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Yan D, Wang Z, Laestadius L, Mosalpuria K, Wilson FA, Yan A, Lv X, Zhang X, Bhuyan SS, Wang Y. A systematic review for the impacts of global approaches to regulating electronic nicotine products. J Glob Health 2023; 13:04076. [PMID: 37622721 PMCID: PMC10451104 DOI: 10.7189/jogh.13.04076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
Background The rapid increase in electronic nicotine product (ENP) use among young people has been a global public health challenge, given the potential harm of ENPs and nicotine dependence. Many countries have recently introduced legislations to regulate ENPs, but the impacts of these policies are poorly understood. This systematic review aims to critically synthesise empirical studies on the effects of global regulations regarding ENPs on the prevalence of use, health outcomes and their determinants, using the 4A marketing mix framework (acceptability, affordability, accessibility and awareness). Methods Following the PRISMA guideline, we searched PubMed, Embase, Scopus, Web of Science, Academic Search Complete, Business Source Complete, and APA PsycINFO databases from inception until June 14, 2022 and performed citation searches on the included studies. Reviewed literature was restricted to peer-reviewed, English-language articles. We included all pre-post and quasi-experimental studies that evaluated the impacts of e-cigarette policies on the prevalence of ENP use and other health outcomes. A modified Joanna Briggs Institute (JBI) Critical Appraisal checklist for quasi-experimental studies was used for quality assessment. Due to heterogeneity of the included studies, we conducted a narrative synthesis of evidence. Results Of 3991 unduplicated records screened, 48 (1.2%) met the inclusion criteria, most were from high-income countries in North America and Europe and 26 studies measured self-reported ENPs use. Flavour restrictions significantly decreased youth ENP use and taxation reduced adult use; mixed results were found for the impacts of age restrictions. Indoor vaping restrictions and the European Tobacco Products Directive (TPD) did not seem to reduce ENP use based on existing studies. Changes in determinants such as sales and perceptions corroborated our conclusions. Few studies assessed the impacts of other regulations such as advertising restrictions and retail licensing requirements. Conclusions Flavour restrictions and taxes have the strongest evidence to support effective control of ENPs, while others need powerful enforcement and meaningful penalties to ensure their effectiveness. Future research should focus on under-examined policies and differential impacts across sociodemographic characteristics and countries. Registration PROSPERO CRD42022337361.
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Affiliation(s)
- Duo Yan
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Zicheng Wang
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Linnea Laestadius
- Joseph J. Zilber College of Public Health, University of Wisconsin – Milwaukee, Milwaukee, Wisconsin USA
| | - Kavita Mosalpuria
- Matheson Center for Health Care Studies, University of Utah, Salt Lake City, Utah, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Fernando A Wilson
- Matheson Center for Health Care Studies, University of Utah, Salt Lake City, Utah, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
- Department of Economics, University of Utah, Salt Lake City, Utah, USA
| | - Alice Yan
- Department of Research Patient Care Service, Stanford Health Care, Palo Alto, California, USA
| | - Xiaoyang Lv
- School of Public Health, Peking University, Beijing, China
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Xiaotian Zhang
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Soumitra S Bhuyan
- Edward J. Bloustein School of Planning and Public Policy, Rutgers University, New Brunswick, New Jersey, USA
- School of Public and International Affairs, Princeton University, Princeton, New Jersey, USA
| | - Yang Wang
- China Center for Health Development Studies, Peking University, Beijing, China
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Vardavas CI. European Tobacco Products Directive (TPD): current impact and future steps. Tob Control 2022; 31:198-201. [PMID: 35241588 DOI: 10.1136/tobaccocontrol-2021-056548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/19/2022] [Indexed: 11/03/2022]
Abstract
Efforts to reduce the toll of tobacco-related morbidity and mortality in the European Union are spearheaded by the Tobacco Products Directive (TPD), a legal act implemented during 2016-2021, with the overall aim to reduce tobacco consumption by 2% in Europe. Within this time frame, several core tobacco control measures were implemented, the impact of which is outlined within this manuscript. Key successful legislative actions implemented in this time frame led to greater availability of information and further regulation of additives, the banning of mentholated cigarettes, enhanced pictorial package warnings and a regulatory framework for e-cigarettes. While repeated cross-sectional data indicated a 12.5% relative reduction in smoking prevalence after implementation of the TPD, the differential regulation of cigarettes and roll-your-own tobacco compared with other products, such as cigarillos, e-cigarettes and heated tobacco products, may have also led to product displacement. Moreover, as the TPD could not keep up with the ever-changing nicotine product landscape, further adaptations may be needed.
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Tao XY, Zhang Y, Zhou Y, Liu ZF, Feng XS. Nicotine in Complex Samples: Recent Updates on the Pretreatment and Analysis Method. Crit Rev Anal Chem 2021; 53:1209-1238. [PMID: 34955065 DOI: 10.1080/10408347.2021.2016365] [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: 08/24/2023]
Abstract
Nicotine is a significant evaluation index of tobacco and its related products' quality, but nicotine overdose can pose serious health hazards and cause addiction and dependence, thus it can be seen that it is necessary to find suitable and efficient detection methods to precisely detect nicotine in diverse samples and complex matrices. In this review, an updated summary of the latest trends in pretreatment and analytical techniques for nicotine is provided. We reviewed various sample pretreatment methods, such as solid phase extraction, solid phase microextraction, liquid phase microextraction, QuEChERS, etc., and diverse nicotine assay methods including liquid chromatography, gas chromatography, electrochemical sensors, etc., focusing on the developments since 2015. Furthermore, the recent progress in the applications and applicability of these techniques as well as our prospects for future developments are discussed.HighlightsUpdated pretreatment and analysis methods of nicotine were systematically summarized.Microextraction and automation were main development trends of nicotine pretreatment.The introduction of novel materials added luster to nicotine pretreatment.The evolutions of ion source and mass analyzer were emphasized.
