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Whaley RC, Harlow AF, Krueger EA, Stone MD, Dimofte CV, Strong DR, Barrington-Trimis JL. Importance of Various E-Cigarette Device and E-Liquid Characteristics by Smoking Status among Young Adults Who Vape. Subst Use Misuse 2024; 59:1503-1510. [PMID: 38816913 DOI: 10.1080/10826084.2024.2360097] [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] [Indexed: 06/01/2024]
Abstract
BACKGROUND E-cigarette product characteristics are known to influence appeal among young adults. Understanding which characteristics appeal to individuals with (vs. without) a history of combusted tobacco use is essential for developing effective tobacco control policies. METHODS Anonymous, self-report data were collected from young adults (18-30 years) who had used e-cigarettes in the past 30 days (n = 295) online via Prolific from September-October 2019. Using a visual analogue scale (range: 0-100), participants rated the importance of ten e-cigarette device and nine e-liquid characteristics. Adjusted linear regression models were used to evaluate the association of combusted tobacco use status (never, former, current) with mean rating scores for each of the nineteen characteristics. RESULTS The most important e-cigarette device characteristics were price (Mean = 81.1; [SD = 17.9]), size (Mean = 75.5 [SD = 20.9]), and hit strength (Mean = 73.8 [SD = 20.4]) while the most important e-liquid characteristics were flavor (M = 85.1 [SD = 16.3]), price (M = 80.9 [SD = 18.4]), and nicotine level (M = 77.8 [18.9]). Differences by combusted tobacco use status were observed for device brand, temperature/voltage, customizability, color, and popularity, with the highest ratings generally observed among those concurrently using combustible tobacco products. For e-liquids, differences by use status were observed for flavor, price, and bottle type. Notably, those concurrently using combusted products rated flavor as less important than those with no history of combustible tobacco use (B=-5.01[95%CI=-9.97, -0.05]). CONCLUSIONS The self-rated importance of e-cigarette device and e-liquid attributes varies by combustible tobacco use status among young adults which may be used to inform regulatory decisions regarding e-cigarette product characteristics.
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Affiliation(s)
- Reid C Whaley
- Department of Population and Public Health Sciences, Keck School of Medicine at USC, University of Southern California, Los Angeles, California, USA
- Institute for Addiction Science, Keck School of Medicine at USC, University of Southern California, Los Angeles, California, USA
| | - Alyssa F Harlow
- Department of Population and Public Health Sciences, Keck School of Medicine at USC, University of Southern California, Los Angeles, California, USA
- Institute for Addiction Science, Keck School of Medicine at USC, University of Southern California, Los Angeles, California, USA
| | - Evan A Krueger
- School of Social Work, Tulane University, New Orleans, Los Angeles, USA
| | - Matthew D Stone
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, California, USA
- Moores Cancer Center, University of California, San Diego, San Diego, California, USA
| | - Claudiu V Dimofte
- Department of Marketing, Fowler College of Business, San Diego State University, San Diego, California, USA
| | - David R Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, San Diego, California, USA
- Moores Cancer Center, University of California, San Diego, San Diego, California, USA
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, Keck School of Medicine at USC, University of Southern California, Los Angeles, California, USA
- Institute for Addiction Science, Keck School of Medicine at USC, University of Southern California, Los Angeles, California, USA
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Pinho-Gomes AC, Santos JA, Jones A, Thout SR, Pettigrew S. E-cigarette attitudes and behaviours amongst 15-30-year-olds in the UK. J Public Health (Oxf) 2023; 45:e763-e775. [PMID: 37525566 PMCID: PMC10687603 DOI: 10.1093/pubmed/fdad138] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/08/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND The use of e-cigarettes has been rising in the UK, particularly by young people. This study investigated behaviours, attitudes and beliefs about e-cigarettes amongst 15-30-year-olds in the UK. METHODS An online survey was administered to a sample of 1009 15-30-year-olds in the UK. RESULTS About one in five participants currently used e-cigarettes at least monthly, with 1 in 10 using them daily. Amongst those using e-cigarettes at least monthly, 90% had used e-cigarettes containing nicotine. E-cigarettes were mainly obtained from vape shops and used at home. Having friends who used e-cigarettes and using them to help quit/reduce smoking were the most common reasons for vaping. About half of participants had been exposed to e-cigarette advertising, especially online, and warning labels on e-cigarettes. Most participants agreed that e-cigarettes are addictive (75%), help people quitting smoking (64%) and are bad for health (63%). Previous or current tobacco smokers were 9 and 22 times more likely to use e-cigarettes than never smokers, respectively. Perceiving e-cigarettes as harmful was associated with a 40% lower likelihood of use. CONCLUSION Raising awareness on the uncertain long-term consequences of vaping and regulation of marketing and sales are crucial to protect young people in the UK.
