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Kishinchand R, Boyce M, Vyas H, Sewell L, Mohi A, Brengartner L, Miller R, Gorr MW, Wold LE, Cray J. In Utero Exposure to Maternal Electronic Nicotine Delivery System use Demonstrate Alterations to Craniofacial Development. Cleft Palate Craniofac J 2024; 61:1389-1397. [PMID: 36916055 DOI: 10.1177/10556656231163400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
OBJECTIVE Develop a model for the study of Electronic Nicotine Device (ENDS) exposure on craniofacial development. DESIGN Experimental preclinical design followed as pregnant murine dams were randomized and exposed to filtered air exposure, carrier exposure consisting of 50% volume of propylene glycol and vegetable glycine (ENDS Carrier) respectively, or carrier exposure with 20 mg/ml of nicotine added to the liquid vaporizer (ENDS carrier with nicotine). SETTING Preclinical murine model exposure using the SciReq exposure system. PARTICIPANTS C57BL6 adult 8 week old female pregnant mice and exposed in utero litters. INTERVENTIONS Exposure to control filtered air, ENDS carrier or ENDS carrier with nicotine added throughout gestation at 1 puff/minute, 4 h/day, five days a week. MAIN OUTCOME MEASURES Cephalometric measures of post-natal day 15 pups born as exposed litters. RESULTS Data suggests alterations to several facial morphology parameters in the developing offspring, suggesting electronic nicotine device systems may alter facial growth if used during pregnancy. CONCLUSIONS Future research should concentrate on varied formulations and exposure regimens of ENDS to determine timing windows of exposures and ENDS formulations that may be harmful to craniofacial development.
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Affiliation(s)
- Rajiv Kishinchand
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Mark Boyce
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Heema Vyas
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Leslie Sewell
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Amr Mohi
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Lexie Brengartner
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Roy Miller
- School of Nursing, The Ohio State University, Columbus, OH 43210, USA
| | - Matthew W Gorr
- School of Nursing, The Ohio State University, Columbus, OH 43210, USA
- Department of Physiology and Cell Biology, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Loren E Wold
- School of Nursing, The Ohio State University, Columbus, OH 43210, USA
- Department of Physiology and Cell Biology, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - James Cray
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
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Wang P, Williams RJ, Chen W, Wang F, Shamout M, Tanz LJ, Herzig CT, Oakley LP, Peak CM, Heinzerling A, Al-Shawaf M, Melstrom P, Marynak K, Tynan MA, Agaku IT, Kumagai K. Chemical Composition of Electronic Vaping Products From School Grounds in California. Nicotine Tob Res 2024; 26:991-998. [PMID: 38407960 PMCID: PMC11262994 DOI: 10.1093/ntr/ntae042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 12/27/2023] [Accepted: 02/17/2024] [Indexed: 02/27/2024]
Abstract
INTRODUCTION The use of electronic vaping products (EVPs) containing nicotine, marijuana, and/or other substances remains prominent among youth; with EVPs containing nicotine being the most commonly used tobacco product among youth since 2014. However, a detailed understanding of the chemical composition of these products is limited. AIMS AND METHODS From February 25th to March 15th, 2019, a total of 576 EVPs, including 233 e-cigarette devices (with 43 disposable vape pens) and 343 e-liquid cartridges/pods/bottled e-liquids, were found or confiscated from a convenience sample of 16 public high schools in California. Liquids inside 251 vape pens and cartridges/pods/bottled e-liquids were analyzed using a gas chromatography/mass spectrometry (GC/MS). For comparison, new JUUL pods, the most commonly used e-cigarette among youth during 2018-2019, with different flavorings and nicotine content were purchased and analyzed. RESULTS For e-cigarette cartridges/pods/bottled e-liquids, nicotine was detected in 204 of 208 (98.1%) samples. Propylene glycol and vegetable glycerin were dominant solvents in nicotine-containing EVPs. Among 43 disposable vape pen devices, cannabinoids such as tetrahydrocannabinol (THC) or cannabidiol (CBD) were identified in 39 of 43 (90.1%) samples, of which three contained both nicotine and THC. Differences in chemical compositions were observed between confiscated or collected JUULs and purchased JUULs. Measured nicotine was inconsistent with labels on some confiscated or collected bottled e-liquids. CONCLUSIONS EVPs from 16 participating schools were found to widely contain substances with known adverse health effects among youth, including nicotine and cannabinoids. There was inconsistency between labeled and measured nicotine on the products from schools. IMPLICATIONS This study measured the main chemical compositions of EVPs found at 16 California public high schools. Continued efforts are warranted, including at the school-level, to educate, prevent, and reduce youth use of EVPs.
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Affiliation(s)
- Ping Wang
- Air Quality Section, Environmental Health Laboratory, Center for Laboratory Sciences, California Department of Public Health, Richmond, CA, USA
| | - Rebecca J. Williams
- California Tobacco Prevention Program, California Department of Public Health, Sacramento, CA, USA
| | - Wenhao Chen
- Air Quality Section, Environmental Health Laboratory, Center for Laboratory Sciences, California Department of Public Health, Richmond, CA, USA
| | - Flavia Wang
- Air Quality Section, Environmental Health Laboratory, Center for Laboratory Sciences, California Department of Public Health, Richmond, CA, USA
| | - Mays Shamout
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lauren J. Tanz
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carolyn T.A. Herzig
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lisa P. Oakley
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Corey M. Peak
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Amy Heinzerling
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Occupational Health Branch, California Department of Public Health, Richmond, CA, USA
| | - Maeh Al-Shawaf
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Paul Melstrom
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kristy Marynak
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michael A. Tynan
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Israel T. Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kazukiyo Kumagai
- Air Quality Section, Environmental Health Laboratory, Center for Laboratory Sciences, California Department of Public Health, Richmond, CA, USA
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Quinones Tavarez Z, Croft DP, Li D, Gill SR, Wojtovich AP, Rahman I, Ossip DJ. Fruit flavors in electronic cigarettes (ECIGs) are associated with nocturnal dry cough: A population longitudinal analysis. PLoS One 2024; 19:e0306467. [PMID: 38941336 PMCID: PMC11213341 DOI: 10.1371/journal.pone.0306467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/18/2024] [Indexed: 06/30/2024] Open
Abstract
Evidence from in vitro and animal models has identified the pulmonary toxicity of flavors in electronic cigarettes (ECIGs); however, less is known from epidemiological studies about the effects of flavors in the respiratory health. This study examined the longitudinal association between exposure to ECIGs flavors and nocturnal dry cough among ECIGs users. A secondary analysis of data from the Population Assessment of Tobacco and Health Study (2014-2019) was conducted. The study population included adults who provided information (n = 18,925) for a total of 38,638 observations. Weighted-incidence estimates and weighted- generalized estimating equation models were performed to assess unadjusted and adjusted associations. The weighted incidence proportion (WIP) of nocturnal dry cough was significantly higher among current (WIP:16.6%; 95%CI 10.5, 21.2) and former fruit flavored ECIGs users (WIP:16.6%; 95%CI 11.3, 21.9) as compared to non-ECIGs users (WIP:11.1%; 95%CI 10.6, 11.6). Current ECIGs users of fruit flavors showed 40% higher risk of reporting cough than non-ECIGs users (aRR:1.40, 95%CI 1.01, 1.94). Former ECIGs users of multiple flavors and other flavors had 300% and 66% higher risk to develop cough, respectively (aRR:3.33, 95%CI 1.51, 7.34 and aRR:1.66, 95%CI 1.0.9, 2.51), relative to non-ECIGs users. We observed a significantly higher risk of developing nocturnal dry cough in the past 12 months in current and former ECIGs users of fruit flavors and in former ECIGs users of multiple flavors. To the extent that cough may serve as an early indicator of respiratory inflammation and potential disease risk, the association between ECIGs use and cough raises potential concerns.
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Affiliation(s)
- Zahira Quinones Tavarez
- Clinical Translational Science Institute, University of Rochester Medical Center, Rochester, New York, United States of America
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
| | - Daniel P. Croft
- Department of Medicine, Pulmonary Diseases and Critical Care, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Dongmei Li
- Clinical Translational Science Institute, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Steven R. Gill
- Department of Microbiology and Immunology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
| | - Andrew P. Wojtovich
- Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
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Tao X, Zhang J, Meng Q, Chu J, Zhao R, Liu Y, Dong Y, Xu H, Tian T, Cui J, Zhang L, Chu M. The potential health effects associated with electronic-cigarette. ENVIRONMENTAL RESEARCH 2024; 245:118056. [PMID: 38157958 DOI: 10.1016/j.envres.2023.118056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/17/2023] [Accepted: 12/25/2023] [Indexed: 01/03/2024]
Abstract
A good old gateway theory that electronic-cigarettes (e-cigarettes) are widely recognized as safer tobacco substitutes. In actuality, demographics also show that vaping cannibalizes smoking, the best explanation of the data is the "common liability". However, the utilization of e-cigarette products remains a controversial topic at present. Currently, there has been a widespread and substantial growth in e-cigarette use worldwide owing to their endless new flavors and customizable characteristics. Furthermore, e-cigarette has grown widespread among smokers as well as non-smokers, including adolescents and young adults. And some studies have shown that e-cigarette users are at greater risk to start using combustible cigarettes while e-cigarettes use was also observed the potential benefits to people who want to quit smoking or not. Although it is true that e-cigarettes generally contain fewer toxic substances than combustible cigarettes, this does not mean that the chemical composition in e-cigarettes aerosols poses absolutely no risks. While concerns about toxic substances in e-cigarettes and their widespread use in the population are reasonable, it is also crucial to consider that e-cigarettes have been associated with the potential for promoting smoking cessation and the clinically relevant improvements in users with smoking-related pathologies. Meanwhile, there is still short of understanding of the health impacts associated with e-cigarette use. Therefore, in this review, we discussed the health impacts of e-cigarette exposure on oral, nasal, pulmonary, cardiovascular systems and brain. We aspire for this review to change people's previous perceptions of e-cigarettes and provide them with a more balanced perspective. Additionally, we suggest appropriate adjustments on regulation and policy for e-cigarette to gain greater public health benefits.
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Affiliation(s)
- Xiaobo Tao
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Jiale Zhang
- The Second People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Qianyao Meng
- Department of Global Health and Population, School of Public Health, Harvard University, Boston, USA
| | - Junfeng Chu
- Department of Oncology, Jiangdu People's Hospital of Yangzhou, Yangzhou, Jiangsu, China
| | - Rongrong Zhao
- Department of Oncology, Jiangdu People's Hospital of Yangzhou, Yangzhou, Jiangsu, China
| | - Yiran Liu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Yang Dong
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Huiwen Xu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Tian Tian
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Jiahua Cui
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Lei Zhang
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China.
| | - Minjie Chu
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, Jiangsu, China.
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Alqahtani MM, Alenezi FK, Almeshari MA, Alanazi AM, Taleb ZB, Kalan MEE, Martinasek MP, McNab RJ, Culbreth R, Alotaibi M, Aljohani H, Goodfellow LT, Ismaeil TT, Algarni SS, Alotaibi TF, Alqahtani MK, Al-Ajel H, Alwadeai KS, Almutairi NS, Ford E. E-cigarette use and respiratory symptoms in adults: A systematic review and meta-analysis. Tob Induc Dis 2023; 21:168. [PMID: 38098748 PMCID: PMC10720266 DOI: 10.18332/tid/174660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 12/17/2023] Open
Abstract
INTRODUCTION Electronic cigarette (e-cigarette) use is gaining popularity among adults. Monitoring e-cigarette-induced respiratory symptoms is crucial for both clinical and regulatory purposes. We systematically reviewed the current literature to understand the prevalence of respiratory symptoms among exclusive e-cigarette users, dual users, and former smokers. METHODS Databases searched included PubMed, CINAHL, Cochrane Library, Embase, and Scopus. We included all English-language, empirical quantitative articles that explored the prevalence of e-cigarette-related respiratory symptoms. Random-effects models were utilized in conducting the meta-analyses. The quality of identified studies was evaluated using the NIH Study Quality Assessment Tools. This study is registered with PROSPERO(#CRD42020165973). RESULTS The literature search identified 1240 references. After removing duplicates and screening for eligibility, 168 studies were included in the final review. The majority of included studies reported a wide range of adverse respiratory symptoms. The respiratory symptoms were prevalent among the exclusive e-cigarette users, dual users, and those who switched from combustible cigarettes to e-cigarettes. Further, out of the RCT studies, 5 were rated as good quality, while 3 were rated as fair. Among the observational studies, 24 were rated as good quality, and 9 were rated as fair. The two experimental studies were both rated as fair quality. CONCLUSIONS Continued monitoring of respiratory symptoms among e-cigarette users is warranted. Due to the heterogeneity and inconsistencies among studies, which limit result interpretation and highlight the need for studies assessing causal inference, further research using robust study designs is essential. This will provide clinicians with comprehensive knowledge about the potential respiratory risks of e-cigarette use.
