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Qureshey AK, Nawawi AF, Alsaedi JR, Alzahrani YA, Alkhlaqi HA, Filfilan FF, Alghamdi AM, Aljunaid MA. Knowledge, Perception, and Associated Factors of Electronic Cigarette Consumption Among the Saudi Population in Jeddah City. Cureus 2024; 16:e60155. [PMID: 38736764 PMCID: PMC11088950 DOI: 10.7759/cureus.60155] [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] [Accepted: 05/12/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction Electronic cigarettes (e-cigarettes) are rising in popularity among young adults and teenagers. Previous studies have shown that among high and middle schoolers, the percentage of e-cigarette smokers was noticeably higher than tobacco cigarette smokers. Various research papers focusing on different communities have reported a low-to-moderate level of knowledge and awareness of e-cigarette's effects on health. E-cigarettes were initially advertised as devices to help people quit smoking, but the use of e-cigarettes in modern days has changed considerably. A big chunk of the population perceived that e-cigarettes have no harmful effects because they are nicotine-free and thus are used as a replacement for regular cigarettes rather than as a way to quit smoking. Objectives The study aimed to assess the perception of e-cigarette consumption and associated factors among the Saudi population in Jeddah city. Methodology A cross-sectional study was conducted on the Saudi population in Jeddah, Saudi Arabia, during the year 2023. The study assessed the participant's perceptions of e-cigarette consumption and its risk factors. A pre-existing online questionnaire created by Google Forms was distributed among the population through social media applications to collect data after obtaining their informed consent. Results A total of 515 participants were included in this study. Relatives and friends were the most common sources (54%) for information about e-cigarettes. Of the sample, 17.5% thought that e-cigarettes were safer than conventional cigarettes, 13.4% used e-cigarettes on a regular basis, and 65% had not smoked electronically before. Vaping pushed only 17.2% to try traditional tobacco cigarettes, and 25% stopped using traditional tobacco products after starting to smoke e-cigarettes. Gender, age group, and total family salary were the associated factors with the use of e-cigarettes. In addition, an association between the perception of e-smoking and its use was noticed, as well as a significant association between gender and withdrawal symptoms. Conclusion A minority of the participants perceived that e-cigarette smoking is safer than conventional methods of smoking. The majority did not practice e-smoking at all. Furthermore, results showed that relatives and friends were the most common sources of information. The findings from the correlation testing underscore several noteworthy associations within the studied population. Notably, gender, age, total family salary, and occupation exhibited statistically significant correlations with e-cigarette usage.
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Record RA, Groznik M, Sussman M. Communicative Processes Underlying DIY eJuice Mixing Among Young Adult International ENDS Users. HEALTH COMMUNICATION 2024; 39:666-674. [PMID: 36809903 DOI: 10.1080/10410236.2023.2179718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The use of electronic nicotine delivery systems (ENDS) is increasing around the world, with contemporary trends outpacing scientific understanding of the health implications. Such trends include do-it-yourself eJuice mixing (DIY eJuice), which involves the unregulated homemade mixing of fogging agents, nicotine salts, and flavorants to create personalized liquid for ENDS products. The purpose of this study was to employ a grounded theory approach to gather formative data on the communicative processes surrounding the behavior of DIY eJuice mixing among international, young adult ENDS users. Participants were recruited locally for mini focus group discussions via SONA (n = 4) and internationally for an open-ended survey via Prolific (n = 138). Questions explored experiences with the online DIY eJuice community, motivations for mixing, information seeking strategies, flavor preferences, and perceived benefits of mixing. Thematic analysis and flow sketching revealed the underlying processes of social cognitive theory to explain the communicative processes of DIY eJuice mixing behaviors. Specifically, environmental determinants emerged in the form of online and social influences; personal determinants in the form of curiosity and control; and behavioral determinants following a benefits/barriers analysis, particularly regarding cost. These findings provide theoretical implications for the role of health communication constructs in understanding contemporary trends in ENDS use and practical implications for tobacco prevention messaging and tobacco control regulations.
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Affiliation(s)
| | | | - Mark Sussman
- Department of Biology, San Diego State University
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Mohamed R, Siddiqui Z, Sutphin R, Kelly KM. Illness representations of vaping associated lung injury (VALI) and E-cigarette use: common sense model of self-regulation driven mixed-method approach. Psychol Health 2023; 38:1494-1514. [PMID: 35014574 DOI: 10.1080/08870446.2021.2024828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 12/01/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The study explored differences in illness representations of VALI guided by the Common-Sense Model of Self-Regulation (CSM-SR) among non-patient adults. DESIGN We employed a cross-sectional concurrent mixed-methods design. In the quantitative analysis, we used multivariate analysis of covariance (MANCOVA). Immersion/crystallization was used to analyze qualitative data. MAIN OUTCOME MEASURES We measured differences in illness representations of VALI by e-cigarette use status, gender, and urban/rural residence. RESULTS E-cigarette use was associated with illness representations of VALI. Current e-cigarette users discounted the detrimental nature of VALI, compared to former and never e-cigarette users. Gender and urban/rural residence moderated the association between e-cigarette use and illness representation of VALI. In the qualitative analysis, 49.3% respondents reported components of the timeline (e.g. permanent), identity (e.g. shortness of breath), causes (e.g. THC products), consequences (e.g. life-threatening), cure/control (e.g. stop vaping), and worry (e.g. fearful). CONCLUSION Perceptions about VALI, such as cure and timeline, were associated with e-cigarettes use. Understanding the context in which adults perceive VALI, such as gender and rurality, may contribute to developing interventions that influence e-cigarette cessation. Future research employing CSM-SR to target strategies for promoting vaping abstinence is warranted.
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Affiliation(s)
- Rowida Mohamed
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Zasim Siddiqui
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Richard Sutphin
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Kimberly M Kelly
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
- West Virginia University Cancer Institute, Morgantown, West Virginia, USA
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Kotewar SS, Pakhale A, Tiwari R, Reche A, Singi SR. Electronic Nicotine Delivery System: End to Smoking or Just a New Fancy Cigarette. Cureus 2023; 15:e43425. [PMID: 37706142 PMCID: PMC10497069 DOI: 10.7759/cureus.43425] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/13/2023] [Indexed: 09/15/2023] Open
Abstract
Smoking and tobacco chewing are the predominant causes of oral cancer. Tobacco is the second-most widely consumed psychoactive substance. There are numerous ways to quit smoking, of which one is electronic cigarettes (e-cigarettes). E-cigarette use is a brand-new, global trend. E-cigarette is a battery-operated device that heats a liquid to create a vapor that the consumer inhales. Several countries have acknowledged that the first step toward electronic nicotine delivery system (ENDS) management is a precise classification of ENDS within the limits of current legislation. Countries have currently categorized ENDS into four generations. People's perceptions about tobacco products have altered recently as a consequence of the advertising of ENDS. The likelihood of starting to smoke cigarettes was four times higher in adolescents who used ENDS, and the probability of quitting was reduced and often prolonged in those who used ENDS. In addition, ENDS normalizes smoking-like actions including inhaling in and exhaling smoke. Adverse marketing via geographic locations and social media platforms, as well as nicotine's irreversible effects on growing adolescent and young adult brains that predispose individuals to addicted behaviors, may be responsible for their rising appeal among teenagers. Despite this, ENDS use has risen among young individuals who have never smoked and undoubtedly face more health risks than those who do not use ENDS. The oral cavity is the first to encounter ENDS in individuals and where it initially affects the human system. As a known contributor to cardiovascular diseases, neurological conditions, and cancers, nicotine seems to be a serious cause for concern. This review provides a concise summary of the research on the components, mode of action, applications, and effects of e-cigarettes on oral as well as systemic systems.
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Affiliation(s)
- Samrudhi S Kotewar
- Department of Public Health Dentistry, Sharad Pawar Dental College ad Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Aayushi Pakhale
- Department of Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Rupali Tiwari
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Amit Reche
- Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
| | - Shriya R Singi
- Department of Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND
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Rychert M, Romeo JS, Wilkins C. Exploring Differences in Daily Vaping of Nicotine and Cannabis among People Who Use Drugs in New Zealand. Subst Use Misuse 2023; 58:1388-1398. [PMID: 37328432 DOI: 10.1080/10826084.2023.2223276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background: Little is known about daily vaping of different substances, particularly cannabis. Aim: To explore daily vaping of cannabis and nicotine products in a sample of people who use drugs in New Zealand. Method: The online New Zealand Drug Trends convenience survey (N = 23,500) was promoted to those aged 16+ via a targeted Facebook™ campaign, with 9,042 reporting vaping in the past six months. Multivariate logistic regression models were fitted to identify predictors of daily vaping of: (i) nicotine e-liquids, (ii) no-nicotine e-liquids, (iii) cannabis e-liquids/oils, (iv)cannabis herb. Results: Forty-two percent of past 6-month vapers used a vaporizing device "daily or near daily" (n = 3,508). Nicotine was most common substance used by daily vapers (96%), followed by dry herb cannabis (12%), no-nicotine e-liquids (10%) and cannabis e-liquid (6%). Daily vaping of no-nicotine e-liquids was associated with abstinence from tobacco use. Frequency of cannabis use was negatively correlated with daily vaping of nicotine liquids and positively correlated with daily vaping of no-nicotine and herbal cannabis. Younger age strongly predicted daily vaping of nicotine and no-nicotine liquids, but the reverse association was observed for daily vaping of herbal cannabis. Māori were less likely to daily vape cannabis herb than NZ Europeans. Daily vaping of both cannabis e-liquid and cannabis herb was associated with medicinal cannabis use. Conclusion: Daily vapers of nicotine and cannabis differed by several characteristics. Younger age group is at risk of daily vaping nicotine and non-nicotine, while herbal cannabis vaping is associated with older and medicinal use, suggesting a need for a nuanced vape policy response.
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Affiliation(s)
- Marta Rychert
- Shore & Whāriki Research Centre, College of Health, Massey University, Palmerston North, New Zealand
| | - Jose S Romeo
- Shore & Whāriki Research Centre, College of Health, Massey University, Palmerston North, New Zealand
| | - Chris Wilkins
- Shore & Whāriki Research Centre, College of Health, Massey University, Palmerston North, New Zealand
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Mears MJ, Hookfin HL, Bandaru P, Vidal P, Stanford KI, Wold LE. Electronic Nicotine Delivery Systems and Cardiovascular/Cardiometabolic Health. Circ Res 2023; 132:1168-1180. [PMID: 37104558 PMCID: PMC10154046 DOI: 10.1161/circresaha.123.321565] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The use of electronic nicotine delivery systems, specifically electronic cigarettes (e-cig), has risen dramatically within the last few years; the demographic purchasing these devices is now predominantly adolescents that are not trying to quit the use of traditional combustible cigarettes, but rather are new users. The composition and appearance of these devices has changed since their first entry into the market in the late 2000s, but they remain composed of a battery and aerosol delivery system that is used to deliver breakdown products of propylene glycol/vegetable glycerin, flavorings, and potentially nicotine or other additives. Manufacturers have also adjusted the type of nicotine that is used within the liquid to make the inhalation more palatable for younger users, further affecting the number of youth who use these devices. Although the full spectrum of cardiovascular and cardiometabolic consequences of e-cig use is not fully appreciated, data is beginning to show that e-cigs can cause both short- and long-term issues on cardiac function, vascular integrity and cardiometabolic issues. This review will provide an overview of the cardiovascular, cardiometabolic, and vascular implications of the use of e-cigs, and the potential short- and long-term health effects. A robust understanding of these effects is important in order to inform policy makers on the dangers of e-cigs use.
