E-Cigarettes and Smoking Cessation: A Primer for Oncology Clinicians

Differences in Pain Severity and Interference between Latinx Combustible Cigarette Smokers and Dual Users with Current Pain

Latinx individuals who smoke represent a tobacco health disparities group. Yet, limited research has focused on examining dual combustible and electronic cigarette use among Latinx populations. Importantly, Latinx persons who smoke also evince elevated rates of pain problems and symptoms and prior research has consistently linked pain problems and severity to smoking prevalence, maintenance, and behavior. Accordingly, the current study sought to build from the limited work that exists among dual combustible cigarette and electronic cigarette Latinx users comparing levels of pain severity and interference. The current sample consists of 196 adult Latinx daily cigarette smokers (35.48 years old; 39.4% female), of which 72 reported current daily dual use of an e-cigarette. Results indicated that Latinx dual users reported greater levels of pain severity (ηp2 = .12) and pain interference (ηp2 = .10) than exclusive combustible cigarette users. The study adds uniquely to the limited literature on the clinical importance of dual cigarette use in relation to pain severity and interference in that pain may serve as an important risk factor for the initiation and maintenance of dual use for increased analgesic nicotine effects.

Opinions and Practices Regarding Electronic Cigarette Use among Middle School Students from Rural Areas of Romania

Background: The objectives of the study were to assess awareness, opinions, and practices regarding electronic cigarette (e-cigarette) use, as well as factors associated with their use, among middle-school aged students from rural areas of Romania. Methods: The study sample included 748 middle-school students aged 13–14 years from 24 schools from rural areas situated in two counties from Romania, after receiving parental consent. A cross-sectional study using confidential questionnaires which assessed smoking-related behaviors, and also opinions and practices related to e-cigarettes use, was performed in 2019 among the participating middle-schoolers. Results: 96.3% of the middle schoolers have heard about e-cigarettes. A percentage of 72.7% of the smokers, 50.8% of the ex-smokers, and 15.4% of the non-smokers had tried e-cigarettes at least once in their life; 20.3% of the smokers, 4.8% of the ex-smokers, and 4.5% of the non-smokers reported using e-cigarettes in the last month. The results of multivariate logistic regression analysis pointed out that e-cigarette use at least once during lifetime was associated with having friends who tried e-cigarettes, having stronger beliefs that they can help quit smoking and that they are less dangerous than traditional cigarettes. The intention to use e-cigarettes in the next year and smoking behavior were also correlated with e-cigarettes experimentation, while no gender differences were found. Conclusions: The results underline the importance of having prevention programs and interventions concerning e-cigarettes consumption, since e-cigarettes consumption is spread among Romanian adolescents from rural areas.

A Mixed Methods Pilot Study on the Short-Term Physiological Effects of Vaping and Attitudes Regarding Its Use and Health Effects in Samples of Young Adults

Vaping is a fairly new and legal way young people are inhaling substances into their lungs. Very little is currently known about the immediate physiological impact or the psychosocial reasons surrounding vape use. This study used a mixed methods approach to (a) understand the short-term physiological implications of vape use compared with people who do not vape and (b) investigate the reasons people choose to vape compared with those who choose not to vape. Twenty-four people participated in the study: 12 self-identified as nonvapers, and 12 self-identified as people who vape. All participants were between 18 and 24 years old. Qualitative analysis suggested people vape because they think it is cool, think it is less risky than smoking, and enjoy the social aspects of vaping. People who choose not to vape are concerned about the unknown health implications, think it is a waste of resources, and are apathetic toward it. Quantitative results revealed statistically significant increases in heart rate and decreases in the percentage of blood oxygenation after 20 minutes of vape use. Blood pressure, respiratory rate, and blood sugar scores did not significantly change after 20 minutes of vape use. Differences in the frequencies of men and women across the two groups were found. Significant differences found for systolic blood pressure, respiratory rate, and pulmonary function test became nonsignificant after controlling for gender. Both long- and short-term effects of vaping need to be further evaluated. The psychosocial reasons why certain people vape whereas others in the same peer group do not also need to be better understood.

Fatigue severity and electronic cigarette beliefs and use behavior

Electronic cigarette (e-cigarette) use has risen dramatically in the United States. Clinically significant fatigue may represent one previously unexplored individual difference factor related to e-cigarette use patterns and e-cigarette specific cognitive processes. Fatigue reflects the experience of being tired, lacking energy, and feeling exhausted. Although fatigue is a normal bodily response, severe or chronic fatigue is maladaptive. Thus, the current study sought to evaluate clinically significant fatigue and its relation to perceived barriers for quitting e-cigarettes, perceived risks and perceived benefits of e-cigarette use, and e-cigarette dependence among 625 adult e-cigarette smokers (51.8% female, M_age = 34.91 years, SD = 10.29). Results indicated that severe fatigue was significantly related to greater perceived barriers to quitting (p < .001), perceived risks (p < .001) and perceived benefits (p < .001) of e-cigarette use, and greater e-cigarette dependence (p < .001); effects that were evident after adjusting for a range of other factors (e.g., combustible cigarette use, pain severity). These novel empirical results highlight the severity of fatigue as a potentially important construct in efforts to better understand beliefs related to e-cigarette use and e-cigarette dependence.

