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Izquierdo-Condoy JS, Naranjo-Lara P, Morales-Lapo E, Hidalgo MR, Tello-De-la-Torre A, Vásconez-Gonzáles E, Salazar-Santoliva C, Loaiza-Guevara V, Rincón Hernández W, Becerra DA, González MBD, López-Cortés A, Ortiz-Prado E. Direct health implications of e-cigarette use: a systematic scoping review with evidence assessment. Front Public Health 2024; 12:1427752. [PMID: 39135931 PMCID: PMC11317248 DOI: 10.3389/fpubh.2024.1427752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Accepted: 07/15/2024] [Indexed: 08/15/2024] Open
Abstract
Background E-cigarettes are often marketed as a less harmful alternative to traditional tobacco cigarettes. Despite their popularity, the evidence regarding their effects on human health remains unclear and is filled with complexities. Objectives This systematic review aims to elucidate the direct effects of electronic cigarette use on human health, carefully distinguishing between the specific characteristics of the populations studied. Methodology Adhering to the PRISMA guidelines, we conducted a comprehensive search in PubMed/Medline, Web of Science, Scopus, and Google Scholar databases without date restrictions, including articles in both Spanish and English. This approach enabled the identification and analysis of primary studies to understand the direct effect of electronic cigarettes on human health. Results A total of 33 studies were included that evaluated cardiovascular, pulmonary, renal, weight and fertility effects. Only five studies analyzed e-cigarettes in healthy populations and seven studies compared healthy individuals against smokers. The effects evaluated on smokers or former tobacco smokers were apparently positive, however, among healthy individuals, increased heart rate, mean arterial pressure, oxidative stress, alteration of respiratory epithelial cells and increased airflow resistance were found. Conclusion Smokers or former smokers who switch to e-cigarettes may reduce their exposure to carcinogens and lower their risk of developing severe health issues associated with conventional smoking. However, in healthy individuals who have never smoked traditional cigarettes, the use of e-cigarettes introduces several cardiovascular and respiratory adverse effects. These findings suggest that while e-cigarettes can be a strategic harm reduction tool for smokers, they are not a safe option for non-smokers.
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Affiliation(s)
| | - Patricio Naranjo-Lara
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
| | - Estefanía Morales-Lapo
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
| | - Marlon R. Hidalgo
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
| | | | | | | | | | | | | | | | - Andrés López-Cortés
- Cancer Research Group (CRG), Faculty of Medicine, Universidad de las Americas, Quito, Ecuador
| | - Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad de las Américas, Quito, Ecuador
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Pluym N, Burkhardt T, Scherer G, Scherer M. The potential of new nicotine and tobacco products as tools for people who smoke to quit combustible cigarettes - a systematic review of common practices and guidance towards a robust study protocol to measure cessation efficacy. Harm Reduct J 2024; 21:130. [PMID: 38970058 PMCID: PMC11225172 DOI: 10.1186/s12954-024-01047-1] [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: 08/31/2023] [Accepted: 06/26/2024] [Indexed: 07/07/2024] Open
Abstract
New types of nicotine and tobacco products like electronic cigarettes (ECs), heated tobacco products or nicotine pouches have been discussed as less harmful alternatives to combustible cigarettes and other toxic forms of tobacco products. Their harm reduction potential lay in the efficient transition away from smoking to those new products. Numerous studies addressing the cessation efficacy of ECs have been published with contradictory outcomes. Yet, a comprehensive Cochrane review concluded with high certainty on the cessation efficacy of ECs. This prompted us to perform a review to identify weaknesses in common study designs and to summarize best practices for the study design on the potential of new nicotine products as cessation aids. 120 articles retrieved from Medline were found to be eligible. Most of the studies in the field were interventional trials while observational studies played a minor role in the evaluation of smoking cessation. Efficacy was predominantly assessed for ECs in 77% of the reports while heated tobacco (17%) and non-combustible products (11%) were less frequently investigated up to now. Measures to determine the efficacy were questionnaire-based assessments as well as use documentation/prevalence and abstinence rates. Studies varied largely in their duration and sample size with medians of 3 months and 156.5 participants, respectively.With the help of this review, we identified several weaknesses in the common study designs. One major limitation in longitudinal trials was the lack of compliance measures suited to verify the use status over longer time periods, relying solely on self-reports. Moreover, the motivation of the participants to quit was rarely defined and a profound familiarization period was not taken into account for the majority of the studies. To what extent such weaknesses influence the outcome of the studies was beyond the scope of this review. We encourage researchers to consider the recommendations which resulted from this review in order to determine the abuse liability and cessation efficacy of the products in a more robust manner. Finally, we like to call attention to the missing data for low- and middle-income countries which would require quitting strategies most urgently to combat the tobacco smoking epidemic.
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Affiliation(s)
- Nikola Pluym
- ABF Analytisch-Biologisches Forschungslabor GmbH, Semmelweisstr. 5, 82152, Planegg, Germany.
| | - Therese Burkhardt
- ABF Analytisch-Biologisches Forschungslabor GmbH, Semmelweisstr. 5, 82152, Planegg, Germany
| | - Gerhard Scherer
- ABF Analytisch-Biologisches Forschungslabor GmbH, Semmelweisstr. 5, 82152, Planegg, Germany
| | - Max Scherer
- ABF Analytisch-Biologisches Forschungslabor GmbH, Semmelweisstr. 5, 82152, Planegg, Germany
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3
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Zong H, Hu Z, Li W, Wang M, Zhou Q, Li X, Liu H. Electronic cigarettes and cardiovascular disease: epidemiological and biological links. Pflugers Arch 2024; 476:875-888. [PMID: 38376568 PMCID: PMC11139732 DOI: 10.1007/s00424-024-02925-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/21/2024]
Abstract
Electronic cigarettes (e-cigarettes), as alternative nicotine delivery methods, has rapidly increased among youth and adults in recent years. However, cardiovascular safety is an important consideration regarding e-cigarettes usage. e-cigarette emissions, including nicotine, propylene glycol, flavorings, nitrosamine, and metals, might have adverse effects on cardiovascular health. A large body of epidemiological evidence has indicated that e-cigarettes are considered an independent risk factor for increased rates of cardiovascular disease occurrence and death. The incidence and mortality of various types of cardiovascular disease, such as cardiac arrhythmia, hypertension, acute coronary syndromes, and heart failure, have a modest growth in vapers (users of e-cigarettes). Although the underlying biological mechanisms have not been fully understood, studies have validated that oxidative stress, inflammation, endothelial dysfunction, atherosclerosis, hemodynamic effects, and platelet function play important roles in which e-cigarettes work in the human body. This minireview consolidates and discusses the epidemiological and biological links between e-cigarettes and various types of cardiovascular disease.
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Affiliation(s)
- Huiqi Zong
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Zhekai Hu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Xicheng District, Beijing, 100053, China
| | - Weina Li
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Xicheng District, Beijing, 100053, China
| | - Mina Wang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Qi Zhou
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Xiang Li
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
| | - Hongxu Liu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
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Kulkarni P, Dao J, King TS, Yingst J, Choi KY. Characterizing Tobacco Usage in Otolaryngology Patients to Target Smoking Cessation Efforts. Tob Use Insights 2024; 17:1179173X241251805. [PMID: 38736631 PMCID: PMC11083923 DOI: 10.1177/1179173x241251805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/12/2024] [Indexed: 05/14/2024] Open
Abstract
Objective Smoking cessation is critical in reducing incidence of head and neck cancers (HNC) and improving postoperative outcomes. Accurate documentation of tobacco usage is necessary to understand prevalence in patients to target smoking cessation. This study aims to characterize tobacco usage documentation, including electronic nicotine delivery systems (ENDS) use, among otolaryngology patients. Study Design Retrospective chart review. Setting Penn State Health Milton S. Hershey Medical Center (PSHMC). Methods A retrospective chart review was conducted on adult otolaryngology patients seen from January 1, 2020 - December 31, 2020. Patient demographics, details of alcohol and tobacco usage, including type of tobacco, and subspecialty seen were collected. Associations were evaluated using chi-square tests and a multivariable logistic regression model. Results Patients (n = 2137) were an average of 58.4 years old ±18.0, 59.3% female, and 78.0% white. Of participants with documented tobacco history (n = 944), 56.7% were never users, 28.9% were former users, and 14.4% were current users. Among current users (n = 308), 86.4% used cigarettes, and 5.2% used ENDS. The remainder used chew (4.9%) and cigars (3.25%). Odds of tobacco use were 1.5x greater for males (95% CI 1.19-2.00), 1.6x greater for unmarried patients (95% CI 1.24-2.09), 2.1x greater for those with no insurance vs government (95% CI 1.43-3.18), and 2.4x greater for those diagnosed with HNC (95% CI 1.64-3.49). Conclusion Most patients report cigarette smoking when asked about tobacco use. Taking into consideration the rise of ENDS use, our sample showed ENDS use that was higher than the national average. There is significant opportunity for improved history taking, especially within general and head and neck oncology subspecialties for more comprehensive treatment.
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Affiliation(s)
- Pallavi Kulkarni
- College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Joseph Dao
- College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - Tonya S. King
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Jessica Yingst
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Karen Y. Choi
- Department of Otolaryngology - Head and Neck Surgery, Penn State College of Medicine, Hershey, PA, USA
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Qi H, Chang X, Wang K, Xu Q, Liu M, Han B. Comparative analyses of transcriptome sequencing and carcinogenic exposure toxicity of nicotine and 6-methyl nicotine in human bronchial epithelial cells. Toxicol In Vitro 2023; 93:105661. [PMID: 37586650 DOI: 10.1016/j.tiv.2023.105661] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/01/2023] [Accepted: 08/14/2023] [Indexed: 08/18/2023]
Abstract
Electronic cigarettes have become a purported safer alternative to the conventional cigarettes in recent years. Nicotine is the main component of electronic cigarettes, and other nicotinic compounds are synthesized as alternatives to nicotine. However, scientific data on the potential health effects of electronic cigarettes are scarce. Herein, we evaluated the cytotoxicity of nicotine and its analog 6-methyl nicotine (6-MN) on human bronchial epithelial cells (BEAS-2B cells) in vitro. Furthermore, we performed transcriptome sequencing to systematically assess the effects of nicotine and 6-MN on BEAS-2B cells. The cytotoxicity assay revealed that BEAS-2B cells were more sensitive to 6-MN than to nicotine. Transcriptome sequencing revealed 1208 differentially expressed cancer-related proteins (CRP) in the 6-MN groups relative to that with CRP in the control group. In addition, 6-MN had a greater negative effect on the CRP expression than nicotine. Bioinformatic analysis revealed that the differentially expressed genes and proteins in the 6-MN group were significantly enriched in the cancer-related pathways, unlike those in the nicotine group. Further validations of some lung cancer-related proteins, such as NF-κB p65, EGFR, and MET, were conducted by immunoblotting and real-time PCR, which revealed that 6-MN may have a greater negative effect on tumor development and metastasis than nicotine. Taken together, our findings suggest that new electronic cigarettes with 6-MN might offer some advantages over conventional electronic cigarettes containing nicotine.
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Affiliation(s)
| | - Xia Chang
- Guangdong Pharmaceutical University, China
| | - Ke Wang
- Guangdong Pharmaceutical University, China
| | - Qiaoxin Xu
- Guangdong Pharmaceutical University, China
| | - Meisen Liu
- Shenzhen Zinwi Bio-Tech Co., LTD., China.
| | - Bin Han
- Guangdong Pharmaceutical University, China.