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Affiliation(s)
- Mohammed M. Alqahtani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Population Science, American Cancer Society, Atlanta, United States
| | - Faraj K. Alenezi
- Department of Anaesthesia Technology, College of Applied Medical Sciences, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
- Birmingham Acute Care Group, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Mohammed A. Almeshari
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M. Alanazi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ziyad Ben Taleb
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, United States
| | | | - Mary P. Martinasek
- Department of Health Sciences and Human Performance, University of Tampa, Tampa, United States
| | - Rheese J. McNab
- Department of Health Sciences and Human Performance, University of Tampa, Tampa, United States
| | - Rachel Culbreth
- Department of Respiratory Therapy, Georgia State University, Atlanta, United States
| | - Mansour Alotaibi
- Department of Physical Therapy, Northern Border University, Arar, Saudi Arabia
| | - Hassan Aljohani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Lynda T. Goodfellow
- Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, United States
| | - Taha T. Ismaeil
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Saleh S. Algarni
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Tareq F. Alotaibi
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mobarak K. Alqahtani
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hamoud Al-Ajel
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, AlRiyadh, Saudi Arabia
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, United States
| | - Khalid S. Alwadeai
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Nafea S. Almutairi
- Department of Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Eric Ford
- Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, United States
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Auschwitz E, Almeda J, Andl CD. Mechanisms of E-Cigarette Vape-Induced Epithelial Cell Damage. Cells 2023; 12:2552. [PMID: 37947630 PMCID: PMC10650279 DOI: 10.3390/cells12212552] [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: 07/25/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023] Open
Abstract
E-cigarette use has been reported to affect cell viability, induce DNA damage, and modulate an inflammatory response resulting in negative health consequences. Most studies focus on oral and lung disease associated with e-cigarette use. However, tissue damage can be found in the cardio-vascular system and even the bladder. While the levels of carcinogenic compounds found in e-cigarette aerosols are lower than those in conventional cigarette smoke, the toxicants generated by the heat of the vaping device may include probable human carcinogens. Furthermore, nicotine, although not a carcinogen, can be metabolized to nitrosamines. Nitrosamines are known carcinogens and have been shown to be present in the saliva of e-cig users, demonstrating the health risk of e-cigarette vaping. E-cig vape can induce DNA adducts, promoting oxidative stress and DNA damage and NF-kB-driven inflammation. Together, these processes increase the transcription of pro-inflammatory cytokines. This creates a microenvironment thought to play a key role in tumorigenesis, although it is too early to know the long-term effects of vaping. This review considers different aspects of e-cigarette-induced cellular changes, including the generation of reactive oxygen species, DNA damage, DNA repair, inflammation, and the possible tumorigenic effects.
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Affiliation(s)
| | | | - Claudia D. Andl
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL 32816, USA
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Chi Y, Chen HY. Investigating Substance Use via Reddit: Systematic Scoping Review. J Med Internet Res 2023; 25:e48905. [PMID: 37878361 PMCID: PMC10637357 DOI: 10.2196/48905] [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: 05/11/2023] [Revised: 08/15/2023] [Accepted: 09/13/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Reddit's (Reddit Inc) large user base, diverse communities, and anonymity make it a useful platform for substance use research. Despite a growing body of literature on substance use on Reddit, challenges and limitations must be carefully considered. However, no systematic scoping review has been conducted on the use of Reddit as a data source for substance use research. OBJECTIVE This review aims to investigate the use of Reddit for studying substance use by examining previous studies' objectives, reasons, limitations, and methods for using Reddit. In addition, we discuss the implications and contributions of previous studies and identify gaps in the literature that require further attention. METHODS A total of 7 databases were searched using keyword combinations including Reddit and substance-related keywords in April 2022. The initial search resulted in 456 articles, and 227 articles remained after removing duplicates. All included studies were peer reviewed, empirical, available in full text, and pertinent to Reddit and substance use, and they were all written in English. After screening, 60 articles met the eligibility criteria for the review, with 57 articles identified from the initial database search and 3 from the ancestry search. A codebook was developed, and qualitative content analysis was performed to extract relevant evidence related to the research questions. RESULTS The use of Reddit for studying substance use has grown steadily since 2015, with a sharp increase in 2021. The primary objective was to identify tendencies and patterns in various types of substance use discussions (52/60, 87%). Reddit was also used to explore unique user experiences, propose methodologies, investigate user interactions, and develop interventions. A total of 9 reasons for using Reddit to study substance use were identified, such as the platform's anonymity, its widespread popularity, and the explicit topics of subreddits. However, 7 limitations were noted, including the platform's low representativeness of the general population with substance use and the lack of demographic information. Most studies use application programming interfaces for data collection and quantitative approaches for analysis, with few using qualitative approaches. Machine learning algorithms are commonly used for natural language processing tasks. The theoretical, methodological, and practical implications and contributions of the included articles are summarized and discussed. The most prevalent practical implications are investigating prevailing topics in Reddit discussions, providing recommendations for clinical practices and policies, and comparing Reddit discussions on substance use across various sources. CONCLUSIONS This systematic scoping review provides an overview of Reddit's use as a data source for substance use research. Although the limitations of Reddit data must be considered, analyzing them can be useful for understanding patterns and user experiences related to substance use. Our review also highlights gaps in the literature and suggests avenues for future research.
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Affiliation(s)
- Yu Chi
- School of Information Science, University of Kentucky, Lexington, KY, United States
| | - Huai-Yu Chen
- Department of Communication, University of Kentucky, Lexington, KY, United States
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Lee J, Orzabal MR, Naik VD, Ramadoss J. Impact of e-cigarette vaping aerosol exposure in pregnancy on mTOR signaling in rat fetal hippocampus. Front Neurosci 2023; 17:1217127. [PMID: 37449268 PMCID: PMC10337480 DOI: 10.3389/fnins.2023.1217127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Electronic cigarette (e-cig) use during pregnancy has become a major health concern in recent years and many view them as less harmful and may help quit or reduce combustible cigarettes. Implementing a state-of-the-art engineered vaping system, comprising an atomizer similar to those sold in vape shops, we aimed to utilize a translational e-cig inhalation delivery method to provide crucial information on the impact of prenatal e-cig aerosols on the developing brain hippocampal mTOR system in a rat model system. Gestational e-cig vaping significantly increased P-mTOR levels (p < 0.05) in the rat fetal hippocampi in the nicotine group (comprising of VG/PG + nicotine) compared to the control and the juice (comprising of VG/PG) groups. Total mTOR expression was not different among groups. Immunofluorescence imaging demonstrated P-mTOR was detected exclusively in the granule cells of the dentate gyrus of the fetal hippocampus. E-cig did not alter DEPTOR, but RAPTOR and RICTOR were higher (p < 0.05) in the Nicotine group. Gestational e-cig vaping with nicotine increased (p < 0.05) the activity and expression of 4EBP1, p70S6K, but decreased (p < 0.05) P-PKCα in the fetal hippocampi. In summary, dysregulation of mTORC1 and the related mTORC2, their activity, and downstream proteins together may play a critical role in e-cig-vaping-induced neurobiological phenotypes during development.
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Affiliation(s)
- Jehoon Lee
- Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, TX, United States
| | - Marcus R. Orzabal
- Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, TX, United States
| | - Vishal D. Naik
- Department of Obstetrics and Gynecology, C.S. Mott Center for Human Growth and Development, School of Medicine, Wayne State University, Detroit, MI, United States
| | - Jayanth Ramadoss
- Department of Obstetrics and Gynecology, C.S. Mott Center for Human Growth and Development, School of Medicine, Wayne State University, Detroit, MI, United States
- Department of Physiology, School of Medicine, Wayne State University, Detroit, MI, United States
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Pitzer CR, Aboaziza EA, O'Reilly JM, Mandler WK, Olfert IM. Nicotine and Microvascular Responses in Skeletal Muscle from Acute Exposure to Cigarettes and Vaping. Int J Mol Sci 2023; 24:10208. [PMID: 37373356 DOI: 10.3390/ijms241210208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/07/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Despite claims of safety or harm reduction for electronic cigarettes (E-cig) use (also known as vaping), emerging evidence indicates that E-cigs are not likely safe, or necessarily safer than traditional cigarettes, when considering the user's risk of developing vascular dysfunction/disease. E-cigs are different from regular cigarettes in that E-cig devices are highly customizable, and users can change the e-liquid composition (such as the base solution, flavors, and nicotine level). Since the effects of E-cigs on the microvascular responses in skeletal muscle are poorly understood, we used intravital microscopy with an acute (one-time 10 puff) exposure paradigm to evaluate the individual components of e-liquid on vascular tone and endothelial function in the arterioles of the gluteus maximus muscle of anesthetized C57Bl/6 mice. Consistent with the molecular responses seen with endothelial cells, we found that the peripheral vasoconstriction response was similar between mice exposed to E-cig aerosol or cigarette smoke (i.e., 3R4F reference cigarette); this response was not nicotine dependent, and endothelial cell-mediated vasodilation was not altered within this acute exposure paradigm. We also report that, regardless of the base solution component [i.e., vegetable glycerin (VG)-only or propylene glycol (PG)-only], the vasoconstriction responses were the same in mice with inhalation exposure to 3R4F cigarette smoke or E-cig aerosol. Key findings from this work reveal that some component other than nicotine, in inhaled smoke or aerosol, is responsible for triggering peripheral vasoconstriction in skeletal muscle, and that regardless of one's preference for an E-cig base solution composition (i.e., ratio of VG-to-PG), the acute physiological response to blood vessels appears to be the same. The data suggest that vaping is not likely to be 'safer' than smoking towards blood vessels and can be expected to produce and/or result in the same adverse vascular health outcomes associated with smoking cigarettes.
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Affiliation(s)
- Christopher R Pitzer
- Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Eiman A Aboaziza
- West Virginia Clinical and Translational Science Institute, Morgantown, WV 26506, USA
- Center for Inhalation Toxicology, West Virginia University, Morgantown, WV 26506, USA
| | - Juliana M O'Reilly
- Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - W Kyle Mandler
- Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - I Mark Olfert
- Division of Exercise Physiology, School of Medicine, West Virginia University, Morgantown, WV 26506, USA
- Center for Inhalation Toxicology, West Virginia University, Morgantown, WV 26506, USA
- Department of Physiology, Pharmacology and Toxicology, West Virginia University, Morgantown, WV 26506, USA
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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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Yang Q, Ma S, He Y, Qiu Z, Chen J, Shang C. What types of e-liquid products were more likely to offer price promotions? Tob Control 2023:tc-2022-057781. [PMID: 37197949 PMCID: PMC10915894 DOI: 10.1136/tc-2022-057781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 05/03/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION The present study empirically examined the association between price discounts and product attributes of e-liquids sold by online retailers. METHODS We analysed 14 000 e-liquid products from five major online e-cigarette retailers between April and May 2021 to determine the association between price discounts and product attributes such as nicotine level and form, flavour and vegetable glycerine/propylene glycol ratio. A fixed-effects model was used in the analysis and discounts were calculated in US cents/mL of e-liquid volume. RESULTS Out of 14 407 e-liquid products, 92.5% were offered at a discounted price. On average, the price discount for the 13 324 products that had discounts was 16.84 cents/mL across the five stores. Among the three forms of nicotine (salt, freebase and nicotine free), salt e-liquids had the highest average price discount. CONCLUSION Our findings suggest that e-liquids with salt nicotine have a higher average price discount when sold online, which may influence consumer purchasing behaviour. Further research is needed to assess the potential impact of these discounts on youth and adult tobacco use. Policymakers may consider implementing measures to limit online price discounts for e-liquids as a means of reducing sales among young people.
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Affiliation(s)
- Qian Yang
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Shaoying Ma
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Yanyun He
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Zefeng Qiu
- Computer Science and Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Jian Chen
- Computer Science and Engineering, The Ohio State University, Columbus, Ohio, USA
| | - Ce Shang
- Center for Tobacco Research, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
- Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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12
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Zhang Q, Wen C. The risk profile of electronic nicotine delivery systems, compared to traditional cigarettes, on oral disease: a review. Front Public Health 2023; 11:1146949. [PMID: 37255760 PMCID: PMC10226679 DOI: 10.3389/fpubh.2023.1146949] [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: 01/18/2023] [Accepted: 04/14/2023] [Indexed: 06/01/2023] Open
Abstract
The use of electronic nicotine delivery systems (ENDS) has exploded, especially among teenagers and new smokers, amid widespread awareness of the dangers of traditional tobacco and restrictions on smoking. However, the risk effects of ENDS on physical health, especially oral health, are still ambiguous. The purpose of this study was to review the available evidence on risks of ENDS on oral health, and compares the differences between ENDS and traditional cigarettes. For heavy smokers, transferring the addiction of tobacco to ENDS can be less harmful to periodontal condition and physical health but is not completely without risk. The components of ENDS vapor have cytotoxic, genotoxic, and carcinogenic properties, and its usage may be associated with a wide range of oral health sequelae. The chemicals in ENDS increase the susceptibility to tooth decay, increase the risk of periodontal disease, peri-implant, and oral mucosal lesions. Nicotine aerosols from ENDS can be a potential risk factor for oral cancer due to the presence of carcinogenic components. Compared to smoking traditional cigarettes, the harm associated with ENDS use may be underestimated due to the reduced ability to control vaping behavior, ease of ENDS access, fewer vaping area restrictions, and better taste. Currently, the available evidence suggests that ENDS may be a safer alternative to traditional tobacco products. Though most oral symptoms experienced by ENDS users are relatively mild and temporary compared to traditional cigarettes, the dangers of ENDS still exist. However, further research with longer follow-up periods is required to establish the long-term safety of ENDS.
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Affiliation(s)
- Qing Zhang
- Department of Nosocomial Infection Control, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Cai Wen
- Department of Oral Implantology, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Department of VIP Dental Service, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Luzhou Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatological Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Institute of Stomatology, Southwest Medical University, Luzhou, Sichuan, China
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13
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Kosarac I, Katuri GP, Kubwabo C, Siddique S, Mischki TK. Quantitation and Stability of Nicotine in Canadian Vaping Liquids. TOXICS 2023; 11:378. [PMID: 37112605 PMCID: PMC10144332 DOI: 10.3390/toxics11040378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/05/2023] [Accepted: 04/14/2023] [Indexed: 06/19/2023]
Abstract
Electronic cigarettes (e-cigarettes, vaping products) have become increasingly popular, with recent increases in use associated with closed systems delivering higher concentrations of nicotine. Most vaping products designed as an alternative to combustible cigarettes contain nicotine. A number of published studies have examined the reported concentrations of nicotine in vaping liquids (e-liquids) and found discrepancies between labelled and measured levels. Some discrepancy can also be explained by the lack of stability of nicotine in these types of products. Recently, a chemical analysis method for the quantitative determination of low and high levels of nicotine in vaping liquids was developed. This method uses dilution with acetonitrile prior to analysis with gas chromatograph mass spectrometry (GC-MS) in single ion monitoring mode (SIM). The developed method was validated using a laboratory-prepared vaping liquid as well as commercially available, nicotine-free products fortified with nicotine in the laboratory. The method detection limit (MDL) and the limit of quantitation (LOQ) for nicotine were calculated to be 0.002 mg/mL and 0.006 mg/mL, respectively. The newly developed method was applied to quantify nicotine in commercially available vaping liquids of various flavour profiles and across a wide range of nicotine concentrations, including those with nicotine salts. Furthermore, a subset of vaping liquids were analyzed to elucidate nicotine stability in various product subtypes. After a period of six months of accelerated storage to mimic one year, the overall mean percent of the original nicotine concentration remaining in the salt-based vaping products was 85% (minimum 64%, maximum 99%) while in the free-base nicotine products it was 74% (minimum 31%, maximum 106%). Nicotine stability in vaping liquids was found to be influenced by the nicotine form (pH) of formulation and its chemical composition. Non-targeted, qualitative analysis of chemical composition of vaping products showed that most constituents were identified and found to be remaining in the products following stability trials; however, three new compounds were tentatively identified in some vaping liquids at the end of the stability trials. Stability studies and the accurate quantitation of nicotine in vaping products can help inform product standards related to the safety, quality and utility of vaping products as a smoking cessation tool.
