1
|
Defoe IN, Rap SE, Romer D. Adolescents' own views on their risk behaviors, and the potential effects of being labeled as risk-takers: A commentary and review. Front Psychol 2022; 13:945775. [PMID: 36467170 PMCID: PMC9714301 DOI: 10.3389/fpsyg.2022.945775] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/10/2022] [Indexed: 04/11/2024] Open
Abstract
Adolescents are stereotypically viewed as risk-takers ("stereotypical risk-takers") in science, mainstream media, fictional literature and in everyday life. However, increasing research suggests that adolescents do not always engage in "heightened" risk-taking, and adolescents' own perspectives (motives) on risk-taking are largely neglected in research. Hence, this paper is a commentary and review with two aims. First, taking a cross-national perspective, we discuss the definition of adolescence and risk behavior. We argue that much of the research on what drives adolescent risk behavior (e.g., substance use) focuses on the harms that this behavior promotes rather than on the need to explore and grow into adulthood. Thereafter we summarize the dominant approach to studying motives behind substance use, which has mostly considered young adults, and which has typically not focused on adolescents' own self-generated motives. The few empirical studies (including one of our qualitative studies) on adolescents' own motivations for engaging in risk behavior (i.e., cannabis use, alcohol use, and tobacco smoking) show that the most frequently mentioned motives by adolescents were being cool/tough, enjoyment, belonging, having fun and experimenting and coping. Interestingly, the "cool/tough identity" motive is virtually overlooked in research on adolescent risk-taking. The above-mentioned motives, however, generally support newer theories, such as the Developmental Neuro-Ecological Risk-taking Model (DNERM) and the Life-span Wisdom Model that suggest that adolescents' motivations to engage in risk-taking include experimentation, identity development, explorative behavior, and sensation seeking, all of which run counter to the stereotype of adolescents engaging in risk-taking due to "storm and stress." Hence, we also briefly consider additional recent attempts to study positive forms of risk taking. Second, extrapolating from sociological/criminological theories on labeling, we suggest that caution is warranted when (inaccurately) labeling adolescents as the "stereotypical risk-takers," because this can instigate a risk-taking identity in adolescents and/or motivate them to associate with risk-taking peers, which could in turn lead to maladaptive forms of risk-taking. Empirical research testing these hypotheses is needed. To conclude we argue that research on adolescent risk-taking could further benefit from considering adolescent's own motivations, which is also in line with the participatory approach advocated by international children's rights standards.
Collapse
Affiliation(s)
- Ivy N. Defoe
- Forensic Child and Youth Care Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Stephanie E. Rap
- Forensic Child and Youth Care Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Daniel Romer
- Annenberg Public Policy Center, The University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
2
|
Gades MS, Alcheva A, Riegelman AL, Hatsukami DK. The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review. Nicotine Tob Res 2022; 24:1332-1343. [PMID: 35305014 PMCID: PMC9356694 DOI: 10.1093/ntr/ntac073] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 01/31/2022] [Accepted: 03/16/2022] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Many adult cigarette smokers use electronic cigarettes (e-cigarettes) to cut down on or quit smoking cigarettes. E-cigarettes with higher abuse potential and appeal might facilitate complete switching. E-liquid nicotine concentration and flavor are two of the characteristics that may affect the abuse potential and appeal of e-cigarettes. The objective of this systematic review was to compile results from survey, animal, human laboratory, and clinical studies to understand the possible effects of nicotine concentration and flavor on abuse potential and appeal of e-cigarettes in adult current and former cigarette and e-cigarette users. AIMS AND METHODS A comprehensive literature search was conducted in Ovid Medline and PsycINFO followed by citation tracking in Web of Science Core Collection. Peer-reviewed studies published in English between 2007 and August 2020 were selected that analyzed differences between e-liquid nicotine concentration and/or flavors, had outcome measures related to abuse potential and/or appeal, and included adult humans (18+) or animals. A total of 1624 studies were identified and screened. A qualitative synthesis of results was performed. RESULTS Results from 104 studies included in this review suggest that higher nicotine concentration and access to a variety of flavors are likely to be associated with higher abuse potential and appeal of e-cigarettes for adult current and former cigarette and e-cigarette users. CONCLUSIONS Higher nicotine concentrations and the availability of a variety of flavors in e-cigarettes might facilitate complete substitution for cigarettes. Future e-cigarette regulations should take into account their impact on smokers, for whom e-cigarettes may be a cessation tool or reduced-harm alternative. IMPLICATIONS E-cigarettes may provide a reduced-harm alternative to cigarettes for smokers unwilling/unable to quit or serve as a path for quitting all nicotine products. Higher nicotine concentrations and flavor variety are associated with higher abuse potential and appeal of e-cigarettes. Higher abuse potential and appeal products may help facilitate complete switching from cigarettes to e-cigarettes. Regulation of nicotine concentration and flavors aimed at decreasing naïve uptake may inadvertently decrease uptake and complete switching among smokers, reducing the harm reduction potential of e-cigarettes. Evidence-based effects of regulating nicotine concentration and flavors must be considered for the population as a whole, including smokers.
Collapse
Affiliation(s)
- Mari S Gades
- Department of Psychology, University of Minnesota, 75 E. River Road, Minneapolis, MN, 55454, USA
| | - Aleksandra Alcheva
- Division of Environmental Health Sciences, School of Public Health and Masonic Cancer Center, University of Minnesota, 2231 6th Street SE, Minneapolis, MN 55455, USA
| | - Amy L Riegelman
- Social Sciences Department, University of Minnesota Libraries, 309 19 Avenue S., Minneapolis, MN, 55455, USA
| | - Dorothy K Hatsukami
- Masonic Cancer Center and Department of Psychiatry and Behavioral Sciences, University of Minnesota, 717 Delaware St. SE, Minneapolis, MN, 55414, USA
| |
Collapse
|
3
|
Personality Traits and Sociodemographic Factors Associated with the Use of E-Cigarettes, Waterpipe and Conventional Cigarettes among Medical University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127000. [PMID: 35742249 PMCID: PMC9222766 DOI: 10.3390/ijerph19127000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 12/04/2022]
Abstract
This study aimed to investigate the prevalence and sociodemographic characteristics of smokers in a private medical university in Malaysia and to examine whether there is an association between personality traits and various smoking types. There were 468 participants in this study and the mean age was 20.97 years (±2.743). The prevalence of conventical cigarette users, e-cigarette users, and water pipe users was 4.7%, 6.4%, and 4.0%, respectively. Parents’ annual income (p = 0.001) and ethnicity (p < 0.001) were significantly associated with the current smoker group. Binary logistic regression modelling revealed that study participants with either Malay (OR 4.23, 95% CI 1.73, 10.34) or Chinese (OR 4.16, 95% CI 1.98, 8.73) ethnicity were approximately four times more likely to use tobacco products compared with study participants with Indian and Other ethnicities. Lower parents’ annual income was almost four times more likely to be associated with smoking behaviour (OR 3.82, 95% CI 1.58, 9.27). Significant differences in mean personality traits score of Openness (p = 0.018) and Extraversion (p = 0.004) were observed between never-smoker and current smoker study participants. In addition, cigarette users scored higher in Conscientiousness personality traits compared with non-cigarette whereas e-cigarette users and waterpipe users scored lower in Extraversion (p = 0.02). Post-hoc analysis revealed that the never-smoker group scored higher in Extraversion compared with the dual tobacco user group (p = 0.03). In addition, the single tobacco user group scored higher in Agreeableness personality trait compared with the never-smoker group (p = 0.01). Deeper understanding of the different cognitive dimensions, ethnicities, and educational backgrounds can potentially impact smoking prevention and cessation programs.
