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Elsherif I, Jammah AA, Ibrahim AR, Alawadi F, Sadek IS, Rahman AM, Sharify GE, AlFeky A, Aldossari K, Roushdy E, ELBarbary NS, BenRajab F, Elghweiry A, Farah SIS, Hajjaji I, AlShammary A, Abdulkareem F, AbdelRahim A, Orabi A. Clinical practice recommendations for management of Diabetes Mellitus in Arab region: An expert consensus statement from Arab Diabetes Forum (ADF). Prim Care Diabetes 2024; 18:471-478. [PMID: 38955658 DOI: 10.1016/j.pcd.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 05/14/2024] [Accepted: 06/02/2024] [Indexed: 07/04/2024]
Abstract
Prevalence of diabetes in Arab region has significantly increased, resulting in a significant economic burden on healthcare systems. This surge can be attributed to obesity, rapid urbanization, changing dietary habits, and sedentary lifestyles. The Arab Diabetes Forum (ADF) has established localized recommendations to tackle the region's rising diabetes prevalence. The recommendations, which incorporate worldwide best practices, seek to enhance the quality of treatment for people with diabetes by raising knowledge and adherence among healthcare providers. The guidelines include comprehensive recommendations for screening, diagnosing, and treating type 1 and type 2 diabetes in children and adults for better overall health results.
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Affiliation(s)
| | - Anwar Ali Jammah
- Endocrinology and Diabetes Division, Medicine Department, King Saud University, Saudi Arabia
| | | | - Fatheya Alawadi
- Dubai Medical College - President of EDS emirates diabetes society, the United Arab Emirates
| | | | | | | | | | - Khaled Aldossari
- Department of family and community medicine, College of Medicine, Prince Sattam Bin Abdulaziz University, Saudi Arabia
| | - Eman Roushdy
- Internal medicine and Diabetes, Cairo University, Egypt
| | - Nancy Samir ELBarbary
- Department of Pediatrics, Diabetes Unit, Faculty of medicine, Ain shams University, Cairo, Egypt
| | | | - Awad Elghweiry
- National Center for Diagnosis and Treatment of Diabetes, Benghazi, Libya
| | | | - Issam Hajjaji
- Endocrine & Diabetes Hospital, University of Tripoli, Libya
| | - Afaf AlShammary
- Department of Internal Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Saudi Arabia
| | - Faris Abdulkareem
- Internal medicine, diabetes and endocrinology, Alkindy College of Medicine, Iraq
| | - Aly AbdelRahim
- Internal medicine and Diabetes Department, Alex University, Egypt
| | - Abbass Orabi
- Internal medicine and Diabetes, Zagazig University, Egypt.
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El-Shahawy O, Walker KL, Groom AM, Payne TJ, Tompkins LK, Kesh A, Landry R, Pfeiffer J, Giachello AL, Vu THT, Ma JZ, Robertson RM, Gunturu S, Blaha MJ, Hart JL. Initial experimentation with tobacco is associated with subsequent tobacco use patterns among youth in the United States. PLoS One 2024; 19:e0308964. [PMID: 39331590 PMCID: PMC11432854 DOI: 10.1371/journal.pone.0308964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 08/02/2024] [Indexed: 09/29/2024] Open
Abstract
Understanding the association between initial experimentation with a tobacco product and subsequent patterns of tobacco use among youth is important to informing prevention activities for youth in the US. We conducted an online survey from August to October 2017 among youth aged 13-18 years. The current analysis focused on respondents reporting initial experimentation with any tobacco product (n = 2,022). Using multinomial logistic regression, we examined the association between first tobacco product tried (cigarettes; cigars including cigarillos, little cigars, and bidis; electronic nicotine delivery systems (ENDS); smokeless and chewing tobacco; or hookah) with subsequent patterns of tobacco use while adjusting for covariates. Of the youth who experimented, 56.8% were non-current tobacco users. Of current tobacco users (n = 934), 13% were exclusive ENDS users, 5.3% exclusive combustible mono-users, 13.4% ENDS plus combustible poly-users, 3.3% combustible product only poly-users, and 8.2% other tobacco poly-users. The most common type of first tobacco product tried was ENDS (44.7%), followed by cigarettes (35.0%) and cigars (8.6%). Those who experimented with combustible tobacco products were less likely to be exclusive ENDS users [Relative Risk Ratio (RRR) = 0.46; 95% CI = 0.28, 0.73 for cigarettes; RRR = 0.32; 95% CI = 0.13, 0.81 for cigars; and RRR = 0.33; 95% CI = 0.14, 0.79 for hookah] when compared to non-current tobacco users (reference group). Tobacco product choices for initial experimentation appear to play a role in subsequent tobacco use patterns among youth. Understanding the reasons behind initial product choice may inform our understanding regarding the reasons for subsequent current tobacco product use, thus informing youth prevention efforts.
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Affiliation(s)
- Omar El-Shahawy
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- New York University Grossman School of Medicine, New York, New York, United States of America
| | - Kandi L. Walker
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- University of Louisville, Louisville, Kentucky, United States of America
| | - Allison M. Groom
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- American Heart Association, Dallas, Texas, United States of America
| | - Thomas J. Payne
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Lindsay K. Tompkins
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- University of Louisville, Louisville, Kentucky, United States of America
| | - Anshula Kesh
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- American Heart Association, Dallas, Texas, United States of America
| | - Robyn Landry
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- American Heart Association, Dallas, Texas, United States of America
| | - Jack Pfeiffer
- University of Louisville, Louisville, Kentucky, United States of America
| | - Aida L. Giachello
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- Northwestern University Feinberg School of Medicine, Evanston, Illinois, United States of America
| | - Thanh-Huyen T. Vu
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- Northwestern University Feinberg School of Medicine, Evanston, Illinois, United States of America
| | - Jennie Z. Ma
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- University of Virginia, Charlottesville, Virginia, United States of America
| | - Rose Marie Robertson
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- American Heart Association, Dallas, Texas, United States of America
| | - Sasidhar Gunturu
- Department of Psychiatry, BronxCare Health System, Bronx, New York, United States of America
- Department of Psychiatry, Icahn School of Mount Sinai, New York, New York, United States of America
| | - Michael J. Blaha
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Maryland, United States of America
| | - Joy L. Hart
- American Heart Association Tobacco Center for Regulatory Science, Dallas, Texas, United States of America
- University of Louisville, Louisville, Kentucky, United States of America
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Kelly BC, Vuolo M, Maggs J, Staff J. E-cigarette use among early adolescent tobacco cigarette smokers: testing the disruption and entrenchment hypotheses in two longitudinal cohorts. Tob Control 2024; 33:497-502. [PMID: 37072167 DOI: 10.1136/tc-2022-057717] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/26/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE Using longitudinal data from two large-scale cohorts in the UK and USA, we examine whether e-cigarette use steers adolescent early smokers away from tobacco cigarettes (disruption hypothesis) or deepens early patterns of tobacco smoking (entrenchment hypothesis) in comparison with early smokers who do not use e-cigarettes. METHODS Youth who smoked tobacco cigarettes by early adolescence (before age 15) were selected from the ongoing UK Millennium Cohort Study (n=1090) and the US Population Assessment of Tobacco and Health (n=803) study. In regression models, the focal predictor was lifetime use of an e-cigarette by early adolescence and the primary outcome was current tobacco use by late adolescence (before age 18). Logistic and multinomial models controlled for early adolescent risk factors and sociodemographic background, and were weighted for attrition and adjusted for complex survey designs. RESULTS Among youth who were early cigarette smokers, 57% of UK and 58% of US youth also used e-cigarettes. The odds of later adolescent smoking among early smoking youth were significantly higher among e-cigarette users relative to those who had not used e-cigarettes (adjusted OR (AORUK)=1.45; AORUSA=2.19). In both samples, multinomial models indicated that early smoking youth who used e-cigarettes were more likely to be frequent smokers relative to not smoking (AORUK=2.01; AORUSA=5.11) and infrequent smoking (AORUK=1.67; AORUSA=2.11). CONCLUSIONS Despite national differences in e-cigarette regulation and marketing, there is evidence e-cigarette use among early adolescent smokers in the UK and USA leads to higher odds of any smoking and more frequent tobacco cigarette use later in adolescence.
