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Garcia Colato E, Rosenberg M, Ludema C, Kianersi S, Luetke M, Macy JT. Does cigarette or E-cigarette use increase the risk for SARS-CoV-2 seroconversion among Midwestern college students? JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1592-1598. [PMID: 35728069 DOI: 10.1080/07448481.2022.2086010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 04/16/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This longitudinal study tested the relationship between cigarette and e-cigarette use and SARS-CoV-2 seroconversion among US college students. PARTICIPANTS Undergraduate students (n = 764), drawn from a randomly selected invitation-only pool from a large Midwestern university, that were initially negative for SARS-CoV-2 antibodies and were re-tested in November were included in this study conducted in Fall 2020. METHODS Demographics and cigarette and e-cigarette use behaviors (nicotine use) were collected in a baseline survey. SARS-CoV-2 antibody tests were administered in September (baseline) and November (endline) of 2020. Log-binomial regression analyses were conducted to test the association between nicotine use and SARS-CoV-2 seroconversion. RESULTS SARS-CoV-2 seroconversion was 5.2%. No statistically significant associations were found between nicotine use and SARS-CoV-2 seroconversion. CONCLUSIONS Contrary to prior results, we found no association between nicotine use and SARS-CoV-2 seroconversion. Nicotine use may not be a key risk factor for COVID-19 acquisition in predominantly healthy college-aged populations.
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Affiliation(s)
- Edlin Garcia Colato
- Department of Applied Health Science, Indiana University School of Public Health Bloomington, Bloomington, Indiana, U.S.A
| | - Molly Rosenberg
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health Bloomington, Bloomington, Indiana, U.S.A
| | - Christina Ludema
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health Bloomington, Bloomington, Indiana, U.S.A
| | - Sina Kianersi
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health Bloomington, Bloomington, Indiana, U.S.A
| | - Maya Luetke
- Institute for Social Research and Data Innovation, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Jonathan T Macy
- Department of Applied Health Science, Indiana University School of Public Health Bloomington, Bloomington, Indiana, U.S.A
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Griffith NB, Baker TB, Heiden BT, Smock N, Pham G, Chen J, Yu J, Reddy J, Lai AM, Hogue E, Bierut LJ, Chen LS. Cannabis, Tobacco Use, and COVID-19 Outcomes. JAMA Netw Open 2024; 7:e2417977. [PMID: 38904961 PMCID: PMC11193123 DOI: 10.1001/jamanetworkopen.2024.17977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/11/2024] [Indexed: 06/22/2024] Open
Abstract
Importance It is unclear whether cannabis use is associated with adverse health outcomes in patients with COVID-19 when accounting for known risk factors, including tobacco use. Objective To examine whether cannabis and tobacco use are associated with adverse health outcomes from COVID-19 in the context of other known risk factors. Design, Setting, and Participants This retrospective cohort study used electronic health record data from February 1, 2020, to January 31, 2022. This study included patients who were identified as having COVID-19 during at least 1 medical visit at a large academic medical center in the Midwest US. Exposures Current cannabis use and tobacco smoking, as documented in the medical encounter. Main Outcomes and Measures Health outcomes of hospitalization, intensive care unit (ICU) admission, and all-cause mortality following COVID-19 infection. The association between substance use (cannabis and tobacco) and these COVID-19 outcomes was assessed using multivariable modeling. Results A total of 72 501 patients with COVID-19 were included (mean [SD] age, 48.9 [19.3] years; 43 315 [59.7%] female; 9710 [13.4%] had current smoking; 17 654 [24.4%] had former smoking; and 7060 [9.7%] had current use of cannabis). Current tobacco smoking was significantly associated with increased risk of hospitalization (odds ratio [OR], 1.72; 95% CI, 1.62-1.82; P < .001), ICU admission (OR, 1.22; 95% CI, 1.10-1.34; P < .001), and all-cause mortality (OR, 1.37, 95% CI, 1.20-1.57; P < .001) after adjusting for other factors. Cannabis use was significantly associated with increased risk of hospitalization (OR, 1.80; 95% CI, 1.68-1.93; P < .001) and ICU admission (OR, 1.27; 95% CI, 1.14-1.41; P < .001) but not with all-cause mortality (OR, 0.97; 95% CI, 0.82-1.14, P = .69) after adjusting for tobacco smoking, vaccination, comorbidity, diagnosis date, and demographic factors. Conclusions and Relevance The findings of this cohort study suggest that cannabis use may be an independent risk factor for COVID-19-related complications, even after considering cigarette smoking, vaccination status, comorbidities, and other risk factors.
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Affiliation(s)
| | - Timothy B. Baker
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison
| | - Brendan T. Heiden
- Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Nina Smock
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Giang Pham
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Jingling Chen
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Justin Yu
- Washington University School of Medicine, St Louis, Missouri
| | - James Reddy
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Albert M. Lai
- Washington University School of Medicine, St Louis, Missouri
| | - Eric Hogue
- Washington University School of Medicine, St Louis, Missouri
| | - Laura J. Bierut
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
- Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital, Washington University School of Medicine, St Louis, Missouri
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3
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Valadez-Cuen K, Bhatt T, Mendez IE, Solanki D, Abdi N, Shelar V, Akplor JJ, Reddy Bhumanapalli SA, Vinyak S, Patel D, Tirupathi R, Shah V, Patel UK, Rana RK. E-cigarette Use and Severe Coronavirus Disease 2019 (COVID-19) Outcomes: A Meta-Analysis. Cureus 2024; 16:e59591. [PMID: 38832202 PMCID: PMC11144579 DOI: 10.7759/cureus.59591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/03/2024] [Indexed: 06/05/2024] Open
Abstract
E-cigarettes have been known to cause varied poor health outcomes prior to coronavirus disease 2019 (COVID-19), but after the impact of COVID-19, evidence came out that was, in some instances, not as expected regarding the severity of COVID-19 among e-cigarette users (vapers). A meta-analysis was performed on the available evidence to comprehensively find the effect of COVID-19 on existing or past e-cigarette users (vapers). The Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines were used to perform this meta-analysis. PubMed was searched for observational studies that described outcomes after COVID-19 positivity from December 1, 2019, to December 2023. Medical Subject Headings (MeSH) keywords were used for searching the relevant studies highlighting the relationship between COVID-19 and e-cigarette users. Calculations for pooled prevalence, 95% confidence interval (95% CI), weights for current e-cigarette users and vapers, and outcomes (events) were made. To analyze the data, Review Manager V.5.4 was used. The I² statistic was used to assess statistical heterogeneity. The I² statistic of >50% was considered significant heterogeneity. The "leave-one-out" method was used for sensitivity analysis. Out of 3231 studies, four studies reported data on vaping and non-vaping status and composite outcomes, resulting in a sample size of 653 COVID-19-positive cases. The pooled prevalence of being COVID-19 positive, having symptoms, or visiting an emergency room was 7.78% (653/8392). COVID-19 patients with current vaping status had decreased odds of poor outcomes compared to non-smokers, with a pooled odds ratio (OR) of 0.09 (95% CI 0.00-2.42; p>0.05) with heterogeneity between studies (I²=99%, p=0.15). Because of difficulties related to data collection and other factors, this meta-analysis was unable to conclusively establish the correlation between e-cigarette usage and severe COVID-19 outcomes such as hospitalization, admission to the intensive care unit, and fatality. Additional research using more detailed data is necessary to fully understand this correlation.
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Affiliation(s)
- Karen Valadez-Cuen
- Department of Internal Medicine, Las Palmas Del Sol Healthcare, El Paso, USA
| | - Tulsi Bhatt
- Department of Internal Medicine, Pramukhswami Medical College, Karamsad, IND
| | - Ileana E Mendez
- Department of Medical Sciences, Universidad Autónoma de Centro América (UACA), San José, CRI
| | - Dhanshree Solanki
- Department of Hospital Administration, Rutgers University, New Brunswick, USA
| | - Nawal Abdi
- Department of Internal Medicine, University Hospitals Cleveland Medical Center, Cleveland, USA
| | - Vrushali Shelar
- Department of Internal Medicine, Saratov State Medical University, Saratov, RUS
| | - Jerry J Akplor
- Faculty of Medicine, Hebei North University, Zhangjiakou, CHN
| | - Sai Akhila Reddy Bhumanapalli
- Department of Internal Medicine, State University of New York (SUNY) Downstate Health Sciences University, School of Public Health (SPH), New York, USA
| | - Suprada Vinyak
- Department of Internal Medicine, Wellmont/Norton Community Hospital (NCH), Norton, USA
| | - Digantkumar Patel
- Department of Medicine, Springfield Memorial Hospital, Springfield, USA
| | | | - Viray Shah
- Department of Hospital Medicine, MedStar Good Samaritan Hospital, Baltimore, USA
| | - Urvish K Patel
- Department of Public Health and Neurology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Rishabh K Rana
- Department of Preventive and Social Medicine/Community Medicine, Shaheed Nirmal Mahto Medical College and Hospital (Erstwhile Patliputra Medical College), Dhanbad, IND
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4
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Hernández-Torres R, Wang H, Orfin R, Castro-Figueroa EM, Freeman J, Cupertino AP, Ossip DJ, Wilson KM, Cartujano-Barrera F. Exposure to E-Cigarette Marketing and Susceptibility to Future Vaping among Black and Latino Adolescents in the United States. CHILDREN (BASEL, SWITZERLAND) 2024; 11:465. [PMID: 38671682 PMCID: PMC11049197 DOI: 10.3390/children11040465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
Evidence suggests an association between exposure to electronic cigarette (e-cigarette) marketing and e-cigarette use (vaping) among adolescents. However, there is limited evidence on exposure to e-cigarette marketing and susceptibility to future vaping, especially among Black and Latino adolescents. This study aimed to examine associations between exposure to e-cigarette marketing and susceptibility to future vaping among Black and Latino adolescents in the United States (US). Participants (N = 362; equal representation between Black and Latino adolescents) completed a baseline assessment (available in English and Spanish) including sociodemographic characteristics (e.g., racial/ethnic group, age, gender, sexual orientation, etc.), exposure to e-cigarette marketing, and susceptibility to future vaping. Exposure to e-cigarette marketing was recoded and organized into two categories (high exposure = 2 to 3; low exposure = 0 to 1). Cochran-Mantel-Haenszel tests were used to evaluate the association between exposure to e-cigarette marketing and susceptibility to future vaping, stratified by racial/ethnic group. Multiple logistic regressions assessed the association between exposure to e-cigarette marketing and susceptibility to future vaping, controlling for gender, sexual orientation, grade, and academic performance within each racial/ethnic group. Black adolescents reported significantly higher frequencies of exposure to e-cigarette marketing (p = 0.005). A significant interaction was found between exposure to e-cigarette marketing and racial/ethnic group (X2 (1) = 6.294, p = 0.012). Among Black adolescents, high exposure to e-cigarette marketing (vs. low exposure) was associated with a higher probability of susceptibility to future vaping (OR: 2.399, 95% CI 1.147-5.021, p = 0.020). For Latino adolescents, exposure to e-cigarette marketing was not associated with susceptibility to future vaping (OR: 0.503, 95% CI 0.245-1.03, p = 0.062). Future studies should evaluate how and where adolescents are exposed to e-cigarette marketing. Prevention efforts must include the implementation of effective counter-marketing campaigns and the reduction of exposure to e-cigarette marketing among Black and Latino adolescents.
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Affiliation(s)
- Ruthmarie Hernández-Torres
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
| | - Hongyue Wang
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Rafael Orfin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.O.); (D.J.O.); (F.C.-B.)
| | - Eida M. Castro-Figueroa
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico;
| | | | - Ana Paula Cupertino
- Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.O.); (D.J.O.); (F.C.-B.)
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Karen M. Wilson
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Francisco Cartujano-Barrera
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.O.); (D.J.O.); (F.C.-B.)
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5
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Smith LM, Boehm L, Strang LV, DeMarre C, Marcyjanik D. Targeted Education for School Staff on Electronic Nicotine Delivery Systems: A Nurse Led Intervention. J Sch Nurs 2024; 40:223-230. [PMID: 34590529 DOI: 10.1177/10598405211043127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
There is a public health epidemic in adolescents' use of Electronic Nicotine Delivery Systems (ENDSs), also known as electronic cigarettes, vaping products, or JUULs. However, little is known about the level of knowledge school staff have about ENDS. The purpose of this study is to examine outcomes of a nurse-led educational intervention designed to increase school staff knowledge about ENDS. A descriptive, nonrandomly selected pre-test/post-test design was used with 125 Wisconsin school staff. Results revealed further educational needs of school staff in content areas including advertising to youth and flavoring of ENDS. Following the educational intervention, post-test results showed a significant overall improvement in participant knowledge scores. Recommendations include implementing nurse-led education about ENDS to a more diverse population of school staff. Providing nurse-led ENDS education to school staff offers an upstream, proactive approach for school nurses to help address this public health epidemic.
