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Dai HD, Buckley J, Leventhal AM. Correlates of using E-cigarettes with high nicotine concentrations among U.S. adults who exclusively vape E-cigarettes or dual use with cigarettes. Addict Behav 2024; 153:107986. [PMID: 38432013 DOI: 10.1016/j.addbeh.2024.107986] [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: 08/15/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Identifying the correlates of using e-cigarettes with high nicotine concentrations in exclusive and dual-using vapers can elucidate which subpopulations might be most impacted by e-cigarette regulatory activities related to nicotine concentration. METHODS Data are drawn from Wave 5 (December 2018-November 2019) of the Population Assessment of Tobacco and Health (PATH) study. Self-reported nicotine concentration was grouped as high (5.0 %+), moderate (1.8-4.9 %), low (0.1-1.7 %), 0 %, and "I don't know." Multivariable logistic regressions estimated associations of sociodemographic factors, tobacco use status, and e-cigarette use patterns of high nicotine concentration vs. other nicotine levels, stratified by current exclusive e-cigarette use and dual use of e-cigarettes and cigarettes. RESULTS In the study samples (exclusive e-cigarette use [n = 1,755], dual-use [n = 1,200]), higher proportions of exclusive e-cigarette users reported using high nicotine concentrations than dual users (18.3 % vs. 8.6 %). Among exclusive e-cigarette users, never vs. former smokers and daily (vs. someday) e-cigarette users were more likely to use high vs. low nicotine. In both exclusive and dual users, younger (vs. older) adults were more likely to report using high nicotine concentration e-cigarettes than most other nicotine levels. Current dual users who did vs. did not report using e-cigarettes to quit smoking had higher odds of using high vs. 0 % nicotine concentrations. CONCLUSIONS High-nicotine e-cigarette use might be elevated in subpopulations that face greater risks for vaping (e.g., never smokers, young adults) than groups who benefit from the potential harm reduction. Regulatory restrictions on high-nicotine products may selectively affect some subgroups adversely impacted by vaping.
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Affiliation(s)
- Hongying Daisy Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States.
| | - James Buckley
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States
| | - Adam M Leventhal
- Institute for Addiction Science and Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, United States
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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.
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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
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Giberson J, Nardone N, Addo N, Khan S, Jacob P, Benowitz N, St.Helen G. Nicotine Intake in Adult Pod E-cigarette Users: Impact of User and Device Characteristics. Nicotine Tob Res 2023; 25:1489-1495. [PMID: 37061820 PMCID: PMC10347964 DOI: 10.1093/ntr/ntad050] [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: 09/23/2022] [Revised: 01/13/2023] [Accepted: 04/14/2023] [Indexed: 04/17/2023]
Abstract
INTRODUCTION This study examined user behavior, e-cigarette dependence, and device characteristics on nicotine intake among users of pod-mod e-cigarettes. AIMS AND METHODS In 2019-2020, people who use pod-mods in the San Francisco Bay Area completed questionnaires and provided a urine sample for analysis of total nicotine equivalents (TNE). The relationship between TNE and e-cigarette use, e-cigarette brands, e-liquid nicotine strength, e-cigarette dependence, and urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), as a measure of combustible cigarette exposure, were examined. RESULTS Of 100 participants (64% male, 71% in the 18-34 age group, 45% white), 53 used JUUL primarily, 12 used Puff Bar primarily, and 35 used other brands, including Suorin; 48 participants reported current cigarette smoking. Participants most often reported use of e-liquid with 4.5%-6.0% nicotine (68%), fruit (35%), tobacco (28%), and menthol or mint flavors (26%), used e-cigarettes on 25.5 (SD = 6.3) days a month, 10.2 (SD = 14.2) times a day, and 40% used 1-2 pods/cartridges per week. In bivariate analysis, urinary TNE was higher with greater frequency (days used) and intensity (number of pods used) of e-cigarette use, e-cigarette dependence, and combustible cigarette use. In multivariable analysis, days of e-cigarette use in the last 30 days, number of pods used per week, and NNAL levels were significantly associated with TNE. There was no significant impact of e-liquid nicotine strength on TNE. CONCLUSIONS Nicotine intake among people who used pod-mod e-cigarettes increased with e-cigarette consumption and e-cigarette dependence, but not with e-liquid nicotine strength. Our findings may inform whether FDA adopts a nicotine standard for e-cigarettes. IMPLICATIONS The study examined how device and user characteristics influence nicotine intake among pod-mod e-cigarette users. Nicotine intake increased with frequency (days of e-cigarette use in past 30 days) intensity of use (number of pods used per day) and e-cigarette dependence but not with the flavor or nicotine concentration of the e-liquids. Regulation of nicotine concentration of e-liquids is unlikely to influence nicotine exposure among adult experienced pod-mod users.
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Affiliation(s)
- Jeremy Giberson
- Research Program in Clinical Pharmacology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
| | - Natalie Nardone
- Research Program in Clinical Pharmacology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
| | - Newton Addo
- Research Program in Clinical Pharmacology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
| | | | - Peyton Jacob
- Research Program in Clinical Pharmacology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA
- Tobacco Center of Regulatory Science, University of California, San Francisco, CA, USA
| | - Neal Benowitz
- Research Program in Clinical Pharmacology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA
- Tobacco Center of Regulatory Science, University of California, San Francisco, CA, USA
| | - Gideon St.Helen
- Research Program in Clinical Pharmacology, Division of Cardiology, Department of Medicine, University of California, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA
- Tobacco Center of Regulatory Science, University of California, San Francisco, CA, USA
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Matar-Khalil S, Piedrahita Vallejo C, Uárez Portilla C. Del consumo ocasional del tabaco a la adicción a la nicotina. NOVA 2022. [DOI: 10.22490/24629448.6592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Introducción. El consumo ocasional de nicotina puede generar una dependencia o adicción, siendo detectable mediante modificaciones en los mecanismos neurobiológicos. Objetivo. Contextualizar del consumo a la adicción e identificar teóricamente el mecanismo neurobiológico de transición del consumo regular del tabaco a la adicción de la nicotina. Metodología. Se realizó una búsqueda de artículos en inglés y español usando diferentes bases de datos y combinaciones de palabras clave, se seleccionaron los artículos que describieran las características de los procesos neurobiológicos implicados en el uso o consumo intermitentedel tabaco a la adicción a la nicotina como el tema principal. Resultados. El número de investigaciones relacionados a este tema es reducido, aún más en relación con la descripción de los procesos y cambios neurales de la adicción a la nicotina. La adicción a las drogas es un proceso neuroconductual complejo que altera los circuitos del sistema de motivaciónrecompensa del cerebro, por la disminución de la dopamina y la afectación en la regulación del glutamato en los ganglios basales y extensión de la amígdala se asocia con el craving, la anticipación y el déficit en la función ejecutiva. Conclusiones. El tabaco está considerado como una droga legal, por lo que su consumo pareciera ser inofensivo. Sin embargo, las evidencias muestran que su consumo a largo plazo tiene consecuencias graves en la salud de los individuos. El entender cómo cambia el hábito de fumar ocasionalmente al consumocrónico nos hace más conscientes sobre las adaptaciones en el cerebro.
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