1
|
Shiffman S, Cohen G, Liang Q, Cook DK, Karles GD. Estimating human pharmacokinetic parameters forelectronic nicotine delivery system products from chemical analyses of their aerosols. Drug Test Anal 2024. [PMID: 38808532 DOI: 10.1002/dta.3737] [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: 02/04/2024] [Revised: 05/02/2024] [Accepted: 05/09/2024] [Indexed: 05/30/2024]
Abstract
The ability of Electronic Nicotine Delivery Systems (ENDS) to deliver nicotine is central to their function to substitute for cigarettes, allowing people who smoke to switch away from smoking, thus reducing their exposure to harmful chemicals in cigarette smoke. The nicotine concentration in ENDS e-liquid has proved to be a poor predictor of nicotine uptake in users. Using meta-analytic methods to analyze 12 pharmacokinetic studies of nicotine-salt closed-system ENDS, this paper examines whether the mass of nicotine/puff of aerosol can predict Cmax in pharmacokinetic studies. Cmax values were available for 38 products, in 58 use conditions (including both controlled [3 s] and ad libitum puffing), comprising 1769 participant observations. Nicotine/puff data reflected chemical analyses of aerosol obtained under nonintense (3 s) or intense (6 s) machine puffing. Meta-regression analyses (weighted by reliability of Cmax estimate) assessed the relationship of nicotine/puff to Cmax. In some models, empirical data were used to impute the variation in Cmax or the nicotine/puff value under intense puffing. In simple linear models, Cmax was significantly associated with nicotine/puff under all combinations of intense/nonintense and controlled/ad-libitum conditions, with R2 values of 0.71-0.77. More complex models based on quadratic effects or log[nicotine/puff] did not generally improve upon more parsimonious linear models. Application of the model illustrates the divergence between nicotine concentration in e-liquids and expected Cmax when other ENDS parameters vary. The meta-analytic model may have utility in settings where clinical pharmacokinetic data are not available, including product development.
Collapse
Affiliation(s)
- Saul Shiffman
- Pinney Associates, Inc, Pittsburgh, Pennsylvania, USA
| | - Gal Cohen
- JUUL Labs, Inc, Washington, District of Columbia, USA
| | - Qiwei Liang
- JUUL Labs, Inc, Washington, District of Columbia, USA
| | - David K Cook
- JUUL Labs, Inc, Washington, District of Columbia, USA
| | | |
Collapse
|
2
|
Wadkin R, Allen C, Fearon IM. E-cigarette puffing topography: The importance of assessing user behaviour to inform emissions testing. Drug Test Anal 2023; 15:1222-1232. [PMID: 36574584 DOI: 10.1002/dta.3322] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/12/2022] [Accepted: 05/15/2022] [Indexed: 12/29/2022]
Abstract
Analysis of the chemical composition of e-cigarette emissions is an important step in determining whether e-cigarettes offer both individual and population-level harm reduction potential. Commonly, e-cigarette emissions for chemical analysis are collected when using e-cigarettes according to standardised puffing regimens, such as those recommended by the International Organization for Standardization (ISO) or the Cooperation Centre for Scientific Research Relative to Tobacco (CORESTA). While the use of such standard puffing regimens affords a degree of uniformity between studies and are also recommended by regulatory authorities who require the submission of e-cigarette emissions data to make decisions regarding allowing a product to be commercially marketed, the standardised regimens do not necessarily reflect human puffing behaviour. This can lead to under- or over-estimating real-world emissions from e-cigarettes and inaccuracy in determining their harm reduction potential. In this review, we describe how human puffing behaviour (topography) information can be collected both in the clinical laboratory and in the real world using a variety of different methodologies. We further discuss how this information can be used to dictate e-cigarette puffing regimens for collecting emissions for chemical analyses and how this may lead to better predictions both of human yields of e-cigarette emissions constituents and of risk assessments to predict e-cigarette tobacco harm reduction potential.
Collapse
Affiliation(s)
- Rhys Wadkin
- Scientific Affairs, Broughton Life Sciences, Earby, UK
| | - Chris Allen
- Scientific Affairs, Broughton Life Sciences, Earby, UK
| | | |
Collapse
|
3
|
El-Hellani A, Hanna E, Sharma M, Blohowiak R, Joseph P, Eid T, Nadim H, El-Hage R, Salman R, Karaoghlanian N, Adeniji A, Salam S, Talih F, Elbejjani M, Breland A, Eissenberg T, Shihadeh A, Baldassarri SR, Talih S. Nicotine flux as a powerful tool for regulating nicotine delivery from e-cigarettes: Protocol of two complimentary randomized crossover clinical trials. PLoS One 2023; 18:e0291786. [PMID: 37733666 PMCID: PMC10513228 DOI: 10.1371/journal.pone.0291786] [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: 07/26/2023] [Accepted: 08/07/2023] [Indexed: 09/23/2023] Open
Abstract
INTRODUCTION Electronic cigarette (EC) use has increased rapidly in the last decade, especially among youth. Regulating nicotine delivery from ECs could help curb youth uptake and leverage EC use in harm reduction yet is complicated by varying device and liquid variables that affect nicotine delivery. Nicotine flux, the nicotine emission rate, is a parameter that incorporates these variables and focuses on the performance rather than the design of an EC. Nicotine flux therefore could be a powerful regulatory tool if it is shown empirically to predict nicotine delivery and subjective effects related to dependence. METHODS AND ANALYSIS This project consists of two complementary clinical trials. In Trial I, we will examine the relationship between nicotine flux and the rate and dose of nicotine delivery from ECs, hence, impacting abuse liability. It will also examine the extent to which this relationship is mediated by nicotine form (i.e., freebase versus protonated). At Yale School of Medicine (YSM), study participants will puff EC devices under conditions that differ by flux and form, while arterial blood is sampled in high time resolution. In Trial II, we will assess the relationship between nicotine flux, form, and subjective effects. At the American University of Beirut (AUB), participants will use EC devices with varying nicotine fluxes and forms, while dependency measures, such as the urge to use ECs, nicotine craving, and withdrawal symptoms, will be assessed. We will also monitor puffing intensity and real-time exposure to toxicants. ETHICS AND DISSEMINATION The protocol of Trial I and Trial II was approved by YSM and AUB IRBs, respectively. We will disseminate study results through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NCT05706701 for Trial I and NCT05430334 for Trial II.
Collapse
Affiliation(s)
- Ahmad El-Hellani
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States of America
| | - Elyana Hanna
- Department of Mechanical Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Mehak Sharma
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Reagan Blohowiak
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Phillip Joseph
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Tore Eid
- Department of Laboratory Medicine, Yale School of Medicine, Washington, DC, United States of America
| | - Haleh Nadim
- Department of Laboratory Medicine, Yale School of Medicine, Washington, DC, United States of America
| | - Rachel El-Hage
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Chemistry, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Rola Salman
- Department of Mechanical Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Nareg Karaoghlanian
- Department of Mechanical Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Ayomipo Adeniji
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, United States of America
| | - Sally Salam
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Chemistry, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Farid Talih
- Clinical Psychiatry, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Martine Elbejjani
- Clinical Research Institute & Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Alison Breland
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Alan Shihadeh
- Department of Mechanical Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Stephen R. Baldassarri
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, United States of America
- Yale Center for the Study of Tobacco Product Use and Addiction, Yale University, New Haven, Connecticut, United States of America
- Program in Addiction Medicine, Yale School of Medicine, Washington, DC, United States of America
| | - Soha Talih
- Department of Mechanical Engineering, Maroun Semaan Faculty of Engineering and Architecture, American University of Beirut, Beirut, Lebanon
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, Virginia, United States of America
| |
Collapse
|
4
|
Soule EK, Sousan S, Pender J, Thomas L, Gold E, Fresquez S, Mooring R, Coombs V, Gogineni A, Tiet A. Secondhand electronic cigarette aerosol in vehicles impacts indoor air quality. Drug Alcohol Depend 2023; 250:110889. [PMID: 37478503 PMCID: PMC10528711 DOI: 10.1016/j.drugalcdep.2023.110889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/26/2023] [Accepted: 07/04/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Electronic cigarette (ECIG) use in vehicles represents a public health concern due to the potential for exposure to high concentrations of particulate matter (PM) and other toxicants. This study examined the impact of ECIG use on air quality in vehicles. METHODS People who reported current ECIG use (n=60; mean age=20.5, SD=2.3) completed a brief survey and a 30-min ECIG use session in their own vehicle. Using a protocol similar to clinical laboratory studies involving tobacco use, participants took 10 directed puffs (i.e., a directed bout with one puff every 30s for 5min) followed by a 25-min ad libitum period in which participants took as many puffs as desired. PM 2.5µm in diameter or smaller (PM2.5) were measured using aerosol monitors set up to sample air from the breathing zone of the passenger seat and total puffs were recorded. The association between peak PM2.5 concentration and puff count was examined. RESULTS Participants took a median 18 total puffs during the sessions. Median PM2.5 concentrations increased from 4.78µg/m3 at baseline to 107.40µg/m3 after the directed bout. Median peak PM2.5 concentration was 464.48µg/m3 and ranged from 9.56µg/m3 to 143,503.91µg/m3 (IQR=132.72-1604.68). After removing two extreme outliers for puff count and PM2.5 concentrations, puff count was significantly correlated with peak PM2.5 concentration during the ad libitum bout (r=0.32, p=0.015). CONCLUSIONS ECIG use in vehicles impacts air quality negatively and may pose health risks to those present in vehicles when ECIG use is occurring.
Collapse
Affiliation(s)
- Eric K Soule
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA; Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA27858, USA.
| | - Sinan Sousan
- Department of Public Health, Brody School of Medicine, East Carolina UniversityGreenville, NC27858, USA; North Carolina Agromedicine Institute, Greenville, NC27858, USA
| | - Jack Pender
- Department of Chemistry, Thomas Harriot College of Arts & Sciences, East Carolina University, Greenville, NC27858, USA
| | - Luke Thomas
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Emily Gold
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Sarah Fresquez
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Ronald Mooring
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Vivien Coombs
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Anish Gogineni
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| | - Alex Tiet
- Department of Health Education and Promotion, College of Health and Human Performance, East Carolina University, Greenville, NC27858, USA
| |
Collapse
|
5
|
Peterson ML, Clark CT, Lynch CJ, Cooper JT, Gelfman N, Blumenstein J, Hansen R, Porter JH, Hillhouse TM. Preliminary assessment of the subjective effects of electronic-cigarettes in young-adult low-dose electronic-cigarette users: Effects of nicotine dose and e-liquid flavor. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1887-1896. [PMID: 34283707 DOI: 10.1080/07448481.2021.1950162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 06/20/2021] [Accepted: 06/25/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The present study evaluated the effects of nicotine concentration (0-10 mg/ml) and flavor (gummy bear vs unflavored) on the subjective experiences of vaporized nicotine in young adult low-dose nicotine (3 mg/ml) ECIG users. PARTICIPANTS Eight young adult ECIG users were recruited. METHODS A single blinded crossover study was used. Participants were instructed to take ten 1.5 second puffs, each separated by 20 seconds. After self-administration, heart rate was recorded, and participants completed the Drug Effects, Direct Effects of Nicotine, and Direct Effects of ECIG questionnaires. RESULTS ECIG user's standard daily nicotine dose influenced the rewarding and aversive effects of nicotine as the 10 mg/ml dose was found to be aversive in this user group. The combination of flavor and nicotine increased the subjective effects of ECIGs. CONCLUSIONS Flavored e-liquids contribute to the reinforcing properties of nicotine by enhancing the subjective effects, which may lead to continued ECIG use.
Collapse
Affiliation(s)
- Makenzie L Peterson
- Department of Psychological Science, Weber State University, Ogden, Utah, USA
| | - Carson T Clark
- Department of Psychological Science, Weber State University, Ogden, Utah, USA
| | - Cayla J Lynch
- Department of Psychological Science, Weber State University, Ogden, Utah, USA
| | - James T Cooper
- Department of Psychological Science, Weber State University, Ogden, Utah, USA
| | - Noah Gelfman
- Department of Psychological Science, Weber State University, Ogden, Utah, USA
| | - Julia Blumenstein
- Department of Exercise and Nutrition Sciences, Weber State University, Ogden, Utah, USA
| | - Rodney Hansen
- Department of Exercise and Nutrition Sciences, Weber State University, Ogden, Utah, USA
| | - Joseph H Porter
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Todd M Hillhouse
- Department of Psychological Science, Weber State University, Ogden, Utah, USA
- Department of Psychology, University of Wisconsin Green Bay, Green Bay, Wisconsin, USA
| |
Collapse
|
6
|
Chen R, Pierce JP, Leas EC, Benmarhnia T, Strong DR, White MM, Stone M, Trinidad DR, McMenamin SB, Messer K. Effectiveness of e-cigarettes as aids for smoking cessation: evidence from the PATH Study cohort, 2017-2019. Tob Control 2023; 32:e145-e152. [PMID: 35131948 PMCID: PMC10423520 DOI: 10.1136/tobaccocontrol-2021-056901] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/12/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To assess the effectiveness of e-cigarettes in smoking cessation in the USA from 2017 to 2019, given the 2017 increase in high nicotine e-cigarette sales. METHODS In 2017, the PATH Cohort Study included data on 3578 previous year smokers with a recent quit attempt and 1323 recent former smokers. Respondents reported e-cigarettes or other products used to quit cigarettes and many covariates associated with e-cigarette use. Study outcomes were 12+ months of cigarette abstinence and tobacco abstinence in 2019. We report weighted unadjusted estimates and use propensity score matched analyses with 1500 bootstrap samples to estimate adjusted risk differences (aRD). RESULTS In 2017, 12.6% (95% CI 11.3% to 13.9%) of recent quit attempters used e-cigarettes to help with their quit attempt, a decline from previous years. Cigarette abstinence for e-cigarette users (9.9%, 95% CI 6.6% to 13.2%) was lower than for no product use (18.6%, 95% CI 16.0% to 21.2%), and the aRD for e-cigarettes versus pharmaceutical aids was -7.3% (95% CI -14.4 to -0.4) and for e-cigarettes versus any other method was -7.7% (95% CI -12.2 to -3.2). Only 2.2% (95% CI 0.0% to 4.4%) of recent former smokers switched to a high nicotine e-cigarette. Subjects who switched to e-cigarettes appeared to have a higher relapse rate than those who did not switch to e-cigarettes or other tobacco, although the difference was not statistically significant. CONCLUSIONS Sales increases in high nicotine e-cigarettes in 2017 did not translate to more smokers using these e-cigarettes to quit smoking. On average, using e-cigarettes for cessation in 2017 did not improve successful quitting or prevent relapse.