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Affiliation(s)
- Lorraine M Smith
- College of Nursing, University of Wisconsin-Eau Claire, Eau Claire, WI, USA
| | - Lindsey Boehm
- College of Nursing, University of Wisconsin-Eau Claire, Eau Claire, WI, USA
| | - Lyndsey V Strang
- College of Nursing, University of Wisconsin-Eau Claire, Eau Claire, WI, USA
| | - Chelsea DeMarre
- College of Nursing, University of Wisconsin-Eau Claire, Eau Claire, WI, USA
| | - Diane Marcyjanik
- College of Nursing, University of Wisconsin-Eau Claire, Eau Claire, WI, USA
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6
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Her W, Jung H, Sam Oh Y. Examining Predictors of Nicotine Dependence in Korean Adolescents : Comparing Ever Quitters and Never Quitters. J Psychoactive Drugs 2024; 56:264-271. [PMID: 36967576 DOI: 10.1080/02791072.2023.2184736] [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: 06/07/2022] [Accepted: 01/30/2023] [Indexed: 03/29/2023]
Abstract
Despite growing research on adolescent smokers, evidence for the differences between the two smoker groups who are ever quitters and never quitters is limited. The study aimed to examine predictors of nicotine dependence (ND) in Korean adolescents by comparing ever quitters and never quitters. Data from 349 adolescents were collected through an online survey. Among respondents, most of them were male, living with families, and were enrolled at schools. Data were analyzed by dividing participants into two groups - ever quitters and never quitters. The study found that adolescents' ND was commonly predicted by smoking peers and anxiety. However, schooling status was significantly associated with ever quitters' ND only. In the total sample, never-quitters were associated with higher ND compared to ever-quitters. This study did not control for differences among ever quitters in terms of the number of attempts to quit smoking and did not significantly control age effects in the sample. Based on study results, we suggest various policy implications. Cessation intervention should be designed keeping in mind the smokers' previous quit attempts and their motivation. It is also recommended that individually tailored smoking cessation programs be used to address the heterogenous nature of the adolescents.
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Affiliation(s)
- Wonbin Her
- Department of Social Welfare, Pukyong National University, Busan, South Korea
| | - Hyejin Jung
- Department of Public Administration, Pusan National University, Busan, South Korea
| | - Young Sam Oh
- Department of Social Welfare, Pukyong National University, Busan, South Korea
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7
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Hill TD, Bostean G, Upenieks L, Bartkowski JP, Ellison CG, Burdette AM. (Un)holy Smokes? Religion and Traditional and E-Cigarette Use in the United States. JOURNAL OF RELIGION AND HEALTH 2024; 63:1334-1359. [PMID: 36520262 PMCID: PMC9753896 DOI: 10.1007/s10943-022-01721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
This study employed national cross-sectional survey data from the 2021 Crime, Health, and Politics Survey (n = 1578 to 1735) to model traditional cigarette and e-cigarette use as a function of religious affiliation, general religiosity, biblical literalism, religious struggles, and the sense of divine control. Although the odds of abstaining from cigarettes and e-cigarettes were comparable for conservative Protestants and non-affiliates, conservative Protestants were more likely to cut down on cigarettes and e-cigarettes during the pandemic. Religiosity increased the odds of abstaining from cigarettes (not e-cigarettes) and reduced pandemic consumption of cigarettes and e-cigarettes. Biblical literalism was unrelated to abstaining from cigarettes and pandemic changes in cigarette use; however, biblical literalists were more likely to cut e-cigarette use during the pandemic. While the sense of divine control was unrelated to abstaining from cigarettes and e-cigarettes, these beliefs increased the odds of cessation from traditional and e-cigarette use. Finally, our religious struggles index was unrelated to smoking behavior. Our study is among the first to report any association between religion and lower e-cigarette use.
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Affiliation(s)
- Terrence D. Hill
- Department of Sociology, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249-1644 USA
| | - Georgiana Bostean
- Department of Sociology and Environmental Science & Policy Program, Chapman University, Orange, USA
| | | | - John P. Bartkowski
- Department of Sociology, University of Texas at San Antonio, San Antonio, USA
| | | | - Amy M. Burdette
- Department of Sociology and Public Health Program, Florida State University, Tallahassee, USA
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8
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Tao X, Zhang J, Meng Q, Chu J, Zhao R, Liu Y, Dong Y, Xu H, Tian T, Cui J, Zhang L, Chu M. The potential health effects associated with electronic-cigarette. ENVIRONMENTAL RESEARCH 2024; 245:118056. [PMID: 38157958 DOI: 10.1016/j.envres.2023.118056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/17/2023] [Accepted: 12/25/2023] [Indexed: 01/03/2024]
Abstract
A good old gateway theory that electronic-cigarettes (e-cigarettes) are widely recognized as safer tobacco substitutes. In actuality, demographics also show that vaping cannibalizes smoking, the best explanation of the data is the "common liability". However, the utilization of e-cigarette products remains a controversial topic at present. Currently, there has been a widespread and substantial growth in e-cigarette use worldwide owing to their endless new flavors and customizable characteristics. Furthermore, e-cigarette has grown widespread among smokers as well as non-smokers, including adolescents and young adults. And some studies have shown that e-cigarette users are at greater risk to start using combustible cigarettes while e-cigarettes use was also observed the potential benefits to people who want to quit smoking or not. Although it is true that e-cigarettes generally contain fewer toxic substances than combustible cigarettes, this does not mean that the chemical composition in e-cigarettes aerosols poses absolutely no risks. While concerns about toxic substances in e-cigarettes and their widespread use in the population are reasonable, it is also crucial to consider that e-cigarettes have been associated with the potential for promoting smoking cessation and the clinically relevant improvements in users with smoking-related pathologies. Meanwhile, there is still short of understanding of the health impacts associated with e-cigarette use. Therefore, in this review, we discussed the health impacts of e-cigarette exposure on oral, nasal, pulmonary, cardiovascular systems and brain. We aspire for this review to change people's previous perceptions of e-cigarettes and provide them with a more balanced perspective. Additionally, we suggest appropriate adjustments on regulation and policy for e-cigarette to gain greater public health benefits.
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Affiliation(s)
- Xiaobo Tao
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Jiale Zhang
- The Second People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Qianyao Meng
- Department of Global Health and Population, School of Public Health, Harvard University, Boston, USA
| | - Junfeng Chu
- Department of Oncology, Jiangdu People's Hospital of Yangzhou, Yangzhou, Jiangsu, China
| | - Rongrong Zhao
- Department of Oncology, Jiangdu People's Hospital of Yangzhou, Yangzhou, Jiangsu, China
| | - Yiran Liu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Yang Dong
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Huiwen Xu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Tian Tian
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Jiahua Cui
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Lei Zhang
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China.
| | - Minjie Chu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China.
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9
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Glantz SA, Nguyen N, Oliveira da Silva AL. Population-Based Disease Odds for E-Cigarettes and Dual Use versus Cigarettes. NEJM EVIDENCE 2024; 3:EVIDoa2300229. [PMID: 38411454 DOI: 10.1056/evidoa2300229] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
BACKGROUND: E-cigarettes are promoted as less harmful than cigarettes. There has not been a direct comparison of health effects of e-cigarettes or dual use (concurrently using e-cigarettes and cigarettes) with those of cigarettes in the general population. METHODS: Studies in PubMed, EMBASE, Web of Science, and PsychINFO published through October 1, 2023, were pooled in a random-effects meta-analysis if five or more studies were identified with a disease outcome. We assessed risk of bias with Risk Of Bias In Non-randomized Studies of Exposure and certainty with Grading of Recommendations, Assessment, Development, and Evaluations. Outcomes with fewer studies were summarized but not pooled. RESULTS: We identified 124 odds ratios (94 cross-sectional and 30 longitudinal) from 107 studies. Pooled odds ratios for current e-cigarette versus cigarette use were not different for cardiovascular disease (odds ratio, 0.81; 95% confidence interval, 0.58 to 1.14), stroke (0.73; 0.47 to 1.13), or metabolic dysfunction (0.99; 0.91 to 1.09) but were lower for asthma (0.84; 0.74 to 0.95), chronic obstructive pulmonary disease (0.53; 0.38 to 0.74), and oral disease (0.87; 0.76 to 1.00). Pooled odds ratios for dual use versus cigarettes were increased for all outcomes (range, 1.20 to 1.41). Pooled odds ratios for e-cigarettes and dual use compared with nonuse of either product were increased (e-cigarette range, 1.24 to 1.47; dual use, 1.49 to 3.29). All included studies were assessed as having a low risk of bias. Results were generally not sensitive to study characteristics. Limited studies of other outcomes suggest that e-cigarette use is associated with additional diseases. CONCLUSIONS: There is a need to reassess the assumption that e-cigarette use provides substantial harm reduction across all cigarette-caused diseases, particularly accounting for dual use.
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Affiliation(s)
| | - Nhung Nguyen
- Center for Tobacco Control Research and Education, University of California, San Francisco, San Francisco
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10
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Alpers SE, Druckrey-Fiskaaen KT, Madebo T, Vold JH, Pallesen S, Skogen JC, Lunde LH, Mæland S, Fadnes LT. The association of psychological distress and economic and health worries with tobacco smoking behavior during the COVID-19 pandemic: a two-year longitudinal cohort study. BMC Public Health 2024; 24:375. [PMID: 38317145 PMCID: PMC10840189 DOI: 10.1186/s12889-024-17943-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/01/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic and other life events may trigger worries and psychological distress. These impacts may lead to unhealthy behaviors, such as tobacco smoking, but the degree of such associations is unclear. The current three-wave longitudinal study examines changes in tobacco smoking in Norway between 2020 and 2022 and their associations with psychological distress as well as health- and economy-related worries. METHODS Data were collected in April 2020 (baseline), January 2021, and January 2022 in Bergen, Norway, from an online longitudinal population-based survey. Smoking tobacco (the outcome variable) was dichotomized based on the responses to the question of whether participants smoked cigarettes or not. Tobacco smoking and its associations with psychological distress were assessed among 24,914 participants (response rate 36%) in a mixed model regression presented with coefficients and 95% confidence intervals (CI), adjusting for COVID-19-related worries, home office/study, occupational situation, age, gender, education, having children below 18 years living at home, living alone, and alcohol consumption. RESULTS A total of 10% of the study sample were current smokers at baseline. At baseline, smoking tobacco was associated with high levels of psychological distress (absolute difference 13%, 95% CI 10%; 15%), advanced age (50-59 years: 11%, CI 10%; 13%), and hazardous alcohol use (4%, CI 3%; 5%) compared to their counterparts. Higher education (-5%, CI -6%; -4%), working from home (-4%, CI -5%; -4%), and higher physical activity levels (-4%, CI -5%; -3%) were associated with non-smoking. The prevalence of smoking among individuals experiencing severe psychological distress decreased slightly over time (-2% per year, CI -3%; -1%). CONCLUSIONS Smoking was associated with severe psychological distress, advanced age, and hazardous alcohol use at baseline; non-smoking was associated with high education, working from home, and high physical activity. Nevertheless, the smoking rate among individuals experiencing severe psychological distress slightly decreased over the course of the COVID-19 pandemic.
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Affiliation(s)
- Silvia Eiken Alpers
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway.
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway.
| | - Karl Trygve Druckrey-Fiskaaen
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Tesfaye Madebo
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Respiratory Medicine, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
| | - Jørn Henrik Vold
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Alcohol & Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Linn-Heidi Lunde
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Silje Mæland
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Lars Thore Fadnes
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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11
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Phandthong R, Wong M, Song A, Martinez T, Talbot P. Does vaping increase the likelihood of SARS-CoV-2 infection? Paradoxically yes and no. Am J Physiol Lung Cell Mol Physiol 2024; 326:L175-L189. [PMID: 38147795 PMCID: PMC11280677 DOI: 10.1152/ajplung.00300.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/30/2023] [Accepted: 12/18/2023] [Indexed: 12/28/2023] Open
Abstract
Data on the relationship between electronic cigarettes (ECs) and SARS-CoV-2 infection are limited and contradictory. Our objectives were to investigate the impact of EC aerosols on SARS-CoV-2 infection of human bronchial epithelial cells and identify the causative chemical(s). Fully differentiated human bronchial epithelial tissues (hBETs) were exposed at the air-liquid interface (ALI) to aerosols produced from JUUL "Virginia Tobacco" and BLU ECs, as well as nicotine, propylene glycol (PG), vegetable glycerin (VG), and benzoic acid, and infection was then evaluated with SARS-CoV-2 pseudoparticles. Pseudoparticle infection of hBETs increased with aerosols produced from PG/VG, PG/VG plus nicotine, or BLU ECs; however, JUUL EC aerosols did not increase infection compared with controls. Increased infection in PG/VG alone was due to enhanced endocytosis, whereas increased infection in PG/VG plus nicotine or in BLU ECs was caused by nicotine-induced elevation of the aerosol's pH, which correlated with increased transmembrane protease, serine 2 (TMPRSS2) activity. Notably, benzoic acid in JUUL aerosols mitigated the enhanced infection caused by PG/VG or nicotine, offering protection that lasted for at least 48 h after exposure. In conclusion, the study demonstrates that EC aerosols can impact susceptibility to SARS-CoV-2 infection depending on their specific ingredients. PG/VG alone or PG/VG plus nicotine enhanced infection through different mechanisms, whereas benzoic acid in JUUL aerosols mitigated the increased infection caused by certain ingredients. These findings highlight the complex relationship between ECs and SARS-CoV-2 susceptibility, emphasizing the importance of considering the specific aerosol ingredients when evaluating the potential effects of ECs on infection risk.NEW & NOTEWORTHY Data on the relationship between electronic cigarettes (ECs) and SARS-CoV-2 infection are limited and contradictory. We investigated the impact of EC aerosols and their ingredients on SARS-CoV-2 infection of human bronchial epithelial cells. Our data show that specific ingredients in EC aerosols impact the susceptibility to SARS-CoV-2 infection. Propylene glycol (PG)/vegetable glycerin (VG) alone or PG/VG plus nicotine enhanced infection through different mechanisms, whereas benzoic acid in JUUL aerosols mitigated the increased infection caused by these ingredients.
