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Olomu IN, Hoang V, Madhukar BV. Low levels of nicotine and cotinine but not benzo[a]pyrene induce human trophoblast cell proliferation. Reprod Toxicol 2024; 125:108572. [PMID: 38453095 DOI: 10.1016/j.reprotox.2024.108572] [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: 09/21/2023] [Revised: 01/22/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
E-cigarettes use constitutes a source of thirdhand nicotine exposure. The increasing use of electronic cigarettes in homes and public places increases the risk of exposure of pregnant women to thirdhand nicotine. The effects of exposure of pregnant women to very low levels of nicotine have not been studied in humans but detrimental in experimental animals. The objective of this study is to investigate the effect of nanomolar concentrations of nicotine and its metabolite cotinine on the proliferation of JEG-3, a human trophoblast cell line. We also studied the proliferative effect of nanomolar concentrations of benzo[a]pyrene (B[a]P), a polycyclic hydrocarbon in tobacco smoke, for comparison. We treated JEG-3 cells in culture with nanomolar concentrations of nicotine, cotinine, and B[a]P. Their effect on cell proliferation was determined, relative to untreated cells, by MTT assay. Western blotting was used to assess the mitogenic signaling pathways affected by nicotine and cotinine. In contrast to the inhibitory effects reported with higher concentrations, we showed that nanomolar concentrations of nicotine and cotinine resulted in significant JEG-3 cell proliferation and a rapid but transient increase in levels of phosphorylated ERK and AKT, but not STAT3. Biphasic, non-monotonic effect on cell growth is characteristic of endocrine disruptive chemicals like nicotine. The mitogenic effects of nicotine and cotinine potentially contribute to increased villous epithelial thickness, seen in placentas of some smoking mothers. This increases the diffusion distance for oxygen and nutrients between mother and fetus, contributing to intrauterine growth restriction in infants of smoking mothers.
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Affiliation(s)
- I Nicholas Olomu
- Department of Pediatrics & Human Development, Michigan State University, East Lansing, MI, USA; Division of Neonatology, Michigan State University, East Lansing, MI, USA.
| | - Vanessa Hoang
- Department of Pediatrics & Human Development, Michigan State University, East Lansing, MI, USA
| | - Burra V Madhukar
- Department of Pediatrics & Human Development, Michigan State University, East Lansing, MI, USA
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Gatzke-Kopp LM, Riis JL, Ahmadi H, Piccerillo HL, Granger DA, Blair CB, Thomas EA. Environmental tobacco smoke exposure is associated with increased levels of metals in children's saliva. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:903-910. [PMID: 37147431 PMCID: PMC10733142 DOI: 10.1038/s41370-023-00554-w] [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: 09/26/2022] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Exposure to environmental tobacco smoke (ETS) has been associated with detectable levels of cotinine (a nicotine metabolite) in children's saliva. However, tobacco smoke also contains toxic and essential trace metals, including chromium (Cr), copper (Cu), lead (Pb), manganese (Mn), nickel (Ni) and zinc (Zn). OBJECTIVE The current study examines whether there is a relationship between ETS exposure, as gauged by salivary cotinine, and salivary levels of these metals in a subset (n = 238) of children from the Family Life Project. METHODS Using inductively-coupled-plasma optical emission spectrophotometry, we measured levels of metals in saliva from children at ~90 months of age. Salivary cotinine was measured using a commercial immunoassay. RESULTS We found that Cr, Cu, Mn, and Zn were detected in most samples (85-99%) with lower levels of detection for Pb and Ni (9.3% and 13.9% respectively). There were no significant differences in any of the metal concentrations between males and females, nor were levels associated with body mass index, although significant differences in salivary Cr and Mn by race, state and income-to-needs ratio were observed. Children with cotinine levels >1 ng/ml had higher levels of Zn (b = 0.401, 95% CI: 0.183 to 0.619; p = 0.0003) and Cu (b = 0.655, 95% CI: 0.206 to 1.104; p = 0.004) compared to children with levels <1 ng/ml, after controlling for multiple confounders, including sex, race, BMI and income-to-needs ratio. Further, we show that children whose cotinine levels were >1 μg/L were more likely to have detectable levels of Pb in their saliva (b = 1.40, 95% CI: 0.424 to 2.459; p = 0.006) compared to children with cotinine levels <1 ng/ml, also considering confounders. IMPACT STATEMENT This is the first study to demonstrate significant associations between salivary cotinine and salivary levels of Cu, Zn and Pb, suggesting that environmental tobacco smoke exposure my be one source of increased children's exposure to heavy metals. This study also demonstrates that saliva samples can be used to measure heavy metal exposure, and thus serve as a non-invasive tool for assessing a broader range of risk indicators.
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Affiliation(s)
- Lisa M Gatzke-Kopp
- Department of Human Development and Family Studies, Penn State University, University Park, PA, 16802, USA
| | - Jenna L Riis
- Department of Psychological Sciences, University of California Irvine, Irvine, CA, USA
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA
| | - Hedyeh Ahmadi
- Department of Psychological Sciences, University of California Irvine, Irvine, CA, USA
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA
- University Statistical Consulting, LLC, Irvine, CA, USA
| | - Hillary L Piccerillo
- Department of Psychological Sciences, University of California Irvine, Irvine, CA, USA
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA
| | - Douglas A Granger
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA
- Johns Hopkins University, Bloomberg School of Public Health, and School of Medicine, Baltimore, MD, USA
| | - Clancy B Blair
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Elizabeth A Thomas
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA.
- Department of Epidemiology, University of California Irvine, Irvine, CA, USA.
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Shearston JA, Eazor J, Lee L, Vilcassim MJR, Reed TA, Ort D, Weitzman M, Gordon T. Effects of electronic cigarettes and hookah (waterpipe) use on home air quality. Tob Control 2023; 32:36-41. [PMID: 34021062 PMCID: PMC10787574 DOI: 10.1136/tobaccocontrol-2020-056437] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION A major site of secondhand smoke exposure for children and adults is the home. Few studies have evaluated the impact of e-cigarette or hookah use on home air quality, despite evidence finding toxic chemicals in secondhand e-cigarette aerosols and hookah smoke. We assessed the effect of e-cigarette and hookah use on home air quality and compared it with air quality in homes where cigarettes were smoked and where no smoking or e-cigarette use occurred. METHODS Non-smoking homes and homes where e-cigarettes, hookah or cigarettes were used were recruited in the New York City area (n=57) from 2015 to 2019. Particulate matter with diameter less than 2.5 µm (PM2.5), black carbon and carbon monoxide (CO) were measured during a smoking or vaping session, both in a 'primary' smoking room and in an adjacent 'secondary' room where no smoking or vaping occurred. Log transformed data were compared with postanalysis of variance Tukey simultaneous tests. RESULTS Use of hookah significantly increased PM2.5 levels compared with non-smoking homes, in both the primary and secondary rooms, while use of e-cigarettes increased PM2.5 levels only in primary rooms. Additionally, in-home use of hookah resulted in greater CO concentrations than the use of cigarettes in primary rooms. CONCLUSIONS Use of e-cigarettes or hookah increases air pollution in homes. For hookah, increases in PM2.5 penetrated even into rooms adjacent to where smoking occurs. Extending smoke-free rules inside homes to include e-cigarette and hookah products is needed to protect household members and visitors from passive exposure to harmful aerosols and gases.
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Affiliation(s)
- Jenni A Shearston
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - James Eazor
- Department of Pediatrics, New York University School of Medicine, New York, New York, USA
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Lily Lee
- State University of New York Downstate Medical Center, New York, New York, USA
| | - M J Ruzmyn Vilcassim
- Department of Environmental Health Sciences, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA
| | - Taylor A Reed
- Department of Social Welfare, University of California Los Angeles, Los Angeles, California, USA
| | - Deborah Ort
- Nemours Children's Urgent Care, Orlando, Florida, USA
| | - Michael Weitzman
- Department of Pediatrics, New York University School of Medicine, New York, New York, USA
- New York University College of Global Public Health, New York, New York, USA
| | - Terry Gordon
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
- New York University College of Global Public Health, New York, New York, USA
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Rossheim ME, Zhao X, Soule EK, Thombs DL, Suzuki S, Ahmad A, Barnett TE. Aerosol, vapor, or chemicals? College student perceptions of harm from electronic cigarettes and support for a tobacco-free campus policy. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:1754-1760. [PMID: 32931725 PMCID: PMC9275670 DOI: 10.1080/07448481.2020.1819293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 08/07/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
Objective: This study is the first to examine the influence of e-cigarette emission phrasing on perceived harm of secondhand exposure, and whether harm perception was associated with support for a tobacco-free campus policy. Participants: In the fall 2018 and spring 2019 semesters, 52 sections of a college English course (N = 791 students) were cluster randomized to one of three conditions ("vapor," "aerosol," or "chemicals") assessing harm of secondhand exposure to e-cigarette emissions. Methods: Regression models adjusted for demographic characteristics, tobacco use, and other potential confounders. Results: Compared to the "vapor" condition, "chemicals" and "aerosol" conditions were associated with increased odds of perceiving secondhand exposure to e-cigarettes to be harmful/very harmful (AOR = 2.0, p < 0.01). Greater perceived harm of secondhand e-cigarette exposure was associated with increased odds of supporting a tobacco-free campus policy (AOR = 2.22, p < 0.001). Conclusions: Health campaigns should use accurate terminology to describe e-cigarette emissions, rather than jargon that conveys lower risk.
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Affiliation(s)
- Matthew E. Rossheim
- Department of Global and Community Health, George Mason University, Fairfax, VA
| | - Xiaoquan Zhao
- Department of Communication, George Mason University, Fairfax, VA
| | - Eric K. Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, NC
| | - Dennis L. Thombs
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX
| | - Sumihiro Suzuki
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX
| | - Asra Ahmad
- Department of Global and Community Health, George Mason University, Fairfax, VA
| | - Tracey E. Barnett
- School of Public Health, University of North Texas Health Science Center, Fort Worth, TX
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Collaco JM, McGrath-Morrow SA. Developmental Effects of Electronic Cigarette Use. Compr Physiol 2022; 12:3337-3346. [PMID: 35578965 DOI: 10.1002/cphy.c210018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Electronic cigarettes have gained widespread acceptance among adolescents and young adults. As a result of this popularity, there are concerns regarding the potential harm of primary, secondhand and thirdhand electronic cigarette exposures on fetal and postnatal development. In vitro studies have shown that constituents in electronic cigarette liquids, including nicotine, flavorings, and carrier agents can alter cellular processes and growth. Additionally, aerosolized electronic cigarette emissions have been shown to disrupt organ development and immune responses in preclinical studies. In clinical studies, an association between electronic cigarette use and frequent respiratory symptoms, greater asthma severity and impaired mucociliary clearance has been demonstrated with adolescent and young adult users of electronic cigarettes having twice the frequency of cough, mucus production, or bronchitis compared to nonusers. Along with the popularity of electronic cigarette use, secondhand electronic cigarette exposure has increased substantially; with almost one-fourth of middle and high school children reporting exposure to secondhand vapors. The health consequences of secondhand electronic cigarette exposure on children and other vulnerable populations are poorly understood but detectable levels of cotinine have been measured in nonusers. Pregnant women and their offspring are another vulnerable group at increased risk for health consequences from electronic cigarette exposure. Nicotine crosses the placenta and can disrupt brain and lung development in preclinical studies. This article will focus on the physiological and health effects associated with primary or secondhand exposure to electronic cigarettes. It is expected that with ongoing availability of electronic cigarettes as well as the accumulation of additional follow-up time for long-term outcomes, the risks associated with exposure will become better clarified. © 2022 American Physiological Society. Compr Physiol 12:3337-3346, 2022.