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Affiliation(s)
- Matthew J. Mears
- Dorothy M. Davis Heart and Lung Research Institute and Department of Physiology and Cell Biology, College of Medicine and Wexner Medical Center, The Ohio State University, Columbus, OH
| | - Harrison L. Hookfin
- Dorothy M. Davis Heart and Lung Research Institute and Department of Physiology and Cell Biology, College of Medicine and Wexner Medical Center, The Ohio State University, Columbus, OH
| | - Priya Bandaru
- Dorothy M. Davis Heart and Lung Research Institute and Department of Physiology and Cell Biology, College of Medicine and Wexner Medical Center, The Ohio State University, Columbus, OH
| | - Pablo Vidal
- Dorothy M. Davis Heart and Lung Research Institute and Department of Physiology and Cell Biology, College of Medicine and Wexner Medical Center, The Ohio State University, Columbus, OH
| | - Kristin I. Stanford
- Dorothy M. Davis Heart and Lung Research Institute and Department of Physiology and Cell Biology, College of Medicine and Wexner Medical Center, The Ohio State University, Columbus, OH
| | - Loren E. Wold
- Dorothy M. Davis Heart and Lung Research Institute and Department of Physiology and Cell Biology, College of Medicine and Wexner Medical Center, The Ohio State University, Columbus, OH
- Division of Cardiac Surgery, Department of Surgery, College of Medicine, The Ohio State University, Columbus, OH
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Wężyk-Caba I, Kaleta D, Zajdel R, Balwicki Ł, Świątkowska B. Do Young People Perceive E-Cigarettes and Heated Tobacco as Less Harmful Than Traditional Cigarettes? A Survey from Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14632. [PMID: 36429359 PMCID: PMC9690410 DOI: 10.3390/ijerph192214632] [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: 10/04/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
New tobacco and nicotine-containing products are gaining more popularity among young people. The aim of this study is to assess the prevalence in the perception of e-cigarettes and heated tobacco among young people in Poland and to assess the factors that are positively correlated with this perception. A cross-sectional study covering almost 12,000 adolescents aged 13-18 was carried out in January and February 2020. Data were collected through a detailed questionnaire recommended for monitoring tobacco use by adolescents. The results of the study showed that 52.2% and 61.9% of young people perceive e-cigarettes and heated tobacco products as less harmful compared to traditional cigarettes, respectively. The risk of perceiving these products as less harmful than smoking was higher among older adolescents, males, those who used these products, had a family member who used e-cigarettes/heated tobacco products and those who were exposed to tobacco advertising. Our study indicates the need to consider the coexistence of traditional smoking, e-cigarettes and heated tobacco and its impact on the assessment of the harmfulness of these products. More research is needed to better understand how perceptions of the harmfulness of e-cigarettes and heated tobacco affect their subsequent use.
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Affiliation(s)
- Ilona Wężyk-Caba
- Department of Hygiene and Epidemiology, Medical University of Lodz, 7/9 Żeligowskiego Street, 90-752 Łódź, Poland
| | - Dorota Kaleta
- Department of Hygiene and Epidemiology, Medical University of Lodz, 7/9 Żeligowskiego Street, 90-752 Łódź, Poland
| | - Radosław Zajdel
- Department of Informatics in Business, University of Łódź, POW 3/5 Street, 90-255 Łódź, Poland
| | - Łukasz Balwicki
- Department of Public Health and Social Medicine, Medical University of Gdańsk, 7 Dębinki Street, 80-210 Gdańsk, Poland
| | - Beata Świątkowska
- Department of Hygiene and Epidemiology, Medical University of Lodz, 7/9 Żeligowskiego Street, 90-752 Łódź, Poland
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Martins BNFL, Normando AGC, Rodrigues-Fernandes CI, Wagner VP, Kowalski LP, Marques SS, Marta GN, Júnior GDC, Ruiz BII, Vargas PA, Lopes MA, Santos-Silva AR. Global frequency and epidemiological profile of electronic cigarette users: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:548-561. [PMID: 36182650 DOI: 10.1016/j.oooo.2022.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/19/2022] [Accepted: 07/26/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Electronic cigarette (e-cigarette) use is growing significantly worldwide, especially among young people. This product has been associated with renormalizing smoking and hindering quit attempts in smokers. Moreover, among nonsmokers, it can lead to subsequent cigarette smoking and nicotine dependence. The present study aimed to assess the epidemiological profile of e-cigarette users worldwide. STUDY DESIGN A systematic review was performed using 3 main electronic databases (Medline/PubMed, SCOPUS, and EMBASE). Studies were independently assessed by 2 reviewers based on established eligibility criteria. The risk of bias was assessed using the MAStARI critical appraisal instrument. RESULTS From 4,496 records, 43 were included. Among the 1,238,392 participants, 132,786 (10.72%) were e-cigarette users. The age range with the highest percentage of e-cigarette users was 18-24 years old, with 40,989 (30.86%) males, 34,875 (26.26%) females, and 33.6% being current cigarette smokers. The highest prevalence of users was 52.88% in Croatia and 49.62% in New Zealand. Other possible correlations were observed with e-cigarette use, such as a high level of education. CONCLUSION Overall, e-cigarette users tended to be male young adults with a higher level of education. The highest prevalence of use was found in Croatia. This systematic review provides valuable information to improve the development of appropriate intervention strategies targeting e-cigarette users for more accurate anti-smoking actions.
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Affiliation(s)
| | | | | | - Vivian Petersen Wagner
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery, University of Sao Paulo Medical School and Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Sandra Silva Marques
- São Paulo State Reference Centre on Alcohol, Tobacco and Other Drugs, Secretary of Health, São Paulo, Brazil; State Coordination of the Tobacco Program, São Paulo, Brazil
| | - Gustavo Nader Marta
- Department of Radiation Oncology, Hospital Sírio-Libanês São Paulo, São Paulo, Brazil
| | - Gilberto de Castro Júnior
- Clinical Oncology Service, São Paulo State Cancer Institute (ICESP-FMUSP), São Paulo, São Paulo, Brazil
| | | | - Pablo Agustin Vargas
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, São Paulo, Brazil
| | - Marcio Ajudarte Lopes
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, São Paulo, Brazil.
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Gibson-Young L, Martinasek M, Tamulevicius N, Fortner M, Alanazi AM. Examining electronic nicotine delivery system use and perception of use among college students with and without asthma across the South. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:2026-2032. [PMID: 33151831 DOI: 10.1080/07448481.2020.1842414] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 07/29/2020] [Accepted: 10/18/2020] [Indexed: 06/11/2023]
Abstract
BackgroundThe effects of environmental tobacco smoke is a risk factor for everyone, but more so for individuals living with asthma. Most studies have focused on youth and young adults as the vulnerable population affected by secondhand smoke with policies related to secondhand smoke enacted to lessen such exposure given the known negative health effects. Most individuals are aware that secondhand exposure to tobacco smoke is not healthy, yet there is a shortage of literature on the secondhand vapor associated with electronic nicotine delivery systems (ENDS). Suggestions for nicotine, metals, and carcinogens in secondhand vapor are beginning to emerge in the literature but are still not common knowledge to the public. This study aims to look at the demographic differences among young adults (college students) with asthma and non-asthma concerning ENDS use. A secondary aim will also look at the difference in perceived health status and perception of harm in the relationship between asthma and ENDS use in these two populations. Methods: A cross-sectional online survey was designed and disseminated to two independent southeastern colleges. The survey was prepared following a comprehensive review of the literature by a group of experts focused on ENDS usage. The survey examined self-reported usage of and perceptions of ENDS within college students with and without asthma. Results: Approximately 50% of college-age students' perceived ENDS vapor as less harmful than traditional cigarette smoke. Around 24% of the students stated they use ENDS daily with over 50% of these students utilizing ENDS in the past 30 days. Asthma was a significant predictor in reporting lower perceived health status than students without asthma and perceived health status was a significant predictor of reporting fewer ever use of ENDS. Higher than the national average, 19% of students self-identified with an asthma diagnosis, and the use of ENDS was 20% in students without asthma and 27% in students with asthma. Conclusions: There are limited studies on perceptions related to ENDS and exposures in college students with and without asthma. Since 2007, various alternative forms of ENDS devices have been marketed. ENDS have gained popularity with young adults and college-age students, while rates of traditional cigarette usage have declined. College students report less perceived harm with ENDS over traditional cigarettes, yet studies acknowledge the high levels of the addictive substance nicotine. Of great concern is the lack of knowledge that college students have regarding nicotine based on their perceptions and the increasing use of these devices in those individuals with underlying respiratory conditions.
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Affiliation(s)
| | - Mary Martinasek
- Public Health, Department of Health Sciences and Human Performance, University of Tampa, Tampa, Florida, USA
| | - Nauris Tamulevicius
- Health Science and Human Performance, Department of Health Sciences and Human Performance, University of Tampa, Tampa, Florida, USA
| | - Molly Fortner
- Alabama Allergy and Asthma Center, Birmingham, Alabama, USA
| | - Abdullah M Alanazi
- Rehabilitation Science Program, School of Health Professions, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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Zhu SH, Ong J, Wong S, Cole A, Zhuang YL, Shi Y. Early adoption of heated tobacco products resembles that of e-cigarettes. Tob Control 2022; 31:e35-e40. [PMID: 33542070 PMCID: PMC8333247 DOI: 10.1136/tobaccocontrol-2020-056089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 12/17/2020] [Accepted: 01/02/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Heated tobacco products (HTP) generate nicotine-containing aerosol by heating tobacco rather than burning it. The US Food and Drug Administration (FDA) has recently authorised the sale of one HTP brand, iQOS, in the USA. This study examined the awareness, use and risk perceptions of HTP in the USA following FDA authorisation. METHODS A national probability sample of 20 449 US adults completed an online survey between November 2019 and February 2020. In addition to assessing awareness and use of HTP, two ratios were calculated: the ratio of those who experimented with HTP given that they had heard about it (E/H) and the ratio of those who currently used HTP given experimentation (C/E). These ratios for HTP were compared against those for e-cigarettes from a similar national survey in 2012. RESULTS Overall, 8.1% of respondents had heard of HTP. Only 0.55% had tried and 0.10% were current users. The rate of experimentation among those who heard about HTP and the rate of current use among experimenters were, however, similar to those for e-cigarettes in 2012: E/H and C/E for HTP were 6.8% and 18.2%, respectively; and 10.7% and 17.8%, respectively for e-cigarettes. The majority of respondents considered HTP either less harmful than (11.6%), or equally harmful as e-cigarettes (42.7%). CONCLUSIONS Only a small fraction of US population in 2020 have tried any HTP. However, the similarity in early adoption rates following awareness, suggests that future adoption for HTP may be similar to that for e-cigarettes, if HTP are marketed more aggressively.
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Affiliation(s)
- Shu-Hong Zhu
- Herbert Wertheim School of Public Healh, University of California San Diego, La Jolla, California, USA
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Julian Ong
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Shiushing Wong
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Adam Cole
- Faculty of Health Science, University of Ontario Institute of Technology Faculty of Health Sciences, Oshawa, Ontario, Canada
| | - Yue-Lin Zhuang
- Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Yuyan Shi
- Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, California, USA
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Espinoza VE, Giner P, Liano I, Mendez IA, O'Dell LE. Sex and age differences in approach behavior toward a port that delivers nicotine vapor. J Exp Anal Behav 2022; 117:532-542. [PMID: 35338651 DOI: 10.1002/jeab.756] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 01/14/2023]
Abstract
The goal of our laboratory is to study the mechanisms that promote nicotine use, particularly in vulnerable populations. To more closely mimic human use patterns, the present study employed nicotine vapor methods involving passive exposure for 14 days in adolescent and adult female and male rats. Age and sex differences in approach behavior (nosepokes) were assessed in a port that delivered nicotine plumes on Day 1 and 14 of our exposure regimen. Controls received ambient air in exposure chambers. After the final session, rats received a nicotinic receptor antagonist to precipitate withdrawal. Then, physical signs, anxiety-like behavior, and plasma levels of cotinine (a nicotine metabolite) were assessed. Over time, females displayed a larger increase in approach behavior to the nicotine port than males, an effect that was larger in adolescents. Nosepoke responses in adolescent females were correlated with anxiety-like behavior, but not physical signs of withdrawal. Adolescents gained more weight than adults regardless of treatment, and the weight gain was larger in male adolescents. Female adolescents also displayed the highest levels of cotinine than all other groups. These findings suggest that nicotine vapor produces greater motivational effects in adolescent females as compared to their adult and male counterparts.