Collapse
|
4
|
Wilson GL, Grogan S, Powell S, Gee I, Porcellato L, Keenan J. A thematic analysis of smokers' and non-smokers' accounts of E-cigarettes. J Health Psychol 2022; 27:24-35. [PMID: 32131638 PMCID: PMC8739557 DOI: 10.1177/1359105320909877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This study explored smokers' and non-smokers' accounts of E-cigarettes. A total of 51 UK-based participants, 20 men and 31 women, responded to open-ended questions online. Inductive thematic analysis identified that the factors that influence E-cigarette behaviour and opinion in adult smokers and non-smokers are related to social context, informative sources, practical aspects and health implications. Participants presented varying accounts of E-cigarettes, suggesting that individual narratives regarding E-cigarettes are multi-faceted. This is important information for health professionals and policy makers tasked with advising on E-cigarette use.
Collapse
Affiliation(s)
| | | | | | - Ivan Gee
- Liverpool John Moores University, UK
| | | | | |
Collapse
|
5
|
Teah GE, Conner TS. Psychological and Demographic Predictors of Vaping and Vaping Susceptibility in Young Adults. Front Psychol 2021; 12:659206. [PMID: 34484026 PMCID: PMC8415821 DOI: 10.3389/fpsyg.2021.659206] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background The use of electronic nicotine delivery systems (ENDS), also known as vaping, is becoming popular among young adults. Few studies have explored the psychological factors that predict ENDS use and susceptibility in young adults, in addition to known demographic predictors. Method In a cross-sectional survey design, 521 young adults (37% male), ages 18-25 from the United States, were recruited via Amazon's Mechanical Turk (MTurk) in 2019, to answer an online survey measuring demographic characteristics and psychological characteristics related to mental health and the Big Five personality traits. The survey also included measures of ENDS ever-use, current use, and susceptibility (never users open to trying ENDS), which we predicted from the demographic and psychological measures using independent and multiple binary logistic regression analyses. Results Of those surveyed (n = 521), 282 (54.1%) were ENDS ever-users, 93 (17.9%) were current ENDS users, and 61 (11.7%) were ENDS susceptible; 62 (11.9%) were current smokers. Demographically, young adults lower in adulthood socioeconomic-status (SES), not pursuing education further than high school, and current smokers were more likely to be ENDS users. Psychologically, young adults higher in anxiety and lower in conscientiousness more likely to have ever-used ENDS. Lower conscientiousness further predicted current ENDS use and ENDS susceptibility. Conclusion In this sample of MTurk workers, young adults with experience in vaping were more demographically and psychologically vulnerable than young adults with no experience in vaping. Young adults interested in vaping, but without prior experience, were less conscientious than their non-interested peers. Interventions to target vaping use should focus on economically disadvantaged young adults and those lower in conscientiousness.
Collapse
Affiliation(s)
- Grace E Teah
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Tamlin S Conner
- Department of Psychology, University of Otago, Dunedin, New Zealand
| |
Collapse
|
6
|
Wilson GL, Keenan J, Grogan S, Porcellato L, Powell S, Gee I. An investigation of factors encouraging and deterring EC use: a thematic analysis of accounts from UK adults. Psychol Health 2021; 37:1379-1395. [PMID: 34279128 DOI: 10.1080/08870446.2021.1952583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to explore E-cigarette (EC) accounts from a small sample of UK adults with varied smoking/EC experiences. This was to contribute to existing knowledge of adult perceptions and understand the factors that encourage or deter use to inform health messaging aimed at professionals, policy makers and the general public. DESIGN Twelve participants, five men and seven women aged 23-55 years (mean age 32.43) with mixed smoking/EC backgrounds took part in face-to-face interviews, analysed using semantic-level inductive thematic analysis. RESULTS The analysis identified three key themes. Social influence (1) relates to the understanding of the social representations of ECs. Representation and knowledge (2) captures the impact of varied EC related communication on perception. Aspects of addiction (3) conveys aspects of nicotine addiction and how this influences EC use. CONCLUSION ECs were generally perceived as more socially acceptable than cigarettes by non-smokers, although there were varying levels of acceptability depending on the type of EC device used. There was also unanimity concerning uncertainty surrounding the devices. Behavioural/sensory elements and personal enjoyment of ECs were consistent elements that encouraged or deterred use. Although non-smokers/vapers did not use the devices, they expressed similar apprehensions to those who did.
Collapse
Affiliation(s)
| | - Joseph Keenan
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Sarah Grogan
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - Lorna Porcellato
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Susan Powell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Ivan Gee
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| |
Collapse
|
7
|
Atuegwu NC, Litt MD, Krishnan-Sarin S, Laubenbacher RC, Perez MF, Mortensen EM. E-Cigarette Use in Young Adult Never Cigarette Smokers with Disabilities: Results from the Behavioral Risk Factor Surveillance System Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5476. [PMID: 34065407 PMCID: PMC8160823 DOI: 10.3390/ijerph18105476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/13/2021] [Accepted: 05/16/2021] [Indexed: 12/29/2022]
Abstract
Young adult never cigarette smokers with disabilities may be at particular risk for adopting e-cigarettes, but little attention has been paid to these people. This study examines the associations between different types of disability and e-cigarette use in this population. Young adult never-smokers from the 2016-2017 Behavioral Risk Factor Surveillance System (BRFSS) survey who were either never or current e-cigarette users (n = 79,177) were selected for the analysis. The Least Absolute Shrinkage and Selection Operator (LASSO) algorithm was used to select confounders for multivariable logistic regression models. Multivariable logistic regression models were used to determine the associations between current e-cigarette use and different types of disability after incorporating BRFSS survey design and adjusting for confounders. Young adult never-smokers who reported any disability had increased odds (OR 1.44, 95% CI 1.18-1.76) of e-cigarette use compared to those who reported no disability. Young adult never-smokers who reported self-care, cognitive, vision, and independent living disabilities had higher odds of e-cigarette use compared to those who reported no disability. There was no statistically significant difference in the odds of e-cigarette use for those reporting hearing and mobility disabilities compared to those who reported no disability. This study highlights the need for increased public education and cessation programs for this population.
Collapse
Affiliation(s)
- Nkiruka C. Atuegwu
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA; (M.F.P.); (E.M.M.)
| | - Mark D. Litt
- Division of Behavioral Sciences and Community Health, University of Connecticut School of Medicine, Farmington, CT 06030, USA;
| | | | - Reinhard C. Laubenbacher
- Laboratory for Systems Medicine, Department of Medicine, University of Florida, Gainesville, FL 32610, USA;
| | - Mario F. Perez
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA; (M.F.P.); (E.M.M.)
| | - Eric M. Mortensen
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA; (M.F.P.); (E.M.M.)
| |
Collapse
|
8
|
Karasneh R, Al-Azzam S, Nusair M, Hawamdeh S. Perceptions, symptoms, and practices of electronic cigarette users: Descriptive analysis and validation of Arabic short form vaping consequences questionnaire. PLoS One 2021; 16:e0245443. [PMID: 33481827 PMCID: PMC7822314 DOI: 10.1371/journal.pone.0245443] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 12/31/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND E-cigarette (EC) use is increasing worldwide. Understanding the practices and perceptions of e-cigarette users and profiling the symptoms they experience is essential for regulating the use of such products. This study aims to investigate the practices and perceptions of e-cigarette users in Jordan and examine the symptoms (e.g. respiratory) they associate with e-cigarette use. METHODS A cross-sectional online survey was conducted to assess EC use and tobacco smoking behaviors and the corresponding health symptoms among EC users in Jordan. EC use expectancies were also assessed using the Short Form Vaping Consequences Questionnaire, which was first translated into Arabic and tested for validity and reliability. RESULTS Out of the 400 EC users surveyed, 95.5% were male, 76.2% used nicotine-containing juice, and 56.8% were concurrent tobacco smokers. Further, the participants had a mean age of 28.9 years (±10.2). Among dual EC/cigarette users, 88.6% reported that they tried to quit cigarette smoking, with e-cigarette use being the most commonly tried method of smoking cessation. The smoking-related symptoms reported by regular cigarette smokers mainly included sputum production (77.5%). The participants reported that using e-cigarettes instead of tobacco cigarettes had led to improvements in their sputum production (60.8%), breathing (59%), and general wellbeing (52%). Pleasant taste, enjoyable taste sensation, and flavor were significantly stronger (P-value < 0.05) among e-cigarette users compared to dual users. Dual EC/cigarette users reported stronger perceptions in the negative consequences scale, particularly with regards to the hazardous effects of smoking on health (P-value < 0.05). CONCLUSION Dual daily use of e-cigarettes and regular cigarettes is a common practice among EC users. We recommend that further research is conducted on dual EC/cigarette use and the potential health risks this may have (e.g. higher nicotine intake as compared to the single use of either products).