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Affiliation(s)
- Joseph M Collaco
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Sharon A McGrath-Morrow
- Division of Pediatric Pulmonology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Khachatoorian C, McWhirter KJ, Luo W, Pankow JF, Talbot P. Tracing the movement of electronic cigarette flavor chemicals and nicotine from refill fluids to aerosol, lungs, exhale, and the environment. CHEMOSPHERE 2022; 286:131494. [PMID: 34392198 PMCID: PMC8787941 DOI: 10.1016/j.chemosphere.2021.131494] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/09/2021] [Accepted: 07/07/2021] [Indexed: 05/12/2023]
Abstract
BACKGROUND Given the high concentrations of nicotine and flavor chemicals in EC (electronic cigarette) fluids, it is important to determine how efficiently they transfer to aerosols, how well they are retained by users (exposure), and if they are exhaled into the environment where they settle of surfaces forming ECEAR (EC exhaled aerosol residue). OBJECTIVES To quantify the flavor chemicals and nicotine in refill fluids, inhaled aerosols, and exhaled aerosols. Then deduce their retention and contribution to ECEAR. METHODS Flavor chemicals and nicotine were identified and quantified by GC-MS in two refill fluids, smoking machine-generated aerosols, and aerosols exhaled by 10 human participants (average age 21; 7 males). Machine generated aerosols were made with varying puff durations and two wattages (40 and 80). Participants generated exhale ad libitum; their exhale was quantified, and chemical retention and contribution to ECEAR was modeled. RESULTS "Dewberry Cream" had five dominant (≥1 mg/mL) flavor chemicals (maltol, ethyl maltol, vanillin, ethyl vanillin, furaneol), while "Cinnamon Roll" had one (cinnamaldehyde). Nicotine transferred well to aerosols irrespective of topography; however, transfer efficiencies of flavor chemicals depended on the chemical, puff volume, puff duration, pump head, and EC power. Participants could be classified as "mouth inhalers" or "lung inhalers" based on their exhale of flavor chemicals and nicotine and retention. Lung inhalers had high retention and exhaled low concentrations of EC chemicals. Only mouth inhalers exhaled sufficient concentrations of flavor chemicals/nicotine to contribute to chemical deposition on environmental surfaces (ECEAR). CONCLUSION These data help distinguish two types of EC users, add to our knowledge of chemical exposure during vaping, and provide information useful in regulating EC use.
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Affiliation(s)
- Careen Khachatoorian
- Cell, Molecular, and Developmental Biology Graduate Program, University of California, Riverside, Riverside, CA, USA.
| | - Kevin J McWhirter
- Department of Civil and Environmental Engineering, Portland State University, Portland, OR, USA.
| | - Wentai Luo
- Department of Civil and Environmental Engineering, Portland State University, Portland, OR, USA.
| | - James F Pankow
- Department of Civil and Environmental Engineering, Portland State University, Portland, OR, USA.
| | - Prue Talbot
- Department of Molecular, Cell & Systems Biology University of California, Riverside, Riverside, CA, USA.
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Khachatoorian C, Luo W, McWhirter KJ, Pankow JF, Talbot P. E-cigarette fluids and aerosol residues cause oxidative stress and an inflammatory response in human keratinocytes and 3D skin models. Toxicol In Vitro 2021; 77:105234. [PMID: 34416289 DOI: 10.1016/j.tiv.2021.105234] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/10/2021] [Accepted: 08/13/2021] [Indexed: 11/24/2022]
Abstract
Our goal was to evaluate the effects of EC refill fluids and EC exhaled aerosol residue (ECEAR) on cultured human keratinocytes and MatTek EpiDerm™, a 3D air liquid interface human skin model. Quantification of flavor chemicals and nicotine in Dewberry Cream and Churrios refill fluids was done using GC-MS. The dominant flavor chemicals were maltol, ethyl maltol, vanillin, ethyl vanillin, benzyl alcohol, and furaneol. Cytotoxicity was determined with the MTT and LDH assays, and inflammatory markers were quantified with ELISAs. Churrios was cytotoxic to keratinocytes in the MTT assay, and both fluids induced ROS production in the medium (ROS-Glo™) and in cells (CellROX). Exposure of EpiDerm™ to relevant concentrations of Dewberry Cream and Churrios for 4 or 24 h caused secretion of inflammatory markers (IL-1α, IL-6, and MMP-9), without altering EpiDerm™ histology. Lab made fluids with propylene glycol (PG) or PG plus a flavor chemical did not produce cytotoxic effects, but increased secretion of IL-1α and MMP-9, which was attributed to PG. ECEAR derived from Dewberry Cream and Churrios did not produce cytotoxicity with Epiderm™, but Churrios ECEAR induced IL-1α secretion. These data support the conclusion that EC chemicals can cause oxidative damage and inflammation to human skin.
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Affiliation(s)
- Careen Khachatoorian
- Department of Molecular, Cell & Systems Biology, University of California, Riverside, Riverside, CA, United States
| | - Wentai Luo
- Department of Civil and Environmental Engineering, Portland State University, Portland, OR, United States
| | - Kevin J McWhirter
- Department of Civil and Environmental Engineering, Portland State University, Portland, OR, United States
| | - James F Pankow
- Department of Civil and Environmental Engineering, Portland State University, Portland, OR, United States
| | - Prue Talbot
- Department of Molecular, Cell & Systems Biology, University of California, Riverside, Riverside, CA, United States.
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Flores RJ, Alshbool FZ, Giner P, O'Dell LE, Mendez IA. Exposure to nicotine vapor produced by an electronic nicotine delivery system causes short-term increases in impulsive choice in adult male rats. Nicotine Tob Res 2021; 24:358-365. [PMID: 34232312 DOI: 10.1093/ntr/ntab141] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 07/05/2021] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Traditional cigarette use influences cost-benefit decision making by promoting impulsive choice. However, the impact of exposure via electronic nicotine delivery systems on impulsive choice remains unclear. Hence, the present study examined the short- and long-term effects of nicotine vapor on impulsive choice. METHODS Twenty-four adult male rats were trained in the delay discounting task, to choose between small, immediate food rewards or large, delayed food rewards. After 24 days of training in the task, rats were exposed to vapor containing either 0, 12, or 24 mg/mL of nicotine, for ten days. To validate inhalation of nicotine vapor, serum cotinine levels were analyzed on exposure days 1, 5, and 10 using enzyme-linked immunosorbent assay (ELISA). Following vapor exposure, rats were retrained in the discounting task until rats displayed stable responding, and the effects of nicotine vapor on choice preference were assessed. RESULTS Rats exposed to 12 and 24 mg/mL nicotine vapor displayed higher serum cotinine levels than control rats exposed to 0 mg/mL vapor. There were no differences in impulsive choice between any vapor exposure groups when tested 15 days after exposure, across 6 days of stable responding, suggesting that nicotine vapor does not have long lasting effects on impulsive choice. Interestingly, a subsequent nicotine vapor challenge revealed short-term increases in impulsive choice immediately following a single exposure to 24 mg/mL nicotine vapor, relative to choice preference immediately following exposure to 0 mg/mL vapor. CONCLUSIONS These results suggest that exposure to nicotine vapor causes immediate, short-term increases in impulsive choice. IMPLICATIONS E-cigarette use is increasing at an alarming rate, particularly among adolescents and young adults. This is concerning given the lack of research into the effects of nicotine vapor exposure on the brain and behavior. The present study describes a viable rodent model of human e-cigarette use and suggest that exposure to nicotine vapor produces short-term increases in impulsive choice.
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Affiliation(s)
- Rodolfo J Flores
- The University of Texas at El Paso, Department of Psychology, El Paso, Texas, USA
| | - Fatima Z Alshbool
- Texas A&M University, Irma Lerma Rangel College of Pharmacy, Department of Pharmacy Practice, Kingsville, Texas, USA
| | - Priscilla Giner
- The University of Texas at El Paso, School of Pharmacy, Department of Pharmaceutical Sciences, El Paso, Texas, USA
| | - Laura E O'Dell
- The University of Texas at El Paso, Department of Psychology, El Paso, Texas, USA
| | - Ian A Mendez
- The University of Texas at El Paso, School of Pharmacy, Department of Pharmaceutical Sciences, El Paso, Texas, USA
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Chavarrio Cañas JE, Monge-Palacios M, Grajales-González E, Sarathy SM. Early Chemistry of Nicotine Degradation in Heat-Not-Burn Smoking Devices and Conventional Cigarettes: Implications for Users and Second- and Third-Hand Smokers. J Phys Chem A 2021; 125:3177-3188. [PMID: 33834773 PMCID: PMC8154610 DOI: 10.1021/acs.jpca.1c01650] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Nicotine exposure results in health risks not only for smokers but also for second- and third-hand smokers. Unraveling nicotine's degradation mechanism and the harmful chemicals that are produced under different conditions is vital to assess exposure risks. We performed a theoretical study to describe the early chemistry of nicotine degradation by investigating two important reactions that nicotine can undergo: hydrogen abstraction by hydroxyl radicals and unimolecular dissociation. The former contributes to the control of the degradation mechanism below 800 K due to a non-Arrhenius kinetics, which implies an enhancement of reactivity as temperature decreases. The latter becomes important at higher temperatures due to its larger activation energy. This change in the degradation mechanism is expected to affect the composition of vapors inhaled by smokers and room occupants. Conventional cigarettes, which operate at temperatures higher than 1000 K, are more prone to yield harmful pyridinyl radicals via nicotine dissociation, while nicotine in electronic cigarettes and vaporizers, with operating temperatures below 600 K, will be more likely degraded by hydroxyl radicals, resulting in a vapor with a different composition. Although low-temperature nicotine delivery devices have been claimed to be less harmful due to their nonburning operating conditions, the non-Arrhenius kinetics that we observed for the degradation mechanism below 873 K suggests that nicotine degradation may be more rapidly initiated as temperature is reduced, indicating that these devices may be more harmful than it is commonly assumed.