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Affiliation(s)
- Ivana Kosarac
- Tobacco Control Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Guru P. Katuri
- Tobacco Control Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Cariton Kubwabo
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Shabana Siddique
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON K1A 0K9, Canada
| | - Trevor K. Mischki
- Tobacco Control Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada
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Larcombe AN, Chivers EK, Huxley RR, Musk A(BW, Franklin PJ, Mullins BJ. Electronic Cigarette Usage Patterns and Perceptions in Adult Australians. TOXICS 2023; 11:290. [PMID: 36977055 PMCID: PMC10056955 DOI: 10.3390/toxics11030290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/17/2023] [Accepted: 03/17/2023] [Indexed: 06/18/2023]
Abstract
Despite their increasing popularity, and Australia's unique regulatory environment, how and why Australian adults use e-cigarettes and their perceptions of their safety, efficacy and regulation have not been extensively reported before. In this study, we screened 2217 adult Australians with the aim of assessing these questions in a sample of current or former e-cigarette users. A total of 505 out of 2217 respondents were current or former e-cigarette users, with only these respondents completing the full survey. Key findings of this survey included the high proportion of respondents who indicated they were currently using e-cigarettes (307 out of 2217 = 13.8%), and the high proportion of current e-cigarette users that were also smokers (74.6%). The majority of respondents used e-liquids containing nicotine (70.3%), despite it being illegal in Australia without a prescription, and the majority bought their devices and liquids in Australia (65.7%). Respondents reported using e-cigarettes in a variety of places, including inside the home, inside public places (where it is illegal to smoke tobacco cigarettes), and around other people-which has implications for second and third hand exposures. A significant proportion of current e-cigarette users (30.6%) thought that e-cigarettes were completely safe to use long-term, although in general, there was a large amount of uncertainty/ambivalence with respect to perceptions of e-cigarette safety and efficacy as smoking cessation tools. This study shows that e-cigarette use is common in Australia, and that appropriate dissemination of unbiased research findings on their safety and efficacy in smoking cessation is urgently required.
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Affiliation(s)
- Alexander N. Larcombe
- Respiratory Environmental Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute, Nedlands, WA 6009, Australia
- Occupation, Environment and Safety, School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Emily K. Chivers
- Respiratory Environmental Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute, Nedlands, WA 6009, Australia
| | - Rachel R. Huxley
- The George Institute for Global Health, University of New South Wales, Newtown, NSW 2042, Australia
- Faculty of Health, Deakin University, Burwood, VIC 3125, Australia
| | - Arthur (Bill) W. Musk
- School of Population and Global Health, University of Western Australia, Crawley, WA 6009, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
| | - Peter J. Franklin
- School of Population and Global Health, University of Western Australia, Crawley, WA 6009, Australia
| | - Benjamin J. Mullins
- Occupation, Environment and Safety, School of Population Health, Curtin University, Perth, WA 6845, Australia
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15
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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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16
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Noël A, Ghosh A. Carbonyl Profiles of Electronic Nicotine Delivery System (ENDS) Aerosols Reflect Both the Chemical Composition and the Numbers of E-Liquid Ingredients-Focus on the In Vitro Toxicity of Strawberry and Vanilla Flavors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16774. [PMID: 36554655 PMCID: PMC9779252 DOI: 10.3390/ijerph192416774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
Propylene glycol (PG) and glycerin (G) are the most widely used humectants in electronic nicotine delivery system (ENDS) devices. Carbonyls are present in aerosols produced when ENDS devices heat PG and G. Whether aerosolized PG and G are innocuous to the lungs has not been established. Here, we determined the chemical profiles of ENDS aerosols containing three humectant ratios (30/70, 50/50 and 70/30, PG/VG), for three flavors (strawberry, vanilla and Catalan cream) containing either 12 or 18 mg/mL of nicotine. Additionally, we examined the in vitro toxicity of the strawberry- and vanilla-flavored ENDS aerosol in human lung epithelial cells (BEAS-2B) exposed at the air-liquid interface for 1 h. For strawberry- and vanilla-flavored aerosols produced by a 3rd-generation ENDS device with the same PG/G ratio, the e-liquid nicotine content of 12 and 18 mg/mL did not transfer to the aerosol with substantial differences in concentrations. Our data also indicate the presence of carbonyls in all three flavored e-cig aerosols analyzed, with levels exceeding 1 µg/puff for acetone, butyraldehyde, and acetaldehyde, in strawberry-, vanilla, and Catalan cream-flavored e-cig aerosols, respectively. Furthermore, closed-system ENDS of the fourth generation emitted trace levels of carbonyls in the aerosols (<0.3 µg/puff), while open-system tank-style ENDS of the third generation produced elevated levels of harmful chemicals, including acrolein (>1 µg/puff), formaldehyde (>5 µg/puff), and m- & p-tolualdehyde (>4 µg/puff). Moreover, under non-cytotoxic conditions, BEAS-2B cells exposed to strawberry-flavored aerosols exhibited significantly increased reactive oxygen and nitric oxide species (ROS/NOS) levels in cell media compared to air controls, while vanilla-flavored ENDS aerosols up-regulated the expression of pro-inflammatory and oxidative stress markers. Our data suggest (a) that ENDS aerosol chemical composition will vary based upon the presence and concentration of the initial e-liquid ingredients, with a pronounced impact of the flavoring components; and (b) short-term exposures to flavored ENDS aerosols may impair lung cells' redox signaling in a flavor-specific manner.
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17
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Yu SJ, Kwon MK, Choi W, Son YS. Preliminary study on the effect of using heat-not-burn tobacco products on indoor air quality. ENVIRONMENTAL RESEARCH 2022; 212:113217. [PMID: 35381261 DOI: 10.1016/j.envres.2022.113217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 06/14/2023]
Abstract
In this study, the effect of the use of heat-not-burn (HnB) products on indoor air quality (IAQ) was evaluated. To do this, the concentrations of nicotine, propylene glycol (PG), and vegetable glycerin (VG) directly emitted when using HnB products were analyzed and compared to those from conventional cigarettes. Furthermore, the levels of VOCs, aldehydes, nanoparticle, and particulate matter (PM) detected when subjects used HnB products in the exposure chamber were evaluated the effect on IAQ. As a result, the range of nicotine levels transferred by HnB products (0.8-1.2 mg cigarette-1) is lower than that by conventional cigarettes (2.4-3.6 mg cigarette-1). On the other hand, the range of VG levels emitted from HnB products (3.1-5.9 mg cigarette-1) were higher than that emitted from conventional cigarettes (0.6-3.0 mg cigarette-1). In addition, although the amount generated from HnB products was small compared to those from conventional cigarettes, various kinds of VOCs, aldehydes, nanoparticle and PM were produced, and these were confirmed to affect IAQ.
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Affiliation(s)
- Seong-Ji Yu
- Division of Earth Environmental System Science, Pukyong National University, 45, Yongso-ro, Nam-gu, Busan, 48513, South Korea
| | - Min-Ku Kwon
- Division of Earth Environmental System Science, Pukyong National University, 45, Yongso-ro, Nam-gu, Busan, 48513, South Korea
| | - Wonsik Choi
- Department of Environmental Atmospheric Sciences, Pukyong National University, 45, Yongso-ro, Nam-gu, Busan, 48513, South Korea
| | - Youn-Suk Son
- Department of Environmental Engineering, Pukyong National University, 45, Yongso-ro, Nam-gu, Busan, 48513, South Korea.
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Orzabal MR, Naik VD, Lee J, Hillhouse AE, Brashear WA, Threadgill DW, Ramadoss J. Impact of E-cig aerosol vaping on fetal and neonatal respiratory development and function. Transl Res 2022; 246:102-114. [PMID: 35351623 PMCID: PMC9197928 DOI: 10.1016/j.trsl.2022.03.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/09/2022] [Accepted: 03/23/2022] [Indexed: 11/15/2022]
Abstract
Electronic cigarette (e-cig) use has increased over the past decade, and exposure to e-cig aerosols during pregnancy raises concern for maternal and fetal health. The developing fetal lung is known to be sensitive to prenatal tobacco product exposure. Utilizing a 3-pronged approach, we examined the effects of prenatal e-cig aerosols with, and without nicotine on respiratory development in a murine model. RNAseq analysis of fetal lungs revealed extensive dysregulation in gene expression. Morphologic assessment of distal airspaces in neonatal lungs display an emphysematic phenotype. Respiratory mechanics of neonates display signs of increased respiratory workload, with increased resistance and decreased compliance. These data are novel and provide evidence that prenatal e-cig exposure may result in altered lung function or development of disease.
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Affiliation(s)
- Marcus R Orzabal
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Vishal D Naik
- Department of Obstetrics & Gynecology, C.S. Mott Center for Human growth and Development, School of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Jehoon Lee
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Andrew E Hillhouse
- Institute for Genome Sciences and Society, Texas A&M University, College Station, Texas, USA
| | - Wesley A Brashear
- Institute for Genome Sciences and Society, Texas A&M University, College Station, Texas, USA
| | - David W Threadgill
- Institute for Genome Sciences and Society, Texas A&M University, College Station, Texas, USA
| | - Jayanth Ramadoss
- Department of Obstetrics & Gynecology, C.S. Mott Center for Human growth and Development, School of Medicine, Wayne State University, Detroit, Michigan, USA; Department of Physiology, School of Medicine, Wayne State University, Detroit, Michigan, USA.
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Johnson NL, Patten T, Ma M, De Biasi M, Wesson DW. Chemosensory Contributions of E-Cigarette Additives on Nicotine Use. Front Neurosci 2022; 16:893587. [PMID: 35928010 PMCID: PMC9344001 DOI: 10.3389/fnins.2022.893587] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
While rates of smoking combustible cigarettes in the United States have trended down in recent years, use of electronic cigarettes (e-cigarettes) has dramatically increased, especially among adolescents. The vast majority of e-cigarette users consume "flavored" products that contain a variety of chemosensory-rich additives, and recent literature suggests that these additives have led to the current "teen vaping epidemic." This review, covering research from both human and rodent models, provides a comprehensive overview of the sensory implications of e-cigarette additives and what is currently known about their impact on nicotine use. In doing so, we specifically address the oronasal sensory contributions of e-cigarette additives. Finally, we summarize the existing gaps in the field and highlight future directions needed to better understand the powerful influence of these additives on nicotine use.
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Affiliation(s)
- Natalie L. Johnson
- Department of Pharmacology and Therapeutics, Center for Smell and Taste, Center for Addiction Research and Education, University of Florida, Gainesville, FL, United States
| | - Theresa Patten
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Pharmacology Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Minghong Ma
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Mariella De Biasi
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Pharmacology Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Daniel W. Wesson
- Department of Pharmacology and Therapeutics, Center for Smell and Taste, Center for Addiction Research and Education, University of Florida, Gainesville, FL, United States
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Esteban-Lopez M, Perry MD, Garbinski LD, Manevski M, Andre M, Ceyhan Y, Caobi A, Paul P, Lau LS, Ramelow J, Owens F, Souchak J, Ales E, El-Hage N. Health effects and known pathology associated with the use of E-cigarettes. Toxicol Rep 2022; 9:1357-1368. [PMID: 36561957 PMCID: PMC9764206 DOI: 10.1016/j.toxrep.2022.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 12/25/2022] Open
Abstract
In recent years, new nicotine delivery methods have emerged, and many users are choosing electronic cigarettes (e-cigarettes) over traditional tobacco cigarettes. E-cigarette use is very popular among adolescents, with more than 3.5 million currently using these products in the US. Despite the increased prevalence of e-cigarette use, there is limited knowledge regarding the health impact of e-cigarettes on the general population. Based on published findings by others, E-cigarette is associated with lung injury outbreak, which increased health and safety concerns related to consuming this product. Different components of e-cigarettes, including food-safe liquid solvents and flavorings, can cause health issues related to pneumonia, pulmonary injury, and bronchiolitis. In addition, e-cigarettes contain alarmingly high levels of carcinogens and toxicants that may have long-lasting effects on other organ systems, including the development of neurological manifestations, lung cancer, cardiovascular disorders, and tooth decay. Despite the well- documented potential for harm, e-cigarettes do not appear to increase susceptibility to SARS-CoV- 2 infection. Furthermore, some studies have found that e-cigarette users experience improvements in lung health and minimal adverse effects. Therefore, more studies are needed to provide a definitive conclusion on the long-term safety of e-cigarettes. The purpose of this review is to inform the readers about the possible health-risks associated with the use of e-cigarettes, especially among the group of young and young-adults, from a molecular biology point of view.