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Affiliation(s)
- Brian C Kelly
- Sociology, Purdue University, West Lafayette, Indiana, USA
| | - Mike Vuolo
- Sociology, Ohio State University, Columbus, Ohio, USA
| | - Jennifer Maggs
- Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Jeremy Staff
- Sociology and Criminology, Pennsylvania State University, University Park, Pennsylvania, USA
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Millard PS. In adult tobacco smokers, adding e-cigarettes to standard smoking cessation counseling increased abstinence at 6 mo. Ann Intern Med 2024; 177:JC70. [PMID: 38830211 DOI: 10.7326/annals-24-00229-jc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
SOURCE CITATION Auer R, Schoeni A, Humair JP, et al. Electronic nicotine-delivery systems for smoking cessation. N Engl J Med. 2024;390:601-610. 38354139.
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Affiliation(s)
- Peter S Millard
- Seaport Community Health Center, Belfast, Maine, USA (P.S.M.)
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Khanagar SB, Aldawas I, Alrusaini SK, Albalawi F, Alshehri A, Awawdeh M, Iyer K, Divakar DD. Association of Electronic Cigarette Usage with the Subsequent Initiation of Combustible Cigarette Smoking among Dental Students in Riyadh, Saudi Arabia: A Longitudinal Study. Healthcare (Basel) 2024; 12:1092. [PMID: 38891167 PMCID: PMC11172238 DOI: 10.3390/healthcare12111092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/20/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
The use of electronic cigarettes, or "e-cigarettes", among youths has sparked worries about the possibility of nicotine dependence as a serious public health issue. Dental practitioners play a critical role in helping their patients quit smoking. Dental schools across the globe have policies encouraging their students to help patients quit smoking. Current research, however, indicates that a significant portion of dental students smoke combustible cigarettes and use e-cigarettes. According to studies, using e-cigarettes has resulted in the subsequent initiation of combustible cigarette smoking among its users. The aim of this study was to determine the association between the use of electronic cigarettes and the subsequent initiation of combustible cigarette smoking among dental students who were not attitudinally susceptible to smoking combustible cigarettes. A longitudinal cohort study was conducted among 121 study participants who were never combustible cigarette users and were attitudinally non-susceptible to smoking at baseline. At baseline, 66 (54.6%) study participants were categorized as e-cigarette users who were attitudinally non-susceptible to combustible cigarette smoking, and 55 (45.4%) study participants were categorized as non-users who were attitudinally non-susceptible to combustible cigarette smoking. The initiation of combustible cigarette smoking was assessed at 6- and 12-month intervals. Binomial regression analysis of the outcome at the end of one-year follow-up, when analyzed with independent variables, revealed a significant influence of e-cigarette use on taking up combustible cigarette smoking [Relative Risk: 9.395; 95% CI: 3.03-29.04]. Chi-squared analysis of independent variables revealed e-cigarette use to be significantly associated with fathers' education level (p = 0.00), parental cigarette smoking status (p = 0.00), cigarette smoking among friends (p = 0.00), and family income (p = 0.00). E-cigarette users are more likely to believe it to be healthier (p = 0.00) than combustible smoking. In the present study, e-cigarette usage demonstrated a significant influence on taking up combustible cigarette smoking among its users. Educational institutions should implement stringent policies and regulations to prevent health professionals from using these products.
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Affiliation(s)
- Sanjeev B. Khanagar
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
- College of Public Health, Texila American University, Georgetown 413741, Guyana
| | - Ibrahim Aldawas
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Salman Khalid Alrusaini
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Farraj Albalawi
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| | - Aram Alshehri
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
- Restorative and Prosthetic Dental Sciences Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
| | - Mohammed Awawdeh
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| | - Kiran Iyer
- Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia
- King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh 11481, Saudi Arabia
| | - Darshan Devang Divakar
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
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Kim MM, Steffensen I, Miguel RTD, Babic T, Carlone J. A systematic review and meta-analysis of the association between e-cigarette use among non-tobacco users and initiating smoking of combustible cigarettes. Harm Reduct J 2024; 21:99. [PMID: 38773514 PMCID: PMC11110305 DOI: 10.1186/s12954-024-01013-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 05/01/2024] [Indexed: 05/24/2024] Open
Abstract
INTRODUCTION The rapid increase in e-cigarette use over the past decade has triggered an important public health question on the potential association between e-cigarette use and combustible cigarette smoking. Following AMSTAR 2 and PRISMA guidelines, this evidence synthesis sought to identify and characterize any associations between e-cigarette use among individuals not smoking cigarettes and initiation of cigarette smoking. METHODS The protocol was registered on September 24, 2018 (PROSPERO 2018 CRD42018108540). Three databases were queried from January 01, 2007 to April 26, 2023. Search results were screened using the PICOS review method. RESULTS Among 55 included studies (40 "good" and 15 "fair"; evidence grade: "high") that adjusted for gender, age, and race/ethnicity between groups, generally, there was a significant association between non-regular e-cigarette use and initiation of cigarette smoking, further supported by the meta-analytic results (AOR 3.71; 95% CI 2.86-4.81). However, smoking initiation was most often measured as ever/current cigarette smoking. Two studies (quality: 2 "good") evaluated progression to regular cigarette smoking among individuals with regular use of e-cigarettes, and generally found no significant associations. One study ("good") evaluated smoking initiation among individuals with regular use of e-cigarettes, finding an increasing probability of ever smoking cigarettes with increased e-cigarette use. Twelve studies (10 "good" and two "fair") examining progression to regular smoking among individuals with non-regular use of e-cigarettes reported inconsistent findings. CONCLUSIONS Numerous methodological flaws in the body of literature limit the generalizability of these results to all individuals who are not smoking cigarettes with few studies measuring established/regular use/smoking of e-cigarettes and cigarettes. Further, studies did not control adequately for specific confounding variables representing common liabilities between e-cigarette use and cigarette smoking, nor did they account for sufficient follow-up durations. Collectively, these flaws limit the generalizability of findings to the question of an association between e-cigarette use and cigarette smoking initiation.