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Affiliation(s)
| | - Priscilla Giner
- Department of Psychology, The University of Texas at El Paso
| | - Isabella Liano
- Department of Psychology, The University of Texas at El Paso
| | - Ian A Mendez
- Department of Pharmaceutical Sciences, The University of Texas at El Paso
| | - Laura E O'Dell
- Department of Psychology, The University of Texas at El Paso
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12
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Bedi MK, Bedi DK, Ledgerwood DM. Gender Differences in Reasons for Using E-Cigarettes: A Systematic Review. Nicotine Tob Res 2022; 24:1355-1362. [PMID: 35439816 DOI: 10.1093/ntr/ntac108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 03/25/2022] [Accepted: 04/14/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Differential reasons for e-cigarette use for men and women have seldom been examined, and there is no systematic overview of this research literature. The aim for this review is to conduct a systematic review of the literature to identify gender differences in the reasons for e-cigarette use. METHODS Systematic searches covered in three databases found 866 unique articles: Web of Science, Pubmed and PsycInfo. Twenty six studies met the inclusion criteria and were reviewed. Reasons for e-cigarette use were sorted into 17 distinct categories. RESULTS AND CONCLUSIONS Fifteen studies identified statistically significant differences in reasons between men and women. Frequently assessed reasons for e-cigarette use across studies included Health/Smoking Cessation, Experimentation/Curiosity, Enjoyment/Pleasure, Use in Specific Locations, Acceptable to Others, and Cost. Of those that identified statistically significant differences in reasons between men and women, the findings varied considerably, and some reasons for e-cigarette use were found to be significant in only one or two studies. Most of the reasons identified were only measured in a small number of studies, complicating our ability to make intervention recommendations based on gender. Additionally, we limited our literature search to peer-reviewed studies. Of the reason categories that did find significant differences between gender, such as reasons related to Health/Smoking Cessation, the outcomes were not consistent across studies. Future studies are needed to identify potentially important differences in the reasons for e-cigarette use among men and women. IMPLICATION This systematic review aims to uncover gender differences in e-cigarette use to understand important differences in motivation for use that may help us better understand strategies for prevention and treatment of tobacco use disorder. This review is the first on this topic and could provide further insight on patterns of e-cigarette use across gender.
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Affiliation(s)
- Mannat K Bedi
- All Department of Psychiatry and Behavioral Neurosciences, Wayne State University
| | - Danishi K Bedi
- All Department of Psychiatry and Behavioral Neurosciences, Wayne State University
| | - David M Ledgerwood
- All Department of Psychiatry and Behavioral Neurosciences, Wayne State University
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13
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Are French adolescents ready to adopt the electronic cigarette? A qualitative study of their knowledge and representations. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01326-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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14
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Al-Hamdani M, Manly E. Harm reduction in tobacco control: where do we draw the line? J Public Health Policy 2022; 43:149-154. [PMID: 34997211 DOI: 10.1057/s41271-021-00327-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2021] [Indexed: 11/21/2022]
Abstract
With substance abuse, harm reduction refers to reducing or replacing use of a harmful product with a less risky agent. But many advertised "non-pharmaceutical" harm reduction alternatives for tobacco smoking are problematic. Studies have revealed inconclusive results using agents including chewing tobacco and e-cigarettes to quit smoking and have demonstrated continued use of these agents. Many smoking harm reduction agents pose other health risks not found in traditional tobacco smoking. Given these limitations, efforts should focus on promoting nicotine replacement therapy, and other pharmacologic agents with a better chance of producing sustained smoking cessation. To address the harmful nature of many tobacco replacement products, public health should focus on regulating these alternatives with the same stringency as tobacco, and social marketing efforts should target evidence-based and safer pharmaceutical grade or behavioural alternatives.
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Affiliation(s)
| | - Eden Manly
- McMaster University, Hamilton, ON, Canada
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15
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Chatziparasidis G, Kantar A. Vaping in Asthmatic Adolescents: Time to Deal with the Elephant in the Room. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030311. [PMID: 35327682 PMCID: PMC8947668 DOI: 10.3390/children9030311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/16/2022]
Abstract
Adolescence is a period characterized by developmental, psychological, and psychosocial alterations, with a major impact on youths’ attitudes and perceptions. Adolescents with asthma may not comply with treatment and may develop risky behaviors, including smoking, vaping, and other substance use, leading to unanticipated exacerbations and consequences. Vaping has become extremely popular in this age group, and studies have suggested that it has potential adverse effects on asthmatic airways. More well-designed studies are needed to confirm the initial worrying data, and action must be taken by both medical officers and health authorities to deal with the elephant in the room and curb the vaping pandemic. The aim of this paper is to provide a review of the current knowledge regarding the effect of vaping on adolescents with asthma and to propose actions to restrain this fast-growing trend.
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Affiliation(s)
- Grigorios Chatziparasidis
- Primary Cilia Dyskinesia Unit, School of Medicine, University of Thessaly, 41110 Thessaly, Greece
- Correspondence:
| | - Ahmad Kantar
- Pediatric Asthma and Cough Centre, Gruppo Ospedaliero San Donato, Bergamo and University Vita Salute San Raffaele, 24046 Milano, Italy;
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16
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Conway M, Alba PR, Zhu SH, Patterson OV. Vaping at the VA: Developing an Annotated Corpus of Electronic Cigarette Mentions in Clinical Notes at the Department of Veterans Affairs. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2022; 2021:343-351. [PMID: 35308940 PMCID: PMC8861676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Use of Electronic Nicotine Delivery Systems (ENDS, colloquially known as "electronic cigarettes") has increased substantially in the United States in the decade since 2010. However, currently relatively little is known regarding the documentation of ENDS use in clinical notes. With this study, we describe the development of an annotation scheme (and associated annotated corpus) consisting of 4,351 ENDS mentions derived from Department of Veterans Affairs clinical notes during the period 2010-2020. Analysis of our corpus provides important insights into ENDS documentation practices at the VA, in addition to providing a resource for the future development and validation of Natural Language Processing algorithms capable of reliably identifying ENDS-use status.
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Affiliation(s)
- Mike Conway
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT
| | - Patrick R Alba
- Department of Internal Medicine, University of Utah, Salt Lake City, UT
- VA Salt Lake City Health Care System, Salt Lake City, UT
| | - Shu-Hong Zhu
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, La Jolla, CA
| | - Olga V Patterson
- Department of Internal Medicine, University of Utah, Salt Lake City, UT
- VA Salt Lake City Health Care System, Salt Lake City, UT
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17
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Kjeld SG, Lund L, Andersen S, Bast LS. Socioeconomic Differences in Cigarette Smoking and Alternative Tobacco Product Use Among Adolescents in a School-Based Smoking Preventive Intervention: Findings From the Second Year of the X:IT II Study. Front Public Health 2022; 10:825585. [PMID: 35265577 PMCID: PMC8900944 DOI: 10.3389/fpubh.2022.825585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/14/2022] [Indexed: 12/02/2022] Open
Abstract
Background Health interventions may differently impact adolescents from diverse backgrounds. This study examined whether a smoking preventive intervention was equally effective in preventing cigarette smoking and use of alternative tobacco products (ATPs, i.e., snus, e-cigarettes, and waterpipe) among students from different socioeconomic backgrounds, i.e., occupational social classes (OSC). Methods Data was from the school-based intervention X:IT II targeting 13- to 15-year-olds Danes. The intervention focused on three main components: smoke-free school time, smoke-free curriculum, and parental involvement. In total, 46 schools were included at baseline (N = 2,307, response rate = 86.3%). Using a difference-in-differences approach, changes in current smoking and ever use of ATPs were estimated among students in high versus low OSC at second follow-up. Analyses were based on available cases (N = 826) and multiple imputations of missing data at the second follow-up (N = 1,965). Results At baseline (age 13), 1.0% of students from high OSC and 4.8% from low OSC currently smoked cigarettes, while this was the case among 24.5 and 25.6%, respectively, at the second follow-up (age 15). Estimates indicated that social inequalities in current smoking diminished over time (p < 0.001). Regarding ATPs, 10.0% of high OSC students and 13.9% of low OSC students had ever used ATPs at baseline, while at second follow-up, 46.8 and 60.8%, respectively, had ever used ATPs. Estimates indicated that social inequalities in ever use of ATPs widened over time (p < 0.001). Conclusions The X:IT II intervention seemed to diminish socioeconomic disparities in smoking over the study period. Meanwhile, social inequalities in ever use of ATPs increased. Therefore, besides focusing on narrowing the social disparities in cigarette smoking, future efforts may, to a larger extent, focus on adolescents' use of ATPs.
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Affiliation(s)
- Simone Gad Kjeld
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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18
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Aqeeli AA, Makeen AM, Al Bahhawi T, Ryani MA, Bahri AA, Alqassim AY, El-Setouhy M. Awareness, knowledge and perception of electronic cigarettes among undergraduate students in Jazan Region, Saudi Arabia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:706-713. [PMID: 32974976 DOI: 10.1111/hsc.13184] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 08/24/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
The use of electronic cigarettes (e-cigarettes) has steadily grown over the past few years, rising in popularity amongst young adults, especially. Owing to the perception that e-cigarettes are less harmful than conventional cigarettes, some people have resorted to using them as a means of quitting cigarette smoking. This study aimed to assess the awareness, knowledge, perception and use of e-cigarettes among Jazan University students in Saudi Arabia. An observational cross-sectional study was conducted with 775 students. Using stratified random sampling to recruit study participants, the dataset tabling the use of e-cigarettes, as well as knowledge, perception and awareness was collected using a translated and culturally adapted structured Arabic questionnaire. Our results showed that 21.0% of the participants used e-cigarettes and 35.1% of them used them to quit smoking. E-cigarette use was mostly reported by students from the College of Medical Applied Sciences (31.7%). The overall knowledge score was 3.9, with a standard deviation of 1.3 for the score range from zero to seven. About half of the participants correctly identified e-cigarettes as not less addictive' than cigarettes. However, 70.2% of students failed to identify e-cigarettes as a source of second-hand exposure to nicotine. About two-thirds of the sample believed that e-cigarettes could adversely affect health. The perception of using e-cigarettes for smoking cessation was not significantly associated with e-cigarette use. In conclusion, the prevalence of e-cigarette use was similar to that reported in the literature. However, Jazan University students failed to identify the health risks associated with e-cigarette use. Therefore, a strategy to enhance students' awareness of the benefits and harms of e-cigarettes is needed.
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Affiliation(s)
- Abdulwahab A Aqeeli
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Anwar M Makeen
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Tariq Al Bahhawi
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Majed A Ryani
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ahmed A Bahri
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ahmad Y Alqassim
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Maged El-Setouhy
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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19
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Amin S, Laranjo L, Dunn AG. Social connections influencing e-cigarette use and intentions in Australia: a survey. J Addict Dis 2022; 40:357-365. [PMID: 35049425 DOI: 10.1080/10550887.2021.2003145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Social factors play a role in e-cigarette uptake, but Australian evidence is limited. This study evaluated associations between social factors and e-cigarette intention and use. Australian participants surveyed between March 2019 and July 2019 using a cross-sectional survey design, measuring e-cigarette intentions and use, and factors including smoking status and social acceptability. Of 243 respondents, 185 were included in the final analysis, measuring e-cigarette intention and use, and factors including smoking status and social acceptability. Of 185 participants, daily, occasional, and ex-smokers (123 participants) were more likely to have used e-cigarettes (OR = 9.33; 95% CI 4.63-18.80) or intend to use e-cigarettes (OR = 4.86; 95% CI 2.32-10.21), relative to nonsmokers (62 participants). Participants reporting acceptability among people they study or work with (70 participants) were more likely to have used e-cigarettes relative to the reference group (OR = 16.76; 95% CI 3.70-75.83; p = 0.001) and were more likely report intending to use e-cigarettes relative to the reference group (OR = 3.40; 95%CI 1.58-7.30; p = 0.002). With caveats related to the survey participant composition, the results suggest that places of work or study may be an appropriate place to consider interventions aimed at reducing e-cigarette uptake among nonsmokers.
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Affiliation(s)
- Samia Amin
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Liliana Laranjo
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
| | - Adam G Dunn
- Discipline of Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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20
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Patil S, Fageeh HN, Mushtaq S, Ajmal M, Chalikkandy SN, Ashi H, Ahmad ZH, Khan SS, Khanagar S, Varadarajan S, Sarode SC, Sarode GS. Prevalence of electronic cigarette usage among medical students in Saudi Arabia – A systematic review. Niger J Clin Pract 2022; 25:765-772. [DOI: 10.4103/njcp.njcp_2006_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Roh EJ, Chen-Sankey JC, Wang MQ. Electronic nicotine delivery system (ENDS) use patterns and its associations with cigarette smoking and nicotine addiction among Asian Americans: Findings from the national adult tobacco survey (NATS) 2013-2014. J Ethn Subst Abuse 2022; 21:253-271. [PMID: 32459579 PMCID: PMC7704701 DOI: 10.1080/15332640.2020.1747039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This study examined the ENDS use and their associations with conventional cigarette smoking and nicotine addiction among Asian Americans (AAs). The study sample was restricted to Non-Hispanic AAs (n = 1,956) using the National Adult Tobacco Survey (NATS) 2013-2014. Chi-square tests and logistic regressions were employed. AAs who ever used ENDS reported they were more likely to smoke conventional cigarettes, smoke ≤100 cigarettes in a lifetime, and felt more difficulty concentrating without using tobacco than those who never used END. Study findings indicate that ENDS use may be associated with conventional cigarette smoking and may lead to nicotine addiction among AAs.