Collapse
Affiliation(s)
- Reema Karasneh
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Sayer Al-Azzam
- Clinical Pharmacy Department, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Nusair
- Department of Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Sahar Hawamdeh
- Clinical Pharmacy Department, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
9
|
Alqahtani MM, Alanazi AMM, Almutairi AS, Pavela G. Electronic cigarette use is negatively associated with body mass index: An observational study of electronic medical records. Obes Sci Pract 2020; 7:226-231. [PMID: 33841892 PMCID: PMC8019282 DOI: 10.1002/osp4.468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 11/01/2020] [Accepted: 11/03/2020] [Indexed: 12/04/2022] Open
Abstract
Objective Vaping is advertised as a method to mitigate weight gain after smoking cessation; however, while there is an established inverse association between conventional tobacco use and body mass index (BMI), there is little research on the relationship between e‐cigarettes and BMI. This research tested whether e‐cigarette use was associated with BMI. Methods A secondary data analysis of 207,117 electronic medical records from the UAB was conducted. Patient data from 1 September 2017 through 1 June 2018 were extracted. To be included in the analysis, a patient's record had to include measures of e‐cigarette use and key sociodemographic information. Ordinary least squares regression was used to test the association between e‐cigarette use and BMI, controlling for covariates; unconditional quantile regression was used to determine whether the association varied by BMI quantile. For comparison with tobacco smoking, the association between current tobacco smoking and BMI was estimated in a sample from the same population. Results Respondents in the sample had an average BMI of 30.8 and average age of 50.0 years when BMI was measured. The sample was 51% female, 49.7% white, 46.7% black, and 1.0% Hispanic; 16.4% of the sample had less than a college education and approximately 5% reported currently using e‐cigarettes. Individuals who reported using e‐cigarettes had, on average, a lower BMI compared to those who did not report currently using e‐cigarettes; results indicated that this association did not significantly vary by BMI quantile. Individuals who reported being current smokers had a lower BMI, on average. Conclusion These findings suggest that using e‐cigarettes is associated with a lower BMI in a population of individuals seeking health care, consistent with the association between conventional tobacco use and BMI. This study is a springboard for future research investigating the associations between e‐cigarette use, BMI, and risk of obesity in the general population.
Collapse
Affiliation(s)
- Mohammed M Alqahtani
- King Saud Abdul-Aziz University for Health Sciences Riyadh Saudi Arabia.,Department of Rehabilitation Science School of Health Profession University of Alabama at Birmingham Birmingham Alabama USA
| | - Abdullah M M Alanazi
- King Saud Abdul-Aziz University for Health Sciences Riyadh Saudi Arabia.,Department of Rehabilitation Science School of Health Profession University of Alabama at Birmingham Birmingham Alabama USA
| | - Abdulaziz S Almutairi
- Immunology Department School of Biomedical Science University of Alabama at Birmingham Birmingham Alabama USA
| | - Gregory Pavela
- Department of Health Behavior School of Public Health University of Alabama at Birmingham Birmingham Alabama USA
| |
Collapse
|
10
|
Navas-Acien A, Martinez-Morata I, Hilpert M, Rule A, Shimbo D, LoIacono NJ. Early Cardiovascular Risk in E-cigarette Users: the Potential Role of Metals. Curr Environ Health Rep 2020; 7:353-361. [PMID: 33242201 DOI: 10.1007/s40572-020-00297-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 01/18/2023]
Abstract
PURPOSE OF REVIEW Electronic cigarettes (e-cigs) are a source of metals. Epidemiologic and experimental evidence support that metals are toxic to the cardiovascular system. Little is known, however, about the role that e-cig metals may play as toxicants for the possible cardiovascular effects of e-cig use. The goal of this narrative review is to summarize the evidence on e-cig use and metal exposure and on e-cig use and cardiovascular toxicity and discuss the research needs. RECENT FINDINGS In vitro studies show cytotoxicity and increased oxidative stress in myocardial cells and vascular endothelial cells exposed to e-liquids and e-cig aerosols, with effects partially reversed with antioxidant treatment. There is some evidence that the heating coil plays a role in cell toxicity. Mice exposed to e-cigs for several weeks showed higher levels of oxidative stress, inflammation, platelet activation, and thrombogenesis. Cross-over clinical experiments show e-cig use alters nitric oxide-mediated flow-mediated dilation, endothelial progenitor cells, and arterial stiffness. Cross-sectional evidence from large nationally representative samples in the USA support that e-cig use is associated with self-reported myocardial infarction. Smaller studies found associations of e-cig use with higher oxidized low-density protein and heart variability compared to healthy controls. Numerous studies have measured elevated levels of toxic metals in e-cig aerosols including lead, nickel, chromium, and manganese. Arsenic has been measured in some e-liquids. Several of these metals are well known to be cardiotoxic. Numerous studies show that e-cigs are a source of cardiotoxic metals. Experimental studies (in vitro, in vivo, and clinical studies) show acute toxicity of e-cigs to the vascular system. Studies of long-term toxicity in animals and humans are missing. Longitudinal studies with repeated measures of metal exposure and subclinical cardiovascular outcomes (e.g., coronary artery calcification) could contribute to determine the long-term cardiovascular effects of e-cigs and the potential role of metals in those effects.
Collapse
Affiliation(s)
- Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY, 10032, USA
| | - Irene Martinez-Morata
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY, 10032, USA
| | - Markus Hilpert
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY, 10032, USA
| | - Ana Rule
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Daichi Shimbo
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Nancy J LoIacono
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th Street, New York, NY, 10032, USA.
| |
Collapse
|
11
|
DiPiazza J, Caponnetto P, Askin G, Christos P, Maglia MLP, Gautam R, Roche S, Polosa R. Sensory experiences and cues among E-cigarette users. Harm Reduct J 2020; 17:75. [PMID: 33059666 PMCID: PMC7559939 DOI: 10.1186/s12954-020-00420-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIMS We characterized the extent and quality of respiratory sensations and sensory-related smoking cues associated with e-cigarette use among those who failed to quit combustible tobacco cigarette (CTC) use with traditional FDA approved medications but succeeded in doing so with e-cigarettes. Further, we sought to understand former smokers' perceptions about the influence of sensory experience with e-cigarette use on CTC cessation outcomes. METHODS A nonrandom purposive sample of 156 participants recruited in the USA through the Consumer Advocates for Smoke Free Alternatives Association Facebook page completed an online cross-sectional survey to assess sensory experiences and smoking cues associated with e-cigarette use. Descriptive statistics were calculated, and the ANOVA/Kruskal-Wallis test with post hoc testing and the two-sample t test/Wilcoxon rank-sum test, as appropriate based on distribution, were used to assess the association between sample characteristics and sensory experiences and cues using investigator constructed questions, the Modified Cigarette Evaluation Questionnaire (mCEQ) and the Smoking Cue Appeal Survey (SCAS). RESULTS With e-cigarette use, participants reported feeling the vapor in their throats, windpipes, noses, lungs, and on their tongues; reductions in nicotine craving; and enjoyment of their e-cigarette, including tasting, smelling, and seeing the vapor and touching the device. Women had greater craving reduction than men (p = 0.023). Those who began smoking at 13 years of age or younger had more satisfaction and had greater sensory enjoyment than those who began smoking at 16-17 years of age (p = 0.015 and p = 0.026, respectively), as well as greater sensory enjoyment than those who began smoking at 14-15 years of age (p = 0.047). There was a significant overall association between the number of years a respondent smoked and e-cigarette sensory enjoyment (p = 0.038). Participants 18-34 years old rated e-cigarettes as being more pleasant compared to 45 + years olds, (p = 0.012). Eighty-four percent of participants reported the sensation of the vapor as important in quitting CTCs, and 91% believed the sensations accompanying e-cigarette use contributed to their smoking cessation success. CONCLUSIONS For those who failed to quit previously using approved cessation medications to stop smoking cigarettes, sensory experiences associated with e-cigarette use may help smokers quit smoking.