E-cigarettes and head and neck cancers: A systematic review of the current literature

BACKGROUND

Cigarette smoking is a well-established risk factor for head and neck (HN) cancers. Use of electronic cigarettes (e-cigarettes) is gaining popularity, being advertised as benign alternatives to tobacco. A wide variety of potentially harmful chemical components with variable quantity have been identified in e-liquids and aerosols of e-cigarettes. However, use of e-cigarettes remains controversial due to conflicting evidence.

OBJECTIVES

We aimed to assess the association between e-cigarettes and HN cancers. We conducted a systematic review to evaluate the literature for evidence on carcinogenic effects of e-cigarettes in the pathogenesis of HN cancers.

TYPE OF REVIEW

Qualitative systematic review.

SEARCH STRATEGY

A PubMed/MEDLINE, Cochrane, CINAHL Plus, Trip Medical Database and Web of Science search was done for studies on e-cigarettes and HN cancer.

EVALUATION METHOD

Abstract review of all articles, full article revision of included studies, data extraction and quality assessment were performed by two independent assessors.

RESULTS

The literature search resulted in the identification of 359 articles. Eighteen articles were selected for inclusion into the systematic review. The majority were laboratory-based studies, followed by several cohort and case studies, representing low-level evidence. A few reports suggested DNA damage following exposure to e-cigarettes potentially due to increased oxidative stress. Flavoured e-liquids appear to be more harmful. There is variable evidence from clinical studies.

CONCLUSIONS

Our review outlines potential dangers associated with the use of e-cigarettes and their role in HN cancers. More longitudinal and controlled studies are needed to assess the possible link between e-cigarettes and HN cancers.

How do we determine the impact of e-cigarettes on cigarette smoking cessation or reduction? Review and recommendations for answering the research question with scientific rigor

AIMS

To propose a hierarchy of methodological criteria to consider when determining whether a study provides sufficient information to answer the question of whether e-cigarettes can facilitate cigarette smoking cessation or reduction.

DESIGN

A PubMed search to 1 February 2017 was conducted of all studies related to e-cigarettes and smoking cessation or reduction.

SETTINGS

Australia, Europe, Iran, Korea, New Zealand and the United States.

PARTICIPANTS AND STUDIES

91 articles.

MEASUREMENTS

Coders organized studies according to six proposed methodological criteria: (1) examines outcome of interest (cigarette abstinence or reduction), (2) assesses e-cigarette use for cessation as exposure of interest, (3) employs appropriate control/comparison groups, (4) ensures that measurement of exposure precedes the outcome, (5) evaluates dose and duration of the exposure and (6) evaluates the type and quality of the e-cigarette used.

FINDINGS

Twenty-four papers did not examine the outcomes of interest. Forty did not assess the specific reason for e-cigarette use as an exposure of interest. Twenty papers did not employ prospective study designs with appropriate comparison groups. The few observational studies meeting some of the criteria (duration, type, use for cessation) triangulated with findings from three randomized trials to suggest that e-cigarettes can help adult smokers quit or reduce cigarette smoking.

CONCLUSIONS

Only a small proportion of studies seeking to address the effect of e-cigarettes on smoking cessation or reduction meet a set of proposed quality standards. Those that do are consistent with randomized controlled trial evidence in suggesting that e-cigarettes can help with smoking cessation or reduction.

Electronic Nicotine Delivery Systems (ENDS): What Nurses Need to Know

BACKGROUND

Efforts to decrease adverse effects of tobacco use are affected by emergence of new nicotine delivery products. Advertising, product promotion, and social media promote use of these products, yet a lack of evidence regarding safety leaves nurses unprepared to counsel patients.

OBJECTIVES

To critically evaluate current research, reviews of literature, expert opinion, and stakeholder policy proposals on use and safety of electronic nicotine delivery systems (ENDS).

DESIGN

A targeted examination of literature generated by key stakeholders and subject matter experts was conducted using key words, modified by risk factors, and limited to the past 8 years.

RESULTS

Current knowledge gaps in research literature and practice implications of the literature are discussed.

CONCLUSIONS

The safety of ENDS is questionable and unclear. There are clear health risks of nicotine exposure to developing brains. Potential health risks of ENDS secondhand emissions exposure exist. Using ENDS to facilitate total tobacco cessation is not proven.