Collapse
Affiliation(s)
- Ruifeng Chen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - John P Pierce
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Eric C Leas
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, California, USA
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Martha M White
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Matthew Stone
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Dennis R Trinidad
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Sara B McMenamin
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Karen Messer
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| |
Collapse
|
7
|
Alkhlaif Y, Shelton KL. Assessment of Abuse-Related Discriminative Stimulus Effects of Nicotine Aerosol in Rodents. J Pharmacol Exp Ther 2023; 385:171-179. [PMID: 36918277 PMCID: PMC10201579 DOI: 10.1124/jpet.122.001520] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/30/2023] [Accepted: 02/24/2023] [Indexed: 03/16/2023] Open
Abstract
The rapid increase in e-cigarette use highlights the importance of developing relevant, predictive animal models exploring their potential health implications. The goal of the present study was to examine the abuse-related effects of brief, repeated e-cigarette aerosol exposures in rodents modeling human e-cigarette user behavior. We evaluated the discriminative stimulus effects of brief, repeated puffs of inhaled nicotine in rats that had been trained to discriminate injected nicotine from saline. Locomotor activity measurement following exposure to injected and aerosolized nicotine was also assessed as an additional behavioral outcome. We hypothesized that the stimulus effects of nicotine aerosol were central nervous system (CNS)-mediated and comparable to that produced by an injected nicotine training stimulus. We further hypothesized that number of aerosol puffs and the e-liquid nicotine concentration which was aerosolized would impact the substitution of nicotine aerosol for injected nicotine. Both nicotine injections and exposures to nicotine aerosol produced a dose-dependent effect on locomotor activity. Nicotine aerosol under our puffing conditions produced e-liquid nicotine concentration-dependent and puff-number-dependent complete substitution for the injected nicotine training condition. The nicotinic antagonist, mecamylamine, completely blocked nicotine-appropriate responding produce by the training dose of 0.3 mg/kg injected nicotine as well as that resulting from exposure to aerosol puffs generated by e-liquid containing 3 mg/ml nicotine, demonstrating that the stimulus of inhaled nicotine was most likely CNS-mediated and not due to olfactory stimulus properties. Overall, the results support the hypothesis that an aerosol exposure drug discrimination model in rodents has applicability to studying the abuse-related effects of e-cigarettes. SIGNIFICANCE STATEMENT: Animal models of nicotine aerosol exposure using testing conditions resembling human e-cigarette use are lacking. In this study, we test a novel preclinical model of nicotine vaping in rodents which allows for the exploration of the abuse-related effects of e-cigarettes. This model has the potential to contribute both to our understanding of the abuse-related pharmacological effects of e-cigarettes as well as aid in the development of rationale, evidence-based e-cigarette regulatory policies.
Collapse
Affiliation(s)
- Yasmin Alkhlaif
- Department of Pharmacology and Toxicology, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, Virginia
| | - Keith L Shelton
- Department of Pharmacology and Toxicology, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, Virginia
| |
Collapse
|
8
|
Ben Taleb Z, Dabroy D, Akins J, Nelson MD, Kalan ME, Rezk-Hanna M, Brothers RM. Pod-based e-cigarettes versus combustible cigarettes: The impact on peripheral and cerebral vascular function and subjective experiences. Tob Induc Dis 2023; 21:71. [PMID: 37252033 PMCID: PMC10210091 DOI: 10.18332/tid/162366] [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: 10/24/2022] [Revised: 03/10/2023] [Accepted: 03/18/2023] [Indexed: 05/31/2023] Open
Abstract
INTRODUCTION The vaping epidemic in the US has been largely attributed to the emergence of pod-based e-cigarette devices. While these devices continue to be promoted as alternatives to cigarettes, their impact on cardiovascular and behavioral outcomes remains incompletely understood. This study assessed the impact of pod-based e-cigarettes on peripheral and cerebral vascular function, along with subjective experiences among adult cigarette smokers. METHODS In a crossover laboratory design study, a total of 19 (e-cigarette naïve) cigarette smokers (aged 21-43 years) attended two lab sessions. In one session, participants smoked a cigarette and in the other, vaped a pod-based e-cigarette. Participants completed questions assessing subjective experiences. Peripheral macrovascular and microvascular function was assessed via brachial artery FMD and reactive hyperemia, while cerebral vascular function was assessed as the blood velocity response of the middle cerebral artery during hypercapnia. Measurements were taken before and after exposure. RESULTS Compared with baseline, there was a reduction in peripheral macrovascular function (indexed by FMD), following e-cigarette (pre=9.3±4.3%; post=6.4±4.1%) and cigarette use (pre=10.2±3.7%; post=6.8±3.8%; main effect of time p<0.0001). Cerebral vascular function (indexed by cerebral vasodilatory response during hypercapnia) was also reduced following e-cigarette (pre=53±19%; post=44±15%) and cigarette use (pre=54±21%; post=44±17%; main effect of time p<0.01). The magnitude of reduction in peripheral and cerebral vascular function was similar between conditions (condition × time, p>0.05). Compared with vaping an e-cigarette, participants scored higher for measures of satisfaction, taste, puff liking, and suppression of craving following smoking (p>0.05). CONCLUSIONS Similar to smoking, vaping a pod-based e-cigarette leads to an impairment in peripheral and cerebral vascular function while providing a reduced subjective experience compared with a cigarette among adult smokers. While these data challenge the notion that e-cigarette use is a safe and satisfactory alternative to cigarette use, large longitudinal studies are needed to assess the long-term impact of pod-based e-cigarette devices on cardiovascular and behavioral outcomes.
Collapse
Affiliation(s)
- Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, United States
| | - Danny Dabroy
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, United States
| | - John Akins
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, United States
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, United States
- The University of Texas Southwestern Medical Center, Dallas, United States
| | - Michael Douglas Nelson
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, United States
- The University of Texas Southwestern Medical Center, Dallas, United States
| | | | - Mary Rezk-Hanna
- School of Nursing, University of California, Los Angeles, Los Angeles, United States
| | - R. Matthew Brothers
- Department of Kinesiology, College of Nursing and Health Innovation, The University of Texas at Arlington, Arlington, United States
| |
Collapse
|
9
|
Hoffman BL, Wolynn R, Barrett E, Manganello JA, Felter EM, Sidani JE, Miller E, Burke JG, Primack BA, Chu KH. Viewer Reactions to EVALI Storylines on Popular Medical Dramas: A Thematic Analysis of Twitter Messages. JOURNAL OF HEALTH COMMUNICATION 2023; 28:282-291. [PMID: 37057592 PMCID: PMC10330130 DOI: 10.1080/10810730.2023.2201814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Previous research has found an association between awareness of e-cigarette, or vaping, product-use associated lung injury (EVALI) and lower intention to use e-cigarettes among young people. This study utilized Twitter data to evaluate if the January 2020 depiction of EVALI on New Amsterdam, Chicago Med, and Grey's Anatomy-three popular primetime medical dramas-could be a potential innovative avenue to raise awareness of EVALI. We obtained tweets containing e-cigarette-related search strings from 1/21/2020 to 02/18/2020 and filtered these with storyline-specific keywords, resulting in 1,493 tweets for qualitative coding by two trained human coders. Content codes were informed by prior research, theories of narrative influence, and e-cigarette related outcomes. Of 641 (42.9%) relevant tweets, the most frequent content codes were perceived realism (n = 292, 45.6%) and negative response (n = 264, 41.2%). A common theme among these tweets was that storylines were unrealistic because none of the characters with EVALI used THC-containing products. Approximately 12% of tweets (n = 78) mentioned e-cigarette knowledge and 28 (4.4%) mentioned behavior, including quitting e-cigarettes because of viewing the storylines. Implications for health communication research utilizing social media data and maximizing the achievement of positive health-related outcomes for storylines depicting current health topics are discussed.
Collapse
Affiliation(s)
- Beth L. Hoffman
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for Social Dynamics and Community Health, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Riley Wolynn
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Erica Barrett
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jennifer A. Manganello
- School of Public Health, University at Albany, State University of New York, Albany, New York, USA
| | - Elizabeth M. Felter
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jaime E. Sidani
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for Social Dynamics and Community Health, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Miller
- Division of Adolescent Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Jessica G. Burke
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for Social Dynamics and Community Health, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Brian A. Primack
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Kar-Hai Chu
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for Social Dynamics and Community Health, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| |
Collapse
|
10
|
Mulorz J, Spin JM, Mulorz P, Wagenhäuser MU, Deng A, Mattern K, Rhee YH, Toyama K, Adam M, Schelzig H, Maegdefessel L, Tsao PS. E-cigarette exposure augments murine abdominal aortic aneurysm development: role of Chil1. Cardiovasc Res 2023; 119:867-878. [PMID: 36413508 PMCID: PMC10409905 DOI: 10.1093/cvr/cvac173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 10/12/2022] [Accepted: 10/19/2022] [Indexed: 11/23/2022] Open
Abstract
AIMS Abdominal aortic aneurysm (AAA) is a common cardiovascular disease with a strong correlation to smoking, although underlying mechanisms have been minimally explored. Electronic cigarettes (e-cigs) have gained recent broad popularity and can deliver nicotine at comparable levels to tobacco cigarettes, but effects on AAA development are unknown. METHODS AND RESULTS We evaluated the impact of daily e-cig vaping with nicotine on AAA using two complementary murine models and found that exposure enhanced aneurysm development in both models and genders. E-cigs induced changes in key mediators of AAA development including cytokine chitinase-3-like protein 1 (CHI3L1/Chil1) and its targeting microRNA-24 (miR-24). We show that nicotine triggers inflammatory signalling and reactive oxygen species while modulating miR-24 and CHI3L1/Chil1 in vitro and that Chil1 is crucial to e-cig-augmented aneurysm formation using a knockout model. CONCLUSIONS In conclusion our work shows increased aneurysm formation along with augmented vascular inflammation in response to e-cig exposure with nicotine. Further, we identify Chil1 as a key mediator in this context. Our data raise concerns regarding the potentially harmful long-term effects of e-cig nicotine vaping.
Collapse
Affiliation(s)
- Joscha Mulorz
- Clinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
- Department of Medicine, Stanford University, 300 Pasteur Drive, Standford, CA 94305, USA
- VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
- Department of Medicine, Stanford Cardiovascular Institute, 300 Pasteur Drive, Standford, CA 94305, USA
| | - Joshua M Spin
- Department of Medicine, Stanford University, 300 Pasteur Drive, Standford, CA 94305, USA
- VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
- Department of Medicine, Stanford Cardiovascular Institute, 300 Pasteur Drive, Standford, CA 94305, USA
| | - Pireyatharsheny Mulorz
- Department of Medicine, Stanford University, 300 Pasteur Drive, Standford, CA 94305, USA
- VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
- Department of Medicine, Stanford Cardiovascular Institute, 300 Pasteur Drive, Standford, CA 94305, USA
| | - Markus Udo Wagenhäuser
- Clinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Alicia Deng
- Department of Medicine, Stanford University, 300 Pasteur Drive, Standford, CA 94305, USA
- VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
- Department of Medicine, Stanford Cardiovascular Institute, 300 Pasteur Drive, Standford, CA 94305, USA
| | - Karin Mattern
- Department of Anesthesiology, Intensive Care and Emergency Medicine, Medical University of Göttingen, Göttingen, Germany
| | - Yae H Rhee
- Clinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
- Department of Medicine, Stanford University, 300 Pasteur Drive, Standford, CA 94305, USA
- VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
- Department of Medicine, Stanford Cardiovascular Institute, 300 Pasteur Drive, Standford, CA 94305, USA
| | - Kensuke Toyama
- Department of Pharmacology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - Matti Adam
- Department of Cardiology, Heart Center, University of Cologne, Cologne, Germany
| | - Hubert Schelzig
- Clinic for Vascular and Endovascular Surgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Lars Maegdefessel
- Department for Vascular and Endovascular Surgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
- German Center for Cardiovascular Research (DZHK), Berlin, Germany (partner site: Munich)
| | - Philip S Tsao
- Department of Medicine, Stanford University, 300 Pasteur Drive, Standford, CA 94305, USA
- VA Palo Alto Health Care System, 3801 Miranda Ave, Palo Alto, CA 94304, USA
- Department of Medicine, Stanford Cardiovascular Institute, 300 Pasteur Drive, Standford, CA 94305, USA
| |
Collapse
|
11
|
Lee J, Su WC, Han I. Understanding the influence of atomizing power on electronic cigarette aerosol size and inhalation dose estimation. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2023; 57:633-644. [PMID: 37997608 PMCID: PMC10665025 DOI: 10.1080/02786826.2023.2202753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/24/2023] [Indexed: 11/25/2023]
Abstract
Although many studies have estimated the inhalation dose of aerosols emitted from electronic cigarettes (e-cigs), the association between the atomizing power and inhalation dose of e-cig aerosols has not been fully examined. The aim of this study was to determine the mass and inhalation doses of e-cig aerosols and their association with the atomizing power of vaping devices. Size-segregated aerosol masses were collected using an 11-stage cascade impactor and the deposition dose in the human respiratory tract was estimated using the size-segregated aerosol mass. The results showed that an increase in atomizing power was positively associated with the amount of aerosol mass generated (p-value < 0.001). The mass median aerodynamic diameter and mass mean diameter of aerosol were 0.91 μm and 0.84 μm, respectively. The average deposition fractions of aerosols in the head airway, tracheobronchial region, and alveolar region were 67.2, 6.2, and 26.6%, respectively. In conclusion, vaping with a higher atomizing power increases the e-cig aerosol inhalation dose in the airway.
Collapse
Affiliation(s)
- Jinho Lee
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Texas USA
| | - Wei-Chung Su
- Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Texas USA
- Southwest Center for Occupational and Environmental Health (SWCOEH), School of Public Health, University of Texas Health Science Center at Houston, Texas, USA
| | - Inkyu Han
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Pennsylvania, USA
| |
Collapse
|
12
|
Soule E, Bansal-Travers M, Grana R, McIntosh S, Price S, Unger JB, Walton K. Electronic cigarette use intensity measurement challenges and regulatory implications. Tob Control 2023; 32:124-129. [PMID: 34059553 PMCID: PMC8630087 DOI: 10.1136/tobaccocontrol-2021-056483] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/04/2022]
Abstract
Assessing tobacco use intensity allows researchers to examine tobacco use in greater detail than assessing ever or current use only. Tobacco use intensity measures have been developed that are specific to tobacco products, such as asking smokers to report number of cigarettes smoked per day. However, consensus on electronic cigarette use intensity measures that can be used for survey research has yet to be established due to electronic cigarette product and user behavior heterogeneity. While some survey measures that attempt to assess electronic cigarette use intensity exist, such as examining number of 'times' using an electronic cigarette per day, number of puffs taken from an electronic cigarette per day, volume of electronic cigarette liquid consumed per day, or nicotine concentration of electronic cigarette liquid, most measures have limitations. Challenges in electronic cigarette measurement often stem from variations across electronic cigarette device and liquid characteristics as well as the difficulty that many electronic cigarette users have regarding answering questions about their electronic cigarette device, liquid, or behavior. The inability for researchers to measure electronic cigarette use intensity accurately has important implications such as failing to detect unintended consequences of regulatory policies. Development of electronic cigarette use intensity measures, though not without its challenges, can improve understanding of electronic cigarette use behaviors and associated health outcomes and inform development of regulatory policies.