Collapse
Affiliation(s)
- J DiPiazza
- Hunter Bellevue School of Nursing, Hunter College-City University of New York, New York, NY, USA
| | - P Caponnetto
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "V.Emanuele-Policlinico", Università di Catania, Catania, Italy.
- Institute of Internal Medicine, Azienda Ospedaliero-Universitaria "Policlinico V. Emanuele", Università di Catania, Catania, Italy.
- Institute for Social Marketing, University of Stirling, Stirling, FK9 4LA, UK.
| | - G Askin
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | - P Christos
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | - M Lyc Psych Maglia
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "V.Emanuele-Policlinico", Università di Catania, Catania, Italy
| | - R Gautam
- Clinical and Translational Science Center, Weill Cornell Medicine, New York, NY, USA
| | - S Roche
- Hunter Bellevue School of Nursing, Hunter College-City University of New York, New York, NY, USA
| | - R Polosa
- Centro per la Prevenzione e Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "V.Emanuele-Policlinico", Università di Catania, Catania, Italy
- Institute of Internal Medicine, Azienda Ospedaliero-Universitaria "Policlinico V. Emanuele", Università di Catania, Catania, Italy
- Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, Catania, Italy
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| |
Collapse
|
12
|
Atuegwu NC, Oncken C, Laubenbacher RC, Perez MF, Mortensen EM. Factors Associated with E-Cigarette Use in U.S. Young Adult Never Smokers of Conventional Cigarettes: A Machine Learning Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197271. [PMID: 33027932 PMCID: PMC7579019 DOI: 10.3390/ijerph17197271] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 02/08/2023]
Abstract
E-cigarette use is increasing among young adult never smokers of conventional cigarettes, but the awareness of the factors associated with e-cigarette use in this population is limited. The goal of this work was to use machine learning (ML) algorithms to determine the factors associated with current e-cigarette use among US young adult never cigarette smokers. Young adult (18-34 years) never cigarette smokers from the 2016 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) who reported current or never e-cigarette use were used for the analysis (n = 79,539). Variables associated with current e-cigarette use were selected by two ML algorithms (Boruta and Least absolute shrinkage and selection operator (LASSO)). Odds ratios were calculated to determine the association between e-cigarette use and the variables selected by the ML algorithms, after adjusting for age, gender and race/ethnicity and incorporating the BRFSS complex design. The prevalence of e-cigarette use varied across states. Factors previously reported in the literature, such as age, race/ethnicity, alcohol use, depression, as well as novel factors associated with e-cigarette use, such as disabilities, obesity, history of diabetes and history of arthritis were identified. These results can be used to generate further hypotheses for research, increase public awareness and help provide targeted e-cigarette education.
Collapse
Affiliation(s)
- Nkiruka C. Atuegwu
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA; (C.O.); (M.F.P.); (E.M.M.)
- Correspondence: ; Tel.: +1-860-0679-2372; Fax: +1-860-0679-8087
| | - Cheryl Oncken
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA; (C.O.); (M.F.P.); (E.M.M.)
| | | | - Mario F. Perez
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA; (C.O.); (M.F.P.); (E.M.M.)
| | - Eric M. Mortensen
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA; (C.O.); (M.F.P.); (E.M.M.)
| |
Collapse
|
13
|
Porcellato L, Ross-Houle K, Quigg Z, Harris J, Bigland C, Bates R, Timpson H, Gee I, Bishop J, Gould A, Davies AR. Welsh Primary Schoolchildren's Perceptions of Electronic Cigarettes: A Mixed Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103639. [PMID: 32455786 PMCID: PMC7277780 DOI: 10.3390/ijerph17103639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/14/2020] [Accepted: 05/18/2020] [Indexed: 11/24/2022]
Abstract
There are concerns that the growing popularity of e-cigarettes promotes experimentation among children. Given the influence of the early years on attitude and habit formation, better understanding of how younger children perceive vaping before experimentation begins is needed, to prevent uptake and inform tobacco control strategies. We explored Welsh primary schoolchildren’s (aged 7–11) awareness of e-cigarettes relative to tobacco smoking, their understanding of the perceived risks and benefits and their intentions and beliefs about vaping. Data was collected using a mix of methods in June and July 2017 from 8 purposively selected primary schools across Wales. Four hundred and ninety-five children (52% female) aged 7 years (n = 165), 9 years (n = 185) and 11 years (n = 145) completed a class-administered booklet encompassing a draw and write exercise and survey. Ninety-six children participated in 24 peer discussion groups comprised of 2 boys and 2 girls from each year group. Data were analysed independently and findings triangulated. Survey analyses used frequencies, descriptive statistics and chi-squared tests. Content analysis was undertaken on the draw and write data and peer discussion groups were analysed thematically. Study findings highlight that primary schoolchildren have general awareness of e-cigarettes. Vaping was perceived to be healthier than smoking and there was some recognition that e-cigarettes were used for smoking cessation. Understanding of any health harms was limited. Few children intended to smoke or vape in the future but almost half thought it was okay for grownups. Children’s perceptions were influenced by exposure through family and friends. Findings suggest a need for e-cigarette education in primary schools, to highlight the associated risks of e-cigarette experimentation including the potential for tobacco initiation.
Collapse
Affiliation(s)
- Lorna Porcellato
- Public Health Institute; Faculty of Health, Liverpool John Moores University, Liverpool L2 2QP, UK; (Z.Q.); (J.H.); (C.B.); (R.B.); (H.T.); (I.G.)
- Correspondence: ; Tel.: +44-0151231-4201
| | - Kim Ross-Houle
- Faculty of Social Sciences, Department of Social and Political Science, University of Chester, Chester CH1 4BJ, UK;
| | - Zara Quigg
- Public Health Institute; Faculty of Health, Liverpool John Moores University, Liverpool L2 2QP, UK; (Z.Q.); (J.H.); (C.B.); (R.B.); (H.T.); (I.G.)
| | - Jane Harris
- Public Health Institute; Faculty of Health, Liverpool John Moores University, Liverpool L2 2QP, UK; (Z.Q.); (J.H.); (C.B.); (R.B.); (H.T.); (I.G.)
| | - Charlotte Bigland
- Public Health Institute; Faculty of Health, Liverpool John Moores University, Liverpool L2 2QP, UK; (Z.Q.); (J.H.); (C.B.); (R.B.); (H.T.); (I.G.)
| | - Rebecca Bates
- Public Health Institute; Faculty of Health, Liverpool John Moores University, Liverpool L2 2QP, UK; (Z.Q.); (J.H.); (C.B.); (R.B.); (H.T.); (I.G.)
| | - Hannah Timpson
- Public Health Institute; Faculty of Health, Liverpool John Moores University, Liverpool L2 2QP, UK; (Z.Q.); (J.H.); (C.B.); (R.B.); (H.T.); (I.G.)
| | - Ivan Gee
- Public Health Institute; Faculty of Health, Liverpool John Moores University, Liverpool L2 2QP, UK; (Z.Q.); (J.H.); (C.B.); (R.B.); (H.T.); (I.G.)