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Affiliation(s)
- Rattapol Phandthong
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, California, United States
| | - Man Wong
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, California, United States
| | - Ann Song
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, California, United States
| | - Teresa Martinez
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, California, United States
| | - Prue Talbot
- Department of Molecular, Cell and Systems Biology, University of California, Riverside, California, United States
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12
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Mallis N, Dailey C, Drewry S, Howard N, Cordero JF, Welton M. SARS-CoV-2 infection and e-cigarette use, binge drinking, and other associated risk factors in a college population. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:366-370. [PMID: 35324389 DOI: 10.1080/07448481.2022.2053133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 03/08/2022] [Indexed: 06/14/2023]
Abstract
In the summer of 2020, SARS-CoV-2 infection rates among the U.S. population aged 20-39 years exceeded other age groups, with the largest increases occurring in the southern US. As many colleges reopened for in-person instruction in August and September, these trends continued among campuses across the country. Our study aimed to identify risk factors (demographic and behavioral) associated with SARS-CoV-2 infection among college students. We used data from a survey administered to students at a southern university in the US. The survey had a total of 765 respondents and this study included the 679 (88.8%) who responded about their SARS-CoV-2 infection status. We examined associations between population characteristics and reported SARS-CoV-2 infection and calculated prevalence ratios along with 95% confidence intervals. SARS-CoV-2 infection was 2.5 times more likely among current users of electronic nicotine delivery systems (ENDS) compared to those who do not use ENDS (95% confidence interval [CI]: (1.76-3.4)) and 2.8 times more likely among those who reported a high frequency of binge drinking compared to those who did not report binge drinking (95% CI: (1.81-4.36)). Current high frequency ENDS users were 2.76 (1.79-4.25) more likely to report SARS-CoV-2 infection than non-users. Current low frequency users of ENDS were 2.27 (1.53-3.37) times more likely to report SARS-CoV-2 infection than nonusers. A trend analysis among ENDS use frequency and SARS-CoV-2 infection was statistically significant, showing a significant dose response with increasing ENDS use. The results of this analysis may assist in providing guidance on policies as well as may serve as a steppingstone for future research concerning SAR-CoV-2 infection among university populations.
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Affiliation(s)
- Nicholas Mallis
- College of Public Health, Department of Epidemiology & Biostatistics, University of Georgia, Athens, Georgia, USA
| | - Cody Dailey
- College of Public Health, Department of Epidemiology & Biostatistics, University of Georgia, Athens, Georgia, USA
| | - Sophia Drewry
- College of Public Health, Department of Epidemiology & Biostatistics, University of Georgia, Athens, Georgia, USA
| | - Nina Howard
- College of Public Health, Department of Epidemiology & Biostatistics, University of Georgia, Athens, Georgia, USA
| | - José F Cordero
- College of Public Health, Department of Epidemiology & Biostatistics, University of Georgia, Athens, Georgia, USA
| | - Michael Welton
- College of Public Health, Department of Epidemiology & Biostatistics, University of Georgia, Athens, Georgia, USA
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13
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Tituana NY, Clavijo CG, Espinoza EF, Tituana VA. E-cigarette use-associated lung injury (EVALI). Pneumologie 2024; 78:58-69. [PMID: 37857323 PMCID: PMC10791482 DOI: 10.1055/a-2161-0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/13/2023] [Indexed: 10/21/2023]
Abstract
The prevalence of vaping has overtaken conventional cigarettes as the most frequent form of nicotine consumption among 15-24-year olds. There are currently a large number of both legitimate and illegitimate products and suppliers offering more than 8000 different flavors of vape on the market, whose additives are not tested, studied or regulated and whose safety and toxicity profile remains unknown. In vitro studies have demonstrated a dose-dependent decrease in the viability of normal human bronchial epithelial cells after exposure to vapor from electronic vape devices.Short- and medium-term studies to date indicate that vapor-induced pulmonary lesions are the most serious and commonly reported side effect; such lesions include bilateral ground glass opacities in lung bases with subpleural preservation, bilateral infiltrates, pleural effusion, pneumomediastinum and nodular opacities. Cases of EVALI have been described in patients with daily exposure, as well as in users who reported having been exposed to these substances at least once a month. The most frequently inhaled substances are THC, flavored liquids of unknown content, and nicotine.The clinical manifestations of dyspnea and cough are the most frequent respiratory symptomatology, in addition to constitutional manifestations such as fever and chills, and gastrointestinal manifestations such as vomiting, nausea, abdominal pain and diarrhea. To these can be added the presence of tachypnea, tachycardia, elevated blood pressure, hypoxia, leukocytosis with neutrophilia and elevated ESR.
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Affiliation(s)
- Nathaly Yessenia Tituana
- Medicina, Universidad Catolica de Cuenca Unidad Academica de Medicina y Ciencias de la Salud, Cuenca, Ecuador
| | - Claudia Gabriela Clavijo
- Medicina, Universidad Catolica de Cuenca Unidad Academica de Medicina y Ciencias de la Salud, Cuenca, Ecuador
| | - Evelyn Fernanda Espinoza
- Medicina, Universidad Catolica de Cuenca Unidad Academica de Medicina y Ciencias de la Salud, Cuenca, Ecuador
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14
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Okamoto SK, Subica AM, An KJ, Okamura KH, Song SD, Saladino PA, Carson AB, Stephens TA, Marshall SM, Chin SK, Wills TA, Kaholokula JK, Pokhrel P. Exploring Native Hawaiian and Pacific Islander Youths' E-Cigarette Resistance Strategies: Implications for Tobacco Product Use Prevention. J Health Care Poor Underserved 2024; 35:692-706. [PMID: 38828589 PMCID: PMC11238740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
This study examined the e-cigarette and vaping resistance strategies used by Native Hawaiian and Pacific Islander (NHPI) youths in rural Hawai'i. Focus groups (N = 17) were conducted in eight geographically dispersed elementary, middle/intermediate, and multilevel schools in low-income communities on Hawai'i Island. Sixty-nine youths (67% NHPI, Mage = 12.5 years) participated in this study. The resistance strategies discussed across the greatest number of groups were "refuse" (saying no), "explain" (providing reasons for vaping refusal), "avoid" (avoiding people or places where e-cigarettes were used), and "leave" (walking away from a situation where e-cigarettes were being used). Participants described the challenges in using these strategies within contexts characterized by widespread peer and family vaping and strong social demands to use e-cigarettes. The findings suggest the need for multi-level interventions based on youths' resistance strategies to meaningfully reduce youth vaping use in rural and/or NHPI communities.
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15
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Algarni SA, ALGhasab NS, Alharbi MS, Albarrak A, Alanezi AA, Al Shehri HM. Sex Differences and Clinical Outcomes of Patients with Coronavirus Disease 2019 Infection and Cerebral Venous Sinus Thrombosis: A Systematic Review. Clin Appl Thromb Hemost 2024; 30:10760296241240748. [PMID: 38551022 PMCID: PMC10981232 DOI: 10.1177/10760296241240748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 04/01/2024] Open
Abstract
Cerebral venous sinus thrombosis (CVST) is a rare neurovascular condition that has been observed in individuals with coronavirus disease 2019 (COVID-19). This systematic review aimed to explore the sex differences and characteristics of concurrent COVID-19 and CVST cases. A total of 212 CVST patients were included in the study. Women with CVST had a slightly higher mean age compared to men (47.359 years vs 46.08 years). Women were more likely to report symptoms such as fever (56.1%) and decreased sense of smell or taste (71.4%), while men more frequently experienced nausea or vomiting (55.6%), headache (62.9%), and seizures (72%). Notably, current smokers, who were predominantly men, had a higher occurrence of CVST. On the other hand, women had a higher likelihood of CVST risk factors such as oral contraceptive pill (OCP) use and autoimmune diseases. Treatment approaches also showed sex-based differences. Unfractionated heparin was administered more often to women with CVST (63.2%). The in-hospital mortality rate for CVST patients was 21.3%, with men having a significantly higher mortality rate than women (65.2% vs 34.8%, P = .027). Survival analysis revealed that factors such as smoking history, diabetes mellitus, hypertension, OCP use, COVID-19 symptoms, CVST symptoms, and the need for intubation significantly influenced survival outcomes. Understanding these sex differences in COVID-19-related CVST is crucial for accurate diagnosis and effective management, ultimately leading to improved patient outcomes. Our findings highlight the importance of considering sex as a factor in the evaluation and treatment of individuals with COVID-19 and concurrent CVST.
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Affiliation(s)
- Saleh A. Algarni
- Department of Neuroscience, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Naif S. ALGhasab
- Department of Internal Medicine, Medical Collage, Ha’il University, Ha’il, Saudi Arabia
| | - Mohammed S. Alharbi
- Department of Internal Medicine, Medical Collage, Ha’il University, Ha’il, Saudi Arabia
| | - Anas Albarrak
- Department of Internal Medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Ahmad A. Alanezi
- Department of Pediatrics, College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
- Department of Pediatrics, King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia
| | - Hamdan M. Al Shehri
- Department of Internal Medicine, Medical Collage, Najran University, Najran, Saudi Arabia
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16
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Kulak JA, Voit HE, Balfour CA, Homish GG. College health providers' knowledge and confidence in addressing students' vaping: Evidence from a pilot study in New York State. PEC INNOVATION 2023; 2:100123. [PMID: 37214494 PMCID: PMC10194164 DOI: 10.1016/j.pecinn.2023.100123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 12/21/2022] [Accepted: 01/16/2023] [Indexed: 05/24/2023]
Abstract
Objective This study examines the knowledge and confidence of college healthcare providers in discussing vaping with their college student populations. Methods This is a mixed-methods descriptive study using a sequential-explanatory approach, consisting of a cross-sectional, online survey followed by qualitative interviews. Survey data was collected from 50 college health providers located at 26 colleges in the 64-campus State University of New York system. Targeted semi-structured interviews (N = 11) were conducted by telephone with providers who completed the survey. Results Despite high reported levels of knowledge and confidence, few providers had participated in educational activities relative to vaping. There was evidence of misinformation about e-cigarettes, and they did not know what product (nicotine/cannabis) students typically vape. Conclusions Findings indicate a potential disconnect between providers' perceived and actual knowledge of college student vaping and demonstrate areas of opportunity to assist college health providers in comprehensively addressing vaping with their college student populations. Innovation College health providers played a key role in lowering rates of combustible cigarette smoking, but little is known about how they are now are communicating with college students about e-cigarette and cannabis vaping. This paper examines college health providers' knowledge, confidence, and training needs relative to vaping communications.
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Affiliation(s)
- Jessica A. Kulak
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
| | - Hannah E. Voit
- Department of Health, Nutrition, and Dietetics, Buffalo State College, Buffalo, NY, USA
| | - Cierra A. Balfour
- Department of Health, Nutrition, and Dietetics, Buffalo State College, Buffalo, NY, USA
| | - Gregory G. Homish
- Department of Community Health and Health Behavior, University at Buffalo, Buffalo, NY, USA
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Raduka A, Gao N, Chatburn RL, Rezaee F. Electronic cigarette exposure disrupts airway epithelial barrier function and exacerbates viral infection. Am J Physiol Lung Cell Mol Physiol 2023; 325:L580-L593. [PMID: 37698113 PMCID: PMC11068398 DOI: 10.1152/ajplung.00135.2023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/07/2023] [Accepted: 09/06/2023] [Indexed: 09/13/2023] Open
Abstract
The use of electronic cigarettes (e-cigs), especially among teenagers, has reached alarming and epidemic levels, posing a significant threat to public health. However, the short- and long-term effects of vaping on the airway epithelial barrier are unclear. Airway epithelial cells are the forefront protectors from viruses and pathogens. They contain apical junctional complexes (AJCs), which include tight junctions (TJs) and adherens junctions (AJs) formed between adjacent cells. Previously, we reported respiratory syncytial virus (RSV) infection, the leading cause of acute lower respiratory infection-related hospitalization in children and high-risk adults, induces a "leaky airway" by disrupting the epithelial AJC structure and function. We hypothesized chemical components of e-cigs disrupt airway epithelial barrier and exacerbate RSV-induced airway barrier dysfunction. Using confluent human bronchial epithelial (16HBE) cells and well-differentiated normal human bronchial epithelial (NHBE) cells, we found that exposure to extract and aerosol e-cig nicotine caused a significant decrease in transepithelial electrical resistance (TEER) and the structure of the AJC even at noncytotoxic concentrations. Western blot analysis of 16HBE cells exposed to e-cig nicotine extract did not reveal significant changes in AJC proteins. Exposure to aerosolized e-cig cinnamon or menthol flavors also induced barrier disruption and aggravated nicotine-induced airway barrier dysfunction. Moreover, preexposure to nicotine aerosol increased RSV infection and the severity of RSV-induced airway barrier disruption. Our findings demonstrate that e-cig exposure disrupts the airway epithelial barrier and exacerbates RSV-induced damage. Knowledge gained from this study will provide awareness of adverse e-cig respiratory effects and positively impact the mitigation of e-cig epidemic.NEW & NOTEWORTHY Electronic cigarette (e-cig) use, especially in teens, is alarming and at epidemic proportions, threatening public health. Our study shows that e-cig nicotine exposure disrupts airway epithelial tight junctions and increases RSV-induced barrier dysfunction. Furthermore, exposure to aerosolized flavors exaggerates e-cig nicotine-induced airway barrier dysfunction. Our study confirms that individual and combined components of e-cigs deleteriously impact the airway barrier and that e-cig exposure increases susceptibility to viral infection.
