Weighing the Risks and Benefits of Electronic Cigarette Use in High-Risk Populations

Preliminary study on the E-liquid and aerosol on the neurobehavior of C. elegans

E-cigarettes, also known as electronic nicotine delivery systems (ENDS), are mainly used among adolescents and young adults. Similar to traditional cigarettes, different concentrations of nicotine are also added to E-cigarette's liquid (E-liquid), but due to the supplementation of chemicals such as propylene glycol (PG), vegetable glycerin (VG) and flavors, it is difficult to determine the risk after using E-cigarettes. And given to the specificity of the aerosol particle composition and atomization process of E-cigarettes, it is necessary to assess the neurotoxic effects of long-term E-cigarettes use. In this study, two commercial nicotine-containing (5%) and nicotine-free E-liquids were diluted to investigate the neurobehavioral changes and addictive tendencies of developing C. elegans after sub-chronic exposure to E-liquid. The results showed that sub-chronic exposure of E-liquid could lead to impaired growth and development of nematodes, abnormal general neuromotor behavior and advanced learning and memory behavior, and nicotine-containing E-liquid could also lead to increased addiction tendency of nematodes. Although the damage effect of nicotine free E-liquid is smaller than that of the nicotine-containing group, its toxic effect cannot be ignored. Further analysis of the neurotoxicity mechanism found that redox imbalance-mediated mitochondrial stress and aging may be important causes of E-liquid-induced biological damage. The biosafety of e-cigarette aerosols was also included in the assessment. The study found that the heated atomization process did not alter the E-liquid components, and E-cigarette aerosols still have the effect of interfering with the growth and development of nematodes and neurobehavior, and its addictive nature is also of concern. This study can provide new ideas for future studies on the neurotoxic effects and safety assessment of the E-cigarettes, and provide theoretical reference for the study on the injury mechanism of E-cigarettes.

Automated Detection of Vaping-Related Tweets on Twitter During the 2019 EVALI Outbreak Using Machine Learning Classification

There are increasingly strict regulations surrounding the purchase and use of combustible tobacco products (i.e., cigarettes); simultaneously, the use of other tobacco products, including e-cigarettes (i.e., vaping products), has dramatically increased. However, public attitudes toward vaping vary widely, and the health effects of vaping are still largely unknown. As a popular social media, Twitter contains rich information shared by users about their behaviors and experiences, including opinions on vaping. It is very challenging to identify vaping-related tweets to source useful information manually. In the current study, we proposed to develop a detection model to accurately identify vaping-related tweets using machine learning and deep learning methods. Specifically, we applied seven popular machine learning and deep learning algorithms, including Naïve Bayes, Support Vector Machine, Random Forest, XGBoost, Multilayer Perception, Transformer Neural Network, and stacking and voting ensemble models to build our customized classification model. We extracted a set of sample tweets during an outbreak of e-cigarette or vaping-related lung injury (EVALI) in 2019 and created an annotated corpus to train and evaluate these models. After comparing the performance of each model, we found that the stacking ensemble learning achieved the highest performance with an F1-score of 0.97. All models could achieve 0.90 or higher after tuning hyperparameters. The ensemble learning model has the best average performance. Our study findings provide informative guidelines and practical implications for the automated detection of themed social media data for public opinions and health surveillance purposes.

College students' reasons for using different e-cigarette products: A mixed methods analysis

This study examined if college students used particular e-cigarette devices for different reasons. Participants: College students from a large southern university completed an online, close- and open-ended survey. Data were delimited to those 18-25 years of age who had used e-cigarettes (n = 338). Methods: A convergent mixed-methods design was employed by quantifying qualitative responses via an inducting coding method. Next, χ² analyses examined relationships between use of different products (i.e., cigalikes, vape pens, eGos, mods) and reasons for using e-cigarettes. Results: Emerging themes representing reasons for trying e-cigarettes included: curiosity, peer pressure, recreation, flavors, better than cigarettes, and to quit/reduce tobacco use. Significant relationships existed between use of cigalikes, (p < . 01), eGos (p < . 05), and mods (p < . 05) and use of e-cigarettes to quitting/reducing tobacco use. Conclusions: Health promotion efforts on college campuses should address curiosity about these products and provide scientifically proven therapy to those seeking to quit tobacco.

A randomized trial comparing the acute coronary, systemic, and environmental effects of electronic vaping cigarettes versus heat-not-burn cigarettes in smokers of combustible cigarettes undergoing invasive coronary assessment: rationale and design of the SUR-VAPES 3 trial

BACKGROUND

Traditional combustible cigarette (TCC) smoking remains a major cause of preventable cardiovascular morbidity and mortality. Modified risk products (MRP) such as electronic vaping cigarettes (EVC) and heat-not-burn cigarettes (HNBC) may be safer than TCC but may still have detrimental oxidative, platelet and vascular effects of particular importance to people with symptomatic coronary artery disease (CAD).

METHODS

We aimed to compare the acute coronary, systemic and environmental effects of two leading MRP in 20 TCC smokers admitted for invasive coronary assessment of CAD and willing to quit or after prior failed quitting attempts. After confirmation at angiography of an intermediate coronary stenosis, coronary flow reserve (CFR) will be appraised. Patients will then be randomized 1:1 to use a single EVC or a single HNBC in the catheterization laboratory, followed by repeat CFR measurement. The primary endpoint will be the change in CFR before and after product use. Quantitative coronary angiography, fractional flow reserve (FFR), and instantaneous wave-free ratio (iFR) will also be measured.