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Affiliation(s)
- Javier E Chavarrio Cañas
- Clean Combustion Research Center (CCRC), Physical Science and Engineering (PSE) Division, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - M Monge-Palacios
- Clean Combustion Research Center (CCRC), Physical Science and Engineering (PSE) Division, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - E Grajales-González
- Clean Combustion Research Center (CCRC), Physical Science and Engineering (PSE) Division, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
| | - S Mani Sarathy
- Clean Combustion Research Center (CCRC), Physical Science and Engineering (PSE) Division, King Abdullah University of Science and Technology (KAUST), Thuwal 23955-6900, Saudi Arabia
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Toxicology of flavoring- and cannabis-containing e-liquids used in electronic delivery systems. Pharmacol Ther 2021; 224:107838. [PMID: 33746051 DOI: 10.1016/j.pharmthera.2021.107838] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/11/2021] [Indexed: 12/15/2022]
Abstract
Electronic cigarettes (e-cigarettes) were introduced in the United States in 2007 and by 2014 they were the most popular tobacco product amongst youth and had overtaken use of regular tobacco cigarettes. E-cigarettes are used to aerosolize a liquid (e-liquid) that the user inhales. Flavorings in e-liquids is a primary reason for youth to initiate use of e-cigarettes. Evidence is growing in the scientific literature that inhalation of some flavorings is not without risk of harm. In this review, 67 original articles (primarily cellular in vitro) on the toxicity of flavored e-liquids were identified in the PubMed and Scopus databases and evaluated critically. At least 65 individual flavoring ingredients in e-liquids or aerosols from e-cigarettes induced toxicity in the respiratory tract, cardiovascular and circulatory systems, skeletal system, and skin. Cinnamaldehyde was most frequently reported to be cytotoxic, followed by vanillin, menthol, ethyl maltol, ethyl vanillin, benzaldehyde and linalool. Additionally, modern e-cigarettes can be modified to aerosolize cannabis as dried plant material or a concentrated extract. The U.S. experienced an outbreak of lung injuries, termed e-cigarette, or vaping, product use-associated lung injury (EVALI) that began in 2019; among 2,022 hospitalized patients who had data on substance use (as of January 14, 2020), 82% reported using a delta-9-tetrahydrocannabinol (main psychoactive component in cannabis) containing e-cigarette, or vaping, product. Our literature search identified 33 articles related to EVALI. Vitamin E acetate, a diluent and thickening agent in cannabis-based products, was strongly linked to the EVALI outbreak in epidemiologic and laboratory studies; however, e-liquid chemistry is highly complex, and more than one mechanism of lung injury, ingredient, or thermal breakdown product may be responsible for toxicity. More research is needed, particularly with regard to e-cigarettes (generation, power settings, etc.), e-liquids (composition, bulk or vaped form), modeled systems (cell type, culture type, and dosimetry metrics), biological monitoring, secondhand exposures and contact with residues that contain nicotine and flavorings, and causative agents and mechanisms of EVALI toxicity.
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11
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Khadka S, Awasthi M, Lamichhane RR, Ojha C, Mamudu HM, Lavie CJ, Daggubati R, Paul TK. The Cardiovascular Effects of Electronic Cigarettes. Curr Cardiol Rep 2021; 23:40. [PMID: 33694009 DOI: 10.1007/s11886-021-01469-4] [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] [Accepted: 02/11/2021] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW Electronic cigarettes (e-cigarettes) are gaining rapid popularity among all age groups, especially among youth. They have evolved into technologically advanced devices capable of delivering nicotine concentration and other substances. In addition to nicotine, e-cigarettes' constituents possess variety of toxic chemicals that have adverse effects on human body. RECENT FINDINGS In recent years, steady downward trend in tobacco usage has been observed; however, e-cigarette use is on upward trend. E-cigarettes are advertised as "safer" alternatives to conventional smoking and as an aid to smoking cessation. Emerging studies have, however, shown that e-cigarettes have harmful effects on the cardiovascular system and that most of the e-cigarette users are dual users, concurrently using e-cigarettes and smoking conventional cigarettes. Despite a gap in clinical studies and randomized trials analyzing adverse cardiovascular effects of e-cigarette use, the existing literature supports that different constituents of e-cigarettes such as nicotine, carbonyls, and particulate matters carry potential risk for cardiovascular diseases (CVD) on its users.
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Affiliation(s)
- Saroj Khadka
- Department of Medicine, Division of Cardiology, East Tennessee State University, 329 N State of Franklin Rd, Johnson City, TN, 37604, USA
| | - Manul Awasthi
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | | | - Chandra Ojha
- Texas Tech University of Health Sciences, El Paso, TX, USA
| | - Hadii M Mamudu
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, TN, USA
| | - Carl J Lavie
- Department of Cardiology, Ochsner Clinic, New Orleans, LA, USA
| | - Ramesh Daggubati
- Division of Cardiology, West Virginia University, Morgantown, WV, USA
| | - Timir K Paul
- Department of Medicine, Division of Cardiology, East Tennessee State University, 329 N State of Franklin Rd, Johnson City, TN, 37604, USA.
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12
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Son Y, Giovenco DP, Delnevo C, Khlystov A, Samburova V, Meng Q. Indoor Air Quality and Passive E-cigarette Aerosol Exposures in Vape-Shops. Nicotine Tob Res 2021; 22:1772-1779. [PMID: 32445475 DOI: 10.1093/ntr/ntaa094] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 05/18/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Direct emissions of nicotine and harmful chemicals from electronic cigarettes (e-cigarettes) have been intensively studied, but secondhand and thirdhand e-cigarette aerosol (THA) exposures in indoor environments are understudied. AIMS AND METHODS Indoor CO2, NO2, particulate matter (PM2.5), aldehydes, and airborne nicotine were measured in five vape-shops to assess secondhand exposures. Nicotine and tobacco-specific nitrosamines were measured on vape-shop surfaces and materials (glass, paper, clothing, rubber, and fur ball) placed in the vape-shops (14 days) to study thirdhand exposures. RESULTS Airborne PM2.5, formaldehyde, acetaldehyde, and nicotine concentrations during shop opening hours were 21, 3.3, 4.0, and 3.8 times higher than the levels during shop closing hours, respectively. PM2.5 concentrations were correlated with the number of e-cigarette users present in vape-shops (ρ = 0.366-0.761, p < .001). Surface nicotine, 4-(N-methyl-N-nitrosamino)-4-(3-pyridyl)butanal (NNA), and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) were also detected at levels of 223.6 ± 313.2 µg/m2, 4.78 ± 11.8 ng/m2, and 44.8 ± 102.3 ng/m2, respectively. Substantial amounts of nicotine (up to 2073 µg/m2) deposited on the materials placed within the vape-shops, and NNA (up to 474.4 ng/m2) and NNK (up to 184.0 ng/m2) were also formed on these materials. The deposited nicotine concentrations were strongly correlated with the median number of active vapers present in a vape-shop per hour (ρ = 0.894-0.949, p = .04-.051). NNK levels on the material surfaces were significantly associated with surface nicotine levels (ρ=0.645, p = .037). CONCLUSIONS Indoor vaping leads to secondhand and THA exposures. Thirdhand exposures induced by e-cigarette vaping are comparable or higher than that induced by cigarette smoking. Long-term studies in various microenvironments are needed to improve our understanding of secondhand and THA exposures. IMPLICATIONS This study adds new convincing evidence that e-cigarette vaping can cause secondhand and THA exposures. Our findings can inform Occupational Safety and Health Administration, state authorities, and other government agencies regarding indoor air policies related to e-cigarette use, particularly in vape-shops. There is an urgent need to ensure that vape-shops maintain suitable ventilation systems and cleaning practices to protect customers, employees, and bystanders. Our study also demonstrates that nicotine can deposit or be adsorbed on baby's clothes and toys, and that tobacco-specific nitrosamines can form and retain on baby's clothes, highlighting children's exposure to environmental e-cigarette aerosol and THA at home is of a particular concern.
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Affiliation(s)
- Yeongkwon Son
- Department of Environmental and Occupational Health, School of Public Health, Rutgers University, Piscataway, NJ.,Division of Atmospheric Sciences, Desert Research Institute, Reno, NV
| | - Daniel P Giovenco
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Cristine Delnevo
- Center for Tobacco Studies, School of Public Health, Rutgers University, Piscataway, NJ.,Cancer Prevention and Control Research Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Andrey Khlystov
- Division of Atmospheric Sciences, Desert Research Institute, Reno, NV
| | - Vera Samburova
- Division of Atmospheric Sciences, Desert Research Institute, Reno, NV
| | - Qingyu Meng
- Department of Environmental and Occupational Health, School of Public Health, Rutgers University, Piscataway, NJ.,Center for Tobacco Studies, School of Public Health, Rutgers University, Piscataway, NJ
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13
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Wetzel TJ, Wyatt TA. Dual Substance Use of Electronic Cigarettes and Alcohol. Front Physiol 2020; 11:593803. [PMID: 33224040 PMCID: PMC7667127 DOI: 10.3389/fphys.2020.593803] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/29/2020] [Indexed: 11/25/2022] Open
Abstract
Electronic cigarettes (ECs) are a modern nicotine delivery system that rapidly grew in widespread use, particularly in younger populations. Given the long history of the comorbidity of alcohol and nicotine use, the rising prevalence of ECs raises the question as to their role in the consumption of alcohol. Of the numerous models of ECs available, JUUL is the most popular. This narrative review aims to determine current trends in literature regarding the relationship between EC and alcohol dual use, as well as hypothesize potential pathogenic tissue damage and summarize areas for future study, including second-hand vapor exposure and calling for standardization among studies. In summary, EC users are more likely to participate in hazardous drinking and are at higher risk for alcohol use disorder (AUD). We surmise the pathogenic damage of dual use may exhibit an additive effect, particularly in pathogen clearance from the lungs, increased inflammation and decreased immune response, physical damage to epithelial cells, and exacerbation of chronic obstructive pulmonary disease (COPD)-like illnesses. A better understanding of pathogenic damages is critical to understand the risks placed on dual users when exposed to respiratory pathogens, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
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Affiliation(s)
- Tanner J Wetzel
- Department of Environmental, Agricultural and Occupational Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Todd A Wyatt
- Department of Environmental, Agricultural and Occupational Health, University of Nebraska Medical Center, Omaha, NE, United States.,Pulmonary, Critical Care, and Sleep, University of Nebraska Medical Center, Omaha, NE, United States.,VA Nebraska-Western Iowa Health Care System, Omaha, NE, United States
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14
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Azagba S, Shan L, Manzione L. Associations of home and workplace vaping restrictions with e-cigarette use among U.S. adults. Prev Med 2020; 139:106196. [PMID: 32653356 DOI: 10.1016/j.ypmed.2020.106196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/12/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
The current study examined home and workplace vaping restrictions and their associations with e-cigarette use, frequency of e-cigarette use, and exposure to environmental vape aerosol among adults in the U.S. We used data from the 2018 Tobacco Use Supplement to the Current Population Survey to determine these associations. Analysis was done with a multivariable logistic and zero-inflated Poisson regression. Of 46,751 participants, 2.1% currently used e-cigarettes and 89% reported restricted home vaping. Of 19,091 working participants, 83% had worksite vaping restrictions and 6% reported environmental vapor exposure. Respondents with household vaping restrictions had lower odds of current e-cigarette use (full ban: aOR: 0.07, 95% CI: 0.05-0.09; partial ban: aOR: 0.51, 95% CI: 0.40-0.66). The expected number of days of past-month e-cigarette use for those with some household vaping restrictions was significantly fewer than for those without restrictions (full ban: IRR: 0.92, 95% CI: 0.85-0.99; partial ban, IRR: 0.89, 95% CI: 0.81-0.97). Workers with full workplace vaping restrictions had lower odds of workplace environmental vape aerosol exposure than those without a restriction (aOR: 0.21, 95% CI: 0.17-0.25). Vaping restrictions in homes were associated with lower prevalence and frequency of e-cigarette use. Those in worksites with complete vaping bans were less likely to be exposed to environmental aerosol at work. Home e-cigarette restrictions appear to have a stronger association with e-cigarette use behaviors than workplace restrictions.
