1
|
Singh R, Burke M, Towns S, Rahman MA, Bittoun R, Shah S, Liu A, Bhurawala H. Exploring General Practitioners' Knowledge, Attitudes, and Practices towards E-Cigarette Use/Vaping in Children and Adolescents: A Pilot Cross-Sectional Study in Sydney. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1215. [PMID: 39338099 PMCID: PMC11444199 DOI: 10.3390/ijerph21091215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/25/2024] [Accepted: 09/15/2024] [Indexed: 09/30/2024]
Abstract
(1) Background: The increasing use of e-cigarettes/vaping in children and adolescents has been recognised as a global health concern. We aim to explore the Knowledge, Attitude, and Practice of General Practitioners (GPs) in Sydney regarding the use of e-cigarettes in children and adolescents and identify the barriers to addressing this issue. (2) Methods: This pilot study was a cross-sectional study conducted using an electronic questionnaire with a Likert scale and free-text responses. (3) Results: Fifty-three GPs participated in the study (male = 24 and female = 29) with a mean age of 50 ± 5.5 years. There was strong agreement (mean 4.5) about respiratory adverse effects and addictive potential. However, there was less awareness of cardiac side effects and the occurrence of burns. There is a lack of conversation about e-cigarettes in GP practice and a deficit of confidence in GPs regarding managing e-cigarette use in children and adolescents. (4) Conclusions: Our pilot study has shown that GPs are somewhat knowledgeable about the potential adverse effects of the use of e-cigarettes in children and adolescents, though there is a lack of knowledge of the complete spectrum of adverse effects and more importantly, there is a paucity of a structured approach to discuss the use of e-cigarettes with children and adolescents, and there is a low level of confidence in addressing these issues. There is a need for educational interventions for GPs to increase awareness of the potential adverse effects of using e-cigarettes and build confidence in providing management to children and adolescents regarding the use of e-cigarettes.
Collapse
Affiliation(s)
- Rajiv Singh
- Department of Paediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Michael Burke
- Department of General Practice at the University of Western Sydney, Sydney, NSW 2560, Australia
| | - Susan Towns
- Department of Adolescent Medicine Unit, The Children’s Hospital at Westmead, Sydney, NSW 2145, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia (A.L.)
| | - Muhammad Aziz Rahman
- Institute of Health and Wellbeing, Federation University Australia, Berwick, VIC 3806, Australia
| | - Renee Bittoun
- Lifestyle Medicine, Nicotine Addiction Unit, Avondale University, Sydney, NSW 2265, Australia, Australia
- Faculty of Medicine, The University of Notre Dame, Sydney, NSW 2007, Australia
| | - Smita Shah
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia (A.L.)
| | - Anthony Liu
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia (A.L.)
- Department of Paediatrics, Nepean Hospital, Kingswood, NSW 2747, Australia
| | - Habib Bhurawala
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia (A.L.)