| | - Julie Bishop
- Public Health Wales, Cardiff CF10 4BZ, UK; (J.B.); (A.G.); (A.R.D.)
| | - Ashley Gould
- Public Health Wales, Cardiff CF10 4BZ, UK; (J.B.); (A.G.); (A.R.D.)
| | - Alisha R. Davies
- Public Health Wales, Cardiff CF10 4BZ, UK; (J.B.); (A.G.); (A.R.D.)
| |
Collapse
|
14
|
Martínez Ú, Martínez-Loredo V, Simmons VN, Meltzer LR, Drobes DJ, Brandon KO, Palmer AM, Eissenberg T, Bullen CR, Harrell PT, Brandon TH. How Does Smoking and Nicotine Dependence Change After Onset of Vaping? A Retrospective Analysis of Dual Users. Nicotine Tob Res 2020; 22:764-770. [PMID: 30883640 PMCID: PMC7171272 DOI: 10.1093/ntr/ntz043] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 03/14/2019] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Although some smokers switch to exclusive use of electronic cigarettes (e-cigarettes), others become dual users of combustible cigarettes and e-cigarettes. Little is known about how the onset of vaping affects the use of and dependence on combustible cigarettes or total nicotine use and dependence, which may influence health-related and cessation outcomes. Using self-report data of current combustible and e-cigarette use and retrospective recall of pre-vaping smoking in a sample of dual users, the aims of this study were (1) to compare pre- and post-vaping number of cigarettes per day and combustible cigarette dependence; (2) to compare pre- and post-vaping total nicotine use frequency (number of vaping sessions and cigarettes smoked per day), and total nicotine dependence; and (3) to examine predictors of nicotine dependence. METHODS We used baseline data from a smoking cessation trial with 2896 dual users. Nicotine use frequency and the Heaviness of Smoking Index were used as measures of nicotine use and dependence, respectively. RESULTS Participants decreased cigarettes/day from pre- (M = 19.24, SD = 9.01) to post-vaping (M = 11.15, SD = 8.02, p < .0001) and combustible cigarette dependence declined from pre- (M = 3.55, SD = 1.51) to post-vaping (M = 2.11, SD = 1.60, p < .0001). Total daily nicotine use frequency increased after initiating vaping (M = 19.25, SD = 9.01 vs. M = 29.46, SD = 8.61; p < .0001), as did total nicotine dependence (M = 3.55, SD = 1.51 vs. M = 4.68, SD = 1.38; p < .0001). Hierarchical regression analyses indicated that variables associated with greater overall nicotine dependence included: younger age, lower education, more years smoking, higher pre-vaping nicotine dependence, using e-cigarettes more days per month, more puffs per vaping session, higher e-liquid nicotine concentration, and longer vaping history. CONCLUSIONS Dual use leads to a reduction in the number of combustible cigarettes, but total nicotine use and dependence increases. IMPLICATIONS In dual users, a reduction in smoking following onset of vaping may offer some harm reduction via reduction in cigarette intake. However, the increase in total nicotine use and dependence could affect the ability to quit either or both products.
Collapse
Affiliation(s)
- Úrsula Martínez
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
| | - Víctor Martínez-Loredo
- Clinical Unit of Addictive Behaviors, Department of Psychology, University of Oviedo, Spain
| | - Vani N Simmons
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
- Department of Psychology, University of South Florida, Tampa, FL
- Department of Oncologic Sciences, University of South Florida, Tampa, FL
| | - Lauren R Meltzer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
| | - David J Drobes
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
- Department of Psychology, University of South Florida, Tampa, FL
- Department of Oncologic Sciences, University of South Florida, Tampa, FL
| | - Karen O Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
| | - Amanda M Palmer
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
- Department of Psychology, University of South Florida, Tampa, FL
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Christopher R Bullen
- School of Population Health, Faculty of Medical and Health Science, University of Auckland, New Zealand
| | - Paul T Harrell
- Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, Tampa, FL
- Department of Psychology, University of South Florida, Tampa, FL
- Department of Oncologic Sciences, University of South Florida, Tampa, FL
| |
Collapse
|
15
|
Hughes JR, Peters EN, Callas PW, Peasley-Miklus C, Oga E, Etter JF, Morley N. Withdrawal Symptoms From E-Cigarette Abstinence Among Adult Never-Smokers: A Pilot Experimental Study. Nicotine Tob Res 2020; 22:740-746. [PMID: 31504882 PMCID: PMC7171287 DOI: 10.1093/ntr/ntz169] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/31/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Use of e-cigarettes among never-smokers has substantially increased; yet there are few descriptions of the consequences of such use. We assessed whether adult never-smokers can have withdrawal from cessation of e-cigarettes. METHODS In an un-blinded pre-post clinical trial, 30 never-smoker daily e-cigarette users used their own nicotine-containing e-cigarette for 7 days followed by 6 days of biologically confirmed abstinence. Participants monitored symptoms of nicotine withdrawal nightly via an Interactive Voice Response system. They attended three lab visits/week to provide expired carbon monoxide and urine samples to determine compliance. FINDINGS Abstinence increased all the DSM5 symptoms of tobacco withdrawal and this occurred in the majority of participants. The increase in severity of withdrawal was small and rarely impaired functioning. CONCLUSIONS Our finding suggests that withdrawal symptoms can occur in never-smokers who stop e-cigarettes abruptly. However, the severity of withdrawal appears to be small and may not be of clinical or regulatory significance. Although our sample size was small and thus replication tests of our results are indicated, it may be prudent to warn never-smokers that withdrawal symptoms may occur. IMPLICATIONS This study indicates that withdrawal symptoms can occur in never-smokers who are daily e-cigarette users. However, the severity of withdrawal from e-cigarette abstinence in never-smokers appears to be small and may not be of clinical or regulatory significance. Given our small sample size, replication of our results is warranted. Nevertheless, it might be prudent to warn never-smokers of addiction to e-cigarettes.Clinical Trial Registration = NCT02825459.
Collapse
Affiliation(s)
- John R Hughes
- Departments of Psychiatry and Psychological Science, Vermont Center for Behavior and Health, University of Vermont, Burlington, VT
| | - Erica N Peters
- Battelle Public Health Center for Tobacco Research, Baltimore, MD
| | - Peter W Callas
- Medical Biostatistics, University of Vermont, Burlington, VT
| | - Catherine Peasley-Miklus
- Departments of Psychiatry and Psychological Science, Vermont Center for Behavior and Health, University of Vermont, Burlington, VT
| | - Emmanuel Oga
- Battelle Public Health Center for Tobacco Research, Baltimore, MD
| | - Jean-Francois Etter
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Nicholas Morley
- Departments of Psychiatry and Psychological Science, Vermont Center for Behavior and Health, University of Vermont, Burlington, VT
| |
Collapse
|
16
|
Tucker JS, Shadel WG, Golinelli D, Seelam R, Siconolfi D. Motivation to quit cigarettes and alternative tobacco products: prevalence and correlates among youth experiencing homelessness. J Behav Med 2020; 43:318-328. [PMID: 31396821 PMCID: PMC7971096 DOI: 10.1007/s10865-019-00092-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/04/2019] [Indexed: 10/26/2022]
Abstract
Use of alternative tobacco products, as well as regular cigarettes, is widespread among unaccompanied youth experiencing homelessness. However, little is known about their level of motivation for quitting use of these products, factors associated with motivation to quit, or how these might vary by type of tobacco product. Unaccompanied homeless youth were sampled from 25 street and service sites in Los Angeles County (N = 469). All participants were past month tobacco users who completed a survey on their tobacco-related behaviors and cognitions, including motivation to quit, as well as background characteristics. Among self-reported users of each product, motivation to quit in the next 30 days was highest for regular cigarettes (33%), followed by e-cigarettes/vaporizers (30%), little cigars/cigarillos (25%), cigars (20%), and natural cigarettes (20%). Between 33 and 49% of youth, depending on product, were not thinking about quitting at all. Correlates of lower motivation to quit differed somewhat by product type, with the most consistent being race, more frequent use, lower perceived riskiness of the product, and using the product because of its good taste or smell. Results from this study identify a set of psychosocial and behavioral factors, some that are common across tobacco products and others that are product-specific, that may be particularly important to address in efforts to reduce tobacco use among youth experiencing homelessness. Future regulations on the sale of flavored tobacco products may also serve to increase motivation to quit in this population.