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Affiliation(s)
- Sunday Azagba
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States of America.
| | - Lingpeng Shan
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States of America
| | - Lauren Manzione
- Department of Family and Preventive Medicine, University of Utah School of Medicine, United States of America
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15
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Dalrymple A, Badrock TC, Terry A, Bean EJ, Barber M, Hall PJ, Coburn S, McAughey J, Murphy J. Development of a novel method to measure material surface staining by cigarette, e-cigarette or tobacco heating product aerosols. Heliyon 2020; 6:e05012. [PMID: 32995648 PMCID: PMC7511806 DOI: 10.1016/j.heliyon.2020.e05012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/21/2020] [Accepted: 09/17/2020] [Indexed: 11/25/2022] Open
Abstract
Tobacco smoke (CS) may visually stain indoor surfaces including ceilings, walls and soft furnishings over time. Potentially reduced risk products (PRRPs) such as e-cigarettes (EC) and tobacco heating products (THP) produce chemically less complex aerosols with significantly reduced levels of toxicants, particles and odour. However, the potential effects of EC and THP aerosols on the staining of indoor surfaces are currently unknown. In this study, an exposure chamber was developed as a model system to enable the accelerated staining of wallpaper and cotton samples by a scientific reference cigarette (3R4F), three THP (glo™, glo™ pro, glo™ sens) and an e-cigarette (iSwitch Maxx). Exposure to 3R4F reference cigarettes caused the greatest level of staining, which was significantly higher than glo™, glo™ pro, glo™ sens or iSwitch Maxx aerosols, all of which showed relatively little colour change. Exposure to 200–1000 puffs of 3R4F cigarette smoke resulted in a visible dose response effect to wallpaper and cotton samples which was not observed following exposure to glo™, glo™ pro, glo™ sens or iSwitch Maxx aerosols. Aging of the samples for 4 weeks post-exposure resulted in changes to the staining levels, however PRRP staining levels were minimal and significantly lower than 3R4F exposed samples. For the first time, diverse PRRPs across the tobacco and nicotine products risk continuum have been assessed in vitro for their impact on surface staining. CS exposure significantly increased the level of wallpaper and cotton staining, whereas exposure to glo™, glo™ pro, glo™ sens or iSwitch Maxx aerosols resulted in significantly reduced levels of staining, staining levels were also comparable to untreated control samples.
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Affiliation(s)
- Annette Dalrymple
- British American Tobacco, R&D, Southampton, Hampshire, SO15 8TL, UK
- Corresponding author.
| | | | - Anya Terry
- British American Tobacco, R&D, Southampton, Hampshire, SO15 8TL, UK
| | - Emma-Jayne Bean
- British American Tobacco, R&D, Southampton, Hampshire, SO15 8TL, UK
| | - Mark Barber
- Borgwaldt KC GmbH Schnackenburgallee 15, 22525, Hamburg, Germany
| | - Peter J. Hall
- Intertek Clinical Research Services, Hooton, Cheshire, CH66 7NZ, UK
| | - Steven Coburn
- British American Tobacco, R&D, Southampton, Hampshire, SO15 8TL, UK
| | - John McAughey
- British American Tobacco, R&D, Southampton, Hampshire, SO15 8TL, UK
| | - James Murphy
- British American Tobacco, R&D, Southampton, Hampshire, SO15 8TL, UK
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16
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Buu A, Hu YH, Wong SW, Lin HC. Comparing American college and noncollege young adults on e-cigarette use patterns including polysubstance use and reasons for using e-cigarettes. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:610-616. [PMID: 30908151 DOI: 10.1080/07448481.2019.1583662] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Objective: Existing literature on young adults' e-cigarette and polysubstance use focused on college students. This study examined the differences between college and noncollege groups on prevalence and patterns of e-cigarette and other substance use using data from a national survey. Participants: Adults aged 18-24 from the 2013-2014 Population Assessment of Tobacco and Health Study (n = 6,608). Methods: Independent sample t-tests and Chi-square tests were conducted to examine group differences. Results: Noncollege young adults had higher prevalence of cigarette, e-cigarette, and marijuana use; college students had higher prevalence of alcohol use. Among current e-cigarette users, college students had higher prevalence of polysubstance use of alcohol and marijuana. College students used e-cigarettes for socializing purposes more. Conclusions: Differences in prevalence and patterns of e-cigarette and other substance use between college and noncollege groups exist. Future interventions should target the social context of college life and reach out to noncollege young adults in workplaces.
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Affiliation(s)
- Anne Buu
- Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Yi-Han Hu
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, Indiana, USA
| | - Su-Wei Wong
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, Indiana, USA
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, Indiana, USA
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17
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Gatzke-Kopp LM, Willoughby MT, Warkentien SM, O'Connor T, Granger DA, Blair C. Magnitude and Chronicity of Environmental Smoke Exposure Across Infancy and Early Childhood in a Sample of Low-Income Children. Nicotine Tob Res 2020; 21:1665-1672. [PMID: 30517756 DOI: 10.1093/ntr/nty228] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 11/02/2018] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Infants and young children may be at an increased risk for second- and thirdhand exposure to tobacco smoke because of increased respiration rate and exposure to surface residue. However, relatively fewer studies have examined biomarkers of exposure (cotinine) in children under age 4 years. This study examines the magnitude and chronicity of exposure across early childhood among children from low-income families in order to better characterize contextual risk factors associated with exposure. METHODS A total of 1292 families were recruited in six nonurban counties of Pennsylvania and North Carolina. Cotinine was assayed from infant saliva at 6, 15, 24, and 48 months of age (N = 1218), and categorized as low (≤0.45 ng/mL), moderate (0.46-12 ng/mL), or high (≥12 ng/mL) at each time point. Categories were highly correlated across time. Latent class analysis was used to summarize patterns of exposure categories across time. RESULTS Magnitude of exposure in this sample was high, with approximately 12% of infants registering cotinine values at least 12 ng/mL, consistent with active smoking in adults. Greater exposure was associated with lower income, less education, more residential instability, and more instability in adult occupants in the home, whereas time spent in center-based day care was associated with lower exposure. CONCLUSIONS Young children from low-income, nonurban communities appear to bear a higher burden of secondhand smoke exposure than previous studies have reported. Results contribute to understanding populations at greater risk, as well as specific, potentially malleable, environmental factors that may be examined as direct contributors to exposure. IMPLICATIONS Results suggest that infants from low-income, nonurban families have higher risk for environmental smoke exposure than data from nationally representative samples. Predictors of exposure offer insights into specific factors that may be targeted for risk reduction efforts, specifically conditions of children's physical space. In addition to considering the increases in risk when an adult smoker lives in a child's home, families should also attend to the possible risk embedded within the home itself, such as residual smoke from previous occupants. For high-risk children, day care appears to mitigate the magnitude of exposure by providing extended time in a smoke-free environment.
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Affiliation(s)
- Lisa M Gatzke-Kopp
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA
| | - Michael T Willoughby
- Education and Workforce Development, RTI International; Research Triangle Park, NC
| | - Siri M Warkentien
- Education and Workforce Development, RTI International; Research Triangle Park, NC
| | - Thomas O'Connor
- Department of Psychiatry, University of Rochester, Rochester, NY
| | - Douglas A Granger
- Department of Psychological Science, Institute for Interdisciplinary Salivary Bioscience, University of California, Irvine, CA.,Department of Acute and Chronic Care, Johsn Hopkins University School of Nursing, Baltimore, MD.,Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.,Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Clancy Blair
- Department of Applied Psychology, New York University, New York, NY
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18
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Matt GE, Quintana PJE, Hoh E, Zakarian JM, Dodder NG, Record RA, Hovell MF, Mahabee-Gittens EM, Padilla S, Markman L, Watanabe K, Novotny TE. Persistent tobacco smoke residue in multiunit housing: Legacy of permissive indoor smoking policies and challenges in the implementation of smoking bans. Prev Med Rep 2020; 18:101088. [PMID: 32368436 PMCID: PMC7186560 DOI: 10.1016/j.pmedr.2020.101088] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/13/2020] [Accepted: 03/29/2020] [Indexed: 01/04/2023] Open
Abstract
Secondhand smoke (SHS) is a common indoor pollutant in multiunit housing (MUH). It is also the precursor of thirdhand smoke (THS), the toxic mixture of tobacco smoke residue that accumulates in indoor environments where tobacco has been used. This study examined the levels, distribution, and factors associated with THS pollution in low-income MUH. Interviews were conducted 2016-2018 in a cross-sectional study of N = 220 MUH homes in San Diego, California. Two surface wipe samples were collected per home and analyzed for nicotine, a THS marker, using liquid chromatography-triple quadrupole mass spectrometry. Nicotine was detected in all homes of nonsmokers with indoor smoking bans (Geo Mean = 1.67 µg/m2; 95% CI = [1.23;2.30]) and smokers regardless of an indoor ban (Geo Mean = 4.80 µg/m2; 95% CI = [1.89;12.19]). Approximately 10% of nonsmokers' homes with smoking bans showed nicotine levels higher than the average level in homes of smokers without smoking bans from previous studies (≥30 µg/m2). Housing for seniors, smoking bans on balconies, indoor tobacco use, difficult to reach surfaces, and self-reported African-American race/ethnicity were independently associated with higher THS levels. Individual cases demonstrated that high levels of surface nicotine may persist in nonsmoker homes for years after tobacco use even in the presence of indoor smoking bans. To achieve MUH free of tobacco smoke pollutants, attention must be given to identifying and remediating highly polluted units and to implementing smoking policies that prevent new accumulation of THS. As THS is a form of toxic tobacco product waste, responsibility for preventing and mitigating harmful impacts should include manufacturers, suppliers, and retailers.