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Wen X, Chung MV, Liszewski KA, Todoro LD, Giancarlo EM, Zhang W, Berkelhamer SK, Goniewicz ML. Cigarette Smoking Abstinence Among Pregnant Individuals Using E-Cigarettes or Nicotine Replacement Therapy. JAMA Netw Open 2023; 6:e2330249. [PMID: 37698863 PMCID: PMC10498331 DOI: 10.1001/jamanetworkopen.2023.30249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/16/2023] [Indexed: 09/13/2023] Open
Abstract
Importance Smoking cigarettes during pregnancy can impair maternal and child health, and pregnant individuals have increasingly used electronic cigarettes (e-cigarettes) for various reasons, including quitting smoking. Objective To assess smoking abstinence rates among pregnant individuals who used e-cigarettes compared with those who used nicotine replacement therapy (NRT). Design, Setting, and Participants This cohort study is a secondary data analysis of phase 8 of the US Pregnancy Risk Assessment Monitoring System, conducted between 2016 and 2020. Eligible participants included pregnant individuals who smoked combustible cigarettes within the 3 months before pregnancy and either used e-cigarettes or NRT during pregnancy. Data analysis was conducted from March 2022 to April 2023. Exposures Combustible cigarette use within 3 months before pregnancy and use of either e-cigarettes or NRT during pregnancy. Main Outcomes and Measures The primary outcome was the individual's self-reported smoking abstinence status during the last 3 months of pregnancy. Weighted percentages were reported and weighted multivariable logistic regression models were used to examine the association of e-cigarette use vs NRT with smoking abstinence. A propensity score was used to control for confounding by sociodemographics, pregnancy characteristics, prepregnancy smoking intensity, depression, behavioral support, and hookah use. Results The cohort included 1329 pregnant individuals (759 ≥25 years [60.2%]; 766 non-Hispanic White individuals [79.8%]) of whom 781 had an education level of high school or lower (61.4%), and 952 had an annual household income of $48 000 or less (81.5%). Of the 1329 individuals, 890 (unweighted percentage, 67.0%) were existing e-cigarette users, 67 (unweighted percentage, 5.0%) were new e-cigarette users, and 372 (unweighted percentage, 28.0%) were NRT users. Compared with individuals who used NRT during pregnancy, individuals who used e-cigarettes had a higher rate of smoking abstinence in late pregnancy (456 individuals [50.8%] vs 67 individuals [19.4%]; propensity score adjusted odds ratio [OR], 2.47; 95% CI, 1.17-5.20; P = .02). In the secondary analysis stratified by the timing of e-cigarette use initiation, existing users of e-cigarettes who initiated before pregnancy had a higher smoking abstinence rate than NRT users (446 users [53.1%] vs 67 users [19.4%]; adjusted OR, 2.61; 95% CI, 1.23-5.51; P = .01). However, new e-cigarette users who initiated use during pregnancy had a similar smoking abstinence rate in late pregnancy when compared with NRT users (10 users [20.6%] vs 67 users [19.4%]; adjusted OR, 1.13; 95% CI, 0.22-5.87; P = .88). Conclusions and Relevance These findings suggest that individuals who used e-cigarettes during pregnancy had a higher smoking abstinence rate in late pregnancy than individuals who used NRT, especially for those who initiated e-cigarette use before pregnancy, indicating that replacement of cigarettes with e-cigarettes during pregnancy may be a viable strategy for harm reduction.
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Affiliation(s)
- Xiaozhong Wen
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | - Minseon V. Chung
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | - Kayla A. Liszewski
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | - Lauren D. Todoro
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | - Eve M. Giancarlo
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | - Wenxin Zhang
- Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo
| | | | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Kotewar SS, Pakhale A, Tiwari R, Reche A, Singi SR. Electronic Nicotine Delivery System: End to Smoking or Just a New Fancy Cigarette. Cureus 2023; 15:e43425. [PMID: 37706142 PMCID: PMC10497069 DOI: 10.7759/cureus.43425] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/13/2023] [Indexed: 09/15/2023] Open
Abstract
Smoking and tobacco chewing are the predominant causes of oral cancer. Tobacco is the second-most widely consumed psychoactive substance. There are numerous ways to quit smoking, of which one is electronic cigarettes (e-cigarettes). E-cigarette use is a brand-new, global trend. E-cigarette is a battery-operated device that heats a liquid to create a vapor that the consumer inhales. Several countries have acknowledged that the first step toward electronic nicotine delivery system (ENDS) management is a precise classification of ENDS within the limits of current legislation. Countries have currently categorized ENDS into four generations. People's perceptions about tobacco products have altered recently as a consequence of the advertising of ENDS. The likelihood of starting to smoke cigarettes was four times higher in adolescents who used ENDS, and the probability of quitting was reduced and often prolonged in those who used ENDS. In addition, ENDS normalizes smoking-like actions including inhaling in and exhaling smoke. Adverse marketing via geographic locations and social media platforms, as well as nicotine's irreversible effects on growing adolescent and young adult brains that predispose individuals to addicted behaviors, may be responsible for their rising appeal among teenagers. Despite this, ENDS use has risen among young individuals who have never smoked and undoubtedly face more health risks than those who do not use ENDS. The oral cavity is the first to encounter ENDS in individuals and where it initially affects the human system. As a known contributor to cardiovascular diseases, neurological conditions, and cancers, nicotine seems to be a serious cause for concern. This review provides a concise summary of the research on the components, mode of action, applications, and effects of e-cigarettes on oral as well as systemic systems.
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Affiliation(s)
- Samrudhi S Kotewar
- Department of Public Health Dentistry, Sharad Pawar Dental College ad Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Aayushi Pakhale
- Department of Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Rupali Tiwari
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Amit Reche
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Shriya R Singi
- Department of Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
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Ali N, Xavier J, Engur M, Pv M, Bernardino de la Serna J. The impact of e-cigarette exposure on different organ systems: A review of recent evidence and future perspectives. JOURNAL OF HAZARDOUS MATERIALS 2023; 457:131828. [PMID: 37320902 DOI: 10.1016/j.jhazmat.2023.131828] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/22/2023] [Accepted: 06/08/2023] [Indexed: 06/17/2023]
Abstract
The use of electronic cigarettes (e-cigs) is rapidly increasing worldwide and is promoted as a smoking cessation tool. The impact of traditional cigs on human health has been well-defined in both animal and human studies. In contrast, little is known about the adverse effects of e-cigs exposure on human health. This review summarizes the impact of e-cigs exposure on different organ systems based on the rapidly expanding recent evidence from experimental and human studies. A number of growing studies have shown the adverse effects of e-cigs exposure on various organ systems. The summarized data in this review indicate that while e-cigs use causes less adverse effects on different organs compared to traditional cigs, its long-term exposure may lead to serious health effects. Data on short-term organ effects are limited and there is no sufficient evidence on long-term organ effects. Moreover, the adverse effects of secondhand and third hand e-cigs vapour exposure have not been thoroughly investigated in previous studies. Although some studies demonstrated e-cigs used as a smoking cessation tool, there is a lack of strong evidence to support it. While some researchers suggested e-cigs as a safer alternative to tobacco smoking, their long-term exposure health effects remain largely unknown. Therefore, more epidemiological and prospective studies including mechanistic studies are needed to address the potential adverse health effects of e-cigs to draw a firm conclusion about their safe use. A wide variation in e-cigs products and the lack of standardized testing methods are the major barriers to evaluating the existing data. Specific regulatory guidelines for both e-cigs components and the manufacturing process may be effective to protect consumer health.
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Affiliation(s)
- Nurshad Ali
- National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, London SW7 2AZ, UK; Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet 3114, Bangladesh.
| | - Joseph Xavier
- National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, London SW7 2AZ, UK; Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum 695012, Kerala, India.
| | - Melih Engur
- National Heart and Lung Institute, Imperial College London, Sir Alexander Fleming Building, London SW7 2AZ, UK
| | - Mohanan Pv
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum 695012, Kerala, India.
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9
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de Lima JM, Macedo CCS, Barbosa GV, Castellano LRC, Hier MP, Alaoui-Jamali MA, da Silva SD. E-liquid alters oral epithelial cell function to promote epithelial to mesenchymal transition and invasiveness in preclinical oral squamous cell carcinoma. Sci Rep 2023; 13:3330. [PMID: 36849550 PMCID: PMC9971414 DOI: 10.1038/s41598-023-30016-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 02/14/2023] [Indexed: 03/01/2023] Open
Abstract
The gaining popularity of tobacco and nicotine delivery products, such as electronic cigarettes (e-cigarettes) being perceived as relatively safe is of a medical concern. The long-term safety of these new products remains uncertain for oral health. In this study, in vitro effects of e-liquid were assessed in a panel of normal oral epithelium cell lines (NOE and HMK), oral squamous cell carcinoma (OSCC) human cell lines (CAL27 and HSC3), and a mouse oral cancer cell line (AT84) using cell proliferation, survival/cell death, and cell invasion assays. In addition, signaling pathways underlying the pro-invasive activity of e-cigarettes were evaluated by gene and protein expression analysis. We demonstrated that e-liquid promotes proliferation and anchorage-independent growth of OSCC and induces morphological changes associated with enhanced motility and invasive phenotypes. Furthermore, e-liquid-exposed cells express significantly reduced cell viability, regardless of e-cigarette flavour content. At the gene expression level, e-liquid induces changes in gene expression consistent with epithelial to mesenchymal transition (EMT) revealed by reduced expression of cell epithelial markers such as E-cadherin and enhanced expression of mesenchymal proteins like vimentin and B-catenin seen both in OSCC cell lines and normal oral epithelium cells. In summary, the ability of e-liquid to induce proliferative and invasive properties along the activation of the EMT process can contribute to the development of tumorigenesis in normal epithelial cells and promote aggressive phenotype in pre-existing oral malignant cells.
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Affiliation(s)
- Jefferson Muniz de Lima
- Department of Otolaryngology Head and Neck Surgery, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
- Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Departments of Medicine, Oncology, and Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Department of Oral Pathology, Faculty of Dentistry, Federal University of Paraiba (UFPB), João Pessoa, Paraíba, Brazil
| | - Carolina Carneiro Soares Macedo
- Department of Otolaryngology Head and Neck Surgery, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
- Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Departments of Medicine, Oncology, and Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Gabriela Vasconcelos Barbosa
- Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Departments of Medicine, Oncology, and Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Department of Oral Pathology, Faculty of Dentistry, Federal University of Paraiba (UFPB), João Pessoa, Paraíba, Brazil
| | - Lúcio Roberto Cançado Castellano
- Department of Otolaryngology Head and Neck Surgery, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
- Human Immunology Research and Education Group, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
- Graduate Program in Dentistry, Federal University of Paraíba, João Pessoa, Paraíba, Brazil
| | - Michael P Hier
- Department of Otolaryngology Head and Neck Surgery, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Moulay A Alaoui-Jamali
- Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Departments of Medicine, Oncology, and Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Sabrina Daniela da Silva
- Department of Otolaryngology Head and Neck Surgery, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada.
- Segal Cancer Centre and Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Departments of Medicine, Oncology, and Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, QC, Canada.
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Travis N, Knoll M, Cook S, Oh H, Cadham CJ, Sánchez-Romero LM, Levy DT. Chemical Profiles and Toxicity of Electronic Cigarettes: An Umbrella Review and Methodological Considerations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1908. [PMID: 36767274 PMCID: PMC9914618 DOI: 10.3390/ijerph20031908] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Electronic cigarettes (ECs) are often marketed as a safer alternative to combustible tobacco products. The global EC market has rapidly expanded since their introduction, creating an urgent need for research describing the toxicity and chemical composition of ECs. We conducted an umbrella review to summarize the evidence from existing systematic reviews (SRs). METHODS The search for SRs was conducted across four electronic databases through 25 January 2022. Methodological quality was assessed using the AMSTAR-2 quality appraisal tool. RESULTS Twenty-five SRs were included in our umbrella review. Chemical profiles widely varied across studies included in the reviews, which was mainly attributed to the lack of standardized protocols investigating the constituents, and differences in EC devices and e-liquids tested. Metals were more abundant in some EC aerosols than cigarettes, while carbonyls were typically found at lower levels. There was consistent evidence of in vitro toxicity from EC aerosol and e-liquid exposure. AMSTAR-2 revealed important limitations across reviews. CONCLUSIONS While most reviews concluded that ECs were likely less harmful than cigarettes, there was hesitancy to draw clear conclusions due to variable analytical procedures and inconsistent findings among the included studies. Future SRs with improved methodology and reporting are needed to adequately inform tobacco regulatory actions.
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Affiliation(s)
- Nargiz Travis
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20007, USA
| | - Marie Knoll
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20007, USA
| | - Steven Cook
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
| | - Hayoung Oh
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20007, USA
| | - Christopher J. Cadham
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA
| | | | - David T. Levy
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20007, USA
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11
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Soo J, Easwaran M, Erickson‐DiRenzo E. Impact of Electronic Cigarettes on the Upper Aerodigestive Tract: A Comprehensive Review for Otolaryngology Providers. OTO Open 2023; 7:e25. [PMID: 36998560 PMCID: PMC10046796 DOI: 10.1002/oto2.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/18/2022] [Accepted: 12/02/2022] [Indexed: 02/19/2023] Open
Abstract
Objective The use and effects of electronic (e)-cigarettes (e-cigs) are particularly relevant for otolaryngology providers as tobacco plays a major role in benign and malignant diseases of the upper aerodigestive tract. This review aims to (1) summarize the recent policies regarding e-cigs and important patterns of use and (2) serve as a comprehensive resource for clinical providers on the known biologic and clinical effects of e-cigs on the upper aerodigestive tract. Data Sources PubMed/MEDLINE. Review Methods We conducted a narrative review on (1) general information on e-cig use and informative findings in the lower respiratory system and a comprehensive review on (2) the effects of e-cigs on cell and animal models and the clinical implications of these products on human health as is relevant to otolaryngology. Conclusions Although e-cigs are likely less harmful than conventional cigarettes, preliminary research on e-cigs suggest several deleterious effects including in the upper aerodigestive tract. Due to this, there has been increased interest in restricting e-cig usage, particularly among the adolescent population, and caution in recommending e-cigs to current smokers. Implications for Practice Chronic e-cig use is likely to have clinical implications. It is critical for otolaryngology providers to be aware of the rapidly changing regulations and use patterns regarding e-cigs and how e-cigs influence human health, particularly with regards to the upper aerodigestive tract, to accurately council patients regarding potential risks and benefits of use.
