesity profile (4 of them found positive correlations with e-cig use). One study (N4 = 373,781) showed that e-cig use was associated with obesity in the general population (OR = 1.6, 95%CI: 1.3-2.1, p < 0.05); another (N5 = 7505, 0.82% were e-cig-only) showed that obesity had a higher prevalence in dual smokers (51%) vs. cig-only (41.2%, p < 0.05), while another (N6 = 3055) found that female (not male) e-cig smokers had higher body mass index vs. non-smokers. Data on metabolic syndrome (MS) are provided for dual smokers (n = 2): one case-control study found that female dual smokers had higher odds of MS than non-smokers. The need for awareness with respect to potential e-cig--associated medical issues should be part of modern medicine, including daily anamnesis. Whether the metabolic/endocrine frame is part of the general picture is yet to be determined. Surveillance protocols should help clinicians to easily access the medical background of one subject, including this specific matter of e-cig with/without conventional cigarettes smoking and other habits/lifestyle elements, especially when taking into consideration metabolism anomalies.
Collapse
Affiliation(s)
- Andrei Osman
- Department of Anatomy and Embryology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Department ENT & Clinical Emergency County Hospital of Craiova, 200349 Craiova, Romania; (A.O.); (C.P.); (A.-Ș.E.)
| | - Gabriel Sebastian Petrescu
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Mihaela Jana Tuculină
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Ionela Teodora Dascălu
- Department of Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Cristina Popescu
- Department of Anatomy and Embryology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Department ENT & Clinical Emergency County Hospital of Craiova, 200349 Craiova, Romania; (A.O.); (C.P.); (A.-Ș.E.)
| | - Anca-Ștefania Enescu
- Department of Anatomy and Embryology, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, Department ENT & Clinical Emergency County Hospital of Craiova, 200349 Craiova, Romania; (A.O.); (C.P.); (A.-Ș.E.)
| | - Constantin Dăguci
- Department of Oro-Dental Prevention, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Anca-Pati Cucu
- PhD Doctoral School, Carol Davila University of Medicine and Pharmacy, Bucharest & Thoracic Surgery Department, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania;
| | - Claudiu Nistor
- Department 4—Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, Carol Davila University of Medicine and Pharmacy & Thoracic Surgery Department, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania;
| | - Mara Carsote
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania & C.I. Parhon National Institute of Endocrinology, 011863 Bucharest, Romania;
| |
Collapse
|
20
|
Dyson J, Skinner J, Crick J, Crooks MG. Designing an intervention to help the quitters quit: A qualitative, intervention co-design study. PEC INNOVATION 2023; 2:100141. [PMID: 37214522 PMCID: PMC10194124 DOI: 10.1016/j.pecinn.2023.100141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 05/24/2023]
Abstract
Objective E-cigarettes are increasingly being provided by publicly funded stop smoking services. Our objectives were to understand the challenges and establish the means by which services could best support the use and subsequent discontinuation of e-cigarettes for this purpose. Methods Semi-structured interviews and co-design workshops with service users and providers of a stop smoking service. Results Thematic analysis was conducted. Interviews identified: 1. a reluctance to use e-cigarettes for cessation, 2. struggle to quit e-cigarettes (dependency, fear of relapse, compensatory "puffing") and 3. service development needs (consistency of approach). Co-design workshops suggested: 1. facilitation of e-cigarette use through understanding previous failed attempts, 2. offering a longer, two-staged approach to tobacco then e-cigarette cessation, careful timing of behavioural strategies and 3. enhanced communication between providers. Conclusions Our study suggests additional modifications to smoking cessation support measures when e-cigarettes are used for smoking cessation to address the challenges posed by public health guidance: "smokers should switch to vaping and vapers should stop smoking completely". Innovation Our study is the first to consider experiences of service users and providers about the challenges of using e-cigarettes for cessation; our co-design group of providers informed nine strategies needed to support this approach in practice.
Collapse
Affiliation(s)
- Judith Dyson
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - James Skinner
- Faculty of Business, Law and Social Sciences, Birmingham City University, Birmingham, UK
| | - James Crick
- Hull Clinical Commissioning Group/Hull City Council, Hull, UK
| | - Michael G. Crooks
- Respiratory Research Group, Institute for Clinical and Applied Health Research, Hull York Medical School, Hull, UK
| |
Collapse
|
21
|
Wang N, Donaldson CD. Youth mental health and nicotine vape use: The moderating role of rural-urban/suburban school environments. Addict Behav 2023; 147:107830. [PMID: 37607466 DOI: 10.1016/j.addbeh.2023.107830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/28/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE To understand and compare the association between nicotine vape use and mental health among youth in rural and urban/suburban areas. METHODS This cross-sectional study included 146,489 high school students from the 2019-2020 California Student Tobacco Survey. Descriptive statistics were estimated with frequencies and percentages. Separate bivariate associations between each covariate/predictor variable and mental health were examined using linear regression. Multivariate linear regression models were used to examine the association between nicotine vape use and mental health for youth attending school in rural versus suburban/urban communities. RESULTS Findings showed that vaping nicotine was associated with poorer overall mental health (b = -0.307, SE = 0.019, p < 0.001), and that this association differed based on rural versus urban/suburban school environments (b = -0.135, SE = 0.046, p = 0.004). Specifically, the relationship between vaping and poor mental health was stronger for youth attending school in rural areas (b = -0.443, SE = 0.042, p < 0.001) than in urban/suburban localities (b = -0.307, SE = 0.019, p < 0.001). CONCLUSIONS Although differences in mental health were not shown based on rural versus urban/suburban school environments alone, findings showed that the relationship between nicotine vape use and mental health was stronger for youth attending high school in rural areas. Additional research is needed to understand the underlying social and environmental mechanisms that exacerbate this relationship. Future interventions might consider how to support and improve the mental health of rural nicotine vapers to better achieve health equity across different school environments.
Collapse
Affiliation(s)
- Nan Wang
- Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Candice D Donaldson
- California Tobacco Prevention Program, California Department of Public Health, Sacramento, CA, USA.
| |
Collapse
|
22
|
Lee S, Xie Z, Xu E, Shao Y, Ossip DJ, Li D. Public perceptions of the FDA's marketing authorization of Vuse on Twitter/X. Front Public Health 2023; 11:1280658. [PMID: 38026290 PMCID: PMC10654997 DOI: 10.3389/fpubh.2023.1280658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction On October 12, 2021, the FDA issued its first marketing granted orders for Vuse, the e-cigarette product by R.J. Reynolds Vapor Company. The public perceptions and reactions to the FDA's Vuse authorization are prevalent on social media platforms such as Twitter/X. We aim to understand public perceptions of the FDA's Vuse authorization in the US using Twitter/X data. Methods Through the Twitter/X streaming API (Application Programming Interface), 3,852 tweets between October 12, 2021, and October 23, 2021, were downloaded using the keyword of Vuse. With the elimination of retweets, irrelevant tweets, and tweets from other countries, the final dataset consisted of 523 relevant tweets from the US. Based on their attitudes toward the FDA authorization on Vuse, these tweets were coded into three major categories: positive, negative, and neutral. These tweets were further manually classified into different categories based on their contents. Results There was a large peak on Twitter/X mentioning FDA's Vuse authorization on October 13, 2021, just after the authorization was announced. Of the 523 US tweets related to FDA's Vuse authorization, 6.12% (n=32) were positive, 26.77% (n=140) were negative, and 67.11% (n=351) were neutral. In positive tweets, the dominant subcategory was Cessation Claims (n=18, 56.25%). In negative tweets, the topics Health Risk (n=43, 30.71%), Criticize Authorization (n=42, 30.00%), and Big Tobacco (n=40, 38.57%) were the major topics. News (n=271, 77.21%) was the most prevalent topic among neutral tweets. In addition, tweets with a positive attitude tend to have more likes. Discussion Public perceptions and discussions on Twitter/X regarding the FDA's Vuse authorization in the US showed that Twitter/X users were more likely to show a negative than a positive attitude with a major concern about health risks.