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Key Words
- AEC, airway epithelial cells
- AM, alveolar macrophages
- BAL, bronchial alveolar lavage
- CC16, Clara cell protein 16
- CM, cardiomyocyte
- CNS, central nervous system
- COPD, chronic obstructive pulmonary disease
- CS, cigarette smoke
- CSC, Cancer Stem Cell
- CYP, cytochrome P450
- E-cigarettes
- E2F1, E2F transcription factor 1
- EMT, epithelial-to-mesenchymal transition
- ENDS, electronic nicotine delivery system
- EVALI
- EVALI, e-cigarette or vaping product use-associated lung injury
- FDA, Food and Drug Administration
- FOXO3, forkhead box O3
- HNSCC, head and neck squamous cancer cells
- HUVEC, human umbilical vein endothelial cells
- Health risks
- IL, interleukin
- LDL, low-density lipoprotein
- MCP-1, monocyte chemoattractant protein-1
- MMP9, matrix metallopeptidase 9
- MPP, Mycoplasma pneumoniae pneumonia
- NET, neutrophil extracellular traps
- NK, natural killer
- NOX, NADPH oxidase
- NQO-1, NAD(P)H quinone dehydrogenase 1
- Nicotine
- Nrf2, nuclear factor erythroid 2-related factor 2
- OGG1/2, 8-oxoguanine glycosylase
- OS, oxidative stress
- Oct4,, Octamer-binding transcription factor 4
- PAFR, platelet-activating factor receptor
- PAHs, polycyclic aromatic hydrocarbons
- PG, propylene glycol
- ROS, reactive oxygen species
- Sox2,, SRY (sex determining region Y)-box 2
- THC, Tetrahydrocannabinol
- TNF‐α, tumor necrosis factor alpha
- VAPI, vaping-associated pulmonary injury
- VG, vegetable glycerin
- Vaping
- XPC, xeroderma pigmentosum complementation group C
- Yap1, Yes associated protein 1
- ZEB, zinc finger E-box binding homeobox
- ZO-1, zonula occludens-1
- e-cigarettes, electronic cigarettes
- e-liquid, e-cigarette liquid
- e-vapor, e-cigarette vapor
- iPSC-EC, induced pluripotent stem cell-derived endothelial cells
- pAMPK, phospho-AMP-activated protein kinase
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Affiliation(s)
- Maria Esteban-Lopez
- Departments of Human and Molecular Genetics, Florida International University, Miami, FL 33199, USA
| | - Marissa D. Perry
- Immunology and Nano-medicine, Florida International University, Miami, FL 33199, USA
| | - Luis D. Garbinski
- Cell Biology and Pharmacology and Florida International University, Miami, FL 33199, USA
| | - Marko Manevski
- Immunology and Nano-medicine, Florida International University, Miami, FL 33199, USA
| | - Mickensone Andre
- Immunology and Nano-medicine, Florida International University, Miami, FL 33199, USA
| | - Yasemin Ceyhan
- Departments of Human and Molecular Genetics, Florida International University, Miami, FL 33199, USA
| | - Allen Caobi
- Immunology and Nano-medicine, Florida International University, Miami, FL 33199, USA
| | - Patience Paul
- Translational Glycobiology, Florida International University, Miami, FL 33199, USA
| | - Lee Seng Lau
- Translational Glycobiology, Florida International University, Miami, FL 33199, USA
| | - Julian Ramelow
- Herbert Wertheim College of Medicine, Biological Sciences in the College of Arts, Science and Education and the Biomolecular Sciences Institute, Florida International University, Miami, FL 33199, USA
| | - Florida Owens
- Immunology and Nano-medicine, Florida International University, Miami, FL 33199, USA
| | - Joseph Souchak
- Translational Glycobiology, Florida International University, Miami, FL 33199, USA
| | - Evan Ales
- Translational Glycobiology, Florida International University, Miami, FL 33199, USA
| | - Nazira El-Hage
- Immunology and Nano-medicine, Florida International University, Miami, FL 33199, USA,Correspondence to: Department of Immunology and Nanomedicine, Florida International University, Herbert Wertheim College of Medicine, Miami, FL 33199, USA.
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21
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Virgili F, Nenna R, Ben David S, Mancino E, Di Mattia G, Matera L, Petrarca L, Midulla F. E-cigarettes and youth: an unresolved Public Health concern. Ital J Pediatr 2022; 48:97. [PMID: 35701844 PMCID: PMC9194784 DOI: 10.1186/s13052-022-01286-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/25/2022] [Indexed: 11/11/2022] Open
Abstract
The use of electronic cigarettes (e-cigarette) and vaping devices started as a potential aid for cessation and reducing the harmful consequences of cigarette smoking, mainly in the adult population. Today e-cigarette use is highly increasing in vulnerable populations, especially young and pregnant women, due to the misconception of its harmless use. Despite the growing acknowledgment in e-cigarette as a potential harmful device, and due to mixed information found concerning its beneficial aid for smokers, along with an insufficient clinical study done in human models, it is important to further evaluate the possible benefits and risks of non-combusting, vaping nicotine or non-nicotine delivery devices. In this review we tried to summarize the latest updated information found in the literature, concentrating mainly in the variety of adverse effects of e-cigarette use and its contribution for recent and future health concerns.
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Affiliation(s)
- Fabrizio Virgili
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Raffaella Nenna
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Shira Ben David
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Enrica Mancino
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Greta Di Mattia
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Luigi Matera
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Laura Petrarca
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Fabio Midulla
- Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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22
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Collaco JM, McGrath-Morrow SA. Developmental Effects of Electronic Cigarette Use. Compr Physiol 2022; 12:3337-3346. [PMID: 35578965 DOI: 10.1002/cphy.c210018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Electronic cigarettes have gained widespread acceptance among adolescents and young adults. As a result of this popularity, there are concerns regarding the potential harm of primary, secondhand and thirdhand electronic cigarette exposures on fetal and postnatal development. In vitro studies have shown that constituents in electronic cigarette liquids, including nicotine, flavorings, and carrier agents can alter cellular processes and growth. Additionally, aerosolized electronic cigarette emissions have been shown to disrupt organ development and immune responses in preclinical studies. In clinical studies, an association between electronic cigarette use and frequent respiratory symptoms, greater asthma severity and impaired mucociliary clearance has been demonstrated with adolescent and young adult users of electronic cigarettes having twice the frequency of cough, mucus production, or bronchitis compared to nonusers. Along with the popularity of electronic cigarette use, secondhand electronic cigarette exposure has increased substantially; with almost one-fourth of middle and high school children reporting exposure to secondhand vapors. The health consequences of secondhand electronic cigarette exposure on children and other vulnerable populations are poorly understood but detectable levels of cotinine have been measured in nonusers. Pregnant women and their offspring are another vulnerable group at increased risk for health consequences from electronic cigarette exposure. Nicotine crosses the placenta and can disrupt brain and lung development in preclinical studies. This article will focus on the physiological and health effects associated with primary or secondhand exposure to electronic cigarettes. It is expected that with ongoing availability of electronic cigarettes as well as the accumulation of additional follow-up time for long-term outcomes, the risks associated with exposure will become better clarified. © 2022 American Physiological Society. Compr Physiol 12:3337-3346, 2022.
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Affiliation(s)
- Joseph M Collaco
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
| | - Sharon A McGrath-Morrow
- Division of Pediatric Pulmonology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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23
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Su WC, Lin YH, Wong SW, Chen JY, Lee J, Buu A. Estimation of the dose of electronic cigarette chemicals deposited in human airways through passive vaping. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:1008-1016. [PMID: 34239037 PMCID: PMC8595527 DOI: 10.1038/s41370-021-00362-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Existing studies on the health effects of e-cigarettes focused on e-cigarette users themselves. To study the corresponding effects on passive vapers, it is crucial to quantify e-cigarette chemicals deposited in their airways. OBJECTIVE This study proposed an innovative approach to estimate the deposited dose of e-cigarette chemicals in the passive vapers' airways. The effect of the distance between active and passive vapers on the deposited dose was also examined. METHODS The chemical constituent analysis was conducted to detect Nicotine and flavoring agents in e-cigarette aerosol. The Mobile Aerosol Lung Deposition Apparatus (MALDA) was employed to conduct aerosol respiratory deposition experiments in real-life settings to generate real-time data. RESULTS For e-cigarette aerosol in the ultrafine particle regime, the deposited doses in the alveolar region were on average 3.2 times higher than those in the head-to-TB airways, and the deposited dose in the passive vaper's airways increased when being closer to the active vaper. SIGNIFICANCE With prolonged exposure and close proximity to active vapers, passive vapers may be at risk for potential health effects of harmful e-cigarette chemicals. The methodology developed in this study has laid the groundwork for future research on exposure assessment and health risk analysis for passive vaping.
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Affiliation(s)
- Wei-Chung Su
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Ying-Hsuan Lin
- Department of Environmental Sciences, University of California, Riverside, CA, USA
- Environmental Toxicology Graduate Program, University of California, Riverside, CA, USA
| | - Su-Wei Wong
- Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Jin Y Chen
- Environmental Toxicology Graduate Program, University of California, Riverside, CA, USA
| | - Jinho Lee
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Anne Buu
- Department of Health Promotion & Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
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24
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Struik L, Yang Y. e-Cigarette Cessation: Content Analysis of a Quit Vaping Community on Reddit. J Med Internet Res 2021; 23:e28303. [PMID: 34694229 PMCID: PMC8576600 DOI: 10.2196/28303] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/20/2021] [Accepted: 07/19/2021] [Indexed: 01/20/2023] Open
Abstract
Background e-Cigarette use, also known as vaping, has increased dramatically over the past few years, especially among younger demographics. However, researchers have found that a large number of e-cigarette users want to quit. Little is known about the unique aspects of vaping cessation, which is critical to informing the development of relevant resources and interventions for e-cigarette users who want to quit. Social media forums such as Reddit provide opportunities to understand the experiences of behavior change such as quitting vaping from the perspective of end users. Objective This study aims to examine a quit vaping subreddit to understand how e-cigarette users are experiencing and approaching vaping cessation. Specifically, we examine methods used to approach quitting, reasons for quitting, and barriers and facilitators to quitting. Methods A total of 1228 posts were collected. The posts were inductively coded to generate categories and subcategories using conventional content analysis. Data were analyzed using the NVivo 12 qualitative data analysis software. Results Most users reported a preference for approaching quitting through gradual reduction, particularly through the use of their own devices by tapering the nicotine content. Their reasons for quitting were primarily related to experiencing negative physical consequences associated with vaping, especially in relation to their lungs (eg, tight chest), and tired of feeling stuck to the vape because of nicotine addiction. Top barriers to quitting were related to withdrawal symptoms and intensity of addiction. The top facilitators to quitting were related to using distraction techniques (eg, hobby, gaming, and mindfulness exercises), as well as having a positive mindset. Conclusions The findings of this study reveal unique aspects that encompass the process of quitting vaping. These findings have significant implications for both policy and intervention development.
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Affiliation(s)
- Laura Struik
- School of Nursing, Department of Health and Social Development, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Youjin Yang
- School of Nursing, Department of Health and Social Development, University of British Columbia Okanagan, Kelowna, BC, Canada
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25
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Briggs K, Bell C, Breik O. What should every dental health professional know about electronic cigarettes? Aust Dent J 2021; 66:224-233. [PMID: 33428774 DOI: 10.1111/adj.12818] [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] [Accepted: 01/04/2021] [Indexed: 01/02/2023]
Abstract
Electronic cigarettes (E-cigarettes) have become increasingly popular around the world. Currently, dental professionals' knowledge and attitudes are varied with many clinicians unclear regarding the impact of E-cigarette products on the oral and general health of their patients. With developing social and health-related challenges, advice of dental and medical associations and other regulatory bodies on E-cigarette use is changing. Growing evidence demonstrating the risks of E-cigarette usage has prompted a review of legislation in the United Kingdom (UK), United States of America (USA), Australia and Canada to include the sale and availability of E-cigarettes, particularly those containing nicotine. Further consideration within the scientific and public health community is being given to assessing demographic usage patterns particularly uptake by non-smokers and adolescents, efficacy as a cessation tool, the impact of vapour on bystanders and direct injuries via explosions as well as emerging lung injuries. This article aims to provide a summary of the most up to date evidence relating to E-cigarette use, the latest position of dental associations and the oral health implications of E-cigarettes compared to conventional smoking. The article also aims to collate this information in order to provide dental clinicians with guidance on how to advise patients, specifically in answering common questions posed regarding E-cigarette use.
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Affiliation(s)
- K Briggs
- General Dentist, Private Practice, Brisbane, Australia
| | - C Bell
- Associate Specialist Oral and Maxillofacial Surgery, Bristol University Hospitals Trust, Bristol, United Kingdom
| | - O Breik
- Oral and Maxillofacial Surgeon, Royal Brisbane and Women's Hospital, Brisbane, Australia
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26
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DeVito EE, Jensen KP, O'Malley SS, Gueorguieva R, Krishnan-Sarin S, Valentine G, Jatlow PI, Sofuoglu M. Modulation of "Protective" Nicotine Perception and Use Profile by Flavorants: Preliminary Findings in E-cigarettes. Nicotine Tob Res 2020; 22:771-781. [PMID: 30995302 DOI: 10.1093/ntr/ntz057] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 04/11/2019] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Characterizing flavors are widely available in e-cigarettes and motivate initiation and continued use. Flavors may enhance appeal and facilitate development of addiction to tobacco products through modulation of tobacco products' reinforcing or aversive actions. Palatable flavors (eg, fruit) may increase appeal through primary reinforcing properties. Menthol's cooling and anesthetic effects may increase appeal by counteracting nicotine's aversive effects. Genetics provide a method for modeling individual differences in sensitivity to nicotine's effects. A common polymorphism, rs16969968, encoded in the α5 nicotinic acetylcholine receptor subunit gene (CHRNA5), is a well-recognized marker for smoking risk and reduces sensitivity to nicotine aversiveness. METHODS This pilot study tested how flavors impacted e-cigarette appeal and self-administration. In a single testing day, cigarette smokers (N = 32; 94% menthol-smokers) self-administered e-cigarettes containing e-liquids differing in nicotine level (0 mg/mL, 24 mg/mL) and flavor (unflavored, menthol, fruit-flavored) within directed and ad libitum e-cigarette paradigms. Subjective drug effects, number of puffs, rs16969968 genotype, plasma nicotine, and menthol glucuronide levels were collected. RESULTS Menthol partially ameliorated nicotine aversiveness; fruit did not. In nicotine's absence, fruit flavor increased self-reported preference and ad libitum use relative to menthol-containing or unflavored e-liquids. Individuals with high-smoking-risk rs16969968 genotype (N = 7) reported greater craving alleviation following directed administration of nicotine-containing e-liquids, showed a trend rating nicotine-containing e-liquids as less harsh, and self-administered more nicotine during ad libitum compared to individuals with low-smoking-risk genotype (N = 23). CONCLUSIONS While menthol countered aversiveness of nicotine-containing e-liquids, fruit flavor increased appeal of nicotine-free e-liquids. These preliminary findings suggest menthol and fruit flavor increase e-cigarettes' appeal through distinct mechanisms. IMPLICATIONS This study provides a detailed characterization of the effects of flavors (unflavored, menthol, fruit), nicotine (0 mg/mL, 24 mg/mL) and their interactions on the subjective drug effects and ad libitum self-administration of e-cigarettes. Genetics were used to assess these effects in higher-smoking-risk (diminished sensitivity to nicotine aversiveness) and lower-risk groups. Findings could inform impact of regulation of flavors or nicotine in e-cigarettes, and their impacts on vulnerable sub-populations.