Collapse
Affiliation(s)
- Eric Soule
- Department of Health Education and Promotion, East Carolina University, Greenville, North Carolina, USA
| | | | - Rachel Grana
- Tobacco Control Research Branch, National Cancer Institute, Rockville, Maryland, USA
| | - Scott McIntosh
- Public Health Sciences, University of Rochester, Rochester, New York, USA
| | - Simani Price
- Public Health and Epidemiology Practice, Westat, Center for Coordination of Analytics, Science, Enhancement, and Logistics, Rockville, Maryland, USA
| | - Jennifer B Unger
- Preventive Medicine, University of Southern California, Los Angeles, California, USA
| | - Kevin Walton
- Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, Bethesda, Maryland, USA
| |
Collapse
|
13
|
White CM, Tessier KM, Koopmeiners JS, Denlinger-Apte RL, Cobb CO, Lane T, Campos CL, Spangler JG, Hatsukami DK, Strasser AA, Donny EC. Preliminary evidence on cigarette nicotine reduction with concurrent access to an e-cigarette: Manipulating cigarette nicotine content, e-liquid nicotine content, and e-liquid flavor availability. Prev Med 2022; 165:107213. [PMID: 35995103 PMCID: PMC10080461 DOI: 10.1016/j.ypmed.2022.107213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/28/2022] [Accepted: 08/17/2022] [Indexed: 10/15/2022]
Abstract
The reinforcing characteristics of e-cigarettes could moderate the impact of reducing cigarette nicotine content. In this study, people who smoke daily were recruited from North Carolina and Pennsylvania (US) in 2018 and 2019. Within a randomized 2 × 2 × 2 factorial design, participants received investigational cigarettes and an e-cigarette for 12 weeks. Cigarette nicotine content was very low (0.4 mg/g of tobacco; VLNC) or normal (15.8 mg/g; NNC). E-liquids were 0.3% ("low") or 1.8% ("moderate") freebase nicotine, and available in tobacco flavors or tobacco, fruit, dessert and mint flavors. Study recruitment concluded before reaching the planned sample size (N = 480). Fifty participants were randomized and 32 completed the study. We found that randomization to VLNC, relative to NNC cigarettes, reduced self-reported cigarettes per day (CPD; mean difference: -12.96; 95% CI: -21.51, -4.41; p = 0.005); whereas e-liquid nicotine content and flavor availability did not have significant effects. The effect of cigarette nicotine content was larger in the moderate vs. low nicotine e-liquid groups and in the all flavors versus tobacco flavors e-liquid groups; tests of the interaction between e-liquid characteristics and cigarette nicotine content were not significant. Biomarkers of smoke exposure at Week 12 did not differ across conditions, which may reflect variability in adherence to only using VLNC cigarettes. In conclusion this study offers preliminary evidence that the extent to which cigarette nicotine reduction decreases smoking may depend on the reinforcing characteristics of alternative products, including the available nicotine contents and flavors of e-cigarettes.
Collapse
Affiliation(s)
- Cassidy M White
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Katelyn M Tessier
- Masonic Cancer Center, Biostatistics Core, University of Minnesota, Minneapolis, MN, USA
| | - Joseph S Koopmeiners
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rachel L Denlinger-Apte
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Caroline O Cobb
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Tonya Lane
- Department of Psychiatry and Behavioral Sciences and Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Claudia L Campos
- Department of General Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - John G Spangler
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Dorothy K Hatsukami
- Department of Psychiatry and Behavioral Sciences and Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Andrew A Strasser
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Eric C Donny
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
14
|
Guo Y, Li S, Wang Z, Jiang F, Guan Y, Huang M, Zhong G. Nicotine Delivery and Pharmacokinetics of an Electronic Cigarette Compared With Conventional Cigarettes in Chinese Adult Smokers: A Randomized Open-Label Crossover Clinical Study. NICOTINE & TOBACCO RESEARCH : OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON NICOTINE AND TOBACCO 2022; 24:1881-1888. [PMID: 35690060 DOI: 10.1093/ntr/ntac143] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/10/2022] [Accepted: 06/10/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION To evaluate the nicotine pharmacokinetics of a commercial electronic cigarette (e-cigarette) relative to conventional cigarettes in Chinese adult smokers. AIMS AND METHODS A randomized, open-label, crossover clinical study was conducted on 23 healthy adult Chinese smokers. In two sessions, subjects used either the e-cigarettes with 30 mg/g nicotine in e-liquid or conventional cigarettes of a given brand, at one puff every 30 seconds for a total of 10 puffs. Blood samples were collected at specified time points for 4 hours after the first puff. Subjective effects on desire-to-smoke and physiological parameters such as heart rate and oxyhemoglobin saturation levels were also examined before and after using the two products. RESULTS The baseline-adjusted maximum nicotine concentration (Cmax-BL), time-to-peak nicotine concentration (Tmax), and nicotine absorption rate (Cmax-BL divided by Tmax) were found to be similar for the e-cigarette versus those of conventional cigarettes (p > .05). Total nicotine exposure measured as the area-under-curve (AUC0-t-BL) was significantly lower for the e-cigarette relative to that of conventional cigarettes. In addition, the subjects found that e-cigarettes were well tolerated under controlled puffing conditions. CONCLUSIONS The test e-cigarettes achieved similar nicotine delivery and pharmacokinetic profiles to those of the comparator cigarettes, indicating that this e-cigarette could be a potential alternative to conventional cigarettes for those adult smokers. IMPLICATIONS There are no data in the published literature on the nicotine pharmacokinetics of e-cigarettes in Chinese smokers. To the best of our knowledge, this is the first study to evaluate the nicotine delivery and pharmacokinetic profile of a commercial e-cigarette brand compared with conventional cigarettes in Chinese adult smokers. After the use of test e-cigarettes, nicotine delivery and pharmacokinetic profile were similar to those of conventional cigarettes in Chinese adult smokers.
Collapse
Affiliation(s)
- Yi Guo
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Shoufeng Li
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhi Wang
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China.,Clinical Trial Center of Dongguan KangHua Hospital, Dongguan, Guangdong, China
| | - Fulin Jiang
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yanping Guan
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Min Huang
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Guoping Zhong
- Institute of Clinical Pharmacology, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, Guangdong, China.,Clinical Trial Center of Dongguan KangHua Hospital, Dongguan, Guangdong, China
| |
Collapse
|
15
|
Chen Z, Chen W, Li Y, Moos M, Xiao D, Wang C. Single-nucleus chromatin accessibility and RNA sequencing reveal impaired brain development in prenatally e-cigarette exposed neonatal rats. iScience 2022; 25:104686. [PMID: 35874099 PMCID: PMC9304611 DOI: 10.1016/j.isci.2022.104686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 05/13/2022] [Accepted: 06/24/2022] [Indexed: 11/03/2022] Open
Abstract
Although emerging evidence reveals that vaping alters the function of the central nervous system, the effects of maternal vaping on offspring brain development remain elusive. Using a well-established in utero exposure model, we performed single-nucleus ATAC-seq (snATAC-seq) and RNA sequencing (snRNA-seq) on prenatally e-cigarette-exposed rat brains. We found that maternal vaping distorted neuronal lineage differentiation in the neonatal brain by promoting excitatory neurons and inhibiting lateral ganglionic eminence-derived inhibitory neuronal differentiation. Moreover, maternal vaping disrupted calcium homeostasis, induced microglia cell death, and elevated susceptibility to cerebral ischemic injury in the developing brain of offspring. Our results suggest that the aberrant calcium signaling, diminished microglial population, and impaired microglia-neuron interaction may all contribute to the underlying mechanisms by which prenatal e-cigarette exposure impairs neonatal rat brain development. Our findings raise the concern that maternal vaping may cause adverse long-term brain damage to the offspring.
Collapse
Affiliation(s)
- Zhong Chen
- Center for Genomics, School of Medicine, Loma Linda University, 11021 Campus St., Loma Linda, CA 92350, USA
| | - Wanqiu Chen
- Center for Genomics, School of Medicine, Loma Linda University, 11021 Campus St., Loma Linda, CA 92350, USA
| | - Yong Li
- Lawrence D. Longo, MD Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Malcolm Moos
- Center for Biologics Evaluation and Research & Division of Cellular and Gene Therapies, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA
| | - Daliao Xiao
- Lawrence D. Longo, MD Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Charles Wang
- Center for Genomics, School of Medicine, Loma Linda University, 11021 Campus St., Loma Linda, CA 92350, USA
- Division of Microbiology & Molecular Genetics, Department of Basic Science, School of Medicine, Loma Linda University, 11021 Campus St., Loma Linda, CA 92350, USA
| |
Collapse
|
16
|
Gades MS, Alcheva A, Riegelman AL, Hatsukami DK. The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review. Nicotine Tob Res 2022; 24:1332-1343. [PMID: 35305014 PMCID: PMC9356694 DOI: 10.1093/ntr/ntac073] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/31/2022] [Accepted: 03/16/2022] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Many adult cigarette smokers use electronic cigarettes (e-cigarettes) to cut down on or quit smoking cigarettes. E-cigarettes with higher abuse potential and appeal might facilitate complete switching. E-liquid nicotine concentration and flavor are two of the characteristics that may affect the abuse potential and appeal of e-cigarettes. The objective of this systematic review was to compile results from survey, animal, human laboratory, and clinical studies to understand the possible effects of nicotine concentration and flavor on abuse potential and appeal of e-cigarettes in adult current and former cigarette and e-cigarette users. AIMS AND METHODS A comprehensive literature search was conducted in Ovid Medline and PsycINFO followed by citation tracking in Web of Science Core Collection. Peer-reviewed studies published in English between 2007 and August 2020 were selected that analyzed differences between e-liquid nicotine concentration and/or flavors, had outcome measures related to abuse potential and/or appeal, and included adult humans (18+) or animals. A total of 1624 studies were identified and screened. A qualitative synthesis of results was performed. RESULTS Results from 104 studies included in this review suggest that higher nicotine concentration and access to a variety of flavors are likely to be associated with higher abuse potential and appeal of e-cigarettes for adult current and former cigarette and e-cigarette users. CONCLUSIONS Higher nicotine concentrations and the availability of a variety of flavors in e-cigarettes might facilitate complete substitution for cigarettes. Future e-cigarette regulations should take into account their impact on smokers, for whom e-cigarettes may be a cessation tool or reduced-harm alternative. IMPLICATIONS E-cigarettes may provide a reduced-harm alternative to cigarettes for smokers unwilling/unable to quit or serve as a path for quitting all nicotine products. Higher nicotine concentrations and flavor variety are associated with higher abuse potential and appeal of e-cigarettes. Higher abuse potential and appeal products may help facilitate complete switching from cigarettes to e-cigarettes. Regulation of nicotine concentration and flavors aimed at decreasing naïve uptake may inadvertently decrease uptake and complete switching among smokers, reducing the harm reduction potential of e-cigarettes. Evidence-based effects of regulating nicotine concentration and flavors must be considered for the population as a whole, including smokers.
Collapse
Affiliation(s)
- Mari S Gades
- Department of Psychology, University of Minnesota, 75 E. River Road, Minneapolis, MN, 55454, USA
| | - Aleksandra Alcheva
- Division of Environmental Health Sciences, School of Public Health and Masonic Cancer Center, University of Minnesota, 2231 6th Street SE, Minneapolis, MN 55455, USA
| | - Amy L Riegelman
- Social Sciences Department, University of Minnesota Libraries, 309 19 Avenue S., Minneapolis, MN, 55455, USA
| | - Dorothy K Hatsukami
- Masonic Cancer Center and Department of Psychiatry and Behavioral Sciences, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, 55414, USA
| |
Collapse
|
17
|
Floyd E, Oni T, Cai C, Rehman B, Hwang J, Watson T. Validation of a High Flow Rate Puff Topography System Designed for Measurement of Sub-Ohm, Third Generation Electronic Nicotine Delivery Systems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137989. [PMID: 35805644 PMCID: PMC9265855 DOI: 10.3390/ijerph19137989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 02/01/2023]
Abstract
There are few known puff topography devices designed solely for gathering electronic cigarette puff topography information, and none made for high-powered sub-ohm devices. Ten replicate Bernoulli flow cells were designed and 3D printed. The relationship between square root of pressure difference and flow rate was determined across 0−70 L/min. One representative flow cell was used to estimate puff volume and flow rate under six simulated puffing regimes (0.710 L, 2.000 L and 3.000 L, at low and high flow rates) to determine the system’s accuracy and utility of using dual pressure sensors for flow measurement. The relationship between flow rate and square root of pressure differential for the ten replicate cells was best fit with a quadratic model (R2 = 0.9991, p < 0.0001). The higher-pressure sensor was accurate at both low and high flow rates for 0.71 L (102% and 111% respectively), 2.00 L (96% and 103% respectively), and 3.00 L (100.1% and 107% respectively) but the lower-pressure sensor provided no utility, underpredicting volume and flow. This puff topography system generates very little resistance to flow, easily fits between user’s atomizer and mouthpiece, and is calibrated to measure flows up to 70 L/min.
Collapse
Affiliation(s)
- Evan Floyd
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (T.O.); (C.C.); (J.H.); (T.W.)
- Correspondence:
| | - Toluwanimi Oni
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (T.O.); (C.C.); (J.H.); (T.W.)
| | - Changjie Cai
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (T.O.); (C.C.); (J.H.); (T.W.)
| | - Bilal Rehman
- University of Oklahoma Health Sciences Center, University of Oklahoma College of Medicine, Oklahoma City, OK 73104, USA;
| | - Jooyeon Hwang
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (T.O.); (C.C.); (J.H.); (T.W.)
| | - Tyler Watson
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (T.O.); (C.C.); (J.H.); (T.W.)
| |
Collapse
|
18
|
Harris AC, Muelken P, Alcheva A, Stepanov I, LeSage MG. Cigarette Smoke Extract, but Not Electronic Cigarette Aerosol Extract, Inhibits Monoamine Oxidase in vitro and Produces Greater Acute Aversive/Anhedonic Effects Than Nicotine Alone on Intracranial Self-Stimulation in Rats. Front Neurosci 2022; 16:868088. [PMID: 35712461 PMCID: PMC9196039 DOI: 10.3389/fnins.2022.868088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/25/2022] [Indexed: 12/14/2022] Open
Abstract
Conventional tobacco cigarettes appear to have greater abuse liability than non-combusted products such as electronic cigarettes (ECs) and nicotine replacement therapy (NRT). This may be due to the higher levels of behaviorally active non-nicotine constituents [e.g., monoamine oxidase (MAO) inhibitors such as β-carbolines] in cigarette smoke (CS) compared to non-combusted products. To evaluate this hypothesis, the current studies compared the relative abuse liability of CS and EC aerosol extracts containing nicotine and a range of non-nicotine constituents to that of nicotine alone (NRT analog) using intracranial self-stimulation (ICSS) in rats. Effects of formulations on brain MAO activity in vitro and ex vivo were also studied to evaluate the potential role of MAO inhibition in the ICSS study. CS extract contained higher levels of several behaviorally active non-nicotine constituents (e.g., the β-carbolines norharmane and harmane) than EC extract. Nicotine alone reduced ICSS thresholds at a moderate nicotine dose, suggesting a reinforcement-enhancing effect that may promote abuse liability, and elevated ICSS thresholds at a high nicotine dose, suggesting an aversive/anhedonic effect that may limit abuse liability. CS extract elevated ICSS thresholds to a greater degree than nicotine alone at high nicotine doses. Effects of EC extract on ICSS did not differ from those of nicotine alone. Finally, CS extract significantly inhibited MAO-A and MAO-B activity in vitro, whereas EC extract and nicotine alone did not. None of the formulations inhibited MAO measured ex vivo. These findings indicate greater acute aversive/anhedonic effects for CS extract compared to nicotine alone, suggesting lower abuse liability. Although confirmation of our findings using other dosing regimens, preclinical addiction models, and tobacco product extracts is needed, these findings suggest that the centrally-mediated effects of MAO inhibitors and other non-nicotine constituents may not account for the greater abuse liability of cigarettes compared to non-combusted products. Nonetheless, identifying the specific constituent(s) mediating the effects of CS extracts in this study could help clarify mechanisms mediating tobacco addiction and inform FDA product standards.