Collapse
Affiliation(s)
- Sarah Lee
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States
| | - Zidian Xie
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, United States
| | - Emily Xu
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States
| | - Yihan Shao
- Goergen Institute for Data Science, University of Rochester, Rochester, NY, United States
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, United States
| |
Collapse
|
23
|
Tian ZR, Sharma A, Muresanu DF, Sharma S, Feng L, Zhang Z, Li C, Buzoianu AD, Lafuente JV, Nozari A, Sjöqvisst PO, Wiklund L, Sharma HS. Nicotine neurotoxicity exacerbation following engineered Ag and Cu (50-60 nm) nanoparticles intoxication. Neuroprotection with nanowired delivery of antioxidant compound H-290/51 together with serotonin 5-HT3 receptor antagonist ondansetron. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2023; 172:189-233. [PMID: 37833012 DOI: 10.1016/bs.irn.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
Nicotine abuse is frequent worldwide leading to about 8 millions people die every year due to tobacco related diseases. Military personnel often use nicotine smoking that is about 12.8% higher than civilian populations. Nicotine smoking triggers oxidative stress and are linked to several neurodegenerative diseases such as Alzheimer's disease. Nicotine neurotoxicity induces significant depression and oxidative stress in the brain leading to neurovascular damages and brain pathology. Thus, details of nicotine neurotoxicity and factors influencing them require additional investigations. In this review, effects of engineered nanoparticles from metals Ag and Cu (50-60 nm) on nicotine neurotoxicity are discussed with regard to nicotine smoking. Military personnel often work in the environment where chances of nanoparticles exposure are quite common. In our earlier studies, we have shown that nanoparticles alone induces breakdown of the blood-brain barrier (BBB) and exacerbates brain pathology in animal models. In present investigation, nicotine exposure in with Ag or Cu nanoparticles intoxicated group exacerbated BBB breakdown, induce oxidative stress and aggravate brain pathology. Treatment with nanowired H-290/51 a potent chain-breaking antioxidant together with nanowired ondansetron, a potent 5-HT3 receptor antagonist significantly reduced oxidative stress, BBB breakdown and brain pathology in nicotine exposure associated with Ag or Cu nanoparticles intoxication. The functional significance of this findings and possible mechanisms of nicotine neurotoxicity are discussed based on current literature.
Collapse
Affiliation(s)
- Z Ryan Tian
- Dept. Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, United States
| | - Aruna Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Dept. of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
| | - Dafin F Muresanu
- Dept. Clinical Neurosciences, University of Medicine & Pharmacy, Cluj-Napoca, Romania; ''RoNeuro'' Institute for Neurological Research and Diagnostic, Mircea Eliade Street, Cluj-Napoca, Romania
| | - Suraj Sharma
- Blekinge Institute of Technology, BTH, Karlskrona, Sweden
| | - Lianyuan Feng
- Blekinge Institute of Technology, BTH, Karlskrona, Sweden
| | - Zhiqiang Zhang
- Department of Neurology, Bethune International Peace Hospital, Zhongshan Road (West), Shijiazhuang, Hebei Province, P.R. China
| | - Cong Li
- Department of Neurology, Bethune International Peace Hospital, Zhongshan Road (West), Shijiazhuang, Hebei Province, P.R. China
| | - Anca D Buzoianu
- The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Dade road No.111, Yuexiu District, Guangzhou, P.R. China; Department of Neurosurgery, Chinese Medicine Hospital of Guangdong Province, Guangzhou University of Chinese Medicine, Dade road No.111, Yuexiu District, Guangzhou, P.R. China
| | - José Vicente Lafuente
- Department of Clinical Pharmacology and Toxicology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ala Nozari
- Department of Anesthesiology, Boston University, Albany str, Boston, MA, USA
| | - Per-Ove Sjöqvisst
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Wiklund
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Dept. of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Dept. of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden; LaNCE, Dept. Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain.
| |
Collapse
|
24
|
Shehata SA, Toraih EA, Ismail EA, Hagras AM, Elmorsy E, Fawzy MS. Vaping, Environmental Toxicants Exposure, and Lung Cancer Risk. Cancers (Basel) 2023; 15:4525. [PMID: 37760496 PMCID: PMC10526315 DOI: 10.3390/cancers15184525] [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: 04/30/2023] [Revised: 06/18/2023] [Accepted: 06/22/2023] [Indexed: 09/29/2023] Open
Abstract
Lung cancer (LC) is the second-most prevalent tumor worldwide. According to the most recent GLOBOCAN data, over 2.2 million LC cases were reported in 2020, with an estimated new death incident of 1,796,144 lung cancer cases. Genetic, lifestyle, and environmental exposure play an important role as risk factors for LC. E-cigarette, or vaping, products (EVPs) use has been dramatically increasing world-wide. There is growing concern that EVPs consumption may increase the risk of LC because EVPs contain several proven carcinogenic compounds. However, the relationship between EVPs and LC is not well established. E-cigarette contains nicotine derivatives (e.g., nitrosnornicotine, nitrosamine ketone), heavy metals (including organometal compounds), polycyclic aromatic hydrocarbons, and flavorings (aldehydes and complex organics). Several environmental toxicants have been proven to contribute to LC. Proven and plausible environmental carcinogens could be physical (ionizing and non-ionizing radiation), chemicals (such as asbestos, formaldehyde, and dioxins), and heavy metals (such as cobalt, arsenic, cadmium, chromium, and nickel). Air pollution, especially particulate matter (PM) emitted from vehicles and industrial exhausts, is linked with LC. Although extensive environmental exposure prevention policies and smoking reduction strategies have been adopted globally, the dangers remain. Combined, both EVPs and toxic environmental exposures may demonstrate significant synergistic oncogenicity. This review aims to analyze the current publications on the importance of the relationship between EVPs consumption and environmental toxicants in the pathogenesis of LC.
Collapse
Affiliation(s)
- Shaimaa A. Shehata
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt; (S.A.S.); (A.M.H.)
| | - Eman A. Toraih
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA;
- Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Ezzat A. Ismail
- Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt;
| | - Abeer M. Hagras
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt; (S.A.S.); (A.M.H.)
| | - Ekramy Elmorsy
- Department of Pathology, Faculty of Medicine, Northern Border University, Arar 73213, Saudi Arabia;
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Manal S. Fawzy
- Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar 73213, Saudi Arabia
| |
Collapse
|
25
|
Babalola O, Ikedinobi M, Kanchustambham V. Pneumomediastinum in Vaping-Associated Acute Lung Injury: An Unusual Presentation. Cureus 2023; 15:e45772. [PMID: 37872934 PMCID: PMC10590546 DOI: 10.7759/cureus.45772] [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] [Accepted: 09/22/2023] [Indexed: 10/25/2023] Open
Abstract
The use of vaping products among adolescents continues to be on the rise despite known health risks. As a result, there are increasing cases of E-cigarette or vaping product use-associated lung injury (EVALI) across the United States especially among male Caucasian users of vaping products. The clinical presentation of EVALI follows the classic pattern of acute lung injury; however, there are peculiar cases with unusual symptomatology and radiographic findings. In this report, we present a case of a 25-year-old male with hemoptysis, subcutaneous emphysema, and pneumomediastinum in the setting of EVALI. He was treated with nebulized tranexamic acid and methylprednisolone with the resolution of symptoms. The diagnostic workup and management of suspected EVALI are discussed in detail. This case highlights how EVALI can present in an atypical manner and why clinicians must be cognizant of the variations in manifestations in order to facilitate early management. Overall, this case further highlights the need for clinicians to continuously push against the use of vaping products in the adolescent group, given that the occurrence of acute lung injury at a younger age predisposes to early-onset chronic lung disease.
Collapse
Affiliation(s)
- Olawale Babalola
- Pulmonology, University of North Dakota School of Medicine and Health Sciences, Fargo, USA
| | - Maureen Ikedinobi
- Pulmonology, University of North Dakota School of Medicine and Health Sciences, Fargo, USA
| | | |
Collapse
|
26
|
Martinez-Morata I, Sobel M, Tellez-Plaza M, Navas-Acien A, Howe CG, Sanchez TR. A State-of-the-Science Review on Metal Biomarkers. Curr Environ Health Rep 2023; 10:215-249. [PMID: 37337116 PMCID: PMC10822714 DOI: 10.1007/s40572-023-00402-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE OF REVIEW Biomarkers are commonly used in epidemiological studies to assess metals and metalloid exposure and estimate internal dose, as they integrate multiple sources and routes of exposure. Researchers are increasingly using multi-metal panels and innovative statistical methods to understand how exposure to real-world metal mixtures affects human health. Metals have both common and unique sources and routes of exposure, as well as biotransformation and elimination pathways. The development of multi-element analytical technology allows researchers to examine a broad spectrum of metals in their studies; however, their interpretation is complex as they can reflect different windows of exposure and several biomarkers have critical limitations. This review elaborates on more than 500 scientific publications to discuss major sources of exposure, biotransformation and elimination, and biomarkers of exposure and internal dose for 12 metals/metalloids, including 8 non-essential elements (arsenic, barium, cadmium, lead, mercury, nickel, tin, uranium) and 4 essential elements (manganese, molybdenum, selenium, and zinc) commonly used in multi-element analyses. RECENT FINDINGS We conclude that not all metal biomarkers are adequate measures of exposure and that understanding the metabolic biotransformation and elimination of metals is key to metal biomarker interpretation. For example, whole blood is a good biomarker of exposure to arsenic, cadmium, lead, mercury, and tin, but it is not a good indicator for barium, nickel, and uranium. For some essential metals, the interpretation of whole blood biomarkers is unclear. Urine is the most commonly used biomarker of exposure across metals but it should not be used to assess lead exposure. Essential metals such as zinc and manganese are tightly regulated by homeostatic processes; thus, elevated levels in urine may reflect body loss and metabolic processes rather than excess exposure. Total urinary arsenic may reflect exposure to both organic and inorganic arsenic, thus, arsenic speciation and adjustment for arsebonetaine are needed in populations with dietary seafood consumption. Hair and nails primarily reflect exposure to organic mercury, except in populations exposed to high levels of inorganic mercury such as in occupational and environmental settings. When selecting biomarkers, it is also critical to consider the exposure window of interest. Most populations are chronically exposed to metals in the low-to-moderate range, yet many biomarkers reflect recent exposures. Toenails are emerging biomarkers in this regard. They are reliable biomarkers of long-term exposure for arsenic, mercury, manganese, and selenium. However, more research is needed to understand the role of nails as a biomarker of exposure to other metals. Similarly, teeth are increasingly used to assess lifelong exposures to several essential and non-essential metals such as lead, including during the prenatal window. As metals epidemiology moves towards embracing a multi-metal/mixtures approach and expanding metal panels to include less commonly studied metals, it is important for researchers to have a strong knowledge base about the metal biomarkers included in their research. This review aims to aid metals researchers in their analysis planning, facilitate sound analytical decision-making, as well as appropriate understanding and interpretation of results.