Collapse
Affiliation(s)
- Joan S Tucker
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA.
| | - William G Shadel
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213-2665, USA
| | - Daniela Golinelli
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Rachana Seelam
- RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA, 90407-2138, USA
| | - Daniel Siconolfi
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213-2665, USA
| |
Collapse
|
17
|
Dinkeloo E, Grier TL, Brooks RD, Jones BH. Vaping, Smoking, and the Physical Fitness of Active Young Men. Am J Prev Med 2020; 58:e31-e37. [PMID: 31759803 DOI: 10.1016/j.amepre.2019.08.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Adverse effects of cigarette smoking on physical performance are well studied. Because of the recent rise in popularity of vaping, it is important to evaluate its effect on fitness both independently and in conjunction with traditional cigarette use. METHODS This was a secondary analysis performed in 2018 on data collected from U.S. Army Soldiers during 2016. All metrics were self-reported via an electronic questionnaire. Personal characteristics of current ENDS users, smokers, and dual users were compared with a reference group that reported no history of use. Adjusting for age and physical training habits, an ANCOVA was used to compare Army physical fitness test results. A Fisher's exact test determined specific mean differences between groups. RESULTS This study population consisted of 2,854 men aged 24.6 years on average. Differences in physical training and fitness were shown between the groups. Never users averaged the most total physical training, followed by ENDS users, smokers, and then dual users. Compared with never users on the fitness tests, ENDS users had an adjusted mean difference of +27 seconds on the 2-mile run, -4.56 push-ups, and -2.01 sit-ups; smokers averaged +8 seconds, -2.15 push-ups, and -1.44 sit-ups; and dual users averaged +32 seconds, -5.17 push-ups, and -3.88 sit-ups. Dual users had significantly (p<0.05) lower scores than current smokers and never users on all 3 fitness events. CONCLUSIONS This study suggests that individuals who use e-cigarettes and tobacco cigarettes average a lower level of fitness than individuals who abstain.
Collapse
Affiliation(s)
- Eero Dinkeloo
- Injury Prevention Division, Clinical Public Health and Epidemiology Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, Maryland; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee.
| | - Tyson L Grier
- Injury Prevention Division, Clinical Public Health and Epidemiology Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, Maryland
| | - Raina D Brooks
- Injury Prevention Division, Clinical Public Health and Epidemiology Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, Maryland
| | - Bruce H Jones
- Injury Prevention Division, Clinical Public Health and Epidemiology Directorate, U.S. Army Public Health Center, Aberdeen Proving Ground, Maryland
| |
Collapse
|
18
|
Hajek P, Phillips-Waller A, Przulj D, Pesola F, Smith KM, Bisal N, Li J, Parrott S, Sasieni P, Dawkins L, Ross L, Goniewicz M, Wu Q, McRobbie HJ. E-cigarettes compared with nicotine replacement therapy within the UK Stop Smoking Services: the TEC RCT. Health Technol Assess 2019; 23:1-82. [PMID: 31434605 PMCID: PMC6732716 DOI: 10.3310/hta23430] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Over the past few years, a large number of smokers in the UK have stopped smoking with the help of e-cigarettes. So far, UK Stop Smoking Services (SSSs) have been reluctant to include e-cigarettes among their treatment options because data on their efficacy compared with the licensed medications are lacking. OBJECTIVE The objective was to compare the efficacy of refillable e-cigarettes and nicotine replacement therapy (NRT) products, when accompanied by weekly behavioural support. DESIGN A randomised controlled trial comparing e-cigarettes and NRT. SETTING Three sites that provide local SSSs. PARTICIPANTS The participants were 886 smokers seeking help to quit smoking, aged ≥ 18 years, not pregnant or breastfeeding, with no strong preference to use or not to use NRT or e-cigarettes in their quit attempt, and currently not using NRT or e-cigarettes. A total of 886 participants were randomised but two died during the study (one in each study arm) and were not included in the analysis. INTERVENTIONS The NRT arm (n = 446) received NRT of their choice (single or combination), provided for up to 12 weeks. The e-cigarette arm (n = 438) received an e-cigarette starter pack and were encouraged to buy addtional e-liquids and e-cigarette products of their choice. Both arms received the same standard behavioural support. Participants attended weekly sessions at their SSS and provided outcome data at 4 weeks. They were then followed up by telephone at 6 and 12 months. Participants reporting abstinence or at least 50% reduction in cigarette consumption at 12 months were invited to attend for carbon monoxide (CO) validation. Participants/researchers could not be blinded to the intervention. MAIN OUTCOME MEASURES The primary outcome was CO-validated sustained abstinence rates at 52 weeks. Participants lost to follow-up or not providing biochemical validation were included as non-abstainers. Secondary outcomes included abstinence at other time points, reduction in smoke intake, treatment adherence and ratings, elicited adverse reactions, and changes in self-reported respiratory health. A cost-efficacy analysis of the intervention was also conducted. RESULTS The 1-year quit rate was 9.9% in the NRT arm and 18.0% in the e-cigarette arm (risk ratio 1.83, 95% confidence interval 1.30 to 2.58; p < 0.001). The e-cigarette arm had significantly higher validated quit rates at all time points. Participants in the e-cigarette arm showed significantly better adherence and experienced fewer urges to smoke throughout the initial 4 weeks of their quit attempt than those in the NRT arm, and gave their allocated product more favourable ratings. They were also more likely to be still using their allocated product at 1 year (39.5% vs. 4.3%, χ2 = 161.4; p < 0.001). Participants assigned to e-cigarettes reported significantly less coughing and phlegm at 1 year than those assigned to NRT (controlling for smoking status). A detailed economic analysis confirmed that, because e-cigarettes incur lower NHS costs than NRT and generate a higher quit rate, e-cigarette use is more cost-effective. LIMITATIONS The results may not be generalisable to other types of smokers or settings, or to cartridge-based e-cigarettes. CONCLUSIONS Within the context of multisession treatment for smokers seeking help, e-cigarettes were significantly more effective than NRT. If SSSs provide e-cigarette starter packs, it is likely to boost their success rates and improve their cost-efficacy. FUTURE WORK The efficacy of e-cigarettes provided with different levels of support will show whether smokers should be encouraged to switch to vaping within support services or whether e-cigarettes can be recommended with less intensive or no support. TRIAL REGISTRATION Current Controlled Trials ISRCTN60477608. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 43. See the NIHR Journals Library website for further project information. The trial was supported by the Cancer Research UK Prevention Trials Unit (grant A16893).