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Affiliation(s)
- Xin-Yue Tao
- School of Pharmacy, China Medical University, Shenyang, China
- Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yuan Zhang
- School of Pharmacy, China Medical University, Shenyang, China
| | - Yu Zhou
- Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhi-Fei Liu
- School of Pharmacy, China Medical University, Shenyang, China
| | - Xue-Song Feng
- School of Pharmacy, China Medical University, Shenyang, China
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Bush A, Ferkol T, Valiulis A, Mazur A, Chkhaidze I, Maglakelidze T, Sargsyan S, Boyajyan G, Cirstea O, Doan S, Katilov O, Pokhylko V, Dubey L, Poluziorovienė E, Prokopčiuk N, Taminskienė V, Valiulis A. Unfriendly Fire: How the Tobacco Industry is Destroying the Future of Our Children. Acta Med Litu 2021; 28:6-18. [PMID: 34393624 PMCID: PMC8311841 DOI: 10.15388/amed.2020.28.1.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 11/27/2022] Open
Abstract
Tobacco has long been known to be one of the greatest causes of morbidity and mortality in the adults, but the effects on the foetus and young children, which are lifelong, have been less well appreciated. Developing from this are electronic nicotine delivery systems or vapes, promulgated as being less harmful than tobacco. Nicotine itself is toxic to the foetus, with permanent effects on lung structure and function. Most vapes contain nicotine, but they also contain many other compounds which are inhaled and for which there are no toxicity studies. They also contain known toxic substances, whose use is banned by European Union legislation. Accelerating numbers of young people are vaping, and this does not reflect an exchange of vapes for cigarettes. The acute toxicity of e-cigarettes is greater than that of tobacco, and includes acute lung injury, pulmonary haemorrhage and eosinophilic and lipoid pneumonia. Given the worse acute toxicity, it should be impossible to be complacent about medium and long term effects of vaping. Laboratory studies have demonstrated changes in lung proteomics and the innate immune system with vaping, some but not all of which overlap with tobacco. It would be wrong to consider vapes as a weaker form of tobacco, they have their own toxicity. Children and young people are being targeted by the vaping industry (which is largely the same as the tobacco industry), including on-line, and unless an efficient legislative program is put in place, a whole new generation of nicotine addicts will result.
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Affiliation(s)
- Andrew Bush
- Imperial College Centre for Paediatrics and Child Health, London, UK
National Heart and Lung Institute, London, UK
Royal Brompton Harefield NHS Foundation Trust, London, UK
| | - Thomas Ferkol
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Algirdas Valiulis
- Vilnius University Medical Faculty Institute of Health Sciences, Vilnius, Lithuania
| | - Artur Mazur
- Medical College of Rzeszow University, Department of Pediatrics, Pediatric Endocrinology and Diabetes, Rzeszow, Poland
| | - Ivane Chkhaidze
- Tbilisi State Medical University, Department of Paediatrics, Tbilisi, Georgia
Iashvili Central Children’s Hospital, Tbilisi, Georgia
| | - Tamaz Maglakelidze
- Ivane Javakhishvili Tbilisi State University, Department of Pulmonology, Tbilisi, Georgia
Chapidze Emergency Cardiology Center, Tbilisi, Georgia Planning Committee of Global Initiative Against Chronic Respiratory Diseases (WHO GARD), Geneva, Switzerland
| | - Sergey Sargsyan
- Arabkir Medical Centre, Instutute of Child and Adolescent Health, Yerevan, Armenia
| | - Gevorg Boyajyan
- Arabkir Medical Centre, Instutute of Child and Adolescent Health, Yerevan, Armenia
| | - Olga Cirstea
- University of Medicine and Pharmacy “Nicolae Testemitanu”, Department of Paediatrics, Chisinau, Republic of Moldova
| | - Svitlana Doan
- Kyiv Medical University, Department of Public Health and Microbiology, Kyiv, Ukraine
| | | | - Valeriy Pokhylko
- Ukrainian Medical Stomatological Academy, Department of Paediatrics, Poltava, Ukraine
| | - Leonid Dubey
- Lviv National Medical University by Danylo Galytsky, Lviv, Ukraine
| | - Edita Poluziorovienė
- Vilnius University Medical Faculty Institute of Clinical Medicine, Vilnius, Lithuania
| | - Nina Prokopčiuk
- Vilnius University Medical Faculty Institute of Clinical Medicine, Vilnius, Lithuania
| | - Vaida Taminskienė
- Vilnius University Medical Faculty Institute of Health Sciences, Vilnius, Lithuania
| | - Arūnas Valiulis
- Vilnius University Medical Faculty Institute of Health Sciences, Vilnius, Lithuania
Vilnius University Medical Faculty Institute of Clinical Medicine, Vilnius, Lithuania
Planning Committee of Global Initiative Against Chronic Respiratory Diseases (WHO GARD), Geneva, Switzerland
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