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Affiliation(s)
- Ana-Catarina Pinho-Gomes
- The George Institute for Global Health, School of Public Health, Imperial College London, 58 Wood Lane London, W12 7RZ, UK
- Institute of Health Informatics, University College London, 222 Euston Road London, NW1 2DA, UK
| | - Joseph A Santos
- The George Institute for Global Health, University of New South Wales, Level 5, 1 King Street Newtown 2042, Sydney, NSW, Australia
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Level 5, 1 King Street Newtown 2042, Sydney, NSW, Australia
| | - Sudhir Raj Thout
- The George Institute for Global Health, 308, Third Floor, Elegance Tower, Plot No. 8, Jasola District Centre New Delhi 110025, India
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Level 5, 1 King Street Newtown 2042, Sydney, NSW, Australia
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Pettigrew S, Santos JA, Pinho-Gomes AC, Li Y, Jones A. Exposure to e-cigarette advertising and young people's use of e-cigarettes: A four-country study. Tob Induc Dis 2023; 21:141. [PMID: 37881174 PMCID: PMC10594952 DOI: 10.18332/tid/172414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 09/15/2023] [Accepted: 09/18/2023] [Indexed: 10/27/2023] Open
Abstract
INTRODUCTION The World Health Organization recommends banning all forms of e-cigarette advertising, promotion, and sponsorship. The aims of the present study were to: 1) examine young people's exposure to e-cigarette advertising across a wide range of media in four diverse countries; and 2) identify any association between the number of different types of media exposures and e-cigarette use. METHODS A cross-sectional online survey was administered to approximately 1000 people aged 15-30 years in Australia, China, India, and the United Kingdom (n=4107). The survey assessed demographic characteristics, e-cigarette and tobacco use, numbers of friends and family members who vape, and exposure to multiple forms of e-cigarette advertising (e.g. television, radio, print, and various types of social media). Descriptive analyses were conducted on those who had heard of e-cigarettes (n=3095, significance threshold p<0.001) and a logistic regression analysis was used to identify factors associated with e-cigarette ever use (significance threshold p<0.05). RESULTS The majority (85%) of respondents who had heard of e-cigarettes reported being exposed to e-cigarette advertising on at least one type of media, and the average number of types of media to which respondents were exposed was 5 (range: 0-17). The number of media types was significantly associated with ever use of e-cigarettes (OR=1.05; 95% CI: 1.02-1.08, p=0.001). CONCLUSIONS Despite advertising restrictions in place in all four countries, large majorities of young people reported being exposed to e-cigarette advertising. Social media and advertising on/around vape shops and other retailers appear to be key exposure locations. Urgent attention is needed to address these forms of exposure given their apparent association with e-cigarette use.
