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Wills TA, Maziak W, Asfar T, Roy S. Current perspective on e-cigarette use and respiratory outcomes: mechanisms and messaging. Expert Rev Respir Med 2024:1-13. [PMID: 39101843 DOI: 10.1080/17476348.2024.2387090] [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: 01/10/2024] [Revised: 05/20/2024] [Accepted: 07/29/2024] [Indexed: 08/06/2024]
Abstract
INTRODUCTION There has been an increasing amount of research on the consequences of e-cigarette use for respiratory outcomes, which is significant for public health and respiratory medicine. We discuss recent findings and lay out implications for prevention and treatment. AREAS COVERED Based on literature searches using several databases (PubMed, Web of Science, Google Scholar) for keywords, including synonyms, 'e-cigarettes,' with 'pulmonary function,' 'oxidative stress,' and 'inflammation,' we review studies on acute effects of e-cigarette use for measures of pulmonary function and discuss selected laboratory studies on mechanisms of effect, focusing on processes with known relation to respiratory disease; oxidative stress and inflammation. We discuss available studies that have tested the effectiveness of communication strategies for prevention of e-cigarette use oriented to different audiences, including nonsmoking adolescents and adult smokers. EXPERT OPINION We conclude that the evidence presents a mixed picture. Evidence is found for adverse consequences of e-cigarette use on measures of lung function and two disease-related biological processes, sometimes but not always less than for cigarette smoking. How to best communicate these results to a complex audience of users, from younger susceptible adolescents to long-term adult smokers interested in quitting, is a question of significant interest and empirically validated communication strategies are greatly needed.
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Affiliation(s)
- Thomas A Wills
- Cancer Prevention in the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Taghrid Asfar
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Simanta Roy
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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Kassem NOF, Strongin RM, Stroup AM, Brinkman MC, El-Hellani A, Erythropel HC, Etemadi A, Exil V, Goniewicz ML, Kassem NO, Klupinski TP, Liles S, Muthumalage T, Noël A, Peyton DH, Wang Q, Rahman I, Valerio LG. A review of the toxicity of ingredients in e-cigarettes, including those ingredients having the FDA's "Generally Recognized as Safe (GRAS)" regulatory status for use in food. Nicotine Tob Res 2024:ntae123. [PMID: 38783714 DOI: 10.1093/ntr/ntae123] [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: 12/27/2023] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Some firms and marketers of electronic cigarettes (e-cigarettes; a type of electronic nicotine delivery system (ENDS)) and refill liquids (e-liquids) have made claims about the safety of ingredients used in their products based on the term "GRAS or Generally Recognized As Safe" (GRAS). However, GRAS is a provision within the definition of a food additive under section 201(s) (21 U.S.C. 321(s)) of the U.S. Federal Food Drug and Cosmetic Act (FD&C Act). Food additives and GRAS substances are by the FD&C Act definition intended for use in food, thus safety is based on oral consumption; the term GRAS cannot serve as an indicator of the toxicity of e-cigarette ingredients when aerosolized and inhaled (i.e., vaped). There is no legal or scientific support for labeling e-cigarette product ingredients as "GRAS". This review discusses our concerns with the GRAS provision being applied to e-cigarette products and provides examples of chemical compounds that have been used as food ingredients but have been shown to lead to adverse health effects when inhaled. The review provides scientific insight into the toxicological evaluation of e-liquid ingredients and their aerosols to help determine the potential respiratory risks associated with their use in e-cigarettes. IMPLICATIONS The rise in prevalence of e-cigarette use and emerging evidence of adverse effects, particularly on lung health, warrant assessing all aspects of e-cigarette toxicity. One development is manufacturers' stated or implied claims of the safety of using e-cigarette products containing ingredients determined to be "Generally Recognized As Safe" (GRAS) for use in food. Such claims, typically placed on e-cigarette product labels and used in marketing, are unfounded, as pointed out by the United States Food and Drug Administration (FDA)1 and the Flavor and Extract Manufacturers Association (FEMA)2. Assessment of inhalation health risks of all ingredients used in e-liquids, including those claimed to be GRAS, is warranted.