Collapse
Affiliation(s)
- Andrew C. Harris
- Hennepin Healthcare Research Institute, Minneapolis, MN, United States,Department of Medicine, University of Minnesota, Minneapolis, MN, United States,Department of Psychology, University of Minnesota, Minneapolis, MN, United States,*Correspondence: Andrew C. Harris,
| | - Peter Muelken
- Hennepin Healthcare Research Institute, Minneapolis, MN, United States
| | - Aleksandra Alcheva
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
| | - Irina Stepanov
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, United States
| | - Mark G. LeSage
- Hennepin Healthcare Research Institute, Minneapolis, MN, United States,Department of Medicine, University of Minnesota, Minneapolis, MN, United States,Department of Psychology, University of Minnesota, Minneapolis, MN, United States
| |
Collapse
|
19
|
Harvanko A, Koester KA, Helen GS, Olson S, Kim HC, Ling PM. A Mixed-Methods Study on Use of Different Tobacco Products among Younger and Older Adults with Lower and Higher Levels of Nicotine Exposure in California in 2019-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5563. [PMID: 35564958 PMCID: PMC9106024 DOI: 10.3390/ijerph19095563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/05/2022] [Accepted: 04/09/2022] [Indexed: 12/04/2022]
Abstract
An increasing number of tobacco products are entering the market, offering a variety of options to attain desired nicotine intake. However, little is known about the effect of this diverse marketplace on the experiences and nicotine exposure among tobacco users. A mixed-methods study examined experiences with tobacco products among individuals with relatively lower or higher levels of biomarkers of nicotine exposure. Semi-structured interviews were conducted with younger and older adults to examine tobacco use behaviors, addiction to tobacco products, and nicotine effects. Younger and older adults provided similar narratives about addiction and nicotine effects, which were similar across age groups, product types (i.e., ENDS, combustible cigarettes, or oral tobacco products), and having lower or higher nicotine exposure. Some individuals with higher nicotine exposure who switched from combustible cigarettes to another product (e.g., ENDS) found similar or greater access and perceived addiction to nicotine. Adults with higher and lower levels of nicotine exposure provided narratives consistent with features of nicotine addiction, regardless of age and products used. Availability of multiple tobacco products may be associated with greater access and exposure to nicotine. Addiction may occur at low levels of use and with non-cigarette products.
Collapse
Affiliation(s)
- Arit Harvanko
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143-1390, USA; (A.H.); (K.A.K.); (G.S.H.); (H.C.K.)
| | - Kimberly A. Koester
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143-1390, USA; (A.H.); (K.A.K.); (G.S.H.); (H.C.K.)
| | - Gideon St. Helen
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143-1390, USA; (A.H.); (K.A.K.); (G.S.H.); (H.C.K.)
| | - Sarah Olson
- Divison of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA 94143-1390, USA;
| | - Hyunjin Cindy Kim
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143-1390, USA; (A.H.); (K.A.K.); (G.S.H.); (H.C.K.)
| | - Pamela M. Ling
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143-1390, USA; (A.H.); (K.A.K.); (G.S.H.); (H.C.K.)
- Divison of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA 94143-1390, USA;
| |
Collapse
|
20
|
E-Cigarette Aerosols Promote Oral S. aureus Colonization by Delaying an Immune Response and Bacterial Clearing. Cells 2022; 11:cells11050773. [PMID: 35269394 PMCID: PMC8909134 DOI: 10.3390/cells11050773] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 12/13/2022] Open
Abstract
E-cigarette (e-cig) vapor has been shown to play a pathological role in oral health and alter the oral microbiota, providing growth advantages for opportunistic pathogens. Enrichment of Staphylococcus aureus, a commensal resident in the oral cavity, correlates with the progression of periodontal disease, suggesting a role as an opportunistic pathogen. Environmental conditions, such as cigarette smoke, are known to increase S. aureus virulence, yet the role of S. aureus in periodontitis and oral preneoplasia is unknown. We exposed oral epithelial cells to e-cig aerosols and showed a dose-dependent cell viability reduction, regardless of nicotine content, in a possible attempt to repair DNA damage, as measured by pH2AX. S. aureus attachment to oral epithelial cells and bacterial biofilm formation were enhanced upon e-cig exposure, indicating an increased capacity for oral colonization. Mechanistically, e-cig aerosol exposure resulted in an immunosuppression, as determined by a reduction in IL8, IL6, and IL1β secretion by oral epithelial cells during co-culture with S. aureus. Consistent with this, e-cig vape reduced the oral epithelial cell clearance of S. aureus. Furthermore, we observed an increased expression of the inflammatory regulator COX2. This work suggests that e-cigs promote S. aureus colonization and modulate the oral inflammatory response, possibly promoting oral periodontitis and preneoplasia.
Collapse
|
21
|
A comprehensive physiologically based pharmacokinetic (PBPK) model for nicotine in humans from using nicotine-containing products with different routes of exposure. Sci Rep 2022; 12:1091. [PMID: 35058535 PMCID: PMC8776883 DOI: 10.1038/s41598-022-05108-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/06/2022] [Indexed: 12/17/2022] Open
Abstract
Physiologically based pharmacokinetic (PBPK) modeling can be a useful tool for characterizing nicotine pharmacokinetics (PK) from use of tobacco products. We expand a previously published PBPK model to simulate a nicotine PK profile, following single or multiple use of various tobacco products [cigarettes, smokeless tobacco, and electronic nicotine delivery systems, or a nicotine inhaler (NICOTROL)] The uptake route in the model was designed to allow for three uptake compartments: buccal cavity (BC), upper respiratory tract (URT) (conducting and transitional airways) and lower respiratory tract (alveolar region). Within each region, the model includes product-specific descriptions of the flux of nicotine into plasma, as well as the flux of nicotine from the BC and URT to the gastrointestinal tract. These descriptions are based on regional deposition and diffusion models of nicotine into plasma, which depends on the product type. Regional deposition flux combined with regional differences in physiological parameters (e.g., blood perfusion ratio and tissue thickness) play a key role in the product-specific PK profile of nicotine. The current model describes the slower flux of nicotine into plasma across the BC and URT, as well as the rapid flux known to occur in the alveolar region. Overall, the addition of the BC and respiratory tract compartments to the nicotine model provided simulation results that are comparable to the nicotine time-course plasma concentrations reported from clinical studies for the four product categories simulated.
Collapse
|
22
|
Walayat A, Li Y, Zhang Y, Fu Y, Liu B, Shao XM, Zhang L, Xiao D. Fetal e-cigarette exposure programs a neonatal brain hypoxic-ischemic sensitive phenotype via altering DNA methylation patterns and autophagy signaling pathway. Am J Physiol Regul Integr Comp Physiol 2021; 321:R791-R801. [PMID: 34524928 PMCID: PMC8616627 DOI: 10.1152/ajpregu.00207.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/08/2021] [Accepted: 09/14/2021] [Indexed: 02/07/2023]
Abstract
Maternal e-cigarette (e-cig) exposure is a pressing perinatal health concern. Emerging evidence reveals its potential adverse impacts on brain development in offspring, yet the underlying mechanisms are poorly understood. The present study tested the hypothesis that fetal e-cig exposure induces an aberrant DNA methylation profile in the developing brain, leading to alteration of autophagic flux signaling and programming of a sensitive phenotype to neonatal hypoxic-ischemic encephalopathy (HIE). Pregnant rats were exposed to chronic intermittent e-cig aerosol. Neonates were examined at the age of 9 days old. Maternal e-cig exposure decreased the body weight and brain weight but enhanced the brain-to-body weight ratio in the neonates. E-cig exposure induced a gender-dependent increase in hypoxic-ischemia-induced brain injury in male neonates associated with enhanced reactive oxygen species (ROS) activity. It differentially altered DNA methyltransferase expression and enhanced both global DNA methylation levels and specific CpG methylation at the autophagy-related gene 5 (ATG5) promoter. In addition, maternal e-cig exposure caused downregulations of ATG5, microtubule-associated protein 1 light chain 3β, and sirtuin 1 expression in neonatal brains. Of importance, knockdown of ATG5 in neonatal pups exaggerated neonatal HIE. In conclusion, the present study reveals that maternal e-cig exposure downregulates autophagy-related gene expression via DNA hypermethylation, leading to programming of a hypoxic-ischemic sensitive phenotype in the neonatal brain.
Collapse
Affiliation(s)
- Andrew Walayat
- Lawrence D. Longo MD Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California
| | - Yong Li
- Lawrence D. Longo MD Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California
| | - Yanyan Zhang
- Lawrence D. Longo MD Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California
| | - Yingjie Fu
- Lawrence D. Longo MD Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California
| | - Bailin Liu
- Lawrence D. Longo MD Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California
| | - Xuesi M Shao
- Department of Neurobiology, David Geffen School of Medicine at UCLA, University of California at Los Angeles, Los Angeles, California
| | - Lubo Zhang
- Lawrence D. Longo MD Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California
| | - Daliao Xiao
- Lawrence D. Longo MD Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, California
| |
Collapse
|
23
|
Mantey DS, Case KR, Chen B, Kelder S, Loukas A, Harrell MB. Subjective experiences at e-cigarette initiation: Implications for e-cigarette and dual/poly tobacco use among youth. Addict Behav 2021; 122:107028. [PMID: 34186298 PMCID: PMC8498802 DOI: 10.1016/j.addbeh.2021.107028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/15/2021] [Accepted: 06/19/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Subjective experiences (SEs) at initiation of cigarettes, cigars, and smokeless tobacco have been established as predictors of continued use. To date, less is known about the relationships between SEs at e-cigarette initiation and subsequent e-cigarette use behaviors. METHODS This study used data from Waves 1-6 of the Texas Adolescent Tobacco and Marketing Surveillance (TATAMS) system; a population-based rapid response study of adolescents in major metropolitan areas of Texas. Participants were adolescents who self-reported ever using e-cigarettes across all 6 waves (n = 1,104; N = 460,069). Factor analyses examined structure of SEs at e-cigarette initiation. Weighted, multilevel, multivariate regression models examined role of SEs at e-cigarette initiation on subsequent past 30-day e-cigarette use behaviors. RESULTS Factor analyses identified a positive (i.e., euphoria, relaxation) and a negative (i.e., dizziness, cough, nausea) domain of SEs. Positive SEs at e-cigarette initiation predicted 1.20 (95% CI: 1.02-1.42) greater odds of subsequent past 30-day e-cigarette use. Similarly, positive SEs at e-cigarette initiation predicted greater relative risk of dual/poly e-cigarette use, relative to non-use (RRR: 1.61; 95% CI: 1.24-2.10) and exclusive e-cigarette use (RRR: 1.68; 95% CI: 1.26-2.24). CONCLUSION This is the first study to observe longitudinal relationships between SEs at e-cigarette initiation and subsequent e-cigarette use behaviors. Findings highlight the importance of preventing initial e-cigarette use among adolescents.
Collapse
Affiliation(s)
- Dale S Mantey
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA.
| | - Kathleen R Case
- UT Health San Antonio, Center for Research to Advance Community Health, 7411 John Smith Dr, Suite 1050, San Antonio, TX 78229, USA
| | - Baojiang Chen
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Steven Kelder
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| | - Alexandra Loukas
- University of Texas at Austin, Department of Kinesiology & Health Education, University 2109 San Jacinto, D3700, Austin, TX 78712, USA
| | - Melissa B Harrell
- UT Health Science Center at Houston, UT Health, School of Public Health in Austin, 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA
| |
Collapse
|
24
|
Kimber CF, Soar K, Dawkins LE. Changes in puffing topography and subjective effects over a 2-week period in e-cigarette naïve smokers: Effects of device type and nicotine concentrations. Addict Behav 2021; 118:106909. [PMID: 33756301 DOI: 10.1016/j.addbeh.2021.106909] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/11/2021] [Accepted: 03/07/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION This study aimed to document changes in puffing topography and, the effects of device type and nicotine concentration on puffing topography, subjective effects and smoking behaviour over two weeks of e-cigarette (EC) use. METHODS EC naïve smokers (N = 50; 64% female) were randomly allocated to a cigalike (18 mg/mL) or tank containing either 18 (Tank18) or 6 mg/mL nicotine concentrations (Tank6). In 3 separate sessions (Baseline, 1 and 2 weeks post-baseline), participants vaped 20 min ad-libitum. Puff duration, puff number, inter-puff intervals (IPI), exhaled carbon monoxide (CO), cigarettes per day (CPD), cigarette dependence, craving, withdrawal, and subjective effects were recorded. RESULTS Two weeks post-baseline, puff duration and IPI significantly increased whilst puff number decreased. Cigalikes were associated with greater puff number and shorter IPI compared to Tanks; there was no difference between Tank18 and Tank6. CPD, CO and cigarette dependence reduced significantly from baseline to week1 but did not differ between conditions. During each session, there was a significant reduction in craving, whilst withdrawal symptoms were only alleviated in week1 and 2; there was no difference between conditions. Tank18 consistently rated highest on positive effects including satisfaction; satisfaction scores for Cigalikes and Tank6 declined overtime. CONCLUSIONS Cigalikes and tanks were both effective for reducing craving, withdrawal symptoms and CPD although for the former, this may only be achieved through more frequent puffing. That the Tank18 yielded greater satisfaction suggests tank devices and higher nicotine concentrations may be more suitable in the early stage of a smoking cessation attempt.