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Affiliation(s)
- Elise E DeVito
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Kevin P Jensen
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT.,VA Connecticut Healthcare System, West Haven, CT
| | | | - Ralitza Gueorguieva
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT.,Department of Biostatistics, Yale School of Public Health, New Haven, CT
| | | | - Gerald Valentine
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT.,VA Connecticut Healthcare System, West Haven, CT
| | - Peter I Jatlow
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT.,Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT.,VA Connecticut Healthcare System, West Haven, CT
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27
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Pullicin AJ, Kim H, Brinkman MC, Buehler SS, Clark PI, Lim J. Impacts of Nicotine and Flavoring on the Sensory Perception of E-Cigarette Aerosol. Nicotine Tob Res 2020; 22:806-813. [PMID: 30997500 DOI: 10.1093/ntr/ntz058] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 04/12/2019] [Indexed: 12/29/2022]
Abstract
INTRODUCTION To examine the interaction between an added flavoring (cherry) and nicotine on the perception of electronic cigarette (e-cigarette) aerosol and how this impacts the appeal of flavored liquids for e-cigarette (e-liquids). METHODS A total of 19 subjects (13 male, 6 female) vaped six commercially available e-liquids with varying contents of nicotine (0, 6, 12 mg/mL) and cherry flavor (4.7% or 9.3% vol/vol). For each e-liquid, subjects first rated overall liking/disliking of the aerosol using the Labeled Hedonic Scale, followed by perceived intensities of sweetness, bitterness, harshness (irritation), and cherry flavor of the aerosol using the general version of Labeled Magnitude Scale. RESULTS The main findings were that (1) added nicotine increased perceived irritation and bitterness, and decreased the perceived sweetness of the e-cigarette aerosol; (2) cherry flavoring added a characteristic "cherry flavor" and an increase in the flavoring concentration from 4.7% to 9.3% tended to increase perceived intensities of sweetness, harshness, and bitterness; and (3) hedonic ratings of the e-cigarette aerosol decreased as nicotine level increased, but were not affected by flavor level. CONCLUSIONS Our findings indicate that the appeal of the e-cigarette aerosol decreases as nicotine concentration increases. Conversely, perceived sweetness improved liking. An increase in the concentration of cherry flavoring did not appear to impact any of the measured attributes to a significant degree. IMPLICATIONS This work demonstrates that the perception of specific sensory attributes of e-cigarettes and their overall appeal are affected by the e-liquid constituents. Most significantly, the results suggest that nicotine decreases the sensory appeal of e-cigarettes by contributing to the perceived irritation and bitterness of the aerosol. These data have implications for the role that nicotine plays in the sensory perception and appeal of e-cigarettes aerosol and further how these sensory factors can be modulated by sweet flavoring.
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Affiliation(s)
- Alexa J Pullicin
- Department of Food Science and Technology, Oregon State University, Corvallis, OR
| | - Hyoshin Kim
- Battelle Public Health Center for Tobacco Research, Battelle Memorial Institute, Seattle, WA
| | | | - Stephanie S Buehler
- Battelle Public Health Center for Tobacco Research, Battelle Memorial Institute, Columbus, OH
| | - Pamela I Clark
- School of Public Health, University of Maryland, College Park, MD
| | - Juyun Lim
- Department of Food Science and Technology, Oregon State University, Corvallis, OR
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28
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Blank MD, Pearson J, Cobb CO, Felicione NJ, Hiler MM, Spindle TR, Breland A. What factors reliably predict electronic cigarette nicotine delivery? Tob Control 2020; 29:644-651. [PMID: 31685583 PMCID: PMC8029495 DOI: 10.1136/tobaccocontrol-2019-055193] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/05/2019] [Accepted: 09/24/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND The ability of an electronic cigarette (e-cigarette) to deliver nicotine effectively may be dependent on features of the device, the liquid and the user. Some of these features have been examined in previous work (eg, liquid nicotine concentration and puff topography), while others have not (eg, nicotine dependence and demographic characteristics). The purpose of this secondary analysis is to examine such features as predictors of e-cigarette nicotine delivery using a relatively large sample. METHODS Four studies were combined in which e-cigarette-experienced users (n=63; 89% men; 75% white) and e-cigarette-naïve cigarette smokers (n=67; 66% men; 54% white) took 10 puffs from an eGo-style e-cigarette (~7.3 watts) filled with liquid that had a nicotine concentration of 18, 25 or 36 mg/mL. Thus, held constant across all studies were device features of battery/cartomiser style and power level and the topography parameters of puff number and interpuff interval. Blood was sampled before and after use, and puff topography was measured. Three general linear models were conducted to predict plasma nicotine concentrations (pre-post increase) for: (1) e-cigarette users only, (2) smokers only and (3) both groups combined. Predictor variables included puff duration, puff volume, liquid nicotine concentration, presession plasma nicotine concentration, nicotine dependence score (smokers only), gender and race. RESULTS In all models tested, longer puff durations and higher liquid nicotine concentrations were associated significantly with increased nicotine delivery (ps<0.05). For e-cigarette users only, higher presession nicotine concentration was associated significantly with increased nicotine delivery (p<0.05). CONCLUSIONS Puff duration and liquid nicotine concentration may be among the more important factors to consider as regulators attempt to balance e-cigarette safety with efficacy. These findings should be interpreted in the context of devices with relatively low power output, a variable not studied here but likely also directly relevant to product regulation.
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Affiliation(s)
- Melissa D Blank
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Jennifer Pearson
- Division of Social and Behavioral Science/Health Administration and Policy, University of Nevada Reno, Reno, Nevada, USA
- Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Caroline O Cobb
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nicholas J Felicione
- Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Marzena M Hiler
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Tory R Spindle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alison Breland
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
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29
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Luo J, Chen L, Lu X, Yuan J, Xie Z, Li D. Analysis of potential associations of JUUL flavours with health symptoms based on user-generated data from Reddit. Tob Control 2020; 30:534-541. [PMID: 32709604 DOI: 10.1136/tobaccocontrol-2019-055439] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 05/22/2020] [Accepted: 05/27/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND The rise of the popular e-cigarette, JUUL, has been partly attributed to various teen-friendly e-liquid flavours offered. However, the possible health risks associated with each e-liquid flavour still remain unclear. This research focuses on the possible associations between JUUL flavours and health symptoms using social media data from Reddit. METHODS Keyword filtering was used to obtain 5,746 JUUL flavour-related posts and 7927 health symptom-related posts from June 2015 to April 2019 from Reddit. Posts from September 2016 to April 2019 were used to conduct temporal analysis for nine health symptom categories and the 8 JUUL flavours. Finally, associations between the JUUL flavours and health symptom categories were examined on the user level using generalised estimating equation models. RESULTS According to our temporal analysis, Mango and Mint were the most discussed JUUL flavours on Reddit. Respiratory and throat symptoms were the most discussed health issues together with JUUL on Reddit over time. Respiratory symptoms had potential associations with the Mango, Mint and Fruit JUUL flavours. Digestive symptoms had a potential association with the Crème flavour, psychological symptoms had a potential association with the Cucumber flavour, and cardiovascular symptoms had a potential association with the tobacco flavours. CONCLUSIONS Mango and Mint were the two most mentioned JUUL flavours on Reddit. Certain JUUL flavours were more likely to be mentioned together with certain categories of health symptoms by the same Reddit users. Our findings could prompt further medical research into the health symptoms associated with different e-liquid flavours.
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Affiliation(s)
- Joyce Luo
- Department of Operations Research & Financial Engineering, Princeton University, Princeton, New Jersey, USA
| | - Long Chen
- Department of Computer Science, University of Rochester, Rochester, New York, USA
| | - Xinyi Lu
- Goergen Institute for Data Science, University of Rochester, Rochester, New York, USA
| | - Jianbo Yuan
- Department of Computer Science, University of Rochester, Rochester, New York, USA
| | - Zidian Xie
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, New York, USA
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, New York, USA
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30
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Liu H, Li Q, Zhan Y, Zhang Z, Zeng DD, Leischow SJ. Characterizing Social Media Messages Related to Underage JUUL E-Cigarette Buying and Selling: Cross-Sectional Analysis of Reddit Subreddits. J Med Internet Res 2020; 22:e16962. [PMID: 32706661 PMCID: PMC7400041 DOI: 10.2196/16962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 05/26/2020] [Accepted: 06/25/2020] [Indexed: 01/18/2023] Open
Abstract
Background Stopping the epidemic of e-cigarette use among youth has become the common goal of both regulatory authorities and health departments. JUUL is currently the most popular e-cigarette brand on the market. Young people usually obtain and exchange information about JUUL with the help of social media platforms. Along with the rising prevalence of JUUL, posts about underage JUUL buying and selling have appeared on social media platforms such as Reddit, which sharply increase the risk of minors being exposed to JUUL. Objective This study aims to analyze Reddit messages about JUUL buying and selling among the users of the UnderageJuul subreddit, and to further summarize the characteristics of those messages. The findings and insights can contribute to a better understanding of the patterns of underage JUUL use, and help public health officials provide timely education and guidance to minors who have intentions of accessing JUUL. Methods We used a novel cross-subreddit method to analyze the Reddit messages on 2 subreddits. From July 9, 2017, to January 7, 2018, we collected data from the UnderageJuul subreddit, which was created for underage JUUL use discussion. The data set included 716 threads, 2935 comments, and 844 Reddit users (ie, Redditors). We collected our second data set, comprising 23,840 threads and 162,106 comments posted between July 9, 2017, and January 8, 2019, from the JUUL subreddit. We conducted analyses including the following: (1) annotation of users with buying/selling intention, (2) posting patterns discovery and topic comparison, and (3) posting activeness observation of discovered Redditors. Term frequency–inverse document frequency and regular expression-enhanced keyword search methods were applied during the content analysis to extract the posting patterns. The public posting records of the discovered users on the JUUL subreddit during the year after the UnderageJuul subreddit was shut down were analyzed to determine whether they were still active and interested in obtaining JUUL. Results Our study revealed the following: (1) Among the 716 threads on the UnderageJuul subreddit, there were 214 threads related to JUUL sale and 168 threads related to JUUL purchase, which accounted for 53.5% (382/714) of threads. (2) Among the 844 Redditors of the UnderageJuul subreddit, 23.82% (201/844) of users were annotated with buying intention, and 21.10% (178/844) of users were annotated with selling intention. There were 34 users with buying/selling intention that self-reported as being <21 years old. (3) The most common key phrases used in selling threads were “WTS,” “want to sell,” “for sale,” and “selling” (154/214, 72.0%). The most common key phrases used in buying threads were “look for/get JUUL/pods” (58/168, 34.5%) and “WTB” (53/168, 31.5%). (4) The most important concern that UnderageJuul Redditors had in obtaining JUULs was the price (311/1306, 23.81%), followed by the delivery service (68/1306, 5.21%). (5) The most popular flavors among the users with buying/selling intention were mango, cucumber, and mint. The flavor preferences remained consistent on both subreddits. Adverse symptoms related to the mango flavor were reported by 3 users on the JUUL subreddit. (6) In total, 24.4% (49/201) of users wanted to buy JUULs and 46.6% (83/178) of users wanted to sell JUULs, including 11 self-reported underage users, who also participated in the discussions on the JUUL subreddit. (7) Within one year of the UnderageJuul subreddit shutting down, there were 40 users who continued to post 186 threads on the JUUL subreddit, including 10 threads indicating buying/selling willingness that were posted shortly after the UnderageJuul subreddit was closed. Conclusions There were overlapping users active in the JUUL and UnderageJuul subreddits. The buying/selling-related content appeared in multiple venues with certain posting patterns from July 9, 2017, to January 7, 2018. Such content might lead to a high risk of health problems for minors, such as nicotine addiction. Based on these findings, this study provided some insights and suggestions that might contribute to the decision-making processes of regulators and public health officials.