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Affiliation(s)
- Nada O F Kassem
- Health Promotion and Behavioral Science, San Diego State University, San Diego, CA 92182, U.S
- Hookah Tobacco Research Center, San Diego State University Research Foundation, San Diego, CA 92123, U.S
| | - Robert M Strongin
- Department of Chemistry, Portland State University, Portland, OR 97207-0751, U.S
| | - Andrea M Stroup
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD 20850, U.S
| | - Marielle C Brinkman
- College of Public Health, The Ohio State University, Columbus, OH 43210, U.S
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43214, U.S
| | - Ahmad El-Hellani
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH 43210, U.S
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43214, U.S
| | - Hanno C Erythropel
- Department of Chemical and Environmental Engineering, Yale University, New Haven, CT 06511, U.S
- Yale Center for the Study of Tobacco Products (YCSTP), Department of Psychiatry, Yale School of Medicine, New Haven, CT 06511, U.S
| | - Arash Etemadi
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD 20892, U.S
| | - Vernat Exil
- School of Medicine, St. Louis University, St. Louis, MO 63104, U.S
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14226, U.S
| | - Noura O Kassem
- Hookah Tobacco Research Center, San Diego State University Research Foundation, San Diego, CA 92123, U.S
| | | | - Sandy Liles
- Hookah Tobacco Research Center, San Diego State University Research Foundation, San Diego, CA 92123, U.S
| | | | - Alexandra Noël
- Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, U.S
| | - David H Peyton
- Department of Chemistry, Portland State University, Portland, OR 97207-0751, U.S
| | - Qixin Wang
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, U.S
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY 14642, U.S
| | - Luis G Valerio
- Division of Nonclinical Science (DNCS), Office of Science/Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, U.S
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Umphres SS, Alarabi AB, Ali HEA, Khasawneh FT, Alshbool FZ. Investigation of the impact of thirdhand e-cigarette exposure on platelet function: A pre-clinical study. Tob Induc Dis 2024; 22:TID-22-56. [PMID: 38560550 PMCID: PMC10980912 DOI: 10.18332/tid/185286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 02/07/2024] [Accepted: 02/23/2024] [Indexed: 04/04/2024] Open
Abstract
INTRODUCTION The use of e-cigarettes (ECs) has reached unprecedented levels, due to a variety of reasons, including the misconception regarding their safety. Thus, there have been efforts to characterize the effects of EC exposure, including in the context of thirdhand EC (THEC) on a host of disorders, such as cardiovascular disease (CVD). METHODS To address this issue, we sought to characterize the effects of THEC on platelet function and thrombus formation, using a novel mouse exposure protocol that resembles real life scenarios. To assess these effects, a host of related in vivo (i.e. tail bleeding time, and ferric chloride injury induced thrombosis model) assays and in vitro platelet specific (e.g. aggregation, and dense granule secretion) investigative assays were conducted. RESULTS Our in vivo characterization demonstrated that THEC exposed mice exhibited a prothrombotic phenotype reflected by their shortened tail bleeding (THEC: 37 ± 15 seconds, versus clean air: 183 ± 56 s) and occlusion times (THEC: 188 ± 39 s, versus clean air: 519 ± 70 s), relative to those exposed to clean air. Importantly, we found no difference in the platelet counts between the THEC and clean air mice. As for the underlying mechanism, separate experiments revealed significantly enhanced platelet aggregation, dense and alpha granule secretion, as well as integrin/GPIIb-IIIa activation and phosphatidylserine exposure in response to thrombin and ADP agonist stimulation. CONCLUSIONS Taken together, these results provide evidence that THEC does have the capacity to increase the risk of thrombotic disease, which should increase awareness regarding its underappreciated negative health effects.