RESULTS

We expected to accrue results able to: 1) test whether MRP have in general a detrimental impact on coronary vascular function in TCC smokers; 2) test whether EVC have a different impact than HNBC on coronary function; 3) provide ancillary pathophysiologic and translational insights on the acute risk and safety profile of MRP in TCC smokers with established cardiovascular disease, including complex correlations between coronary, cardiac, systemic and environmental effects. In addition, by directly informing participants of their individual results, they will be further empowered to quit TCC.

CONCLUSIONS

The Sapienza University of Rome-Vascular Assessment of Proatherosclerotic Effects of Smoking (SUR-VAPES) 3 trial will provide important insights into the pathophysiologic cardiovascular impact of EVC and HNBC, also suitable to inform patients and individualize their smoking cessation strategy.

Demographic, Behavioral, and Social Characteristics Associated With Smoking and Vaping Among Men Who Have Sex With Men in San Francisco

Tobacco use is the leading lifestyle-related cause of death in the United States. We analyzed correlates of smoking and vaping tobacco in the National HIV Behavioral Surveillance (NHBS) among men who have sex with men (MSM) in San Francisco in 2014 (n = 410) using multivariable logistic regression models. We found that more than two in five MSM (41%) smoked or vaped. Smoking was greater for men of color (46% vs. 35%; p = .02); those with annual income below $50,000 (47% vs. 34%; p = .01); those without a college education (51% vs. 30%; p < .01); and the uninsured (55% vs. 38%; p = .04). In multivariable analyses, greater odds of smoking were observed among men living with HIV (adjusted odds ratio [aOR] = 1.7; 95% CI [1.00, 2.8]); men who reported cocaine use (aOR = 3.1; 95% CI [1.9, 5.0]), and men who reported greater number of alcohol drinks on a drinking day (aOR = 1.2; 95% CI [1.05, 1.29]). Lower odds of smoking were observed for men who completed college (aOR = 0.57; 95% CI [0.36, 0.88]). Greater odds of vaping were observed among men who reported meth use (aOR = 3.01; 95% CI [1.65, 5.50]). Lower odds of vaping were observed among men who completed college (aOR = 0.55; 95% CI [0.32, 0.98]). In conclusion, the prevalence of smoking and vaping among MSM is extremely high, particularly HIV-positive MSM. MSM who smoked and vaped were more likely to be racial and ethnic minorities, have lower socioeconomic status, and report more substance and alcohol use. These findings highlight the need to develop strategies effectively addressing the high rates of cigarette smoking and vaping among MSM, particularly among minority MSM and MSM living with HIV.

Differential Effects of Anxiety Sensitivity on E-Cigarettes Processes: The Importance of E-Cigarette Quit Attempt History

BACKGROUND AND OBJECTIVES

Electronic cigarettes (e-cigarettes) are recognized as a prevalent form of substance use among adults in the United States. The rise in e-cigarette use has motivated research to identify subgroups of the population that may be particularly vulnerable to e-cigarette use and its associated harm. Individuals with elevated psychological vulnerability are one such group more at risk for being a lifetime or current e-cigarette user. Yet, little is known about how factors of psychological vulnerability relate to perceptions of e-cigarette use within the context of e-cigarette quit attempts. The current study evaluated the differential relations of anxiety sensitivity (AS), a core affective vulnerability factor, on several relevant e-cigarette processes across those with and without a previous attempt to quit using e-cigarettes.

METHODS

Our sample consisted of 547 current e-cigarette users (51% female, M_age  = 35.38 years, SD = 10.1).

RESULTS

Results indicated that AS significantly related to greater perceived risks, benefits, and positive outcome expectancies of e-cigarette use among current e-cigarette users who reported at least one attempt to quit e-cigarettes but was unrelated among those who had never attempted to quit.

DISCUSSION AND CONCLUSIONS

Findings identify e-cigarette users who fail to quit as a potential vulnerable subgroup of users who experience more strongly held perceptions about e-cigarettes because of increased AS.

SCIENTIFIC SIGNIFICANCE

This work provides initial evidence for a conceptual model in which levels of AS and e-cigarette processes are strengthened by and differ across e-cigarette quit attempt history. (Am J Addict 2019;28:390-397).

E-Cigarettes Increase Candida albicans Growth and Modulate its Interaction with Gingival Epithelial Cells

Electronic cigarette (e-cigarette) vapor comes in contact with the different constituents of the oral cavity, including such microorganisms as Candida albicans. We examined the impact of e-cigarettes on C. albicans growth and expression of different virulent genes, such as secreted aspartic proteases (SAPs), and the effect of e-cigarette vapor-exposed C. albicans on gingival epithelial cell morphology, growth, and lactate dehydrogenase (LDH) activity. An increase in C. albicans growth was observed with nicotine-rich e-cigarettes compared with non-exposed cultures. Following exposure to e-cigarette vapor, C. albicans produced high levels of chitin. E-cigarettes also increased C. albicans hyphal length and the expression of SAP2, SAP3, and SAP9 genes. When in contact with gingival epithelial cells, e-cigarette-exposed C. albicans adhered better to epithelial cells than the control. Indirect contact between e-cigarette-exposed C. albicans and gingival epithelial cells led to epithelial cell differentiation, reduced cell growth, and increased LDH activity. Overall, results indicate that e-cigarettes may interact with C. albicans to promote their pathogenesis, which may increase the risk of oral candidiasis in e-cigarette users.