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Becker TD. A clinical overview of adolescent e-cigarette use (vaping). Minerva Pediatr (Torino) 2024; 76:108-118. [PMID: 37427959 DOI: 10.23736/s2724-5276.23.07131-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
E-cigarette use (also known as "vaping") has become increasingly popular among adolescents over the past decade and grown into a significant public health concern in North America, the United Kingdom, and other countries. Concerns about this new trend have generated numerous new research studies. This aim of this study was to summarize recent scientific findings, with a focus on their relevance to clinicians working with adolescents. The first half covers epidemiology, risk factors for e-cigarette use, characteristics of e-cigarette use, youth perceptions of e-cigarettes, physical health risks of e-cigarettes, evidence for "gateway effects" of e-cigarette exposure on subsequent substance use, and the relationship between e-cigarette use and mental health. The review concludes with a clinical focus on assessment of youth who vape, psychoeducation for youth and families, clinical management of vaping, and regulatory considerations.
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Affiliation(s)
- Timothy D Becker
- Department of Psychiatry, New York-Presbyterian Hospital, New York, NY, USA -
- Division of Child and Adolescent Psychiatry, Weill Cornell Medicine, New York, NY, USA -
- Division of Child and Adolescent Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA -
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ElSayed NA, Aleppo G, Bannuru RR, Bruemmer D, Collins BS, Ekhlaspour L, Hilliard ME, Johnson EL, Khunti K, Lingvay I, Matfin G, McCoy RG, Perry ML, Pilla SJ, Polsky S, Prahalad P, Pratley RE, Segal AR, Seley JJ, Stanton RC, Gabbay RA. 14. Children and Adolescents: Standards of Care in Diabetes-2024. Diabetes Care 2024; 47:S258-S281. [PMID: 38078582 PMCID: PMC10725814 DOI: 10.2337/dc24-s014] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, an interprofessional expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Dautzenberg B, Legleye S, Underner M, Arvers P, Pothegadoo B, Bensaidi A. Systematic Review and Critical Analysis of Longitudinal Studies Assessing Effect of E-Cigarettes on Cigarette Initiation among Adolescent Never-Smokers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6936. [PMID: 37887674 PMCID: PMC10606427 DOI: 10.3390/ijerph20206936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023]
Abstract
Prospective longitudinal studies mainly conclude on a causal role of e-cigarettes in the initiation of cigarettes in flagrant contradiction with conclusions drawn from epidemiology and other studies showing a sharp decline in cigarette use in parallel with the spread of e-cigarette use. This systematic review explores the reasons for this discrepancy. METHODS Among 84 publications on e-cigarette/cigarette association in adolescents identified in the Medline database from 2011 to 2022, 23 concern 22 never-smoker longitudinal sub-cohorts. RESULTS A link between e-cigarette experimentation at T1 and cigarette initiation at T2 is reported in sub-cohort analyses of never-smokers (AOR: 1.41 to 8.30). However, studies exclude 64.3% of T1 e-cigarette experimenters (because of dual-use) and 74.1% of T2 cigarette experimenters. With this study design, e-cigarettes contribute only to 5.3% of T2 cigarette experimentation, casting major doubt on the external validity of results and authors' conclusions that e-cigarettes have a significant effect on the initiation of cigarettes (Gateway effect) at the population level. This sub-cohort design prohibits highlighting any Diversion effect, which is the most likely mechanism accounting for the competition between these two products. CONCLUSIONS While nicotine abstinence remains the best medical option, over-regulation of e-cigarettes because of misinterpretation of longitudinal study results may be detrimental to public health and tobacco control.
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Affiliation(s)
- Bertrand Dautzenberg
- Sorbonne Université & ex CHU Pitié-Salpêtrière (APHP), 14 Avenue Bosquet, 75007 Paris, France
- Institut Arthur Vernes, Tabacologie, 75006 Paris, France
| | - Stéphane Legleye
- Ensai & Cesp, 35172 Bruz, France;
- Université Paris-Saclay, Faculté de Médecine UVSQ, 91190 Gif-sur-Yvette, France
| | - Michel Underner
- Centre Hospitalier Laborit, Unité de Recherche Clinique Pierre Deniker, Tabacologie, 86000 Poitiers, France;
| | - Philippe Arvers
- 7ème Centre Médical des Armées, Quartier De Reyniès, D1075, Consultation Addictologie et Tabacologie, 38760 Varces-Allières-et-Risset, France;
| | - Bhavish Pothegadoo
- Hôpital Maison Lafitte, Unité de Cardiologie, 78600 Maison Lafitte, France;
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Tashakkori NA, Park-Lee E, Roh EJ, Christensen CH. Multiple Tobacco Product Use Among Youth E-Cigarette Users: National Youth Tobacco Survey, 2020. J Adolesc Health 2023; 73:769-775. [PMID: 37410002 DOI: 10.1016/j.jadohealth.2023.05.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/24/2023] [Accepted: 05/24/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE Limited information exists on multiple tobacco product use, particularly among youth. This study assessed the prevalence of current youth use of e-cigarettes with other tobacco products and their associated characteristics using 2020 National Youth Tobacco Survey data. METHODS Prevalence estimates were calculated for current e-cigarette users, by multiple tobacco product use status and product combination. Demographic characteristics, e-cigarette use behaviors, age at first combustible tobacco use, and tobacco dependence symptoms were compared between current users of both e-cigarettes and combustible tobacco (dual users) and current exclusive e-cigarette users. RESULTS In 2020, 61.1% of all current e-cigarette users reported exclusive e-cigarette use, and 38.9% used e-cigarettes with other tobacco products. Among those who used e-cigarettes with other tobacco products, 85.0% used combustible tobacco, with cigarettes being the most commonly used other tobacco product. Compared with current exclusive e-cigarette users, higher proportions of dual users reported the following: frequent e-cigarette use; obtaining e-cigarettes from gas stations, persons other than a family member/friend, vape shops, or the internet; and having any tobacco dependence symptoms. Among dual users, 31.2% reported first combustible product use after e-cigarette initiation, and 34.3% reported first combustible product use prior to e-cigarette initiation. DISCUSSION Approximately four in 10 youth current e-cigarette users reported using multiple tobacco products, with a majority using combustible tobacco. Frequent e-cigarette use and tobacco dependence symptoms were more prevalent among dual users of e-cigarettes and combustible tobacco.