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Affiliation(s)
- Shelby S. Umphres
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, United States
| | - Ahmed B. Alarabi
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, United States
| | - Hamdy E. A. Ali
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, United States
| | - Fadi T. Khasawneh
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, United States
| | - Fatima Z. Alshbool
- Department of Pharmacy Practice, Irma Lerma Rangel School of Pharmacy, Texas A&M University, Kingsville, United States
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Tadin A, Stazic V, Galic N, Zeljezic D. Evaluation of Cytotoxic and Genotoxic Effects in Buccal Mucosal Cells in Non-Smokers and Users of Traditional Combustible Tobacco Products and Non-Combustible Alternatives. J Xenobiot 2024; 14:154-165. [PMID: 38249106 PMCID: PMC10801550 DOI: 10.3390/jox14010009] [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: 11/15/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
AIMS/OBJECTIVES The aim of this cross-sectional observational study was to investigate cytogenetic damage to the buccal mucosa in non-smokers and consumers of traditional combustible tobacco products and non-combustible alternatives. METHODS A total of 160 participants were divided into four groups according to the type of product used, including non-smokers, users of conventional combustible tobacco (cigarettes), heated tobacco, and electronic, tobacco-free vapor products (e-cigarettes). Buccal mucosa samples were analyzed using the micronucleus cytome assay to assess cytotoxic and genotoxic damage. RESULTS E-cigarette users showed significantly higher values for all tested parameters in the micronucleus test compared to non-smokers (p < 0.05). Similarly, users of tobacco heating products showed an increase in all parameters (p < 0.05), with the exception of the number of cells with micronuclei. Conventional cigarette smokers showed a notable increase in the number of binucleated cells and cells with karyorrhexis and karyolysis (p ≤ 0.05). When assessing the differences between users of traditional combustible tobacco products and non-combustible alternatives, these did not appear to be significant, except for e-cigarette users, who had significantly more cells with condensed chromatin (p ≤ 0.001), while users of tobacco heating products had more pyknotic cells (p ≤ 0.001). CONCLUSION The results of this study underscore the heightened occurrence of cytotoxic and genotoxic damage in users of both conventional combustible tobacco products and non-combustible alternatives compared to non-smokers, emphasizing the detrimental impact of these products on the oral mucosa.
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Affiliation(s)
- Antonija Tadin
- Department of Restorative Dental Medicine and Endodontics, Study of Dental Medicine, School of Medicine, University of Split, 21000 Split, Croatia
- Department of Maxillofacial Surgery, Clinical Hospital Centre Split, 21000 Split, Croatia
| | - Vinka Stazic
- Health Center of Split-Dalmatia County, 21000 Split, Croatia;
| | - Nada Galic
- Department of Endodontics and Restorative Dental Medicine, School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia;
| | - Davor Zeljezic
- Division of Toxicology, Institute for Medical Research and Occupational Health, 10000 Zagreb, Croatia;
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Merianos AL, Mahabee-Gittens EM, Hill MJ, Olaniyan AC, Smith ML, Choi K. Electronic cigarette use and cigarette smoking associated with inadequate sleep duration among U.S. young adults. Prev Med 2023; 175:107712. [PMID: 37758124 PMCID: PMC10591887 DOI: 10.1016/j.ypmed.2023.107712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/18/2023] [Accepted: 09/23/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVE Nicotine use can influence inadequate sleep, but less is known about the associations of exclusive and dual use of electronic cigarettes (e-cigarettes) with combustible cigarettes in U.S. young adults. This study assessed the associations between current exclusive e-cigarette use, exclusive cigarette smoking, and dual e-cigarette and combustible cigarette use and inadequate sleep duration among U.S. young adults. METHODS We performed a secondary analysis of 2020 Behavioral Risk Factor Surveillance System (BRFSS) data including 13,978 U.S. young adults ages 18-24 years. Inadequate sleep duration was assessed categorically using the National Sleep Foundation's age-specific recommendations that define <7 h as inadequate sleep. Weighted logistic regression models were performed while adjusting for participants' sex, race/ethnicity, education level, annual household income level, body mass index, current physical activity, mental health status, disability status, current alcohol use, and current smokeless tobacco use. RESULTS Concerning use patterns, 11.8% of young adults were exclusive e-cigarette users, 4.7% were exclusive cigarette smokers, and 3.8% were dual e-cigarette and combustible cigarette users. Exclusive e-cigarette users (adjusted odds ratio [AOR] = 1.41, 95% confidence interval [CI] = 1.16-1.72), exclusive cigarette smokers (AOR = 1.63, 95%CI = 1.22-2.18), and dual product users (AOR = 2.03, 95%CI = 1.44-2.86) were at increased odds of having inadequate sleep duration compared to non-users, while adjusting for the covariates. Additionally, dual product users were at increased odds (AOR = 1.52, 95%CI = 1.06-2.19) of reporting inadequate sleep duration compared to exclusive e-cigarette users, while adjusting for the covariates. CONCLUSIONS Current e-cigarette and cigarette use may influence inadequate sleep among U.S. young adults. Tobacco cessation efforts may encourage increased sleep health.