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Affiliation(s)
- Andjela Raduka
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States
| | - Nannan Gao
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States
| | - Robert L Chatburn
- Enterprise Respiratory Care Research Cleveland Clinic, Cleveland Clinic Children's, Cleveland, Ohio, United States
| | - Fariba Rezaee
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, United States
- Center for Pediatric Pulmonary Medicine, Cleveland Clinic Children's, Cleveland, Ohio, United States
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18
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Nguyen AX, Gaiha SM, Chung S, Halpern-Felsher B, Wu AY. Ocular Symptoms in Adolescents and Young Adults With Electronic Cigarette, Cigarette, and Dual Use. JAMA Ophthalmol 2023; 141:937-946. [PMID: 37651129 PMCID: PMC10472265 DOI: 10.1001/jamaophthalmol.2023.3852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/05/2023] [Indexed: 09/01/2023]
Abstract
Importance Despite increasing use of cigarettes and electronic cigarettes (e-cigarettes) and related health effects among youth, few studies have reported their effects on eyes. Objective To examine the frequency and severity of ocular symptoms (ocular discomfort, pain, burning, itching, redness, dryness, glare, blurriness, strain, and headaches) in young e-cigarette and cigarette users. Design, Setting, and Participants In an observational cross-sectional study, a survey conducted in May 6 to 14, 2020, asked participants about use (ever, past 30 days, and past 7 days) of e-cigarettes and cigarettes. The participants included US individuals aged 13 to 24 years. Main Outcomes and Measures Associations between vision-related outcomes (general vision, severity/frequency of ocular symptoms) and tobacco use were analyzed using weighted multivariable logistic regressions, adjusting for sociodemographic factors, contact lens use, and other combustible use. Results There were 2168 never users, 2183 ever users, 1092 past 30-day users, and 919 past 7-day users of e-cigarettes; 55.9% of e-cigarette ever users also used cigarettes (dual users). Of the 4351 respondents, 63.8% identified as female, and mean (SD) age was 19.1 (2.9) years. Between 1.1% and 3.9% of ever dual users reported severe to very severe ocular symptoms; between 0.9% and 4.3% reported daily symptoms, which was higher than the proportion of symptoms in e-cigarette- or cigarette-only users. Past 7-day dual users had more severe itching (adjusted odds ratio [AOR], 2.37; 95% CI, 1.36-4.13; P = .002), redness (AOR, 2.58; 95% CI, 1.50-4.46; P = .001), dryness (AOR, 2.89; 95% CI, 1.64-5.08; P < .001), glare (AOR, 2.56; 95% CI, 1.50-4.35; P = .001), blurriness (AOR, 2.47; 95% CI, 1.36-4.50; P = .003), headaches (AOR, 2.31; 95% CI, 1.34-4.00; P = .003); and more frequent pain (AOR, 3.45; 95% CI, 2.09-5.68; P < .001), burning (AOR, 3.08; 95% CI, 1.86-5.09; P < .001), and redness (AOR, 2.72; 95% CI, 1.69-4.36; P < .001) than all other participants. Past 30-day dual users had more severe dryness (AOR, 2.65; 95% CI, 1.61-4.36; P < .001) and more frequent pain (AOR, 3.33; 95% CI, 2.12-5.21; P < .001) than all other participants. Ever dual users experienced more severe dryness (AOR, 1.60; 95% CI, 1.05-2.43; P = .03) and blurriness (AOR, 1.79; 95% CI, 1.21-2.64; P = .003) and more frequent pain (AOR, 1.69; 95% CI, 1.13-2.53; P = .01) and blurriness (AOR, 1.63; 95% CI, 1.13-2.36; P = .009) than never users. Conclusions and Relevance In this cross-sectional US study, adolescents and young adult users of both e-cigarettes and cigarettes had a higher likelihood of experiencing severe and frequent ocular symptoms, with past 7-day users reporting more symptoms than past 30-day users or ever users. These findings provide additional reasons for users of e-cigarettes and cigarettes to reduce their tobacco use to possibly prevent or minimize ocular symptoms.
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Affiliation(s)
- Anne X. Nguyen
- Faculty of Medicine, McGill University, Montréal, Quebec, Canada
| | - Shivani M. Gaiha
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford, California
| | - Sukyung Chung
- Center for Population Health Sciences, School of Medicine, Stanford University, Stanford, California
| | - Bonnie Halpern-Felsher
- REACH Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford, California
| | - Albert Y. Wu
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, California
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19
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Sitas F, Short G, Brooke M, Griffiths K. Smoking and vaping on death notification forms in Australia: Improving the reporting of preventable risk factors. Health Promot J Austr 2023; 34:723-724. [PMID: 36789794 DOI: 10.1002/hpja.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Affiliation(s)
- Freddy Sitas
- Centre for Primary Health Care and Equity, School of Population Health, University of New South Wales, Sydney, Australia
- Menzies Centre for Health Policy and Economics, School of Public Health, University of Sydney
| | | | - Mark Brooke
- Lung Foundation Australia, Milton, Queensland, Australia
| | - Kalinda Griffiths
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Darwin, Australia
- Centre for Health Equity, University of Melbourne, Melbourne, Australia
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
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20
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Yaugher AC, Pay CC, Hawks J, Meier CL. Evaluating a Multicomponent e-Cigarette Prevention Program in the Rural Northwest: Teacher and Parent/Guardian Program Outcomes. J Sch Nurs 2023:10598405231198020. [PMID: 37644848 DOI: 10.1177/10598405231198020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
There are effective prevention strategies to combat increasing rates of youth e-cigarette use. This study assessed the outcomes of an e-cigarette prevention program with teachers and parents/guardians across a three-county rural area. Researchers assessed teachers' and parent/guardians' increased knowledge and confidence in implementing vape prevention after receiving evidence-based trainings. Pre- and post-surveys demonstrated that teachers had a statistically significant increase in knowledge gain across all eight vape-specific domains assessed as expected. The parent/guardian pre- and post-survey results also show that knowledge and confidence increased significantly across seven domains. Findings suggest that multicomponent e-cigarette education and prevention programs better prepare teachers and parents/guardians to intervene with youth e-cigarette use and initiation, including being more likely to talk to youth about the risks of tobacco and vaping. Recommendations for school nurses are discussed and include educating youth, families, and staff for positive impacts.
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Affiliation(s)
- Ashley C Yaugher
- Utah State University, Cooperative Extension in Carbon, Emery, and Grand Counties, Logan, UT, USA
| | - Christina C Pay
- Utah State University, Cooperative Extension in Carbon, Emery, and Grand Counties, Logan, UT, USA
| | - Jenna Hawks
- Utah State University, Cooperative Extension in Carbon, Emery, and Grand Counties, Logan, UT, USA
| | - Cristian L Meier
- Utah State University, Cooperative Extension in Carbon, Emery, and Grand Counties, Logan, UT, USA
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21
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Pokhrel P, Lipperman-Kreda S, Wills TA, Keaweʻaimoku Kaholokula J, Kawamoto CT, Amin S, Herzog TA. Ethnicity, Coronavirus Disease-Related Stress, and E-cigarette Use and Cigarette Smoking Among Young Adults: A Longitudinal Study. Nicotine Tob Res 2023; 25:1676-1686. [PMID: 37330693 PMCID: PMC10445257 DOI: 10.1093/ntr/ntad095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 06/08/2023] [Accepted: 06/14/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Research has rarely examined ethnic differences in exposure to coronavirus disease (COVID)-related stress in relation to smoking and e-cigarette use. AIMS AND METHODS Using pre- and post-COVID data from a sample of predominantly Asian American (AA) and Native Hawaiian and Pacific Islander (NHPI) young adults, this study aimed to test the effects of ethnicity on cigarette smoking and e-cigarette use through exposure to COVID-related stress. Young adults from Hawaii who provided pre-COVID data in or before January 2020 were followed up with in March-May 2021. N = 1907 (mean age = 24.9 [SD = 2.9], 56% women) provided complete data relevant to the current analysis at both waves of data collection. Structural equation modeling was used to test the effects of ethnicity (white, Asian [eg, Japanese, Chinese], Filipino, NHPI, and other) on pre- to post-COVID changes in cigarette and e-cigarette use via effects on COVID-related stress. RESULTS Relative to Asian young adults, members of all other ethnic groups (NHPI, Filipino, white, and other) indicated greater exposure to COVID-related stress. Higher levels of COVID-related stress were associated with increased dual-use status and increased current e-cigarette and cigarette use frequencies. Higher COVID-related stress mediated the effects of NHPI, Filipino, and other ethnicity on increased dual-use status. CONCLUSIONS The current data indicate that young adults of vulnerable ethnic groups who experience higher COVID-related stress are at increased risk for dual use of cigarettes and e-cigarettes. IMPLICATIONS The findings imply that tobacco use prevention and treatment efforts may need to pay increased attention to racial or ethnic groups that have experienced greater adverse impact of the COVID-19 pandemic.
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Affiliation(s)
- Pallav Pokhrel
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | - Thomas A Wills
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Joseph Keaweʻaimoku Kaholokula
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Crissy T Kawamoto
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Samia Amin
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Thaddeus A Herzog
- Population Sciences in the Pacific Program, University of Hawaii Cancer Center, University of Hawaii at Mānoa, Honolulu, HI, USA
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22
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Bandi P, Star J, Minihan AK, Patel M, Nargis N, Jemal A. Changes in E-Cigarette Use Among U.S. Adults, 2019-2021. Am J Prev Med 2023; 65:322-326. [PMID: 37479423 DOI: 10.1016/j.amepre.2023.02.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/27/2023] [Accepted: 02/27/2023] [Indexed: 07/23/2023]
Abstract
INTRODUCTION E-cigarette use increased between 2014 and 2018 among younger U.S. adults who had never smoked combustible cigarettes, potentially increasing nicotine addiction risk and progression to combustible tobacco products. It is unknown how prevalence changed after the E-cigarette, or vaping, product use-associated lung injury epidemic (late 2019) and COVID-19 pandemic (March 2020) by age group and combustible cigarette smoking status. METHODS Data from cross-sectional, nationally representative National Health Interview Surveys in 2019, 2020, and 2021 (analyzed in 2022) were used to estimate current E-cigarette use prevalence, adjusted prevalence difference between survey years, and population counts, by age group (younger, 18-29 years, n=11,700; middle age, 30-44 years, n=21,300, 45-59 years, n=21,308; older, ≥60 years, n=36,224) and cigarette smoking status (current, former, and never). RESULTS E-cigarette use prevalence increased among younger adults between 2019 and 2021 (8.8%-10.2%, adjusted prevalence difference=1.7% points, 95% CI=0.1, 3.3), primarily owing to an increase among those who never smoked cigarettes (4.9%-6.4%, adjusted prevalence difference=1.7% points, 95% CI=0.3, 3.1). People who never smoked cigarettes constituted 53% (2.68 million) of younger adults who used E-cigarettes in 2021, increasing by 0.71 million from 2019. Conversely, among middle age and older adults, the prevalence was similar in 2019 and 2021 irrespective of cigarette smoking status, and those who formerly smoked cigarettes constituted the largest proportion of people who used E-cigarettes in 2021 (age 30-44 years: 51.8%, 1.8 million; age 45-59 years: 51.6%, 0.85 million; age ≥60 years: 47.5%, 0.45 million). CONCLUSIONS Efforts must address the rise in E-cigarette use among younger adults who never smoked cigarettes. At the same time, assistance is needed to help those who switched to E-cigarettes to stop smoking to transition to non-use of all products.
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Affiliation(s)
- Priti Bandi
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia.
| | - Jessica Star
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Adair K Minihan
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Minal Patel
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Nigar Nargis
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Ahmedin Jemal
- Surveillance & Health Equity Science, American Cancer Society, Atlanta, Georgia
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23
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Dubrosa F, Sangiuolo K, Franco J, Milanaik RL. Quick nic: novel smokeless nicotine products and pediatric trends. Curr Opin Pediatr 2023; 35:500-512. [PMID: 37335274 DOI: 10.1097/mop.0000000000001270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
PURPOSE OF REVIEW The development and marketing of smokeless nicotine products in recent years have become increasingly popular among adolescents. In addition to well known conventional inhaled nicotine products, noninhaled products, such as nicotine toothpicks, orbs, lozenges, strips, and more, have dangerously captivated a new youth audience. Although smokeless nicotine products may seem to be less threatening than conventional inhaled nicotine products, there are significant risks associated with the use of these products, including addiction and severe health issues. The purpose of this review is to provide up-to-date information about alternative nicotine products currently on the market that may appeal to youth, and the dangers of nicotine use for pediatric populations. RECENT FINDINGS Smokeless nicotine products appeal to minors with their varying flavors and discrete packaging. These products may lead to nicotine toxicity as well as severe health problems, such as cancer, issues with reproduction, and heart attacks. Nicotine is extremely dangerous for young children; in fact, using nicotine products before the age of 18 years can lead to addiction and is linked to an increased likelihood of experimenting with stronger nicotine products or illicit drugs. The development of inconspicuous nicotine packaging has led to increasing concerns for accidental nicotine exposure and overdose in youth. SUMMARY Greater knowledge regarding current nicotine products on the market, specifically smokeless nicotine products, will help clinicians be more aware of the dangers associated with these products. Clinicians will be better able to provide their patients and families with proper guidance to avoid nicotine addiction, further drug use, and detrimental health issues. Caregivers and medical professionals must recognize novel and inconspicuous nicotine products commonly used among youth, understand the signs of nicotine abuse and dependence, and take measures to address possible nicotine-related health risks.