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Affiliation(s)
- Joanne Soo
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
| | - Meena Easwaran
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
| | - Elizabeth Erickson‐DiRenzo
- Department of Otolaryngology–Head & Neck Surgery Stanford University School of Medicine Stanford California USA
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12
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Wang W, Zeng R, Liu M, Chen M, Wei S, Li B, Yu S. Exosome proteomics study of the effects of traditional cigarettes and electronic cigarettes on human bronchial epithelial cells. Toxicol In Vitro 2022; 86:105516. [DOI: 10.1016/j.tiv.2022.105516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 09/25/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2022]
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13
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Vivarelli F, Granata S, Rullo L, Mussoni M, Candeletti S, Romualdi P, Fimognari C, Cruz-Chamorro I, Carrillo-Vico A, Paolini M, Canistro D. On the toxicity of e-cigarettes consumption: Focus on pathological cellular mechanisms. Pharmacol Res 2022; 182:106315. [PMID: 35724819 DOI: 10.1016/j.phrs.2022.106315] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 10/18/2022]
Abstract
Tobacco smoking remains without a doubt one of the leading causes of premature death worldwide. In combination with conventional protocols for smoking cessation, e-cigarettes have been proposed as a useful tool to quit smoking. Advertised as almost free of toxic effects, e-cigarettes have rapidly increased their popularity, becoming a sought-after device, especially among young people. Recently some health concerns about e-cigarette consumption are being raised. It is well known that they can release several toxic compounds, some of which are carcinogenic to humans, and emerging results are now outlining the risks related to the onset of respiratory and cardiovascular diseases and even cancer. The present review shows the emerging evidence about the role of technical components of the devices, the e-liquid composition as well as customization by consumers. The primary topics we discuss are the main toxicological aspects associated with e-cigarette consumption, focusing on the molecular pathways involved. Here it will be shown how exposure to e-cigarette aerosol induces stress/mitochondrial toxicity, DNA breaks/fragmentation following the same pathological pathways triggered by tobacco smoke, including the deregulation of molecular signalling axis associated with cancer progression and cell migration. Risk to fertility and pregnancy, as well as cardiovascular risk associated with e-cigarette use, have also been reported.
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Affiliation(s)
- Fabio Vivarelli
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy.
| | - Silvia Granata
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy; Department of Medicine and Surgery - University of Milano - Bicocca
| | - Laura Rullo
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Matilde Mussoni
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Sanzio Candeletti
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Patrizia Romualdi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
| | - Carmela Fimognari
- Department for Life Quality Studies, Alma Mater Studiorum-University of Bologna, Corso d'Augusto 237, 47921 Rimini, Italy
| | - Ivan Cruz-Chamorro
- Instituto de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), 41013 Seville, Spain; Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Universidad de Sevilla, 41009 Seville, Spain
| | - Antonio Carrillo-Vico
- Instituto de Biomedicina de Sevilla, IBiS (Universidad de Sevilla, HUVR, Junta de Andalucía, CSIC), 41013 Seville, Spain; Departamento de Bioquímica Médica y Biología Molecular e Inmunología, Universidad de Sevilla, 41009 Seville, Spain
| | - Moreno Paolini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy.
| | - Donatella Canistro
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum-University of Bologna, Via Irnerio 48, 40126 Bologna, Italy
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Travis N, Knoll M, Cadham CJ, Cook S, Warner KE, Fleischer NL, Douglas CE, Sánchez-Romero LM, Mistry R, Meza R, Hirschtick JL, Levy DT. Health Effects of Electronic Cigarettes: An Umbrella Review and Methodological Considerations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9054. [PMID: 35897421 PMCID: PMC9330875 DOI: 10.3390/ijerph19159054] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/19/2022] [Accepted: 07/19/2022] [Indexed: 02/04/2023]
Abstract
E-cigarettes are often marketed as a safer alternative to combustible cigarettes. However, their health effects, especially those associated with long-term use, remain largely uncertain. We conducted an umbrella review of the cardiopulmonary and carcinogenic risks of e-cigarette use, distinguishing between short-term and long-term health effects. The search for systematic reviews was conducted across four electronic databases through 25 January 2022. Methodological quality was assessed using the AMSTAR-2 quality appraisal tool. Seventeen systematic reviews, including five meta-analyses, were included in our umbrella review. There was a clear underreporting of e-cigarette devices and e-liquid types, e-cigarette and cigarette exposure, and the health and smoking status of study participants. Overall, the findings suggest that short-term use of e-cigarettes may be associated with acute cardiopulmonary risks, although to a lesser extent than cigarette use. Long-term e-cigarette use may have pulmonary/respiratory benefits in those who switch from chronic cigarette smoking, particularly in individuals with asthma and chronic obstructive pulmonary disease (COPD). Evidence on intermediate and long-term carcinogenic effects is lacking. This umbrella review underscores the urgent need for systematic reviews with better adherence to established reporting guidelines, consistent definitions of duration of e-cigarette use, a focus on newer devices, and accounting for the impacts of former or current smoking.
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Affiliation(s)
- Nargiz Travis
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20057, USA; (M.K.); (L.M.S.-R.); (D.T.L.)
| | - Marie Knoll
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20057, USA; (M.K.); (L.M.S.-R.); (D.T.L.)
| | - Christopher J. Cadham
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (C.J.C.); (K.E.W.); (C.E.D.)
| | - Steven Cook
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (S.C.); (N.L.F.); (R.M.); (J.L.H.)
| | - Kenneth E. Warner
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (C.J.C.); (K.E.W.); (C.E.D.)
| | - Nancy L. Fleischer
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (S.C.); (N.L.F.); (R.M.); (J.L.H.)
| | - Clifford E. Douglas
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (C.J.C.); (K.E.W.); (C.E.D.)
| | - Luz María Sánchez-Romero
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20057, USA; (M.K.); (L.M.S.-R.); (D.T.L.)
| | - Ritesh Mistry
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Rafael Meza
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (S.C.); (N.L.F.); (R.M.); (J.L.H.)
| | - Jana L. Hirschtick
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; (S.C.); (N.L.F.); (R.M.); (J.L.H.)
| | - David T. Levy
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC 20057, USA; (M.K.); (L.M.S.-R.); (D.T.L.)
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15
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Koo EY, Jin V, Weinreich HM, Wenig BL. Otolaryngology Resident Education and Perceptions of e-cigarettes. Ann Otol Rhinol Laryngol 2022; 131:622-628. [PMID: 34365835 PMCID: PMC10066855 DOI: 10.1177/00034894211037415] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To date, there are no reports of otolaryngology residents' knowledge and confidence in discussing e-cigarette use. The purpose of this study was to evaluate otolaryngology resident e-cigarette knowledge and confidence in counseling patients on e-cigarette use. STUDY DESIGN Cross-sectional national survey. SETTING Accreditation Council for Graduate Medical Education otolaryngology residents in the United States. METHODS US otolaryngology residents were distributed surveys electronically in September 2020. RESULTS A total of 150 participants replied for a response rate of 8.88%. The majority, 93.10% have not received formal education on e-cigarettes during their residency training. The most common resource of e-cigarette information overall was social media (78.46%). Within academia, the most common resources of e-cigarette education were patient interactions (63.16%) and colleagues (54.74%). Patients commonly inquire residents about e-cigarettes for smoking cessation (85.07%) and their long-term health effects (83.58%). Almost 67% of residents rarely or never ask patients about e-cigarette use. Only 4.35% of residents are not confident discussing traditional cigarette use, while 58.70% are not confident discussing e-cigarettes. CONCLUSION Otolaryngology residents have not received formal education in e-cigarettes and are not confident discussing e-cigarettes with their patients. This highlights the need for e-cigarette education during otolaryngology residency to improve patient e-cigarette counseling.
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Affiliation(s)
- Elliot Y Koo
- Department of Otolaryngology-Head & Neck Surgery, University of Illinois Chicago, Chicago, IL, USA
| | - Vivian Jin
- Department of Otolaryngology-Head & Neck Surgery, University of Illinois Chicago, Chicago, IL, USA
| | - Heather M Weinreich
- Department of Otolaryngology-Head & Neck Surgery, University of Illinois Chicago, Chicago, IL, USA
| | - Barry L Wenig
- Department of Otolaryngology-Head & Neck Surgery, University of Illinois Chicago, Chicago, IL, USA
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16
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Babjaková J, Rimárová K, Weitzman M, Bušová M, Jurkovičová J, Dorko E, Argalášová Ľ. E-cigarette use, opinion about harmfulness and addiction among university students in Bratislava, Slovakia. Cent Eur J Public Health 2022; 30:S50-S56. [PMID: 35841226 DOI: 10.21101/cejph.a7240] [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: 12/12/2021] [Accepted: 12/12/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The study aimed to investigate the use of electronic cigarettes (EC) among medical students, their knowledge and beliefs (opinion about harmfulness and addiction potential) on ECs, perceptions of the risk, as well as to assess the type of education and cessation training they received during their study at Faculty of Medicine, Comenius University in Bratislava, Slovakia. METHODS This cross-sectional, anonymous online e-mailed survey was conducted among medical students via the Study Department by sending e-mails containing the survey link. Participants completed the online questionnaire adapted from the American Survey on Tobacco and Alternative Tobacco Products. It included questions about the personal use of EC, perceptions about the harms and their role in disease causation, education and cessation training, and practices related to conventional cigarettes (CC), EC, and alternative tobacco products (ATP). The e-mailed questionnaire filled in 577 medical students (71.9% women) from Comenius University in Bratislava, the average age was 23 ± 2 years. The sample comprised 486 (84.2%) Slovak and 91 (15.8%) foreign students. The data were analysed using the Statistical Package for Social Science (SPSS) version 25. RESULTS There were 385 (66.7%) non-smokers, 111 (19.3%) ex-smokers and 81 (14%) current smokers in the study sample. EC currently use 13.5% of medical students, with a statistically significant intersexual difference (22.2% males vs. 10.12% females; OR = 2.53, 95% CI: 1.55-4.13), more foreign students than Slovak students (24.2% vs. 11.52%; OR = 2.44, 95% CI: 1.41-4.26), more smokers of conventional cigarettes than non-smokers (46.9% vs. 8.06%; OR = 10.07, 95% CI: 5.85-17.34). EC seems to be less harmful to 59.97% of students, mostly in the age group ≤ 24 (61.76% vs. 51.49%; OR = 1.46, 95% CI: 1.03-2.07), 41.25% of students consider EC to be less addictive, 55.6% think they do not get enough education on EC during their medical study. CONCLUSION The results overall show the high consumption of tobacco products and the lack of knowledge and awareness among medical students, future health care providers. In health promotion and disease prevention, they should serve as a model for their patients and for the general public as well. Our study emphasizes the need for intervention in this field at medical faculties and for support of further monitoring in Slovakia and other countries and draws attention to the ongoing lack of EC regulation.