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Affiliation(s)
- Georg E Matt
- San Diego State University Department of Psychology, San Diego, CA, USA
| | | | - Eunha Hoh
- San Diego State University School of Public Health, San Diego, CA, USA
| | - Joy M Zakarian
- San Diego State University Research Foundation, San Diego, CA, USA
| | - Nathan G Dodder
- San Diego State University Research Foundation, San Diego, CA, USA
| | - Rachael A Record
- San Diego State University School of Communication, San Diego, CA, USA
| | | | - E Melinda Mahabee-Gittens
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Samuel Padilla
- San Diego State University Research Foundation, San Diego, CA, USA
| | - Laura Markman
- San Diego State University School of Public Health, San Diego, CA, USA
| | - Kayo Watanabe
- San Diego State University School of Public Health, San Diego, CA, USA
| | - Thomas E Novotny
- San Diego State University School of Public Health, San Diego, CA, USA
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19
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Dunbar ZR, Giovino G, Wei B, O’Connor RJ, Goniewicz ML, Travers MJ. Use of Electronic Cigarettes in Smoke-Free Spaces by Smokers: Results from the 2014-2015 Population Assessment on Tobacco and Health Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030978. [PMID: 32033239 PMCID: PMC7038091 DOI: 10.3390/ijerph17030978] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/31/2020] [Accepted: 01/31/2020] [Indexed: 01/04/2023]
Abstract
Background: Smoke-free air policies exist to protect users and nonusers from exposure to tobacco smoke. Although electronic nicotine delivery systems (ENDS) may expose passerby to nicotine and particulate matter, few US states regulate indoor use of ENDS. The purpose of this study was to investigate reported rationales for ENDS use and reported ENDS use in public smoke-free places by dual cigarette/ENDS users. Methods: A population of ENDS/cigarette co-users (n = 2051) was drawn from Wave 2 of the Population Assessment of Tobacco and Health (PATH) dataset (2014–2015). Harm reduction beliefs and cessation behavior of co-users were investigated as predictors of ENDS use in public smoke-free places using logistic regression. Results: Fifty-eight percent of dual users reported past 30-day ENDS use in public smoke-free places. Reported use of ENDS to cut down on cigarette smoking (OR: 2.38, 95% CI: 1.86, 3.05), as an alternative to quitting tobacco (OR: 1.71, 95% CI: 1.37, 2.13), or because of belief that ENDS help people to quit cigarettes (OR: 1.52, 95% CI: 1.20, 1.92) were significantly associated with increased odds of ENDS use in smoke-free places. Conclusions: Beliefs that ENDS were useful as cessation tools or posed modified risk to users and nonusers were associated with elevated odds of use ENDS in locations where conventional tobacco is prohibited. Due to limitations in the survey instrument, in-home ENDS use could not be directly assessed in this analysis. However, these self-reported findings suggest that use of ENDS in public places where cigarette use is prohibited is prevalent enough to be of concern for future regulation and enforcement efforts.
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Affiliation(s)
- Zachary R. Dunbar
- Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Gary Giovino
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY 14214-8028, USA;
| | - Binnian Wei
- Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Richard J. O’Connor
- Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Maciej L. Goniewicz
- Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Elm and Carlton Streets, Buffalo, NY 14263, USA
| | - Mark J. Travers
- Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Elm and Carlton Streets, Buffalo, NY 14263, USA
- Correspondence:
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20
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Marcham CL, Springston JP. Electronic cigarettes in the indoor environment. REVIEWS ON ENVIRONMENTAL HEALTH 2019; 34:105-124. [PMID: 31112510 DOI: 10.1515/reveh-2019-0012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 03/05/2019] [Indexed: 06/09/2023]
Abstract
The use of electronic cigarettes (e-cigarettes or "vaping") has seen an unprecedented increase worldwide. Vaping has been promoted as a beneficial smoking cessation tool and an alternative nicotine delivery device that contains no combustion by-products. However, nicotine is highly addictive, and the increased use of nicotine-containing e-cigarettes among teens and individuals who are not in need of smoking cessation may lead to overall greater nicotine dependence in the population. Furthermore, available research indicates that vaping solutions and their emissions may contain much more than just nicotine, including aerosolized flavorings, propylene glycol (PG), and other intentional and unintentional contaminants. These materials could present undefined potential health hazards to both e-cigarette users and bystanders, the full extent of which is not well understood at this time. Whereas e-cigarette usage and exposures may lower some or most of the risks associated with conventional cigarette use, the health effects of nicotine and aerosol exposures from e-cigarettes are not well understood. Research indicates that vaping aerosols are not benign, especially for nearby people in areas with limited ventilation and people with compromised health conditions. In addition, e-juice liquids have already been responsible for an increase in accidental poisonings in children. Because the magnitude of health and safety hazards that vaping may present to nonusers remains unclear, it is prudent to manage and control vaping in indoor locations where smoking is currently restricted. Based on a review of current scientific information, the American Industrial Hygiene Association (AIHA) recommends that e-cigarettes should be considered a source of aerosols, volatile organic compounds (VOCs), and particulates in the indoor environment that have not been thoroughly characterized or evaluated for health risk or safety.
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Affiliation(s)
- Cheryl L Marcham
- Department of Graduate Studies, College of Aeronautics, Embry-Riddle Aeronautical University Worldwide Campus, Daytona Beach, FL, USA
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21
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Larcombe AN. Early-life exposure to electronic cigarettes: cause for concern. THE LANCET RESPIRATORY MEDICINE 2019; 7:985-992. [PMID: 31160239 DOI: 10.1016/s2213-2600(19)30189-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 04/17/2019] [Accepted: 04/17/2019] [Indexed: 01/29/2023]
Abstract
Electronic nicotine delivery systems, or ENDS, are devices that heat and aerosolise a solution of propylene glycol, glycerine, nicotine, and flavourings. They have only achieved widespread use in the past 5 years or so, and therefore evidence around their potential to effect health is scarce. Importantly, they are often viewed as safer than tobacco cigarettes, meaning that at-risk populations, including pregnant women, might be more inclined to use them. No human studies, however, have assessed the potential for maternal ENDS use to effect the health of a developing baby. Experimental research suggests that nicotine alone is likely to adversely affect the fetus. Further, there is a misconception that ENDS do not produce second-hand aerosols. This misconception might put infants and young children at risk because their parents are more likely to use ENDS around them than they are to use tobacco cigarettes. Emerging evidence also proposes that nicotine and other substances produced by ENDS can deposit onto surfaces, and subsequently be exposed to infants and children; a process known as third-hand exposure. Finally, ENDS are often refillable, and instances of accidental poisonings of children who drink nicotine-containing refills have occurred. Thus, there are a multitude of ways that, with respect to early-life exposures and health, ENDS are a cause for concern.
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Affiliation(s)
- Alexander N Larcombe
- Telethon Kids Institute, Perth Children's Hospital, Nedlands, WA, Australia; School of Public Health, Curtin University, Bentley, WA, Australia.
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22
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Marcham CL, Floyd EL, Wood BL, Arnold S, Johnson DL. E-cigarette nicotine deposition and persistence on glass and cotton surfaces. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2019; 16:349-354. [PMID: 30870115 DOI: 10.1080/15459624.2019.1581366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Nicotine from electronic cigarette aerosol will deposit on surfaces immediately after vaping, but how long deposited nicotine will persist on various surfaces is unknown. This work exposed glass and terrycloth (cotton) materials to electronic cigarette aerosols for 1 hr, assessed the initial nicotine sorption, and characterized surface persistence over a 72-hr period. Exponential decay of surface concentration was observed for both materials. Terrycloth had higher initial nicotine deposition and retained nicotine substantially longer than glass. Residual nicotine concentrations persisted on both surface types for 72 hr. Statistical modeling predicted surface concentrations to reach background levels after 4 and 16 days for glass and terrycloth, respectively. Nicotine persistence was long enough to pose a potential thirdhand nicotine exposure risk, and reactions to produce tobacco-specific nitrosamines may be possible from nicotine deposition from electronic cigarette aerosols, but further study is needed.
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Affiliation(s)
- Cheryl L Marcham
- a Embry-Riddle Aeronautical University , Daytona Beach , Florida
| | - Evan L Floyd
- b University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma
| | - Beverly L Wood
- a Embry-Riddle Aeronautical University , Daytona Beach , Florida
| | - Susan Arnold
- c University of Minnesota , Minneapolis , Minnesota
| | - David L Johnson
- b University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma
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Khachatoorian C, Jacob P, Sen A, Zhu Y, Benowitz NL, Talbot P. Identification and quantification of electronic cigarette exhaled aerosol residue chemicals in field sites. ENVIRONMENTAL RESEARCH 2019; 170:351-358. [PMID: 30623881 PMCID: PMC6410739 DOI: 10.1016/j.envres.2018.12.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/04/2018] [Accepted: 12/13/2018] [Indexed: 05/11/2023]
Abstract
BACKGROUND Electronic cigarette (EC) users may exhale large clouds of aerosol that can settle on indoor surfaces forming ECEAR (EC exhaled aerosol residue). Little is known about the chemical composition or buildup of this residue. OBJECTIVE Our objective was to identify and quantify ECEAR chemicals in two field sites: an EC user's living room and a multi-user EC vape shop. METHODS We examined the buildup of ECEAR in commonly used materials (cotton, polyester, or terrycloth towel) placed inside the field sites. Materials were subjected to different lengths of exposure. Nicotine, nicotine alkaloids, and tobacco-specific nitrosamines (TSNAs) were identified and quantified in unexposed controls and field site samples using analytical chemical techniques. RESULTS Nicotine and nicotine alkaloids were detected in materials inside the EC user's living room. Concentrations of ECEAR chemicals remained relatively constant over the first 5 months, suggesting some removal of the chemicals by air flow in the room approximating a steady state. ECEAR chemicals were detected in materials inside the vape shop after 6 h of exposure and levels continually increased over a month. By 1 month, the nicotine in the vape shop was 60 times higher than in the EC user's living room. ECEAR chemical concentrations varied in different locations in the vape shop. Control fabrics had either no detectable or very low concentrations of chemicals. CONCLUSIONS In both field sites, chemicals from exhaled EC aerosols were deposited on indoor surfaces and accumulated over time forming ECEAR. Non-smokers, EC users, and employees of vape shops should be aware of this potential environmental hazard.
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Affiliation(s)
- Careen Khachatoorian
- Cell, Molecular, and Developmental Biology Graduate Program, University of California, Riverside, Riverside, CA, United States
| | - Peyton Jacob
- Departments of Medicine and Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Amy Sen
- Department of Environmental Health Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Yifang Zhu
- Department of Environmental Health Sciences, University of California, Los Angeles, Los Angeles, CA, United States
| | - Neal L Benowitz
- Departments of Medicine and Bioengineering & Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Prue Talbot
- Department of Molecular, Cell & Systems Biology University of California, Riverside, Riverside, CA, United States.