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Affiliation(s)
- Ashley L Merianos
- School of Human Services, University of Cincinnati, P.O. Box 210068, Cincinnati, OH 45221, USA.
| | - E Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
| | - Madelyn J Hill
- School of Human Services, University of Cincinnati, P.O. Box 210068, Cincinnati, OH 45221, USA.
| | - Afolakemi C Olaniyan
- School of Population and Health Sciences, Dillard Unversity, New Orleans, LA, USA.
| | - Matthew Lee Smith
- Department of Health Behavior, Texas A&M University, College Station, TX, USA.
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA.
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Hamann SL, Kungskulniti N, Charoenca N, Kasemsup V, Ruangkanchanasetr S, Jongkhajornpong P. Electronic Cigarette Harms: Aggregate Evidence Shows Damage to Biological Systems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6808. [PMID: 37835078 PMCID: PMC10572885 DOI: 10.3390/ijerph20196808] [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: 06/19/2023] [Revised: 08/25/2023] [Accepted: 09/15/2023] [Indexed: 10/15/2023]
Abstract
Evidence of the harms of e-cigarettes has been unfolding slowly and has been documented in many reviews and reports worldwide. A narrative review of new evidence is presented since, as research has continued, newly aggregated evidence of the dangers of electronic cigarettes on the brain, heart, and lungs is vital to inform decisions on restricting the use of e-cigarettes. Several biomedical research databases were searched for electronic cigarette health effects, emphasizing reviews, systematic reviews, and meta-analyses. Over 50 review studies, primarily in 2022 and 2023, illustrate some of the latest information on e-cigarette harms. Results show studies of respiratory, neurological, and cardiovascular effects. Researchers call for expanding studies through new methods to elaborate on initial findings of multiple harms emerging in clinical investigations. Since the use of electronic cigarettes for adult cessation is not sanctioned in most countries, it is clear that health authorities see significant costs to the health of the general population if the promotion and use of electronic cigarettes occur worldwide. Regulatory action to control electronic cigarettes should consider the substantial evidence of electronic cigarette harm.
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Affiliation(s)
- Stephen L. Hamann
- Tobacco Control Research and Knowledge Management Center, Bangkok 10400, Thailand; (S.L.H.); (V.K.); (S.R.); (P.J.)
| | - Nipapun Kungskulniti
- Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand;
- Thailand Health Promotion Institute, Bangkok 10330, Thailand
| | - Naowarut Charoenca
- Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand;
- Thailand Health Promotion Institute, Bangkok 10330, Thailand
| | - Vijj Kasemsup
- Tobacco Control Research and Knowledge Management Center, Bangkok 10400, Thailand; (S.L.H.); (V.K.); (S.R.); (P.J.)
| | - Suwanna Ruangkanchanasetr
- Tobacco Control Research and Knowledge Management Center, Bangkok 10400, Thailand; (S.L.H.); (V.K.); (S.R.); (P.J.)
| | - Passara Jongkhajornpong
- Tobacco Control Research and Knowledge Management Center, Bangkok 10400, Thailand; (S.L.H.); (V.K.); (S.R.); (P.J.)