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Affiliation(s)
- Jana Babjaková
- Institute of Hygiene, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovak Republic
| | - Kvetoslava Rimárová
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Michael Weitzman
- Department of Pediatrics, New York University, School of Medicine, New York, USA
| | - Milena Bušová
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jana Jurkovičová
- Institute of Hygiene, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovak Republic
| | - Erik Dorko
- Department of Public Health and Hygiene, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic
| | - Ľubica Argalášová
- Institute of Hygiene, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovak Republic
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Effect Comparison of E-Cigarette and Traditional Smoking and Association with Stroke-A Cross-Sectional Study of NHANES. Neurol Int 2022; 14:441-452. [PMID: 35736618 PMCID: PMC9227824 DOI: 10.3390/neurolint14020037] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 12/22/2022] Open
Abstract
Introduction: Tobacco use is one of the most significant risk factors for stroke. Besides traditional cigarettes and combustible products, the use of e-cigarettes and electronic nicotine delivery products has been widespread among young adults in the recent era. Furthermore, the trend of vaping has increased over the last decade. However, the relationship between e-cigarettes and stroke is largely unknown. The aim of this study was to evaluate the prevalence and identify the relationship between e-cigarette smoking and stroke. Methods: A cross-sectional study was performed using the NHANES database of the US population. Adults with a history of smoking were considered in our study and divided into three groups, e-cigarette users, traditional, and dual smokers. The Chi-squared test, Wilcoxon rank-sum test, and multivariable logistic regression analysis were used to identify the prevalence and association of e-cigarette consumption and stroke. Results: Out of a total of 266,058 respondents from 2015 to 2018, we found 79,825 respondents who smoked e-cigarettes (9.72%) or traditional (29.37%) or dual smoking (60.91%). Stroke prevalence among e-cigarette smokers was 1.57%. Stroke was more prevalent among traditional smokers than among e-cigarette smokers. (6.75% vs. 1.09%; p < 0.0001) E-cigarette smokers had early onset of stroke in comparison with traditional smokers. (median age: 48 vs. 59 years; p < 0.0001). Among females with stroke, the prevalence of e-cigarette use was higher in comparison with traditional smoking (36.36% vs. 33.91%; p < 0.0001). Among the stroke population, the prevalence of e-cigarette use was higher among Mexican-Americans (21.21% vs. 6.02%) and other Hispanics (24.24% vs. 7.70%) compared with traditional smoking (p < 0.0001). The regression analysis found higher odds of stroke history among e-cigarette users than traditional smokers [aOR: 1.15; 95% CI: 1.15−1.16)]. Conclusion: Though stroke was more prevalent in traditional smokers, the incidence of stroke was early-in-onset and was strongly associated with e-cigarette use compared to traditional smokers. We have also identified vascular effects of e-cigarettes components as possible triggers for the stroke.
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Ismail NA, Nabila T, Ramadhani AS, Ahsani DN. Electronic and Conventional Cigarette Exposure Aggravate Metabolic Parameters in High-Fat Diet-Induced Rats. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The health implications of the perceived use of electronic cigarettes (e-cigarettes) are safer than conventional cigarettes on metabolic parameters are not clearly understood. The current study evaluates the metabolic parameters as the impact of cigarette and e-cigarette exposure in high-fat-diet (HFD)-induced rats.
METHODS: Twenty-four male Wistar rats were divided into four groups: i) NC: normal control group; ii) HFD Alone; iii) HFD + Cig and iv) HFD + E-Cig, administered HFD followed by cigarette or e-cigarette exposure, respectively. Six cigarettes stick with nicotine 2 mg/stick and 2 ml of e-cigarette liquid with nicotine 6 mg/ml were used for 25 cycles of exposure. In the end, the rats were sacrificed and obtained blood for metabolic parameter analysis, consisting of lipid profile, glucose, uric acid, urea, creatinine, aspartate transaminase (AST), and alanine transaminase (ALT). Statistical analysis with One-Way ANOVA with post hoc was used for high-density lipoprotein (HDL), triglyceride, total cholesterol, glucose, uric acid, urea, and creatinine. Furthermore, Kruskal-Wallis with Mann-Whitney U was used for nonparametric data such as low-density lipoprotein (LDL), AST, and ALT.
RESULTS: Data of all metabolic parameters were shown a significant increase in the group of HFD Alone, HFD + Cig, and HFD + E-Cig, otherwise HDL levels. Furthermore, HFD + Cig followed by HFD + E-Cig groups were significantly higher compared to HFD Alone group.
CONCLUSION: E-cigarettes were shown to be less harmful than conventional cigarettes but did not guarantee it was safe. Both cigarettes and e-cigarettes aggravated metabolic parameters in HFD-induced rats.
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Osibogun O, Bursac Z, Maziak W. Longitudinal transition outcomes among adult dual users of e-cigarettes and cigarettes with the intention to quit in the United States: PATH Study (2013-2018). Prev Med Rep 2022; 26:101750. [PMID: 35256929 PMCID: PMC8897625 DOI: 10.1016/j.pmedr.2022.101750] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/21/2022] [Accepted: 02/26/2022] [Indexed: 11/16/2022] Open
Abstract
Many dual users of e-cigarettes/cigarettes report using e-cigarettes with the ITQ. Data was from 3,542 adults (≥18 years) from the PATH cohort (2013–2018). Dual users with ITQ were compared with mono cigarette smokers with ITQ. Dual users with ITQ were less likely to transition to cessation. This needs to be considered when assessing the population impact of e-cigarettes.
Many adult dual users of e-cigarettes and cigarettes in the United States report using e-cigarettes with the intention to quit (ITQ) smoking. This study examined transition outcomes among adult dual users of e-cigarettes and cigarettes with the ITQ compared to mono cigarette smokers with ITQ. We conducted a longitudinal analysis of 3,542 adults aged ≥ 18 years with data from Waves 1 and 4 of the United States Population Assessment of Tobacco and Health study (2013–2018) between May 2021 and January 2022. Current dual users (e-cigarettes and cigarettes use on ≥ 20 days in the past month) with the ITQ were compared to current mono cigarette smokers with the ITQ for transition outcomes (cessation, mono e-cigarette, mono cigarette and dual use) three years later. We conducted multinomial logistic regression modeling adjusting for potential confounders and reported the adjusted relative risk ratios (aRRR) with 95% confidence intervals (CI) for the transition outcomes. Approximately 10.7% (7.8–14.3) of dual users with the ITQ (in 2013) reported cessation (no past-month use of any tobacco) three years later, compared to 16.1% (14.6–17.7) of mono cigarette smokers. Dual users were 83% and 79% less likely to transition to cessation (aRRR: 0.17, 95% CI:0.09–0.32) or mono cigarette use (0.21, 0.14–0.32), respectively, compared to mono cigarette smokers. Our findings show that in a real-world scenario, dual e-cigarette and cigarette use may hinder rather than facilitate smoking cessation among those interested in quitting. This needs consideration when assessing the population impact of e-cigarettes and their role in harm reduction.
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Affiliation(s)
- Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
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Pascoe M, Nagia S, Atal N, Gadway H, Huizenga K, Bailey B. Have e-cigarettes created a new crop of young adult substance users? Overlap between e-cigarette, traditional cigarette, and alcohol use. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.2010141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michael Pascoe
- Central Michigan University College of Medicine, Mt Pleasant, Michigan, USA
| | - Sally Nagia
- Central Michigan University College of Medicine, Mt Pleasant, Michigan, USA
| | - Nanaki Atal
- Central Michigan University College of Medicine, Mt Pleasant, Michigan, USA
| | - Hannah Gadway
- Central Michigan University College of Medicine, Mt Pleasant, Michigan, USA
| | - Kamren Huizenga
- Central Michigan University College of Medicine, Mt Pleasant, Michigan, USA
| | - Beth Bailey
- Central Michigan University College of Medicine, Mt Pleasant, Michigan, USA
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21
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Kim MM, Pound L, Steffensen I, Curtin GM. Reporting and methodological quality of systematic literature reviews evaluating the associations between e-cigarette use and cigarette smoking behaviors: a systematic quality review. Harm Reduct J 2021; 18:121. [PMID: 34838030 PMCID: PMC8627036 DOI: 10.1186/s12954-021-00570-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/09/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction Several published systematic reviews have examined the potential associations between e-cigarette use and cigarette smoking, but their methodological and/or reporting quality have not yet been assessed. This systematic quality review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and AMSTAR (A MeaSurement Tool to Assess systematic Reviews) 2 to evaluate the quality of systematic reviews investigating potential associations between e-cigarette use and cigarette smoking. Materials and methods PubMed/MEDLINE, Embase, and PsycINFO were searched from 01 January 2007 to 24 June 2020. Methodological quality was assessed using AMSTAR 2, and reporting quality was assessed using PRISMA guidelines. Results Of 331 potentially relevant systematic reviews, 20 met predefined inclusion criteria. Most reviews (n = 15; 75%) reported on e-cigarette use and cigarette smoking cessation, while three reported on e-cigarette use and cigarette smoking initiation (15%); and two reported on cigarette smoking initiation and cessation (10%). According to AMSTAR 2 guidelines, 18 of the 20 reviews (90%) were “critically low” in overall confidence of the results, while two were ranked “low.” Additionally, reporting quality varied across the reviews, with only 60% reporting at least half of the PRISMA items. Discussion Methodological limitations were identified across reviews examining potential associations between e-cigarette use and cigarette smoking behaviors, indicating that findings from these reviews should be interpreted with caution. Conclusions Future systematic reviews in this field should strive to adhere to AMSTAR 2 and PRISMA guidelines, to provide high quality syntheses of the available data with transparent and complete reporting. Supplementary Information The online version contains supplementary material available at 10.1186/s12954-021-00570-9.
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Affiliation(s)
- Mimi M Kim
- Scientific and Regulatory Affairs, RAI Services Company, 401 North Main Street, Winston-Salem, NC, 27101, USA.
| | | | | | - Geoffrey M Curtin
- Scientific and Regulatory Affairs, RAI Services Company, 401 North Main Street, Winston-Salem, NC, 27101, USA
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22
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Objective assessment of nasal resistance among electronic cigarette users. The Journal of Laryngology & Otology 2021; 135:616-619. [PMID: 34078481 DOI: 10.1017/s0022215121001432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Electronic cigarettes have been a popular alternative to tobacco smoking. The effect of tobacco smoking on nasal airway resistance has been investigated before; however, the effect of the aerosol generated by electronic cigarettes is still unknown. This study aimed to evaluate the short-term effects of e-cigarettes on nasal airway resistance. METHODS Sixty-one participants were recruited into a vapers group and a control group. The vapers group was instructed to smoke for 5 minutes, and their nasal resistance was measured pre-procedure and at 1 and 5 minutes post-procedure. The results were compared between both groups. RESULTS Repeated measures analysis of variance demonstrated that vaping has no statistically significant effect on total nasal airway resistance. CONCLUSION Although the differences between both groups were not statistically significant overall, the vapers group showed a reduction in nasal airway resistance in the short term.
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23
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Sun W, Huang X, Wu H, Zhang CJP, Yin Z, Fan Q, Wang H, Jayavanth P, Akinwunmi B, Wu Y, Wang Z, Ming WK. Maternal tobacco exposure and health-related quality of life during pregnancy: a national-based study of pregnant women in China. Health Qual Life Outcomes 2021; 19:152. [PMID: 34016119 PMCID: PMC8139077 DOI: 10.1186/s12955-021-01785-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 05/03/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND With the increase of the number of smokers, tobacco exposure among pregnant women is becoming more and more common. Pregnant women exposed to first-hand smoke and second-hand smoke are susceptible to physiological and psychological health issues has been proved in previous studies. Nevertheless, there are no enough studies focus on the impact of third-hand smoke during pregnancy. This study aimed to assess and compare health-related quality of life for pregnant women with exposure to first-hand smoke, second-hand smoke, third-hand smoke and non-exposure to tobacco in mainland China. METHODS National-based cross-sectional study is based on a questionnaire survey which collects information including demographics, smoking behaviors and self-evaluation. All questionnaires were delivered and collected from August to September 2019. EuroQol group's visual analog scale and EuroQoL Five-dimension Questionnaire were used to collect data in mainland China. RESULTS Totally, 15,682 pregnant women were included in this study, among which non-exposure to smoke were 7564 (48.2%), exposed to first-hand smoke, second-hand smoke and third-hand smoke were 89 (0.6%), 2349 (15.0%), and 5680 (36.2%) respectively. Pregnant women without tobacco exposure had the highest EuroQol group's visual analog scale score (mean value = 85.4[SD = 14.0]), while those with first-hand smoke had the lowest score (mean value = 77.4[SD = 22.2]). Among all five dimensions of EuroQoL Five-dimension Questionnaire, there were significant differences of EQ-index among groups with different tobacco exposure in usual activity and anxiety or depression dimensions (p < 0.001). CONCLUSIONS Third-hand smoke exposure had close relationship with low health-related quality of life in pregnant women. Moreover, second-hand smoke exposure significantly led more problems on mental dimension of pregnant women.
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Affiliation(s)
- Weiwei Sun
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- International School, Jinan University, Guangzhou, China
| | - Xinyu Huang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- International School, Jinan University, Guangzhou, China
| | - Huailiang Wu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- International School, Jinan University, Guangzhou, China
| | - Casper J P Zhang
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Zongzhi Yin
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Qianqian Fan
- Department of Pharmacy, Peking Union Medical College Hospital, Beijing, China
| | - Huiyun Wang
- School of Pharmacy, JiNing Medical University, Jining, China
| | - Pallavi Jayavanth
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- International School, Jinan University, Guangzhou, China
| | - Babatunde Akinwunmi
- Maternal-Fetal Medicine Unit, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Yanxin Wu
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Zilian Wang
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Wai-Kit Ming
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.
- International School, Jinan University, Guangzhou, China.