- Faculty of Medicine, The University of Notre Dame, Sydney, NSW 2007, Australia
- Department of Paediatrics, Nepean Hospital, Kingswood, NSW 2747, Australia
| |
Collapse
|
2
|
Gould A, Dargan PI, Wood DM. An Internet Snapshot Survey Assessing the sale of Synthetic Cannabinoid Receptor Agonists for use with Electronic Vaping Devices. J Med Toxicol 2024; 20:271-277. [PMID: 38839732 PMCID: PMC11288222 DOI: 10.1007/s13181-024-01013-0] [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: 02/29/2024] [Revised: 05/02/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024] Open
Abstract
INTRODUCTION Synthetic cannabinoid receptor agonists (SCRAs) are associated with significant toxicity and are increasingly used in electronic vaping devices. We assessed the availability of SCRA vaping products to UK purchasers on the surface web. METHODS An internet snapshot survey was performed between October 2022 and January 2023 on 'google.com' using the search terms "buy c-liquid vape", "buy herbal incense vape liquid", "buy cannabis vape liquid", "buy hashish vape liquid", "buy K2 vape liquid". RESULTS 62 websites selling 128 SCRA vaping brands were identified. Most were purportedly based in the USA (41 websites, 66%) and most sold other controlled substances. Purchase incentives offered included discreet packaging (38, 61%), discounts for bulk purchase (34, 55%) and tracked delivery (30, 48%). Many websites stated SCRA products were: not for human consumption (41, 66%), for research purposes only (15, 24%), or legal (28, 45%). Websites sold a median (IQR) of 16 (7-25) SCRA vaping brands. Almost all were bottles of vaping liquid (1220/1225, 99.6%). The most common bottle size was 5mL (60%), the median (IQR) total volume of SCRA liquid per sale was 50mL (10-200mL). Median (IQR) price was £3.39/mL (£2.01/mL- £5.29/mL). Price decreased with increasing volume purchased (£6.58/mL for ≤ 5mL, £1.60/mL for > 200mL). CONCLUSION SCRA vaping products are easily obtainable online, in both small and bulk quantities. Information provided to purchasers on safety and legality is lacking or misleading. Further studies are needed to confirm the chemistry of these products. Policymakers should consider steps to limit the potential harm caused by the purchase and use of these products.
Collapse
Affiliation(s)
- Allon Gould
- Respiratory Medicine, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.
| | - Paul I Dargan
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Clinical Toxicology, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - David M Wood
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Clinical Toxicology, Faculty of Life Sciences and Medicine, King's College London, London, UK
| |
Collapse
|
3
|
Sund LJ, Dargan PI, Archer JRH, Blundell MS, Wood DM. The Emerging Cloud: a survey of vapers, their health and utilization of healthcare within the UK. QJM 2023; 116:993-1001. [PMID: 37738584 PMCID: PMC10753409 DOI: 10.1093/qjmed/hcad210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/04/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Recent work in the UK estimated the prevalence of current cannabinoid-based vaping to be higher than in the USA, a factor previously associated with e-cigarette or vaping-associated lung injury (EVALI). Research in the USA has demonstrated that attendances to emergency departments relating to e-cigarettes began to rise before the EVALI outbreak, suggesting that vapers also experience milder forms of vaping-related illness. AIM Quantify symptom prevalence and healthcare utilization amongst current UK vapers. DESIGN Voluntary online survey of individuals aged 16 and over within the UK. METHODS Anonymized data were collected on demographics, vaping/smoking status and vaping substances used. Current vapers were asked about the presence of 10 prevalent symptoms from previous US EVALI case series, healthcare attendances and diagnoses given. Risk-ratios were calculated to compare the likelihood of symptoms and attendances between substances. RESULTS A total of 2477 complete responses were analysed. In all, 397 respondents were current vapers. Symptom prevalence within the previous 12 months ranged from 3.8% to 30.5% (bloody sputum, cough). Healthcare attendances per symptomatic respondent ranged from 0.1 to 1.4 (bloody sputum, shortness of breath). Current vapers of cannabinoid-based products (alone/in combination) had the most attendances per symptomatic respondent for 9/10 symptoms and were more likely to report symptoms aside from 'cough' (nicotine-free e-liquids [risk ratio = 1.7]). Clinicians reportedly never diagnosed vaping-related illness. CONCLUSIONS UK vapers experience symptoms previously reported in EVALI cases for which they also seek healthcare. Users of cannabinoid-based products were more likely to report symptoms and accounted for a higher healthcare burden. UK vapers may also experience vaping-related illness that does not meet EVALI case criteria.