Collapse
Affiliation(s)
- Irene Martinez-Morata
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 1107, New York, NY, 10032, USA.
| | - Marisa Sobel
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 1107, New York, NY, 10032, USA
| | - Maria Tellez-Plaza
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 1107, New York, NY, 10032, USA
| | - Caitlin G Howe
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Tiffany R Sanchez
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 1107, New York, NY, 10032, USA
| |
Collapse
|
27
|
Sreeramareddy CT, Shroff SM, Gunjal S. Nicotine dependence and associated factors among persons who use electronic e-cigarettes in Malaysia - an online survey. Subst Abuse Treat Prev Policy 2023; 18:51. [PMID: 37644524 PMCID: PMC10466701 DOI: 10.1186/s13011-023-00558-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/05/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Nicotine dependence, factors associated with dependence, and self-reported side effects among people who use e-cigarettes are scarce in developing countries. METHODS A sample of 302 persons who currently use e-cigarettes was recruited from discussion forums on Reddit, Facebook, and the forum 'lowyat'. The online Google form survey collected data on demographics, e-cigarette use, and the reasons, for cigarette smoking, Fagerstorm Test for Nicotine Dependence adapted for e-cigarettes (eFTND), and side effects experienced. RESULTS The mean age was 25.5 years (6.5), 60.6% were males and 86% had higher education. About 47% were using e-cigarettes only, 27.8% were currently using dual products (both electronic and conventional cigarettes), and 25.2% had also smoked cigarettes in the past. 'Less harmful than cigarettes' (56.3%), 'because I enjoy it' (46.7%), and 'it has a variety of flavors (40.4%) were the common reasons for e-cigarette use. The mean eFTND score was 3.9 (SD = 2.2), with a median of four side effects (IQR 3-6), sore or dry mouth/throat (41.4%), cough 33.4%, headache (20.5%), dizziness (16.2%) were commonly reported side effects. eFTND score and side effects were higher among persons using dual products. By multiple linear regression analysis, males (β = 0.56 95% CI 0.45, 1.05, p = 0.033), dual-use (β = 0.95 95% CI 0.34, 1.56, p < 0.003), and use of nicotine-containing e-cigarettes (β = 0.66 95% CI 0.07, 1.25 p = 0.024) had higher eFTND score. CONCLUSION Our findings of the study call for the placement of disclaimers about possible nicotine addiction and side effects of e-cigarette products.
Collapse
Affiliation(s)
| | - Sameeha Misriya Shroff
- School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
| | - Shilpa Gunjal
- Clinical Oral Health Sciences, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| |
Collapse
|
28
|
Crosbie E, Severini G, Beem A, Tran B, Sebrie EM. New tobacco and nicotine products in Latin America and the Caribbean: assessing the market and regulatory environment. Tob Control 2023; 32:458-466. [PMID: 34916305 DOI: 10.1136/tobaccocontrol-2021-056959] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/04/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To document the regulatory environment of new tobacco and nicotine products (NTNPs), including electronic nicotine delivery systems (ENDS) and heated tobacco products (HTPs), in Latin America and the Caribbean (LAC). METHODS Review of market research reports and databases, regulatory websites, Campaign for Tobacco-Free Kids, relevant published literature and the 2021 WHO Report on the Global Tobacco Epidemic. RESULTS ENDS entered the LAC market in the 2010s and are now available in most LAC countries. A majority of LAC countries (n=18) have either banned the commercialisation of ENDS (n=7) or regulated ENDS as tobacco products (n=7), medicinal products (n=1) or consumer products (n=3). The remaining LAC countries (n=15) do not regulate ENDS. HTPs were first introduced in 2017 and have been officially launched in five countries (Colombia, Guatemala, Dominican Republic, Mexico and Costa Rica). Few countries have banned HTP commercialisation (n=3) or regulated commercialisation and use (n=7), while the majority of countries have existing legislation that applies to HTPs (n=19). A few countries (n=4) have no tobacco control legislation and therefore do not regulate HTPs. CONCLUSION NTNPs are emerging products in the LAC region. Governments should follow WHO guidance and the decisions of the Conference of Parties to the WHO Framework Convention on Tobacco Control and ban or regulate NTNPs as tobacco products; otherwise NTNPs could create a new generation of tobacco and nicotine users.
Collapse
Affiliation(s)
- Eric Crosbie
- School of Public Health, University of Nevada, Reno, Reno, NV, USA
| | | | | | - Brian Tran
- School of Public Health, University of Nevada, Reno, Reno, NV, USA
| | | |
Collapse
|
29
|
Melero-Ollonarte JL, Lidón-Moyano C, Perez-Ortuño R, Fu M, Ballbè M, Martín-Sánchez JC, González-Marrón A, Cartanyà-Hueso À, Pascual JA, Fernández E, Martínez-Sánchez JM. Specific biomarker comparison in current smokers, e-cigarette users, and non-smokers. Addict Behav 2023; 140:107616. [PMID: 36680837 DOI: 10.1016/j.addbeh.2023.107616] [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: 09/05/2022] [Revised: 12/19/2022] [Accepted: 01/06/2023] [Indexed: 01/09/2023]
Abstract
INTRODUCTION This study aims to address the existing gap in the literature, while adding evidence, by comparing tobacco-specific biomarkers (cotinine and nitrosamines: NNK, NNAL, NNN), and other biomarkers of e-cigarette use (humectants: glycerol, 1,2-PD, 1,3-PD) according to five study groups. METHODS A pooling analysis including two different studies was conducted. In both analyses, we took saliva samples from smokers (n = 409) and non-smokers (n = 154), dual tobacco and e-cig users (n = 92), exclusive e-cig user with nicotine (n = 158), and exclusive e-cig users without nicotine (n = 38). We analyzed and compared the geometric means (GM) and geometric standard deviations (GSD) of the concentration of tobacco-specific biomarkers, and e-cigarette biomarkers among groups. We used log-linear models adjusted for sex and age to model the change percentage and their 95% confidence intervals. RESULTS Cotinine was significantly higher in nicotine consumers and in e-cigarette users without nicotine when compared to non-smokers. TSNAs were generally significantly lower in non-smokers and higher in nicotine consumers. NNN and NNAL were lower in e-cigarette users with nicotine comparted to smokers, and NNN was higher in e-cigarette users without nicotine when compared to non-smokers. No differences were found in humectant biomarkers between e-cigarette groups. CONCLUSIONS Although there was a reduction in TSNAs in e-cigarette exclusive users compared to smokers, and a reduction of cotinine concentrations in e-cigarette exclusive users without nicotine compared to smokers, there are still high levels of these biomarkers when compared to non-smokers, which may be a clue towards the harmful effect of e-cigarettes.