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Affiliation(s)
- Fiona Dubrosa
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, Lake Success, New York, USA
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24
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Begum R, Thota S, Batra S. Interplay between proteasome function and inflammatory responses in e-cig vapor condensate-challenged lung epithelial cells. Arch Toxicol 2023; 97:2193-2208. [PMID: 37344694 DOI: 10.1007/s00204-023-03504-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 04/20/2023] [Indexed: 06/23/2023]
Abstract
Exposure to cigarettes and other nicotine-based products results in persistent inflammation in the lung. In recent years, electronic cigarettes (e-cigs) have become extremely popular among adults and youth alike. E-cigarette vapor-induced oxidative stress promotes protein breakdown, DNA damage and cell death, culminating in a variety of respiratory diseases. The proteasome, a multi-catalytic protease, superintends protein degradation within the cell. When cells are stimulated with inflammatory cytokines such as IFN-γ and TNF-α, the constitutive catalytic proteasome subunits are replaced by the inducible subunits-low-molecular mass polypeptide (LMP)2 (β1i), multi-catalytic endopeptidase complex-like (MECL)1 (β2i), and LMP7 (β5i), which are required for the production of certain MHC class I-restricted T-cell epitopes. In this study, we used human alveolar epithelial cells (A549) and exposed them to filtered air or (1%) tobacco-flavored (TF) electronic cigarette vapor condensate (ECVC) ± nicotine (6 mg/ml) (TF-ECVC ± N) for 24 h. We observed an increase in the levels of IFN-γ, TNF-α, and inducible proteasome subunits (LMP7/PSMB8, LMP2/PSMB9, MECL1/PSMB10), and a reduced expression of constitutive proteasome subunits (β1/PSMB6 and β2/PSMB7) in challenged A549 cells. Interestingly, knockdown of the inducible proteasome subunit LMP7 reversed ECVC-induced expression of NADPH oxidase and immunoproteasome subunits in A549 cells. In addition, pre-exposure to an LMP7 inhibitor (ONX-0914) abrogated the mRNA expression of several NOX subunits and rescued the excessive production/release of inflammatory cytokines/chemokines (IL-6, IL-8, CCL2, and CCL5) in ECVC-challenged cells. Our findings suggest an important role of LMP7 in regulating the expression of inflammatory mediators during ECVC exposure. Overall, our results provide evidence for proteasome-dependent ROS-mediated inflammation in ECVC-challenged cells.
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Affiliation(s)
- R Begum
- Laboratory of Pulmonary Immunotoxicology, Department of Environmental Toxicology, Southern University and A&M College, 129 Health Research Center, Baton Rouge, Louisiana, 70813, USA
| | - S Thota
- Laboratory of Pulmonary Immunotoxicology, Department of Environmental Toxicology, Southern University and A&M College, 129 Health Research Center, Baton Rouge, Louisiana, 70813, USA
| | - S Batra
- Laboratory of Pulmonary Immunotoxicology, Department of Environmental Toxicology, Southern University and A&M College, 129 Health Research Center, Baton Rouge, Louisiana, 70813, USA.
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25
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Fairman RT, Churchill V, Garner JB, Brown D, Massey ZB, Ashley DL, Popova L. It's addiction at this Point": A qualitative examination of youth E-cigarette use trajectory in the United States. Tob Use Insights 2023; 16:1179173X231185455. [PMID: 37528837 PMCID: PMC10387766 DOI: 10.1177/1179173x231185455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/14/2023] [Indexed: 08/03/2023] Open
Abstract
E-cigarettes (electronic cigarettes) have been the most used tobacco product among US youth since 2014, reaching a plateau during the COVID-19 pandemic. Youth e-cigarette use is associated with negative health consequences such as impaired cognitive functioning. For many, the COVID-19 pandemic altered social interactions, harm perceptions, and product availability. This changed the frequency and locations in which youth use e-cigarettes. To better understand youth e-cigarette use, we need more information on factors that can alter e-cigarette use, specifically, how the pandemic changed e-cigarette use among youth. In 2020-2021, we conducted online, individual interviews with 19 youth (aged 13-17) e-cigarette users living in the US to explore how COVID-19 impacted their e-cigarette use. Youth described a progression of e-cigarette use from initial experimentation, regular social use, and ultimately to nicotine addiction demonstrated by individual use in isolation. Many youth initiated e-cigarette use due to influences by friends or family members. Youth discussed progression to social use, with social interactions as an important reason for use and an avenue for expanding one's knowledge of e-cigarettes. After a period of time, youth began to recognize that the social interactions mattered less, suggesting to them that they had become addicted. This realization became more apparent during COVID-19, which changed how youth used e-cigarettes, especially around where use was occurring, health concerns, and use behavior and frequency. In our interviews, youth trajectory began with an initiation with family and friends, progressed to social use, and eventually developed to addiction, at which point social use was no longer the primary motivation for e-cigarette use. Understanding the trajectory of e-cigarette use will allow for effective interventions that reduce harm to youth from e-cigarette use.
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Affiliation(s)
| | - Victoria Churchill
- Morehouse School of Medicine, Cancer Health Equity Institute, Atlanta, GA, USA
| | - Jamani B. Garner
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Devon Brown
- JSI Research and Training Institute, Inc., Atlanta, GA, USA
| | | | - David L. Ashley
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, GA, USA
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26
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Manglallan KS, Johnson DL, Rosario MH, An KJ, Carson AB, Phillips KT, Pokhrel P, Okamoto SK. A Systematic Literature Review of Asian American, Native Hawaiian, and Pacific Islander Youth Electronic Nicotine Delivery Systems (ENDS) Use. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:151-157. [PMID: 37465472 PMCID: PMC10351245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Rates of electronic nicotine delivery systems (ENDS) use are exponentially increasing in youth and young adults within the United States, including Asian American, Native Hawaiian, and Pacific Islander (AANHPI) youth in Hawai'i. Disproportionately high ENDS use rates for AANHPI youth point to the need to understand the empirical literature in this area. A systematic literature review is a prerequisite for programs effectively curbing AANHPI youths' elevated use of ENDS. This systematic literature review examines empirical studies published between 2010-2020 on ENDS and their use as it applies to AANHPI youth. A total of 11 articles were identified using specific inclusionary and exclusionary criteria in a literature search. Studies described individual and interpersonal correlates to ENDS use. Notably, there were no published ENDS intervention studies detailed to AANHPI youth. Implications of these studies for prevention and social welfare interventions are discussed.
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Affiliation(s)
| | - Dixie L. Johnson
- School of Social Work, Hawai‘i Pacific University, Honolulu, HI (KSM, DLJ, SKO)
| | | | - Katlyn J. An
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI (KJA, ABC, PP, SKO)
| | - Adabelle B. Carson
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI (KJA, ABC, PP, SKO)
| | - Kristina T. Phillips
- Center for Integrated Health Care Research (CIHR), Kaiser Permanente Hawai‘i, Honolulu, HI (KTP)
| | - Pallav Pokhrel
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI (KJA, ABC, PP, SKO)
| | - Scott K. Okamoto
- School of Social Work, Hawai‘i Pacific University, Honolulu, HI (KSM, DLJ, SKO)
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI (KJA, ABC, PP, SKO)
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27
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Chattopadhyay S, Malayil L, Kaukab S, Merenstein Z, Sapkota AR. The predisposition of smokers to COVID-19 infection: A mini-review of global perspectives. Heliyon 2023; 9:e17783. [PMID: 37455971 PMCID: PMC10306417 DOI: 10.1016/j.heliyon.2023.e17783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 06/22/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
Both SARS-CoV-2 and smoking tobacco adversely impact the respiratory system, damaging the airways and impairing lung function. While some studies have identified a positive association between smoking and increased susceptibility to COVID-19 infections, a few papers have concluded that smokers may be protected against such infections. Given these contradictory findings, there is an ongoing debate in the scientific community about whether or not smokers have a stronger predisposition towards COVID-19 infections. Through this mini-review, we aimed to study the relationship between tobacco smoking and COVID-19 infections by conducting a comprehensive literature search of peer reviewed articles that reported on the effects of smoking on COVID-19 susceptibility and were published globally over the past two years (January 2020-April 2022). Our search identified 31 articles that demonstrated a positive or strong relationship between smoking and COVID-19, while 13 articles had contrasting results. Additionally, we evaluated mechanistic studies suggesting that, among smokers, angiotensin-converting enzyme-2 genes are upregulated, facilitating easier binding of SARS-CoV-2, thereby increasing the risk of COVID-19 infection. In conclusion, the majority of studies in this area to date provide evidence of a strong relationship between smoking and COVID-19 infection; however, the strength of this association may vary across the smoking behaviors of differing populations. Future work could involve a meta-analysis of studies focusing on susceptibility to COVID-19 infection for different types of tobacco product smokers, which would result in a more comprehensive understanding of the predisposition of smokers towards COVID-19 infections.
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Affiliation(s)
- Suhana Chattopadhyay
- Corresponding author. Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, 4200 Valley Drive, College Park, MD-20742, USA.
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28
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Rosario MH, Johnson DL, Manglallan KS, Phillips KT, Pokhrel P, Okamoto SK. Tobacco use among native Hawaiian and Pacific Islander youth in the U.S. and USAPI: a systematic review of the literature. J Ethn Subst Abuse 2023; 22:500-515. [PMID: 34424138 PMCID: PMC8863994 DOI: 10.1080/15332640.2021.1965934] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
With rates of tobacco use among youth in the United States on the rise, further analysis of disproportionately impacted populations, like Native Hawaiian and other Pacific Islanders (NHPIs), is needed. NHPIs face a unique set of challenges compared to other ethnic minorities that contribute to their health disparities from tobacco use. This systematic literature review investigated empirical studies published between 2010-2020 on tobacco use among NHPI youth and young adults. Using comprehensive literature search engines and focused author searches of tobacco researchers in NHPI communities, 7,208 article abstracts were extracted for potential inclusion. Explicit inclusionary and exclusionary criteria were used to identify peer-reviewed articles related to tobacco use correlates and interventions for NHPI youth populations. A total of 17 articles met our criteria for inclusion in this study. Community influences, peer pressure, social status, variety of flavors, craving, and stimulation were correlates found in smoking and vaping for NHPI youth. There were also few published tobacco use prevention and intervention studies focused specifically on NHPI youth. Our study addresses the needs of an under-researched population that is heavily affected by the adverse consequences of short-term and long-term use of cigarettes and e-cigarettes. Additional research should focus on developing effective and culturally relevant interventions to reduce NHPI health disparities.
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Affiliation(s)
| | | | | | | | - Pallav Pokhrel
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center
| | - Scott K. Okamoto
- School of Social Work, Hawai‘i Pacific University
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center
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29
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Moyers SA, Hartwell M, Chiaf A, Greiner B, Oliver JA, Croff JM. Associations of Combustible Cigarette, Electronic Cigarette, and Dual Use With COVID Infection and Severity in the U.S.: A Cross-sectional Analysis of the 2021 National Health Information Survey. Tob Use Insights 2023; 16:1179173X231179675. [PMID: 37324057 PMCID: PMC10262671 DOI: 10.1177/1179173x231179675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Given the potential respiratory health risks, the association of COVID infection and the use of combustible cigarettes, electronic nicotine delivery systems (ENDS), and concurrent dual use is a priority for public health. Many published reports have not accounted for known covarying factors. This study sought to calculate adjusted odds ratios for self-reported COVID infection and disease severity as a function of smoking and ENDS use, while accounting for factors known to influence COVID infection and disease severity (i.e., age, sex, race and ethnicity, socioeconomic status and educational attainment, rural or urban environment, self-reported diabetes, COPD, coronary heart disease, and obesity status). Data from the 2021 U.S. National Health Interview Survey, a cross-sectional questionnaire design, were used to calculate both unadjusted and adjusted odds ratios for self-reported COVID infection and severity of symptoms. Results indicate that combustible cigarette use is associated with a lower likelihood of self-reported COVID infection relative to non-use of tobacco products (AOR = .64; 95% CI [.55, .74]), whereas ENDS use is associated with a higher likelihood of self-reported COVID infection (AOR = 1.30; 95% CI [1.04, 1.63]). There was no significant difference in COVID infection among dual users (ENDS and combustible use) when compared with non-users. Adjusting for covarying factors did not substantially change the results. There were no significant differences in COVID disease severity between those of varying smoking status. Future research should examine the relationship between smoking status and COVID infection and disease severity utilizing longitudinal study designs and non-self-report measures of smoking status (e.g., the biomarker cotinine), COVID infection (e.g., positive tests), and disease severity (e.g., hospitalizations, ventilator assistance, mortality, and ongoing symptoms of long COVID).
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Affiliation(s)
- Susette A Moyers
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Micah Hartwell
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- Office of Medical Student Research, Oklahoma State University College of Osteopathic Medicine, Tulsa, OK, USA
| | - Ashleigh Chiaf
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Benjamin Greiner
- Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Jason A Oliver
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Julie M Croff
- Center for Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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30
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Valencia-Pérez Rea D, Falfán-Valencia R, Fricke-Galindo I, Buendía-Roldán I, Chávez-Galán L, Nava-Quiroz KJ, Alanis-Ponce J, Pérez-Rubio G. The rs16969968 Tobacco Smoking-Related Single-Nucleotide Variant Is Associated with Clinical Markers in Patients with Severe COVID-19. Int J Mol Sci 2023; 24:9811. [PMID: 37372959 PMCID: PMC10298344 DOI: 10.3390/ijms24129811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/26/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Tobacco smoking is the leading risk factor for many respiratory diseases. Several genes are associated with nicotine addiction, such as CHRNA5 and ADAM33. This research aims to evaluate the association of the polymorphisms rs16969968 (CHRNA5) and rs3918396 (ADAM33) in patients who developed severe COVID-19. We included 917 COVID-19 patients hospitalized with critical disease and oxygenation impairment. They were divided into two groups, tobacco-smoking (n = 257) and non-smoker (n = 660) patients. The genotype and allele frequencies of two single nucleotide variants, the rs16969968 (CHRNA5) and rs3918396 (ADAM33), were evaluated. The rs3918396 in ADAM33 does not show a significative association. We analyzed the study population according to the rs16969968 genotype (GA + AA, n = 180, and GG, n = 737). The erythrocyte sedimentation rate (ESR) shows statistical differences; the GA + AA group had higher values than the GG group (p = 0.038, 32 vs. 26 mm/h, respectively). The smoking patients and GA or AA genotype carriers had a high positive correlation (p < 0.001, rho = 0.753) between fibrinogen and C-reactive protein. COVID-19 patients and smokers carriers of one or two copies of the risk allele (rs16969968/A) have high ESR and a positive correlation between fibrinogen and C-reactive protein.