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Affiliation(s)
- Nicole A Tashakkori
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland.
| | - Eunice Park-Lee
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Esther J Roh
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
| | - Carol H Christensen
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
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Stubbs T, White V, Yong HH, Toumbourou JW. Implications of nicotine vaping products for tobacco control in ASEAN low-income and middle-income countries: in-depth interviews with experts from the region. BMJ Open 2023; 13:e073106. [PMID: 37730408 PMCID: PMC10510874 DOI: 10.1136/bmjopen-2023-073106] [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] [Received: 02/23/2023] [Accepted: 08/25/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVES The use of nicotine vaping products (NVPs) has increased in low-income and middle-income countries (LMICs) in the Association of Southeast Asian Nations (ASEAN) region; however, it is uncertain what implications the presence and use of NVPs have for tobacco control. DESIGN In-depth interviews were conducted to explore ASEAN tobacco control experts' (n=11) views on the rise of NVP use in ASEAN LMICs, current NVP policies, the potential harm reduction and smoking cessation utilities of these devices, and what implications they may have for tobacco control. Data were analysed using inductive, reflexive thematic analysis. RESULTS Five themes emerged: (1) NVPs threaten tobacco control in ASEAN LMICs; (2) commercial factors influence youth appeal and access: product attributes, marketing, supply chains; (3) opposition to the smoking cessation and harm reduction utilities of NVPs; (4) policies are inconsistent and fragmented in the region; and (5) tobacco industry power and tactics have been used to capture NVP markets. CONCLUSIONS ASEAN tobacco control experts believe that NVPs pose a threat to youth and non-smokers in LMICs in the region, largely because of tobacco industry NVP marketing activities. They do not support the use of NVPs for smoking cessation or harm reduction and call for more restrictions and consistent policy enforcement across the region to protect young people, while also cautiously recognising that use of NVPs may have some benefits for smokers.
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Affiliation(s)
- Thomas Stubbs
- Faculty of Health, School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Victoria White
- Faculty of Health, School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Hua-Hie Yong
- Faculty of Health, School of Psychology, Deakin University, Burwood, Victoria, Australia
| | - John W Toumbourou
- Centre for Drug Use, Addictive and Anti-social Behaviour Research, School of Psychology, Deakin University, Burwood, Victoria, Australia
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Alkhlaif Y, Shelton KL. Assessment of Abuse-Related Discriminative Stimulus Effects of Nicotine Aerosol in Rodents. J Pharmacol Exp Ther 2023; 385:171-179. [PMID: 36918277 PMCID: PMC10201579 DOI: 10.1124/jpet.122.001520] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/30/2023] [Accepted: 02/24/2023] [Indexed: 03/16/2023] Open
Abstract
The rapid increase in e-cigarette use highlights the importance of developing relevant, predictive animal models exploring their potential health implications. The goal of the present study was to examine the abuse-related effects of brief, repeated e-cigarette aerosol exposures in rodents modeling human e-cigarette user behavior. We evaluated the discriminative stimulus effects of brief, repeated puffs of inhaled nicotine in rats that had been trained to discriminate injected nicotine from saline. Locomotor activity measurement following exposure to injected and aerosolized nicotine was also assessed as an additional behavioral outcome. We hypothesized that the stimulus effects of nicotine aerosol were central nervous system (CNS)-mediated and comparable to that produced by an injected nicotine training stimulus. We further hypothesized that number of aerosol puffs and the e-liquid nicotine concentration which was aerosolized would impact the substitution of nicotine aerosol for injected nicotine. Both nicotine injections and exposures to nicotine aerosol produced a dose-dependent effect on locomotor activity. Nicotine aerosol under our puffing conditions produced e-liquid nicotine concentration-dependent and puff-number-dependent complete substitution for the injected nicotine training condition. The nicotinic antagonist, mecamylamine, completely blocked nicotine-appropriate responding produce by the training dose of 0.3 mg/kg injected nicotine as well as that resulting from exposure to aerosol puffs generated by e-liquid containing 3 mg/ml nicotine, demonstrating that the stimulus of inhaled nicotine was most likely CNS-mediated and not due to olfactory stimulus properties. Overall, the results support the hypothesis that an aerosol exposure drug discrimination model in rodents has applicability to studying the abuse-related effects of e-cigarettes. SIGNIFICANCE STATEMENT: Animal models of nicotine aerosol exposure using testing conditions resembling human e-cigarette use are lacking. In this study, we test a novel preclinical model of nicotine vaping in rodents which allows for the exploration of the abuse-related effects of e-cigarettes. This model has the potential to contribute both to our understanding of the abuse-related pharmacological effects of e-cigarettes as well as aid in the development of rationale, evidence-based e-cigarette regulatory policies.
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Affiliation(s)
- Yasmin Alkhlaif
- Department of Pharmacology and Toxicology, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, Virginia
| | - Keith L Shelton
- Department of Pharmacology and Toxicology, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, Virginia
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Patten T, Johnson NL, Shaw JK, Dossat AM, Dreier A, Kimball BA, Wesson DW, De Biasi M. Strawberry Additive Increases Nicotine Vapor Sampling and Systemic Exposure But Does Not Enhance Pavlovian-Based Nicotine Reward in Mice. eNeuro 2023; 10:ENEURO.0390-22.2023. [PMID: 37253590 PMCID: PMC10275399 DOI: 10.1523/eneuro.0390-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/01/2023] [Accepted: 05/10/2023] [Indexed: 06/01/2023] Open
Abstract
Nicotine is an addictive drug whose popularity has recently increased, particularly among adolescents, because of the availability of electronic nicotine devices (i.e., "vaping") and nicotine e-liquids containing additives with rich chemosensory properties. Some efforts to understand the role of these additives in nicotine reward suggest that they increase nicotine reward and reinforcement, but the sensory contributions of additives, especially in their vapor forms, are largely untested. Here, to better understand how a fruit-flavored (i.e., strawberry) additive influences nicotine reward and aversion, we used a conditioned place preference (CPP) procedure in which nicotine and a strawberry additive were delivered as a vapor to male and female adolescent mice. We found that nicotine vapor alone can lead to a dose-dependent CPP when using a biased design. The strawberry additive did not produce CPP on its own, and we did not observe an effect of the strawberry additive on nicotine vapor-induced reward. Nevertheless, mice exposed to nicotine plus strawberry additive vapor had higher plasma cotinine concentrations, which did not appear to reflect altered nicotine metabolism. Instead, by directly measuring vapor sampling through respiration monitoring, we uncovered an increase in the amount of sniffing toward strawberry-containing nicotine vapor compared with nicotine vapor alone. Together these data indicate that chemosensory-rich e-liquid additives may enhance the perceived sensory profile of nicotine vapors rather than the reward value per se, which leads to overall increased nicotine exposure.