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Affiliation(s)
- Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Joseph A. Santos
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Ana-Catarina Pinho-Gomes
- The George Institute for Global Health, London, United Kingdom
- School of Public Health, Imperial College London, London, United Kingdom
- Institute of Health Informatics, University College London, London, United Kingdom
| | - Yuan Li
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- The George Institute for Global Health, Beijing, China
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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Pettigrew S, Santos JA, Li Y, Jun M, Anderson C, Jones A. Short report: Factors contributing to young people's susceptibility to e-cigarettes in four countries. Drug Alcohol Depend 2023; 250:109944. [PMID: 37316389 DOI: 10.1016/j.drugalcdep.2023.109944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/21/2023] [Accepted: 05/19/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Identifying young people who are susceptible to e-cigarettes is important for developing interventions designed to discourage uptake. Current evidence in a broader range of national contexts is needed given recent surges in youth e-cigarette use in many countries and the constantly evolving nature of vaping products and the promotional strategies used by the industry to increase their appeal. METHODS A cross-sectional online survey was administered to around 1000 15-30 year olds in each of four countries: Australia, China, India, and the United Kingdom (total n = 4007). The survey assessed demographic characteristics, e-cigarette and tobacco use, exposure to e-cigarette advertising, and number of friends and family members who vape. Those who had never used e-cigarettes (n = 1589) were assessed for susceptibility (curiosity about e-cigarettes, intentions to use in the next 12 months, and likely use if offered by a friend). Mixed effects logistic regression analysis was used to identify factors associated with susceptibility to e-cigarette use. RESULTS Susceptibility to e-cigarette use was apparent among 54% of respondents from Australia, 61% from India, 62% from the UK, and 82% from China. Factors positively associated with susceptibility were tobacco use, exposure to advertising, higher income, and having friends and family members who vape. Factors negatively associated with susceptibility were perceptions of harmfulness and education. CONCLUSION The results indicate the need across a diverse range of countries for interventions designed to address substantial proportions of young people who are likely to be susceptible to e-cigarette use.
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Affiliation(s)
- Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
| | - Yuan Li
- The George Institute for Global Health, Beijing, China.
| | - Min Jun
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
| | - Craig Anderson
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
| | - Alexandra Jones
- The George Institute for Global Health, University of New South Wales, Sydney, 1 King StNewtown2042, Australia.
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Thoonen KAHJ, Jongenelis MI. Perceptions of e-cigarettes among Australian adolescents, young adults, and adults. Addict Behav 2023; 144:107741. [PMID: 37121085 DOI: 10.1016/j.addbeh.2023.107741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 05/02/2023]
Abstract
Increases in e-cigarette use are of concern to public health authorities given the harms associated with vaping. Understanding people's perceptions of the risks and benefits of e-cigarette use has the potential to assist with prevention efforts. However, research assessing the perceptions of Australian adolescents and any differences in perceptions between adolescents, young adults, and adults is limited. Additionally, research exploring perceptions of various types of e-cigarettes is lacking. To inform the development of prevention and intervention programs and policies, this study aimed to explore Australians' perceptions of the risks and benefits associated with e-cigarette use and whether perceptions differ by age and user status. A sample of 4,617 Australians aged 12 + years completed an online survey that assessed (i) smoking and e-cigarette user status, (ii) e-cigarette risk perceptions, (iii) beliefs about e-cigarettes as a smoking cessation tool, and (iv) positive e-cigarette outcome expectancies. Across all age groups, respondents perceived non-nicotine and flavoured e-cigarettes as less harmful than nicotine e-cigarettes. Significantly more adolescents and young adults than adults held positive outcome expectancies, and a substantial minority of non-users and never users in all age groups believed that using e-cigarettes confers social and mental health benefits. Given the potential benefits they perceived to be associated with e-cigarette use, a substantial proportion of adolescent and young adult never users may be vulnerable to initiation. These findings highlight the importance of (i) adequately communicating the risks associated with non-nicotine e-cigarette use and (ii) addressing misperceptions about use, especially among youth.
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Affiliation(s)
- Karlijn A H J Thoonen
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Australia
| | - Michelle I Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Australia.
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Larcombe AN, Chivers EK, Huxley RR, Musk A(BW, Franklin PJ, Mullins BJ. Electronic Cigarette Usage Patterns and Perceptions in Adult Australians. TOXICS 2023; 11:290. [PMID: 36977055 PMCID: PMC10056955 DOI: 10.3390/toxics11030290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/17/2023] [Accepted: 03/17/2023] [Indexed: 06/18/2023]
Abstract
Despite their increasing popularity, and Australia's unique regulatory environment, how and why Australian adults use e-cigarettes and their perceptions of their safety, efficacy and regulation have not been extensively reported before. In this study, we screened 2217 adult Australians with the aim of assessing these questions in a sample of current or former e-cigarette users. A total of 505 out of 2217 respondents were current or former e-cigarette users, with only these respondents completing the full survey. Key findings of this survey included the high proportion of respondents who indicated they were currently using e-cigarettes (307 out of 2217 = 13.8%), and the high proportion of current e-cigarette users that were also smokers (74.6%). The majority of respondents used e-liquids containing nicotine (70.3%), despite it being illegal in Australia without a prescription, and the majority bought their devices and liquids in Australia (65.7%). Respondents reported using e-cigarettes in a variety of places, including inside the home, inside public places (where it is illegal to smoke tobacco cigarettes), and around other people-which has implications for second and third hand exposures. A significant proportion of current e-cigarette users (30.6%) thought that e-cigarettes were completely safe to use long-term, although in general, there was a large amount of uncertainty/ambivalence with respect to perceptions of e-cigarette safety and efficacy as smoking cessation tools. This study shows that e-cigarette use is common in Australia, and that appropriate dissemination of unbiased research findings on their safety and efficacy in smoking cessation is urgently required.