- Department of Obstetrics and Gynaecology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
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24
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Marques P, Piqueras L, Sanz MJ. An updated overview of e-cigarette impact on human health. Respir Res 2021; 22:151. [PMID: 34006276 PMCID: PMC8129966 DOI: 10.1186/s12931-021-01737-5] [Citation(s) in RCA: 116] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 05/03/2021] [Indexed: 12/18/2022] Open
Abstract
The electronic cigarette (e-cigarette), for many considered as a safe alternative to conventional cigarettes, has revolutionised the tobacco industry in the last decades. In e-cigarettes, tobacco combustion is replaced by e-liquid heating, leading some manufacturers to propose that e-cigarettes have less harmful respiratory effects than tobacco consumption. Other innovative features such as the adjustment of nicotine content and the choice of pleasant flavours have won over many users. Nevertheless, the safety of e-cigarette consumption and its potential as a smoking cessation method remain controversial due to limited evidence. Moreover, it has been reported that the heating process itself can lead to the formation of new decomposition compounds of questionable toxicity. Numerous in vivo and in vitro studies have been performed to better understand the impact of these new inhalable compounds on human health. Results of toxicological analyses suggest that e-cigarettes can be safer than conventional cigarettes, although harmful effects from short-term e-cigarette use have been described. Worryingly, the potential long-term effects of e-cigarette consumption have been scarcely investigated. In this review, we take stock of the main findings in this field and their consequences for human health including coronavirus disease 2019 (COVID-19).
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Affiliation(s)
- Patrice Marques
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Avda. Blasco Ibañez 15, 46010, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain
| | - Laura Piqueras
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Avda. Blasco Ibañez 15, 46010, Valencia, Spain.,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain.,CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Maria-Jesus Sanz
- Department of Pharmacology, Faculty of Medicine, University of Valencia, Avda. Blasco Ibañez 15, 46010, Valencia, Spain. .,Institute of Health Research INCLIVA, University Clinic Hospital of Valencia, Valencia, Spain. .,CIBERDEM-Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders, ISCIII, Av. Monforte de Lemos 3-5, 28029, Madrid, Spain.
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Abstract
Cigarette smoke (CS) is likely the most common preventable cause of human morbidity and mortality worldwide. Consequently, inexpensive interventional strategies for preventing CS-related diseases would positively impact health systems. Inhaled CS is a powerful inflammatory stimulus and produces a shift in the normal balance between antioxidants and oxidants, inducing oxidative stress in both the respiratory system and throughout the body. This enduring and systemic pro-oxidative state within the body is reflected by increased levels of oxidative stress and inflammation biomarkers seen in smokers. Smokers might benefit from consuming antioxidant supplements, or a diet rich in fruit and vegetables, which can reduce the CS-related oxidative stress. This review provides an overview of the plasma profile of antioxidants observable in smokers and examines the heterogeneous literature to elucidate and discuss the effectiveness of interventional strategies based on antioxidant supplements or an antioxidant-rich diet to improve the health of smokers. An antioxidant-rich diet can provide an easy-to-implement and cost-effective preventative strategy to reduce the risk of CS-related diseases, thus being one of the simplest ways for smokers to stay in good health for as long as possible. The health benefits attributable to the intake of antioxidants have been observed predominantly when these have been consumed within their natural food matrices in an optimal antioxidant-rich diet, while these preventive effects are rarely achieved with the intake of individual antioxidants, even at high doses.
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26
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Mayorga NA, Rogers AH, Smit T, Garey L, Zvolensky MJ. Evaluating the psychometric properties of the e-cigarette barriers to cessation scale. Cogn Behav Ther 2021; 50:492-508. [PMID: 33910485 DOI: 10.1080/16506073.2021.1901773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Evidence suggests that electronic cigarette (e-cigarette) users have difficulty quitting e-cigarettes. The Electronic Cigarette Barriers to Cessation Scale (E-BCS) was developed to assess barriers to cessation among e-cigarette users. Yet, no work has evaluated the psychometric properties of the E-BCS. The current study utilized data from two independent samples of adult e-cigarette users to evaluate the psychometric properties and structure of the E-BCS. In Study 1, competing models of the E-BCS were evaluated, and initial construct validity and reliability were explored using data from 599 adult e-cigarettes users (52.3% female, Mage = 35.16 years, SD = 10.30). Results supported a unidimensional structure for the E-BCS comprised of 18 items. In Study 2, the unidimensional structure of the 18-item E-BCS and construct validity were evaluated among a sample of 516 current e-cigarette using adults (52.3% female; Mage = 34.74, SD = 11.37). Results confirmed the unidimensional structure, measurement invariance across sex, and construct validity across related e-cigarette behavior constructs and psychopathology for the E-BCS. These findings suggest that the E-BCS is a potentially useful clinical instrument for measuring barriers that may interfere with e-cigarette cessation.
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Affiliation(s)
- Nubia A Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andrew H Rogers
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Tanya Smit
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,HEALTH Institute, University of Houston, Houston, TX, USA
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27
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Xian S, Chen Y. E-cigarette users are associated with asthma disease: A meta-analysis. CLINICAL RESPIRATORY JOURNAL 2021; 15:457-466. [PMID: 33683790 DOI: 10.1111/crj.13346] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 03/04/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND At present, there are more than 300 million asthma patients in the world. Electronic cigarettes (e-cigarettes) are considered as a new way of smoking and are loved by young people. The relationship between e-cigarettes and asthma risk is still controversial. Therefore, we conducted a meta-analysis to explore the relationship between e-cigarettes and asthma. METHODS We searched PubMed, Embase, and Web of Science for research results published before august 2020. All data analysis was through R version 3.6.3. Publication bias was assessed using funnel plots, Begg's rank correlation test, and Egger regression asymmetry tests. Most of the included studies were adjusted for potential confounding factors. RESULTS This meta found the association of e-cigarette use with asthma, and the combined OR value was 1.27 (95% CI = 1.17-1.37). We found the significant association of current e-cigarette usage with asthma (OR = 1.30, 95% CI = 1.17-1.45), and the former use of e-cigarettes also had an association with asthma (OR = 1.22, 95% CI = 1.08-1.39). Then, when e-cigarettes were used in combination with traditional cigarettes, the association odds with asthma was 1.47 (95% CI = 1.13-1.91), which was higher than that of users who used traditional cigarettes (OR = 1.33, 95% CI = 1.19-1.49). In subgroup analysis, adult and female e-cigarette users were more closely associated with asthma. CONCLUSION In short, in this meta-analysis, we found that current or former use of e-cigarettes are associated with the prevalence of asthma. However, the specific relationship required more rigorous design for further verification.
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Affiliation(s)
- Shaojing Xian
- Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yongxing Chen
- Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
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28
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E-cigarette use and concurrent risk behaviors among adolescents. Nurs Outlook 2020; 69:302-310. [PMID: 33121761 DOI: 10.1016/j.outlook.2020.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/17/2020] [Accepted: 09/22/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE Although electronic cigarette (e-cigarette) use is on the rise among adolescents, its relationship with risk behaviors is unclear. This study aimed to examine whether e-cigarette use was related to other risk behaviors and whether age and sex play a role in those associations. METHODS Data from the 2017 Youth Risk Behavior Surveillance System was used. Weighted logistic regression analysis was conducted to examine the relationships among variables of interest. FUNDINGS The results showed that e-cigarette users, compared to nonusers, had higher odds of using other types of substances, as well as being involved in other risk behaviors including driving-related behaviors, sexual activity-related behaviors, and violence-related behaviors. Furthermore, some of these relationships are moderated by age and sex. DISCUSSION Our findings suggest that e-cigarette use is linked to other risk behaviors among adolescents. Policy makers and educators should address multiple risk behaviors as part of comprehensive tobacco-free policies and youth substance use prevention programs.
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Wang W, Lu M, Cai Y, Feng N. Awareness and use of e-cigarettes among university students in Shanghai, China. Tob Induc Dis 2020; 18:76. [PMID: 32994762 PMCID: PMC7516251 DOI: 10.18332/tid/125748] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/26/2020] [Accepted: 07/26/2020] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION The use of electronic cigarettes (e-cigarettes) in adults is increasing globally, and similar trends may be observed in the young population. Our objective was to estimate the awareness and use of e-cigarettes among the students from two comprehensive universities in Shanghai, China, and to identify the factors that may influence their decision to use e-cigarettes and their possible adverse effects. METHODS An online cross-sectional survey was conducted among the students of Shanghai Jiao Tong University and Fudan University. A total of 869 students (412 males and 457 females), mean age 21.09 years (SD=2.44), were recruited in 2018. Multivariate binary logistic regression analyses were performed to explore the associations between ever e-cigarette use and influencing factors. RESULTS Of the responding students, 88.4% were aware of e-cigarettes, 4.6% had used e-cigarettes at least once in their lifetime, and 1.7% were current e-cigarettes users. Males and smokers were more likely to use e-cigarettes (ever used e-cigarettes even once) than females (OR=3.51; 95% CI: 1.69–7.27; p=0.001) and non-smokers (OR=28.58; 95% CI: 14.03–58.20; p<0.001). University students were easily motivated to use e-cigarettes when their peers also used them, and the risk ratio was 4.15 (95% CI: 2.11–8.19) compared with if their peers never used e-cigarettes. The major factors found to motivate university students to use e-cigarettes were the belief that e-cigarettes were less harmful or not harmful (55.0%) and the perception that e-cigarettes were helpful to quit smoking (37.5%). The survey also indicated that 72.4% of the respondents heard about e-cigarettes from television advertisements, 42.7% from websites online, and 41.2% from their parents and friends. CONCLUSIONS University students who were males, cigarette smokers and whose peers used e-cigarettes were more likely to use e-cigarettes. The use of traditional cigarettes should be controlled strictly in order to reduce the likelihood of e-cigarette use among university students.
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Affiliation(s)
- Wenyuanyue Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Maojie Lu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuyang Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
| | - Nannan Feng
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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30
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Golbidi S, Edvinsson L, Laher I. Smoking and Endothelial Dysfunction. Curr Vasc Pharmacol 2020; 18:1-11. [PMID: 30210003 DOI: 10.2174/1573403x14666180913120015] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 02/07/2023]
Abstract
Cigarette smoking is one of the most important health concerns worldwide. Even though the rate of smoking is declining in developed countries, it is still experiencing growth in developing regions. Many studies have examined the relationship between smoking, as an established risk factor, and cardiovascular diseases. We provide an updated review of the underlying mechanisms of smokinginduced cardiovascular diseases, with a focus on the relationship between smoking and oxidative stress, particularly from the perspective of endothelial cell dysfunction. We review smoking-induced oxidative stress as a trigger for a generalized vascular inflammation associated with cytokine release, adhesion of inflammatory cells and, ultimately, disruption of endothelial integrity as a protective barrier layer. We also briefly discuss the harms related to the vaping of electronic cigarettes, which many erroneously consider as a safe alternative to smoking. We conclude that even though e-cigarette could be a helpful device during the transition period of cigarette quitting, it is by no means a safe substitute.
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Affiliation(s)
- Saeid Golbidi
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lars Edvinsson
- Department of Medicine, Institute of Clinical Sciences, Lund University, Getingevägen, 22185 Lund, Sweden
| | - Ismail Laher
- Department of Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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31
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Abdel-Qader DH, Al Meslamani AZ. Knowledge and Beliefs of Jordanian Community Toward E-cigarettes: A National Survey. J Community Health 2020; 46:577-586. [PMID: 32772206 DOI: 10.1007/s10900-020-00896-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Electronic nicotine delivery systems were promoted publically as a healthier replacement for conventional cigarettes. Knowledge and beliefs of the public can drive their behaviours to adapt or reject the new habit. No previous research was conducted in Jordan to assess electronic cigarettes (e-cigarettes) prevalence, and limited data are available on public opinions and orientation toward this new habit. To assess prevalence of, knowledge, attitude and beliefs about e-cigarettes, and examine factors associated with plans of quitting or initiating e-cigarettes among adults in Jordan. A large cross-sectional face-to-face survey on a random sample of adult population aged ≥ 18 years was conducted over two months to include 1820 adults in Jordan. A representative sample was collected using proportionate random sampling technique, which enabled us to geographically categorise the study population. Reliability and validity measures were taken to ensure a comprehensive and appropriate study tool. The Statistical Package for Social Science (SPSS®) version 24 was used to conduct descriptive analysis, logistic regression, and Rao-Scott chi-square. Findings were considered statistically significant at p value < 0.05 (with a confidence limit at 95%). Of 2164 adults approached, 1820 completed the questionnaire (84.1% response rate). The prevalence of current e-cigarette smokers and dual smokers were 11.7% and 4.0%, respectively. Quitting conventional smoking (38.8%) and enjoying the flavour (32.5%) were the most common reasons to start vaping. Friends were the major source of information about e-cigarettes. There was evidence that adults aged 45-59 years were less likely to be dual smokers (OR 0.51; 95%CI 0.29-0.66; p = 0.03). Poor knowledge about the content (23.7%) and types of e-cigarettes (14.5%) was reported. Plans to reduce or quit e-cigarettes were significantly associated with three factors: smokers' knowledge about its content, social impression, smokers' satisfaction with e-cigarettes. Social impression was also associated with plans of initiating e-cigarettes. Most participants thought vaping cannot be harmful to children and pregnant women (73.1%) and cannot be addictive (58.2%). Electronic cigarettes were considered helpful in smoking cessation by 69.1% of participants. The proportions of adults who were currently electronic cigarette and dual smokers were 11.7% and 4.0%, respectively. Our research may provide insight to product and individual factors that were associated with plans to sustain, quit or initiate electronic smoking.