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Affiliation(s)
- Esther J Roh
- University of Maryland, College Park, Maryland, USA
| | - Julia C Chen-Sankey
- National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
| | - Min Q Wang
- University of Maryland, College Park, Maryland, USA
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22
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PALMES MADONNA, TRAJERA SHEILLAM, SAJNANI ANANDK. Knowledge and attitude related to use of electronic cigarettes among undergraduate nursing students in an urban university setting in Philippines. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E770-E775. [PMID: 34909507 PMCID: PMC8639113 DOI: 10.15167/2421-4248/jpmh2021.62.3.1709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 06/23/2021] [Indexed: 11/07/2022]
Abstract
Background Electronic cigarette (e-cigarette) use has risen dramatically since its introduction in 2004. Nurses play a critical role in screening, disease prevention and smoking cessation for their patient. Their knowledge and attitude related to e-cigarettes will play a major part in development of tobacco control activities. Aim Thus, this study was conducted to determine the knowledge and attitude toward e-cigarettes among undergraduate nursing students in the Philippines. Methods The participants of the study were 122 level four nursing students of West Visayas State University, Iloilo city, Philippines. A standardized self-administered questionnaire was used to collect the data and statistical analyses were performed. Results Majority of the participants were female, were never smokers and were aware or conscious of the existence of the e-cigarettes but had poor knowledge on e-cigarettes. Furthermore, in terms of attitude the students as an entire group had a positive attitude opposing e-cigarette use. Never and former smokers had positive attitude opposing e-cigarette use while current smokers had negative attitude supporting e-cigarette use. There was no significant relationship between knowledge and attitude of nursing students towards e-cigarettes. Conclusion Nursing students did not have adequate knowledge regarding e-cigarettes but maintained a positive attitude opposing e-cigarette use. Poor knowledge did not influence the attitude of participants towards e-cigarettes.
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Affiliation(s)
- MADONNA PALMES
- College of Nursing, West Visayas State University, Iloilo City, Philippines
| | - SHEILLA M. TRAJERA
- College of Nursing, University of St. La Salle, Bacolod City, Philippines
| | - ANAND K. SAJNANI
- Department of Pediatric Dentistry KIMS Qatar Medical Centre, Wakra, Qatar
- Correspondence: Anand K. Sajnani, KIMS Qatar Medical Centre, Abdulrahman Bin Jassim Al Thani Street, 82125 Wakra, Qatar - Tel.: +974-30181952 - E-mail:
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Kjeld SG, Andersen S, Andersen A, Glenstrup S, Lund L, Danielsen D, Bast LS. Who are the young users of tobacco products? Prevalence and characteristics of Danish adolescents who have either smoked cigarettes, used alternative tobacco products, or used both. NORDIC STUDIES ON ALCOHOL AND DRUGS 2021; 38:555-572. [PMID: 35309851 PMCID: PMC8900172 DOI: 10.1177/14550725211027687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 06/08/2021] [Indexed: 01/16/2023] Open
Abstract
Aims: We examined characteristics (smoking in social relations, binge drinking, and well-being measures) of Danish 13-year-olds in relation to their tobacco use patterns. Ever use of cigarettes exclusively, ever use of alternative tobacco products (ATPs; e-cigarettes, snus, or waterpipe) exclusively, and use of both cigarettes and ATPs were studied. Methods: We used self-reported data from students at 46 Danish schools in 2017 comprising 2,307 students (response rate = 86%). Multi-level logistic regression analyses were used to examine the associations between student characteristics and the odds for having ever used any tobacco products, smoked cigarettes exclusively, used ATPs exclusively, or used both cigarettes and ATPs compared with never use of any tobacco products. Unadjusted estimates and estimates adjusted for gender were reported. Results: A significant minority of youth (13.2%) had used one or more tobacco products. Of these, 2.0% had exclusively smoked cigarettes, 7.2% had exclusively used ATPs, and 4.0% had used both. Findings showed that all included characteristics (families’ and friends’ smoking, binge drinking, and well-being characteristics) were associated with using any tobacco product; however, students with friends who smoked, had been binge drinking, and had low well-being at home had notably higher odds for having both smoked cigarettes and used ATPs compared to the other tobacco use patterns. Conclusion: ATPs were popular among Danish adolescents compared with conventional cigarettes. Thus, prevention efforts among adolescents should not merely focus on the health risks of conventional cigarette smoking but also on ATPs. Students with diverse tobacco use patterns were similar on various characteristics. However, findings indicate that adolescents who had used both conventional cigarettes and ATPs constitute a more risk-averse group in special need of prevention efforts. Gender did not markedly influence the results. These findings may help future strategies aiming at the youngest adolescents at risk of using tobacco products.
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Affiliation(s)
- Simone Gad Kjeld
- Simone Gad Kjeld, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen, Denmark.
| | | | | | | | - Lisbeth Lund
- University of Southern Denmark, Copenhagen, Denmark
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Iles IA, Gillman AS, Klein WMP, Ferrer RA, Kaufman A. Associations between absolute and relative electronic cigarette harm perceptions and information-seeking behaviours among US adult current, former and never smokers. Drug Alcohol Rev 2021; 41:356-364. [PMID: 34342384 DOI: 10.1111/dar.13368] [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] [Received: 04/01/2021] [Revised: 07/13/2021] [Accepted: 07/13/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Electronic cigarette (e-cigarette) harm perceptions and information seeking behaviours are both important antecedents of e-cigarette use, yet the relationship between them has been rarely studied. We assessed how absolute (e-cigarettes are harmful to my health) and relative harm perceptions (e-cigarettes are more/less harmful than cigarettes) were associated with specific e-cigarette information seeking behaviours in a sample of current, former and never cigarette smokers. METHODS We used data from US adults in two cycles of the Health Information National Trends Survey (HINTS-FDA 2015, n = 3738; 2017, n = 1736). Analyses controlled for socio-demographics, ever e-cigarette use and survey cycle. Data were analysed between January and August 2020. RESULTS Higher relative harm perceptions were associated with lower odds of having sought any information on e-cigarettes [adjusted odds ratio 0.61, 95% confidence interval (0.48, 0.84)] and on how to use e-cigarettes to quit smoking specifically [adjusted odds ratio 0.59, 95% confidence interval (0.38, 0.91)]. Smoking status did not moderate associations between absolute or relative harm perceptions and information seeking behaviours, nor was it associated with specific information seeking behaviours after adjusting for covariates. DISCUSSION AND CONCLUSIONS The risks of e-cigarettes relative to combusted cigarettes (as opposed to the absolute risks of e-cigarettes) appear to be more important in individuals' information seeking behaviours about e-cigarettes. Public health messages could ensure that all individuals understand how one's health risk would change if they exclusively used e-cigarettes, switched to e-cigarettes completely or used both products.
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Affiliation(s)
- Irina A Iles
- Office of the Associate Director, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Arielle S Gillman
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - William M P Klein
- Office of the Associate Director, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Rebecca A Ferrer
- Basic Biobehavioral and Psychological Sciences Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Annette Kaufman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, USA
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Ahmed LA, Verlinden M, Alobeidli MA, Alahbabi RH, AlKatheeri R, Saddik B, Oulhaj A, Al-Rifai RH. Patterns of Tobacco Smoking and Nicotine Vaping among University Students in the United Arab Emirates: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147652. [PMID: 34300103 PMCID: PMC8306162 DOI: 10.3390/ijerph18147652] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 01/15/2023]
Abstract
Various forms of tobacco smoking and nicotine vaping tools are available on the market. This study quantified the prevalence of and identified factors associated with patterns of smoking and nicotine vaping among university students in the United Arab Emirates (UAE). A cross-sectional sample of students enrolled in three public universities was surveyed. Self-reported current smoking and nicotine vaping were recorded. Of 1123 students, 81.7% completed the online survey (mean age, 20.7 ± 3.4 (SD) years; 70.7% females). The prevalence of current smoking was 15.1% while the prevalence of current nicotine vaping was nearly 4.0%. Among current smokers, 54.7% reported conventional smoking only, 15.1% reported nicotine vaping only, and 28.8% were poly-users. Conventional midwakh (47.5%), followed by conventional shisha/waterpipe (36.7%), conventional cigarettes (36.7%), electronic shisha/waterpipe (25.2%), and electronic cigarettes (24.5%), were most commonly reported by students. Students aged 20–25 years (adjusted odds ratios (aOR): 2.08, 95% confidence interval (CI): 1.18–3.67) or >25 years (aOR: 4.24, 95% CI: 1.41–12.80) had higher odds of being current smokers compared to those aged 17–19 years. The male gender was also independently associated with higher odds of being a current smoker (aOR: 5.45, 95% CI: 3.31–8.97) as well as higher odds of smoking cigarettes, shisha, and midwakh, or nicotine vaping compared to being female. Of nicotine vaping users, 36.1% reported using nicotine vaping because they enjoyed the flavor and vaporizing experience and 34.4% used it to help them to quit smoking. A relatively high prevalence of self-reported smoking was reported among university students in the UAE. The findings also suggest that nicotine vaping use is relatively widespread, but still less common than traditional smoking. Vigilant and tailored university-based smoking control and preventive measures are warranted.
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Affiliation(s)
- Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (L.A.A.); (A.O.)
| | - Marina Verlinden
- Department of Psychology, College of Natural and Health Sciences, Zayed University, Abu Dhabi P.O. Box 144534, United Arab Emirates;
| | - Mariam Ali Alobeidli
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (M.A.A.); (R.H.A.); (R.A.)
| | - Reem Hamad Alahbabi
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (M.A.A.); (R.H.A.); (R.A.)
| | - Radeya AlKatheeri
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (M.A.A.); (R.H.A.); (R.A.)
| | - Basema Saddik
- Department of Family and Community Medicine, College of Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates;
| | - Abderrahim Oulhaj
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (L.A.A.); (A.O.)
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 17666, United Arab Emirates; (L.A.A.); (A.O.)
- Correspondence:
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Abrams LR, Kalousova L, Fleischer NL. Gender differences in relationships between sociodemographic factors and e-cigarette use with smoking cessation: 2014-15 current population survey tobacco use supplement. J Public Health (Oxf) 2021; 42:e42-e50. [PMID: 31220294 DOI: 10.1093/pubmed/fdz017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/07/2018] [Accepted: 01/23/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND There is conflicting evidence regarding whether men and women are equally likely to quit smoking. We assessed whether gender differences in smoking cessation varied between different sociodemographic groups and across e-cigarette use. METHODS The 2014-15 cross-section of the Current Population Survey Tobacco Use Supplement was weighted to represent the US adult population of current/former smokers (N = 16 040). Log binomial models tested whether gender modified the relationships between race/ethnicity, education, income or e-cigarette use and 90-day smoking cessation in the past year. RESULTS Gender was not associated with cessation in adjusted models (RR = 0.97, CI: 0.85, 1.11). There were no statistically significant interactions between gender and sociodemographic covariates. Current e-cigarette use was associated with higher cessation (RR = 1.53, CI: 1.30, 1.81), and the association varied by gender (Interaction P = 0.013). While male e-cigarette users had a 15% predicted cessation in the past year (CI: 12, 18%), female users had a 9% predicted cessation (95% CI: 7, 11%). Probability of cessation for female e-cigarette users was not different from non-users. CONCLUSIONS These findings suggest that there are no gender differences in smoking cessation in the USA overall, or by sociodemographic groups. Current e-cigarette use is associated with higher likelihood of recent successful smoking cessation, particularly for men.