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Affiliation(s)
- Alexander N. Larcombe
- Respiratory Environmental Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute, Nedlands, WA 6009, Australia
- Occupation, Environment and Safety, School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Emily K. Chivers
- Respiratory Environmental Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute, Nedlands, WA 6009, Australia
| | - Rachel R. Huxley
- The George Institute for Global Health, University of New South Wales, Newtown, NSW 2042, Australia
- Faculty of Health, Deakin University, Burwood, VIC 3125, Australia
| | - Arthur (Bill) W. Musk
- School of Population and Global Health, University of Western Australia, Crawley, WA 6009, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
| | - Peter J. Franklin
- School of Population and Global Health, University of Western Australia, Crawley, WA 6009, Australia
| | - Benjamin J. Mullins
- Occupation, Environment and Safety, School of Population Health, Curtin University, Perth, WA 6845, Australia
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Pettigrew S, Miller M, Alvin Santos J, Raj TS, Brown K, Jones A. E-cigarette attitudes and use in a sample of Australians aged 15–30 years. Aust N Z J Public Health 2023; 47:100035. [PMID: 36977623 DOI: 10.1016/j.anzjph.2023.100035] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/09/2022] [Accepted: 01/27/2023] [Indexed: 03/28/2023] Open
Abstract
OBJECTIVE The aim of this study was to explore e-cigarette exposure and patterns of vaping in a sample of Australians aged 15-30 years to provide insight into potential means of minimising young people's harm from e-cigarettes. METHODS A national sample of 1,006 Australians aged 15-30 years completed an online survey. Demographics, use of tobacco and vaping products, motivations for use, how e-cigarettes are obtained, where they are used, intentions to use among nonusers, exposure to others' vaping behaviours, exposure to e-cigarette advertising, perceptions of harms associated with e-cigarettes, and minors' perceptions of ease of access were assessed. RESULTS Almost half of respondents reported being either current users (14%) or having tried/used e-cigarettes in the past (33%). Factors positively associated with ever use were being a past or present user of tobacco cigarettes and number of friends who vape. Stronger perceptions of addictiveness were inversely associated with use. CONCLUSIONS Despite current restrictions on e-cigarette availability and promotion, the results suggest many young people in Australia may be exposed to e-cigarettes in multiple ways. IMPLICATIONS FOR PUBLIC HEALTH Additional efforts appear to be needed to control e-cigarette availability and promotion to prevent young people's exposure to vaping.
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Scott L, McCausland K, Maycock B, Jancey J. The emergence of e-cigarette retail shops in a regulated tobacco control environment. Health Promot J Austr 2023; 34:185-192. [PMID: 36054267 PMCID: PMC10087173 DOI: 10.1002/hpja.657] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 01/27/2023] Open
Abstract
ISSUE ADDRESSED E-cigarettes are of growing concern. We aimed to determine the location and characteristics of retail shops selling e-cigarette products in Perth, Western Australia. METHODS Two phase study: (i) identifying all e-cigarette retailers in the Greater Capital City Statistical Area of Perth; (ii) audit at the point-of-sale to assess products, promotions and shop characteristics (n = 41). RESULTS Ninety-eight retailers selling e-cigarette products were identified: 43 tobacconists (44%), 21 vape shops (21% - up from one shop in 2017), 14 supermarkets (14%), 12 service stations (12%) and 8 smoke shops (8%). The most common e-cigarette product was non-nicotine e-liquid, available at 38 (93%) stores audited. Most stores sold parts of e-cigarette devices (n = 25, 61%). Front counter displays were the most frequent form of promotion (n = 40, 98%). Vape shops differed from other retailers, having bar-style layouts (n = 15, 71%), lounge areas (n = 7, 33%) and free e-liquid samples (n = 17, 89%). CONCLUSION The availability of e-cigarette products from retail shops and particularly vape shops is increasing. E-cigarette retailers are using traditional promotional techniques including point-of-sale displays to market their products, while vape shops are extending their appeal through bar style, lounge layouts and free trials. IMPLICATIONS FOR PUBLIC HEALTH Understanding the e-cigarette retail store environment is essential for identifying emergent trends, potential regulations and future research. SO WHAT?: The e-cigarette retail market in the Perth is growing, shops using traditional and new promotional techniques to market e-cigarette products. Our findings identify a need for public health surveillance, regulations and legislation.