Collapse
Affiliation(s)
- C F Kimber
- London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom.
| | - K Soar
- London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom
| | - L E Dawkins
- London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom
| |
Collapse
|
25
|
Li Y, Burns AE, Tran LN, Abellar KA, Poindexter M, Li X, Madl AK, Pinkerton KE, Nguyen TB. Impact of e-Liquid Composition, Coil Temperature, and Puff Topography on the Aerosol Chemistry of Electronic Cigarettes. Chem Res Toxicol 2021; 34:1640-1654. [PMID: 33949191 DOI: 10.1021/acs.chemrestox.1c00070] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
E-cigarette aerosol is a complex mixture of gases and particles with a composition that is dependent on the e-liquid formulation, puffing regimen, and device operational parameters. This work investigated mainstream aerosols from a third generation device, as a function of coil temperature (315-510 °F, or 157-266 °C), puff duration (2-4 s), and the ratio of propylene glycol (PG) to vegetable glycerin (VG) in e-liquid (100:0-0:100). Targeted and untargeted analyses using liquid chromatography high-resolution mass spectrometry, gas chromatography, in situ chemical ionization mass spectrometry, and gravimetry were used for chemical characterizations. PG and VG were found to be the major constituents (>99%) in both phases of the aerosol. Most e-cigarette components were observed to be volatile or semivolatile under the conditions tested. PG was found almost entirely in the gas phase, while VG had a sizable particle component. Nicotine was only observed in the particle phase. The production of aerosol mass and carbonyl degradation products dramatically increased with higher coil temperature and puff duration, but decreased with increasing VG fraction in the e-liquid. An exception is acrolein, which increased with increasing VG. The formation of carbonyls was dominated by the heat-induced dehydration mechanism in the temperature range studied, yet radical reactions also played an important role. The findings from this study identified open questions regarding both pathways. The vaping process consumed PG significantly faster than VG under all tested conditions, suggesting that e-liquids become more enriched in VG and the exposure to acrolein significantly increases as vaping continues. It can be estimated that a 30:70 initial ratio of PG:VG in the e-liquid becomes almost entirely VG when 60-70% of e-liquid remains during the vaping process at 375 °F (191 °C). This work underscores the need for further research on the puffing lifecycle of e-cigarettes.
Collapse
Affiliation(s)
- Yichen Li
- Department of Environmental Toxicology, University of California at Davis, Davis, California 95616, United States
| | - Amanda E Burns
- Department of Environmental Toxicology, University of California at Davis, Davis, California 95616, United States
| | - Lillian N Tran
- Department of Environmental Toxicology, University of California at Davis, Davis, California 95616, United States
| | - Karizza A Abellar
- Department of Chemistry, University of California at Davis, Davis, California 95616, United States
| | - Morgan Poindexter
- Center for Health and the Environment, University of California at Davis, Davis, California 95616, United States
| | - Xiaohan Li
- Center for Health and the Environment, University of California at Davis, Davis, California 95616, United States
| | - Amy K Madl
- Center for Health and the Environment, University of California at Davis, Davis, California 95616, United States
| | - Kent E Pinkerton
- Center for Health and the Environment, University of California at Davis, Davis, California 95616, United States
| | - Tran B Nguyen
- Department of Environmental Toxicology, University of California at Davis, Davis, California 95616, United States
| |
Collapse
|
26
|
Wagener TL, Avery JA, Leavens ELS, Simmons WK. Associated Changes in E-cigarette Puff Duration and Cigarettes Smoked per Day. Nicotine Tob Res 2021; 23:760-764. [PMID: 33049064 DOI: 10.1093/ntr/ntaa211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/08/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION To examine whether changes in select measures of e-cigarette puffing topography are associated with changes in smoking behavior. METHODS Sixteen current cigarette smokers were instructed to completely switch from smoking combustible cigarettes to using e-cigarettes over a 2-week period. The study was completed in the Southern Midwestern region of the United States. Measures included demographics, smoking history, and cigarette dependence, as well as baseline and 2-week follow-up self-reported cigarettes per day, cigarette craving and urges, exhaled carbon monoxide readings, and e-cigarette usage data (puff number, puffing time, and average puff duration) collected via the e-cigarette built-in puff counter. RESULTS Over the 2-week switching period, participants significantly reduced their cigarettes per day (~80% reduction, p < .0001). Although the number of e-cigarette puffs/day remained relatively stable (p > .05), the average total e-cigarette daily puffing time increased significantly (p = .001). Users' average puff duration increased by 91 ms/puff/d (p < .001). The percentage decrease in cigarettes smoked per day was significantly and directly related to the slope of subjects' average puff duration over time (r(13) = .62, p = .01), such that as cigarettes per day decreased, puff duration increased. Self-reported smoking urges remained relatively stable from baseline to the end of the 2-week period (p > .05). CONCLUSIONS Among smokers switching to an e-cigarette, greater increases in e-cigarette puff duration was associated with greater reductions in cigarette smoking. IMPLICATIONS The current study is one of the first to examine changes in smokers' e-cigarette puffing behavior and associated changes in cigarette consumption as they attempt to completely switch to e-cigarettes. During a 2-week switching period, participants reduced their cigarettes per day. Moreover, although e-cigarette puffs per day remained relatively stable, users' average puff duration increased significantly. Greater increases in e-cigarette puff duration were associated with greater reductions in cigarette smoking. Understanding how to effectively use an e-cigarette to best reduce and eventually quit smoking will be necessary as smokers increasingly turn to these products to facilitate possible cessation.
Collapse
Affiliation(s)
- Theodore L Wagener
- Department of Internal Medicine and Center for Tobacco Research, Comprehensive Cancer Center, The Ohio State University and James Cancer Hospital, Columbus, OH
| | - Jason A Avery
- Laboratory of Brain and Cognition, National Institute of Mental Health, Bethesda, MD
| | - Eleanor L S Leavens
- Department of Population Health, University of Kansas School of Medicine, Kansas City, KS
| | - W Kyle Simmons
- Department of Pharmacology and Physiology, Oklahoma State University Center for Health Sciences, Tulsa, OK.,Center for Wellness and Recovery, Oklahoma State University Center for Health Sciences, Tulsa, OK
| |
Collapse
|
27
|
Phillips G, Czekala L, Behrsing HP, Amin K, Budde J, Stevenson M, Wieczorek R, Walele T, Simms L. Acute electronic vapour product whole aerosol exposure of 3D human bronchial tissue results in minimal cellular and transcriptomic responses when compared to cigarette smoke. TOXICOLOGY RESEARCH AND APPLICATION 2021. [DOI: 10.1177/2397847320988496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
The use of electronic vapour products (EVPs) continues to increase worldwide and with advances in cell culture systems, molecular biology and the computational sciences there is also accumulating evidence of their potential reduced toxicity and reduced potential harm when compared to cigarette smoke. To further understand the potential risks and health effects associated with exposure to EVP aerosols we have assessed the cellular and transcriptomic response from a commercially available lung tissue culture system (MucilAirTM) following a single sub-cytotoxic exposure to cigarette smoke and the equivalent nicotine delivered dose of EVP aerosol. The transcriptomic, cellular (cilia beat frequency (CBF) and percent active area (%AA), trans epithelial electrical resistance (TEER), histology) and cytokine release were assessed at 4- and 48- hours following recovery from air, EVP aerosol (8.4% V/V: mybluTM blueberry flavour, 2.4% nicotine) and 3R4F smoke (3.5% V/V: exposure). No pathological changes were observed at either recovery time point from any exposure. Air and EVP aerosol exposure had no effect on CBF, %AA nor TEER at 48 hours. Exposure to cigarette smoke resulted in a decrease in TEER, an increase in CBF and the release of proinflammatory cytokines at both recovery time points. Although the number of significantly expressed genes was minimal following exposure to EVP aerosol, exposure to 3R4F smoke resulted in a significant upregulation of several disease relevant pathways. These data provide evidence that following an acute exposure to EVP aerosol there is significantly less damage to lung cells in culture than the equivalent, nicotine based, dose of cigarette smoke.
Collapse
Affiliation(s)
- Gary Phillips
- Group Science and Regulatory Affairs, Imperial Brands PLC, Bristol, United Kingdom
| | - Lukasz Czekala
- Group Science and Regulatory Affairs, Imperial Brands PLC, Bristol, United Kingdom
| | - Holger P Behrsing
- Respiratory Toxicology, Institute for In Vitro Sciences, Inc., Gaithersburg, MD, USA
| | - Khalid Amin
- University of Minnesota Medical Center, Minneapolis, MN, USA
| | - Jessica Budde
- Reemtsma Cigarettenfabriken GmbH, An Imperial Brands PLC Company, Hamburg, Germany
| | - Matthew Stevenson
- Group Science and Regulatory Affairs, Imperial Brands PLC, Bristol, United Kingdom
| | - Roman Wieczorek
- Reemtsma Cigarettenfabriken GmbH, An Imperial Brands PLC Company, Hamburg, Germany
| | - Tanvir Walele
- Group Science and Regulatory Affairs, Imperial Brands PLC, Bristol, United Kingdom
| | - Liam Simms
- Group Science and Regulatory Affairs, Imperial Brands PLC, Bristol, United Kingdom
| |
Collapse
|
28
|
Goldenson NI, Fearon IM, Buchhalter AR, Henningfield JE. An Open-Label, Randomized, Controlled, Crossover Study to Assess Nicotine Pharmacokinetics and Subjective Effects of the JUUL System with Three Nicotine Concentrations Relative to Combustible Cigarettes in Adult Smokers. Nicotine Tob Res 2021; 23:947-955. [PMID: 33486526 PMCID: PMC8628869 DOI: 10.1093/ntr/ntab001] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/04/2021] [Indexed: 11/30/2022]
Abstract
Introduction This randomized, open-label, crossover clinical study evaluated nicotine
pharmacokinetics (PK) and subjective effects of the JUUL System (JS; Juul
Labs, Inc.) with three nicotine concentrations compared to the usual brand
(UB) cigarettes in 24 adult smokers. Methods At five study visits, subjects used either the JS in 59 mg/mL, JS 18 mg/mL
(two visits), and JS 9 mg/mL (all tobacco-flavored) or smoked their UB
cigarette first during a controlled puffing sequence (CPS) and then ad
libitum (5 min) use sessions. Blood samples were taken at specified
timepoints for 60 min in each session. The modified Product Evaluation Scale
assessed subjective effects 30-min post-use in the CPS session. Results Maximum plasma nicotine concentration (Cmax-BL),
total nicotine exposure (AUC0-60-BL), and rate of plasma nicotine
rise were significantly lower for all JS products compared to subjects' UB
cigarette in CPS and ad libitum use sessions. In both use sessions these PK
parameters were significantly higher for JS 59 mg/mL compared to 18 and 9
mg/mL. Subjective measures of cigarette craving relief and “Enough
Nicotine” for JS 59 mg/mL did not differ significantly from UB
cigarettes, but JS 18 and 9 mg/mL were rated significantly lower than JS 59
mg/mL and UB cigarettes. Conclusions Nicotine exposure and subjective relief were directly related to JS nicotine
concentration: higher nicotine concentrations gave rise to significantly
greater plasma nicotine levels and relief from craving. Heavier and more
dependent smokers may require the greater nicotine delivery of JS 59 mg/mL
to successfully transition away from cigarettes. Implications It has been suggested that electronic nicotine delivery systems (ENDS) and
other alternative nicotine delivery products that more closely mimic the
nicotine pharmacokinetics (PK) of cigarettes may facilitate smokers
transitioning away from cigarettes. We examined nicotine PK and subjective
effects of JUUL System (JS) ENDS with three nicotine concentrations (59, 18
and 9 mg/mL) compared to combustible cigarettes. Nicotine delivery from JS
ENDS was nicotine concentration dependent, with higher nicotine
concentrations giving rise to higher nicotine exposure. These findings
suggest that heavier and more dependent smokers may require ENDS with
nicotine concentrations greater than 20 mg/mL to successfully transition
away from cigarettes.
Collapse
|
29
|
Hair EC, Barton AA, Perks SN, Kreslake J, Xiao H, Pitzer L, Leventhal AM, Vallone DM. Association between e-cigarette use and future combustible cigarette use: Evidence from a prospective cohort of youth and young adults, 2017-2019. Addict Behav 2021; 112:106593. [PMID: 32927247 DOI: 10.1016/j.addbeh.2020.106593] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 07/28/2020] [Accepted: 07/28/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION A surge in popularity of e-cigarettes prompts concern given the association between e-cigarettes and future cigarette use. However, much of the evidence for this association comes from early, less efficient, and lower nicotine e-cigarettes than are available and widely used now. The goal of this study was to examine the relationship between e-cigarette use in 2018 and subsequent smoking initiation and continued e-cigarette use. METHODS Participants included members of a national longitudinal panel of youth and young adults aged 15-27 who, in 2017, reported never having used a nicotine containing product (n = 3360). Logistic regression analyses assessed associations between participants' self-reported ever e-cigarette use in 2018 and ever cigarette use, current cigarette use, and current e-cigarette use in 2019, after controlling for demographic and psychosocial variables. RESULTS Compared with those who still had never used an e-cigarette, those who reported ever e-cigarette use in 2018 had significantly higher odds of ever cigarette use (aOR = 7.29, 95% CI [4.10, 12.97]), current cigarette use (aOR = 8.26, 95% CI [3.17, 21.53]), and current e-cigarette use (aOR = 9.70, 95% CI [6.41, 14.69]) one year later in 2019. CONCLUSIONS These findings show that the pod mod style, high nicotine containing e-cigarettes subject young users to the same risks of transitioning to combustible cigarettes as their earlier, less efficient predecessors. Strong regulation of all nicotine products, including e-cigarettes, is needed to prevent the trajectory of e-cigarette to cigarette use among youth and young adults.
Collapse
Affiliation(s)
- Elizabeth C Hair
- Schroeder Institute at Truth Initiative, Washington, DC, USA; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; College of Global Public Health, New York University, New York, NY, USA.
| | - Alexis A Barton
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Siobhan N Perks
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Jennifer Kreslake
- Schroeder Institute at Truth Initiative, Washington, DC, USA; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Haijun Xiao
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Lindsay Pitzer
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles CA, USA
| | - Donna M Vallone
- Schroeder Institute at Truth Initiative, Washington, DC, USA; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; College of Global Public Health, New York University, New York, NY, USA
| |
Collapse
|
30
|
Nicotine pharmacokinetics of electronic cigarettes: A pooled data analysis from the literature. Toxicol Rep 2020; 8:84-95. [PMID: 33437651 PMCID: PMC7786013 DOI: 10.1016/j.toxrep.2020.12.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022] Open
Abstract
Evaluating the pharmacokinetics of nicotine absorption from electronic cigarettes. Nicotine absorption into the blood is influenced by several factors. These include e-liquid composition, user behavior and device characteristics. Any regulation of nicotine levels in e-liquids should reflect this heterogeneity.