Collapse
Affiliation(s)
- Peter Hajek
- Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Anna Phillips-Waller
- Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Dunja Przulj
- Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Francesca Pesola
- King's Clinical Trials Unit, Institute of Psychiatry, King's College London, London, UK
| | - Katie Myers Smith
- Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Natalie Bisal
- Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Jinshuo Li
- Department of Health Sciences, University of York, York, UK
| | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
| | - Peter Sasieni
- King's Clinical Trials Unit, Institute of Psychiatry, King's College London, London, UK
| | - Lynne Dawkins
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, London, UK
| | | | - Maciej Goniewicz
- Department of Health Behavior, Division of Cancer Prevention and Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Qi Wu
- Department of Health Sciences, University of York, York, UK
| | - Hayden J McRobbie
- Health and Lifestyle Research Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| |
Collapse
|
19
|
Bianco CL, Pratt SI, Ferron JC, Brunette MF. Electronic Cigarette Use During a Randomized Trial of Interventions for Smoking Cessation Among Medicaid Beneficiaries with Mental Illness. J Dual Diagn 2019; 15:184-191. [PMID: 31169077 DOI: 10.1080/15504263.2019.1620400] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: People with mental illness have high rates of cigarette smoking, but many wish to quit. Electronic cigarette (e-cigarette) use has become increasingly common, especially among smokers who wish to quit, but research on whether this facilitates quitting has been mixed, and little research has examined e-cigarette use among smokers with mental illness. This secondary analysis examined the associations between spontaneous e-cigarette use during cessation treatment and 6-month outcomes within a cessation trial among Medicaid beneficiaries with mental illness. Main outcomes were previously reported. Methods: Adult Medicaid beneficiaries receiving mental health services were recruited between 2012 and 2015. Eligible daily smokers were randomized, using equipoise stratification, to one of six cessation treatment conditions (combinations of prescriber visit for pharmacotherapy, behavioral interventions, and abstinence incentives; e-cigarette use was not a recommended intervention). Presence of any self-reported e-cigarette use, all tobacco product use, quit attempts, and biologically verified abstinence were assessed at 3, 6, 9, and 12 months. The 456 participants who completed the 6-month assessment were included in logistic regressions, adjusting for subject characteristics and treatment condition, examining associations between self-reported, spontaneous e-cigarette use and 6-month outcomes. We evaluated three outcomes: biologically verified abstinence at 6 months, quit attempts over the treatment period, and heavy smoking (≥20 cigarettes per day) at 6 months. Results: Any use of e-cigarettes was reported by 192 participants (42.1%) during the treatment period. Use of pharmacotherapy was not different between those who used e-cigarettes and those who did not use e-cigarettes. A total of 13.5% of participants (n = 61) had achieved biologically verified abstinence at the 6-month assessment. E-cigarettes were not significantly associated with biologically verified abstinence, use of cessation pharmacotherapy, self-reported quit attempts, or heavy smoking at the 6-month assessment. Conclusions: Spontaneous e-cigarette use during cessation treatment was common among smokers with mental illness and was not associated with positive or negative treatment outcomes. The high rate of naturalistic e-cigarette use in this group suggests that e-cigarettes are an appealing strategy to obtain nicotine during cessation treatment that could be harnessed as a smoking cessation tool or for harm reduction.
Collapse
Affiliation(s)
- Cynthia L Bianco
- Department of Psychiatry, Geisel School of Medicine, Dartmouth , Hanover , NH , USA.,Department of Psychiatry Research, Dartmouth-Hitchcock, Lebanon, NH, USA
| | - Sarah I Pratt
- Department of Psychiatry, Geisel School of Medicine, Dartmouth , Hanover , NH , USA.,Department of Psychiatry Research, Dartmouth-Hitchcock, Lebanon, NH, USA
| | - Joelle C Ferron
- Department of Psychiatry, Geisel School of Medicine, Dartmouth , Hanover , NH , USA.,Department of Psychiatry Research, Dartmouth-Hitchcock, Lebanon, NH, USA
| | - Mary F Brunette
- Department of Psychiatry, Geisel School of Medicine, Dartmouth , Hanover , NH , USA.,Department of Psychiatry Research, Dartmouth-Hitchcock, Lebanon, NH, USA
| |
Collapse
|
20
|
Mayorga NA, Garey L, Zvolensky MJ. Differences in perceptions of e-cigarettes across daily and non-daily users. Addict Behav 2019; 90:415-420. [PMID: 30537655 DOI: 10.1016/j.addbeh.2018.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 11/18/2018] [Accepted: 12/04/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVE E-cigarette use has increased significantly over the past decade. Among the growing population of e-cigarette users, several pattern-based subgroups have emerged, including daily and non-daily users. Daily users are at greater risk for experiencing negative health consequences from use. Yet, little is understood about underlying e-cigarette processes that may be related to daily use relative to non-daily use. METHOD The present study sought to investigate differences in three clinically-relevant e-cigarette processes, including perceived risks (including both absolute and comparable risks to combustible cigarettes), benefits, and innovation of e-cigarettes between daily and non-daily users. The study included 564 adult current e-cigarette users (51.1% female, Mage = 35.1 years, SD = 10.2). RESULTS Results indicated a significant difference in levels of perception for all three dependent variables, such that daily users reported a higher level of perceived risks, benefits, and innovation for e-cigarettes. CONCLUSIONS Overall, the current study provides empirical evidence that perceived risks, benefits and innovations may be more strongly endorsed by more daily e-cigarette uses. Importantly, this study adds to evolving, but thus far limited, knowledge of e-cigarettes by highlighting how frequency of e-cigarette use relates to beliefs about e-cigarette use.
Collapse
|
21
|
Park MB, Choi JK. Differences between the effects of conventional cigarettes,
e-cigarettes and dual product use on urine cotinine levels. Tob Induc Dis 2019; 17:12. [PMID: 31582923 PMCID: PMC6751982 DOI: 10.18332/tid/100527] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION METHODS RESULTS CONCLUSIONS
Collapse
Affiliation(s)
- Myung-Bae Park
- Department of Gerontal Health and Welfare, Pai Chai University, Dae Jeon, Republic of Korea
| | - Jung-Kyu Choi
- Institute of Health Insurance and Clinical Research, National Health Insurance Corporation Ilsan Hospital, Goyang, Republic of Korea
| |
Collapse
|
22
|
Rouabhia M, Alanazi H, Park HJ, Gonçalves RB. Cigarette Smoke and E-Cigarette Vapor Dysregulate Osteoblast Interaction With Titanium Dental Implant Surface. J ORAL IMPLANTOL 2019; 45:2-11. [DOI: 10.1563/aaid-joi-d-18-00009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to determine the possible deleterious effects of e-cigarette vapor on osteoblast interaction with dental implant material. Osteoblasts were cultured onto Ti6Al4V titanium implant disks and were then exposed or not to whole cigarette smoke (CS), as well as to nicotine-rich (NR) or nicotine-free (NF) e-vapor for 15 or 30 minutes once a day for 1, 2, or 3 days, after which time various analyses were performed. Osteoblast growth on the titanium implant disks was found to be significantly (P < .001) reduced following exposure to CS and to the NR and NF e-vapors. Osteoblast attachment to the dental implant material was also dysregulated by CS and the NR and NF e-vapors through a decreased production of adhesion proteins such as F-actin. The effects of CS and e-cigarette vapor on osteoblast growth and attachment were confirmed by reduced alkaline phosphatase (ALP) activity and tissue mineralization. The adverse effects of CS and the NR and NF e-vapors on osteoblast interaction with dental implant material also involved the caspase-3 pathway, as the caspase-3 protein level increased following exposure of the osteoblasts to CS or e-vapor. It should be noted that the adverse effects of CS on osteoblast growth, attachment, ALP, and mineralized degradation were greater than those of the NR and NF e-vapors, although the latter did downregulate osteoblast interaction with the dental implant material. Overall results suggest the need to consider e-cigarettes as a possible contributor to dental implant failure and/or complications.