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Nabi-Burza E, Regan S, Walters BH, Drehmer JE, Rigotti NA, Ossip DJ, Gorzkowski JA, Levy DE, Winickoff JP. Parental Dual Use of e-Cigarettes and Traditional Cigarettes. Acad Pediatr 2019; 19:842-848. [PMID: 30981026 PMCID: PMC6732020 DOI: 10.1016/j.acap.2019.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/02/2019] [Accepted: 04/06/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND E-cigarettes are growing in popularity. Dual use of e-cigarettes and cigarettes is an increasingly common practice, but little is known about patterns of dual use in parents. We sought to describe smoking-related behaviors among dual-users. METHODS Parent exit surveys were conducted following their child's visit in 5 control pediatric practices in 5 states participating in the Clinical Effort Against Secondhand Smoke Exposure trial. We examined factors associated with dual use of e-cigarettes and cigarettes versus cigarette-only smokers, assessed by self-report. RESULTS Of 1382 smokers or recent quitters screened after their child's visit between April and October 2017, 943 (68%) completed the survey. Of these, 727 parents reported current use of cigarettes; of those, 81 (11.1%) also reported e-cigarette use, meeting the definition of dual use. Compared with cigarette-only smokers, dual users were more likely to have a child younger than 1 year old, planned to quit in the next 6 months, and had tried to quit in the past (had a quit attempt in the past 3 months, called the quitline, or used medicine to quit in the past 2 years; P < .05 for each). CONCLUSIONS Parents who use both e-cigarettes and cigarettes may have greater rates of contemplating smoking cessation than parents who only smoke cigarettes. These parents may be using e-cigarettes for harm reduction or as a step toward cessation. Identification of these parents may provide an opportunity to deliver effective treatment, including nicotine-replacement therapies that do not expose infants and children to e-cigarette aerosol.
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Affiliation(s)
- Emara Nabi-Burza
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, United States,Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States
| | - Susan Regan
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States
| | - Bethany Hipple Walters
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, United States,Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States
| | - Jeremy E. Drehmer
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, United States,Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States
| | - Nancy A. Rigotti
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States,Harvard Medical School, Boston, MA,Massachusetts General Hospital, Mongan Institute Health Policy Center
| | - Deborah J. Ossip
- University of Rochester Medical Center, Department of Public Health Sciences, Rochester, NY
| | - Julie A. Gorzkowski
- American Academy of Pediatrics, Julius B. Richmond Center of Excellence, Itasca, IL
| | - Douglas E. Levy
- Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States,Harvard Medical School, Boston, MA,Massachusetts General Hospital, Mongan Institute Health Policy Center
| | - Jonathan P. Winickoff
- Massachusetts General Hospital for Children, Division of General Academic Pediatrics, Boston, MA, United States,Massachusetts General Hospital, Tobacco Research and Treatment Center, Boston, MA, United States,Harvard Medical School, Boston, MA,American Academy of Pediatrics, Julius B. Richmond Center of Excellence, Itasca, IL
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25
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Díez-Izquierdo A, Cassanello-Peñarroya P, Lidón-Moyano C, Matilla-Santander N, Balaguer A, Martínez-Sánchez JM. Update on thirdhand smoke: A comprehensive systematic review. ENVIRONMENTAL RESEARCH 2018; 167:341-371. [PMID: 30096604 DOI: 10.1016/j.envres.2018.07.020] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 07/09/2018] [Accepted: 07/09/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The objective of this study is to perform a comprehensive review of the literature about thirdhand smoke (THS). METHODS Systematic review of all aspects of THS. Standard methodological procedures were used to search the following databases through April 2018: MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science (WOS) in Indo-European languages. To identify published grey literature, the first 200 hits from Google Scholar™ were evaluated. Clinical trial databases, conference proceedings, and reference lists from the identified articles were also searched. Two unblinded review authors independently assessed trials for inclusion in the review. These same reviewers also extracted study data in accordance with PRISMA guidelines. The study protocol was registered with PROSPERO (CRD42018083619). RESULTS Sixty-eight articles were included in this systematic review. Of these, 28 analyzed the concentration of nicotine as a component of THS (the most commonly-used method to measure THS in those studies was chromatography, followed by the mass spectrometry), 21 evaluated the exposure and impact of THS on health (11 studies analyzed the effect of THS in cells [human and animal], 4 in animals, 1 in adults, and 5 in children), 16 investigated the beliefs, behaviours, and policies related to THS, and 3 evaluated other aspects such as THS in e-cigarettes or hookahs. In these 68 studies, THS was determined by measuring the following components: nicotine (30 studies), nitrosamines (17 studies) and cotinine (15 studies). The findings from most of these studies suggest a potential health impact of THS exposure (i.e.: cytotoxicity, metabolic alterations in metabolism, in glycemia; or cell structure; alterations in liver, lung, skin and behaviour in mice), and low awareness about the risks of THS among the general population. CONCLUSIONS Numerous specific biomarkers of THS were evaluated, with the most common being nicotine, nitrosamines, and cotinine. The most common method of preparing THS dust samples were cotton wipes, while chromatography, used alone or coupled with mass spectrometry, was the most common analytical technique. We have tried to establish common bases after reviewing all the current literature of the THS although, there is great heterogeneity between the studies and we have not always succeeded. The studies in this review demonstrate the harmful effects of THS on health in cells, in animal models, and in people including children. However, in people, the long-term effects remain unknown and more research is needed. These studies show that knowledge about THS and its potential harmful effects are poorly understood among the general population. For this reason, THS should receive greater emphasis in education and awareness policies.
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Affiliation(s)
- Ana Díez-Izquierdo
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Paediatrics Department, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Pia Cassanello-Peñarroya
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Paediatrics Department, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Cristina Lidón-Moyano
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Group of Evaluation of Health Determinants and Health Policies, Departament de Ciències Bàsiques, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Nuria Matilla-Santander
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Group of Evaluation of Health Determinants and Health Policies, Departament de Ciències Bàsiques, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Albert Balaguer
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Paediatrics Department, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Spain
| | - Jose M Martínez-Sánchez
- Faculty of Medicine and Health Science, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain; Group of Evaluation of Health Determinants and Health Policies, Departament de Ciències Bàsiques, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain.
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Khachatoorian C, Jacob Iii P, Benowitz NL, Talbot P. Electronic cigarette chemicals transfer from a vape shop to a nearby business in a multiple-tenant retail building. Tob Control 2018; 28:519-525. [PMID: 30158206 DOI: 10.1136/tobaccocontrol-2018-054316] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Electronic cigarettes (ECs) are nicotine delivery devices that produce aerosol without combustion of tobacco; therefore, they do not produce sidestream smoke. Nevertheless, many users exhale large clouds of aerosol that can result in passive exposure of non-users. Analogous to thirdhand cigarette smoke, the exhaled aerosol also settles on indoor surfaces where it can produce a residue. We refer to this residue as EC exhaled aerosol residue (ECEAR). Our objective was to determine if exhaled EC aerosol transferred from a vape shop in a multiple-tenant retail building, where it was produced, to a nearby business (field site) where it could deposit as ECEAR. METHODS We examined the build-up of ECEAR in commonly used materials (cotton towel and paper towels) placed inside the field site across from the vape shop. Materials were subjected to short-term (days) and long-term (months) exposures. Nicotine, other alkaloids and tobacco-specific nitrosamines (TSNAs) were identified and quantified in controls and field site samples using analytical chemical techniques. RESULTS Nicotine and other alkaloids were detected after 1 day of exposure in the field site, and these chemicals generally increased as exposure times increased. TSNAs, which have been linked to carcinogenesis, were also detected in short-term and long-term exposed samples from the field site. CONCLUSIONS In a multiple-tenant retail building, chemicals in EC aerosol travelled from a vape shop into an adjacent business where they deposited forming ECEAR. Regulatory agencies and tenants occupying such buildings should be aware of this potential environmental hazard.
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Affiliation(s)
- Careen Khachatoorian
- Cell Molecular and Developmental Biology Graduate Program, University of California, Riverside, California, USA
| | - Peyton Jacob Iii
- Division of Clinical Pharmacology, University of California, San Francisco, California, USA
| | - Neal L Benowitz
- Departments of Medicine, Psychiatry and Bioengineering and Therapeutic Sciences, University of California, San Francisco, California, USA
| | - Prue Talbot
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, California, USA
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27
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Rostami AA, Agyemang S, Pithawalla YB. A distributed computational model for estimating room air level of constituents due to aerosol emission from e-vapor product use. Food Chem Toxicol 2018; 116:114-128. [PMID: 29653179 DOI: 10.1016/j.fct.2018.04.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/09/2018] [Indexed: 11/28/2022]
Abstract
Most indoor air quality models reported in the literature are well-mixed models. A well-mixed model estimates the room average concentration of constituents from sources. It does not provide information on (1) how far and how fast the emitted chemicals travel in the indoor space? And (2) how the concentration changes as a function of distance from the emission source? We developed a distributed model, using computational fluid dynamics and thermodynamics principles, which allows for aerosol dispersion in an indoor space and includes evaporation and condensation of constituents in a multi-compound aerosol mixture. The distributed model can estimate the spatial and temporal variations of the concentration of individual constituents present in the emitted aerosol in vapor and particulate phases separately. Results from the model were compared with the published experimental data and were found to be in good agreement. A sensitivity analysis was performed to evaluate the impact of various parameters that affect the air level of the emitted constituents within an indoor space, including rate of emission, the rate of air exchange, etc. The model can also be used to estimate the level of second hand exposure in a confined space where e-vapor products (EVPs) are used.
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Affiliation(s)
- Ali A Rostami
- Altria Client Services LLC, Research, Development and Sciences, 601 East Jackson Street, Richmond, VA 23219, USA.
| | - Samuel Agyemang
- TriMech Solutions LLC, 4461 Cox Rd. Suite 302, Glen Allen, VA 23060, USA
| | - Yezdi B Pithawalla
- Altria Client Services LLC, Research, Development and Sciences, 601 East Jackson Street, Richmond, VA 23219, USA
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28
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DeVito EE, Krishnan-Sarin S. E-cigarettes: Impact of E-Liquid Components and Device Characteristics on Nicotine Exposure. Curr Neuropharmacol 2018; 16:438-459. [PMID: 29046158 PMCID: PMC6018193 DOI: 10.2174/1570159x15666171016164430] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 08/09/2017] [Accepted: 10/13/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Electronic cigarette (e-cigarette) use has increased substantially in recent years. While e-cigarettes have been proposed as a potentially effective smoking cessation tool, dualuse in smokers is common and e-cigarettes are widely used by non-smokers, including youth and young-adult non-smokers. Nicotine, the primary addictive component in cigarettes, is present at varying levels in many e-liquids. E-cigarettes may lead to initiation of nicotine use in adult and youth non-smokers, re-initiation of nicotine dependence in ex-smokers or increased severity of nicotine dependence in dual-users of cigarettes and e-cigarettes. As such, there are important clinical and policy implications to understanding factors impacting nicotine exposure from e-cigarettes. However, the broad and rapidly changing range of e-liquid constituents and e-cigarette hardware which could impact nicotine exposure presents a challenge. Recent changes in regulatory oversight of e-cigarettes underscore the importance of synthesizing current knowledge on common factors which may impact nicotine exposure. METHODS This review focuses on factors which may impact nicotine exposure by changing e-cigarette use behavior, puff topography, altering the nicotine yield (amount of nicotine exiting the e-cigarette mouth piece including nicotine exhaled as vapor) or more directly by altering nicotine absorption and bioavailability. RESULTS Topics reviewed include e-liquid components or characteristics including flavor additives (e.g., menthol), base e-liquid ingredients (propylene glycol, vegetable glycerin), components commonly used to dissolve flavorants (e.g., ethanol), and resulting properties of the e-liquid (e.g., pH), e-cigarette device characteristics (e.g., wattage, temperature, model) and user behavior (e.g., puff topography) which may impact nicotine exposure. CONCLUSION E-liquid characteristics and components, e-cigarette hardware and settings, and user behavior can all contribute substantially to nicotine exposure from e-cigarettes.