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Affiliation(s)
- Theresa Patten
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Pharmacology Graduate Group, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Natalie L Johnson
- Department of Pharmacology and Therapeutics, Center for Smell and Taste, Center for Addiction Research and Education, University of Florida College of Medicine, Gainesville, Florida 32610
| | - Jessica K Shaw
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Amanda M Dossat
- Department of Pharmacology and Therapeutics, Center for Smell and Taste, Center for Addiction Research and Education, University of Florida College of Medicine, Gainesville, Florida 32610
| | - Allison Dreier
- School of Arts and Sciences, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Bruce A Kimball
- Monell Chemical Senses Center, Philadelphia, Pennsylvania 19104
| | - Daniel W Wesson
- Department of Pharmacology and Therapeutics, Center for Smell and Taste, Center for Addiction Research and Education, University of Florida College of Medicine, Gainesville, Florida 32610
| | - Mariella De Biasi
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Department of Neuroscience, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Pharmacology Graduate Group, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- School of Arts and Sciences, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
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14
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Kim M, Neilands TB, Gregorich SE, Jordan JW, Ling PM. Young Adult Responses to Peer Crowd-Based Targeting in E-cigarette Advertisements: An Experimental Study. Nicotine Tob Res 2023; 25:1125-1134. [PMID: 37101413 PMCID: PMC10202626 DOI: 10.1093/ntr/ntac292] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 11/16/2022] [Accepted: 12/21/2022] [Indexed: 04/28/2023]
Abstract
AIMS To examine the effects of psychographically targeted e-cigarette advertisements on young adults. METHODS A total of 2100 young adults (18-29 years old) representing five peer crowds (groups with shared values, interests, and lifestyle: Mainstream, Young Professional, Hip Hop, Hipster, and Partier) were recruited from a nationwide opt-in online panel. Participants were randomly assigned to view e-cigarette advertisements featuring characters that either did or did not match their own peer crowd affiliation and evaluated advertising effectiveness using Likert-type and semantic differential scales. Participants also reported their attitudes toward using e-cigarettes. RESULTS No significant overall effect of peer crowd matching was observed. However, significant two-way interaction effects emerged where matching advertisements yielded higher evaluations than mismatching advertisements among those who currently do not use tobacco and nicotine products and among Mainstream participants. Advertisements featuring Mainstream characters were in general rated more highly than other advertisements. Additional analyses found significant effects of peer crowd matching among those who viewed advertisements featuring non-Mainstream characters. CONCLUSIONS Peer crowd-based targeting can increase the effectiveness of e-cigarette advertisements which may impact initiation among current nonusers, requiring stricter marketing regulations. More research is needed to determine if anti-tobacco messaging tailored by peer crowds may effectively counteract targeted e-cigarette marketing. IMPLICATIONS E-cigarette advertisements often use psychographic targeting strategies, using lifestyles, attitudes, and values. Low-risk young adults (eg, those who currently do not use tobacco and nicotine products) are susceptible to psychographically targeted e-cigarette advertisements. This may result in the initiation of e-cigarette use among young adults who would otherwise be less likely to use tobacco and nicotine products. Stricter marketing regulations for emerging tobacco and nicotine products are required to reduce marketing exposure.
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Affiliation(s)
- Minji Kim
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Torsten B Neilands
- Division of Prevention Science, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Steven E Gregorich
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | - Pamela M Ling
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA, USA
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15
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Stanton CA, Tang Z, Sharma E, Seaman E, Gardner LD, Silveira ML, Hatsukami D, Day HR, Cummings KM, Goniewicz ML, Limpert J, Everard C, Bansal-Travers M, Ambrose B, Kimmel HL, Borek N, Compton WM, Hyland AJ, Pearson JL. Predictors of E-cigarette and Cigarette Use Trajectory Classes from Early Adolescence to Emerging Adulthood Across Four Years (2013-2017) of the PATH Study. Nicotine Tob Res 2023; 25:421-429. [PMID: 35554569 PMCID: PMC9910140 DOI: 10.1093/ntr/ntac119] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 02/10/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This study examines predictors of trajectories of cigarette and e-cigarette use among a cohort of US adolescents transitioning into young adulthood. Comparing trajectories of each tobacco product is important to determine if different intervention targets are needed to prevent progression to daily use. METHODS Latent trajectory class analyses identified cigarette and e-cigarette use (never, ever excluding past 12-month, past 12-month (excluding past 30-day (P30D)), P30D 1-5 days, P30D 6+ days) trajectory classes, separately, among US youth (12-17; N = 10,086) using the first 4 waves (2013-2017) of data from the nationally representative PATH Study. Weighted descriptive analyses described the class characteristics. Weighted multinomial logistic regression analyses examined demographic, psychosocial, and behavioral predictors of class membership. RESULTS Younger adolescents 12-15 years had lower tobacco use compared to 16-17 year olds and less stable classes. In the 16-17 year group, there were five unique trajectories of cigarette smoking, including a Persistent High Frequency class. Four e-cigarette use trajectories were identified; but not a persistent use class. Shared predictors of class membership for cigarettes and e-cigarettes included mental health problems, other tobacco use, marijuana use, and poorer academic achievement. Male sex and household tobacco use were unique e-cigarette trajectory class predictors. CONCLUSIONS There was no evidence that initiation with e-cigarettes as the first product tried was associated with cigarette progression (nor cigarettes as first product and e-cigarette progression). Interventions should focus on well-established risk factors such as mental health and other substance use to prevent progression of use for both tobacco products. IMPLICATIONS Using nationally representative data and definitions of use that take into account frequency and recency of use, longitudinal 4-year trajectories of e-cigarette and cigarette use among US adolescents transitioning into young adulthood were identified. Results among 16-17-year olds revealed a class of persistent high frequency cigarette smoking that was not identified for e-cigarette use. Cigarette use progression was not associated with e-cigarettes as the first product tried. Risk factors for progression of use of both products included mental health and other substance use, which are important prevention targets for both tobacco products.