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Affiliation(s)
- Leah R Abrams
- Department of Health Management and Policy, University of Michigan School of Public Health, Michigan, USA
| | - Lucie Kalousova
- Nuffield College, University of Oxford, New Road, Oxford, UK
| | - Nancy L Fleischer
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, MI, USA
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Wang Y, Duan Z, Emery SL, Kim Y, Chaloupka FJ, Huang J. The Association between E-Cigarette Price and TV Advertising and the Sales of Smokeless Tobacco Products in the USA. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6795. [PMID: 34202723 PMCID: PMC8297131 DOI: 10.3390/ijerph18136795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 11/28/2022]
Abstract
This study aims to examine how e-cigarette prices and advertising, key determinants of e-cigarette demand, are associated with the demand for smokeless tobacco (SLT) products in the US. Market-level sales and price data by year (2010-2017), quarter, and type of retail store were compiled from Nielsen retail store scanner database. E-cigarette TV advertising ratings data were compiled from Kantar Media. Four-way (market, year, quarter, store type) fixed-effect models were used to estimate the associations between e-cigarette price and TV advertising and sales of SLT products (chewing loose leaf, moist snuff, and snus). Our results showed that a 1% rise in own price was associated with a reduction in sales by 1.8% for chewing loose leaf, 1.6% for moist snuff, and 2.2% for snus, respectively. In addition, a 1% rise in disposable e-cigarette price was associated with 0.3% and 0.6% increased sales for moist snuff and snus, respectively. The association between e-cigarette TV advertising and SLT product sales was not significant. Our results suggest that disposable e-cigarettes and certain SLT products (moist snuff and snus) are potential substitutes. Policies aiming to regulate e-cigarette use and sales need to consider their potential link with the demand for SLT products.
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Affiliation(s)
- Yu Wang
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (Y.W.); (Z.D.)
| | - Zongshuan Duan
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (Y.W.); (Z.D.)
| | - Sherry L. Emery
- NORC at The University of Chicago, Chicago, IL 60637, USA; (S.L.E.); (Y.K.)
| | - Yoonsang Kim
- NORC at The University of Chicago, Chicago, IL 60637, USA; (S.L.E.); (Y.K.)
| | - Frank J. Chaloupka
- School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA;
| | - Jidong Huang
- School of Public Health, Georgia State University, Atlanta, GA 30303, USA; (Y.W.); (Z.D.)
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Jasper AE, Sapey E, Thickett DR, Scott A. Understanding potential mechanisms of harm: the drivers of electronic cigarette-induced changes in alveolar macrophages, neutrophils, and lung epithelial cells. Am J Physiol Lung Cell Mol Physiol 2021; 321:L336-L348. [PMID: 34009037 DOI: 10.1152/ajplung.00081.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Electronic (e-) cigarettes are growing in popularity despite uncertainties regarding their long-term health implications. The link between cigarette smoking and initiation of chronic lung disease took decades to unpick so in vitro studies mimicking e-cigarette exposure aim to detect early indicators of harm. In response to e-cigarette exposure, alveolar macrophages adopt a proinflammatory phenotype of increased secretion of proinflammatory cytokines, reduction in phagocytosis, and efferocytosis and reactive oxygen species generation. These effects are largely driven by free radical exposure, changes in PI3K/Akt signaling pathways, nicotine-induced reduction in phagocytosis receptors, and impaired lipid homeostasis leading to a foam-like lipid-laden phenotype. Neutrophils exhibit disrupted chemotaxis and transmigration to chemokines, reduced phagocytosis and bacterial killing, and an increase in protease secretion without corresponding antiproteases in response to e-cigarette exposure. This is driven by an altered ability to respond and to polarize toward chemoattractants, an activation of the p38 MAPK signaling pathway and inability to assemble NADPH oxidase. E-cigarettes induce lung epithelial cells to display decreased ciliary beat frequency and ion channel conductance as well as changes in chemokine secretion and surface protein expression. Changes in gene expression, mitochondrial function, and signaling pathways have been demonstrated in lung epithelial cells to explain these changes. Many functional outputs of alveolar macrophages, neutrophils, and lung epithelial cells have not been fully explored in the context of e-cigarette exposure and the underlying driving mechanisms are poorly understood. This review discusses current evidence surrounding the effects of e-cigarettes on alveolar macrophages, neutrophils, and lung epithelial cells with particular focus on the cellular mechanisms of change.
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Affiliation(s)
- Alice E Jasper
- Birmingham Acute Care Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - Elizabeth Sapey
- Birmingham Acute Care Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - David R Thickett
- Birmingham Acute Care Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
| | - Aaron Scott
- Birmingham Acute Care Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, United Kingdom
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Minh AE. Effects of vaping E-juices with and without alcohol on the accuracy of the Alco-Sensor FST ® approved screening device. CANADIAN SOCIETY OF FORENSIC SCIENCE JOURNAL 2021. [DOI: 10.1080/00085030.2021.1898774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Amy Eng Minh
- Royal Canadian Mounted Police, National Forensic Laboratory Services, Surrey, Canada
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30
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Suryadinata RV, Wirjatmadi B, Lorensia A. The time pattern of selenomethionine administration in preventing free radicals due to exposure to electric cigarette smoke. J Public Health Res 2021; 10. [PMID: 33855416 PMCID: PMC8129744 DOI: 10.4081/jphr.2021.2232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 03/29/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Most people believe that electric cigarettes have no negative effect on health, which causes them to use it more. However, exposure to the smoke from these cigarettes is bad for the health and causes cell damage. Antioxidants play an important role in preventing cell damage, and they can be obtained through the oral administration of selenomethionine. DESIGN AND METHODS This study used an experimental method and a post-test control group design. Male Wistar rats, which were exposed to cigarette smoke were given selenomethionine orally and then tested for the presence of free radicals. The measurement of lung tissue damage was conducted by assessing the level of malondialdehyde in the blood and immunohistochemistry (IHC) of the lung tissue. RESULT The study showed that differences in the time of administration of selenomethionine affect the levels of malondialdehyde in the blood and expression of malondialdehyde in the lung tissue (p<0.05). Consequently, the two groups showed a strong (r=0.861) and significant (p=0.000) relationship with each other. CONCLUSION The early application of selenomethionine can prevent increased levels of malondialdehyde in the blood and lung tissue due to exposure to e-cigarette smoke.
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Affiliation(s)
| | | | - Amelia Lorensia
- Faculty of Pharmacy, Universitas Surabaya (UBAYA), Surabaya.
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Zvolensky MJ, Manning K, Garey L, Alfano CA, Mayorga NA, Peraza N. Emotion dysregulation, fatigue, and electronic cigarette expectancies. Cogn Behav Ther 2021; 50:138-153. [PMID: 33006499 PMCID: PMC7916989 DOI: 10.1080/16506073.2020.1819868] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
Emotion dysregulation and the experience of fatigue have both been linked to the maintenance of substance use. However, limited empirical data has evaluated individual differences in these constructs in terms of e-cigarette use expectancies. The present study examined a theoretically relevant model focused on whether the experience of more severe fatigue explains, in part, the relation between individual differences in emotion dysregulation and positive and negative e-cigarette expectancies among 525 adult e-cigarette users (50.9% female, Mage = 35.25 years, SD = 10.10). It was hypothesized that emotion dysregulation, via fatigue severity, would significantly predict greater positive and negative e-cigarette expectancies, which was examined in two separate mediation models. Fatigue severity significantly explained, in part, the relation between emotion dysregulation and positive (b = 0.02, CI [0.01, 0.02]) and negative expectancies of e-cigarette use (b = 0.02, 95% CI [0.02, 0.03]). The current findings suggest that the experience of fatigue helps explain the relation between emotion dysregulation and positive and negative e-cigarette expectancies among adult e-cigarette users. Future work is needed to explicate how reducing fatigue severity in the context of emotion dysregulation may change expectancies about e-cigarette expectancies.
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Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Department of Psychology, HEALTH Institute, University of Houston, Houston, TX, USA
| | - Kara Manning
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Nubia A. Mayorga
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Natalia Peraza
- Department of Psychology, University of Houston, Houston, TX, USA
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Szukalska M, Szyfter K, Florek E, Rodrigo JP, Rinaldo A, Mäkitie AA, Strojan P, Takes RP, Suárez C, Saba NF, Braakhuis BJ, Ferlito A. Electronic Cigarettes and Head and Neck Cancer Risk-Current State of Art. Cancers (Basel) 2020; 12:E3274. [PMID: 33167393 PMCID: PMC7694366 DOI: 10.3390/cancers12113274] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 11/03/2020] [Indexed: 01/11/2023] Open
Abstract
E-cigarettes have become increasingly popular in the last decade and are considered less harmful than traditional tobacco products due to the lower content of toxic and carcinogenic compounds. However, this is still a controversial issue. This paper contains a review of previous reports on the composition of e-cigarettes and their impact on the pathogenesis and risk of head and neck cancer (HNC). The objective of the review was to compare the molecular and health effects of e-cigarette use in relation to the effects of traditional cigarette smoking in the upper respiratory tract, and to assess the safety and effect of e-cigarettes on HNC risk. A review for English language articles published until 31 August 2020 was made, using a PubMed (including MEDLINE), CINAHL Plus, Embase, Cochrane Library and Web of Science data. The authors reviewed articles on both toxic and carcinogenic compounds contained in e-cigarettes and their molecular and health effects on the upper respiratory tract in comparison to tobacco cigarettes. The risk of developing head and neck squamous cell carcinoma (HNSCC) remains lower in users of e-cigarettes compared with tobacco smokers. However, more long-term studies are needed to better address the safety of e-cigarettes.
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Affiliation(s)
- Marta Szukalska
- Laboratory of Environmental Research, Department of Toxicology, Poznan University of Medical Sciences, 60-631 Poznan, Poland
| | - Krzysztof Szyfter
- Institute of Human Genetics, Polish Academy of Sciences, 60-479 Poznan, Poland;
| | - Ewa Florek
- Laboratory of Environmental Research, Department of Toxicology, Poznan University of Medical Sciences, 60-631 Poznan, Poland
| | - Juan P. Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias-University of Oviedo, 33011 Oviedo, Spain;
- Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, CIBERONC, 33011 Oviedo, Spain;
| | | | - Antti A. Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, 00029 HUS Helsinki, Finland;
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute and Karolinska Hospital, 141 86 Stockholm, Sweden
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, 1000 Ljubljana, Slovenia;
| | - Robert P. Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands;
| | - Carlos Suárez
- Instituto de Investigación Sanitaria del Principado de Asturias, Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, CIBERONC, 33011 Oviedo, Spain;
| | - Nabil F. Saba
- Department of Hematology and Medical Oncology, Emory University, Atlanta, GA 30322, USA;
| | | | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, 35100 Padua, Italy;
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Duru Çetinkaya P, Turan A, Deniz PP. Effectiveness of Behavioral and Pharmacological Smoking Cessation Treatment in Patients with Failed Attempt at Quitting with E-cigarettes. Turk Thorac J 2020; 21:404-408. [PMID: 33352096 DOI: 10.5152/turkthoracj.2020.20181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/21/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The tobacco industry has introduced electronic cigarettes (e-cigarettes) as a less harmful substitute to cigarettes and as an aid to smoking cessation. This study aimed to evaluate the success of evidence-based pharmacological treatments and behavioral/cognitive training in patients who failed to quit smoking with e-cigarettes. MATERIAL AND METHODS A total of 109 consecutive patients with failed attempts at smoking cessation by e-cigarettes were admitted. A questionnaire was administered to evaluate the demographic characteristics and smoking habits. Nicotine dependence scores of the smokers were obtained using the Fagerström addiction test. Appropriate pharmacological therapy and behavioral/cognitive training were given to each patient who failed to quit smoking with e-cigarettes. RESULTS The mean age of the participants was 35.2±10.4 years, and 89 (81.7%) were men. Education level was high school or university for 92 (84.4%) patients; only 17 (15.6%) graduated from middle school. The mean number of cigarettes smoked per day was 25.8±10.8, and the mean nicotine dependence score was 6.7±1.9. Only 6 (5.5%) individuals quit smoking temporarily after using e-cigarettes, with a mean restarting time of 3.3±2.0 months in all 6 patients. The smoking cessation rate in our study was 43.1% (47 patients) with medical treatment. The remaining individuals were unable to quit smoking with pharmacological treatment, and the mean restarting time for these patients was 10.4±2.2 months. CONCLUSION It has been shown that the success rate of smoking cessation increases with pharmacological treatment and behavioral/cognitive training in individuals who failed to quit smoking with e-cigarettes.