Collapse
Affiliation(s)
- Juan Luis Melero-Ollonarte
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Cristina Lidón-Moyano
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain.
| | - Raúl Perez-Ortuño
- Group of Integrative Pharmacology and Systems Neuroscience, Neurosciences Programme, IMIM (Hospital del Mar Medical Research Institute), Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, l'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Programme, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; Department of Public Health, Mental Health, and Maternal and Child Health Nursing, Faculty of Medicine and Health Sciences - Bellvitge Campus, Universitat de Barcelona, Barcelona, Spain; Center for Biomedical Research in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Montse Ballbè
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, l'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Programme, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; Center for Biomedical Research in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Juan Carlos Martín-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Adrián González-Marrón
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Àurea Cartanyà-Hueso
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Group of Perinatal Epidemiology, Environmental Health, and Clinical Research, Department of Medicine, School of Health Sciences, Universitat Jaume I, Av. Vicent Sos Baynat, s/n 12071 Castelló de la Plana, Spain
| | - José A Pascual
- Group of Integrative Pharmacology and Systems Neuroscience, Neurosciences Programme, IMIM (Hospital del Mar Medical Research Institute), Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain; Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona, Barcelona, Spain
| | - Esteve Fernández
- Department of Clinical Sciences, Faculty of Medicine and Health Sciences - Bellvitge Campus, Universitat de Barcelona, Barcelona, Spain; Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Programme, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; Department of Public Health, Mental Health, and Maternal and Child Health Nursing, Faculty of Medicine and Health Sciences - Bellvitge Campus, Universitat de Barcelona, Barcelona, Spain; Center for Biomedical Research in Respiratory Diseases (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Jose M Martínez-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, l'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Epidemiology, Public Health, Cancer Prevention and Palliative Care Programme, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain
| |
Collapse
|
30
|
Tran V, Mian M, Sreedharan S, Robertson R, Saha A, Tadakamadla SK, Lee K. Oral and Maxillofacial Injuries Associated With E-Cigarette Explosions: A Systematic Review and Management Guidelines Proposal. J Oral Maxillofac Surg 2023; 81:583-592. [PMID: 36806607 DOI: 10.1016/j.joms.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 02/16/2023]
Abstract
PURPOSE E-cigarettes have become increasingly popular devices used to consume nicotine in recent years. There is a growing body of evidence regarding the risk of spontaneous explosion of these devices causing burn and projectile injuries. The primary purpose of this review was to summarize all injuries to the oral and maxillofacial region secondary to explosion of e-cigarettes. The secondary purpose was to propose an initial management algorithm for such injuries based on the findings in the literature. This review also aims to test the hypothesis that e-cigarette explosive injuries to the oral region were associated with an increased risk of intubation and surgery and examine whether any other injury pattern was associated with an increased risk of intubation or surgery. METHODS A cohort study based on identifying cases in the literature was conducted to summarize injuries to the oral and maxillofacial region and examine the associations between injury types and location and management. A literature search of the major biomedical databases was conducted in September 2022 using terms such as e-cigarette, explosion, blast, trauma, and burn, among others, which yielded 922 studies. Nonclinical studies, review articles, and studies without injuries to the facial region were excluded. Study subjects were recorded for demographics, device characteristics, injury mechanism, injury location, management, and complications. Chi-squared analysis was used to determine if the predictor variables of type of injury (burn or projectile) and its associated location (ocular, facial, or intraoral for burns and facial thirds for projectile) were associated with the outcomes of intubation and surgical management. The collected data were then used as a guide to propose an initial management algorithm for these injuries. RESULTS Twenty eight studies, including 20 case reports and 8 case series met the inclusion criteria. A total of 32 explosions of e-cigarettes to 32 patients caused 105 recorded injuries to the facial region. Projectile injuries made up 73.3% (n = 77) of all facial injuries, while burn injuries made up of 26.7% (n = 28). There were 14 (43.8%) patients who suffered both projectile and burn injuries. Burn injuries mostly involved the face (64.3%, n = 18), oral cavity (25%, n = 7), and eye (10.7%, n = 7). The majority (81.8%, n = 63) of projectile injuries occurred in the lower facial third. There were 20 (62.5%) patients who suffered a bone or tooth fracture. Management of injuries involved surgery in 62.5% (n = 20) of patients, which included open reduction and internal fixation of fractures, dental extraction, bone and skin grafts, and ocular surgery. A complication rate of 44.4% (n = 8) was observed across studies that reported on follow-up. There was no statistically significant association between explosive injury to the oral region and intubation or surgical management. There was also no other statistically significant association between any other injury type and location with intubation or surgical management. CONCLUSIONS E-cigarettes are at risk for spontaneous combustion that can cause serious oral and maxillofacial injuries, particularly to the lower facial third and commonly requiring surgical management. Safety of these devices should be improved through increased user education and regulation.
Collapse
Affiliation(s)
- Vincent Tran
- Master of Philosophy Candidate, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
| | - Mustafa Mian
- Resident Medical Officer, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Subhashaan Sreedharan
- Resident Medical Officer, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Ross Robertson
- Resident Medical Officer, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Anik Saha
- Oral and Maxillofacial Registrar, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Santosh Kumar Tadakamadla
- Discipline Lead of Dentistry, Associate Professor, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Kai Lee
- Associate Professor, Consultant Oral & Maxillofacial Surgeon, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| |
Collapse
|
31
|
Geci M, Scialdone M, Tishler J. The Dark Side of Cannabidiol: The Unanticipated Social and Clinical Implications of Synthetic Δ 8-THC. Cannabis Cannabinoid Res 2023; 8:270-282. [PMID: 36264171 PMCID: PMC10061328 DOI: 10.1089/can.2022.0126] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: The explosive growth of the cannabis industry in the United States over the past decade has spurred a multitude of products derived from phytocannabinoids produced by Cannabis sativa L. Decades of cannabis prohibition coupled with the more recent 2018 Farm Bill have lead to several unanticipated consequences and the widespread availability of synthetic cannabinoids derived from hemp CBD, including Δ8-THC, Δ10-THC and HHC. Methods: Herein, we review the available literature of the complexity of the chemistry of its current manufacture, namely, the acid-catalyzed ring closure of cannabidiol (ACRCC), the myriad of issues involving the unsolved technical problems with quality control of ACRCC-Δ8-THC and the multitude of isomerized byproducts, and the lack of consistent regulation regarding consumer safety and labeling. Results: We provide what we believe is the first comprehensive listing of all the documented ACRCC-Δ8-THC byproducts. Perhaps, most importantly, we highlight the growing concern that, other than Δ8-THC itself, the compounds in ACRCC-Δ8-THC product mixtures have not been subjected to any human toxicological evaluation. This is especially troubling as ACRCC-Δ8-THC products relate to vaping, and their contribution to a growing and lethal epidemic of electronic cigarette, or vaping, product use-associated lung injury (EVALI). Conclusions: Quality control is totally inadequate in the newly emerging Δ8-THC industry. American consumers are ingesting products that are mislabeled with many compounds that have never received any toxicological testing. EVALI cases continue to be reported with a fatality rate approaching 2% (in California).
Collapse
Affiliation(s)
- Michael Geci
- Whole Health & Healing Integrative Clinic, Cherry Valley, New York, USA
| | | | | |
Collapse
|
32
|
Ashour O, Al-Huneidy L, Noordeen H. The implications of vaping on surgical wound healing: A systematic review. Surgery 2023; 173:1452-1462. [PMID: 36997424 DOI: 10.1016/j.surg.2023.02.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND E-cigarette use is rapidly growing, and little is known about the postoperative complications. Cigarette smoking has been well-established to be associated with delayed wound healing and increased complications in surgical patients. Due to the intricate and harmonious nature of the wound-healing process, vaping may impair tissue regeneration, posing a risk for patients undergoing surgery. This systematic review aimed to review the evidence on the implications of vaping on wound healing. METHODS A systematic search of PubMed and Scopus databases was conducted on October 2022 per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The following keywords were used to conduct the search: vaping, vape, e-cigarettes, electronic cigarettes, wound healing, tissue regeneration, postoperative complications, wound infection, and blood flow. RESULTS Of 5,265 screened articles, only 37 were eligible for qualitative synthesis. A total of 18 articles studied the effect of e-cigarettes on human volunteers, 14 investigated e-cigarette extract on human cell lines, and 5 used animal rat models. CONCLUSION Despite limited objective data, the recommendation is that e-cigarettes be treated as tobacco cigarettes; hence, vaping should be stopped in the perioperative period to decrease the incidence of wound healing complications. Clinical trials are required to understand the health hazards of e-cigarettes further and maximize patient safety and clinical outcomes.