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Bafunno D, Catino A, Lamorgese V, Del Bene G, Longo V, Montrone M, Pesola F, Pizzutilo P, Cassiano S, Mastrandrea A, Ricci D, Petrillo P, Varesano N, Zacheo A, Galetta D. Impact of tobacco control interventions on smoking initiation, cessation, and prevalence: a systematic review. J Thorac Dis 2020; 12:3844-3856. [PMID: 32802466 PMCID: PMC7399441 DOI: 10.21037/jtd.2020.02.23] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article investigates the effects of tobacco control policies on smoking initiation, cessation and prevalence by examining the papers published in the last 5 years. Twenty-one articles have been selected by two authors and sorted by four types of tobacco control: tobacco prices, anti-smoking campaigns for young people, mass media intervention and public smoking bans. Price/tax increase has deterrent effect on smoking initiation but does not promote smoking cessation; intervention on young people could reduce the smoking initiation if carried out at an early age and if acted on social skills and with peer-led approach, as opposed to restraining measures which hare generally easily circumvented by young people. The mass media campaigns showed positive effect on attempts to quit among smokers if carried forward over time and by involving multiple communication channels (TV, internet, radio). The bans in public have little effect on smoking cessation but could improve the overall well-being of non-smokers. Heterogeneous results have been described by different studies probably because of different research methodologies, cultural aspects and the really effective implementation of the rules for each country. In conclusion, comprehensive tobacco control interventions to reduce smoking prevalence and modify the smoking behavior are recommended. Moreover, the use of e-cigarettes and heat-not-burn (HnB) products, as possible helping tool for smoke cessation, currently remains controversial.
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Affiliation(s)
- Daniela Bafunno
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Annamaria Catino
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Vito Lamorgese
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Gabriella Del Bene
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Vito Longo
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Michele Montrone
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Francesco Pesola
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Pamela Pizzutilo
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Sandro Cassiano
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | | | - Donata Ricci
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Patrizia Petrillo
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Niccolò Varesano
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Antonella Zacheo
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Domenico Galetta
- Thoracic Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
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Floyd EL, Subedi S, Wagener TL, Johnson DL, Oni TM. Low powered variable voltage E-Cigarette batteries under perform at higher power settings. Inhal Toxicol 2020; 32:110-114. [PMID: 32279591 DOI: 10.1080/08958378.2020.1748145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Electronic Cigarettes (EC) use continues to increase with many efforts underway to develop dose-response relationships for clinical and sub-clinical purposes. This study investigated the battery performance of several variable voltage (VV) ECs capable of varied voltage outputs.Materials and Methods: Six brands of VV EC batteries were tested for dial setting accuracy (voltage) and power supplied during simulated vaping. All measurements were conducted using a single atomizer with two different resistance coils at four voltage settings in a blocked randomized structure. Battery dial settings were accurate when disconnected from an atomizer.Results: When powering an atomizer during simulated vaping, all batteries supplied power linearly up to approximately 8.5 watts. Beyond 8.5 watts all batteries began to undersupply power, plateauing around 9-10 watts, depending on the specific battery.Discussion: This behavior was not consistent with battery internal resistance. Undersupply of power at higher device settings will result in lower-than-expected nicotine (or THC) delivery and potentially lower pyrolysis products such as aldehydes.Conclusion: Studies seeking to associate VV EC power with psychological, physiological or toxicological effects should measure the actual power supplied or else a negative bias is likely to be observed in trials above 8.5 watts.
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Affiliation(s)
- Evan L Floyd
- Department of Occupational and Environmental Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Subekchhya Subedi
- Department of Occupational and Environmental Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Theodore L Wagener
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Oklahoma Tobacco Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - David L Johnson
- Department of Occupational and Environmental Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Toluwanimi M Oni
- Department of Occupational and Environmental Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Martin SL, Reihill JA. Promotion of a Protease-Antiprotease Imbalance in the Airways through Chronic Vaping. Am J Respir Crit Care Med 2020; 200:1337-1339. [PMID: 31496259 PMCID: PMC6884052 DOI: 10.1164/rccm.201908-1605ed] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- S Lorraine Martin
- School of PharmacyQueen's University BelfastBelfast, Northern Ireland
| | - James A Reihill
- School of PharmacyQueen's University BelfastBelfast, Northern Ireland
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Lewek P, Woźniak B, Maludzińska P, Smigielski J, Kardas P. E-cigarette use and its predictors: Results from an online cross-sectional survey in Poland. Tob Induc Dis 2019; 17:79. [PMID: 31772557 PMCID: PMC6856825 DOI: 10.18332/tid/113093] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/05/2019] [Accepted: 10/15/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Since the invention of electronic cigarettes (ECs) in 2003, their use has spread worldwide; however, little is known about the profiles of EC users. Understanding the motivators for using ECs enables more accurate prediction of their use and more effective direction of pro-health activities. Our objective was to identify the factors that may influence the decision to use ECs and their possible adverse effects according to the experiences of EC users. METHODS A cross-sectional online survey was administered between 1 July 2016 and 1 January 2017 among 1288 Polish-speaking users of social networks and EC forums. To explore associations between current EC use and other factors, multivariate binary logistic regression analyses were performed. RESULTS The final analysis included 1142 survey participants: mean age 25.9 years (± 11.1), 85.6% were male, 50.3% had secondary education, 98.2% were Polish citizens, and 81.0% were current EC users. Male gender, lower education, aged ≤40 years, former cigarette smoking, previous attempts to quit smoking, perception of lack of harmful effects of ECs, perception of ECs as being tastier and cheaper than cigarettes, awareness of the advantages of ECs and their use as a smoking cessation aid were all statistically significant factors increasing the risk of EC use. The majority of study participants claimed that ECs are less addictive or not addictive compared to cigarettes (62.6%) and less harmful or not harmful (89.5%) compared to cigarettes. The most common reported side effects of ECs were dryness in the mouth (8.3%), itching in the throat (4.5%) and nausea (1.9%). CONCLUSIONS Males aged ≤40 years with a lower level education were more likely to use ECs in the studied Polish population. The perception that ECs are less harmful than regular cigarettes is a factor increasing the odds of EC use; however, although ECs have few adverse effects, they nevertheless exist.
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Affiliation(s)
- Pawel Lewek
- Department of Family Medicine, Medical University of Lodz, Lodz, Poland
| | | | | | - Janusz Smigielski
- Social and Technical Department, State Higher Vocational School, Konin, Poland
| | - Przemyslaw Kardas
- Department of Family Medicine, Medical University of Lodz, Lodz, Poland
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Kollath-Cattano C, Dorman T, Albano AW, Jindal M, Strayer SM, Thrasher JF. E-cigarettes and the clinical encounter: Physician perspectives on e-cigarette safety, effectiveness, and patient educational needs. J Eval Clin Pract 2019; 25:761-768. [PMID: 30784164 DOI: 10.1111/jep.13111] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/15/2019] [Accepted: 01/18/2019] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES There is limited research on how health care providers approach the topic of e-cigarettes in clinical encounters, especially in conjunction with other best-practice recommendations for smoking cessation. This qualitative study explored physician perceptions and recommendations involving e-cigarettes in the context of smoking cessation counselling, including their opinions about the implementation and content of patient educational materials that focus on e-cigarettes. METHODS Semistructured interviews were conducted with 15 physicians from family medicine, internal medicine, and obstetrics/gynaecology (OB/GYN). RESULTS Physicians did not routinely assess e-cigarette use among patients and reported that discussions were often initiated by patients. Only a minority of participants discussed e-cigarettes in conjunction with other best-practice recommendations for smoking cessation. Most others were more ambivalent about e-cigarette safety and effectiveness for cessation and did not address the topic, unless patients were already using e-cigarettes. Almost all, however, agreed that more research on e-cigarettes was needed. Physicians expressed an interest in having enhanced discussions about e-cigarettes with their patients and in using patient educational materials to accomplish this. Physicians recommended that these materials not actively promote e-cigarettes and be tailored to patients based on their demographics and motivation to quit. CONCLUSIONS Physicians were open to improving their smoking cessation counselling and to integrating new patient educational materials that addressed e-cigarettes. Patient educational materials that provide tailored information about e-cigarettes could potentially be used initiate e-cigarette discussions and inform smokers about what is known vs unknown about e-cigarettes.
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Affiliation(s)
- Christy Kollath-Cattano
- Department of Health and Human Performance, College of Charleston, Charleston, South Carolina
| | - Tyler Dorman
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
| | - Andrew W Albano
- Department of Family Medicine, Prisma Health, University of South Carolina School of Medicine Greenville, Greenville, South Carolina
| | - Meenu Jindal
- Internal Medicine Clinic, Prisma Health Upstate, Greenville, South Carolina
| | - Scott M Strayer
- Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, South Carolina
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
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Ratneswaran C, Steier J, Reed K, Khong TK. Electronic Cigarette Advertising Impacts Adversely on Smoking Behaviour Within a London Student Cohort: A Cross-Sectional Structured Survey. Lung 2019; 197:533-540. [PMID: 31463548 PMCID: PMC6778585 DOI: 10.1007/s00408-019-00262-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 08/14/2019] [Indexed: 11/29/2022]
Abstract
Introduction In contrast to tobacco smoking, electronic cigarette (“vaping”) advertisement had been approved in the United Kingdom (UK) in January 2013. Currently, there are an estimated 3.2 million UK e-cigarette users. The impact of e-cigarette advertisement on tobacco use has not been studied in detail. We hypothesised that e-cigarette advertisement impacts on conventional smoking behaviour. Methods A cross-sectional structured survey assessed the impact of e-cigarette advertising on the perceived social acceptability of cigarette and e-cigarette smoking and on using either cigarettes or e-cigarettes (on a scale of 1 to 5/‘not at all’ to ‘a lot’). The survey was administered between January to March 2015 to London university students, before and after viewing 5 UK adverts including a TV commercial. Results Data were collected from 106 participants (22 ± 2 years, 66% male), comprising cigarette smokers (32%), non-smokers (54%) and ex-smokers (14%). This included vapers (16%), non-vapers (77%) and ex-vapers (7%). After viewing the adverts, smokers (2.6 ± 1.0 vs. 3.8 ± 1.1, p = 0.001) and non-smokers (3.2 ± 0.7 vs. 3.7 ± 0.8, p = 0.007) felt smoking was more socially acceptable, compared to before viewing them. Participants were more likely to try both e-cigarettes (1.90 ± 1.03 to 3.09 ± 1.11, p < 0.001) and conventional cigarettes (1.73 ± 0.83 to 2.27 ± 1.13, p < 0.001) after viewing the adverts compared to before. Vapers were less likely to smoke both an e-cigarette, and a conventional cigarette after viewing the adverts. Conclusion E-cigarette advertising encourages both e-cigarette and conventional cigarette use in young smokers and non-smokers. The adverts increase the social acceptability of smoking without regarding the importance of public health campaigns that champion smoking cessation. Electronic supplementary material The online version of this article (10.1007/s00408-019-00262-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- C Ratneswaran
- Lane Fox Unit/ Sleep Disorders Centre, NHS Foundation Trust, Guy's and St ThomasWestminster Bridge Road, London, SE1 7EH, UK. .,Faculty of Life Sciences and Medicine, Centre for Human & Applied Physiological Sciences, King's College London, London, UK. .,Institute of Medical and Biomedical Education, St George's, University of London, London, UK.