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Affiliation(s)
- Hejing Liu
- The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China
| | - Qiudan Li
- The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Shenzhen Artificial Intelligence and Data Science Institute (Longhua), Shenzhen, China
| | - Yongcheng Zhan
- Orfalea College of Business, California Polytechnic State University, San Luis Obispo, CA, United States
| | - Zhu Zhang
- The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,Shenzhen Artificial Intelligence and Data Science Institute (Longhua), Shenzhen, China
| | - Daniel D Zeng
- The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,School of Artificial Intelligence, University of Chinese Academy of Sciences, Beijing, China.,Shenzhen Artificial Intelligence and Data Science Institute (Longhua), Shenzhen, China
| | - Scott J Leischow
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
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Jiang H, Ahmed CMS, Martin TJ, Canchola A, Oswald IWH, Garcia JA, Chen JY, Koby KA, Buchanan AJ, Zhao Z, Zhang H, Chen K, Lin YH. Chemical and Toxicological Characterization of Vaping Emission Products from Commonly Used Vape Juice Diluents. Chem Res Toxicol 2020; 33:2157-2163. [PMID: 32618192 DOI: 10.1021/acs.chemrestox.0c00174] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Recent reports have linked severe lung injuries and deaths to the use of e-cigarettes and vaping products. Nevertheless, the causal relationship between exposure to vaping emissions and the observed health outcomes remains to be elucidated. Through chemical and toxicological characterization of vaping emission products, this study demonstrates that during vaping processes, changes in chemical composition of several commonly used vape juice diluents (also known as cutting agents) lead to the formation of toxic byproducts, including quinones, carbonyls, esters, and alkyl alcohols. The resulting vaping emission condensates cause inhibited cell proliferation and enhanced cytotoxicity in human airway epithelial cells. Notably, substantial formation of the duroquinone and durohydroquinone redox couple was observed in the vaping emissions from vitamin E acetate, which may be linked to acute oxidative stress and lung injuries reported by previous studies. These findings provide an improved molecular understanding and highlight the significant role of toxic byproducts in vaping-associated health effects.
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Affiliation(s)
- Huanhuan Jiang
- Department of Environmental Sciences, University of California, Riverside, California 92521, United States.,Department of Chemical and Environmental Engineering, University of California, Riverside, California 92521, United States
| | - C M Sabbir Ahmed
- Environmental Toxicology Graduate Program, University of California, Riverside, California 92521, United States
| | - Thomas J Martin
- Abstrax Tech, 15550 Rockfield Boulevard, Suite B120, Irvine, California 92618, United States
| | - Alexa Canchola
- Environmental Toxicology Graduate Program, University of California, Riverside, California 92521, United States
| | - Iain W H Oswald
- Abstrax Tech, 15550 Rockfield Boulevard, Suite B120, Irvine, California 92618, United States
| | - Jose Andres Garcia
- Department of Chemical and Environmental Engineering, University of California, Riverside, California 92521, United States
| | - Jin Y Chen
- Environmental Toxicology Graduate Program, University of California, Riverside, California 92521, United States
| | - Kevin A Koby
- Abstrax Tech, 15550 Rockfield Boulevard, Suite B120, Irvine, California 92618, United States
| | - Anthony J Buchanan
- SepSolve Analytical Ltd., 4 Swan Court, Forder Way, Peterborough, Cambridgeshire, PE7 8GX, United Kingdom
| | - Zixu Zhao
- Department of Chemistry, University of California, Riverside, California 92521, United States
| | - Haofei Zhang
- Department of Chemistry, University of California, Riverside, California 92521, United States
| | - Kunpeng Chen
- Department of Environmental Sciences, University of California, Riverside, California 92521, United States
| | - Ying-Hsuan Lin
- Department of Environmental Sciences, University of California, Riverside, California 92521, United States.,Environmental Toxicology Graduate Program, University of California, Riverside, California 92521, United States
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Jackson A, Grobman B, Krishnan-Sarin S. Recent findings in the pharmacology of inhaled nicotine: Preclinical and clinical in vivo studies. Neuropharmacology 2020; 176:108218. [PMID: 32592708 DOI: 10.1016/j.neuropharm.2020.108218] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/13/2020] [Accepted: 06/17/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The rise of vaping in adolescents, the recent entrance of new inhaled nicotine products such as iQOS on the market and e-cigarette or vaping product use-associated lung injury cases has created concern for the use of inhaled non-combustible nicotine products. This narrative review discusses recent experimental in vivo studies that utilize human, rat and mouse models to understand the pharmacological impact of nicotine from non-combustible products. METHODS The search engine PubMed was utilized with the following search terms: inhaled nicotine, nicotine e-cigarette, heated tobacco products, iQOS, electronic cigarette, nicotine inhaler, nicotine vaping. This review highlights recent primary in vivo studies of inhaled nicotine administration experimental paradigms that occurred in laboratory settings using human and rodent (rats and mice) models that have been published from January 2017-December 2019. RESULTS The pharmacokinetics of nicotine via e-cigarettes is influenced by the PG/VG and flavor constituents in e-liquids, the presence of nicotine salts in e-liquids, puff topography of nicotine and tobacco product users and the power of the e-cigarette device. The pharmacodynamic impact of inhaled nicotine has cardiovascular, pulmonary and central nervous system implications. CONCLUSION The articles reviewed here highlight the importance of both animal and human models to fully understand the impact of inhaled nicotine pharmacology There is a need for more rodent pharmacokinetic inhaled nicotine studies to understand the influences of factors such as flavor and nicotine salts. Additionally, consensus on nicotine measurement in both human and rodent studies is greatly needed.
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Affiliation(s)
- Asti Jackson
- Department of Psychiatry, Yale School of Medicine, United States.
| | - Ben Grobman
- Department of Psychiatry, Yale School of Medicine, United States
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Chen L, Lu X, Yuan J, Luo J, Luo J, Xie Z, Li D. A Social Media Study on the Associations of Flavored Electronic Cigarettes With Health Symptoms: Observational Study. J Med Internet Res 2020; 22:e17496. [PMID: 32568093 PMCID: PMC7338924 DOI: 10.2196/17496] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/22/2020] [Accepted: 04/10/2020] [Indexed: 12/16/2022] Open
Abstract
Background In recent years, flavored electronic cigarettes (e-cigarettes) have become popular among teenagers and young adults. Discussions about e-cigarettes and e-cigarette use (vaping) experiences are prevalent online, making social media an ideal resource for understanding the health risks associated with e-cigarette flavors from the users’ perspective. Objective This study aimed to investigate the potential associations between electronic cigarette liquid (e-liquid) flavors and the reporting of health symptoms using social media data. Methods A dataset consisting of 2.8 million e-cigarette–related posts was collected using keyword filtering from Reddit, a social media platform, from January 2013 to April 2019. Temporal analysis for nine major health symptom categories was used to understand the trend of public concerns related to e-cigarettes. Sentiment analysis was conducted to obtain the proportions of positive and negative sentiment scores for all reported health symptom categories. Topic modeling was applied to reveal the topics related to e-cigarettes and health symptoms. Furthermore, generalized estimating equation (GEE) models were used to quantitatively measure potential associations between e-liquid flavors and the reporting of health symptoms. Results Temporal analysis showed that the Respiratory category was consistently the most discussed health symptom category among all categories related to e-cigarettes on Reddit, followed by the Throat category. Sentiment analysis showed higher proportions of positive sentiment scores for all reported health symptom categories, except for the Cancer category. Topic modeling conducted on all health-related posts showed that 17 of the top 100 topics were flavor related. GEE models showed different associations between the reporting of health symptoms and e-liquid flavor categories, for example, lower association of the Beverage flavors with Respiratory compared with other flavors and higher association of the Fruit flavors with Cardiovascular than other flavors. Conclusions This study identified different potential associations between e-liquid flavors and the reporting of health symptoms using social media data. The results of this study provide valuable information for further investigation of the health effects associated with different e-liquid flavors.
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Affiliation(s)
- Long Chen
- University of Rochester, Rochester, NY, United States
| | - Xinyi Lu
- University of Rochester, Rochester, NY, United States
| | - Jianbo Yuan
- University of Rochester, Rochester, NY, United States
| | - Joyce Luo
- Princeton University, Princeton, NJ, United States
| | - Jiebo Luo
- University of Rochester, Rochester, NY, United States
| | - Zidian Xie
- University of Rochester Medical Center, Rochester, NY, United States
| | - Dongmei Li
- University of Rochester Medical Center, Rochester, NY, United States
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Yang I, Sandeep S, Rodriguez J. The oral health impact of electronic cigarette use: a systematic review. Crit Rev Toxicol 2020; 50:97-127. [PMID: 32043402 DOI: 10.1080/10408444.2020.1713726] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Electronic cigarette (e-cigarette) use is becoming more prevalent and is particularly popular among adolescents and conventional smokers. While the oral health sequelae of conventional smoking are well-established, the impact of e-cigarettes on oral health is still unknown. This study aims to systematically review the available research evidence on the oral health impact of e-cigarette use.Methods: This systematic review was conducted according to PRISMA guidelines and used the Effective Public Health Practice Project Quality Assessment Tool to evaluate the evidence. Three electronic databases (PubMed, Web of Science, and Embase) were systematically searched for studies including case reports. Two independent reviewers extracted data and synthesized the findings.Results: Ninety-nine articles were included in this systematic review. Analyses of the articles yielded seven categories based on symptom similarity and/or focus: mouth effects, throat effects, periodontal effects, dental effects, cytotoxic/genotoxic/oncologic effects, oral microbiome effects, and traumatic/accidental injury. The majority of mouth and throat symptoms experienced by e-cigarette users were relatively minor and temporary, with some evidence that conventional smokers who switched to e-cigarettes experienced mitigation of these symptoms. E-cigarette exposure increased the risk for deteriorating periodontal, dental and gingival health as well as changes to the oral microbiome. Extensive dental damage as a result of e-cigarette explosions were described in case reports. Components of e-cigarette vapor have known cytotoxic, genotoxic, and carcinogenic properties.Conclusions: Although switching to e-cigarettes may mitigate oral symptomatology for conventional smokers, findings from this review suggest that a wide range of oral health sequelae may be associated with e-cigarette use. Well-designed studies to investigate oral health outcomes of e-cigarette use are needed.
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Affiliation(s)
- Irene Yang
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Shelly Sandeep
- Emory University Midtown Hospital, Emory University, Atlanta, GA, USA
| | - Jeannie Rodriguez
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
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35
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Kwon M, Park E. Perceptions and Sentiments About Electronic Cigarettes on Social Media Platforms: Systematic Review. JMIR Public Health Surveill 2020; 6:e13673. [PMID: 31939747 PMCID: PMC6996744 DOI: 10.2196/13673] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 09/23/2019] [Accepted: 09/27/2019] [Indexed: 01/02/2023] Open
Abstract
Background Electronic cigarettes (e-cigarettes) have been widely promoted on the internet, and subsequently, social media has been used as an important informative platform by e-cigarette users. Beliefs and knowledge expressed on social media platforms have largely influenced e-cigarette uptake, the decision to switch from conventional smoking to e-cigarette smoking, and positive and negative connotations associated with e-cigarettes. Despite this, there is a gap in our knowledge of people’s perceptions and sentiments on e-cigarettes as depicted on social media platforms. Objective This study aimed to (1) provide an overview of studies examining the perceptions and sentiments associated with e-cigarettes on social media platforms and online discussion forums, (2) explore people’s perceptions of e-cigarette therein, and (3) examine the methodological limitations and gaps of the included studies. Methods Searches in major electronic databases, including PubMed, Cumulative Index of Nursing and Allied Health Literature, EMBASE, Web of Science, and Communication and Mass Media Complete, were conducted using the following search terms: “electronic cigarette,” “electronic vaporizer,” “electronic nicotine,” and “electronic nicotine delivery systems” combined with “internet,” “social media,” and “internet use.” The studies were selected if they examined participants’ perceptions and sentiments of e-cigarettes on online forums or social media platforms during the 2007-2017 period. Results A total of 21 articles were included. A total of 20 different social media platforms and online discussion forums were identified. A real-time snapshot and characteristics of sentiments, personal experience, and perceptions toward e-cigarettes on social media platforms and online forums were identified. Common topics regarding e-cigarettes included positive and negative health effects, testimony by current users, potential risks, benefits, regulations associated with e-cigarettes, and attitude toward them as smoking cessation aids. Conclusions Although perceptions among social media users were mixed, there were more positive sentiments expressed than negative ones. This study particularly adds to our understanding of current trends in the popularity of and attitude toward e-cigarettes among social media users. In addition, this study identified conflicting perceptions about e-cigarettes among social media users. This suggests that accurate and up-to-date information on the benefits and risks of e-cigarettes needs to be disseminated to current and potential e-cigarette users via social media platforms, which can serve as important educational channels. Future research can explore the efficacy of social media–based interventions that deliver appropriate information (eg, general facts, benefits, and risks) about e-cigarettes. Trial Registration PROSPERO CRD42019121611; https://tinyurl.com/yfr27uxs
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Affiliation(s)
- Misol Kwon
- School of Nursing, University at Buffalo, Buffalo, NY, United States
| | - Eunhee Park
- School of Nursing, University at Buffalo, Buffalo, NY, United States
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36
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Hua M, Sadah S, Hristidis V, Talbot P. Health Effects Associated With Electronic Cigarette Use: Automated Mining of Online Forums. J Med Internet Res 2020; 22:e15684. [PMID: 31899452 PMCID: PMC6969389 DOI: 10.2196/15684] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/11/2019] [Accepted: 10/20/2019] [Indexed: 12/22/2022] Open
Abstract
Background Our previous infodemiological study was performed by manually mining health-effect data associated with electronic cigarettes (ECs) from online forums. Manual mining is time consuming and limits the number of posts that can be retrieved. Objective Our goal in this study was to automatically extract and analyze a large number (>41,000) of online forum posts related to the health effects associated with EC use between 2008 and 2015. Methods Data were annotated with medical concepts from the Unified Medical Language System using a modified version of the MetaMap tool. Of over 1.4 million posts, 41,216 were used to analyze symptoms (undiagnosed conditions) and disorders (physician-diagnosed terminology) associated with EC use. For each post, sentiment (positive, negative, and neutral) was also assigned. Results Symptom and disorder data were categorized into 12 organ systems or anatomical regions. Most posts on symptoms and disorders contained negative sentiment, and affected systems were similar across all years. Health effects were reported most often in the neurological, mouth and throat, and respiratory systems. The most frequently reported symptoms and disorders were headache (n=939), coughing (n=852), malaise (n=468), asthma (n=916), dehydration (n=803), and pharyngitis (n=565). In addition, users often reported linked symptoms (eg, coughing and headache). Conclusions Online forums are a valuable repository of data that can be used to identify positive and negative health effects associated with EC use. By automating extraction of online information, we obtained more data than in our prior study, identified new symptoms and disorders associated with EC use, determined which systems are most frequently adversely affected, identified specific symptoms and disorders most commonly reported, and tracked health effects over 7 years.