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Affiliation(s)
- Pelin Duru Çetinkaya
- Department of Chest Diseases, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
| | - Ayşe Turan
- Clinic of Smoking Cessation, Adana Seyhan Hospital, Adana, Turkey
| | - Pelin Pınar Deniz
- Department of Chest Diseases, University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey
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Shinbashi M, Rubin BK. Electronic cigarettes and e-cigarette/vaping product use associated lung injury (EVALI). Paediatr Respir Rev 2020; 36:87-91. [PMID: 32653465 DOI: 10.1016/j.prrv.2020.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/04/2020] [Indexed: 12/25/2022]
Abstract
Electronic cigarettes (e-cigarettes) are noncombustible tobacco products that have been promoted as safer alternatives to conventional cigarettes and beneficial tools for smoking cessation. However, e-cigarettes have been shown to produce aerosols with high concentrations of propylene glycol, glycerol, volatile organic compounds, and free radicals, which can lead to lung damage. Furthermore, e-cigarettes can deliver nicotine at concentrations higher than traditional combustibles, making them highly addictive. As delivery devices became smaller, less expensive, and refillable, the use of e-cigarettes dramatically increased, especially among adolescents and young adults in the United States. This rise in popularity of noncombustible products led to an outbreak of e-cigarette or vaping product use-associated lung injury (EVALI) in the fall of 2019. In this article, we review the history of e-cigarettes and its prevalence among American youth, the EVALI outbreak and clinical presentation of EVALI patients, and recent legislative efforts to regulate e-cigarette use.
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Affiliation(s)
- Meagan Shinbashi
- Virginia Commonwealth University, Department of Pediatrics and the Children's Hospital of Richmond at VCU, Richmond, VA, United States
| | - Bruce K Rubin
- Virginia Commonwealth University, Department of Pediatrics and the Children's Hospital of Richmond at VCU, Richmond, VA, United States.
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Effects of 3-Month Exposure to E-Cigarette Aerosols on Glutamatergic Receptors and Transporters in Mesolimbic Brain Regions of Female C57BL/6 Mice. TOXICS 2020; 8:toxics8040095. [PMID: 33137879 PMCID: PMC7712012 DOI: 10.3390/toxics8040095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/17/2020] [Accepted: 10/22/2020] [Indexed: 12/16/2022]
Abstract
Electronic cigarettes (e-cigs) use has been dramatically increased recently, especially among youths. Previous studies from our laboratory showed that chronic exposure to e-cigs, containing 24 mg/mL nicotine, was associated with dysregulation of glutamate transporters and neurotransmitter levels in the brain of a mouse model. In this study, we evaluated the effect of three months’ continuous exposure to e-cig vapor (JUUL pods), containing a high nicotine concentration, on the expression of glutamate receptors and transporters in drug reward brain regions such as the nucleus accumbens (NAc) core (NAc-core), NAc shell (NAc-shell) and hippocampus (HIP) in female C57BL/6 mice. Three months’ exposure to mint- or mango-flavored JUUL (containing 5% nicotine, 59 mg/mL) induced upregulation of metabotropic glutamate receptor 1 (mGluR1) and postsynaptic density protein 95 (phosphorylated and total PSD95) expression, and downregulation of mGluR5 and glutamate transporter 1 (GLT-1) in the NAc-shell. In addition, three months’ exposure to JUUL was associated with upregulation of mGluR5 and GLT-1 expression in the HIP. These findings demonstrated that three-month exposure to e-cig vapor containing high nicotine concentrations induced differential effects on the glutamatergic system in the NAc and HIP, suggesting dysregulation of glutamatergic system activity in mesolimbic brain regions.
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Malt L, Verron T, Cahours X, Guo M, Weaver S, Walele T, O’Connell G. Perception of the relative harm of electronic cigarettes compared to cigarettes amongst US adults from 2013 to 2016: analysis of the Population Assessment of Tobacco and Health (PATH) study data. Harm Reduct J 2020; 17:65. [PMID: 32948187 PMCID: PMC7501702 DOI: 10.1186/s12954-020-00410-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 09/09/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) have been characterised as significantly less harmful than cigarettes by many health agencies and regulators globally. In this study, we examined to what extent perceived relative harms of e-cigarettes compared to cigarettes have changed in the USA. METHODS We analysed the data from the longitudinal and nationally representative, Population Assessment of Tobacco and Health Study to assess the relative perceived harm of e-cigarettes amongst US adults between 2013 and 2016. RESULTS The proportion of US adults who correctly perceived e-cigarettes as less harmful than cigarettes decreased each year from 41.1% (CI 40.1-42.1%) in 2013-2014, 31.5% (CI 30.8-32.2%) in 2014-2015 and 25.3% (CI 24.6-26.0%) in 2015-2016. Concurrently, the proportion of US adults who perceived e-cigarettes as equally, or more, harmful than cigarettes increased from 53.7% (CI 52.3-55.1%), 64.9% (CI 63.6-66.2%) to 72.7% (CI 71.5-73.9%) respectively. The proportion of US adults who held negative relative harm perceptions of e-cigarettes increased regardless of current smoking or vaping status by 24.6% and 29.6% respectively within 3 years. In Wave 3, the proportion of current smokers who perceived the relative harm of e-cigarettes as less harmful was lower at 29.3% (CI 28.2-30.4%) compared to current e-cigarette users at 43.5% (CI 40.3-46.7%). Former smokers who used e-cigarettes and believed that they were equally, or more, harmful than cigarettes in 2014-2015 had significantly higher rates of smoking relapse in the following year, 29% and 37% (p < 2.2e-16), respectively, compared to those with positive relative harm perceptions who reported relapse rates of 19%. CONCLUSIONS In this study, the proportion of US adults who incorrectly perceived e-cigarettes as equal to, or more, harmful than cigarettes increased steadily regardless of smoking or vaping status. Current adult smokers appear to be poorly informed about the relative risks of e-cigarettes yet have potentially the most to gain from transitioning to these products. The findings of this study emphasise the urgent need to accurately communicate the reduced relative risk of e-cigarettes compared to continued cigarette smoking and clearly differentiate absolute and relative harms. Further research is required to elucidate why the relative harm of e-cigarettes is misunderstood and continues to deteriorate.
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Affiliation(s)
- Layla Malt
- Imperial Brands Plc., 121 Winterstoke Road, Bristol, BS3 2LL UK
| | - Thomas Verron
- SEITA, Imperial Brands, 143 Boulevard Romain Rolland, 75014 Paris, France
| | - Xavier Cahours
- SEITA, Imperial Brands, 143 Boulevard Romain Rolland, 75014 Paris, France
| | - Mengran Guo
- SEITA, Imperial Brands, 143 Boulevard Romain Rolland, 75014 Paris, France
| | - Sarah Weaver
- Imperial Brands Plc., 121 Winterstoke Road, Bristol, BS3 2LL UK
| | - Tanvir Walele
- Imperial Brands Plc., 121 Winterstoke Road, Bristol, BS3 2LL UK
| | - Grant O’Connell
- Imperial Brands Plc., 121 Winterstoke Road, Bristol, BS3 2LL UK
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Obisesan OH, Osei AD, Uddin SMI, Dzaye O, Cainzos-Achirica M, Mirbolouk M, Orimoloye OA, Sharma G, Al Rifai M, Stokes A, Bhatnagar A, El Shahawy O, Benjamin EJ, DeFilippis AP, Blaha MJ. E-Cigarette Use Patterns and High-Risk Behaviors in Pregnancy: Behavioral Risk Factor Surveillance System, 2016-2018. Am J Prev Med 2020; 59:187-195. [PMID: 32362509 PMCID: PMC8349302 DOI: 10.1016/j.amepre.2020.02.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The prevalence of e-cigarette use has increased dramatically in the last decade in the U.S. Understanding the prevalence, patterns of use, and risk factor associations of e-cigarette use in pregnant women is particularly important, as this could have potential health implications for the mother and the developing child. METHODS Using Behavioral Risk Factor Surveillance System Survey data from 2016 to 2018, adult women of reproductive age (18-49 years) who reported being pregnant (n=7,434) were studied. Self-reported current e-cigarette use was the main exposure. Other measures included combustible cigarette smoking status and high-risk behaviors (including other tobacco, marijuana, or heavy alcohol use; binge drinking; and others). All analyses were done in 2019. RESULTS Approximately 2.2% of pregnant women reported current e-cigarette use, of whom 0.6% reported daily use. The highest prevalence of e-cigarette use was observed in the youngest age group of pregnant women (3.2%), with 41.7% of all pregnant current e-cigarette users being aged 18-24 years. There was a marked increase in the prevalence of current use of e-cigarettes among pregnant women from 1.9% in 2016 to 3.8% in 2018. Approximately 46% of pregnant current e-cigarette users reported concomitant cigarette smoking. Compared with pregnant never e-cigarette users, pregnant current e-cigarette users had a higher prevalence of other tobacco product use, marijuana use, heavy alcohol intake, binge drinking, and other high-risk behaviors. CONCLUSIONS These findings underscore the need to strengthen prevention and policy efforts, specifically in the vulnerable subgroup of pregnant women.
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Affiliation(s)
- Olufunmilayo H Obisesan
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland; American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
| | - Albert D Osei
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland; American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
| | - S M Iftekhar Uddin
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland; American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas
| | - Omar Dzaye
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland; Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Radiology and Neuroradiology, Charité, Berlin, Germany
| | - Miguel Cainzos-Achirica
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland
| | | | - Olusola A Orimoloye
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Garima Sharma
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland
| | - Mahmoud Al Rifai
- Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Andrew Stokes
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas; Department of Global Health, Boston University, Boston, Massachusetts
| | - Aruni Bhatnagar
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas; Department of Medicine, University of Louisville, Louisville, Kentucky
| | - Omar El Shahawy
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas; Section on Tobacco, Alcohol and Drug Use, Department of Population Health, School of Medicine, New York University, New York, New York; Public Health Research Center, New York University Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Emelia J Benjamin
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas; Department of Medicine, Boston University, Boston, Massachusetts
| | - Andrew P DeFilippis
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas; Department of Medicine, University of Louisville, Louisville, Kentucky
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland; American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas.
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Habib E, Helaly M, Elshaer A, Sriwi D, Ahmad MS, Mohamed MI, Obeidat A. Prevalence and perceptions of e-cigarette use among medical students in a Saudi University. J Family Med Prim Care 2020; 9:3070-3075. [PMID: 32984175 PMCID: PMC7491770 DOI: 10.4103/jfmpc.jfmpc_235_20] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/13/2020] [Accepted: 04/02/2020] [Indexed: 12/15/2022] Open
Abstract
Background and Aims: We hypothesized that the prevalence of electronic cigarette vaping among the medical student population is on the rise. Our aims were to assess the prevalence of electronic cigarette vaping among medical students in Saudi Arabia, to understand and analyze the reasons that led them to try it, and to investigate students’ perceptions towards electronic cigarette vaping. Methods: An anonymous, paper-based, cross-sectional questionnaire was distributed amongst 401 undergraduate medical students from years 1-5 at Alfaisal University in Riyadh, Saudi Arabia. Prevalence, intensity of e-cigarette use and reasons for it, relation of electronic cigarettes to cessation of tobacco smoking, and side effects were studied. Results: The prevalence of vaping was 49/401 (12.2%). There was a strong association between gender and vaping, with males being 3 times more likely to vape compared to females (χ2 (1) =13.62, P <.001). The three most common reasons for using electronic cigarettes were to enjoy the variability in flavours (61.4%, n = 30), to reduce or quit tobacco cigarettes (29.5%, n = 14), and to avert the public smoking ban (13.6%, n = 7). The three most common side effects experienced by users were coughing (26.7%, n = 13), dry mouth/throat (24.4%, n = 12), and dizziness (20%, n = 10). Conclusion: Use of the electronic cigarettes is not uncommon amongst medical students, mostly due to their appealing flavor variability. Further research is required to define long-term safety and side effect profiles, and to generate evidence-based guidelines concerning e-cigarette safety and efficacy for smoking cessation.