| | - J Steier
- Lane Fox Unit/ Sleep Disorders Centre, NHS Foundation Trust, Guy's and St ThomasWestminster Bridge Road, London, SE1 7EH, UK.,Faculty of Life Sciences and Medicine, Centre for Human & Applied Physiological Sciences, King's College London, London, UK
| | - K Reed
- Faculty of Life Sciences and Medicine, Centre for Human & Applied Physiological Sciences, King's College London, London, UK
| | - T K Khong
- Institute of Medical and Biomedical Education, St George's, University of London, London, UK
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Quiroga L, Asif M, Lagziel T, Bhat D, Caffrey J. E-Cigarette Battery Explosions: Review of the Acute Management of the Burns and the Impact on Our Population. Cureus 2019; 11:e5355. [PMID: 31608190 PMCID: PMC6783228 DOI: 10.7759/cureus.5355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Electronic cigarettes, also known as e-cigarettes (E-cig), are lithium-battery-powered devices, which became available for sale in the United States in 2017. It has gained significant popularity among younger-generation tobacco smokers due to its advertisement as a non-toxic inhalation property and a potential smoking-cessation aid. The US Food and Drug Administration (FDA) has been regulating e-cigarettes as tobacco products and not as drug-delivery devices, as many medical experts think it should be categorized. In the last few years, the medical community has encountered increasing episodes of burn injuries secondary to e-cigarette battery explosion. Explosions occur through a process known as a "thermal runaway.” This process occurs when the battery overheats and the internal battery temperature increases dangerously high, to the point of inner fire and explosion. Overcharge, puncture, external heat, short circuit, amongst others, are conditions that cause a “thermal runaway.” This is a retrospective review and analysis of six patients with superficial, partial, and full-thickness burn injuries related to e-cigarette battery explosions managed at Johns Hopkins Bayview Burn Center over the course of one year. Lund-Browder diagrams and calculations were used to assess the total body surface area (TBSA) burns. Laser Doppler imaging (LDI) was used to evaluate the indeterminate depth of the burn. Only one of our six patients required tangential excision and skin grafting. The rest of our patients were treated conservatively with complex wound care, which included the mixed combination of topical collagenase and bacitracin, collagenase and mafenide, or silver sulfadiazine as a single-agent treatment with an excellent response. Five patients were discharged home within a week, including the patient who required operative excision and auto-grafting. One patient stayed for eight days for pain control and complex wound care. Our experience with these burns has been similar to what is previously reported. Most of these burns are managed with complex wound care without any surgical interventions. The e-cigarette batteries seem more prone to failure due to an inherent weakness in their structural design. This makes them particularly susceptible to the “thermal runaway.” Therefore, we recognized the need to expand the regulation and control of the quality of these devices. Prevention of these burns will require continuing education for the community on the use of E-cig. products and its potential hazardous implications. New efforts should be made to educate the community and healthcare providers regarding the potential hazardous implication of carrying these batteries. Also, there is insufficient data to support or deny the long-term health effects of using e-cigarettes.
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Affiliation(s)
- Luis Quiroga
- Surgery, Burn Center, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Mohammed Asif
- Surgery, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Tomer Lagziel
- Medicine, Burn Center, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Deepa Bhat
- Surgery, Burn Center, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Julie Caffrey
- Surgery, The Johns Hopkins University School of Medicine, Baltimore, USA
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Prevalence and correlates of dual tobacco use in cancer survivors. Cancer Causes Control 2019; 30:217-223. [PMID: 30671688 DOI: 10.1007/s10552-019-1132-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 01/17/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Tobacco use in cancer survivors remains a significant problem, however, the use of non-cigarette tobacco products (NCTPs) in this population is less understood. This study examined prevalence and correlates of tobacco use among cancer survivors who were never, current, and former cigarette users. Tobacco-related behaviors and quitting attitudes were compared between survivors dually using cigarettes and electronic cigarettes (ECs) and cigarette-only users. METHODS In this cross-sectional study, patients at Mid-South cancer centers (n = 629; 50.4% never, 17.8% current, and 31.8% former cigarette users) responded to an anonymous questionnaire about tobacco-related behaviors and quitting attitudes. RESULTS Among current cigarette users, 27.7% reported using two or more tobacco products. Most commonly, 15.2% of cigarettes users were using ECs. Compared to cigarette only use, dual use of tobacco products was associated with male gender (p < 0.0001), being single (p = 0.009), and a lung cancer diagnosis (p < 0.0001). Dual users of cigarettes and ECs were more likely to report a readiness to quit cigarettes within 6 months (p = 0.0317) and that a physician recommended ECs as a quit resource (p = 0.0361) compared to cigarette-only users. CONCLUSIONS Results suggest that using more than one tobacco product is common among cancer survivor cigarette users. Dual use of cigarettes and ECs was associated with an increased readiness for cigarette cessation and a physician recommendation of ECs. Targeting potential dual use of tobacco products, particularly cigarettes and ECs, might be beneficial for cigarette cessation among cancer survivors.
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Volesky KD, Maki A, Scherf C, Watson L, Van Ryswyk K, Fraser B, Weichenthal SA, Cassol E, Villeneuve PJ. The influence of three e-cigarette models on indoor fine and ultrafine particulate matter concentrations under real-world conditions. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 243:882-889. [PMID: 30245450 DOI: 10.1016/j.envpol.2018.08.069] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 07/29/2018] [Accepted: 08/21/2018] [Indexed: 05/21/2023]
Abstract
Electronic cigarette (e-cigarette) use has steadily increased since 2010. Indoor e-cigarette use exposes bystanders to a new source of particulate matter (PM) air pollution. Elevated short-term exposures to PM with a lower measuremented aerodynamic diameter (≤2.5 μm), PM2.5 and ultrafine particles (UFPs) have been linked to increased risk of adverse respiratory and cardiac events. This exposure study estimated concentrations of PM2.5 and UFPs from indoor e-cigarette use at 0.5 meters (m) and 1 m away from an e-cigarette user and investigated whether these indoor concentrations varied across three common e-cigarette models. One e-cigarette user tested three different e-cigarettes containing the same nicotine solution on three separate occasions and measured concentrations on PM2.5 and UFPs at 0.5 and 1 m in a ∼38 m3 office. Continuous measures of PM2.5 and UFPs were taken for 5.5 min before e-cigarette use, then the user puffed seven times for 6.5 min (exposure), and for 10 min after ceasing e-cigarette use. Following the initiation of e-cigarette use, levels of PM2.5 increased 160-fold at a distance of 0.5 m, and 103-fold at 1 m. The corresponding increases in UFP counts were 5.2, and 3.0-fold higher, respectively. The PM2.5 concentrations and UFP counts between e-cigarette models were statistically significantly different at 1 m, but not at 0.5 m. There was substantial variability between distances, e-cigarettes, and replicates. This study indicates that e-cigarette vapors influence PM2.5 and UFPs concentrations/counts at close proximity distances indoors; additional research is needed to characterize the composition of those particles and evaluate the impacts of other e-cigarette solutions on indoor air quality.
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Affiliation(s)
- Karena D Volesky
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6, Canada
| | - Anthony Maki
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6, Canada
| | - Christopher Scherf
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6, Canada
| | - Louis Watson
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6, Canada
| | - Keith Van Ryswyk
- Air Health Sciences Division, Health Canada, 269 Laurier Avenue West, Ottawa, Ontario, K1A 0K9, Canada
| | - Bruce Fraser
- Air Health Sciences Division, Health Canada, 269 Laurier Avenue West, Ottawa, Ontario, K1A 0K9, Canada
| | - Scott A Weichenthal
- Air Health Sciences Division, Health Canada, 269 Laurier Avenue West, Ottawa, Ontario, K1A 0K9, Canada
| | - Edana Cassol
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6, Canada
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6, Canada.
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East K, Brose LS, McNeill A, Cheeseman H, Arnott D, Hitchman SC. Harm perceptions of electronic cigarettes and nicotine: A nationally representative cross-sectional survey of young people in Great Britain. Drug Alcohol Depend 2018; 192:257-263. [PMID: 30300799 PMCID: PMC6204576 DOI: 10.1016/j.drugalcdep.2018.08.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/10/2018] [Accepted: 08/14/2018] [Indexed: 01/14/2023]
Abstract
BACKGROUND E-cigarettes often contain nicotine without the most harmful constituents of tobacco smoke. AIMS This study aims to assess prevalence and correlates of accurately perceiving e-cigarettes as less harmful than cigarettes and that none or a small amount of the harm from smoking comes from nicotine. METHODS Cross-sectional survey of 2,103 11-18-year-olds in Great Britain in 2016. Prevalence of e-cigarette and nicotine harm perceptions were calculated. Logistic regressions assessed associations between accurate e-cigarette and nicotine harm perceptions and smoking, e-cigarette use, gender, age, region, social grade, family smoking, family e-cigarette use, smoking friends, public approval of smoking, and public approval of e-cigarettes. Associations between accurate e-cigarette and nicotine harm perceptions were also assessed. RESULTS Most (63.4%) accurate e-cigarette harm perceptions were higher among those aged 16+ (OR = 1.89 [95%CI = 1.45-2.47]), 14-15 (OR = 1.29 [1.00-1.65]), who tried/used an e-cigarette sometimes (OR = 1.51 [1.03-2.21]), with family e-cigarette use (OR = 2.11 [1.46-3.04]), who perceived public disapproval of smoking (OR = 2.11 [1.18-3.77]) and approval of e-cigarettes (OR = 2.44 [1.73-3.45]), and with accurate nicotine harm perceptions (OR = 2.05 [1.28-3.28]). Accurate nicotine harm perceptions were higher among those aged 16+ (OR = 2.60 [1.62-4.16]), from North England (OR = 1.87 [1.02-3.43]) and Wales/Scotland (OR = 2.61 [1.35-5.03]) vs. London, with family smoking (OR = 1.59 [1.05-2.42]), and with accurate e-cigarette harm perceptions (OR = 2.12 [1.32-3.41]). CONCLUSIONS Many young people have inaccurate harm perceptions of e-cigarettes and nicotine. Accurate e-cigarette and nicotine harm perceptions were associated with one another. E-cigarette use was associated with accurate e-cigarette but not nicotine harm perceptions; smoking was not associated with either.
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Affiliation(s)
- Katherine East
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, Denmark Hill, SE5 8BB, London, UK; UK Centre for Tobacco and Alcohol Studies, University of Nottingham, NG5 1PB, Nottingham, UK.
| | - Leonie S Brose
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, Denmark Hill, SE5 8BB, London, UK; UK Centre for Tobacco and Alcohol Studies, University of Nottingham, NG5 1PB, Nottingham, UK.
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, Denmark Hill, SE5 8BB, London, UK; UK Centre for Tobacco and Alcohol Studies, University of Nottingham, NG5 1PB, Nottingham, UK.
| | - Hazel Cheeseman
- Action on Smoking and Health UK, 6th floor, Suites 59-63, New House, 67-68 Hatton Garden, EC1N 8JY, London, UK.
| | - Deborah Arnott
- Action on Smoking and Health UK, 6th floor, Suites 59-63, New House, 67-68 Hatton Garden, EC1N 8JY, London, UK.
| | - Sara C Hitchman
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 4 Windsor Walk, Denmark Hill, SE5 8BB, London, UK; UK Centre for Tobacco and Alcohol Studies, University of Nottingham, NG5 1PB, Nottingham, UK.
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Salloum RG, Lee J, Porter M, Dallery J, McDaniel AM, Bian J, Thrasher JF. Evidence-based tobacco treatment utilization among dual users of cigarettes and E-cigarettes. Prev Med 2018; 114:193-199. [PMID: 30026117 DOI: 10.1016/j.ypmed.2018.07.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 07/04/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
Dual users of e-cigarettes and cigarettes may represent a unique and receptive population for evidence-based tobacco dependence treatment. We measured the frequency of quit attempts during the past year, and the use of evidence-based tobacco dependence treatments (i.e., behavioral and/or pharmacological treatments), among adult smokers who are current e-cigarette users (dual users) compared with those who do not use e-cigarettes (exclusive smokers). Data were analyzed from the 2015 National Health Interview Survey. Multivariate-adjusted regression models were used to examine the correlates of tobacco treatment use among adult smokers, comparing current e-cigarette users with those who did not use e-cigarettes, stratifying by age group, and adjusting for sociodemographic characteristics. Analyses were based on 5415 adult current cigarette smokers. Compared to exclusive smokers, dual users were more likely to report a quit attempt in the past year among adults <65 years: 18-24 years (odds ratio [OR] = 2.25), 25-44 years (OR = 1.60), and 45-64 years (OR = 1.96). With the exception of adults ≥65 years, dual users reported low rates of using combination (behavioral and pharmacological) treatments that were not statistically different from exclusive smokers: 18-24 years (0.1% vs. 2.1%, respectively), 25-44 years (4.3% vs. 4.7%), and 45-64 years (3.0% vs. 8.3%). Despite higher likelihood for dual users to make a quit attempt, their use of evidence-based tobacco treatment is low, similar to exclusive smokers. Dual users of cigarettes and e-cigarettes represent a prime target for interventions to expand access and utilization of evidence-based tobacco use treatments.