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Affiliation(s)
- Lucy Scott
- Collaboration for Evidence, Research and Impact in Population Health (CERIPH), School of Population Health, Curtin University, Perth, WA, Australia
| | - Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Population Health (CERIPH), School of Population Health, Curtin University, Perth, WA, Australia
| | - Bruce Maycock
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Jonine Jancey
- Collaboration for Evidence, Research and Impact in Population Health (CERIPH), School of Population Health, Curtin University, Perth, WA, Australia.,Enable Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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9
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Jongenelis MI. E-cigarette product preferences of Australian adolescent and adult users: a 2022 study. BMC Public Health 2023; 23:220. [PMID: 36726091 PMCID: PMC9893577 DOI: 10.1186/s12889-023-15142-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/12/2023] [Accepted: 01/25/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Research that comprehensively documents preferences for different types of novel nicotine products in Australia is lacking, making it difficult for policymakers to determine where public health efforts should be focused. This study thus sought to explore Australian adolescent and adult e-cigarette users' preferences for different types of e-cigarettes and e-liquids. Purchasing behaviours and sources of e-liquid were also examined. METHODS An online survey was administered to 4,617 Australians aged 12 + years, 636 of whom had used an e-cigarette in the last 30 days and were the focus of this study. Among users, 45% also smoked tobacco cigarettes, 41% were non-smokers, and 14% had never smoked. RESULTS The majority (82%) of e-cigarette users surveyed reported using nicotine-containing e-liquid in their devices. Fewer (60%) reported using non-nicotine e-liquid. The preference for nicotine over non-nicotine e-liquid was observed among all age and smoking groups. Most users (89%) reported using flavoured e-liquids, with adolescents (96%) significantly more likely than young adults (90%) and adults aged 25 + years (85%) to report using such e-liquids. Fruit flavours were the most popular among all subgroups. In terms of device type, disposable e-cigarettes were the most common product used among almost all groups; the exception being adults aged 25 + years who preferred systems with refillable tanks. Friends and tobacco retailers were the most frequently nominated sources of nicotine e-liquid among adolescents and young adults. Among adults aged 25 + years, tobacco retailers and the Internet were the most frequently nominated sources of these products. CONCLUSION Disposable e-cigarettes with flavoured, nicotine-containing e-liquid are popular among users of the devices, including adolescents. Measures that restrict the accessibility and availability of flavoured e-liquids and disposable e-cigarettes, and greater enforcement of laws regarding the sale and importation of nicotine e-liquids, are urgently needed to protect youth and never smokers from these products.
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Affiliation(s)
- Michelle I Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, 3010, Parkville, VIC, Australia.
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10
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Gschwend G, Jenkins C, Jones A, Kelso C, Morgan J. A Wide Range of Flavoring-Carrier Fluid Adducts Form in E-Cigarette Liquids. Chem Res Toxicol 2023; 36:14-22. [PMID: 36597559 DOI: 10.1021/acs.chemrestox.2c00200] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A range of flavoring molecules are used in electronic cigarette liquids (e-liquids), some of which have been shown to form cyclic acetal adducts with e-liquid solvent components propylene glycol (PG) and vegetable glycerine (VG). The objective of this study was to identify the range of flavoring molecules which form adducts in e-liquid products. Common e-liquid flavoring molecules (N = 36) from a range of chemical class groups were exposed to PG, VG, or methanol and analyzed by GC-MS over a time frame of 4 weeks to identify possible reaction products. Adduct formation was observed, with 14 of the flavoring molecules reacting with methanol, 10 reacting with PG, and 10 reacting with VG. Furfural PG and VG acetals, valeraldehyde PG and VG acetals, veretraldehyde PG and VG acetals, p-anisaldehyde PG and VG acetals, and piperonal VG acetal were confirmed for the first time. Adducts formed by reaction with ketone-containing flavoring molecules were also observed for the first time. The presence of these acetals was confirmed in 32% of commercial e-liquid products analyzed (N = 142). This study has established a range of flavoring molecules which are able to react with solvent components PG and VG in e-liquids under standard storage conditions. These newly identified adducts need to be further assessed to determine their toxicological safety.