Collapse
|
33
|
Rivera-Garcia MT, Rose RM, Wilson-Poe AR. High-CBD Cannabis Vapor Attenuates Opioid Reward and Partially Modulates Nociception in Female Rats. ADDICTION NEUROSCIENCE 2023; 5:100050. [PMID: 36937502 PMCID: PMC10019487 DOI: 10.1016/j.addicn.2022.100050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Chronic pain patients report analgesic effects when using cannabidiol (CBD), a phytocannabinoid found in whole-plant cannabis extract (WPE). Several studies suggest that cannabis-derived products may serve as an analgesic adjunct or alternative to opioids, and importantly, CBD may also attenuate the abuse potential of opioids. Vaping is a popular route of administration among people who use cannabis, however both the therapeutic and hazardous effects of vaping are poorly characterized. Despite the fact that chronic pain is more prevalent in women, the ability of inhaled high-CBD WPE to relieve pain and reduce opioid reward has not been studied in females. Here, we present a comprehensive analysis of high-CBD WPE vapor inhalation in female rats. We found that WPE was modestly efficacious in reversing neuropathy-induced cold allodynia in rats with spared nerve injury (SNI). Chronic exposure to WPE did not affect lung cytoarchitecture or estrous cycle, and it did not induce cognitive impairment, social withdrawal or anxiolytic effects. WPE inhalation prevented morphine-induced conditioned place preference and reinstatement. Similarly, WPE exposure reduced fentanyl self-administration in rats with and without neuropathic pain. We also found that WPE vapor lacks of reinforcing effects compared to the standard excipient used in most vapor administration research. Combined, these results suggest that although high-CBD vapor has modest analgesic effects, it has a robust safety profile, no abuse potential, and it significantly reduces opioid reward in females. Clinical studies examining high-CBD WPE as an adjunct treatment during opioid use disorder are highly warranted.
Collapse
Affiliation(s)
- Maria T Rivera-Garcia
- RS Dow Neurobiology Laboratories, Legacy Research Institute, Portland, OR, United States
| | - Rizelle Mae Rose
- RS Dow Neurobiology Laboratories, Legacy Research Institute, Portland, OR, United States
| | - Adrianne R Wilson-Poe
- RS Dow Neurobiology Laboratories, Legacy Research Institute, Portland, OR, United States
- Integrative Physiology and Neuroscience, Washington State University
- Corresponding author. Adrianne R Wilson-Poe, Ph.D., 1225 NE 2nd Ave, suite 249, Portland, OR 97232, USA. Tel. (503) 413-1754, (A.R. Wilson-Poe)
| |
Collapse
|
34
|
Jeon J, Zhang Q, Chepaitis PS, Greenwald R, Black M, Wright C. Toxicological Assessment of Particulate and Metal Hazards Associated with Vaping Frequency and Device Age. TOXICS 2023; 11:155. [PMID: 36851030 PMCID: PMC9967192 DOI: 10.3390/toxics11020155] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 06/18/2023]
Abstract
Electronic nicotine delivery systems (ENDS) aerosols are complex mixtures of chemicals, metals, and particles that may present inhalation hazards and adverse respiratory health risks. Despite being considered a safer alternative to tobacco cigarettes, metal exposure levels and respiratory effects associated with device aging and vaping frequency have not been fully characterized. In this study, we utilize an automated multi-channel ENDS aerosol generation system (EAGS) to generate aerosols from JUUL pod-type ENDS using tobacco-flavored e-liquid. Aerosol puff fractions (1-50) and (101-150) are monitored and sampled using various collection media. Extracted aerosols are prepared for metal and toxicological analysis using human primary small airway epithelial cells (SAEC). ENDS aerosol-mediated cellular responses, including reactive oxygen species (ROS), oxidative stress, cell viability, and DNA damage, are evaluated after 24 h and 7-day exposures. Our results show higher particle concentrations in later puff fractions (0.135 mg/m3) than in initial puff fractions (0.00212 mg/m3). Later puff fraction aerosols contain higher toxic metal concentrations, including chromium, copper, and lead, which elicit increased levels of ROS followed by significant declines in total glutathione and cell viability. Notably, a 30% increase in DNA damage was observed after 7 days because of later puff fraction exposures. This work is consistent with ENDS aerosols becoming more hazardous across the use of pre-filled pod devices, which may threaten respiratory health.
Collapse
Affiliation(s)
- Jennifer Jeon
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
| | - Qian Zhang
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
| | - Patrick S. Chepaitis
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
| | - Roby Greenwald
- School of Public Health, Georgia State University, Atlanta, GA 303132, USA
| | - Marilyn Black
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
| | - Christa Wright
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
| |
Collapse
|
35
|
Kartiko M, Miller A. A Case Report of Secondary Spontaneous Pneumomediastinum Induced by Vaping. Cureus 2023; 15:e35153. [PMID: 36949981 PMCID: PMC10027423 DOI: 10.7759/cureus.35153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2023] [Indexed: 02/20/2023] Open
Abstract
We present a rare case of vaping-induced spontaneous pneumomediastinum in a young healthy female. The patient presented to the emergency department with the chief complaint of acute onset chest pain. Imaging studies, chest X-ray, and computed tomography of the chest showed findings of pneumomediastinum. The patient was counseled on vaping cessation and discharged after 48 hours.
Collapse
Affiliation(s)
- Michael Kartiko
- Internal Medicine, Piedmont Macon Medical Center, Macon, USA
- Radiology, Creighton University School of Medicine, Omaha, USA
| | - Aisha Miller
- Internal Medicine, Piedmont Macon Medical Center, Macon, USA
| |
Collapse
|
36
|
Zhang Q, Jeon J, Goldsmith T, Black M, Greenwald R, Wright C. Characterization of an Electronic Nicotine Delivery System (ENDS) Aerosol Generation Platform to Determine Exposure Risks. TOXICS 2023; 11:99. [PMID: 36850974 PMCID: PMC9967066 DOI: 10.3390/toxics11020099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Evaluating vaping parameters that influence electronic nicotine delivery system (ENDS) emission profiles and potentially hazardous exposure levels is essential to protecting human health. We developed an automated multi-channel ENDS aerosol generation system (EAGS) for characterizing size-resolved particle emissions across pod- and mod-type devices using real-time monitoring instruments, an exposure chamber, and vaping parameters including different ventilation rates, device type and age, e-liquid formulation, and atomizer setup. Results show the ENDS device type, e-liquid flavoring, and nicotine content can affect particle emissions. In general, pod-type devices have unimodal particle size distributions and higher number emissions, while mod-type devices have bimodal size distributions and higher mass emissions. For pod-type devices, later puff fractions emit lower aerosols, which is potentially associated with the change of coil resistance and power during ageing. For a mod-type device, an atomizer with a lower resistance coil and higher power generates larger particle emissions than an atomizer with a greater resistance coil and lower power. The unventilated scenario produces higher particle emission factors, except for particle mass emission from pod-type devices. The data provided herein indicate the EAGS can produce realistic and reproducible puff profiles of pod- and mod-type ENDS devices and therefore is a suitable platform for characterizing ENDS-associated exposure risks.
Collapse
Affiliation(s)
- Qian Zhang
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
| | - Jennifer Jeon
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
| | - Travis Goldsmith
- Department of Physiology and Pharmacology, West Virginia University/IEStechno, Morgantown, WV 26505, USA
| | - Marilyn Black
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
| | - Roby Greenwald
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA
| | - Christa Wright
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
| |
Collapse
|
37
|
Zhao+ K, Li + J, Zhou P, Xu L, Yang M. Is electronic cigarette use a risk factor for stroke?
A systematic review and meta-analysis. Tob Induc Dis 2022; 20:101. [DOI: 10.18332/tid/154364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 09/15/2022] [Accepted: 09/17/2022] [Indexed: 11/16/2022] Open
|
38
|
E-cigarette aerosol exposure of pulmonary surfactant impairs its surface tension reducing function. PLoS One 2022; 17:e0272475. [PMID: 36350850 PMCID: PMC9645651 DOI: 10.1371/journal.pone.0272475] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/27/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction E-cigarette (EC) and vaping use continue to remain popular amongst teenage and young adult populations, despite several reports of vaping associated lung injury. One of the first compounds that EC aerosols comes into contact within the lungs during a deep inhalation is pulmonary surfactant. Impairment of surfactant’s critical surface tension reducing activity can contribute to lung dysfunction. Currently, information on how EC aerosols impacts pulmonary surfactant remains limited. We hypothesized that exposure to EC aerosol impairs the surface tension reducing ability of surfactant. Methods Bovine Lipid Extract Surfactant (BLES) was used as a model surfactant in a direct exposure syringe system. BLES (2ml) was placed in a syringe (30ml) attached to an EC. The generated aerosol was drawn into the syringe and then expelled, repeated 30 times. Biophysical analysis after exposure was completed using a constrained drop surfactometer (CDS). Results Minimum surface tensions increased significantly after exposure to the EC aerosol across 20 compression/expansion cycles. Mixing of non-aerosolized e-liquid did not result in significant changes. Variation in device used, addition of nicotine, or temperature of the aerosol had no additional effect. Two e-liquid flavours, menthol and red wedding, had further detrimental effects, resulting in significantly higher surface tension than the vehicle exposed BLES. Menthol exposed BLES has the highest minimum surface tensions across all 20 compression/expansion cycles. Alteration of surfactant properties through interaction with the produced aerosol was observed with a basic e-liquid vehicle, however additional compounds produced by added flavourings appeared to be able to increase inhibition. Conclusion EC aerosols alter surfactant function through increases in minimum surface tension. This impairment may contribute to lung dysfunction and susceptibility to further injury.