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Affiliation(s)
- Daniela Valencia-Pérez Rea
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico; (D.V.-P.R.); (R.F.-V.); (I.F.-G.); (K.J.N.-Q.); (J.A.-P.)
| | - Ramcés Falfán-Valencia
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico; (D.V.-P.R.); (R.F.-V.); (I.F.-G.); (K.J.N.-Q.); (J.A.-P.)
| | - Ingrid Fricke-Galindo
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico; (D.V.-P.R.); (R.F.-V.); (I.F.-G.); (K.J.N.-Q.); (J.A.-P.)
| | - Ivette Buendía-Roldán
- Translational Research Laboratory on Aging and Pulmonary Fibrosis, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico;
| | - Leslie Chávez-Galán
- Laboratory of Integrative Immunology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico;
| | - Karol J. Nava-Quiroz
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico; (D.V.-P.R.); (R.F.-V.); (I.F.-G.); (K.J.N.-Q.); (J.A.-P.)
| | - Jesús Alanis-Ponce
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico; (D.V.-P.R.); (R.F.-V.); (I.F.-G.); (K.J.N.-Q.); (J.A.-P.)
| | - Gloria Pérez-Rubio
- HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City 14080, Mexico; (D.V.-P.R.); (R.F.-V.); (I.F.-G.); (K.J.N.-Q.); (J.A.-P.)
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31
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Halliday DM, Epperson AE, Gonzalez M, Song AV. Perceptions of COVID-related risks among people who smoke: A mediation model. Prev Med Rep 2023; 33:102205. [PMID: 37193534 PMCID: PMC10106784 DOI: 10.1016/j.pmedr.2023.102205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/06/2023] [Indexed: 05/18/2023] Open
Abstract
The COVID-19 pandemic provides both reasons to quit smoking as well as stress that may promote increased cigarette consumption. Perceptions of COVID-19 risk related to smoking may motivate cessation among smokers. At the same time, other evidence shows that affective perceptions (i.e., worry) could lead to increased smoking as a coping mechanism. Using a sample drawn from a rural region of California (N = 295), we examined the relationship between perceptions about health risks for smokers during the pandemic and both reported increases in smoking frequency and intentions to quit smoking. We also examined whether worry about health risks mediated these relationships. High perceived risk was associated both with reported increases in smoking frequency as well as greater intentions to quit smoking. Worry partially mediated both these relationships, with worry accounting for 29.11% of the variance in the relationship between high risk perceptions and increased smoking as well as 20.17% of the relationship between risk perceptions and intentions to quit smoking. These findings suggest that while smokers' awareness about their increased risk of COVID-19 can motivate intent to quit smoking in the future, smokers may require greater support to act on these intentions.
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Affiliation(s)
- Deanna M. Halliday
- Department of Psychological Sciences, University of California, Merced, United States
- Nicotine and Cannabis Policy Center, University of California, Merced, United States
| | - Anna E. Epperson
- Department of Psychological Sciences, University of California, Merced, United States
- Nicotine and Cannabis Policy Center, University of California, Merced, United States
| | - Mariaelena Gonzalez
- Nicotine and Cannabis Policy Center, University of California, Merced, United States
- Department of Public Health, University of California, Merced, United States
| | - Anna V. Song
- Department of Psychological Sciences, University of California, Merced, United States
- Nicotine and Cannabis Policy Center, University of California, Merced, United States
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32
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Awatade NT, Wark PAB, Chan ASL, Mamun SMAA, Mohd Esa NY, Matsunaga K, Rhee CK, Hansbro PM, Sohal SS. The Complex Association between COPD and COVID-19. J Clin Med 2023; 12:jcm12113791. [PMID: 37297985 DOI: 10.3390/jcm12113791] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is significant cause of morbidity and mortality worldwide. There is mounting evidence suggesting that COPD patients are at increased risk of severe COVID-19 outcomes; however, it remains unclear whether they are more susceptible to acquiring SARS-CoV-2 infection. In this comprehensive review, we aim to provide an up-to-date perspective of the intricate relationship between COPD and COVID-19. We conducted a thorough review of the literature to examine the evidence regarding the susceptibility of COPD patients to COVID-19 infection and the severity of their disease outcomes. While most studies have found that pre-existing COPD is associated with worse COVID-19 outcomes, some have yielded conflicting results. We also discuss confounding factors such as cigarette smoking, inhaled corticosteroids, and socioeconomic and genetic factors that may influence this association. Furthermore, we review acute COVID-19 management, treatment, rehabilitation, and recovery in COPD patients and how public health measures impact their care. In conclusion, while the association between COPD and COVID-19 is complex and requires further investigation, this review highlights the need for careful management of COPD patients during the pandemic to minimize the risk of severe COVID-19 outcomes.
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Affiliation(s)
- Nikhil T Awatade
- Immune Health Program, Hunter Medical Research Institute and University of Newcastle, Newcastle 2305, Australia
| | - Peter A B Wark
- Immune Health Program, Hunter Medical Research Institute and University of Newcastle, Newcastle 2305, Australia
- Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle 2305, Australia
| | - Andrew S L Chan
- Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, St. Leonards 2065, Australia
- Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
| | - S M Abdullah Al Mamun
- Department of Respiratory Medicine & Sleep Medicine, Evercare Hospitals Dhaka, Dhaka 1229, Bangladesh
| | | | - Kazuto Matsunaga
- Department of Respiratory Medicine and Infectious Disease Graduate School of Medicine, Yamaguchi University, 1-1-1 Minami-kogushi, Ube 755-8505, Japan
| | - Chin Kook Rhee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Philip M Hansbro
- Immune Health Program, Hunter Medical Research Institute and University of Newcastle, Newcastle 2305, Australia
- Centre for Inflammation, Faculty of Science, School of Life Sciences, Centenary Institute and University of Technology Sydney, Sydney 2050, Australia
| | - Sukhwinder Singh Sohal
- Respiratory Translational Research Group, Department of Laboratory Medicine, School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston 7248, Australia
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Scieszka DP, Garland D, Hunter R, Herbert G, Lucas S, Jin Y, Gu H, Campen MJ, Cannon JL. Multi-omic assessment shows dysregulation of pulmonary and systemic immunity to e-cigarette exposure. Respir Res 2023; 24:138. [PMID: 37231407 PMCID: PMC10209577 DOI: 10.1186/s12931-023-02441-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/01/2023] [Indexed: 05/27/2023] Open
Abstract
Electronic cigarette (Ecig) use has become more common, gaining increasing acceptance as a safer alternative to tobacco smoking. However, the 2019 outbreak of Ecig and Vaping-Associated Lung Injury (EVALI) alerted the community to the potential for incorporation of deleterious ingredients such as vitamin E acetate into products without adequate safety testing. Understanding Ecig induced molecular changes in the lung and systemically can provide a path to safety assessment and protect consumers from unsafe formulations. While vitamin E acetate has been largely removed from commercial and illicit products, many Ecig products contain additives that remain largely uncharacterized. In this study, we determined the lung-specific effects as well as systemic immune effects in response to exposure to a common Ecig base, propylene glycol and vegetable glycerin (PGVG), with and without a 1% addition of phytol, a diterpene alcohol that has been found in commercial products. We exposed animals to PGVG with and without phytol and assessed metabolite, lipid, and transcriptional markers in the lung. We found both lung-specific as well as systemic effects in immune parameters, metabolites, and lipids. Phytol drove modest changes in lung function and increased splenic CD4 T cell populations. We also conducted multi-omic data integration to better understand early complex pulmonary responses, highlighting a central enhancement of acetylcholine responses and downregulation of palmitic acid connected with conventional flow cytometric assessments of lung, systemic inflammation, and pulmonary function. Our results demonstrate that Ecig exposure not only leads to changes in pulmonary function but also affects systemic immune and metabolic parameters.
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Affiliation(s)
- David P Scieszka
- Department of Pharmaceutical Sciences, University of New Mexico School of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Devon Garland
- Department of Molecular Genetics and Microbiology, University of New Mexico School of Medicine, MSC 08 4660, 1 University of New Mexico, Albuquerque, NM, 87131, USA
| | - Russell Hunter
- Department of Pharmaceutical Sciences, University of New Mexico School of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Guy Herbert
- Department of Pharmaceutical Sciences, University of New Mexico School of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Selita Lucas
- Department of Pharmaceutical Sciences, University of New Mexico School of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Yan Jin
- Center for Translational Science, Florida International University, Port St. Lucie, FL, USA
| | - Haiwei Gu
- Center for Translational Science, Florida International University, Port St. Lucie, FL, USA
| | - Matthew J Campen
- Department of Pharmaceutical Sciences, University of New Mexico School of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Judy L Cannon
- Department of Molecular Genetics and Microbiology, University of New Mexico School of Medicine, MSC 08 4660, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
- Autophagy, Inflammation, and Metabolism Center of Biomedical Research Excellence, University of New Mexico School of Medicine, Albuquerque, NM, USA.
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Singh I, Valavil Punnapuzha V, Mitsakakis N, Fu R, Chaiton M. A Machine Learning Approach Reveals Distinct Predictors of Vaping Dependence for Adolescent Daily and Non-Daily Vapers in the COVID-19 Era. Healthcare (Basel) 2023; 11:healthcare11101465. [PMID: 37239751 DOI: 10.3390/healthcare11101465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/04/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Since 2016, there has been a substantial rise in e-cigarette (vaping) dependence among young people. In this prospective cohort study, we aimed to identify the different predictors of vaping dependence over 3 months among adolescents who were baseline daily and non-daily vapers. We recruited ever-vaping Canadian residents aged 16-25 years on social media platforms and asked them to complete a baseline survey in November 2020. A validated vaping dependence score (0-23) summing up their responses to nine questions was calculated at the 3-month follow-up survey. Separate lasso regression models were developed to identify predictors of higher 3-month vaping dependence score among baseline daily and non-daily vapers. Of the 1172 participants, 643 (54.9%) were daily vapers with a mean age of 19.6 ± 2.6 years and 76.4% (n = 895) of them being female. The two models achieved adequate predictive performance. Place of last vape purchase, number of days a pod lasts, and the frequency of nicotine-containing vaping were the most important predictors for dependence among daily vapers, while race, sexual orientation and reporting treatment for heart disease were the most important predictors in non-daily vapers. These findings have implications for vaping control policies that target adolescents at different stages of vape use.
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Affiliation(s)
- Ishmeet Singh
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada
| | - Varna Valavil Punnapuzha
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada
| | - Nicholas Mitsakakis
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada
| | - Rui Fu
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Research Institute, University of Toronto, Toronto, ON M4N 3M5, Canada
| | - Michael Chaiton
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
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Shin H, Park S, Yon H, Ban CY, Turner S, Cho SH, Shin YH, Shin JU, Koyanagi A, Jacob L, Smith L, Min C, Lee YJ, Kim SY, Lee J, Kwon R, Koo MJ, Fond G, Boyer L, Hahn JW, Kim N, Rhee SY, Shin JI, Woo HG, Park H, Kim HJ, Lee Y, Kim MS, Lefkir E, Hadalin V, Choi J, Lee SW, Yon DK, Kim S. Estimated prevalence and trends in smoking among adolescents in South Korea, 2005-2021: a nationwide serial study. World J Pediatr 2023; 19:366-377. [PMID: 36645642 PMCID: PMC9842213 DOI: 10.1007/s12519-022-00673-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/06/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Although smoking is classified as a risk factor for severe COVID-19 outcomes, there is a scarcity of studies on prevalence of smoking during the COVID-19 pandemic. Thus, this study aims to analyze the trends of prevalence of smoking in adolescents over the COVID-19 pandemic period. METHODS The present study used data from middle to high school adolescents between 2005 and 2021 who participated in the Korea Youth Risk Behavior Web-based Survey (KYRBS). We evaluated the smoking prevalence (ever or daily) by year groups and estimated the slope in smoking prevalence before and during the pandemic. RESULTS A total of 1,137,823 adolescents participated in the study [mean age, 15.04 years [95% confidence interval (CI) 15.03-15.06]; and male, 52.4% (95% CI 51.7-53.1)]. The prevalence of ever smokers was 27.7% (95% CI 27.3-28.1) between 2005 and 2008 but decreased to 9.8% (95% CI 9.3-10.3) in 2021. A consistent trend was found in daily smokers, as the estimates decreased from 5.4% (95% CI 5.2-5.6) between 2005 and 2008 to 2.3% (95% CI 2.1-2.5) in 2021. However, the downward slope in the overall prevalence of ever smokers and daily smokers became less pronounced in the COVID-19 pandemic period than in the pre-pandemic period. In the subgroup with substance use, the decreasing slope in daily smokers was significantly more pronounced during the pandemic than during the pre-pandemic period. CONCLUSIONS The proportion of ever smokers and daily smokers showed a less pronounced decreasing trend during the pandemic. The findings of our study provide an overall understanding of the pandemic's impact on smoking prevalence in adolescents. Supplementary file2 (MP4 64897 KB).
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Affiliation(s)
- Hyoin Shin
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Sangil Park
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hyunju Yon
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Chae Yeon Ban
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Stephen Turner
- Maternity and Child Health Division, NHS Grampian Aberdeen, Aberdeen, UK
| | - Seong Ho Cho
- Division of Allergy-Immunology, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South Korea
| | - Jung U Shin
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, ISCIII, Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Pg. Lluis Companys, Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, ISCIII, Barcelona, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-Le-Bretonneux, France
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Chanyang Min
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, 02447, South Korea
| | - Young Joo Lee
- Department of Obstetrics and Gynecology, Kyung Hee University College of Medicine, Seoul, South Korea
| | - So Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Jinseok Lee
- Department of Biomedical Engineering, Kyung Hee University, Yongin, South Korea
| | - Rosie Kwon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, 02447, South Korea
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Min Ji Koo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, 02447, South Korea
- Department of Human Biology, University of Toronto, Toronto, ON, Canada
| | - Guillaume Fond
- AP-HM, Aix-Marseille Univ., CEReSS-Health Service Research and Quality of Life Center, Marseille, France
- FondaMental Foundation, Creteil, France
| | - Laurent Boyer
- AP-HM, Aix-Marseille Univ., CEReSS-Health Service Research and Quality of Life Center, Marseille, France
- FondaMental Foundation, Creteil, France
| | - Jong Woo Hahn
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Namwoo Kim
- Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Sang Youl Rhee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, 02447, South Korea
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Ho Geol Woo
- Department of Neurology, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hyeowon Park
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, 02447, South Korea
| | - Hyeon Jin Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, 02447, South Korea
| | - Yoonsung Lee
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Man S Kim
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Eléa Lefkir
- Faculty of Medicine, University of Rennes 1, Rennes, France
| | - Vlasta Hadalin
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Jungwoo Choi
- Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea.