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
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Mason A, Riordan BC, Winter T, Conner TS, Sibley CG, Scarf D. Effects of vaping on uptake and cessation of smoking: Longitudinal analysis in Aotearoa New Zealand adults. Drug Alcohol Rev 2023; 42:1587-1594. [PMID: 37368846 DOI: 10.1111/dar.13702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 05/04/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023]
Abstract
INTRODUCTION Globally, the use of vapes, or e-cigarettes, is increasing. While vaping is less harmful than smoking and may help smokers to quit, there is also the possibility that vaping may lead to smoking. The current study aimed to determine the prevalence of vaping and smoking in Aotearoa New Zealand and explore longitudinal pathways between smoking status and vape use. METHOD Data related to smoking and vaping status was analysed from Times 10, 11 and 12 across 2018-2020 of the New Zealand Attitudes and Values study, a large, representative, multi-wave study of adults living in New Zealand. Weighted descriptive analyses were used to determine prevalence rates of vaping and smoking and a generalised linear modelling approach was used to examine the likelihood of changing to, or taking up, the other behaviour in the transition between time points. RESULTS Broadly, the prevalence of smoking was found to be decreasing over time while the prevalence of vaping was increasing. Despite these general trends, no differences were observed in the likelihood of transitioning from smoking to vaping or from vaping to smoking, indicating that either pathway was equally as likely. DISCUSSION AND CONCLUSIONS The current findings demonstrate that vaping appeared to be just as likely to have a gateway effect to smoking as it was to have a cessation effect. This highlights the need for greater consideration regarding vaping-related policies and restrictions.
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Affiliation(s)
- Andre Mason
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Benjamin C Riordan
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Taylor Winter
- School of Mathematics and Statistics, University of Canterbury, Christchurch, New Zealand
| | - Tamlin S Conner
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Chris G Sibley
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Damian Scarf
- Department of Psychology, University of Otago, Dunedin, New Zealand
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Cook SF, Hirschtick JL, Fleischer NL, Arenberg DA, Barnes GD, Levy DT, Sanchez-Romero LM, Jeon J, Meza R. Cigarettes, ENDS Use, and Chronic Obstructive Pulmonary Disease Incidence: A Prospective Longitudinal Study. Am J Prev Med 2023; 65:173-181. [PMID: 36890083 PMCID: PMC10363225 DOI: 10.1016/j.amepre.2023.01.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 03/09/2023]
Abstract
INTRODUCTION Understanding the relationship between ENDS use and chronic obstructive pulmonary disease (COPD) and other respiratory conditions is critical. However, most previous studies have not fully adjusted for cigarette smoking history. METHODS Using Waves 1-5 of the U.S. Population Assessment of Tobacco and Health study, the association between ENDS use and self-reported incident COPD was examined among adults aged 40+ years using discrete-time survival models. Current ENDS use was measured as a time-varying covariate, lagged by 1 wave, defined as established daily or some days of use. Multivariable models were adjusted for baseline demographics (age, sex, race/ethnicity, education), health characteristics (asthma, obesity, exposure to second-hand smoke), and smoking history (smoking status and cigarette pack years). Data were collected between 2013 and 2019, and the analysis was conducted in 2021-2022. RESULTS Incident COPD was self-reported by 925 respondents during the 5-year follow-up. Before adjusting for other covariates, time-varying ENDS use appeared to double COPD incidence risk (hazard ratio=1.98, 95% CI=1.44, 2.74). However, ENDS use was no longer associated with COPD (adjusted hazard ratio=1.10, 95% CI=0.78, 1.57) after adjusting for current cigarette smoking and cigarette pack years. CONCLUSIONS ENDS use did not significantly increase the risk of self-reported incident COPD over a 5-year period once current smoking status and cigarette pack years were included. Cigarette pack years, by contrast, remained associated with a net increase in COPD incidence risk. These findings highlight the importance of using prospective longitudinal data and adequately controlling for cigarette smoking history to assess the independent health effects of ENDS.
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Affiliation(s)
- Steven F Cook
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Jana L Hirschtick
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Nancy L Fleischer
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Douglas A Arenberg
- Division of Pulmonary & Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Geoffrey D Barnes
- Department of Internal Medicine, Frankel Cardiovascular Center, University of Michigan Health System, Ann Arbor, Michigan; Institute for Healthcare Policy & Innovation, University of Michigan, Ann Arbor, Michigan
| | - David T Levy
- Department of Oncology, School of Medicine, Georgetown University, Washington, District of Columbia
| | - Luz Maria Sanchez-Romero
- Department of Oncology, School of Medicine, Georgetown University, Washington, District of Columbia
| | - Jihyoun Jeon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Rafael Meza
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan; Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, British Columbia, Canada.