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Affiliation(s)
- Grace Gschwend
- School of Chemistry and Molecular Bioscience, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Caitlin Jenkins
- School of Chemistry and Molecular Bioscience, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Alison Jones
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia.,School of Public Health, University of Western Australia, Perth, WA 6907, Australia
| | - Celine Kelso
- School of Chemistry and Molecular Bioscience, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia.,Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Jody Morgan
- Molecular Horizons, University of Wollongong, Wollongong, NSW 2522, Australia.,School of Chemistry, Faculty of Science, University of Sydney, Sydney, NSW 2006, Australia
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Bhatt JM, Ramphul M, Bush A. An update on controversies in e-cigarettes. Paediatr Respir Rev 2020; 36:75-86. [PMID: 33071065 PMCID: PMC7518964 DOI: 10.1016/j.prrv.2020.09.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022]
Abstract
E-cigarettes are electronic nicotine delivery systems (ENDS) which mimic tobacco smoking without the combustion of tobacco. These devices have been misleadingly marketed as "less harmful" alternatives to conventional smoking tobacco products. The e-liquid in e-cigarettes include nicotine, a humectant and other additives including flavourings, colourants, or adulterants such as bacterial and fungal products. In this review, we discuss the contrasting views of the tobacco lobby and most professional societies. We describe the epidemiology of the use of these devices, with a widespread and significant rise in youth e-cigarette use seen in both the USA and Europe. We also describe what is known about the toxicity and mechanisms of EVALI (e-cigarette or vaping associated lung injury). This characterised by respiratory failure with an intense inflammatory response. The presentations are diverse and clinicians should consider vaping as a possible cause of any unusual respiratory illness in patients who have a history of vaping or other use of e-cigarette-related products. Second hand exposure to e-cigarettes is also harmful through respiration and transdermal absorption. E-cigarettes have a worse acute toxicity than tobacco and their long-term toxicity is unknown, and we advocate for the immediate, most vigorous anti-vaping legislation possible.
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Affiliation(s)
- Jayesh Mahendra Bhatt
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, United Kingdom.
| | - Manisha Ramphul
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, NG7 2UH, United Kingdom.
| | - Andrew Bush
- Paediatrics and Paediatric Respirology, National Heart and Lung Institute, United Kingdom; Paediatric Chest Physician, Royal Brompton & Harefield NHS Foundation Trust, United Kingdom; Imperial Centre for Paediatrics and Child Health, United Kingdom; Royal Brompton Hospital, Sydney Street, London SW3 6NP, United Kingdom.
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Hickman E, Herrera CA, Jaspers I. Common E-Cigarette Flavoring Chemicals Impair Neutrophil Phagocytosis and Oxidative Burst. Chem Res Toxicol 2019; 32:982-985. [PMID: 31117350 DOI: 10.1021/acs.chemrestox.9b00171] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
E-cigarette flavorings have not been thoroughly evaluated for inhalational toxicity. We have shown that the flavoring chemical cinnamaldehyde impairs human neutrophils, macrophages, and natural killer cells. Here we investigated the effects of other common e-liquid flavoring chemicals on phagocytosis and oxidative burst in neutrophils. We demonstrate that cinnamaldehyde and ethyl vanillin dose-dependently decrease oxidative burst and that benzaldehyde and benzaldehyde propylene glycol acetal dose-dependently impair phagocytosis. Isoamyl acetate did not affect either measure of neutrophil function. These data suggest that inhaling aromatic aldehydic flavoring chemicals, such as cinnamaldehyde, benzaldehyde, benzaldehyde propylene glycol acetal, or ethyl vanillin, could impair neutrophil function.
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