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, 02447, South Korea.
- Department of Pediatrics, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South Korea.
| | - Sunyoung Kim
- Department of Family Medicine, Kyung Hee University College of Medicine, 23 Kyungheedae-Ro, Dongdaemun-Gu, Seoul, 02447, South Korea.
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Han SG, Sillé FC, Mihalic JN, Rule AM. The relationship between the use of electronic nicotine delivery systems (ENDS) and effects on pulmonary immune responses-a literature review. ENVIRONMENTAL RESEARCH 2023; 221:115234. [PMID: 36634896 DOI: 10.1016/j.envres.2023.115234] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 12/16/2022] [Accepted: 01/04/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION The use of electronic nicotine delivery systems (ENDS), or vaping, is a relatively recent phenomenon, and there are various gaps in our current knowledge regarding the specific effects of e-cigarettes, such as their immunological effects. The importance of this question became even more relevant in light of the COVID-19 pandemic. OBJECTIVE This literature review examines the relationship between the use of electronic nicotine delivery systems (ENDS) and immunological effects to examine available information and identify gaps in the current knowledge. Our search strategy included studies focusing on the effects of ENDS on the immune response during infectious respiratory diseases such as COVID-19 and pneumonia. METHODS Peer-reviewed studies presenting quantitative data published from 2007, the year that e-cigarettes were introduced to the US market until 2022 have been included. All studies were indexed in PubMed. We excluded papers on THC and EVALI (E-cigarette, or Vaping Product, Use Associated Lung Injury) as we wanted to focus on the effects of nicotine devices. RESULTS Among the 21 articles that assessed the relationship between ENDS and immunological health effects, we found eight studies based on cell models, two articles based on both cell and mouse models, five articles based on mouse models, and six studies of human populations. Most of the articles identified in our review demonstrated a potential association between vaping and adverse immunological health effects. DISCUSSION Overall, the evidence from the cell and animal studies indicates that there is a positive, statistically significant association between vaping and adverse immune response during infectious respiratory diseases. The evidence from human studies is not conclusive.
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Affiliation(s)
- Seok Gyu Han
- Johns Hopkins Bloomberg School of Public Health; 615 N. Wolfe St, Baltimore, MD, 21205, United States
| | - Fenna Cm Sillé
- Johns Hopkins Bloomberg School of Public Health; 615 N. Wolfe St, Baltimore, MD, 21205, United States
| | - Jana N Mihalic
- Johns Hopkins Bloomberg School of Public Health; 615 N. Wolfe St, Baltimore, MD, 21205, United States
| | - Ana M Rule
- Johns Hopkins Bloomberg School of Public Health; 615 N. Wolfe St, Baltimore, MD, 21205, United States.
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Wharton MK, Islam S, Abadi MH, Pokhrel P, Lipperman-Kreda S. COVID-19 Restrictions and Adolescent Cigarette and E-cigarette Use in California. Am J Prev Med 2023; 64:385-392. [PMID: 36347663 PMCID: PMC9636984 DOI: 10.1016/j.amepre.2022.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Shelter-in-place orders altered facilitators and barriers to tobacco use (e.g., outlet closures, restricted social gatherings). This study examined whether the duration of time in shelter in place and compliance with different shelter-in-place orders influenced adolescent cigarette and E-cigarette use and how the use may differ by demographic characteristics. METHODS Shelter-in-place policy data obtained from government websites were merged with cross-sectional 2020 survey data on adolescents in California. Treatment variables included the proportion of time in shelter in place and self-reported compliance with shelter-in-place orders (for essential businesses and retail spaces and social and outdoor contexts). Multilevel logit models for dichotomous past 6-month cigarette and E-cigarette use and multilevel negative binomial regression models for past 6-month frequency of use were used. Moderation analyses were conducted on demographic measures. The sample included 1,196 adolescents (mean age=15.8 years, age range=13-19 years, 49.2% female, 50.0% White). Analyses were conducted in 2022. RESULTS No associations were found between the proportion of time in shelter in place and outcomes. Shelter-in-place compliance with essential business and retail space orders was associated with lower odds of using cigarettes and E-cigarettes in the past 6 months. Compliance with social and outdoor context-related orders were associated with lower odds of using E-cigarettes and fewer days using cigarettes and E-cigarettes. Being aged ≥18 years moderated the associations between essential business/retail space and social/outdoor context-related shelter-in-place compliance orders and past 6-month frequency of cigarette smoking. CONCLUSIONS Findings support tailored interventions for less compliant and older adolescents for future pandemic mitigation measures.
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Affiliation(s)
- M Kristina Wharton
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California; School of Public Health, University of California, Berkeley, Berkeley, California.
| | - Sabrina Islam
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California; School of Public Health, University of California, Berkeley, Berkeley, California
| | - Melissa H Abadi
- Pacific Institute for Research and Evaluation, Louisville, Kentucky
| | - Pallav Pokhrel
- University of Hawai'i Cancer Center, University of Hawai'i, Honolulu, Hawaii
| | - Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California
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Chen DTH. Dual and poly-use of novel and conventional nicotine and tobacco product use in Europe: Challenges for population health, regulatory policies, and the ways ahead. Front Public Health 2023; 11:1093771. [PMID: 36875352 PMCID: PMC9975263 DOI: 10.3389/fpubh.2023.1093771] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Affiliation(s)
- Daniel Tzu-Hsuan Chen
- Primary Care Epidemiology, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
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Mat Salleh R, Baharom N, Siau CS, Chan CMH, Amit N, Sia PY, Wee LH. E-Cigarette Users' Profiles and Their Association with Identified Impacts of COVID-19 on Vaping among Young Adults in Malaysia. Healthcare (Basel) 2023; 11:healthcare11030434. [PMID: 36767009 PMCID: PMC9914650 DOI: 10.3390/healthcare11030434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Electronic cigarettes (ECs) users' profiles and behaviors during the COVID-19 pandemic remain unclear. This cross-sectional study aimed to explore Malaysian EC users' profiles and their associations with related behaviors during the pandemic. The EC users (N = 351) were recruited from an official national vape entity. Respondents were predominantly of Malay ethnicity (90.6%), aged 31 to 35 years (27.6%), males (97.7%), married (68.7%), from Malaysia's west region states (63.5%) and tertiary educated (69.2%). The majority (80.3%) were non-dual users, and most purchased their vaping products online (77.2%), liked that they can vape while working at home (83.8%) and vaped more because of boredom (55.3%), had low and moderate nicotine addiction levels (94.9%), had low motivation level to quit EC use (92.6%) and were more likely to perceive that vaping did not increase the chances of complications from COVID-19. Respondents with moderate to high addiction levels had twice the odds of checking on their current EC supplies, whilst respondents with low motivation to quit had higher odds of using their tank/pod until the last drop and distancing from others when vaping. EC users should be encouraged to quit EC use, especially during the COVID-19 pandemic.
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Affiliation(s)
- Rawaida Mat Salleh
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Nizam Baharom
- Primer Care Health Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Bandar Baru Nilai, Nilai 71800, Negeri Sembilan, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Caryn Mei Hsien Chan
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Noh Amit
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Pei Yin Sia
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
| | - Lei Hum Wee
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Selangor, Malaysia
- Faculty of Health and Medical Sciences, Taylors University Lakeside Campus, No. 1 Jalan Taylor’s, Subang Jaya 47500, Selangor, Malaysia
- Correspondence: or
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40
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Mavragani A, Deck A, Baskerville NB, Chaiton M. Supporting Youth Vaping Cessation With the Crush the Crave Smartphone App: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e42956. [PMID: 36705967 PMCID: PMC9919446 DOI: 10.2196/42956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/09/2022] [Accepted: 12/27/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The use of e-cigarettes, or vaping, has increased exponentially in the past decade, particularly among youth. Emerging evidence indicates growing nicotine dependence among youth, revealing historically higher rates of dependence among current e-cigarette users compared to rates seen in earlier research. Despite the urgent need for youth vaping cessation interventions, there is limited knowledge about the process of vaping cessation, and few evidence-based interventions are available to young people seeking support. A notable literature review on vaping cessation resources for young people recommended technology-based interventions, such as smartphone apps and SMS text messaging services, as a promising area of vaping cessation research and intervention development. OBJECTIVE The primary aim of our study is to determine the effectiveness of the Crush the Crave app in supporting vaping cessation among youth recruited to the intervention arm via comparison with an assessment-only control group. The primary hypothesis is that participants in the intervention group-those using Crush the Crave-will be more likely to be abstinent at the 6-month follow-up point than participants in the assessment-only control arm. METHODS A 2-arm, single-blind, parallel randomized controlled trial will be conducted over 12 months. Study invitations will be sent to 600 youth (age: 16-18 years) and young adult (age: 19-29 years) e-cigarette users and randomized between an intervention arm, which will be using Crush the Crave (n=300), and an assessment-only control arm (n=300) in a 1:1 ratio. The primary hypothesis is that participants in the intervention group-those using Crush the Crave-will be more likely to be abstinent at the 6-month follow-up point. RESULTS Study recruitment began on March 4, 2022. Recruitment is anticipated to be completed in December 2022. CONCLUSIONS This protocol describes one of the first-ever randomized controlled trial studies to evaluate the effectiveness of an app-based intervention for supporting vaping cessation among youth aged 16 to 18 years and young adults aged 19 to 29 years. The findings from our trial will help increase our understanding of the process of vaping cessation among youth and provide evidence on the effectiveness of an app-based intervention in helping young people quit vaping. The trial results will also have implications in the development of current and future approaches to youth vaping cessation. TRIAL REGISTRATION OSF Registries osf.io/hmd87; https://doi.org/10.17605/OSF.IO/HMD87. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42956.
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Affiliation(s)
| | - Alicia Deck
- Department of Biochemistry & Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | | | - Michael Chaiton
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Ontario Tobacco Research Unit, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Çok İ, İyıgündoğdu İ. Impact of the COVID-19 pandemic on alcohol use and smoking habits. JOURNAL OF SUBSTANCE USE 2023. [DOI: 10.1080/14659891.2023.2167745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- İsmet Çok
- Department of Toxicology, Faculty of Pharmacy, Gazi University, Ankara, Turkey
| | - İrem İyıgündoğdu
- Department of Toxicology, Faculty of Pharmacy, Gazi University, Ankara, Turkey
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Lee J, Murthy D, Kong G. Content Analysis of YouTube Videos Related to E-cigarettes and COVID-19. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.06.23284266. [PMID: 36711470 PMCID: PMC9882443 DOI: 10.1101/2023.01.06.23284266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION E-cigarettes are frequently promoted on social media and portrayed in ways that are attractive to youth. While COVID-19 pandemic significantly affected people's lives, less known is how the pandemic influenced e-cigarette-related marketing and information on social media. This study identifies how e-cigarettes are portrayed during the COVID-19 pandemic on YouTube, one of the most popular social media platforms. METHODS We searched for combinations of search terms related to e-cigarettes (i.e., "electronic cigarette", "e-cigarette", "e-cig", "vape" and "vaping") and COVID-19 (i.e., "corona", "COVID", "lockdown" and "pandemic"). To be included in the analysis, the video must be: uploaded after February 1, 2020, in English, related to e-cigarettes and COVID-19 and less than 30 minutes in length. We assessed video themes related to e-cigarettes and COVID-19, uploader characteristics, and featured e-cigarette products. RESULTS We examined N=307 videos and found that N=220 (73.6%) were related to the health effects of e-cigarette use on COVID-19, followed by videos of how COVID-19 affects e-cigarette access/sales (N=40, 12.9%), and face mask-related videos (N=16, 5.1%) which included content regarding masks and e-cigarette use. Instructional videos on how to modify e-cigarettes to use with masks had the highest number of likes (Median=23; IQR=32) and comments (Median=10; IQR=7). CONCLUSIONS This study identified various e-cigarette contents on YouTube during the COVID-19 pandemic. Our findings support the need for continuous surveillance on novel vaping-related content in reaction to policies and events such as the global pandemic on social media is needed.