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Affiliation(s)
- Elise E. DeVito
- Yale University School of Medicine, Department of Psychiatry, New Haven, CT, USA
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29
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Zainol Abidin N, Zainal Abidin E, Zulkifli A, Karuppiah K, Syed Ismail SN, Amer Nordin AS. Electronic cigarettes and indoor air quality: a review of studies using human volunteers. REVIEWS ON ENVIRONMENTAL HEALTH 2017; 32:235-244. [PMID: 28107173 DOI: 10.1515/reveh-2016-0059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 11/25/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This paper is primarily aimed to review articles on electronic cigarettes (e-cigarettes) focusing on indoor air quality (IAQ) assessment that were conducted using human volunteers under natural settings that mimic actual vaping scenarios. Such studies may give a better representation of the actual potential exposure towards e-cigarettes emissions in indoor settings. METHODS A systematic literature search was conducted using PubMed search engine database. Search terms such as "electronic cigarette", "e-cigarette", "electronic nicotine delivery system", and "indoor air quality" were used to identify the relevant articles to be included in this review. Articles that involved human volunteers who were asked to vape in natural settings or settings that mimic the actual vaping scenario were chosen to be reviewed. The search yielded a total of 15 published articles. Eleven articles were excluded due to 1) unavailability of its full-text (n=1), 2) did not involve human volunteers (n=5) and 3) did not involve an IAQ study (n=5). Four articles were critically reviewed in this paper. RESULTS From the four selected articles, two of the papers focused on the determination of nicotine level released by e-cigarettes whereas the other two covered IAQ parameters namely; particulate matters (PM), propylene glycols, formaldehyde, metals and polycyclic aromatic hydrocarbons (PAHs). Only two of the studies involved determination of biomarkers of exposure. The level of chemical contents released varied between studies. The differences in the brands of e-cigarette used, number of vapers recruited and the sensitivity of the methodologies employed in these studies may be the possible causes for such differences. However, studies using human volunteers conducted in a natural setting are more relevant to portray the actual exposure to vapors among e-cigarettes users and non-users compared to studies using a smoking machine/an exposure chamber. This is because such studies take into account the behavior of consumers and individual retention of nicotine. Such method will therefore avoid the possibility of overestimation in terms of exposures toward e-cigarettes users and non-users. CONCLUSION There are limited e-cigarette studies on the impact of IAQ performed using human volunteers in natural settings. The available studies however, provided inconsistent scientific evidence on the actual exposure towards the vapor contents as unstandardized methodology were used in conducting such research. Therefore, there is a need to conduct IAQ studies in natural settings by using a standardized protocol in terms of the number of vapers recruited, the size of the indoor settings, the methods used in detecting and quantifying the contents and levels of emissions and the sensitivity of the equipment used in analyzing the contents. This will help in better utilization of the findings from such studies for the use of risk assessment of the exposures towards e-cigarette emissions. There is also a need to emphasize that it is the onus of the manufacturers in providing and proving scientifically sound safety claims for their products prior to commercializing it in the market.
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30
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Liu J, Liang Q, Oldham MJ, Rostami AA, Wagner KA, Gillman IG, Patel P, Savioz R, Sarkar M. Determination of Selected Chemical Levels in Room Air and on Surfaces after the Use of Cartridge- and Tank-Based E-Vapor Products or Conventional Cigarettes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14090969. [PMID: 28846634 PMCID: PMC5615506 DOI: 10.3390/ijerph14090969] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/07/2017] [Accepted: 08/16/2017] [Indexed: 02/08/2023]
Abstract
There is an ongoing debate regarding the potential of secondhand exposure of non-users to various chemicals from use of e-vapor products (EVPs). Room air levels of 34 chemicals (nicotine, propylene glycol (PG), glycerol, 15 carbonyl chemicals, 12 volatile organic chemicals (VOCs), and four selected trace elements) were measured where EVPs and cigarettes were used by n = 37 healthy adult tobacco users in an exposure chamber. The products used were MarkTen® 2.5% Classic (Group I), a Prototype GreenSmoke® 2.4% (Group II), Ego-T® Tank with subjects' own e-liquids (Group III) and subjects' own conventional cigarettes (Group IV). Products were used under controlled conditions and 4-h ad libitum use. Background (without subjects) and baseline levels (with subjects) were measured. Cumulative 4-h. levels of nicotine, PG and glycerol measured were several-fold below the time-weighted average limits used in workplace exposure evaluation. Most the other chemicals (>75%) were at or below the limit of quantification during EVP use. Significant levels of chemicals (17 out of 34) were observed in Group IV. Overall, our results indicate that under the study conditions with the products tested, cumulative room air levels of the selected chemicals measured over 4-h were relatively small and were several-fold below the current occupational regulatory and consensus limits.
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Affiliation(s)
- Jianmin Liu
- Center for Research and Technology, Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA 23219, USA.
| | - Qiwei Liang
- Center for Research and Technology, Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA 23219, USA.
| | - Michael J Oldham
- Center for Research and Technology, Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA 23219, USA.
| | - Ali A Rostami
- Center for Research and Technology, Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA 23219, USA.
| | - Karl A Wagner
- Center for Research and Technology, Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA 23219, USA.
| | - I Gene Gillman
- Enthalpy Analytical Inc., 800 Capitola Drive, Durham, NC 27713, USA.
| | - Piyush Patel
- Inflamax Research Inc., 1310 Fewster Drive, Mississauga, ON L4W 1A4, Canada.
| | - Rebecca Savioz
- Clinopsis SA, Chemin des Jardins 6, 1426 Concise, Switzerland.
| | - Mohamadi Sarkar
- Center for Research and Technology, Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA 23219, USA.
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Qasim H, Karim ZA, Rivera JO, Khasawneh FT, Alshbool FZ. Impact of Electronic Cigarettes on the Cardiovascular System. J Am Heart Assoc 2017; 6:JAHA.117.006353. [PMID: 28855171 PMCID: PMC5634286 DOI: 10.1161/jaha.117.006353] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Hanan Qasim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas El Paso, El Paso, TX
| | - Zubair A Karim
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas El Paso, El Paso, TX
| | - Jose O Rivera
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas El Paso, El Paso, TX
| | - Fadi T Khasawneh
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas El Paso, El Paso, TX
| | - Fatima Z Alshbool
- Department of Pharmaceutical Sciences, School of Pharmacy, The University of Texas El Paso, El Paso, TX
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32
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Davis ES, Sassano MF, Goodell H, Tarran R. E-Liquid Autofluorescence can be used as a Marker of Vaping Deposition and Third-Hand Vape Exposure. Sci Rep 2017; 7:7459. [PMID: 28785072 PMCID: PMC5547159 DOI: 10.1038/s41598-017-07862-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/04/2017] [Indexed: 11/17/2022] Open
Abstract
In the past 5 years, e-cigarette use has been increasing rapidly, particularly in youth and young adults. Due to the novelty of e-cigarettes (e-cigs) and e-cigarette liquids (e-liquids), research on their chemo-physical properties is still in its infancy. Here, we describe a previously unknown and potentially useful property of e-liquids, namely their autofluorescence. We performed an emission scan at 9 excitation wavelengths common to fluorescent microscopy and found (i) that autofluorescence differs widely between e-liquids, (ii) that e-liquids are most fluorescent in the UV range (between 350 and 405 nm) and (iii) fluorescence intensity wanes as the emission wavelength increases. Furthermore, we used the autofluorescence of e-liquids as a marker for tracking e-cig aerosol deposition in the laboratory. Using linear regression analysis, we were able to quantify the deposition of a “vaped” e-liquid onto hard surfaces. Using this technique, we found that every 70 mL puff of an e-cigarette deposited 0.019% e-liquid (v/v) in a controlled environment. Finally, we vaped a surface in the laboratory and used our method to detect e-cig aerosol third-hand exposure. In conclusion, our data suggest that e-cigarette autofluorescence can be used as a marker of e-cigarette deposition.
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Affiliation(s)
- Eric S Davis
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina, Chapel Hill, NC, USA
| | - M Flori Sassano
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina, Chapel Hill, NC, USA
| | - Henry Goodell
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA
| | - Robert Tarran
- Marsico Lung Institute/Cystic Fibrosis Research Center, University of North Carolina, Chapel Hill, NC, USA. .,Department of Cell Biology & Physiology, University of North Carolina, Chapel Hill, NC, USA.
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Laube BL, Afshar-Mohajer N, Koehler K, Chen G, Lazarus P, Collaco JM, McGrath-Morrow SA. Acute and chronic in vivo effects of exposure to nicotine and propylene glycol from an E-cigarette on mucociliary clearance in a murine model. Inhal Toxicol 2017. [PMID: 28651446 DOI: 10.1080/08958378.2017.1336585] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To determine the effect of an acute (1 week) and chronic (3 weeks) exposure to E-cigarette (E-cig) emissions on mucociliary clearance (MCC) in murine lungs. METHODS C57BL/6 male mice (age 10.5 ± 2.4 weeks) were exposed for 20 min/day to E-cigarette aerosol generated by a Joyetech 510-T® E-cig containing either 0% nicotine (N)/propylene glycol (PG) for 1 week (n = 6), or 3 weeks (n = 9), or 2.4% N/PG for one week (n = 6), or 3 weeks (n = 9), followed by measurement of MCC. Control mice (n = 15) were not exposed to PG alone, or N/PG. MCC was assessed by gamma camera following aspiration of 99mtechnetium aerosol and was expressed as the amount of radioactivity removed from both lungs over 6 hours (MCC6hrs). Venous blood was assayed for cotinine levels in control mice and in mice exposed for 3-weeks to PG alone and N/PG. RESULTS MCC6hrs in control mice and in mice acutely exposed to PG alone and N/PG was similar, averaging (±1 standard deviation) 8.6 ± 5.2%, 7.5 ± 2.8% and 11.2 ± 5.9%, respectively. In contrast, chronic exposure to PG alone stimulated MCC6hrs (17.2 ± 8.0)% and this stimulation was significantly blunted following chronic exposure to N/PG (8.7 ± 4.6)% (p < .05). Serum cotinine levels were <0.5 ng/ml in control mice and in mice exposed to PG alone, whereas, N/PG exposed mice averaged 14.6 ± 12.0 ng/ml. CONCLUSIONS In this murine model, a chronic, daily, 20 min-exposure to N/PG, but not an acute exposure, slowed MCC, compared to exposure to PG alone and led to systemic absorption of nicotine.