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Affiliation(s)
- My Hua
- University of California, Riverside, Riverside, CA, United States
| | - Shouq Sadah
- University of California, Riverside, Riverside, CA, United States
| | | | - Prue Talbot
- University of California, Riverside, Riverside, CA, United States
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Voos N, Kaiser L, Mahoney MC, Bradizza CM, Kozlowski LT, Benowitz NL, O'Connor RJ, Goniewicz ML. Randomized within-subject trial to evaluate smokers' initial perceptions, subjective effects and nicotine delivery across six vaporized nicotine products. Addiction 2019; 114:1236-1248. [PMID: 30851137 PMCID: PMC6646880 DOI: 10.1111/add.14602] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 01/08/2019] [Accepted: 03/04/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Vaporized nicotine products (VNPs) can vary in important characteristics including size, shape, flavor and nicotine yield. We examined whether complex interactions among these characteristics could affect smokers' VNP perceptions and usage patterns. DESIGN A within-subject randomized cross-over trial. SETTING Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA. PARTICIPANTS Eighteen daily cigarette smokers. MEASUREMENTS Participants attended eight weekly visits during which they sampled six different VNPs (disposable, rechargeable, eGO, mod, e-Cigar and e-Pipe) with tobacco-flavored e-liquid. Prior to device use, participants completed product-ranking questionnaires. Participants completed controlled puffing sessions during each of the six trials, after which satisfaction questionnaires were completed and blood samples were taken. FINDINGS Initial perceptions showed that the smallest device (disposable) was ranked as safer compared with a larger device (e-Pipe) (P < 0.05). Participants rated the eGO and mod devices higher on satisfaction and enjoyment from use, taste, pleasantness, harshness ('throat hit') and speed of effect, but lower on perceived health risk and embarrassment from use (P < 0.05). All devices had a lower Cmax than the combustible cigarette (P < 0.05), but there were differences among devices (P < 0.05). The mod, e-Pipe and eGO provided the highest amount of perceived smoking urge relief, and this correlated strongly with Cmax across all devices (R2 = 0.8614, P = 0.007). The perceived speed of urge relief was not correlated with Tmax (R2 = 0.0035, P = 0.911) CONCLUSIONS: Daily cigarette smokers testing six types of vaporized nicotine products (VNPs) reported that they varied in taste, amount of withdrawal relief, harshness, embarrassment from use, perceived health risk and subjective and objective nicotine delivery. The eGO and mod models have properties that may make them most effective for cigarette substitution among smokers who intend to switch to a VNP.
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Affiliation(s)
- Natalie Voos
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, USA
| | - Lisa Kaiser
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, USA
| | - Martin C Mahoney
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, USA
| | | | - Lynn T Kozlowski
- School of Public Health and Health Professions, University at Buffalo, NY, USA
| | - Neal L Benowitz
- Division of Clinical Pharmacology, Department of Medicine and Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, USA
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Wong SW, Lin HC, Piper ME, Siddiqui A, Buu A. Measuring characteristics of e-cigarette consumption among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:338-347. [PMID: 29979924 PMCID: PMC6320724 DOI: 10.1080/07448481.2018.1481075] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 04/03/2018] [Accepted: 05/18/2018] [Indexed: 05/21/2023]
Abstract
Objective: E-cigarette use among college students has increased drastically in recent years. This study aims to inform development of a comprehensive measure of e-cigarette consumption for this population. Participants and Methods: This mixed-method study collected both quantitative and qualitative data from a sample of 43 experienced e-cigarette users from two college campuses, using a self-reported questionnaire and a semi-structured interview, in March-September of 2017. Results: College student users found some of the consumption questions in national surveys difficult to answer. Switching nicotine levels, mixing flavors, co-using with alcohol and marijuana, using with others who were vaping or drinking, and vaping in a car or indoor space were all common. The participants defined "regular user" based on ownership of a device rather than on quantity/frequency. Conclusions: A comprehensive e-cigarette consumption measure should cover the complex characteristics that are potentially associated with negative health consequences such as flavorings, co-use and social contexts.
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Affiliation(s)
- Su-Wei Wong
- Department of Applied Health Science, School of Public Health, Indiana University, 1025 E. 7 Street, SPH 116, Bloomington, IN 47405, USA
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University, 1025 E. 7 Street, SPH 116, Bloomington, IN 47405, USA
| | - Megan E. Piper
- Center for Tobacco Research & Intervention, University of Wisconsin, 1930 Monroe Street, Suite 200, Madison, WI 53711, USA
| | - Adam Siddiqui
- Department of Health Behavior and Biological Sciences, University of Michigan, 400 North Ingalls, Ann Arbor, MI 48109, USA
| | - Anne Buu
- Department of Health Behavior and Biological Sciences, University of Michigan, 400 North Ingalls, Ann Arbor, MI 48109, USA
- Corresponding author at: 400 North Ingalls, Ann Arbor, MI 48109, USA. Tel.: +1 (734) 764-9008; fax: +1(734) 647-2416. E-mail: (Anne Buu)
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Zhan Y, Etter JF, Leischow S, Zeng D. Electronic cigarette usage patterns: a case study combining survey and social media data. J Am Med Inform Assoc 2019; 26:9-18. [PMID: 30544163 PMCID: PMC6308011 DOI: 10.1093/jamia/ocy140] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/13/2018] [Accepted: 10/09/2018] [Indexed: 11/14/2022] Open
Abstract
Objective To identify who were social media active e-cigarette users, to compare the use patterns from both survey and social media data for data triangulation, and to jointly use both datasets to conduct a comprehensive analysis on e-cigarette future use intentions. Materials and Methods We jointly used an e-cigarette use online survey (n = 5132) and a social media dataset. We conducted analysis from 3 different perspectives. We analyzed online forum participation patterns using survey data. We compared e-cigarette use patterns, including brand and flavor types, ratings, and purchase approaches, between the 2 datasets. We used logistic regression to study intentions to use e-cigarettes using both datasets. Results Male and younger e-cigarette users were the most likely to participate in e-cigarette-related discussion forums. Forum active survey participants were hardcore vapers. The e-cigarette use patterns were similar in the online survey data and the social media data. Intention to use e-cigarettes was positively related to e-liquid ratings and flavor ratings. Social media provided a valuable source of information on users' ratings of e-cigarette refill liquids. Discussion For hardcore vapers, social media data were consistent with online survey data, which suggests that social media may be useful to study e-cigarette use behaviors and can serve as a useful complement to online survey research. We proposed an innovative framework for social media data triangulation in public health studies. Conclusion We illustrated how social media data, combined with online survey data, can serve as a new and rich information source for public health research.
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Affiliation(s)
- Yongcheng Zhan
- Department of Management Information Systems, University of Arizona, Tucson, Arizona, USA
| | - Jean-François Etter
- Institute of Global Health, Faculty of Medicine, University of Geneva, Switzerland
| | - Scott Leischow
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Daniel Zeng
- Department of Management Information Systems, University of Arizona, Tucson, Arizona, USA
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Kim SA, Smith S, Beauchamp C, Song Y, Chiang M, Giuseppetti A, Frukhtbeyn S, Shaffer I, Wilhide J, Routkevitch D, Ondov JM, Kim JJ. Cariogenic potential of sweet flavors in electronic-cigarette liquids. PLoS One 2018; 13:e0203717. [PMID: 30192874 PMCID: PMC6128655 DOI: 10.1371/journal.pone.0203717] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 08/24/2018] [Indexed: 01/12/2023] Open
Abstract
Background Most electronic-cigarette liquids contain propylene glycol, glycerin, nicotine and a wide variety of flavors of which many are sweet. Sweet flavors are classified as saccharides, esters, acids or aldehydes. This study investigates changes in cariogenic potential when tooth surfaces are exposed to e-cigarette aerosols generated from well-characterized reference e-liquids with sweet flavors. Methods Reference e-liquids were prepared by combining 20/80 propylene glycol/glycerin (by volume fraction), 10 mg/mL nicotine, and flavors. Aerosols were generated by a Universal Electronic-Cigarette Testing Device (49.2 W, 0.2 Ω). Streptococcus mutans (UA159) were exposed to aerosols on tooth enamel and the biological and physiochemical parameters were measured. Results E-cigarette aerosols produced four-fold increase in microbial adhesion to enamel. Exposure to flavored aerosols led to two-fold increase in biofilm formation and up to a 27% decrease in enamel hardness compared to unflavored controls. Esters (ethyl butyrate, hexyl acetate, and triacetin) in e-liquids were associated with consistent bacteria-initiated enamel demineralization, whereas sugar alcohol (ethyl maltol) inhibited S. mutans growth and adhesion. The viscosity of the e-liquid allowed S. mutans to adhere to pits and fissures. Aerosols contained five metals (mean ± standard deviation): calcium (0.409 ± 0.002) mg/L, copper (0.011 ± 0.001) mg/L, iron (0.0051 ± 0.0003) mg/L, magnesium (0.017 ± 0.002) mg/L, and silicon (0.166 ± 0.005) mg/L. Conclusions This study systematically evaluated e-cigarette aerosols and found that the aerosols have similar physio-chemical properties as high-sucrose, gelatinous candies and acidic drinks. Our data suggest that the combination of the viscosity of e-liquids and some classes of chemicals in sweet flavors may increase the risk of cariogenic potential. Clinical investigation is warranted to confirm the data shown here.
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Affiliation(s)
- Shin Ae Kim
- Volpe Research Center, American Dental Association Foundation, Gaithersburg, Maryland, United States of America
| | - Samuel Smith
- Department of Chemical and Biological Engineering, University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Carlos Beauchamp
- National Institute of Standards and Technology, U.S. Department of Commerce, Gaithersburg, Maryland, United States of America
| | - Yang Song
- National Institute of Standards and Technology, U.S. Department of Commerce, Gaithersburg, Maryland, United States of America
| | - Martin Chiang
- National Institute of Standards and Technology, U.S. Department of Commerce, Gaithersburg, Maryland, United States of America
| | - Anthony Giuseppetti
- Volpe Research Center, American Dental Association Foundation, Gaithersburg, Maryland, United States of America
| | - Stanislav Frukhtbeyn
- Volpe Research Center, American Dental Association Foundation, Gaithersburg, Maryland, United States of America
| | - Ian Shaffer
- Molecular Characterization and Analysis Complex, University of Maryland, Baltimore County, Baltimore, Maryland, United States of America
| | - Joshua Wilhide
- Molecular Characterization and Analysis Complex, University of Maryland, Baltimore County, Baltimore, Maryland, United States of America
| | - Denis Routkevitch
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - John M. Ondov
- Department of Chemistry and Biochemistry, University of Maryland, College Park, Maryland, United States of America
| | - Jeffrey J. Kim
- Volpe Research Center, American Dental Association Foundation, Gaithersburg, Maryland, United States of America
- * E-mail:
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41
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Buu A, Hu YH, Piper ME, Lin HC. The association between e-cigarette use characteristics and combustible cigarette consumption and dependence symptoms: Results from a national longitudinal study. Addict Behav 2018; 84:69-74. [PMID: 29627636 DOI: 10.1016/j.addbeh.2018.03.035] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/20/2018] [Accepted: 03/31/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND Existing longitudinal surveys focused on the association between ever use of e-cigarettes and combustible cigarette consumption, making it difficult to infer what characteristics of e-cigarette use could potentially change combustible cigarette use behavior, which may have long-term health consequences. Although e-cigarettes' efficacy of alleviating dependence symptoms was supported by studies conducted in laboratory settings, whether the results can be translated into symptom reduction in the real world and over time is an open question. METHODS This study conducted secondary analysis on the Waves 1-2 data of the Population Assessment of Tobacco and Health (PATH) Study to examine the association between e-cigarette use characteristics (frequency, flavoring, and voltage adjustment) and combustible cigarette use outcomes (frequency, quantity, and symptoms), using the Heckman 2-step selection procedure with the selection bias controlled. The inclusion criteria ensured that we followed an adult cohort of exclusive combustible cigarette users at Wave 1. RESULTS The result shows that higher frequency of e-cigarette use was associated with lower combustible cigarette consumption and dependence symptoms, controlling for the corresponding baseline cigarette use variable and other confounders. Given the frequency of e-cigarette use, the feature of voltage adjustment was not significantly associated with any of the cigarette use outcomes. Flavoring, on the other hand, was associated with lower quantity of cigarette use. CONCLUSIONS Exclusive smokers who start using e-cigarettes do indeed change the frequency and quantity with which they smoke cigarettes. E-cigarette use may also help reduce dependence symptoms.
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Affiliation(s)
- Anne Buu
- Department of Health Behavior and Biological Sciences, University of Michigan, 400 North Ingalls, Ann Arbor, MI 48109, USA.
| | - Yi-Han Hu
- Department of Applied Health Science, School of Public Health, Indiana University, 1025 E. 7th Street, SPH 116, Bloomington, IN 47405, USA.
| | - Megan E Piper
- Center for Tobacco Research & Intervention, University of Wisconsin, 1930 Monroe Street, Suite 200, Madison, WI 53711, USA.
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University, 1025 E. 7th Street, SPH 116, Bloomington, IN 47405, USA.