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Affiliation(s)
- Juhan Lee
- Yale University School of Medicine, New Haven, CT, USA
| | - Dhiraj Murthy
- University of Texas at Austin, School of Journalism and Media, Department of Sociology, Austin, TX, US
| | - Grace Kong
- Yale University School of Medicine, New Haven, CT, USA
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Clendennen SL, Chen B, Sumbe A, Harrell MB. Patterns in Mental Health Symptomatology and Cigarette, E-cigarette, and Marijuana Use Among Texas Youth and Young Adults Amid the Coronavirus Disease 2019 Pandemic. Nicotine Tob Res 2023; 25:266-273. [PMID: 36018816 PMCID: PMC9825349 DOI: 10.1093/ntr/ntac205] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 08/16/2022] [Accepted: 08/25/2022] [Indexed: 01/12/2023]
Abstract
INTRODUCTION This study examined patterns in mental health symptomatology and smoking and vaping behaviors among youth and young adults over a 1-year period from before to during the first year of the Coronavirus Disease 2019 (COVID-19) pandemic. AIMS AND METHODS Participants (n = 2148) were 16-24-year-olds who completed three waves of the Texas Adolescent Tobacco and Marketing Surveillance Study (TATAMS). Descriptive statistics and mixed effects logistic regression models were used to examine changes in anxiety symptoms, depressive symptoms, perceived stress, and cigarette, e-cigarette, and marijuana use from before COVID-19 (fall 2019) to 6-month follow-up (spring 2020) and 12-month follow-up (fall 2020) periods during COVID-19. Longitudinal associations between mental health symptomatology and smoking and vaping were examined. RESULTS Modest increases in symptoms of anxiety and depression were observed from before to during COVID-19. Perceived stress remained high and unchanged. Ever marijuana use increased at 6- and 12-month follow-up, while ever cigarette and e-cigarette use increased significantly only at 12-month follow-up. Marijuana use frequency increased significantly at 6- and 12-month follow-ups. Adjusting for sociodemographic factors, increased symptoms of anxiety and depression predicted increases in ever cigarette, e-cigarette, and marijuana use, and past 30-day cigarette and e-cigarette use, but not past 30-day marijuana use. Higher perceived stress predicted increases in ever use of cigarettes and e-cigarettes and past 30-day cigarette use. CONCLUSIONS Changes in mental health symptomatology and smoking and vaping behaviors among young people in Texas varied during this period of the COVID era. Increases in mental health symptomatology predicted increases in cigarette, e-cigarette, and marijuana use behaviors. IMPLICATIONS This study adds to the limited research on the longitudinal impact of anxiety symptoms, depressive symptoms, and perceived stress on cigarette, e-cigarette, and marijuana use from before to during the first year of the COVID-19 pandemic. Findings warrant health messaging and interventions that address the significant impact of worse mental health on increased smoking and vaping behavior, especially during crises like COVID-19 that may exacerbate mental health and substance use behaviors.
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Affiliation(s)
- Stephanie L Clendennen
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Baojiang Chen
- Department of Biostatistics, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Aslesha Sumbe
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Melissa B Harrell
- Department of Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
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Lee MS, Kim DJ, Lee H. Trends in health behaviors and mental health among Korean adolescents in Korea over 5 years, 2017-2021: focusing on the comparisons before and during the COVID-19 pandemic. Front Public Health 2023; 11:1139110. [PMID: 37139372 PMCID: PMC10149801 DOI: 10.3389/fpubh.2023.1139110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
Objectives We investigated recent trends in health behaviors and mental health conditions among Korean adolescents from 2017 to 2021 and compared the changes before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods Data analysis was conducted on 289,415 adolescents participating in the Korea Youth Risk Behavior Web-Based Survey, an annual cross-sectional study from 2017 to 2021. All analysis was conducted using sex stratification, and the annual percentage change (APC) was calculated. Results Alcohol consumption and smoking decreased in the first year of the COVID-19 pandemic compared with before, except for girls from the low-income level. The prevalence of inadequate physical activity for both boys and girls increased in 2020 compared with the pre-COVID-19 period and decreased again by 2021. The prevalence of obesity in both sexes increased regardless of the period (boys, APC = 8.2%, 95% confidence intervals (CI), 6.4-10.1; girls, APC = 3.3%, 95% CI, 1.8-4.8). The prevalence of stress, depression, and suicidal ideation, plans, and attempts for both sexes decreased in 2020 compared to the pre-COVID-19 period. By 2021, this prevalence had returned to a level similar to before the pandemic. No significant APC changes were observed in the prevalence of mental health. Conclusions These findings demonstrate the trends and APCs in health behaviors and mental health conditions among Korean adolescents over the last 5 years. We must pay attention to the heterogeneous and multifaceted features of the COVID-19 pandemic.
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Affiliation(s)
- Mi-Sun Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Jun Kim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Public Health, Graduate School, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hooyeon Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Public Health, Graduate School, The Catholic University of Korea, Seoul, Republic of Korea
- *Correspondence: Hooyeon Lee
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Rodriguez-Miguelez P, Heefner A, Carbone S. Recognizing risk factors associated with poor outcomes among patients with COVID-19. Prog Cardiovasc Dis 2023; 76:3-11. [PMID: 36693489 PMCID: PMC9862711 DOI: 10.1016/j.pcad.2023.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has affected >610 million people globally, exerting major social, economic, and health impacts. Despite the large number of global casualities and severe symptomatology associated with COVID-19, a large number of individuals remain at elevated risk of infection and severe outcomes related to poor lifestyle behaviors and/or associated comorbidities. Beyond the well-known social distance and masking policies, maintaining an active lifestyle, minimizing the consumption of tobacco products, and maintaining an adequate nutrition status are some of the key factors that, in an affordable and accessible way, have the potential to improve health and minimize COVID-19 impact. In addition, bringing awareness of the higher risks and poor prognosis of COVID-19 when other conditions are present seems to be essential to protect those individuals with the highest risks.
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Affiliation(s)
- Paula Rodriguez-Miguelez
- Department of Kinesiology and Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, United States of America; Division of Pulmonary and Critical Care, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States of America.
| | - Allison Heefner
- Department of Kinesiology and Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, United States of America; Virginia Commonwealth University School of Medicine, Richmond, VA, United States of America
| | - Salvatore Carbone
- Department of Kinesiology and Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, United States of America; VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States of America
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Linkenbach JW, Lubbers DT, Brandon JM, Ooms JD, Langenberg AJ, Kilmer JR. Assessing Adolescent Vaping Norms and Perceptions in a Statewide Multi-Community Project. Subst Use Misuse 2023; 58:428-433. [PMID: 36633293 DOI: 10.1080/10826084.2023.2165413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background: Adolescent e-cigarette use has increased dramatically in recent years and is quickly becoming a serious public health issue. While studies have identified the influence of social norms on the use of traditional cigarettes, few have examined these factors in the context of e-cigarettes and other vaping devices. Objective: The goal of this study was to examine social norms predictors of past 30-day e-cigarette use among high school students in 10 communities located in Minnesota. Results: In our sample (N = 3,285), students who believe most students in their school vape daily are more likely to have vaped in the past 30 days than those who believe most students vape weekly or less frequently. Further, students were likely to have used e-cigarettes in the past 30 days if they perceived that most students approved of vaping (i.e., they disagreed with the statement that, "vaping is not a good thing for anyone their age to do"). Findings from this study highlight social norms related to perceptions that increase the likelihood of past 30-day e-cigarette use. Conclusions: Results from this study lend themselves to norms-based prevention science strategies that are critical to reducing e-cigarette use among high school students.
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Affiliation(s)
| | | | | | | | | | - Jason R Kilmer
- Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA
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Rebuli ME, Rose JJ, Noël A, Croft DP, Benowitz NL, Cohen AH, Goniewicz ML, Larsen BT, Leigh N, McGraw MD, Melzer AC, Penn AL, Rahman I, Upson D, Crotty Alexander LE, Ewart G, Jaspers I, Jordt SE, Kligerman S, Loughlin CE, McConnell R, Neptune ER, Nguyen TB, Pinkerton KE, Witek TJ. The E-cigarette or Vaping Product Use-Associated Lung Injury Epidemic: Pathogenesis, Management, and Future Directions: An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2023; 20:1-17. [PMID: 36584985 PMCID: PMC9819258 DOI: 10.1513/annalsats.202209-796st] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
E-cigarette or vaping product use-associated lung injury (EVALI) is a severe pulmonary illness associated with the use of e-cigarettes or vaping products that was officially identified and named in 2019. This American Thoracic Society workshop was convened in 2021 to identify and prioritize research and regulatory needs to adequately respond to the EVALI outbreak and to prevent similar instances of disease associated with e-cigarette or vaping product use. An interdisciplinary group of 26 experts in adult and pediatric clinical care, public health, regulatory oversight, and toxicology were convened for the workshop. Four major topics were examined: 1) the public health and regulatory response to EVALI; 2) EVALI clinical care; 3) mechanisms contributing to EVALI; and 4) needed actions to address the health effects of EVALI. Oral presentations and group discussion were the primary modes used to identify top priorities for addressing EVALI. Initiatives including a national EVALI case registry and biorepository, integrated electronic medical record coding system, U.S. Food and Drug Administration regulation and enforcement of nicotine e-cigarette standards, regulatory authority over nontobacco-derived e-cigarettes, training in evaluating exogenous exposures, prospective clinical studies, standardized clinical follow-up assessments, ability to more readily study effects of cannabinoid e-cigarettes, and research to identify biomarkers of exposure and disease were identified as critical needs. These initiatives will require substantial federal investment as well as changes to regulatory policy. Overall, the workshop identified the need to address the root causes of EVALI to prevent future outbreaks. An integrated approach from multiple perspectives is required, including public health; clinical, basic, and translational research; regulators; and users of e-cigarettes. Improving the public health response to reduce the risk of another substantial disease-inducing event depends on coordinated actions to better understand the inhalational toxicity of these products, informing the public of the risks, and developing and enforcing regulatory standards for all e-cigarettes.
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Kelly BC, Pawson M, Vuolo M. Social Network Ties and Responses to COVID-19 Among E-Cigarette Users. JOURNAL OF DRUG ISSUES 2023; 53:145-158. [PMID: 36606120 PMCID: PMC9684061 DOI: 10.1177/00220426221107555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Social networks can enhance behavioral changes or entrench existing patterns of behavior. We aimed to identify how network ties to other e-cigarette users shaped responses to the pandemic and e-cigarette considerations. A national U.S. survey of 562 e-cigarette users was conducted during April 2020. Participants self-reported network ties to other e-cigarette users and pandemic outcomes: receiving expressions of concern about vaping, risk for a bad COVID outcome, changes in e-cigarette risk perceptions, and considerations of quitting. Each additional e-cigarette user tie was associated with a 0.014 unit increase in expressions of concern (p < 0.001), a 0.034 unit increase in perceived risk of a bad outcome (p < 0.05), and 3.9% higher odds of quit considerations (OR = 1.039; p < 0.01). Family ties to e-cigarette users were particularly important. Additional e-cigarette users within a network shaped risk perceptions in response to COVID-19. Network ties to other e-cigarette users have implications for cessation or reduction of e-cigarette use.
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Affiliation(s)
- Brian C. Kelly
- Department of Sociology, Purdue University, West Lafayette, IN, USA,Brian C. Kelly, Department of Sociology,
Purdue University, 700 W State St, West Lafayette, IN 47907, USA.
| | - Mark Pawson
- Department of Sociology, Purdue University, West Lafayette, IN, USA
| | - Mike Vuolo
- Department of Sociology, The Ohio State
University, Columbus, OH, USA
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Hill TD, Bostean G, Upenieks L, Bartkowski JP, Ellison CG, Burdette AM. (Un)holy Smokes? Religion and Traditional and E-Cigarette Use in the United States. JOURNAL OF RELIGION AND HEALTH 2022; 62:906-931. [PMID: 36520262 DOI: 10.1007/s10943-022-01682-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 05/26/2023]
Abstract
This study employed national cross-sectional survey data from the 2021 Crime, Health, and Politics Survey (n = 1578 to 1735) to model traditional cigarette and e-cigarette use as a function of religious affiliation, general religiosity, biblical literalism, religious struggles, and the sense of divine control. Although the odds of abstaining from cigarettes and e-cigarettes were comparable for conservative Protestants and non-affiliates, conservative Protestants were more likely to cut down on cigarettes and e-cigarettes during the pandemic. Religiosity increased the odds of abstaining from cigarettes (not e-cigarettes) and reduced pandemic consumption of cigarettes and e-cigarettes. Biblical literalism was unrelated to abstaining from cigarettes and pandemic changes in cigarette use; however, biblical literalists were more likely to cut e-cigarette use during the pandemic. While the sense of divine control was unrelated to abstaining from cigarettes and e-cigarettes, these beliefs increased the odds of cessation from traditional and e-cigarette use. Finally, our religious struggles index was unrelated to smoking behavior. Our study is among the first to report any association between religion and lower e-cigarette use.
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Affiliation(s)
- Terrence D Hill
- Department of Sociology, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX, 78249-1644, USA.
| | - Georgiana Bostean
- Department of Sociology and Environmental Science & Policy Program, Chapman University, Orange, USA
| | | | - John P Bartkowski
- Department of Sociology, University of Texas at San Antonio, San Antonio, USA
| | | | - Amy M Burdette
- Department of Sociology and Public Health Program, Florida State University, Tallahassee, USA
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Tobacco use and risk of COVID-19 infection in the Finnish general population. Sci Rep 2022; 12:20335. [PMID: 36434073 PMCID: PMC9700668 DOI: 10.1038/s41598-022-24148-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
Empirical evidence, primarily based on hospital-based or voluntary samples, suggests that current smokers have a lower risk of COVID-19 infection than never smokers. In this study, we used nationally representative data to examine the association between tobacco use and the risk of having a confirmed COVID-19 case. We explored several forms of tobacco use, contributing to separate the role of nicotine from smoking. We used data from 44,199 participants from three pooled national health surveys in Finland (FinSote 2018-2020). The primary outcome was a confirmed COVID-19 case. We examined current smoking, moist smokeless tobacco (snus), e-cigarettes with and without nicotine and nicotine replacement therapy products. Current daily smokers had a relative risk of 1.12 of a confirmed COVID-19 case (95% CI 0.65; 1.94) in fully adjusted models compared with never smokers. Current snus use was associated with a 68% higher risk of a confirmed COVID-19 case (RR 1.68, 95% CI 1.02; 2.75) than never users. We did not find conclusive evidence of associations between e-cigarettes with and without nicotine and nicotine replacement therapy products and the risk of confirmed COVID-19 cases. Our findings suggest that nicotine might not have a protective role in the risk of COVID-19 as previously hypothesized.
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