Several regulatory initiatives around the world restrict the amount of nicotine permitted in electronic cigarette liquids in an attempt to reproduce the nicotine delivery of combusted tobacco products, such as cigarettes, and or reduce the risk of consumers absorbing too much nicotine into their body at one time. Such an approach, however, assumes that (i) there is a strong correlation between the levels of nicotine in electronic cigarette liquids and nicotine intake into the body and (ii) that this correlation holds true across the various different types of electronic cigarette devices currently available on the market. In order to test these hypotheses, this study examines the available scientific literature on nicotine intake from electronic cigarettes, as measured by levels in the blood. Analysis of the published data reveals that nicotine absorption into the body is influenced by a combination of many factors, including electronic cigarette liquid composition, user behavior and device characteristics. Notably, it was observed that open-tank (refillable) electronic cigarettes, which often enable users to vary device power, can deliver high nicotine levels to consumers, sometimes at greater doses than a conventional tobacco cigarette, even at the lower nicotine liquid concentrations typically available. For electronic cigarettes to be viable alternative choices to smoking, they should provide consumers with an equally satisfying experience, including in terms of nicotine absorption into the body. Therefore, any regulation seeking to restrict the amount of nicotine in electronic cigarette liquids should take all the factors influencing nicotine intake into account.
Collapse
|
31
|
Mantey DS, Omega-Njemnobi O, Kelder SH. E-Cigarette Use Is Associated With Intentions to Lose Weight Among High School Students. Nicotine Tob Res 2020; 22:838-842. [PMID: 30452714 DOI: 10.1093/ntr/nty245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/12/2018] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Recent literature has demonstrated individuals may be using electronic cigarettes (e-cigarettes) as a method of weight loss and/or management. Furthermore, e-cigarette companies are developing and patenting technologies related to e-cigarettes and weight loss. This study aims to determine the association between intentions to lose weight and e-cigarette use behaviors among a nationally representative sample of high school students. METHODS Data were obtained from the 2015 Youth Risk Behavior Surveillance survey. Participants were 12 847 students in grades 9-12 in the United States. Multivariate multinomial logistic regression models assessed the association between past 30-day e-cigarette use and weight loss intentions among 9-12 grade students. Subsample analyses were conducted, stratified by sex. Covariates included perceived weight, sex, race/ethnicity, grade, and past 30-day tobacco use. RESULTS Overall, 23.7% of the sample used e-cigarettes in the past 30 days. E-cigarette use was associated with 1.38 (95% CI = 1.07% to 1.78%) greater risk of intentions to lose weight among the full sample, controlling for covariates. Among girls, e-cigarette use was associated with 1.44 (95% CI = 1.05% to 1.97%) greater risk of intentions to lose weight, controlling for covariates. Among boys, e-cigarette use was associated with 1.40 (95% CI = 1.04% to 1.88%) greater odds of intentions to gain weight, controlling for covariates. CONCLUSION Findings show a significant association between e-cigarette use and intentions to lose weight among high school students, among the full sample. Interestingly, e-cigarette use was statistically associated with intentions to gain weight among boys. Longitudinal study is needed to further examine this relationship. IMPLICATIONS AND CONTRIBUTION This is the one of the first studies reporting on e-cigarette use and weight loss intentions among adolescents, both highly prevalent among this population. These findings are an important development in the study of e-cigarette use given the established link between conventional cigarette smoking and weight loss and/or management.
Collapse
Affiliation(s)
- Dale S Mantey
- Division of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Austin, TX
| | - Onyinye Omega-Njemnobi
- Division of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Austin, TX
| | - Steven H Kelder
- Division of Health Promotion and Behavioral Sciences, UTHealth School of Public Health, Austin, TX
| |
Collapse
|
32
|
Smith TT, Heckman BW, Wahlquist AE, Cummings KM, Carpenter MJ. The Impact of E-liquid Propylene Glycol and Vegetable Glycerin Ratio on Ratings of Subjective Effects, Reinforcement Value, and Use in Current Smokers. Nicotine Tob Res 2020; 22:791-797. [PMID: 31403695 DOI: 10.1093/ntr/ntz130] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 07/30/2019] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Electronic nicotine delivery systems (ENDS) vary on a wide range of characteristics that may affect reinforcement value and use. One characteristic is the ratio of two solvents commonly used in most e-liquids: propylene glycol (PG) and vegetable glycerin (VG). The goal of this study was to understand how PG/VG ratio affects subjective effects, reinforcement value, and tobacco use patterns among current smokers who try using ENDS. AIMS AND METHODS Current smokers with minimal ENDS use history (n = 30) sampled, in a double-blind fashion, three different e-liquids that varied in PG/VG ratio (70/30, 50/50, 0/100) while holding constant other aspects of the e-liquid and ENDS. Participants tried each e-liquid before rating the subjective effects on a modified version of the Cigarette Evaluation Questionnaire. Reinforcement value was assessed using a preference task where participants chose between the three e-liquids. The impact of each e-liquid on cigarette reinforcement was assessed using a modified version of the Cigarette Purchase Task. Participants were randomly assigned to receive one e-liquid to take home for 1 week. RESULTS PG/VG ratio had minimal impact on most of the tested outcomes. Participants rated the highest PG concentration as having a stronger "throat hit" than the other two. There was no significant difference between the number of participants who preferred each of the PG/VG ratios in the preference assessment. PG/VG ratio did not affect cigarette or ENDS use during the sampling week. CONCLUSIONS These data suggest that PG/VG ratio has minimal impact on subjective effects and reinforcement value in ENDS naive current smokers. IMPLICATIONS These data suggest that PG/VG ratio, within the range that is commonly used, has minimal impact on subjective effects, reinforcement value, or uptake in current smokers with minimal ENDS experience.
Collapse
Affiliation(s)
- Tracy T Smith
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.,Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
| | - Bryan W Heckman
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.,Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC
| | - Amy E Wahlquist
- Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC.,Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.,Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC.,Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC.,Cancer Control and Prevention, Hollings Cancer Center, Medical University of South Carolina, Charleston, SC.,Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| |
Collapse
|
33
|
Blank MD, Pearson J, Cobb CO, Felicione NJ, Hiler MM, Spindle TR, Breland A. What factors reliably predict electronic cigarette nicotine delivery? Tob Control 2020; 29:644-651. [PMID: 31685583 PMCID: PMC8029495 DOI: 10.1136/tobaccocontrol-2019-055193] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/05/2019] [Accepted: 09/24/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND The ability of an electronic cigarette (e-cigarette) to deliver nicotine effectively may be dependent on features of the device, the liquid and the user. Some of these features have been examined in previous work (eg, liquid nicotine concentration and puff topography), while others have not (eg, nicotine dependence and demographic characteristics). The purpose of this secondary analysis is to examine such features as predictors of e-cigarette nicotine delivery using a relatively large sample. METHODS Four studies were combined in which e-cigarette-experienced users (n=63; 89% men; 75% white) and e-cigarette-naïve cigarette smokers (n=67; 66% men; 54% white) took 10 puffs from an eGo-style e-cigarette (~7.3 watts) filled with liquid that had a nicotine concentration of 18, 25 or 36 mg/mL. Thus, held constant across all studies were device features of battery/cartomiser style and power level and the topography parameters of puff number and interpuff interval. Blood was sampled before and after use, and puff topography was measured. Three general linear models were conducted to predict plasma nicotine concentrations (pre-post increase) for: (1) e-cigarette users only, (2) smokers only and (3) both groups combined. Predictor variables included puff duration, puff volume, liquid nicotine concentration, presession plasma nicotine concentration, nicotine dependence score (smokers only), gender and race. RESULTS In all models tested, longer puff durations and higher liquid nicotine concentrations were associated significantly with increased nicotine delivery (ps<0.05). For e-cigarette users only, higher presession nicotine concentration was associated significantly with increased nicotine delivery (p<0.05). CONCLUSIONS Puff duration and liquid nicotine concentration may be among the more important factors to consider as regulators attempt to balance e-cigarette safety with efficacy. These findings should be interpreted in the context of devices with relatively low power output, a variable not studied here but likely also directly relevant to product regulation.
Collapse
Affiliation(s)
- Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Jennifer Pearson
- Division of Social and Behavioral Science/Health Administration and Policy, University of Nevada Reno, Reno, Nevada, USA
- Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nicholas J Felicione
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Marzena M Hiler
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Tory R Spindle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alison Breland
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| |
Collapse
|
34
|
Ashley DL, Spears CA, Weaver SR, Huang J, Eriksen MP. E-cigarettes: How can they help smokers quit without addicting a new generation? Prev Med 2020; 140:106145. [PMID: 32473270 PMCID: PMC7680279 DOI: 10.1016/j.ypmed.2020.106145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/01/2020] [Accepted: 05/24/2020] [Indexed: 12/17/2022]
Abstract
The dramatic increase in youth use of electronic nicotine delivery systems (ENDS; e.g., e-cigarettes) in the United States has focused regulatory efforts to address this concern while still encouraging smokers to switch completely to lower risk products or quit all tobacco product use. Increases in the minimum age for purchase of all tobacco products and changes in enforcement policy for ENDS have been recently enacted in an effort to address the youth vaping epidemic. Since all ENDS marketed after February 15, 2007 will be required to meet the "appropriate for the protection of public health" standard for marketing authorization of new products, ENDS manufacturers will have to demonstrate, in part, that their products help lessen the adverse impact on youth use. Some, such as disallowing flavors other than tobacco or menthol or limiting nicotine delivery, may help reduce youth use but could also inhibit smokers from quitting smoking. Other approaches, including reducing the high-tech appearance and discreteness of ENDS, discontinuing use of coupons and two-for-one type price incentives for ENDS, limiting retail sales of these products to adult-only facilities, and incorporating technological innovations such as biometrics or geofencing into ENDS, may help manufacturers demonstrate that marketing of their products would help reduce youth use of ENDS and lessen the epidemic, while still assuring adult smokers have access to products that encourage discontinuing combusted product use.
Collapse
Affiliation(s)
- David L Ashley
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States of America; Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States of America.
| | - Claire Adams Spears
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States of America; Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States of America
| | - Scott R Weaver
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States of America; Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States of America
| | - Jidong Huang
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States of America; Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States of America
| | - Michael P Eriksen
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States of America; Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States of America
| |
Collapse
|
35
|
Jackson A, Grobman B, Krishnan-Sarin S. Recent findings in the pharmacology of inhaled nicotine: Preclinical and clinical in vivo studies. Neuropharmacology 2020; 176:108218. [PMID: 32592708 DOI: 10.1016/j.neuropharm.2020.108218] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/13/2020] [Accepted: 06/17/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The rise of vaping in adolescents, the recent entrance of new inhaled nicotine products such as iQOS on the market and e-cigarette or vaping product use-associated lung injury cases has created concern for the use of inhaled non-combustible nicotine products. This narrative review discusses recent experimental in vivo studies that utilize human, rat and mouse models to understand the pharmacological impact of nicotine from non-combustible products. METHODS The search engine PubMed was utilized with the following search terms: inhaled nicotine, nicotine e-cigarette, heated tobacco products, iQOS, electronic cigarette, nicotine inhaler, nicotine vaping. This review highlights recent primary in vivo studies of inhaled nicotine administration experimental paradigms that occurred in laboratory settings using human and rodent (rats and mice) models that have been published from January 2017-December 2019. RESULTS The pharmacokinetics of nicotine via e-cigarettes is influenced by the PG/VG and flavor constituents in e-liquids, the presence of nicotine salts in e-liquids, puff topography of nicotine and tobacco product users and the power of the e-cigarette device. The pharmacodynamic impact of inhaled nicotine has cardiovascular, pulmonary and central nervous system implications. CONCLUSION The articles reviewed here highlight the importance of both animal and human models to fully understand the impact of inhaled nicotine pharmacology There is a need for more rodent pharmacokinetic inhaled nicotine studies to understand the influences of factors such as flavor and nicotine salts. Additionally, consensus on nicotine measurement in both human and rodent studies is greatly needed.
Collapse
Affiliation(s)
- Asti Jackson
- Department of Psychiatry, Yale School of Medicine, United States.
| | - Ben Grobman
- Department of Psychiatry, Yale School of Medicine, United States
| | | |
Collapse
|
36
|
Talih S, Salman R, El-Hage R, Karam E, Karaoghlanian N, El-Hellani A, Saliba N, Eissenberg T, Shihadeh A. Might limiting liquid nicotine concentration result in more toxic electronic cigarette aerosols? Tob Control 2020; 30:348-350. [PMID: 32522818 DOI: 10.1136/tobaccocontrol-2019-055523] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/25/2020] [Accepted: 04/06/2020] [Indexed: 11/04/2022]
Abstract
Some jurisdictions have instituted limits on electronic cigarette (ECIG) liquid nicotine concentration, in an effort to control ECIG nicotine yield, and others are considering following suit. Because ECIG nicotine yield is proportional to the product of liquid nicotine concentration (milligram per millilitre) and device power (watts) regulations that limit liquid nicotine concentration may drive users to adopt higher wattage devices to obtain a desired nicotine yield. In this study we investigated, under various hypothetical regulatory limits on ECIG liquid nicotine concentration, a scenario in which a user of a common ECIG device (SMOK TF-N2) seeks to obtain in 15 puffs the nicotine emissions equivalent to one combustible cigarette (ie, 1.8 mg). We measured total aerosol and carbonyl compound (CC) yields in 15 puffs as a function of power (15-80 W) while all else was held constant. The estimated nicotine concentration needed to achieve combustible cigarette-like nicotine yield at each power level was then computed based on the measured liquid consumption. We found that for a constant nicotine yield of 1.8 mg, reducing the liquid nicotine concentration resulted in greater amount of liquid aerosolised (p<0.01) and greater CC emissions (p<0.05). Thus, if users seek a given nicotine yield, regulatory limits on nicotine concentration may have the unintended consequence of increasing exposure to aerosol and respiratory toxicants. This outcome demonstrates that attempting to control ECIG nicotine yield by regulating one factor at a time may have unintended health effects and highlights the need to consider multiple factors and outcomes simultaneously when designing regulations.
Collapse
Affiliation(s)
- Soha Talih
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.,Center for the Study of Tobacco Products, Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rola Salman
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.,Center for the Study of Tobacco Products, Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rachel El-Hage
- Center for the Study of Tobacco Products, Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA.,Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Ebrahim Karam
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.,Center for the Study of Tobacco Products, Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nareg Karaoghlanian
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon.,Center for the Study of Tobacco Products, Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ahmad El-Hellani
- Center for the Study of Tobacco Products, Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA.,Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Najat Saliba
- Center for the Study of Tobacco Products, Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA.,Chemistry Department, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Alan Shihadeh
- Mechanical Engineering Department, American University of Beirut, Beirut, Lebanon .,Center for the Study of Tobacco Products, Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA
| |
Collapse
|
37
|
Patten T, De Biasi M. History repeats itself: Role of characterizing flavors on nicotine use and abuse. Neuropharmacology 2020; 177:108162. [PMID: 32497589 DOI: 10.1016/j.neuropharm.2020.108162] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/22/2020] [Accepted: 05/24/2020] [Indexed: 12/13/2022]
Abstract
The popularity of e-cigarettes has skyrocketed in recent years, and most vapers use flavored e-cigarette products. Consumption of flavored e-cigarettes exceeds that of combustible cigarettes and other tobacco products among adolescents, who are particularly vulnerable to becoming nicotine dependent. Flavorings have been used by the tobacco industry since the 17th century, but the use of flavors by the e-cigarette industry to create products with "characterizing" flavors (i.e. flavors other than tobacco or menthol) has sparked a public health debate. This review addresses the possibility that characterizing flavors make nicotine more appealing, rewarding and addictive. It also discusses ways in which preclinical and clinical studies could improve our understanding of the mechanisms by which flavors may alter nicotine reward and reinforcement. This article is part of the special issue on 'Contemporary Advances in Nicotine Neuropharmacology'.