Collapse
Affiliation(s)
- Mahmoud Rouabhia
- Groupe de Recherche en Écologie Buccale, Faculté de Médecine Dentaire, Université Laval, Québec, QC, Canada
| | - Humidah Alanazi
- Groupe de Recherche en Écologie Buccale, Faculté de Médecine Dentaire, Université Laval, Québec, QC, Canada
| | - Hyun Jin Park
- Groupe de Recherche en Écologie Buccale, Faculté de Médecine Dentaire, Université Laval, Québec, QC, Canada
| | - Reginaldo Bruno Gonçalves
- Groupe de Recherche en Écologie Buccale, Faculté de Médecine Dentaire, Université Laval, Québec, QC, Canada
| |
Collapse
|
23
|
Bianco CL. Rates of electronic cigarette use among adults with a chronic mental illness. Addict Behav 2019; 89:1-4. [PMID: 30237110 DOI: 10.1016/j.addbeh.2018.08.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/06/2018] [Accepted: 08/28/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Electronic cigarette (e-cig) use has increased dramatically over the past decade, rates of e-cig use among those with a chronic mental illness has largely been unexplored. Exploring this relationship for adults with a mental illness is necessary when examining the health needs of this population. METHODS Data from the 2016 National Health Interview Survey (NHIS) was used to explore associations between e-cig use and chronic mental illness. E-cig use was explored in two different contexts, having tried an e-cig at least once and current e-cig use. Chronic mental illness was categorized as depression, anxiety, emotional disorder, or ADD, bipolar, schizophrenia, other disorder. RESULTS Rates of ever trying an e-cig and current e-cig use were higher among those with a chronic mental illness. Complex logistic regressions suggested having a chronic mental illness significantly increases the likelihood of both trying an e-cig and being an e-cig user. CONCLUSIONS Increased likelihood of e-cig use in chronic mental illness supports previous findings. This may be due to perceptions that e-cigs are less harmful and they provide ways of socially connecting with others. IMPLICATIONS Current knowledge surrounding e-cig use in this population is lacking. The 2016 NHIS allows for a nationally representative prediction of e-cig use in this population. This data is relevant in monitoring potential harm caused by e-cigs, in addition it may be helpful when assessing the value of e-cigs as a smoking cessation tool for those with a mental illness.
Collapse
|
24
|
Zvolensky MJ, Mayorga NA, Garey L. Worry, anxiety sensitivity, and electronic cigarettes among adults. Psychiatry Res 2018; 269:321-327. [PMID: 30173037 PMCID: PMC10034964 DOI: 10.1016/j.psychres.2018.08.087] [Citation(s) in RCA: 21] [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: 05/16/2018] [Revised: 08/22/2018] [Accepted: 08/24/2018] [Indexed: 12/27/2022]
Abstract
Although electronic cigarette (e-cigarette) use is now a common substance use behavior, there is little understanding of the individual difference factors related to e-cigarette use beliefs and dependence. The present investigation sought to test a theoretically-driven model of anxiety sensitivity as an explanatory element in a worry-e-cigarette beliefs and dependence model. Participants included 558 adult e-cigarette users (51.4% female; 35.2 years, SD = 10.1) who were nationally recruited via an online survey system. Participants completed a single survey that assessed their mood and e-cigarette behavior and beliefs. Results supported a statistically significant indirect pathway for worry in relation to perceived benefits of e-cigarettes, e-cigarette positive outcome expectancies, and e-cigarette dependence via anxiety sensitivity; effect sizes were small. The indirect effects were evident when accounting for several theoretically relevant covariates (sex, income, education, concurrent cigarette use, and neuroticism). This study provides the first empirical evidence of the role of anxiety sensitivity in the relation between worry and e-cigarette use beliefs and behavior, which may represent a novel intervention target.
Collapse
Affiliation(s)
- Michael J Zvolensky
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX 77204, USA; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Health Institute, University of Houston, Houston, TX, USA.
| | - Nubia A Mayorga
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX 77204, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX 77204, USA
| |
Collapse
|
25
|
Le D, D'Souza G, Atnafou R, Matson PA, Jones MR, Moran MB. "It Felt Like I Was Smoking Nothing:" Examining E-cigarette Perception and Discontinuation among Young Adults. HEALTH BEHAVIOR AND POLICY REVIEW 2018; 5:50-55. [PMID: 32490029 PMCID: PMC7266136 DOI: 10.14485/hbpr.5.6.4] [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] [Indexed: 11/18/2022]
Abstract
OBJECTIVE In this study, we sought to understand why young adults from urban low-income regions discontinue using e-cigarettes. METHODS We recruited 97 tobacco users aged 18-26 years from Baltimore, Maryland to participate in 17 focus groups. Qualitative data were analyzed using framework analysis. RESULTS Being less satisfying than combustible tobacco, perceived cumulating costs, and negative physical effects were expressed as top reasons for never using or discontinuing the use of e-cigarettes. CONCLUSION Understanding why young adults discontinue e-cigarette use is critical to inform e-cigarette intervention efforts and public policy. If e-cigarettes are to be promoted as harm reduction devices for combustible tobacco users, it will be important to ensure that they are affordable, satisfying, and formulated to minimize negative physical effects.
Collapse
Affiliation(s)
- Daisy Le
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | | | | | | - Miranda R Jones
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | | |
Collapse
|
26
|
Sussan TE, Shahzad FG, Tabassum E, Cohen JE, Wise RA, Blaha MJ, Holbrook JT, Biswal S. Correction to: electronic cigarette use behaviors and motivations among smokers and non-smokers. BMC Public Health 2018; 18:175. [PMID: 29368600 PMCID: PMC5784689 DOI: 10.1186/s12889-018-5048-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 01/09/2018] [Indexed: 11/21/2022] Open
Affiliation(s)
- Thomas E Sussan
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA.,Present Address: United States Army Public Health Center, Toxicology Directorate, Aberdeen Proving Ground, Aberdeen, MD, USA
| | - Fatima G Shahzad
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA
| | - Eefa Tabassum
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Robert A Wise
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Michael J Blaha
- Department of Medicine, Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Janet T Holbrook
- Department of Epidemiology, Center for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shyam Biswal
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, USA.
| |
Collapse
|
27
|
Kawamura K, Yamada K, Morioka I. [Health Effects Accompanying the Transition from Cigarettes to Heat-not-burn Tobacco: Nicotine Dependence, Nicotine Withdrawal Symptoms, and Changes in Smoking Behaviors]. Nihon Eiseigaku Zasshi 2018; 73:379-387. [PMID: 30270306 DOI: 10.1265/jjh.73.379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The purposes of this research were to investigate the hazardous effects of heat-not-burn tobacco and to clarify the health effects accompanying the transition from cigarettes to heat-not-burn tobacco. METHODS The concentrations of carbon monoxide, ammonia, formaldehyde, acetaldehyde, and dust (hazardous substances) were measured in the smoke of heat-not-burn tobacco. Twenty-nine smokers were used as the subjects. The concentrations of hazardous substances were measured in exhalation of heat-not-burn tobacco. The concentration of cotinine in saliva was also measured after the transition. A questionnaire survey was performed before and after the transition to evaluate nicotine dependence, nicotine withdrawal symptoms, and smoking behaviors. RESULTS In the mainstream smoke, all hazardous substances investigated were detected. Carbon monoxide and dust were detected in the exhalation of heat-not-burn tobacco. The concentration of cotinine in the saliva of heat-not-burn tobacco users corresponded to that of cigarette smokers. Cigarette smoking was significantly positively related to the score of Fagerström Test for Nicotine Dependence (FTND). Heat-not-burn tobacco was significantly positively related to FTND and Minnesota Nicotine Withdrawal Scale (MNWS) scores. The group in which the number of heat-not-burn tobacco sticks consumed increased after transition showed a smaller number of cigarettes consumed and a higher MNWS score before transition than the group in which it decreased after transition. These two factors were significantly related to the difference between the numbers of cigarettes and heat-not-burn tobacco sticks in multiple linear regression analysis. CONCLUSIONS The mainstream smoke of heat-not-burn tobacco contains harmful substances. There were the possibilities that nicotine dependence and nicotine withdrawal symptoms appear after transition and that the number of heat-not-burn tobacco sticks consumed increases.
Collapse
Affiliation(s)
- Kosuke Kawamura
- Graduate School of Health and Nursing Science, Wakayama Medical University
| | - Kazuko Yamada
- Graduate School of Health and Nursing Science, Wakayama Medical University
| | - Ikuharu Morioka
- Graduate School of Health and Nursing Science, Wakayama Medical University
| |
Collapse
|