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Affiliation(s)
- Eiad Habib
- College of Medicine, Alfaisal University, Saudi Arabia
| | - Mayar Helaly
- College of Medicine, Alfaisal University, Saudi Arabia
| | - Amani Elshaer
- College of Medicine, Alfaisal University, Saudi Arabia
| | - Dalia Sriwi
- College of Medicine, Alfaisal University, Saudi Arabia
| | | | | | - Akef Obeidat
- College of Medicine, Alfaisal University, Saudi Arabia
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Winters BR, Kochar TK, Clapp PW, Jaspers I, Madden MC. Impact of E-Cigarette Liquid Flavoring Agents on Activity of Microsomal Recombinant CYP2A6, the Primary Nicotine-Metabolizing Enzyme. Chem Res Toxicol 2020; 33:1689-1697. [PMID: 32496054 DOI: 10.1021/acs.chemrestox.9b00514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Nicotine is the primary psychoactive chemical in both traditional and electronic cigarettes (e-cigarettes). Nicotine levels in both traditional cigarettes and e-cigarettes are an important concern for public health. Nicotine exposure due to e-cigarette use is of importance primarily due to the addictive potential of nicotine, but there is also concern for nicotine poisoning in e-cigarette users. Nicotine concentrations in e-liquids vary widely. Additionally, there is significant genetic variability in the rate of metabolism of nicotine due to polymorphisms of CYP2A6, the enzyme responsible for the metabolism of approximately 80% of nicotine. Recent studies have shown CYP2A6 activity is also reduced by aromatic aldehydes such as those added to e-liquids as flavoring agents, which may increase nicotine serum concentrations. However, the impacts of flavored e-liquids on CYP2A6 activity are unknown. In this study, we investigated the impact of three flavored e-liquids on microsomal recombinant CYP2A6. Microsomal recombinant CYP2A6 was challenged at e-liquid concentrations ranging up to 0.125% (v/v) and monitored for metabolic activity using a probe molecule approach. Two e-liquids exhibited dose-dependent inhibition of CYP2A6 activity. Mass spectrometry was conducted to identify flavoring agents in flavored e-liquids that inhibited CYP2A6. Microsomal recombinant CYP2A6 was subsequently exposed to flavoring agents at concentrations ranging from 0.03 μM to 500 μM. Cinnamaldehyde and benzaldehyde were found to be the most potent inhibitors of microsomal CYP2A6 of the flavoring agents tested, with identified IC50 values of 1.1 μM and 3.0 μM, respectively. These data indicate certain aromatic aldehyde flavoring agents are potent inhibitors of CYP2A6, which may reduce nicotine metabolism in vivo. These findings indicate an urgent need to evaluate the effects of flavoring agents in e-cigarette liquids on the pharmacokinetics of nicotine in vivo.
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Affiliation(s)
- Brett R Winters
- Curriculum in Toxicology and Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27514, United States.,GSI Environmental Inc., Oakland, California 94612, United States
| | - Tavleen K Kochar
- Department of Chemistry, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27514, United States
| | - Phillip W Clapp
- Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27514, United States
| | - Ilona Jaspers
- Curriculum in Toxicology and Environmental Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27514, United States.,Center for Environmental Medicine, Asthma, and Lung Biology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27514, United States
| | - Michael C Madden
- Public Health and Integrative Toxicology Division, Office of Research and Development, United States Environmental Protection Agency, Chapel Hill, North Carolina 27514, United States
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40
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Stanton CA, Sharma E, Edwards KC, Halenar MJ, Taylor KA, Kasza KA, Day H, Anic G, Gardner LD, Hammad HT, Bansal-Travers M, Limpert J, Borek N, Kimmel HL, Compton WM, Hyland A. Longitudinal transitions of exclusive and polytobacco electronic nicotine delivery systems (ENDS) use among youth, young adults and adults in the USA: findings from the PATH Study Waves 1-3 (2013-2016). Tob Control 2020; 29:s147-s154. [PMID: 32321848 PMCID: PMC7530834 DOI: 10.1136/tobaccocontrol-2019-055574] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/08/2020] [Accepted: 01/15/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Electronic nicotine delivery systems (ENDS; including e-cigarettes) are rapidly evolving in the US marketplace. This study reports cross-sectional prevalence and longitudinal pathways of ENDS use across 3 years, among US youth (12-17 years), young adults (18-24 years) and adults 25+ (25 years and older). DESIGN Data were from the first three waves (2013-2016) of the Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study of US youth and adults. Respondents with data at all three waves (youth, n=11 046; young adults, n=6478; adults 25+, n=17 188) were included in longitudinal analyses. RESULTS Weighted cross-sectional ever use of ENDS increased at each wave. Across all three waves, young adults had the highest percentages of past 12-month, past 30-day (P30D) and daily P30D ENDS use compared with youth and adults 25+. Only about a quarter of users had persistent P30D ENDS use at each wave. Most ENDS users were polytobacco users. Exclusive Wave 1 ENDS users had a higher proportion of subsequent discontinued any tobacco use compared with polytobacco ENDS users who also used cigarettes. CONCLUSIONS ENDS use is most common among young adults compared with youth and adults 25+. However, continued use of ENDS over 2 years is not common for any age group. Health education efforts to reduce the appeal and availability of ENDS products might focus on reducing ENDS experimentation, and on reaching the smaller subgroups of daily ENDS users to better understand their reasons for use.
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Affiliation(s)
- Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
- Department of Oncology, Georgetown University Medical Center, Washington, DC, United States
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Kathryn C Edwards
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Michael J Halenar
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Kristie A Taylor
- Behavioral Health and Health Policy Practice, Westat, Rockville, MD, USA
| | - Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Hannah Day
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Gabriella Anic
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Lisa D Gardner
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Hoda T Hammad
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Maansi Bansal-Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Jean Limpert
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, United States
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, United States
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
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41
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Singh S, Windle SB, Filion KB, Thombs BD, O'Loughlin JL, Grad R, Eisenberg MJ. E-cigarettes and youth: Patterns of use, potential harms, and recommendations. Prev Med 2020; 133:106009. [PMID: 32027913 DOI: 10.1016/j.ypmed.2020.106009] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/27/2020] [Accepted: 02/01/2020] [Indexed: 12/20/2022]
Abstract
Electronic cigarette (e-cigarette) use has risen to unprecedented levels among youth in the United States. In this review, we discuss the patterns of use underlying the current youth vaping epidemic, potential harms from e-cigarette use, and the regulatory, public health, and clinical responses to e-cigarette use among youth. Between 2017 and 2018, past 30-day use of nicotine e-cigarettes among high school seniors nearly doubled, from 11% to 21%, representing the largest recorded increase for any adolescent substance use in over four decades. There are concerns that e-cigarette use could renormalize smoking behaviors, lead to the uptake of conventional cigarette use by youth, and have adverse effects in the developing brain and lungs of adolescents. Prevention and harm reduction efforts thus far have focused on policies to prevent youth access to vaping products and on public health strategies to expose the risks of youth vaping. However, it remains unclear if ongoing initiatives are sufficient to curb e-cigarette use by youth. Most health professionals agree that youth exposure to e-cigarettes needs to be addressed but feel uninformed, rely on unconventional information sources such as the media and their patients, and report that routine screening procedures concerning e-cigarettes are lacking. A coordinated effort from policy makers, public health agencies, parents, educators, health practitioners, and researchers is essential to mitigate harms from e-cigarette use in this vulnerable population.
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Affiliation(s)
- Sareen Singh
- Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Sarah B Windle
- Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Kristian B Filion
- Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Brett D Thombs
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Jennifer L O'Loughlin
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Roland Grad
- Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada; Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Mark J Eisenberg
- Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Division of Cardiology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
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42
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Lozano P, Arillo-Santillán E, Barrientos-Gutiérrez I, Zavala-Arciniega L, Reynales-Shigematsu LM, Thrasher JF. E-cigarette use and its association with smoking reduction and cessation intentions among Mexican smokers. SALUD PUBLICA DE MEXICO 2020; 61:276-285. [PMID: 31276343 DOI: 10.21149/9797] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/04/2018] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Evaluate the patterns of e-cigarette use andtheir association with smoking behavior. MATERIALS AND METHODS We analyzed data from a population-based representative cohort of adult smokers who participated in the International Tobacco Control Policy Evaluation Surveys in Mexico. The analytic sample (n=760) was restricted to participants who were followed up from wave 6 (2012) to wave 7 (2014-2015). GEE models regressed e-cigarette use at follow-up and changes in cigarettes per day (CPD) between waves, on baseline sociodemographic variables, smoking status (daily, non-daily, quit), e-cigarette trial, and quit intentions. RESULTS Smokers who were younger, had a higher income, and had tried e-cigarettes at baseline were more likely to be current e-cigarette users at follow-up. Ecigarette use at follow-up was not associated with a change in CPD over time. CONCLUSIONS E-cigarette use does not appear to have promoted smoking cessation or reduction in this sample of Mexican smokers.
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Affiliation(s)
- Paula Lozano
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina. Columbia, SC, USA
| | - Edna Arillo-Santillán
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Inti Barrientos-Gutiérrez
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | - Luis Zavala-Arciniega
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
| | | | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina. Columbia, SC, USA.,Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública. Cuernavaca, Morelos, México
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43
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Smit T, Olofsson H, Nizio P, Garey L, Zvolensky MJ. Pain severity and e-cigarette health literacy: the moderating role of sex. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2020; 13:1178221819897070. [PMID: 31908468 PMCID: PMC6937532 DOI: 10.1177/1178221819897070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 11/25/2019] [Indexed: 11/15/2022]
Abstract
Although electronic cigarette (e-cigarette) use has increased among adults in the United States, there is still little knowledge of factors that may influence e-cigarette use or beliefs about use. Prior research suggests that health literacy plays an important role in e-cigarette beliefs, including perceived benefits and risks of e-cigarette use, as well as e-cigarette dependence. Yet, limited work has examined risk factors of poor e-cigarette health literacy. From a biopsychological perspective, sex and pain severity represent two constructs that may impact e-cigarette health literacy. To date, however, no research has investigated differences in e-cigarette health literacy across pain, sex, or their interrelation. Thus, the present study was conducted to evaluate the interactive effect of pain severity and sex on e-cigarette health literacy. Participants included 319 current, adult e-cigarette users (60.5% female, Mage = 36.82 years, SD = 10.62). Findings supported a significant pain by sex interaction, such that pain related to e-cigarette health literacy among women (b = .10, SE = .03, P < .001), but not men (b = .01, SE = .03, P = .60). The present findings suggest that pain may uniquely impact the degree to which women, but not men, seek and understand information on e-cigarettes.
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Affiliation(s)
- Tanya Smit
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Hannah Olofsson
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Pamella Nizio
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,HEALTH Institute, University of Houston, Houston, TX, USA
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44
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Lewek P, Woźniak B, Maludzińska P, Smigielski J, Kardas P. E-cigarette use and its predictors: Results from an online cross-sectional survey in Poland. Tob Induc Dis 2019; 17:79. [PMID: 31772557 PMCID: PMC6856825 DOI: 10.18332/tid/113093] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 10/05/2019] [Accepted: 10/15/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Since the invention of electronic cigarettes (ECs) in 2003, their use has spread worldwide; however, little is known about the profiles of EC users. Understanding the motivators for using ECs enables more accurate prediction of their use and more effective direction of pro-health activities. Our objective was to identify the factors that may influence the decision to use ECs and their possible adverse effects according to the experiences of EC users. METHODS A cross-sectional online survey was administered between 1 July 2016 and 1 January 2017 among 1288 Polish-speaking users of social networks and EC forums. To explore associations between current EC use and other factors, multivariate binary logistic regression analyses were performed. RESULTS The final analysis included 1142 survey participants: mean age 25.9 years (± 11.1), 85.6% were male, 50.3% had secondary education, 98.2% were Polish citizens, and 81.0% were current EC users. Male gender, lower education, aged ≤40 years, former cigarette smoking, previous attempts to quit smoking, perception of lack of harmful effects of ECs, perception of ECs as being tastier and cheaper than cigarettes, awareness of the advantages of ECs and their use as a smoking cessation aid were all statistically significant factors increasing the risk of EC use. The majority of study participants claimed that ECs are less addictive or not addictive compared to cigarettes (62.6%) and less harmful or not harmful (89.5%) compared to cigarettes. The most common reported side effects of ECs were dryness in the mouth (8.3%), itching in the throat (4.5%) and nausea (1.9%). CONCLUSIONS Males aged ≤40 years with a lower level education were more likely to use ECs in the studied Polish population. The perception that ECs are less harmful than regular cigarettes is a factor increasing the odds of EC use; however, although ECs have few adverse effects, they nevertheless exist.