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Affiliation(s)
- Beth L Laube
- a Department of Pediatrics , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Nima Afshar-Mohajer
- b Department of Environmental Health Sciences , Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA
| | - Kirsten Koehler
- b Department of Environmental Health Sciences , Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA
| | - Gang Chen
- c Department of Pharmaceutical Science , Washington State University , Spokane , WA , USA
| | - Philip Lazarus
- c Department of Pharmaceutical Science , Washington State University , Spokane , WA , USA
| | - Joseph M Collaco
- a Department of Pediatrics , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | - Sharon A McGrath-Morrow
- a Department of Pediatrics , Johns Hopkins University School of Medicine , Baltimore , MD , USA
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Zucchet A, Schmaltz G. Electronic cigarettes—A review of the physiological health effects. Facets (Ott) 2017. [DOI: 10.1139/facets-2017-0014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Electronic cigarettes (ECs) are devices that are used recreationally or as smoking cessation tools, and have become increasingly popular in recent years. We conducted a review of the available literature to determine the health effects caused by the use of these devices. A heating element in the EC aerosolizes a solution of propylene glycol, glycerol, nicotine (optional), and flavouring (optional). These compounds are generally harmless on their own. However, upon heating, they produce various carcinogens and irritants. We found that concentrations of these toxicants vary significantly depending on the type of EC device, the type of EC liquid, and the smoking behaviour of the user. Exposure to these vapours can cause inflammation and oxidative damage to in vitro and in vivo cells. EC aerosol can also potentially affect organ systems and especially cardiovascular and lung function. We concluded that EC use causes acute effects on health but not as severe as those of conventional cigarettes (CCs). These devices could, therefore, be of use for smokers of CCs wishing to quit. However, as EC aerosol introduces new toxicants not found in CCs, long-term studies are needed to investigate possible chronic effects associated with EC use.
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Affiliation(s)
- Alyssa Zucchet
- Department of Biology, University of the Fraser Valley, Abbotsford, BC V2S 7M8, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Grégory Schmaltz
- Department of Biology, University of the Fraser Valley, Abbotsford, BC V2S 7M8, Canada
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Melstrom P, Koszowski B, Thanner MH, Hoh E, King B, Bunnell R, McAfee T. Measuring PM2.5, Ultrafine Particles, Nicotine Air and Wipe Samples Following the Use of Electronic Cigarettes. Nicotine Tob Res 2017; 19:1055-1061. [DOI: 10.1093/ntr/ntx058] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 03/06/2017] [Indexed: 11/12/2022]
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Mohanty VR, Chahar P, Balappanavar AY, Yadav V. Electronic Nicotine Delivery Systems (ENDS): Mapping the Indian Online Retail Market. Nicotine Tob Res 2017; 19:1386-1389. [PMID: 28199725 DOI: 10.1093/ntr/ntx044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 02/07/2017] [Indexed: 11/12/2022]
Affiliation(s)
- Vikrant R Mohanty
- Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Puneet Chahar
- Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Aswini Y Balappanavar
- Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Vipul Yadav
- Department of Public Health Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
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Glasser AM, Collins L, Pearson JL, Abudayyeh H, Niaura RS, Abrams DB, Villanti AC. Overview of Electronic Nicotine Delivery Systems: A Systematic Review. Am J Prev Med 2017; 52:e33-e66. [PMID: 27914771 PMCID: PMC5253272 DOI: 10.1016/j.amepre.2016.10.036] [Citation(s) in RCA: 320] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/07/2016] [Accepted: 10/26/2016] [Indexed: 12/20/2022]
Abstract
CONTEXT Rapid developments in e-cigarettes, or electronic nicotine delivery systems (ENDS), and the evolution of the overall tobacco product marketplace warrant frequent evaluation of the published literature. The purpose of this article is to report updated findings from a comprehensive review of the published scientific literature on ENDS. EVIDENCE ACQUISITION The authors conducted a systematic review of published empirical research literature on ENDS through May 31, 2016, using a detailed search strategy in the PubMed electronic database, expert review, and additional targeted searches. Included studies presented empirical findings and were coded to at least one of nine topics: (1) Product Features; (2) Health Effects; (3) Consumer Perceptions; (4) Patterns of Use; (5) Potential to Induce Dependence; (6) Smoking Cessation; (7) Marketing and Communication; (8) Sales; and (9) Policies; reviews and commentaries were excluded. Data from included studies were extracted by multiple coders (October 2015 to August 2016) into a standardized form and synthesized qualitatively by topic. EVIDENCE SYNTHESIS There were 687 articles included in this systematic review. The majority of studies assessed patterns of ENDS use and consumer perceptions of ENDS, followed by studies examining health effects of vaping and product features. CONCLUSIONS Studies indicate that ENDS are increasing in use, particularly among current smokers, pose substantially less harm to smokers than cigarettes, are being used to reduce/quit smoking, and are widely available. More longitudinal studies and controlled trials are needed to evaluate the impact of ENDS on population-level tobacco use and determine the health effects of longer-term vaping.
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Affiliation(s)
- Allison M Glasser
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia.
| | - Lauren Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Jennifer L Pearson
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Haneen Abudayyeh
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, District of Columbia
| | - Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, District of Columbia; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Meng Q, Schwander S, Son Y, Rivas C, Delveno C, Graber J, Giovenco D, Bruen U, Mathew R, Robson M. Has the mist been peered through? Revisiting the building blocks of human health risk assessment for electronic cigarette use. HUMAN AND ECOLOGICAL RISK ASSESSMENT : HERA 2016; 22:558-579. [PMID: 38162291 PMCID: PMC10756495 DOI: 10.1080/10807039.2015.1100064] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Background Electronic cigarettes, battery-powered nicotine delivery devices, have been increasingly used in the past decade. However, human health risks associated with E-vapor inhalation have not been fully characterized. Aims This critical review aims at revisiting the building blocks of human health risk assessment, summarizing the state of the science, and identifying major knowledge gaps in exposure assessment and toxicity assessment. Approach A qualitative research synthesis was conducted based on scientific findings reported to date in peer-reviewed publications and our own preliminary experimental results. Results There are a limited number of studies across all lines of evidence on E-vapor exposure and the health impacts of E-vapor inhalation. E-cigarette may be as efficient as traditional cigarettes in nicotine delivery, especially for experienced users, and studies suggest lower emissions of air toxics from E-cigarette vapor and lower second- and third-hand vapor exposures. But some toxic emissions may surpass those of traditional cigarettes, especially under high voltage vaping conditions. Experimentally, E-vapor/E-liquid exposures reduce cell viability and promote pro-inflammatory cytokine release. User vulnerability to concomitant environmental agent exposures, such as viruses and bacteria, may potentially be increased. Conclusion While evidence to date suggests that e-cigarettes release fewer toxins and carcinogens and compared to cigarettes, E-vapor is not safe and might adversely affect human immune functions. Major knowledge gaps hinder risk quantification and effective regulation of E-cigarette products including: 1) lack of long-term exposure studies; 2) lack of understanding of biological mechanisms associated with exposure; and 3) lack of integration of exposure and toxicity assessments.,. Better data are needed to inform human health risk assessments and to better understand the public health impact of E-vapor exposures.
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Affiliation(s)
- Qingyu Meng
- School of Public Health, Rutgers University, Piscataway, NJ, USA
- Center for Tobacco Studies, Rutgers University, New Brunswick, NJ, USA
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - Stephan Schwander
- School of Public Health, Rutgers University, Piscataway, NJ, USA
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - Yeongkwon Son
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Cesar Rivas
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Cristine Delveno
- School of Public Health, Rutgers University, Piscataway, NJ, USA
- Center for Tobacco Studies, Rutgers University, New Brunswick, NJ, USA
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - Judith Graber
- School of Public Health, Rutgers University, Piscataway, NJ, USA
- Center for Tobacco Studies, Rutgers University, New Brunswick, NJ, USA
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
| | - Daniel Giovenco
- School of Public Health, Rutgers University, Piscataway, NJ, USA
- Center for Tobacco Studies, Rutgers University, New Brunswick, NJ, USA
| | - Uma Bruen
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Rose Mathew
- School of Public Health, Rutgers University, Piscataway, NJ, USA
| | - Mark Robson
- School of Public Health, Rutgers University, Piscataway, NJ, USA
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
- School of Environmental and Biological Sciences Rutgers University, New Brunswick, NJ, USA
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Martínez-Sánchez JM, Fu M, Martín-Sánchez JC, Ballbè M, Saltó E, Fernández E. Perception of electronic cigarettes in the general population: does their usefulness outweigh their risks? BMJ Open 2015; 5:e009218. [PMID: 26534735 PMCID: PMC4636602 DOI: 10.1136/bmjopen-2015-009218] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To describe and compare the perceptions of the general population about the harmful effects of electronic cigarettes (e-cigarettes) on users and on those passively exposed to e-cigarettes and the perceptions about e-cigarette usefulness for reducing or eliminating tobacco smoking. DESIGN, SETTING, AND PARTICIPANTS We analysed cross-sectional data from a longitudinal study of a representative sample of the general adult (≥16 years) population of Barcelona, Spain (336 men and 400 women). The fieldwork was conducted between May 2013 and February 2014. We computed the percentages, adjusted OR and their corresponding 95% CI among participants with some awareness of e-cigarettes (79.2% of the sample). PRIMARY AND SECONDARY OUTCOME MEASURES We assessed the perception about harmfulness for e-cigarette users and for passively exposed non-e-cigarette users, as well as the perception of usefulness for smokers of cigarette cessation and reduction. RESULTS In this sample, 40.1% thought that e-cigarettes had a harmful effect on users, and 27.1% thought that e-cigarettes had a harmful effect on passively exposed bystanders (p<0.001). Particularly, more never-smokers perceived that e-cigarettes had harmful effects on passively exposed bystanders than current smokers (34.4% vs 20.6%; OR=1.93, 95% CI 1.02 to 3.63). More people perceived e-cigarettes as being useful for reducing smoking than for quitting (50.6% vs 29.9%, p<0.001), as well as for reducing smoking than as being harmful to users (50.6% vs 40.1%, p=0.044). DISCUSSION The perception that e-cigarettes are useful for reducing tobacco consumption was more prevalent than the perception that e-cigarettes are harmful to users and to those passively exposed to e-cigarettes. Advertisements and messages about the use of e-cigarettes and their harmful effects should be regulated and based on scientific evidence to avoid creating erroneous ideas about their use.
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Affiliation(s)
- Jose M Martínez-Sánchez
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge—IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge—IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Juan Carlos Martín-Sánchez
- Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Montse Ballbè
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge—IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
- Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Esteve Saltó
- Health Plan Directorate, Ministry of Health, Generalitat de Catalunya, Barcelona, Spain
- Department of Public Health, Universitat de Barcelona, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
- Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge—IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
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Bell K, Stimson GV. Nicotine: Science, regulation and policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:533-5. [PMID: 25890784 DOI: 10.1016/j.drugpo.2015.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Kirsten Bell
- Department of Anthropology, University of British Columbia, Canada.
| | - Gerry V Stimson
- London School of Hygiene and Tropical Medicine and Knowledge-Action-Change, United Kingdom
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