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Zhang Q, Jeon J, Goldsmith T, Black M, Greenwald R, Wright C. Characterization of an Electronic Nicotine Delivery System (ENDS) Aerosol Generation Platform to Determine Exposure Risks. TOXICS 2023; 11:99. [PMID: 36850974 PMCID: PMC9967066 DOI: 10.3390/toxics11020099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Evaluating vaping parameters that influence electronic nicotine delivery system (ENDS) emission profiles and potentially hazardous exposure levels is essential to protecting human health. We developed an automated multi-channel ENDS aerosol generation system (EAGS) for characterizing size-resolved particle emissions across pod- and mod-type devices using real-time monitoring instruments, an exposure chamber, and vaping parameters including different ventilation rates, device type and age, e-liquid formulation, and atomizer setup. Results show the ENDS device type, e-liquid flavoring, and nicotine content can affect particle emissions. In general, pod-type devices have unimodal particle size distributions and higher number emissions, while mod-type devices have bimodal size distributions and higher mass emissions. For pod-type devices, later puff fractions emit lower aerosols, which is potentially associated with the change of coil resistance and power during ageing. For a mod-type device, an atomizer with a lower resistance coil and higher power generates larger particle emissions than an atomizer with a greater resistance coil and lower power. The unventilated scenario produces higher particle emission factors, except for particle mass emission from pod-type devices. The data provided herein indicate the EAGS can produce realistic and reproducible puff profiles of pod- and mod-type ENDS devices and therefore is a suitable platform for characterizing ENDS-associated exposure risks.
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Affiliation(s)
- Qian Zhang
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
| | - Jennifer Jeon
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
| | - Travis Goldsmith
- Department of Physiology and Pharmacology, West Virginia University/IEStechno, Morgantown, WV 26505, USA
| | - Marilyn Black
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
| | - Roby Greenwald
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA
| | - Christa Wright
- Chemical Insights Research Institute, UL Research Institutes, Marietta, GA 30067, USA
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Casale TB, Barnes PJ. Smoke and the Lungs. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY: IN PRACTICE 2022; 10:2852-2853. [DOI: 10.1016/j.jaip.2022.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 11/09/2022]
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Bagale K, Kulkarni R. A Systematic Review of the Literature Examining the Effects of Cigarette Smoke and e-Cigarette Vapor on the Virulence of Human Pathogenic Bacteria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12518. [PMID: 36231813 PMCID: PMC9565164 DOI: 10.3390/ijerph191912518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/22/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
The bioactive chemicals in cigarette smoke (CS) and e-cigarette vapor (EV) may affect pathogenic bacteria in the nasopharyngeal microflora, which may have implications on the pathophysiology of respiratory infections in cigarette smokers and e-cigarette users. In this systematic review, we seek to synthesize the research evidence supporting this hypothesis. To address the central research question, "what is known from the published, peer-reviewed literature about the effects of cigarette smoke or e-cigarette vapor exposure on the physiology of human pathogenic bacteria?", we screened the PubMed®, Web of ScienceTM, and ScienceDirect databases for reports examining the virulence characteristics and gene expression in human pathogenic bacteria exposed to either CS or EV. The principal conclusion from our analysis is that exposure to either CS or EV induces the virulence of respiratory pathogenic bacteria in a strain-dependent manner, which may in turn facilitate respiratory infections in cigarette smokers and e-cigarette users. In addition, we present evidence that nicotine and reactive oxygen species are the main chemicals responsible for CS/EV-mediated alterations in bacterial physiology. We note limitations that this review does not examine reports describing the alterations in host respiratory physiology or nasopharyngeal dysbiosis caused by CS/EV exposure. Future research to determine whether CS/EV-mediated augmentation of bacterial virulence indeed plays a role in human respiratory tract infections is warranted.
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