Collapse
Affiliation(s)
- L J Sund
- St Thomas' Hospital , Department of Emergency Medicine, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, Westminster Bridge Rd, London SE1 7EH, UK
- St Thomas' Hospital , Department of Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, Westminster Bridge Rd, London SE1 7EH, UK
- St Thomas' Hospital campus , Faculty of Life Sciences and Medicine, King’s College London, Westminster Bridge Rd, London SE1 7EH, UK
| | - P I Dargan
- St Thomas' Hospital , Department of Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, Westminster Bridge Rd, London SE1 7EH, UK
- St Thomas' Hospital campus , Faculty of Life Sciences and Medicine, King’s College London, Westminster Bridge Rd, London SE1 7EH, UK
| | - J R H Archer
- St Thomas' Hospital , Department of Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, Westminster Bridge Rd, London SE1 7EH, UK
- St Thomas' Hospital campus , Faculty of Life Sciences and Medicine, King’s College London, Westminster Bridge Rd, London SE1 7EH, UK
| | - M S Blundell
- St Thomas' Hospital , Department of Emergency Medicine, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, Westminster Bridge Rd, London SE1 7EH, UK
- St Thomas' Hospital , Department of Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, Westminster Bridge Rd, London SE1 7EH, UK
| | - D M Wood
- St Thomas' Hospital , Department of Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, Westminster Bridge Rd, London SE1 7EH, UK
- St Thomas' Hospital campus , Faculty of Life Sciences and Medicine, King’s College London, Westminster Bridge Rd, London SE1 7EH, UK
| |
Collapse
|
4
|
Shehata SA, Toraih EA, Ismail EA, Hagras AM, Elmorsy E, Fawzy MS. Vaping, Environmental Toxicants Exposure, and Lung Cancer Risk. Cancers (Basel) 2023; 15:4525. [PMID: 37760496 PMCID: PMC10526315 DOI: 10.3390/cancers15184525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/18/2023] [Accepted: 06/22/2023] [Indexed: 09/29/2023] Open
Abstract
Lung cancer (LC) is the second-most prevalent tumor worldwide. According to the most recent GLOBOCAN data, over 2.2 million LC cases were reported in 2020, with an estimated new death incident of 1,796,144 lung cancer cases. Genetic, lifestyle, and environmental exposure play an important role as risk factors for LC. E-cigarette, or vaping, products (EVPs) use has been dramatically increasing world-wide. There is growing concern that EVPs consumption may increase the risk of LC because EVPs contain several proven carcinogenic compounds. However, the relationship between EVPs and LC is not well established. E-cigarette contains nicotine derivatives (e.g., nitrosnornicotine, nitrosamine ketone), heavy metals (including organometal compounds), polycyclic aromatic hydrocarbons, and flavorings (aldehydes and complex organics). Several environmental toxicants have been proven to contribute to LC. Proven and plausible environmental carcinogens could be physical (ionizing and non-ionizing radiation), chemicals (such as asbestos, formaldehyde, and dioxins), and heavy metals (such as cobalt, arsenic, cadmium, chromium, and nickel). Air pollution, especially particulate matter (PM) emitted from vehicles and industrial exhausts, is linked with LC. Although extensive environmental exposure prevention policies and smoking reduction strategies have been adopted globally, the dangers remain. Combined, both EVPs and toxic environmental exposures may demonstrate significant synergistic oncogenicity. This review aims to analyze the current publications on the importance of the relationship between EVPs consumption and environmental toxicants in the pathogenesis of LC.
Collapse
Affiliation(s)
- Shaimaa A. Shehata
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt; (S.A.S.); (A.M.H.)
| | - Eman A. Toraih
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA;
- Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Ezzat A. Ismail
- Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt;
| | - Abeer M. Hagras
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt; (S.A.S.); (A.M.H.)
| | - Ekramy Elmorsy
- Department of Pathology, Faculty of Medicine, Northern Border University, Arar 73213, Saudi Arabia;
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Manal S. Fawzy
- Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar 73213, Saudi Arabia
| |
Collapse
|
5
|
Sahni V. Vaping accuracy. Br Dent J 2023; 235:361-362. [PMID: 37737382 DOI: 10.1038/s41415-023-6348-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 09/01/2023] [Indexed: 09/23/2023]
Affiliation(s)
- V Sahni
- Private Practice, New Delhi, India.
| |
Collapse
|