Collapse
Affiliation(s)
- Theresa Patten
- Pharmacology Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Mariella De Biasi
- Pharmacology Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
| |
Collapse
|
38
|
Harvanko AM, Helen GS, Nardone N, Addo N, Benowitz NL. Twenty-four-hour subjective and pharmacological effects of ad-libitum electronic and combustible cigarette use among dual users. Addiction 2020; 115:1149-1159. [PMID: 31837232 PMCID: PMC7255919 DOI: 10.1111/add.14931] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/23/2019] [Accepted: 12/06/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Relative pharmacological effects of e-cigarettes and cigarettes during 24 hours of ad-libitum use have not been described. In this study, 24-hour blood plasma nicotine concentrations and 48-hour subjective effects with use of cigarettes and e-cigarettes were measured among dual users. DESIGN Two-arm within-subject cross-over design with preferred e-cigarette or cigarette ad-libitum use over 48 hours. SETTING Hospital research ward in San Francisco, California, USA. PARTICIPANTS Thirty-six healthy dual users of e-cigarettes and cigarettes (n = 8, 25% females). MEASUREMENTS Twenty-four-hour blood plasma nicotine and cotinine concentrations and 48-hour self-reported nicotine withdrawal symptoms and rewarding effects. FINDINGS Analyses used analysis of variance (ANOVA)-based mixed models with order of product (e-cigarette or cigarette) and product type (combustible cigarette or type of e-cigarette) as fixed effects, and subject as a repeated effect. During a 24-hour period, e-cigarettes produced lower nicotine exposure than cigarettes for the majority of users, although 25% received more nicotine from e-cigarettes, which was predicted by more frequent e-cigarette use or greater dependence. Compared to cigarette smoking, nicotine exposure for variable-power tank users was similar, while cig-a-like (t(30) = 2.71, P = 0.011, d = 0.745) and fixed-power tank users (t(30) = 3.37, P = 0.002, d = 0.993) were exposed to less nicotine. Cigarettes were rated higher than e-cigarettes on some desirable subjective effects (e.g. psychological reward, t(322) = 7.24 P < 0.001, d = 0.432), but withdrawal symptom reduction was comparable. No differences were found between e-cigarette types, but Bayes factors indicate that these measures were insensitive. CONCLUSIONS During a 24-hour period in a hospital setting in the United States, nicotine exposure for dual users of e-cigarettes and cigarettes was similar when using cigarettes or variable-power tank devices only but was lower for those using cig-a-like or fixed-power devices only. Despite lower nicotine levels, all types of e-cigarette were effective in preventing withdrawal symptoms. E-cigarettes were rated less rewarding than cigarettes.
Collapse
Affiliation(s)
- Arit M. Harvanko
- Center for Tobacco Control Research and Education, University of California, San Francisco, California
| | - Gideon St. Helen
- Center for Tobacco Control Research and Education, University of California, San Francisco, California,Clinical Pharmacology Research Program, Division of Cardiology, Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, San Francisco, California
| | - Natalie Nardone
- Clinical Pharmacology Research Program, Division of Cardiology, Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, San Francisco, California
| | - Newton Addo
- Clinical Pharmacology Research Program, Division of Cardiology, Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, San Francisco, California
| | - Neal L. Benowitz
- Center for Tobacco Control Research and Education, University of California, San Francisco, California,Clinical Pharmacology Research Program, Division of Cardiology, Zuckerberg San Francisco General Hospital, Department of Medicine, University of California, San Francisco, California,Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, California
| |
Collapse
|
39
|
Blank ML, Hoek J, George M, Gendall P, Conner TS, Thrul J, Ling PM, Langlotz T. An Exploration of Smoking-to-Vaping Transition Attempts Using a "Smart" Electronic Nicotine Delivery System. Nicotine Tob Res 2020; 21:1339-1346. [PMID: 29878179 DOI: 10.1093/ntr/nty093] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 05/07/2018] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Electronic nicotine delivery systems (ENDS) are used to aid smoking cessation attempts; however, many smokers continue to smoke while using an ENDS (dual use). Although uncertainty remains regarding whether specific ENDS patterns hinder or support successful smoking cessation, recent advances in "smart" technology allow passive and active recording of behaviors in real time, enabling more detailed insights into how smoking and vaping patterns may coevolve. We describe patterns of ENDS initiation, and subsequent use, including any changes in cigarette consumption, among daily smokers using a "smart" ENDS (S-ENDS) to quit smoking. METHOD An 8-week long mixed-methods feasibility study used Bluetooth-enabled S-ENDS that passively recorded real-time device use by participants (n = 11). Daily surveys administered via smartphones collected data on self-reported cigarette consumption. RESULTS All 11 participants were dual users, at least initially, during their quit attempt. We observed three provisional vaping and smoking patterns: immediate and intensive ENDS initiation coupled with immediate, dramatic, and sustained smoking reduction, leading to smoking abstinence; gradual ENDS uptake with gradual smoking reductions, leading to daily dual use throughout the study period; and ENDS experimentation with return to exclusive smoking. For six participants, the patterns observed in week 1 were similar to the vaping and smoking patterns observed throughout the rest of the study period. CONCLUSION Technological advances now allow fine-grained description of ENDS use and smoking patterns. Larger and longer studies describing smoking-to-vaping patterns, and estimating associations with smoking outcomes, could inform ENDS-specific cessation advice promoting full transition from smoking to exclusive ENDS use. IMPLICATIONS The use of an S-ENDS that recorded real-time device use among daily smokers engaged in a quit attempt provides insight into patterns and trajectories of dual use (continuing to smoke while using ENDS), and the possible associations between ENDS initiation, subsequent use, and smoking cessation outcomes. Such work could support more targeted cessation counseling and technical advice for smokers using ENDS to quit smoking, reduce the risk of users developing long-term dual use patterns, and enhance the contributions ENDS may make to reducing smoking prevalence.
Collapse
Affiliation(s)
| | - Janet Hoek
- University of Otago, Dunedin, New Zealand
| | | | | | | | | | - Pamela M Ling
- University of California San Francisco, San Francisco, CA
| | | |
Collapse
|
40
|
Barrington-Trimis JL, Yang Z, Schiff S, Unger J, Cruz TB, Urman R, Cho J, Samet JM, Leventhal AM, Berhane K, McConnell R. E-cigarette Product Characteristics and Subsequent Frequency of Cigarette Smoking. Pediatrics 2020; 145:peds.2019-1652. [PMID: 32253264 PMCID: PMC7193941 DOI: 10.1542/peds.2019-1652] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There is a dearth of evidence regarding the association of use of electronic cigarettes (e-cigarettes) with certain product characteristics and adolescent and young adult risk of unhealthy tobacco use patterns (eg, frequency of combustible cigarette smoking), which is needed to inform the regulation of e-cigarettes. METHODS Data were collected via an online survey of participants in the Southern California Children's Health Study from 2015 to 2016 (baseline) and 2016 to 2017 (follow-up) (N = 1312). We evaluated the association of binary categories of 3 nonmutually exclusive characteristics of the e-cigarette used most frequently with the number of cigarettes smoked in the past 30 days at 1-year follow-up. Product characteristics included device (vape pen and/or modifiable electronic cigarette [mod]), use of nicotine in electronic liquid (e-liquid; yes or no), and use for dripping (directly dripping e-liquid onto the device; yes or no). RESULTS Relative to never e-cigarette users, past-30-day e-cigarette use was associated with greater frequency of past-30-day cigarette smoking at follow-up. Among baseline past-30-day e-cigarette users, participants who used mods (versus vape pens) smoked >6 times as many cigarettes at follow-up (mean: 20.8 vs 1.3 cigarettes; rate ratio = 6.33; 95% confidence interval: 1.64-24.5) after adjustment for sociodemographic characteristics, baseline frequency of cigarette smoking, and number of days of e-cigarette use. After adjustment for device, neither nicotine e-liquid nor dripping were associated with frequency of cigarette smoking. CONCLUSIONS Baseline mod users (versus vape pen users) smoked more cigarettes in the past 30 days at follow-up. Regulation of e-cigarette device type warrants consideration as a strategy to reduce cigarette smoking among adolescents and young adults who vape.
Collapse
Affiliation(s)
- Jessica L. Barrington-Trimis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Zhi Yang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Sara Schiff
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Jennifer Unger
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Tess Boley Cruz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Robert Urman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Junhan Cho
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Jonathan M. Samet
- Colorado School of Public Health, University of Colorado, Aurora, Colorado
| | - Adam M. Leventhal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Kiros Berhane
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Rob McConnell
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| |
Collapse
|
41
|
Perkins KA, Karelitz JL. A Procedure to Standardize Puff Topography During Evaluations of Acute Tobacco or Electronic Cigarette Exposure. Nicotine Tob Res 2020; 22:689-698. [PMID: 30590778 PMCID: PMC7171283 DOI: 10.1093/ntr/nty261] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 12/04/2018] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Documenting factors that influence differential sensitivity to acutely inhaled nicotine products requires carefully controlling the amount of exposure (dose), and thus a procedure by which to control such exposure. METHODS We evaluated consistency of puff volume from intermittent acute exposures to smoked tobacco cigarettes (study 1, n = 45, plus a comparison study of uninstructed use with n = 59) and to vaped electronic cigarettes (e-cigarettes; study 2, n = 27 naive to e-cigarettes) in adult-dependent smokers. All in primary studies 1 and 2 participated in research administering different nicotine levels in each product under blind conditions, one per session using within-subject designs. In both studies, participants followed an automated instructional procedure on a computer monitor standardizing the timing and amount of exposure to each product during a given trial, with four trials per session, each separated by 20 minutes. Puff volume per trial via Clinical Research Support System (CReSS) was the primary dependent measure to determine consistency across trials via intraclass correlation coefficients (ICCs). RESULTS Control over topography with both inhaled products was demonstrated by highly significant ICCs for puff volume across trials. Instructed control with own brand was generally better in study 1 than with uninstructed smoking in the comparison sample, as expected. As intended, reliability of puff volume generally did not differ by menthol preference or sex in either study, but ICCs in study 2 tended to be lower for some men using the placebo e-cigarette. CONCLUSIONS This instructional procedure may substantially improve control over amounts of acute exposure to tobacco or e-cigarette use. IMPLICATIONS Control over topography in studies of acute exposure to these inhaled products can potentially aid validity of research into differential sensitivity to use, so findings can be attributed to factors of interest and not to variable exposure. Our procedure minimized variability in exposure to the same product and between moderate nicotine products, but remaining differences suggest that compensation for very low or no nicotine commercial products may be difficult to totally eliminate with these instructions alone. Further study is needed to determine this procedure's utility with other inhaled products among experienced users and when comparing different products in between-groups analyses.
Collapse
Affiliation(s)
- Kenneth A Perkins
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Joshua L Karelitz
- Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, PA
| |
Collapse
|
42
|
McGrath-Morrow SA, Gorzkowski J, Groner JA, Rule AM, Wilson K, Tanski SE, Collaco JM, Klein JD. The Effects of Nicotine on Development. Pediatrics 2020; 145:peds.2019-1346. [PMID: 32047098 PMCID: PMC7049940 DOI: 10.1542/peds.2019-1346] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/05/2019] [Indexed: 01/08/2023] Open
Abstract
Recently, there has been a significant increase in the use of noncombustible nicotine-containing products, including electronic cigarettes (e-cigarettes). Of increasing popularity are e-cigarettes that can deliver high doses of nicotine over short periods of time. These devices have led to a rise in nicotine addiction in adolescent users who were nonsmokers. Use of noncombustible nicotine products by pregnant mothers is also increasing and can expose the developing fetus to nicotine, a known teratogen. In addition, young children are frequently exposed to secondhand and thirdhand nicotine aerosols generated by e-cigarettes, with little understanding of the effects these exposures can have on health. With the advent of these new nicotine-delivery systems, many concerns have arisen regarding the short- and long-term health effects of nicotine on childhood health during all stages of development. Although health studies on nicotine exposure alone are limited, educating policy makers and health care providers on the potential health effects of noncombustible nicotine is needed because public acceptance of these products has become so widespread. Most studies evaluating the effects of nicotine on health have been undertaken in the context of smoke exposure. Nevertheless, in vitro and in vivo preclinical studies strongly indicate that nicotine exposure alone can adversely affect the nervous, respiratory, immune, and cardiovascular systems, particularly when exposure occurs during critical developmental periods. In this review, we have included both preclinical and clinical studies to identify age-related health effects of nicotine exposure alone, examining the mechanisms underlying these effects.
Collapse
Affiliation(s)
- Sharon A. McGrath-Morrow
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois;,Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, School of Medicine and
| | - Julie Gorzkowski
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois
| | - Judith A. Groner
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois;,Department of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio
| | - Ana M. Rule
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois;,Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Karen Wilson
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois;,Department of Pediatrics, Icahn School of Medicine at Mount Sinai and Kravis Children’s Hospital, New York, New York
| | - Susanne E. Tanski
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois;,Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Lebanon, New Hampshire; and
| | - Joseph M. Collaco
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois;,Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, School of Medicine and
| | - Jonathan D. Klein
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Itasca, Illinois;,Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois
| |
Collapse
|
43
|
Lozano P, Arillo-Santillán E, Barrientos-Gutiérrez I, Zavala-Arciniega L, Reynales-Shigematsu LM, Thrasher JF. E-cigarette use and its association with smoking reduction and cessation intentions among Mexican smokers. SALUD PUBLICA DE MEXICO 2020; 61:276-285. [PMID: 31276343 DOI: 10.21149/9797] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/04/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Evaluate the patterns of e-cigarette use andtheir association with smoking behavior. MATERIALS AND METHODS We analyzed data from a population-based representative cohort of adult smokers who participated in the International Tobacco Control Policy Evaluation Surveys in Mexico. The analytic sample (n=760) was restricted to participants who were followed up from wave 6 (2012) to wave 7 (2014-2015). GEE models regressed e-cigarette use at follow-up and changes in cigarettes per day (CPD) between waves, on baseline sociodemographic variables, smoking status (daily, non-daily, quit), e-cigarette trial, and quit intentions. RESULTS Smokers who were younger, had a higher income, and had tried e-cigarettes at baseline were more likely to be current e-cigarette users at follow-up. Ecigarette use at follow-up was not associated with a change in CPD over time. CONCLUSIONS E-cigarette use does not appear to have promoted smoking cessation or reduction in this sample of Mexican smokers.