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Affiliation(s)
- Cassandra A Stanton
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, MD, USA
- Department of Oncology, Georgetown University Medical Center, Washington, DC, USA
| | - Zhiqun Tang
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, MD, USA
| | - Eva Sharma
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, MD, USA
| | - Elizabeth Seaman
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, MD, USA
| | - Lisa D Gardner
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Marushka L Silveira
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- Kelly Government Solutions, Rockville, MD, USA
| | - Dorothy Hatsukami
- Masonic Cancer Center, Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Hannah R Day
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - K Michael Cummings
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jean Limpert
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Colm Everard
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
- Kelly Government Solutions, Rockville, MD, USA
| | - Maansi Bansal-Travers
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bridget Ambrose
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Heather L Kimmel
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Nicolette Borek
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Wilson M Compton
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - Andrew J Hyland
- Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Jennifer L Pearson
- School of Community Health Sciences, University of Nevada, Reno, Reno, NV, USA
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ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Hilliard ME, Isaacs D, Johnson EL, Kahan S, Khunti K, Leon J, Lyons SK, Perry ML, Prahalad P, Pratley RE, Seley JJ, Stanton RC, Gabbay RA, on behalf of the American Diabetes Association. 14. Children and Adolescents: Standards of Care in Diabetes-2023. Diabetes Care 2023; 46:S230-S253. [PMID: 36507640 PMCID: PMC9810473 DOI: 10.2337/dc23-s014] [Citation(s) in RCA: 84] [Impact Index Per Article: 84.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The American Diabetes Association (ADA) "Standards of Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations and a full list of Professional Practice Committee members, please refer to Introduction and Methodology. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Horn K, Schoenberg N, Rose S, Romm K, Berg CJ. Tobacco use among Appalachian adolescents: An urgent need for virtual scale out of effective interventions. Tob Prev Cessat 2022; 8:39. [PMID: 36404952 PMCID: PMC9635399 DOI: 10.18332/tpc/155331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 10/05/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
Tobacco use, typically initiated during adolescence, can escalate into young adulthood, even among experimenting or intermittent users. Despite declines in cigarette smoking among US adolescents, use of other tobacco products and poly-tobacco are on the rise among Appalachian adolescents. Unfortunately, Appalachian adolescent tobacco users also are less likely to receive effective tobacco interventions due to various barriers: a) accessibility (e.g. service and provider shortages, affordability, and transportation; b) acceptability (e.g. issues of privacy and stigma); and c) cultural relevance. The present review provides critical considerations synthesized from an extensive body of literature on the suitability of virtual tobacco interventions, the need for well-timed interventions that address complex tobacco use, and the rationale for leveraging and scaling evidence-based interventions inform novel interventions for Appalachian adolescent tobacco users. Borrowing strength from existing in-person evidence-based adolescent tobacco interventions and state-of-the-art virtual health services, a well-planned virtual scale out of tobacco interventions holds potential to minimize barriers unique to Appalachia.
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Affiliation(s)
- Kimberly Horn
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, United States
- Fralin Biomedical Research Institute, Virginia Polytechnic Institute and State University, Blacksburg, United States
| | - Nancy Schoenberg
- Center for Health Equity Transformation, University of Kentucky, Lexington, United States
| | - Shyanika Rose
- Center for Health Equity Transformation, University of Kentucky, Lexington, United States
| | - Katelyn Romm
- Milken Institute School of Public Health, The George Washington University, Washington, United States
| | - Carla J. Berg
- Milken Institute School of Public Health, The George Washington University, Washington, United States
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de Looze ME, Henking C, Torsheim T, Currie DB, Weber MW, Alemán-Díaz AY. The association between MPOWER tobacco control policies and adolescent smoking across 36 countries: An ecological study over time (2006–2014). THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 109:103871. [DOI: 10.1016/j.drugpo.2022.103871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/16/2022] [Accepted: 09/18/2022] [Indexed: 10/31/2022]
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Gupte HA, Chatterjee N, Mandal G, D’Costa M. Adolescents and E-cigarettes in India: A Qualitative Study of Perceptions and Practices. Asian Pac J Cancer Prev 2022; 23:2991-2997. [PMID: 36172661 PMCID: PMC9810289 DOI: 10.31557/apjcp.2022.23.9.2991] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 09/11/2022] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Global Youth Tobacco Survey-4, India conducted in 2019 showed 'ever use' of e-cigarettes among adolescents to be 2.8%. However, there is dearth of qualitative data on adolescent use of e-cigarettes in the country. This study was conducted to explore and gain better understanding on adolescents' perceptions and practices about e-cigarette use. METHODS In-depth interviews were conducted with 24 adolescents who self-reported use of e-cigarettes. The participants were recruited from ten municipal schools of Mumbai, India that cater to students from lower socio-economic background. Participants were from 7th to 9th grades, and aged 11-16 years. Data from in-depth interviews were analyzed using inductive thematic analysis. RESULTS Adolescents referred to 'e-cigarette' as 'pen-hookah.' E-cigarettes were perceived as relatively harmless compared to regular hookahs and conventional cigarettes. Initiation was influenced by a friend, peer, or sibling. A variety of flavors, the after-taste, the ability to perform playful tricks with smoke, and fun-time spent with friends were cited as reasons for continued use. Social media influenced both initiation and continuation. Most adolescents' regular use was with a group of friends; the device was shared with or obtained from friends or siblings. Adolescents were unclear about the presence of nicotine in refill liquids and the harmful health effects. CONCLUSION Increasing awareness among adolescents about the harms of e-cigarettes is urgently required through comprehensive tobacco-prevention programs. More research is needed to examine the role of flavors in increasing acceptability of e-cigarettes and how it affects perceived harmfulness of tobacco products.
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Howard MB, Guse S. Liquid Nicotine, E-Cigarettes, and Vaping: Information for the Pediatric Emergency Medicine Provider. Pediatr Emerg Care 2022; 38:399-403. [PMID: 35904953 DOI: 10.1097/pec.0000000000002793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT E-cigarettes, or electronic cigarettes, are electronic nicotine delivery systems that are marketed as a healthier alternative to tobacco cigarettes. There has been an exponential increase in their use among youth since their introduction to the United States market in 2007. With increased use and popularity, there has been an increase in calls to poison control centers regarding liquid nicotine toxicity in children and adolescents. Recent US Food and Drug Administration and other federal regulations of e-cigarettes have attempted to limit availability to youth. This article reviews trends in e-cigarette use among youth, the background and mechanism of action of e-cigarettes, liquid nicotine toxicity, management of liquid nicotine toxicity, and recent policy updates regarding e-cigarettes.
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Affiliation(s)
- Mary Beth Howard
- From the Assistant Professor of Pediatrics, Division of Pediatric Emergency Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
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21
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Xiao L, Yin X, Di X, Nan Y, Lyu T, Wu Y, Li X. Awareness and prevalence of e-cigarette use among Chinese adults: policy implications. Tob Control 2022; 31:498-504. [PMID: 33608465 PMCID: PMC9234419 DOI: 10.1136/tobaccocontrol-2020-056114] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/22/2020] [Accepted: 10/28/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To assess the awareness and prevalence of electronic cigarettes (e-cigarettes) and associated factors among Chinese adults (15 years and older). METHOD This study examined data from Global Adults Tobacco Survey China Project, which was nationally representative and used stratified multiphase cluster randomised sampling design. Data were collected in 2018 through a household survey with in-person interviews using tablet computers. Complex sampling weighted analysis method was used. RESULTS 48.5% of Chinese adults had heard of e-cigarettes. The proportions of Chinese adults who had ever used, had used in the last 12 months, and currently used e-cigarettes were 5.0%, 2.2% and 0.9%, respectively; people in the 15-24 years group showed the highest rates of ever use, last 12-month use and current use at 7.6%, 4.4%, and 1.5%, respectively. Among males, higher e-cigarette use was associated with 15-24 years age group, college/university or above education, and daily use of combustible cigarettes. Among all e-cigarette users, 90.6% also used combustible cigarettes. The most common reason for e-cigarette use was smoking cessation (46.2%) while among ever smokers, 9.5% of ever e-cigarette users had quit smoking and 21.8% of never e-cigarette users had quit smoking (adjusted OR 0.454, 95% CI 0.290 to 0.712). CONCLUSION Prevalence of e-cigarettes among Chinese adults had increased since 2015, especially among young people aged 15-24. The high level of dual use and lower quit rate among e-cigarette users indicated e-cigarettes had not shown cessation utility at the population level in China. Regulation of e-cigarettes is needed to protect youth and minimise health risks.