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42
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Li Q, Wang C, Liu R, Wang L, Zeng DD, Leischow SJ. Understanding Users' Vaping Experiences from Social Media: Initial Study Using Sentiment Opinion Summarization Techniques. J Med Internet Res 2018; 20:e252. [PMID: 30111530 PMCID: PMC6115599 DOI: 10.2196/jmir.9373] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 05/21/2018] [Accepted: 07/10/2018] [Indexed: 11/13/2022] Open
Abstract
Background E-liquid is one of the main components in electronic nicotine delivery systems (ENDS). ENDS review comments could serve as an early warning on use patterns and even function to serve as an indicator of problems or adverse events pertaining to the use of specific e-liquids—much like types of responses tracked by the Food and Drug Administration (FDA) regarding medications. Objective This study aimed to understand users’ “vaping” experience using sentiment opinion summarization techniques, which can help characterize how consumers think about specific e-liquids and their characteristics (eg, flavor, throat hit, and vapor production). Methods We collected e-liquid reviews on JuiceDB from June 27, 2013 to December 31, 2017 using its public application programming interface. The dataset contains 27,070 reviews for 8058 e-liquid products. Each review is accompanied by an overall rating and a set of 4 aspect ratings of an e-liquid, each on a scale of 1-5: flavor accuracy, throat hit, value, and cloud production. An iterative dichotomiser 3 (ID3)-based influential aspect analysis model was adopted to learn the key elements that impact e-liquid use. Then, fine-grained sentiment analysis was employed to mine opinions on various aspects of vaping experience related to e-liquids. Results We found that flavor accuracy and value were the two most important aspects that affected users’ sentiments toward e-liquids. Of reviews in JuiceDB, 67.83% (18,362/27,070) were positive, while 12.67% (3430/27,070) were negative. This indicates that users generally hold positive attitudes toward e-liquids. Among the 9 flavors, fruity and sweet were the two most popular. Great and sweet tastes, reasonable value, and strong throat hit made users satisfied with fruity and sweet flavors, whereas “strange” tastes made users dislike those flavors. Meanwhile, users complained about some e-liquids’ steep or expensive prices, bad quality, and harsh throat hit. There were 2342 fruity e-liquids and 2049 sweet e-liquids. There were 55.81% (1307/2342) and 59.83% (1226/2049) positive sentiments and 13.62% (319/2342) and 12.88% (264/2049) negative sentiments toward fruity e-liquids and sweet e-liquids, respectively. Great flavors and good vapors contributed to positive reviews of fruity and sweet products. However, bad tastes such as “sour” or “bitter” resulted in negative reviews. These findings can help businesses and policy makers to further improve product quality and formulate effective policy. Conclusions This study provides an effective mechanism for analyzing users’ ENDS vaping experience based on sentiment opinion summarization techniques. Sentiment opinions on aspect and products can be found using our method, which is of great importance to monitor e-liquid products and improve work efficiency.
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Affiliation(s)
- Qiudan Li
- The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Can Wang
- The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Ruoran Liu
- The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China
| | - Lei Wang
- The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Daniel Dajun Zeng
- The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.,University of Chinese Academy of Sciences, Beijing, China.,Department of Management Information Systems, Eller College of Management, The University of Arizona, Tucson, AZ, United States
| | - Scott James Leischow
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
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43
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Spindle TR, Talih S, Hiler MM, Karaoghlanian N, Halquist MS, Breland AB, Shihadeh A, Eissenberg T. Effects of electronic cigarette liquid solvents propylene glycol and vegetable glycerin on user nicotine delivery, heart rate, subjective effects, and puff topography. Drug Alcohol Depend 2018; 188:193-199. [PMID: 29778773 PMCID: PMC7193252 DOI: 10.1016/j.drugalcdep.2018.03.042] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 03/18/2018] [Accepted: 03/23/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Electronic cigarettes (ECIGs) are a class of tobacco products that produce different effects (e.g., nicotine delivery), depending on the device, liquid, and behavioral factors. However, the influence of the two primary ECIG liquid solvents, propylene glycol (PG) and vegetable glycerin (VG), on ECIG acute effects is unknown. METHODS Thirty ECIG-experienced, ≥12-h nicotine- abstinent participants completed four conditions consisting of two ECIG-use bouts (10 puffs, 30 s interpuff-interval) differing only by liquid PG:VG ratio (2PG:98VG, 20PG:80VG, 55PG:45VG, 100PG). Device power (7.3 W) and liquid nicotine concentration (18 mg/ml) remained constant. Nicotine delivery, subjective effects, heart rate (HR), and puff topography were assessed. RESULTS In the 100PG condition, participants took shorter and smaller puffs but obtained significantly more nicotine relative to the two VG-based conditions. Total nicotine exposure (i.e., area under the curve) was also significantly higher during use of the two PG-based liquids. However, participants reported that the 100 PG liquid was significantly less "pleasant" and "satisfying" relative to the other liquids (all ps < .05). Increases in HR and decreases in abstinence symptoms (e.g., "craving") did not differ across conditions. CONCLUSIONS PG:VG ratio influenced nicotine delivery, some subjective effects, and puff topography. Lower overall product satisfaction associated with the 100PG liquid suggests factors other than nicotine delivery (e.g., aerosol visibility) may play a role in maintaining ECIG use. Regulating ECIG acute effects such as nicotine delivery and subjective effects may require simultaneous attention to liquid PG:VG ratio as well as device, liquid, and behavioral factors known to influence these outcomes.
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Affiliation(s)
- Tory R Spindle
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States
| | - Soha Talih
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States; Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Marzena M Hiler
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States
| | - Nareg Karaoghlanian
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States; Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Matthew S Halquist
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA, United States
| | - Alison B Breland
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States
| | - Alan Shihadeh
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States; Department of Mechanical Engineering, American University of Beirut, Beirut, Lebanon
| | - Thomas Eissenberg
- Department of Psychology, Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States.
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44
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Behar RZ, Wang Y, Talbot P. Comparing the cytotoxicity of electronic cigarette fluids, aerosols and solvents. Tob Control 2018; 27:325-333. [PMID: 28596276 PMCID: PMC6397802 DOI: 10.1136/tobaccocontrol-2016-053472] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 03/21/2017] [Accepted: 04/24/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND As thousands of electronic cigarette (e-cigarette) refill fluids continue to be formulated and distributed, there is a growing need to understand the cytotoxicity of the flavouring chemicals and solvents used in these products to ensure they are safe. The purpose of this study was to compare the cytotoxicity of e-cigarette refill fluids/solvents and their corresponding aerosols using in vitro cultured cells. METHODS E-cigarette refill fluids and do-it-yourself products were screened in liquid and aerosol form for cytotoxicity using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. The sensitivity of human pulmonary fibroblasts, lung epithelial cells (A549) and human embryonic stem cells to liquids and aerosols was compared. Aerosols were produced using Johnson Creek's Vea cartomizer style e-cigarette. RESULTS A hierarchy of potency was established for the aerosolised products. Our data show that (1) e-cigarette aerosols can produce cytotoxic effects in cultured cells, (2) four patterns of cytotoxicity were found when comparing refill fluids and their corresponding aerosols, (3) fluids accurately predicted aerosol cytotoxicity 74% of the time, (4) stem cells were often more sensitive to aerosols than differentiated cells and (5) 91% of the aerosols made from refill fluids containing only glycerin were cytotoxic, even when produced at a low voltage. CONCLUSIONS Our data show that various flavours/brands of e-cigarette refill fluids and their aerosols are cytotoxic and demonstrate the need for further evaluation of e-cigarette products to better understand their potential health effects.
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Affiliation(s)
- Rachel Z Behar
- Cell Molecular and Developmental Biology Graduate Program, University of California, Riverside, California, USA
- Department of Cell Biology and Neuroscience, University of California, Riverside, California, USA
| | - Yuhuan Wang
- Department of Cell Biology and Neuroscience, University of California, Riverside, California, USA
| | - Prue Talbot
- Department of Cell Biology and Neuroscience, University of California, Riverside, California, USA
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45
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Camenga DR, Morean M, Kong G, Krishnan-Sarin S, Simon P, Bold K. Appeal and Use of Customizable E-cigarette Product Features in Adolescents. TOB REGUL SCI 2018; 4:51-60. [PMID: 33163582 PMCID: PMC7643857 DOI: 10.18001/trs.4.2.5] [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: 11/25/2022]
Abstract
OBJECTIVES We evaluated the appeal and use of e-cigarette product features in a sample of high school students in Connecticut. METHODS In 2015, we conducted school-wide surveys in 8 high schools and analyzed data from 1765 students (877 susceptible tobacco-naïve never-e-cigarette users, 315 susceptible tobacco-exposed never-e-cigarette users, and 656 current e-cigarette users). Students were asked: "What is cool about e-cigarettes?" Response options included e-liquid ingredients (eg, flavors, nicotine content, propylene glycol/vegetable glycerin ratio [ie, PG/VG), the heating source (eg, battery), and physical design (eg, color, shape, appearance). Students were asked: "How do you customize your e-cigarette?" (Change flavors, voltage, PG/VG levels, temperature, skin/tank color, other) and use of nicotine in the e-liquid (yes/no). Multivariable regression assessed associations between current e-cigarette users' customization and e-cigarette use frequency (#days/month). RESULTS Flavors were the most appealing product feature among all groups. Among current users, using nicotine e-liquid was more prevalent than changing flavors (44.2% vs 29.6%). Using nicotine e-liquids and changing PG/vG ratios were associated with more frequent e-cigarette use among current users. CONCLUSIONS These findings can inform tobacco regulatory actions that put forth evidence-based recommendations to manufacture e-liquid flavors, nicotine concentrations and PG/VG ratios that prevent e-cigarette initiation and escalation of use.
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Affiliation(s)
- Deepa R Camenga
- Department of Emergency Medicine, Yale University School of Medicine, New Haven CT
| | | | - Grace Kong
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | | | - Patricia Simon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Krysten Bold
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
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46
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Collaco JM, McGrath-Morrow SA. Electronic Cigarettes: Exposure and Use Among Pediatric Populations. J Aerosol Med Pulm Drug Deliv 2017; 31:71-77. [PMID: 29068754 DOI: 10.1089/jamp.2017.1418] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
As an emerging inhalational exposure, electronic cigarettes (e-cigarettes) have rapidly gained public awareness with increasing use among adolescents and adults, leading to increased primary use by adolescents and increased secondhand exposure to emissions in infants, children, and adolescents. Although the long-term health risks for primary use and secondhand emission exposure are unknown, limited data from animal studies suggest that there is the potential for long-term lung injury and altered neurocognitive development in children with exposure to nicotine-containing aerosols. In this pediatric-focused review, we discuss the history of e-cigarettes, the demographics of adolescent users, effects on health, and current legislative efforts to protect infants, children, and adolescents from exposure.
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Affiliation(s)
- Joseph M Collaco
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins Medical Institutions , Baltimore, Maryland
| | - Sharon A McGrath-Morrow
- Eudowood Division of Pediatric Respiratory Sciences, Johns Hopkins Medical Institutions , Baltimore, Maryland
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47
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Chen Z, Zeng DD. Mining online e-liquid reviews for opinion polarities about e-liquid features. BMC Public Health 2017; 17:633. [PMID: 28683797 PMCID: PMC5501340 DOI: 10.1186/s12889-017-4533-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 06/21/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In recent years, the emerging electronic cigarette (e-cigarette) marketplace has developed prosperously all over the world. By analyzing online e-liquid reviews, we seek to identify the features attracting users. METHODS We collected e-liquid reviews from one of the largest online e-liquid review websites and extracted the e-liquid features by keywords. Then we used sentiment analysis to classify the features into two polarities: positive and negative. The positive sentiment ratio of a feature reflects the e-cigarette users' preference on this feature. RESULTS The popularity and preference of e-liquid features are not correlated. Nuts and cream are the favorite flavor categories, while fruit and cream are the most popular categories. The top mixed flavors are preferable to single flavors. Fruit and cream categories are most frequently mixed with other flavors. E-cigarette users are satisfied with cloud production, but not satisfied with the ingredients and throat hit. CONCLUSIONS We identified the flavors that e-cigarette users were satisfied with, and we found the users liked e-cigarette cloud production. Therefore, flavors and cloud production are potential factors attracting new users.
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Affiliation(s)
- Zhipeng Chen
- Department of Management Information Systems, University of Arizona, 1130 East Helen Street, Tucson, 85721-0108, USA.
| | - Daniel D Zeng
- Department of Management Information Systems, University of Arizona, 1130 East Helen Street, Tucson, 85721-0108, USA.,The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, People's Republic of China
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48
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Daniluk A, Gawlikowska-Sroka A, Stępien-Słodkowska M, Dzięciołowska-Baran E, Michnik K. Electronic Cigarettes and Awareness of Their Health Effects. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1039:1-8. [PMID: 28801792 DOI: 10.1007/5584_2017_83] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The use of electronic cigarettes or e-cigarettes is strongly on the rise. The literature confirms that in the process of quitting smoking using an electronic device dispensing nicotine should be a transitional stage before the complete cessation of smoking. The aim of the present study was to assess the popularity of e-cigarettes, the underlying reasons for use of such nicotine products, and the level of awareness of health hazards associated with e-cigarettes. The study is of a survey type. The material consisted of data collected from an anonymous survey distributed among 46 female and 23 male users of e-cigarettes in 2015. We used a questionnaire of our own design. The findings demonstrate that the main reason for a recourse to e-cigarettes is a desire to use fashionable technological innovations, and the conviction that such cigarettes are less harmful than the traditional tobacco products. Some respondents used e-cigarettes to quit smoking; others to minimize the harmful effects of smoking. Most respondents acquired information about e-cigarettes from friends or from the Internet. There was a high awareness of the chemical composition of substances contained in e-cigarettes. An interest in e-cigarettes is caused by an increased knowledge on the negative effects of traditional smoking. Currently, the e-cigarettes remains a technological novelty, so that the exact health effects of their long-term use are open to conjecture.
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Affiliation(s)
- A Daniluk
- Faculty of Physical Culture and Health Promotion, University of Szczecin, Szczecin, Poland
| | - A Gawlikowska-Sroka
- Department of Anatomy, Pomeranian Medical University, 72 Powstańców Wielkopolskich Street, 70-111, Szczecin, Poland.
| | - M Stępien-Słodkowska
- Faculty of Physical Culture and Health Promotion, University of Szczecin, Szczecin, Poland
| | - E Dzięciołowska-Baran
- Department of Anatomy, Pomeranian Medical University, 72 Powstańców Wielkopolskich Street, 70-111, Szczecin, Poland
| | - K Michnik
- School of European Integration, Szczecin, Poland
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