Collapse
Affiliation(s)
- Paula Lozano
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina. Columbia, SC, USA
| | - Edna Arillo-Santillán
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Inti Barrientos-Gutiérrez
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Luis Zavala-Arciniega
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | | | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina. Columbia, SC, USA.,Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| |
Collapse
|
44
|
Cioe PA, Mercurio AN, Lechner W, Costantino CC, Tidey JW, Eissenberg T, Kahler CW. A pilot study to examine the acceptability and health effects of electronic cigarettes in HIV-positive smokers. Drug Alcohol Depend 2020; 206:107678. [PMID: 31711874 PMCID: PMC9295550 DOI: 10.1016/j.drugalcdep.2019.107678] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 09/29/2019] [Accepted: 10/07/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Some HIV-positive smokers report ambivalence about quitting. Switching to electronic cigarettes (ECs) may be a viable option to reduce the negative health effects for smokers who are unable or unwilling to quit smoking combustible cigarettes (CCs). This study examined the acceptability and health-related effects of ECs in HIV-positive smokers who were not seeking smoking cessation treatment. METHODS HIV-positive smokers (N = 19) were enrolled and followed for 12 weeks. Cartridge-based ECs were provided at baseline, and E-liquid was provided weekly for 8 weeks. At baseline, weeks 1-8, and week 12, EC and CC use, cardiopulmonary function, respiratory symptoms, and carbon monoxide (CO) levels were measured. RESULTS At week 8, cigarettes per day (CPD) were reduced by more than 80%, with reduction maintained at week 12 (p's < .001). Cigarette dependence scores were 40% lower at week 8 than at baseline (p < .001). Seven (36.8%) participants reported transitioning completely from CCs to ECs. Mean CO decreased significantly from BL to week 8 (p < .05) and remained significantly lower at week 12 (p < .001). Intention to quit increased significantly over time. CONCLUSIONS Switching from CCs to ECs in HIV-positive smokers who are not ready to quit smoking in the next 30 days appears to be feasible. Beneficial effects were seen, such as reduced CPD, reduced CO and CC dependence, and increased motivation to quit. ECs may be promising as a harm reduction approach among HIV-positive smokers who are unable or unwilling to quit smoking.
Collapse
Affiliation(s)
- Patricia A Cioe
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA.
| | - Alana N Mercurio
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - William Lechner
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Catherine C Costantino
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Thomas Eissenberg
- Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA
| | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
45
|
Bold KW, Krishnan-Sarin S, Stoney CM. E-cigarette use as a potential cardiovascular disease risk behavior. ACTA ACUST UNITED AC 2019; 73:955-967. [PMID: 30394775 DOI: 10.1037/amp0000231] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Electronic cigarette (e-cigarette) use is rapidly increasing among youth and adults despite limited information regarding the long-term risks or benefits. The potential impact of e-cigarette use on public health is complex. E-cigarettes are sometimes considered as smoking cessation aids and, to the extent that they are successful in this regard, could have a net population benefit for adult smokers. However, limited knowledge exists about the long-term health effects of e-cigarette use, and research has suggested these novel tobacco products may lead to initiation and continued use among vulnerable populations, including youth. The current review aimed to summarize trends and available scientific information about e-cigarette use, focusing on the potential cardiovascular health risks and benefits, characteristics associated with e-cigarette use, and critical areas for future investigation to inform the research and clinical work of psychologists. Psychologists have a leadership role in mitigating health risks from smoking behavior, and there is a need for rigorous research assessing the impact of e-cigarette use on population health. In addition, psychologists are uniquely qualified to understand the underlying processes regarding decision-making and behaviors around e-cigarette use. Collectively, the research of psychologists in this area can have a substantial impact on patient education, policies, and the development of prevention and intervention programs to promote public health. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Collapse
Affiliation(s)
- Krysten W Bold
- Department of Psychiatry, Yale University School of Medicine
| | | | - Catherine M Stoney
- Clinical Applications and Prevention Branch, National Heart, Lung, and Blood Institute, National Institutes of Health
| |
Collapse
|
46
|
Rowell TR, Keating JE, Zorn BT, Glish GL, Shears SB, Tarran R. Flavored e-liquids increase cytoplasmic Ca 2+ levels in airway epithelia. Am J Physiol Lung Cell Mol Physiol 2019; 318:L226-L241. [PMID: 31693394 DOI: 10.1152/ajplung.00123.2019] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
E-cigarettes are noncombustible, electronic nicotine-delivery devices that aerosolize an e-liquid, i.e., nicotine, in a propylene glycol-vegetable glycerin vehicle that also contains flavors. While the effects of nicotine are relatively well understood, more information regarding the potential biological effects of the other e-liquid constituents is needed. This is a serious concern, because e-liquids are available in >7,000 distinct flavors. We previously demonstrated that many e-liquids affect cell growth/viability through an unknown mechanism. Since Ca2+ is a ubiquitous second messenger that regulates cell growth, we characterized the effects of e-liquids on cellular Ca2+ homeostasis. To better understand the extent of this effect, we screened e-liquids for their ability to alter cytosolic Ca2+ levels and found that 42 of 100 flavored e-liquids elicited a cellular Ca2+ response. Banana Pudding (BP) e-liquid, a representative e-liquid from this group, caused phospholipase C activation, endoplasmic reticulum (ER) Ca2+ release, store-operated Ca2+ entry (SOCE), and protein kinase C (PKCα) phosphorylation. However, longer exposures to BP e-liquid depleted ER Ca2+ stores and inhibited SOCE, suggesting that this e-liquid may alter Ca2+ homeostasis by short- and long-term mechanisms. Since dysregulation of Ca2+ signaling can cause chronic inflammation, ER stress, and abnormal cell growth, flavored e-cigarette products that can elicit cell Ca2+ responses should be further screened for potential toxicity.
Collapse
Affiliation(s)
- Temperance R Rowell
- Marsico Lung Institute, University of North Carolina, Chapel Hill, North Carolina.,Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina
| | - James E Keating
- Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina
| | - Bryan T Zorn
- Marsico Lung Institute, University of North Carolina, Chapel Hill, North Carolina
| | - Gary L Glish
- Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina
| | - Stephen B Shears
- Laboratory of Signal Transduction, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Robert Tarran
- Marsico Lung Institute, University of North Carolina, Chapel Hill, North Carolina.,Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina
| |
Collapse
|
47
|
Martner SG, Dallery J. Technology-based contingency management and e-cigarettes during the initial weeks of a smoking quit attempt. J Appl Behav Anal 2019; 52:928-943. [PMID: 31578724 DOI: 10.1002/jaba.641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/16/2019] [Indexed: 12/18/2022]
Abstract
Contingency management (CM) interventions are among the most effective behavioral interventions for smoking. This study assessed the effects of CM and electronic cigarettes (ECs) on smoking reductions and abstinence for durations of 30-36 days. Twelve participants were exposed to Baseline, EC alone, and EC + CM conditions. An internet-based platform was used to monitor smoking via breath carbon monoxide (CO) and deliver CM for smoking abstinence (CO ≤4 ppm). A Bluetooth-enabled EC monitored daily EC puffs. Abstinence rates were equivalent between EC (34.4%) and EC + CM (30.4%) conditions. Both conditions promoted smoking reductions. We observed an inverse correlation between smoking and EC puffs (r = -.62, p < .05). Results suggest the use of electronic cigarettes can promote smoking reductions and abstinence, and CM did not improve these outcomes. Larger magnitude consequences or tailoring EC characteristics (e.g., flavor) may have improved outcomes. Technology-based methods to collect intensive, longitudinal measures of smoking and electronic cigarette use may be useful to characterize their environmental determinants.
Collapse
|
48
|
Cobb CO, Lopez AA, Soule EK, Yen MS, Rumsey H, Lester-Schotles R, Rudy AK, Lipato T, Guy M, Eissenberg T. Influence of electronic cigarette liquid flavors and nicotine concentration on subjective measures of abuse liability in young adult cigarette smokers. Drug Alcohol Depend 2019; 203:27-34. [PMID: 31401532 PMCID: PMC9307062 DOI: 10.1016/j.drugalcdep.2019.05.024] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/17/2019] [Accepted: 05/21/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND A rapidly evolving tobacco marketplace highlights the timeliness of the FDA's authority to regulate tobacco, specifically the role that flavorings in nicotine-containing electronic cigarette (ECIG) liquids have on public health. This study aimed to evaluate the extent to which ECIG liquid flavor and nicotine concentration influenced subjective measures of abuse liability among young adult cigarette (cig) smokers. METHODS Young adult (18-21 y.o.) smokers (M = 10.1 cig/day, no regular ECIG use history) completed 7 Latin-square ordered conditions each preceded by 12 h. nicotine/tobacco abstinence. Conditions were own brand cig (OB) and eGo-style ECIG paired with three liquid flavors (cream, tropical fruit, tobacco/menthol) varying in nicotine concentration (0 or 36 mg/ml). Products were administered in two 10-puff bouts in each condition. Heart rate/blood pressure (HR/BP) and tobacco/nicotine abstinence symptoms, nicotine/general drug effects, and acceptability measures were assessed repeatedly throughout sessions. Mixed linear models were followed-up with Tukey's HSD t-tests. RESULTS HR/BP indicated nicotine exposure during nicotine-containing conditions. OB and tobacco/menthol 36 mg/ml conditions produced significant decreases in ratings of cig smoking urges. Nicotine/drug effects were elevated significantly for OB and 36 mg/ml ECIG conditions with one exception noted for the tobacco/menthol 0 mg/ml condition. OB had the highest acceptability ratings, and ECIG condition results varied by acceptability item. CONCLUSIONS Among young adult smokers, ECIG conditions containing nicotine were positively associated with several subjective measures of abuse liability but not all. Flavors did not consistently mask/enhance effects observed. Results reinforce continued examination of ECIG-delivered nicotine and liquid flavors in relationship to abuse liability.
Collapse
Affiliation(s)
- Caroline O. Cobb
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA,Correspondence: Caroline O. Cobb, Virginia Commonwealth University, 808 W Franklin, Room 304, P.O. Box 842018, Richmond, VA 23284-2018 Phone: 804-828-8687
| | - Alexa A. Lopez
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Eric K. Soule
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Miao-Shan Yen
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA
| | - Hannah Rumsey
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Rebecca Lester-Schotles
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Alyssa K. Rudy
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Thokozeni Lipato
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Mignonne Guy
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of African American Studies, Virginia Commonwealth University, Richmond, VA, USA
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
49
|
Abstract
Sale of electronic cigarette (e-cigarette) products has exponentially increased in the past decade, which raise concerns about its safety. This updated review provides the available toxicology profile of e-cigarettes, summarizing evidence from in vitro and in vivo studies. Data regarding which components in e-liquids exhibit potential toxicities are inconsistent. Some studies have reported that nicotine plays a significant role in inducing adverse outcomes and that solvents alone do not induce any adverse effects. However, other studies have suggested that nicotine is not associated with any adverse outcomes, whereas solvents and flavorings are the key components to elicit considerable deleterious effects on cells or animals. In addition, most of the studies that have compared the toxicity of e-cigarettes with tobacco cigarettes have suggested that e-cigarettes are less toxic than tobacco cigarettes. Nevertheless, scientific evidence regarding the toxicity profile of e-cigarette is insufficient owing to the lack of a standardized research approach. In the future, scientific toxicology data derived from standardized testing protocols including nicotine, ingredients analysis, the various e-cigarette devices made from different materials are urgently needed for thorough toxicology assessment. This review aims to update the toxicity profiles, identify knowledge gaps, and outline future directions for e-cigarettes research, which would greatly benefit public health professionals.
Collapse
Affiliation(s)
- Guanghe Wang
- Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Wenjing Liu
- Science and Technology Museum of Inner Mongolia , Hohhot, Inner Mongolia , China
| | - Weimin Song
- Department of Environmental Health, School of Public Health and the Key Laboratory of Public Health Safety, Fudan University , Shanghai , China
| |
Collapse
|
50
|
Lee YO, Nonnemaker JM, Bradfield B, Hensel EC, Robinson RJ. Examining Daily Electronic Cigarette Puff Topography Among Established and Nonestablished Cigarette Smokers in their Natural Environment. Nicotine Tob Res 2019; 20:1283-1288. [PMID: 29059416 DOI: 10.1093/ntr/ntx222] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 09/28/2017] [Indexed: 11/13/2022]
Abstract
Introduction Understanding exposures and potential health effects of e-cigarettes is complex. Users' puffing behavior, or topography, affects function of e-cigarette devices (eg, coil temperature) and composition of their emissions. Users with different topographies are likely exposed to different amounts of any harmful or potentially harmful constituents (HPHCs). In this study, we compare e-cigarette topographies of established cigarette smokers and nonestablished cigarette smokers. Methods Data measuring e-cigarette topography were collected using a wireless hand-held monitoring device in users' everyday lives over 1 week. Young adult (aged 18-25) participants (N = 20) used disposable e-cigarettes with the monitor as they normally would and responded to online surveys. Topography characteristics of established versus nonestablished cigarette smokers were compared. Results On average, established cigarette smokers in the sample had larger first puff volume (130.9 mL vs. 56.0 mL, p < .05) and larger puff volume per session (1509.3 mL vs. 651.7 mL, p < .05) compared with nonestablished smokers. At marginal significance, they had longer sessions (566.3 s vs. 279.7 s, p = .06) and used e-cigarettes more sessions per day (5.3 s vs. 3.5 s, p = .14). Established cigarette smokers also used e-cigarettes for longer puff durations (3.3 s vs. 1.8 s, p < .01) and had larger puff volume (110.3 mL vs. 54.7 mL, p < .05) compared with nonestablished smokers. At marginal significance, they had longer puff interval (38.1 s vs. 21.7 s, p = .05). Conclusions Our results demonstrate that topography characteristics differ by level of established cigarette smoking. This suggests that exposure to constituents of e-cigarettes depends on user characteristics and that specific topography parameters may be needed for different user populations when assessing e-cigarette health effects. Implications A user's topography affects his or her exposure to HPHCs. As this study demonstrates, user characteristics, such as level of smoking, can influence topography. Thus, it is crucial to understand the topography profiles of different user types to assess the potential for population harm and to identify potentially vulnerable populations. This study only looked at topography of cigarette smokers using disposable e-cigarettes. Further research is needed to better understand potential variation in e-cigarette topography and resulting exposures to HPHCs among users of different e-cigarette devices and liquids.
Collapse
Affiliation(s)
- Youn Ok Lee
- RTI International, Research Triangle Park, NC
| | | | | | - Edward C Hensel
- Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY
| | - Risa J Robinson
- Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, NY
| |
Collapse
|