Collapse
|
39
|
Floyd E, Oni T, Cai C, Rehman B, Hwang J, Watson T. Validation of a High Flow Rate Puff Topography System Designed for Measurement of Sub-Ohm, Third Generation Electronic Nicotine Delivery Systems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137989. [PMID: 35805644 PMCID: PMC9265855 DOI: 10.3390/ijerph19137989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 02/01/2023]
Abstract
There are few known puff topography devices designed solely for gathering electronic cigarette puff topography information, and none made for high-powered sub-ohm devices. Ten replicate Bernoulli flow cells were designed and 3D printed. The relationship between square root of pressure difference and flow rate was determined across 0−70 L/min. One representative flow cell was used to estimate puff volume and flow rate under six simulated puffing regimes (0.710 L, 2.000 L and 3.000 L, at low and high flow rates) to determine the system’s accuracy and utility of using dual pressure sensors for flow measurement. The relationship between flow rate and square root of pressure differential for the ten replicate cells was best fit with a quadratic model (R2 = 0.9991, p < 0.0001). The higher-pressure sensor was accurate at both low and high flow rates for 0.71 L (102% and 111% respectively), 2.00 L (96% and 103% respectively), and 3.00 L (100.1% and 107% respectively) but the lower-pressure sensor provided no utility, underpredicting volume and flow. This puff topography system generates very little resistance to flow, easily fits between user’s atomizer and mouthpiece, and is calibrated to measure flows up to 70 L/min.
Collapse
Affiliation(s)
- Evan Floyd
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (T.O.); (C.C.); (J.H.); (T.W.)
- Correspondence:
| | - Toluwanimi Oni
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (T.O.); (C.C.); (J.H.); (T.W.)
| | - Changjie Cai
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (T.O.); (C.C.); (J.H.); (T.W.)
| | - Bilal Rehman
- University of Oklahoma Health Sciences Center, University of Oklahoma College of Medicine, Oklahoma City, OK 73104, USA;
| | - Jooyeon Hwang
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (T.O.); (C.C.); (J.H.); (T.W.)
| | - Tyler Watson
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (T.O.); (C.C.); (J.H.); (T.W.)
| |
Collapse
|
40
|
Dyson J, Bhatnagar M, Skinner J, Crooks M. Helping the quitters quit: A systematic review and narrative synthesis of the barriers and facilitators to e-cigarette cessation and the support that is needed. PATIENT EDUCATION AND COUNSELING 2022; 105:1402-1410. [PMID: 34579994 DOI: 10.1016/j.pec.2021.09.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/10/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the barriers and facilitators to and support needed for e-cigarette cessation. METHODS We systematically searched the subject-specific databases MEDLINE, CINAHL complete and psycINFO and the Cochrane database using synonyms relating to the terms e-cigarettes and cessation including English language, empirical, peer reviewed research papers, published from 2010 to 2021. We included papers that addressed the research question in its broadest sense, including papers reporting reasons for and interventions to support e-cigarette cessation. Data extraction was completed two authors independently using a bespoke spreadsheet. We conducted a narrative synthesis of all data and we were able to extract and combine descriptive quantitative data from included survey papers. RESULTS After reviewing 2593 titles 10 papers fit our criteria. Barriers to e-cigarette cessation were: a fear of returning to tobacco, dependency and stress reduction. Barriers or facilitators were: health and hazard beliefs, degree of enjoyment, social influences and environmental factors. A number of e-cigarette smoking support measures were suggested by participants. PRACTICE IMPLICATIONS E-cigarette cessation poses similar and additional challenges to that of tobacco cessation. E-cigarettes are not the final step on a journey to smoking cessation. Addressing barriers specific to e-cigarettes need to be considered in intervention design.
Collapse
Affiliation(s)
- Judith Dyson
- Social Care, Health and Related Research (C-SCHaRR) Birmingham City University, Westbourne Road, Edgbaston, Birmingham B15 3TN, United Kingdom.
| | | | - James Skinner
- School of Sociology, Politics and International Studies (SPAIS), University of Bristol, Bristol, United Kingdom
| | - Michael Crooks
- Respiratory Research Group, Institute for Clinical and Applied Health Research, Hull York Medical school, Hull HU16 5JQ, United Kingdom
| |
Collapse
|
41
|
Schekochikhina N, Meister R, Trivedi K. E-cigarette or Vaping Product Associated Lung Injury (EVALI) Presenting As Cardiac Arrest. Cureus 2022; 14:e25010. [PMID: 35719811 PMCID: PMC9198287 DOI: 10.7759/cureus.25010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2022] [Indexed: 12/04/2022] Open
Abstract
E-cigarettes or vaping products became available in the market in 2004. Since then, their use has rapidly increased in all sections of society. They have been increasingly used as a "safer" alternative for combustible cigarettes and as an aid toward smoking cessation. Over time, the acceptability of e-cigarettes in public spaces increased. Lack of regulatory control also led to a rapid rise in the rate of e-cigarette/vaping product users. We report a case of a 35-year-old female who recently switched from conventional cigarettes to e-cigarette usage, and who presented to the emergency department after an out-of-hospital cardiac arrest. She was found to have bilateral extensive nodular ground-glass opacities on a CT angiogram of the chest. She needed non-invasive ventilation and was initially started on broad-spectrum antibiotic treatment for possible pneumonia. Due to a worsening clinical status, e-cigarette or vaping product associated lung injury (EVALI) diagnosis was considered, and she was started on parenteral steroid therapy, leading to rapid recovery in respiratory status. With a tapering course of steroid therapy and cessation of e-cigarette use, there was complete clinical and radiological recovery. This case highlights that EVALI can have varied clinical presentations, and the diagnosis should be considered in anyone who presents with an acute cardio-pulmonary decline and a concomitant history of e-cigarette use.
Collapse
Affiliation(s)
| | - Riley Meister
- Internal Medicine, Western University of Health Sciences, Lebanon, USA
| | - Kovid Trivedi
- Pulmonary/Critical Care Medicine, Salem Pulmonary Associates, Salem, USA
| |
Collapse
|
42
|
How E-cigarettes and vaping can affect asthma in children and adolescents. Curr Opin Allergy Clin Immunol 2022; 22:86-94. [PMID: 35197429 DOI: 10.1097/aci.0000000000000807] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW Electronic nicotine delivery systems such as e-cigarettes are commonly felt to be harmless devices when compared to traditional cigarettes. However, an increasing number of studies support the biological plausibility for the potential detrimental effects of vaping on the respiratory mucosa. To date, few human studies have been carried out on adult vapers showing a reduction in lung function testing, especially in those with asthma, whereas the effects of vaping on children and adolescents have not been elucidated so far. RECENT FINDINGS Several cross-sectional, national, population-based studies on large groups of adolescents have been carried out showing an association between vape exposure and self-reported asthma diagnosis and/or respiratory symptoms in this age group. The effects of second and third-hand exposure together with those of active and passive exposure in pregnancy, are almost completely unknown. SUMMARY This review outlines recent data on the potential effects of vaping on asthma, focusing on vape composition, reported effects on the respiratory mucosa, available data in adolescents, and reasons behind the current vaping epidemic. The evidence so far available both in animals and humans suggests that vaping is not harmless, and its exposure should be limited in children and adolescents, especially when affected by asthma.
Collapse
|
43
|
Hanewinkel R, Niederberger K, Pedersen A, Unger JB, Galimov A. E-cigarettes and nicotine abstinence: a meta-analysis of randomised controlled trials. Eur Respir Rev 2022; 31:210215. [PMID: 35321930 PMCID: PMC9488503 DOI: 10.1183/16000617.0215-2021] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/17/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To determine the effects of electronic cigarettes (e-cigarettes) as a therapeutic intervention compared to nicotine replacement therapy (NRT) on nicotine abstinence. METHODS Two authors independently searched the PubMed, Embase, PsycInfo and Cochrane Central Register of Controlled Trials databases for articles published up to and including 10 July 2021. We included randomised controlled trials (RCTs) in which nicotine e-cigarettes were compared to NRT among current cigarette users. The primary outcome was abstaining from all nicotine-delivery devices. Secondary outcomes were 1) allocated product use (e-cigarettes or NRT) among successful cigarette quitters and 2) quitting cigarettes at the end of the trial using fixed-effect Mantel-Haenszel models. RESULTS We included four RCTs representing 1598 adult participants (51.0% females). The mean age of participants in these studies ranged from 41 to 54 years, while average baseline smoking ranged from 14 to 21 cigarettes per day. Compared to NRT, e-cigarette use was associated with lower nicotine abstinence rates at the longest follow-up (risk ratio 0.50 (95% CI 0.32-0.77)). Among successful cigarette quitters, the risk of allocated product use by the end of the observational time was higher for e-cigarette users compared to NRT (risk ratio 8.94 (95% CI 3.98-20.07)). E-cigarette users had higher cigarette smoking cessation rates compared to NRT users (risk ratio 1.58 (95% CI 1.20-2.08)). CONCLUSIONS The use of e-cigarettes as a therapeutic intervention for smoking cessation may lead to permanent nicotine dependence.