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Affiliation(s)
- Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America.
| | - JuHan Lee
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, United States of America
| | - Maribeth Porter
- Department of Community Health and Family Medicine, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Jesse Dallery
- Department of Psychology, College of Liberals Arts and Sciences, University of Florida, Gainesville, FL, United States of America
| | - Anna M McDaniel
- Department of Family, Community and Health System Science, College of Nursing, University of Florida, Gainesville, FL, United States of America
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
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Foran I, Oak NR, Meunier MJ. High-Pressure Injection Injury Caused by Electronic Cigarette Explosion: A Case Report. JBJS Case Connect 2018; 7:e36. [PMID: 29244675 DOI: 10.2106/jbjs.cc.16.00177] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE Electronic cigarettes are an increasingly popular and poorly regulated alternative to traditional cigarettes that deliver nicotine and other aerosolized substances to the user via a battery-powered atomizer. We report a case in which an electronic cigarette explosion resulted in a high-pressure injection injury of the finger. CONCLUSION Explosions involving electronic cigarettes and similar handheld products should be treated as high-pressure injection injuries until proven otherwise. Radiographs are indispensable in the workup of these injuries. Because the true content of injected material cannot be determined with certainty, we recommend immediate surgical debridement, intravenous antibiotics, and close follow-up to observe the evolution of the injury.
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Affiliation(s)
- Ian Foran
- University of California San Diego, San Diego, California
| | - Nikhil R Oak
- Department of Orthopaedic Surgery, Kaiser Permanente, Mid-Atlantic Permanente Medical Group, Rockville, Maryland
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Hickey S, Goverman J, Friedstat J, Sheridan R, Schulz J. Thermal injuries from exploding electronic cigarettes. Burns 2018; 44:1294-1301. [DOI: 10.1016/j.burns.2018.02.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/11/2017] [Accepted: 02/07/2018] [Indexed: 10/17/2022]
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Yang YT. FDA's regulatory shift on tobacco control. Prev Med 2018; 113:153-155. [PMID: 29866276 DOI: 10.1016/j.ypmed.2018.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/31/2018] [Accepted: 02/02/2018] [Indexed: 02/08/2023]
Abstract
In July 2017, the Food and Drug Administration (FDA) announced that it wants to reduce the nicotine in cigarettes to make them less addictive. Also, it is delaying for several years a key regulation affecting cigars and e-cigarettes, including flavored vaping products that tend to appeal to younger consumers. Specifically, it postponed the requirement that such products be approved by the agency. Both actions are part of a comprehensive plan to eventually wean smokers off conventional cigarettes and steer them toward less harmful alternative forms of nicotine. With its new approach to the fight against smoking, the FDA has unquestionably made great strides toward more effectively addressing the prevalence of related deaths and diseases in the U.S. However, much important work must be undertaken before this ultimate goal can be accomplished. For instance, further research into long-term effects of e-cigarettes must be conducted before these products can truly be seen as safer alternatives to combustible cigarettes. Additionally, public education is necessary to inform smokers about the range of tobacco products available and the actual harms associated with their use. Finally, the agency might have to work alongside the powerful tobacco industry to minimize potential legal challenges and to convince businesses that a shift to low-nicotine products and e-cigarettes is best for their future success and for the health of the American citizenry.
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Affiliation(s)
- Y Tony Yang
- Department of Health Administration and Policy, George Mason University, Fairfax, VA 22030, USA.
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Abstract
Background and Objective The aim of this study was to test the hypothesis that tincture of benzoin (TOB) facilitates immediate transmucosal nicotine absorption while simultaneously promoting a safe and sustained delivery of the nicotine. Methods In combination with TOB, nicotine toxicity and diffusion across human mucosal cells were measured using a 3-D human mucosal tissue model. Results Nicotine was delivered 2.1 times more quickly in combination with TOB than in combination with saline (p < 0.05). Despite the increased diffusion, nicotine in combination with TOB significantly increased mucosal cell survival (p < 0.05) by reducing the release of mitochondrial cytochrome c into the cytoplasm when compared with nicotine without TOB. The average percentage distribution of cytochrome c in the cytosolic fraction over time of nicotine + 79% ethyl alcohol (ETOH) versus nicotine plus TOB (79% ETOH) was significantly different over 120 min (60.0 ± 29.9% cytosol, 16.1 ± 9.4% cytosol, p = 0.03). Related to the reduction of cytochrome c release into the cytoplasm, TOB suppressed caspase-3 and -9 activity, thereby preventing intrinsic apoptosis and providing cytoprotection of the mucosal cells (ETOH + nicotine vs ETOH + nicotine + TOB: p = 0.008 for caspase 3, p < 0.001 for caspase 9). Conclusion Two hours of TOB (17–24% benzoin, 79% ETOH) plus nicotine promotes diffusion of nicotine across human mucosal cells and simultaneously prevents human mucosal cell toxicity by inhibiting cytochrome c release into the cytosol, thereby preventing caspase 3 and 9 activity and subsequent intrinsic apoptosis.
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Snow E, Johnson T, Ossip DJ, Williams GC, Ververs D, Rahman I, McIntosh S. Does E-cigarette Use at Baseline Influence Smoking Cessation Rates among 2-Year College Students? J Smok Cessat 2018; 13:110-120. [PMID: 30034554 PMCID: PMC6051717 DOI: 10.1017/jsc.2017.11] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION This study evaluates the impact of baseline e-cigarette use on smoking cessation rates in a national sample of two-year college student smokers. METHODS Participants were 1400 students from over 60 two-year colleges across 25 states who were current smokers enrolled in a web-assisted tobacco intervention (WATI) trial. Survey data were collected at baseline, 1-, 6-, and 12-months, with primary outcomes evaluated at 6-months. RESULTS At 6-months, baseline e-cigarette users were more likely to report cessation of traditional cigarettes compared to non-users (OR 1.39, 95% CI 1.002-1.92). Cessation was also associated with higher baseline confidence in quitting and greater time to first cigarette in the morning. Baseline e-cigarette use was not found to be associated with self-reported cessation of all nicotine/tobacco products (OR 1.09, 95% CI 0.75-1.58) nor biochemically verified cessation of all nicotine/tobacco products (OR 0.83, 95% CI 0.47-1.47). Higher confidence was again associated with both self-reported and biochemically verified cessation of all nicotine/tobacco products. Female gender was associated only with biochemically verified cessation of all nicotine/tobacco products at 6-months. CONCLUSIONS Two-year college students represent a priority population for cessation interventions. The findings from this study highlight the complexities of evaluating the impact of e-cigarette use on cessation.
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Affiliation(s)
- Erika Snow
- Department of Public Health Sciences; University of Rochester Medical Center, Rochester, NY
| | - Tye Johnson
- Department of Public Health Sciences; University of Rochester Medical Center, Rochester, NY
| | - Deborah J. Ossip
- Department of Public Health Sciences; University of Rochester Medical Center, Rochester, NY
| | | | - Duncan Ververs
- Department of Public Health Sciences; University of Rochester Medical Center, Rochester, NY
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY
| | - Scott McIntosh
- Department of Public Health Sciences; University of Rochester Medical Center, Rochester, NY
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Buczek EJ, Harrington KF, Hendricks PS, Schmalbach CE. Electronic Cigarette Awareness, Use, and Perceptions among Cancer Patients. OTO Open 2018; 2:2473974X18774543. [PMID: 30480216 PMCID: PMC6239146 DOI: 10.1177/2473974x18774543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/03/2018] [Accepted: 04/12/2018] [Indexed: 11/16/2022] Open
Abstract
Objective Electronic cigarettes (e-cigs) are an emerging trend, yet little is known about their use in the cancer population. The objectives of this study were (1) to describe characteristics of e-cig use among cancer patients, (2) to define e-cig advertising exposure, and (3) to characterize perceptions of traditional cigarettes versus e-cigs. Study Design Cross-sectional study. Setting Comprehensive cancer center. Subjects and Methods Inpatient, current smokers with a cancer diagnosis. E-cig exposure and use were defined using descriptive statistics. Wilcoxon rank test was used to compare perceptions between e-cigs and traditional cigarettes. Results A total of 979 patients were enrolled in the study; 39 cancer patients were identified. Most cancer patients were women (59%), with an average age of 53.3 years. Of the patients, 46.2% reported e-cig use, most of which (88.9%) was “experimental or occasional.” The primary reason for e-cig use was to aid smoking cessation (66.7%), alternative use in nonsmoking areas (22.2%), and “less risky” cigarette replacement (5.6%). The most common sources for e-cig information were TV (76.9%), stores (48.7%), friends (35.9%), family (30.8%), and newspapers or magazines (12.8%). Compared with cigarettes, e-cigs were viewed as posing a reduced health risk (P < .001) and conferring a less negative social impression (P < .001). They were also viewed as less likely to satisfy nicotine cravings (P = .002), to relieve boredom (P = .0005), to have a calming effect (P < .001), and as tasting pleasant (P = .006) Conclusions E-cig use and advertising exposure are common among cancer patients. E-cig use is perceived as healthier and more socially acceptable but less likely to produce a number of desired consequences of cigarette use.
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Affiliation(s)
- Erin J Buczek
- Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kathleen F Harrington
- Division of Pulmonary, Allergy & Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Peter S Hendricks
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Cecelia E Schmalbach
- Department of Otolaryngology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Maclean JC, Oney M, Marti J, Sindelar J. What factors predict the passage of state-level e-cigarette regulations? HEALTH ECONOMICS 2018; 27:897-907. [PMID: 29468781 PMCID: PMC5882548 DOI: 10.1002/hec.3642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 11/27/2017] [Accepted: 01/03/2018] [Indexed: 06/08/2023]
Abstract
E-cigarettes are controversial products. They may help addicted smokers to consume nicotine in a less harmful manner or to quit tobacco cigarettes entirely, but these products may also entice youth into smoking. This controversy complicates e-cigarette regulation as any regulation may lead to health improvements for some populations, and health declines for other populations. Using data from 2007 to 2016, we examine factors that are plausibly linked with U.S. state e-cigarette regulations. We find that less conservative states are more likely to regulate e-cigarettes and that states with stronger tobacco lobbies are less likely to regulate e-cigarettes. This information can help policymakers as they determine how best to promote public health through regulation.
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Affiliation(s)
- Johanna Catherine Maclean
- Temple University, Philadelphia, PA, USA
- National Bureau of Economic Research, Cambridge, MA, USA
- Institute for Labor Economics, Bonn, Germany
| | | | - Joachim Marti
- Institute of Social and Preventive Medicine (IUMSP), Centre Hospitalier Universitaire Vaudois, Université de Lausanne, Lausanne, Switzerland
| | - Jody Sindelar
- Laboratory of Epidemiology and Public Health, Yale University, New Haven, CT, USA
- National Bureau of Economic Research, Cambridge, MA, USA
- Institute for Labor Economics, Bonn, Germany
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Spears CA, Jones DM, Weaver SR, Pechacek TF, Eriksen MP. Motives and perceptions regarding electronic nicotine delivery systems (ENDS) use among adults with mental health conditions. Addict Behav 2018; 80:102-109. [PMID: 29407679 PMCID: PMC5857232 DOI: 10.1016/j.addbeh.2018.01.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/10/2018] [Accepted: 01/12/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Smoking rates are disproportionately high among adults with mental health conditions (MHC), and recent research suggests that among former smokers, those with MHC are more likely to use electronic nicotine delivery systems (ENDS). This study investigated reasons for ENDS use and related risk perceptions among individuals with versus without MHC. METHODS Among adult current ENDS users (n=550), associations between self-reported MHC diagnoses and motives for ENDS use and ENDS risk perceptions were examined, stratified by smoking status. RESULTS There were no significant associations between MHC status and ENDS motives or perceptions in the overall sample. However, current smokers with MHC indicated thinking more about how ENDS might improve their health, and former smokers with MHC reported thinking less about how ENDS might harm their health, compared to their counterparts without MHC. Former smokers with MHC rated several reasons for ENDS use (e.g., less harmful than regular cigarettes; to quit smoking; appealing flavors) as more important than did those without MHC. CONCLUSIONS Current and former smokers with MHC may be especially optimistic about health benefits of ENDS. However, they might also be prone to health risks of continued ENDS use or concurrent use with traditional cigarettes. It will be important for public health messaging to provide this population with accurate information about benefits and risks of ENDS.
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Affiliation(s)
- Claire Adams Spears
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States; Division of Health Promotion and Behavior, School of Public Health, Georgia State University, Atlanta, GA, United States.
| | - Dina M Jones
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States.
| | - Scott R Weaver
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States; Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University, Atlanta, GA, United States.
| | - Terry F Pechacek
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States; Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA, United States.
| | - Michael P Eriksen
- Tobacco Center of Regulatory Science (TCORS), School of Public Health, Georgia State University, Atlanta, GA, United States; Division of Health Management and Policy, School of Public Health, Georgia State University, Atlanta, GA, United States.
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