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Affiliation(s)
- Pawel Lewek
- Department of Family Medicine, Medical University of Lodz, Lodz, Poland
| | | | | | - Janusz Smigielski
- Social and Technical Department, State Higher Vocational School, Konin, Poland
| | - Przemyslaw Kardas
- Department of Family Medicine, Medical University of Lodz, Lodz, Poland
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45
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Boyle RG, Richter S, Helgertz S. Who is using and why: Prevalence and perceptions of using and not using electronic cigarettes in a statewide survey of adults. Addict Behav Rep 2019; 10:100227. [PMID: 31832535 PMCID: PMC6889732 DOI: 10.1016/j.abrep.2019.100227] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/26/2019] [Accepted: 10/05/2019] [Indexed: 01/03/2023] Open
Abstract
E-cigarettes continue to generate curiosity among smokers and nonsmokers. Higher nicotine content devices have sustained interest in e-cigarettes. Nonsmokers were 37% of users and flavors were a primary reason for trying. Users were young adults , curious adults, smokers trying to quit, and dual users.
A statewide survey examined prevalence, reasons for using, discontinuing use, and not wanting to try e-cigarettes. Methods Participants (n = 6052) were adult Minnesota residents. E-cigarette initiation and current use prevalence rates were calculated for demographic characteristics and smoking status. The percent of respondents endorsing a reason for trying e-cigarettes are reported overall and by smoking status. The percent of respondents endorsing each reason for discontinuing or not using e-cigarettes are reported for daily and occasional smokers. All descriptive analyses were weighted. To develop profiles of e-cigarette users, a latent class analysis (LCA) was undertaken. Results Overall, 20.7% of adults reported ever use and 4.6% were current users. Use varied notably by age and smoking status. Only 2.8% of never smokers were current e-cigarette users. Among young adults, 14.6% reported current use but most (70.0%) were never smokers. The reasons given for using e-cigarettes varied by smoking status. Curiosity was the top reason for all groups except recent former smokers, for whom cutting down or quitting other tobacco products was primary. Most smokers discontinuing e-cigarettes preferred cigarettes, and four-fifths of smokers who never tried e-cigarettes lacked interest. From the LCA four profiles were evident: young adult experimenters, curious adults, smokers trying to quit cigarettes, and dual users. Conclusions Innovative higher nicotine content devices have sustained interest in e-cigarettes especially among young adults and smokers with a goal of cutting down or quitting smoking. Future regulations and communication should focus on reducing e-cigarette use among young adult nonsmokers.
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46
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Baltz GM, Lach HW. Perceptions, Knowledge, and Use of Electronic Cigarettes: A Survey of Mental Health Patients. Issues Ment Health Nurs 2019; 40:887-894. [PMID: 31058546 DOI: 10.1080/01612840.2019.1579281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Tobacco smoking is the leading cause of preventable illness and death in the United States. Smoking and mental illness are often comorbid, yet little is known about mental health patients' perceptions, knowledge, and use of electronic nicotine delivery systems (ENDS). ENDS may be a beneficial short-term intervention to help this group quit smoking. A survey was administered to a sample of patients at an adult outpatient mental health office (N = 109, 45% male, mean age 33). The majority of participants had tried ENDS. Most used ENDS to quit smoking, and believed it was less harmful than smoking. Participants had variable knowledge about ENDS, but few had asked providers for recommendations. They reported providers were not very knowledgeable about ENDS, and were not asking providers for recommendations. ENDS may help mental health patients who have been unable to quit tobacco, but should not be recommended outside of smoking cessation. This survey provides needed information about how ENDS are being used by mental health patients to help guide future recommendations by their healthcare providers when screening for tobacco use.
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Affiliation(s)
- Gerald M Baltz
- Saint Louis University School of Nursing , Saint Louis , Missouri , USA
| | - Helen W Lach
- Saint Louis University School of Nursing , Saint Louis , Missouri , USA
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47
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Berkelhamer SK, Helman JM, Gugino SF, Leigh NJ, Lakshminrusimha S, Goniewicz ML. In Vitro Consequences of Electronic-Cigarette Flavoring Exposure on the Immature Lung. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193635. [PMID: 31569724 PMCID: PMC6801380 DOI: 10.3390/ijerph16193635] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 12/17/2022]
Abstract
Background: The developing lung is uniquely susceptible and may be at increased risk of injury with exposure to e-cigarette constituents. We hypothesize that cellular toxicity and airway and vascular responses with exposure to flavored refill solutions may be altered in the immature lung. Methods: Fetal, neonatal, and adult ovine pulmonary artery smooth muscle cells (PASMC) were exposed to popular flavored nicotine-free e-cigarette refill solutions (menthol, strawberry, tobacco, and vanilla) and unflavored solvents: propylene glycol (PG) or vegetable glycerin (VG). Viability was assessed by lactate dehydrogenase assay. Brochodilation and vasoreactivity were determined on isolated ovine bronchial rings (BR) and pulmonary arteries (PA). Results: Neither PG or VG impacted viability of immature or adult cells; however, exposure to menthol and strawberry flavored solutions increased cell death. Neonatal cells were uniquely susceptible to menthol flavoring-induced toxicity, and all four flavorings demonstrated lower lethal doses (LD50) in immature PASMC. Exposure to flavored solutions induced bronchodilation of neonatal BR, while only menthol induced airway relaxation in adults. In contrast, PG/VG and flavored solutions did not impact vasoreactivity with the exception of menthol-induced relaxation of adult PAs. Conclusion: The immature lung is uniquely susceptible to cellular toxicity and altered airway responses with exposure to common flavored e-cigarette solutions.
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Affiliation(s)
- Sara K Berkelhamer
- Department of Pediatrics, University at Buffalo, SUNY, Buffalo, NY 14203, USA.
| | - Justin M Helman
- Department of Pediatrics, University at Buffalo, SUNY, Buffalo, NY 14203, USA.
| | - Sylvia F Gugino
- Department of Pediatrics, University at Buffalo, SUNY, Buffalo, NY 14203, USA.
| | - Noel J Leigh
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
| | | | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
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48
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Rodu B, Plurphanswat N. E-cigarette Use Among US Adults: Population Assessment of Tobacco and Health (PATH) Study. Nicotine Tob Res 2019; 20:940-948. [PMID: 29986104 DOI: 10.1093/ntr/ntx194] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 09/18/2017] [Indexed: 11/13/2022]
Abstract
Introduction In 2011 the US Food and Drug Administration launched the Population Assessment of Tobacco and Health (PATH) Study to gather information for regulatory activities authorized by the Family Smoking Prevention and Tobacco Control Act (TCA). Methods Data were drawn from the first wave of the PATH survey, involving interviews of 32 320 civilian and non-institutionalized adults. In addition to conventional classifications for current, former and never smoking and e-cigarette use, we used PATH questions to classify former and current triers of these products. Descriptive statistics were used to describe the prevalence, patterns of, and reasons for e-cigarette use, and the perceptions of nicotine and e-cigarettes among user groups, according to smoking status. Results The prevalence of current smoking was 18%; an additional 3.1% of participants were current triers. The prevalence of current e-cigarette use was 2.4% (1.0% every day, 1.4% some days), with another 3.2% as current triers. The majority of nonsmokers who were current e-cigarette users were already current (56%) or former (34%) cigarette triers. Reasons for e-cigarette use were similar across subgroups, but patterns of use were different. Majorities of participants believed that nicotine is the main substance driving tobacco use, that nicotine causes most cancers, and that e-cigarettes were less harmful than cigarettes. Conclusions E-cigarettes were used primarily by current smokers and recent former smokers. The main reasons for use center around perceptions that e-cigarettes are less harmful than cigarettes to users and others. Implications This study reports detailed information about the prevalence, patterns of, and reasons for e-cigarette use in the first (baseline) wave of the PATH Study in 2014. In addition to conventional categories for current, former and never smoking and e-cigarette use, the PATH questionnaire facilitated classification of new usage groups consisting of current and former triers of these products, which may impact prevalence estimates.
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Affiliation(s)
- Brad Rodu
- Department of Medicine, School of Medicine, University of Louisville, Louisville, KY.,James Graham Brown Cancer Center, University of Louisville, Louisville, KY
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Smiley SL, DeAtley T, Rubin LF, Harvey E, Kierstead EC, Webb Hooper M, Niaura RS, Abrams DB, Pearson JL. Early Subjective Sensory Experiences with "Cigalike" E-cigarettes Among African American Menthol Smokers: A Qualitative Study. Nicotine Tob Res 2019; 20:1069-1075. [PMID: 28549156 DOI: 10.1093/ntr/ntx102] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 05/09/2017] [Indexed: 12/20/2022]
Abstract
Introduction Despite smoker interest in e-cigarettes as a harm reduction or cessation aid, many smokers prematurely discontinue vaping after trying a product. This study explored the role of early subjective sensory experiences in vaping persistence and desistance. Methods African American menthol cigarette smokers aged ≥18 years (N = 15; M = 54.1 years; SD = 8.2), motivated to quit smoking, and interested in trying e-cigarettes were recruited in Washington, DC. Participants were followed for 3 weeks and provided menthol cigalike e-cigarettes after Week 1. Participants completed three interviews about their vaping experiences. Thematic analysis of responses was designed to understand the sensory aspects of vaping. Results During the first 2 weeks of vaping, four participants reported a positive vaping experience while 11 reported decreased satisfaction. Salient sensory attributes of dissatisfaction included poor taste, insufficient throat hit, difficulty pulling, and a lack of "whole body" satisfaction compared to their preferred cigarette brand. Conclusions The sensory experiences with a specific cigalike e-cigarette were related to vaping persistence and desistence. Although this was a small volunteer sample of African American menthol smokers motivated to quit smoking, 27% (N = 4) of participants with a positive vaping experience continued using the product, while 73% (N = 11) of participants' vaping experience was unsatisfactory across several experiential categories. In future research of e-cigarettes' efficacy as a smoking cessation or reduction aid, both device characteristics and smokers' expectations for these devices should be considered, so vapers do not expect the same taste sensations, throat sensations, and "whole body" satisfaction as they experienced with their menthol cigarettes. Implications The subjective sensory experiences associated with initial e-cigarette product use are associated with use patterns. Subjective sensory experiences may also help understand the differences in the appeal, satisfaction, and harm-reduction potential of the rapidly evolving diverse types of products emerging in the marketplace. How products meet the sensory needs of smokers wanting to switch or quit smoking may influence adherence and success rates.
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Affiliation(s)
- Sabrina L Smiley
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Teresa DeAtley
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Leslie F Rubin
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Department of Psychology, American University, Washington, DC
| | - Emily Harvey
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC
| | - Elexis C Kierstead
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Milken Institute School of Public Health, The George Washington University, Washington, DC
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Raymond S Niaura
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
| | - David B Abrams
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC
| | - Jennifer L Pearson
- Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Abstract
AbstractIntroductionEvidence is mixed on e-cigarette's effectiveness as a tobacco cessation aid. Research suggests that e-cigarette users face greater barriers to quitting tobacco.AimTo examine the association between e-cigarette use and tobacco cessation outcomes among quitline callers.MethodsWe examined 2,204 callers who enrolled and completed 7-month follow-up surveys between April 2014 and January 2017. We examined the association between any e-cigarette use and tobacco cessation. We also evaluated these relationships by e-cigarette use patterns between enrollment and 7-month follow-up: sustained, adopted, discontinued, and non-use. We used multivariable logistic regression to control for caller characteristics, tobacco history, and program utilization.ResultsOverall, 18% of callers reported using e-cigarettes at enrollment, follow-up, or both. Compared to non-users, e-cigarette users were more likely to be younger, non-Hispanic, and report a mental health condition. The adjusted odds of tobacco cessation were not statistically different for callers who used e-cigarettes compared to those who did not (adjusted odds ratios = 1.02, 95% confidence interval 0.79–1.32). Results were similar when examining cessation by patterns of e-cigarette use.ConclusionsE-cigarette use was not associated with tobacco cessation. This suggests that e-cigarette use may neither facilitate nor deter tobacco cessation among quitline callers. Future research should continue exploring how e-cigarette use affects quitting.
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