Collapse
Affiliation(s)
| | - Kathrin Niederberger
- Clinical Psychology and Psychotherapy, Dept of Psychology, Kiel University, Kiel, Germany
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Anya Pedersen
- Clinical Psychology and Psychotherapy, Dept of Psychology, Kiel University, Kiel, Germany
| | - Jennifer B Unger
- Institute for Health Promotion and Disease Prevention Research, Dept of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Artur Galimov
- Institute for Health Promotion and Disease Prevention Research, Dept of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
44
|
Zutrauen S, Do MT, Ghandour L, Moore-Hepburn C, Beno S, Richmond SA, Chadi N. Acute injury or illness related to the inhalation of vaping aerosols among children and adolescents across Canada: A cross-sectional survey of Canadian paediatricians. Paediatr Child Health 2022; 27:43-49. [DOI: 10.1093/pch/pxab062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/11/2021] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Vaping prevalence rates have increased among Canadian youth. Evidence suggests that vaping poses significant health risks to children and adolescents.
Objectives
The objectives of the study were to investigate epidemiological characteristics of acute injury/illness cases due to the inhalation of vaping aerosols among children and adolescents across Canada and to explore factors contributing to severe cases.
Methods
Data from the 2019 Canadian Paediatric Surveillance Program cross-sectional survey on vaping-related injury/illness were used. Analyses focused on injury/illness cases (n=71) among children and adolescents aged 0 to 17 years who presented to participating paediatricians for a harm related to the inhalation of vaping aerosols. We conducted descriptive analyses and performed logistic regression to explore associations between severe presentations requiring hospitalization or intensive care unit (ICU) admission and selected case characteristics.
Results
Of the 71 reported injury/illness cases related to inhalation of vaping aerosols, 56% of patients were male, and 68% were aged 15 to 17 years. Nicotine vaping was reported in 42% of cases, and cannabis vaping in 24%. Fifty-four per cent presented with respiratory distress, 18% with symptoms of nicotine toxicity, and 41% required hospitalization and/or admission to the ICU. Cases presenting with respiratory distress were more likely to be hospitalized/admitted to the ICU (odds ratio [OR]=5.37, 95% confidence interval [CI]:1.76 to 16.39).
Conclusions
The inhalation of vaping aerosols among children and adolescents may contribute to acute injury/illness. Clear associations between study variables and severe cases could not be established due to a small sample size. Additional research is needed to determine predictors and preventable risk factors of severe vaping-related injuries.
Collapse
Affiliation(s)
- Sarah Zutrauen
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Minh T Do
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Consumer and Hazardous Products Safety Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Lina Ghandour
- Consumer and Hazardous Products Safety Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Charlotte Moore-Hepburn
- Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Suzanne Beno
- Division of Emergency Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sarah A Richmond
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Nicholas Chadi
- Division of Adolescent Medicine, Department of Paediatrics, Sainte-Justine University Hospital Centre, Montréal, Québec, Canada
| |
Collapse
|
45
|
Conway M, Alba PR, Zhu SH, Patterson OV. Vaping at the VA: Developing an Annotated Corpus of Electronic Cigarette Mentions in Clinical Notes at the Department of Veterans Affairs. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2022; 2021:343-351. [PMID: 35308940 PMCID: PMC8861676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Use of Electronic Nicotine Delivery Systems (ENDS, colloquially known as "electronic cigarettes") has increased substantially in the United States in the decade since 2010. However, currently relatively little is known regarding the documentation of ENDS use in clinical notes. With this study, we describe the development of an annotation scheme (and associated annotated corpus) consisting of 4,351 ENDS mentions derived from Department of Veterans Affairs clinical notes during the period 2010-2020. Analysis of our corpus provides important insights into ENDS documentation practices at the VA, in addition to providing a resource for the future development and validation of Natural Language Processing algorithms capable of reliably identifying ENDS-use status.
Collapse
Affiliation(s)
- Mike Conway
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT
| | - Patrick R Alba
- Department of Internal Medicine, University of Utah, Salt Lake City, UT
- VA Salt Lake City Health Care System, Salt Lake City, UT
| | - Shu-Hong Zhu
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, La Jolla, CA
| | - Olga V Patterson
- Department of Internal Medicine, University of Utah, Salt Lake City, UT
- VA Salt Lake City Health Care System, Salt Lake City, UT
| |
Collapse
|
46
|
Laudanski K, Wain J. Considerations for Cannabinoids in Perioperative Care by Anesthesiologists. J Clin Med 2022; 11:jcm11030558. [PMID: 35160010 PMCID: PMC8836924 DOI: 10.3390/jcm11030558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 02/07/2023] Open
Abstract
Increased usage of recreational and medically indicated cannabinoid compounds has been an undeniable reality for anesthesiologists in recent years. These compounds’ complicated pharmacology, composition, and biological effects result in challenging issues for anesthesiologists during different phases of perioperative care. Here, we review the existing formulation of cannabinoids and their biological activity to put them into the context of the anesthesia plan execution. Perioperative considerations should include a way to gauge the patient’s intake of cannabinoids, the ability to gain consent properly, and vigilance to the increased risk of pulmonary and airway problems. Intraoperative management in individuals with cannabinoid use is complicated by the effects cannabinoids have on general anesthetics and depth of anesthesia monitoring while simultaneously increasing the potential occurrence of intraoperative hemodynamic instability. Postoperative planning should involve higher vigilance to the risk of postoperative strokes and acute coronary syndromes. However, most of the data are not up to date, rending definite conclusions on the importance of perioperative cannabinoid intake on anesthesia management difficult.
Collapse
Affiliation(s)
- Krzysztof Laudanski
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA 19104, USA
- Correspondence: (K.L.); (J.W.)
| | - Justin Wain
- School of Osteopathic Medicine, Campbell University, Buies Creek, NC 27506, USA
- Correspondence: (K.L.); (J.W.)
| |
Collapse
|
47
|
Keijsers M, Vega-Corredor MC, Hoermann S, Tomintz M. Cue Reactivity to Electronic Cigarettes: A Systematic Review. Subst Abuse 2022; 16:11782218221114971. [PMID: 35923180 PMCID: PMC9340385 DOI: 10.1177/11782218221114971] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 07/02/2022] [Indexed: 04/20/2023]
Abstract
Cue reactivity to Electronic Nicotine Delivery Systems (ENDS) has been studied by several researchers, yet the variability in user types (smokers, former smokers, dual users, exclusive ENDS users) and ENDS designs used between the studies may have undermined consistent results. This systematic review aims to give an overview of ENDS cue reactivity and how smoking status and device design may moderate this. A systematic search of Medline, Embase, Web of Science, PubMed and Cochrane was completed. All studies which reported findings on reactivity to ENDS cues in the form of craving or desire for ENDS or cigarettes, attention to cue, delay of gratification or economic decisions were included. Exclusion criteria were non-human subjects, non-adult participants or participants with comorbidities. Literature selection was carried out by 2 independent reviewers. The risk of bias and study quality were assessed using tools developed by Cochrane, BMJ and NHLBI. A total of 711 papers were screened and 22 studies were included in the current review. Study design, research question(s), population of interest, number of participants, dependent variable(s), ENDS generation and nicotine content used and study results were extracted. ENDS cues reliably induced ENDS craving, with no clear moderation by smoking status and no apparent moderation by device generation. In about half of the studies, ENDS cues induced craving for conventional cigarettes. Most studies used a smoker sample, thus limiting the conclusions that can be drawn on the moderation of cue reactivity by smoking status. The quality varied among studies but comparing the findings against the outcomes of only high-quality studies did not yield any different results. The results of this review support the notion of cue reactivity to ENDS, identifies gaps in current research on different user types and implies that ENDS design iterations have little impact on cue reactivity.