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Affiliation(s)
- Lin Xiao
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, Beijing, China
| | - Xi Yin
- China office, World Health Organization, Geneve, GE, Switzerland
| | - Xinbo Di
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, Beijing, China
| | - Yi Nan
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, Beijing, China
| | - Tianchu Lyu
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, Beijing, China
| | - Yiqun Wu
- ThinkTank Research Center for Health Development, Beijing, Beijing, China
| | - Xinhua Li
- Chinese Center for Disease Control and Prevention, Beijing, Beijing, China
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22
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Kaliamurthy S, Camenga DR. Clinical approach to the treatment of e-cigarette use among adolescents. Curr Probl Pediatr Adolesc Health Care 2022; 52:101203. [PMID: 35534404 DOI: 10.1016/j.cppeds.2022.101203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
E-cigarette use remains a serious public health threat for adolescents in the United States. Pediatric providers can intervene early to prevent the adverse, and sometimes life-long, health consequences of e-cigarette use. This article reviews the clinical management of e-cigarette use among adolescents using the "Ask-Counsel-Treat" model. This model was recently introduced by the American Academy of Pediatrics to help pediatric healthcare providers manage e-cigarette screening, counseling, and treatment. Behavioral treatments for e-cigarette cessation can be delivered via multiple formats, including via text, in-person, or online. Additionally, pediatric healthcare providers may consider the off-label use of nicotine replacement therapy in individuals less than 18 years of age to alleviate some of the symptoms of nicotine withdrawal. Further research is needed to inform the design and implementation of effective e-cigarette cessation strategies for adolescents.
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Affiliation(s)
- Sivabalaji Kaliamurthy
- Children's National Hospital, Washington, DC, USA; Department of Psychiatry, Yale University, New Haven, CT, USA.
| | - Deepa R Camenga
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
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23
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Osibogun O, Chapman S, Peters M, Bursac Z, Maziak W. E-cigarette Transitions Among US Youth and Adults: Results from the Population Assessment of Tobacco and Health Study (2013-2018). JOURNAL OF PREVENTION (2022) 2022; 43:387-405. [PMID: 35513733 PMCID: PMC9350905 DOI: 10.1007/s10935-022-00678-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/31/2022] [Indexed: 10/18/2022]
Abstract
Currently, the debate surrounding the regulation of e-cigarettes focuses mainly on the size of e-cigarettes' potentially beneficial effects (i.e., adult cessation) versus their unwarranted effects (i.e., initiation among tobacco-naïve adolescents). Therefore, we investigated the relative scale of e-cigarette use transitions in the United States. We reported cross-sectional weighted prevalence estimates of past-month e-cigarette use by ever cigarette use from Waves 1-4 of the Population Assessment of Tobacco and Health study (2013-2018) among youth (12-17 years) and adults (≥ 18 years). We also examined past-month e-cigarette mono and dual transitions related to cigarette smoking and reported the longitudinal weighted prevalence across waves. Among youth new e-cigarette users, the proportion of never-cigarette smokers increased from 24.1 in Wave 1 (n = 418) to 51.4% in Wave 4 (n = 310) (p < 0.0001 for trend). Of youth past-month e-cigarette mono-users in Wave 1 (n = 151), 15.2% transitioned to cigarette mono-use and 8.2% dual-use at Wave 2 or 3 or 4, compared to 60.2% no tobacco use and 16.4% e-cigarette mono-use. Among young adult past-month dual-users (18-24 years; n = 684), 22.6% transitioned to no tobacco use, 60.1% continued cigarette use, 11.4% dual use, and 5.9% e-cigarette mono-use. Among adult dual-users ≥ 25 years old (n = 1560), 13.6% transitioned to no tobacco use, 71.3% cigarette mono-use, 9.0% dual-use, and 6.1% e-cigarette mono-use. Transition to cigarette mono-use and continued dual-use were common among adult past-month e-cigarette users, while e-cigarette initiation was common among youth never-cigarette smokers. These findings contrast with data from other countries showing limited evidence of e-cigarette initiation among youth never cigarette smokers. Both e-cigarette and cigarette use should be addressed in youth and adults, given the potential for dual use in both populations.
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Affiliation(s)
- Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC5, Miami, FL, 33199, USA.
| | - Simon Chapman
- School of Public Health, University of Sydney, Sydney, 2006, Australia
| | - Matthew Peters
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, NSW, 2109, Australia
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC5, Miami, FL, 33199, USA
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Gernun S, Franzen KF, Mallock N, Benthien J, Luch A, Mortensen K, Drömann D, Pogarell O, Rüther T, Rabenstein A. Cardiovascular functions and arterial stiffness after JUUL use. Tob Induc Dis 2022; 20:34. [PMID: 35431721 PMCID: PMC8973023 DOI: 10.18332/tid/144317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 10/31/2021] [Accepted: 11/28/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The rapid growth in the e-cigarette market after the launch of JUUL e-cigarettes led to much discussion on the potential benefits and risks of pods, JUUL devices, and conventional e-cigarettes compared with combustible cigarettes. Independent data are required to assess the effects of these products on cardiovascular surrogate parameters and cardiovascular risk. METHODS We conducted a single-center three-arm study comparing combustible cigarettes with JUUL e-cigarettes with the old and new technology. We recruited 32 participants who were active smokers (n=15) or vapers (n=17) and performed a total of 39 measurements before and 5, 15, and 30 minutes, after participants smoked a combustible cigarette or vaped a JUUL e-cigarette with the new or old technology. Measurements included peripheral and central blood pressures and parameters of arterial stiffness, including pulse wave velocity and augmentation index. RESULTS Peripheral systolic blood pressure, central blood pressure, and peripheral pulse rate increased significantly in all three groups (each p<0.05). Heart rate (HR) changes lasted significantly longer than blood pressure changes. The augmentation index and pulse wave velocity increased in all three groups, and a multivariate analysis of variance showed that the increases were independent of systolic blood pressure, sex, age, device, and HR. CONCLUSIONS Changes in blood pressure and arterial stiffness are similar after cigarette smoking and JUUL use. These changes may be associated with an increased cardiovascular risk compared with no product use. However, a long-term follow-up evaluation of JUUL use and a head-to-head comparison with conventional e-cigarettes are still needed.