Collapse
Affiliation(s)
- Merel Keijsers
- Human Interface Technology Laboratory,
University of Canterbury, Christchurch, New Zealand
| | | | - Simon Hoermann
- School of Product Design, University of
Canterbury, Christchurch, New Zealand
- Simon Hoermann, School of Product Design,
University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand.
| | - Melanie Tomintz
- Geospatial Research Institute,
University of Canterbury, Christchurch, New Zealand
| |
Collapse
|
48
|
Barufaldi LA, Guerra RL, Albuquerque RDCRD, Nascimento AD, Chança RD, Souza MCD, Almeida LMD. [Risk of initiation to smoking with the use of electronic cigarettes: systematic review and meta-analysis]. CIENCIA & SAUDE COLETIVA 2021; 26:6089-6103. [PMID: 34910001 DOI: 10.1590/1413-812320212612.35032020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/18/2020] [Indexed: 11/22/2022] Open
Abstract
This article aims to evaluate the association between the use of electronic cigarettes and initiation to smoking, through a systematic review with meta-analysis of longitudinal studies. A bibliographic search was performed on the MEDLINE, Embase, LILACS and PsycInfo databases. Reference selection, data extraction and risk of bias assessment of the studies were independently carried out in pairs, and the disagreements were discussed with a third researcher to reach a consensus. Meta-analysis was performed using the Mantel-Haenszel random effects model. Among the 25 studies included, 22 evaluated the outcome of conventional cigarette experimentation and nine assessed the outcome of current smoking (in the last 30 days). The meta-analysis showed that the use of electronic cigarettes increased the risk of conventional cigarette experimentation by almost three and a half times (RR=3.42; 95%CI 2.81-4.15), and by more than four times the risk of current smoking (RR=4.32; 95%CI 3.13-5.94). The risk of smoking initiation is significantly higher among electronic cigarette users. The marketing authorization of such devices may represent a threat to public health policies in Brazil.
Collapse
Affiliation(s)
- Laura Augusta Barufaldi
- Núcleo de Avaliação de Tecnologias em Saúde, Divisão de Pesquisa Populacional, Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA). Praça Cruz Vermelha 23, Centro. 20230-130 Rio de Janeiro RJ Brasil.
| | - Renata Leborato Guerra
- Núcleo de Avaliação de Tecnologias em Saúde, Divisão de Pesquisa Populacional, Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA). Praça Cruz Vermelha 23, Centro. 20230-130 Rio de Janeiro RJ Brasil.
| | - Rita de Cássia Ribeiro de Albuquerque
- Núcleo de Avaliação de Tecnologias em Saúde, Divisão de Pesquisa Populacional, Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA). Praça Cruz Vermelha 23, Centro. 20230-130 Rio de Janeiro RJ Brasil.
| | - Aline do Nascimento
- Núcleo de Avaliação de Tecnologias em Saúde, Divisão de Pesquisa Populacional, Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA). Praça Cruz Vermelha 23, Centro. 20230-130 Rio de Janeiro RJ Brasil.
| | - Raphael Duarte Chança
- Núcleo de Avaliação de Tecnologias em Saúde, Divisão de Pesquisa Populacional, Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA). Praça Cruz Vermelha 23, Centro. 20230-130 Rio de Janeiro RJ Brasil.
| | | | | |
Collapse
|
49
|
Ihongbe TO, Olayinka PO, Curry S. Association Between Bully Victimization and Vaping Among Texas High School Students. Am J Prev Med 2021; 61:910-918. [PMID: 34456103 DOI: 10.1016/j.amepre.2021.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/18/2021] [Accepted: 06/10/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Bullying and vaping among adolescents in Texas is a major public health concern. Bully victimization has been associated with substance use in adolescents; however, research examining the association between bully victimization and vaping in adolescents is sparse. This study aims to examine the independent association between bully victimization and vaping among Texas high school students. METHODS Pooled data from the 2017 and 2019 Texas Youth Risk Behavior Survey (N=3,486) were analyzed in July 2020. Past-year bully victimization was categorized into 4 mutually exclusive groups: no bully victimization, school bully victimization only, cyberbully victimization only, and both school bully and cyberbully victimization. Current vape use was measured as a binary variable. Multivariable logistic regression was used to examine the association. RESULTS In the total sample, the past-year prevalence of school bully victimization only, cyberbully victimization only, and both school bully and cyberbully victimization was 8.3%, 4.6%, and 7.7%, respectively. Approximately 1 in 7 students (14.5%) reported vaping during the past 30 days. Female students who experienced both school bullying and cyberbullying had 68% greater odds of vaping than female students who did not experience bullying (AOR=1.68, 95% CI=1.02, 3.41). Bully victimization was not significantly associated with vaping in male students. CONCLUSIONS Female Texas high school students who are victims of both school bullying and cyberbullying have a greater likelihood of vaping. Healthcare providers, school counselors, and educators should be aware of the association and sex differences that exist while developing intervention programs to address bullying and vaping in high school students.
Collapse
Affiliation(s)
- Timothy O Ihongbe
- Center for Health Statistics, Texas Department of State Health Services, Austin, Texas.
| | - Precious O Olayinka
- Faculty of Basic Medical and Applied Sciences, Lead City University, Ibadan, Nigeria
| | - Stephani Curry
- Center for Health Statistics, Texas Department of State Health Services, Austin, Texas
| |
Collapse
|
50
|
Larue F, Tasbih T, Ribeiro PAB, Lavoie KL, Dolan E, Bacon SL. Immediate physiological effects of acute electronic cigarette use in humans: A systematic review and meta-analysis. Respir Med 2021; 190:106684. [PMID: 34808583 DOI: 10.1016/j.rmed.2021.106684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Electronic cigarettes (e-cigs) are widely used devices that were initially created to aid in smoking cessation. However, their acute physiological effects are unclear and there have been a number of E-cig and Vaping Acute Lung Injury (EVALI) events reported. RESEARCH QUESTION What are the immediate physiological effects (i.e. cardiovascular, respiratory or blood-based responses) of acute e-cig usage in humans? STUDY DESIGN AND METHODS PubMed, Web of Science, Cochrane and Scopus databases were searched for English or French peer-reviewed articles published until May 20, 2021 and measuring at least one physiological parameter before and after using an e-cig. The study followed PRISMA guidelines and assessed article quality using the Downs and Black checklist. Independent extraction was conducted by two reviewers. Data were pooled using random-effect models. Sensitivity analysis and meta-regressions were performed to explore heterogeneity. MAIN OUTCOMES Systolic and diastolic blood pressure, heart rate, augmentation index (AIx75), fraction of exhaled nitric oxide (FeNO), and spirometry were the most frequently assessed parameters and were therefore chosen for meta-analyses. RESULTS Of 19823 articles screened, 45 articles were included for the qualitative synthesis, and 27 articles (919 patients) were included in meta-analyses. Acute use of nicotine e-cig was associated with increased heart rate(SMD = 0.71; 95%CI 0.46-0.95), systolic blood pressure (SMD = 0.38; 95%CI 0.18-0.57), diastolic blood pressure (SMD = 0.52; 95%CI 0.33-0.70), and augmentation index AIx75 (SMD = 0.580; 95%CI 0.220-0.941), along with decreased FeNO (SMD = -0.26; 95%CI -0.49 to -0.04). E-cig exposure wasn't associated with significant changes in any spirometry measure. INTERPRETATION Acute use of nicotine e-cigs was associated with statistically significant cardiovascular and respiratory responses. These devices have a physiological impact that could be clinically relevant, especially in terms of cardiovascular morbidity. However, the direct consequences of long-term e-cig use needs to be further explored.
Collapse
Affiliation(s)
- Florent Larue
- Montreal Behavioural Medicine Centre, Centre Integrée Universitaire de Santé et Services Sociaux Du Nord de L'Ile de Montréal (CIUSSS-NIM), Montreal, QC, H4J 1C5, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, 7141 Sherbrooke St West, Montreal, H4B 1R6, Canada; Faculty of Medicine of Montpellier, Montpellier, France
| | - Tasfia Tasbih
- Montreal Behavioural Medicine Centre, Centre Integrée Universitaire de Santé et Services Sociaux Du Nord de L'Ile de Montréal (CIUSSS-NIM), Montreal, QC, H4J 1C5, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, 7141 Sherbrooke St West, Montreal, H4B 1R6, Canada
| | - Paula A B Ribeiro
- Montreal Behavioural Medicine Centre, Centre Integrée Universitaire de Santé et Services Sociaux Du Nord de L'Ile de Montréal (CIUSSS-NIM), Montreal, QC, H4J 1C5, Canada
| | - Kim L Lavoie
- Montreal Behavioural Medicine Centre, Centre Integrée Universitaire de Santé et Services Sociaux Du Nord de L'Ile de Montréal (CIUSSS-NIM), Montreal, QC, H4J 1C5, Canada; Department of Psychology, University of Quebec at Montreal, CP 8888, Succursale Centre-Ville, Montreal, QC, H3C 3P8, Canada
| | - Emilie Dolan
- Montreal Behavioural Medicine Centre, Centre Integrée Universitaire de Santé et Services Sociaux Du Nord de L'Ile de Montréal (CIUSSS-NIM), Montreal, QC, H4J 1C5, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, 7141 Sherbrooke St West, Montreal, H4B 1R6, Canada
| | - Simon L Bacon
- Montreal Behavioural Medicine Centre, Centre Integrée Universitaire de Santé et Services Sociaux Du Nord de L'Ile de Montréal (CIUSSS-NIM), Montreal, QC, H4J 1C5, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, 7141 Sherbrooke St West, Montreal, H4B 1R6, Canada.
| |
Collapse
|