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Affiliation(s)
- Solveig Gernun
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
| | - Klaas F. Franzen
- Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North, Germany
| | - Nadja Mallock
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
- Institute of Pharmacy, Department of Biology, Chemistry and Pharmacy, Freie Universität Berlin, Berlin, Germany
| | - Julia Benthien
- Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North, Germany
| | - Andreas Luch
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment, Berlin, Germany
- Institute of Pharmacy, Department of Biology, Chemistry and Pharmacy, Freie Universität Berlin, Berlin, Germany
| | | | - Daniel Drömann
- Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein, Lübeck, Germany
- Airway Research Center North, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
| | - Tobias Rüther
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
| | - Andrea Rabenstein
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany
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Hanafin J, Sunday S, Clancy L. Sociodemographic, personal, peer, and familial predictors
of e-cigarette ever use in ESPAD Ireland: A forward stepwise
logistic regression model. Tob Induc Dis 2022; 20:12. [PMID: 35300051 PMCID: PMC8809134 DOI: 10.18332/tid/144234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/24/2021] [Accepted: 11/24/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION E-cigarette ever use has risen significantly in recent years in Ireland, similar to trends elsewhere in Europe, the United States, and Asia-Pacific region. Results from ESPAD Ireland (European School Survey Project on Alcohol and other Drugs) show teenage e-cigarette ever use increased from 18% (2015) to 37% (2019). Given this increase, our aim is to profile e-cigarette ever users and never users in this age group; to examine sociodemographic, personal, peer, and familial factors associated with e-cigarette ever use; and to suggest appropriate measures to reduce use. METHODS A nationally representative stratified random sample of 50 ESPAD schools was surveyed in 2019, with 3495 students aged 15–17 years. Bivariate and multivariable logistic regression analyses were performed using Stata version 16. RESULTS E-cigarette ever use was significantly associated with ever smoking (AOR=4.15; 95% CI: 1.29–13.41), ever cannabis use (AOR=2.21; 95% CI: 1.11–4.41) and ever inhalants use (AOR=2.51; 95% CI: 1.07–5.88). Children of university-educated mothers had significantly higher odds of e-cigarette ever use (AOR=3.46; 95% CI: 1.40–8.54). Associated with reduced AORs were reading books for enjoyment (AOR=0.32; 95% CI: 0.16–0.64), living in households where smoking was regulated (AOR=0.53; 95% CI: 0.30–0.94), and perceiving moderate risk in trying e-cigarettes once or twice (AOR=0.20; 95% CI: 0.07–0.67). CONCLUSIONS E-cigarette ever use is part of a pattern of teenage polysubstance use including cigarette smoking, providing some support for the common liability theory. Regulation of smoking in the home, reading for enjoyment, and perceiving risk from e-cigarette use are associated with decreased likelihood of ever use, and higher parental education with increased likelihood. Thus, health education emphasizing the role of parents and risks of e-cigarette use is indicated to reduce the rise in e-cigarette ever use in teenagers.
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Affiliation(s)
- Joan Hanafin
- TobaccoFree Research Institute Ireland, Dublin, Ireland
- Technological University Dublin, Dublin, Ireland
| | - Salome Sunday
- TobaccoFree Research Institute Ireland, Dublin, Ireland
- Technological University Dublin, Dublin, Ireland
| | - Luke Clancy
- TobaccoFree Research Institute Ireland, Dublin, Ireland
- Technological University Dublin, Dublin, Ireland
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Becker TD, Rice TR. Youth vaping: a review and update on global epidemiology, physical and behavioral health risks, and clinical considerations. Eur J Pediatr 2022; 181:453-462. [PMID: 34396473 PMCID: PMC8364775 DOI: 10.1007/s00431-021-04220-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/24/2021] [Accepted: 07/21/2021] [Indexed: 12/15/2022]
Abstract
Worldwide, youth electronic cigarette use (vaping) has risen significantly over the past decade. This public health concern has spurred many high-quality studies characterizing country-specific prevalence, risk factors, physical and behavioral health complications, and optimal methods of assessment and counseling for youth vaping. Clinicians remain underexposed to this recent work, limiting translation of evidence into higher quality patient care. This review aims to provide pediatricians and other clinicians working with youth a clinically focused survey of key research findings and considerations based on recent evidence. This narrative review surveys emerging trends in EC use across different countries, reasons for youth vaping, characteristics of vaping materials that promote youth use, associations with combustible cigarette use, relation with cannabis and other illicit substances, physical and behavioral health risks associated with vaping, and methods of assessment, counseling, and intervention for problematic vaping in youth. Since vaping remains a relatively new phenomenon, long-term health consequences remain unknown.Conclusion: Youth vaping is an increasingly well-studied phenomenon with both physical and behavioral health risks. Pediatricians and other youth-focused clinicians can apply the lessons of recent research in work with youth and their families. What is Known: • Youth vaping is an increasingly prevalent public health concern. • Recent research demonstrates physical and behavioral health risks associated with vaping as well as methods for assessment, counseling, and intervention. What is New: • The current review summarizes the latest evidence in a clinically focused framework to facilitate translation of emerging knowledge to practice.
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Affiliation(s)
- Timothy D Becker
- Department of Psychiatry, Icahn School of Medicine At Mount Sinai, One Gustave Levy Place, Box 1230, New York, NY, 10019, USA.
| | - Timothy R Rice
- Department of Psychiatry, Icahn School of Medicine At Mount Sinai, One Gustave Levy Place, Box 1230, New York, NY, 10019, USA.
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Bębenek PK, Gholap V, Halquist M, Sobczak A, Kośmider L. E-Liquids from Seven European Countries-Warnings Analysis and Freebase Nicotine Content. TOXICS 2022; 10:51. [PMID: 35202238 PMCID: PMC8875468 DOI: 10.3390/toxics10020051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/04/2022] [Accepted: 01/17/2022] [Indexed: 01/30/2023]
Abstract
Electronic cigarettes are available in a variety of devices with e-liquids also available in many flavors, and nicotine concentrations, albeit less than 20 mg/mL in Europe. Given the dynamics of these products, it is important to evaluate product content, including labeling, nicotine content versus labeled claim, nicotine form, and other aspects that may help policy decisions and align with the Tobacco Product Directive (TPD). Herein, we performed a study on 86 e-liquids from seven European countries (Croatia, Czech Republic, France, Germany, Italy, Poland, and the United Kingdom) with 34 different liquid brands and 57 different flavors. Nicotine content versus labeled claim, labeling, volume, pH, and nicotine form (i.e., freebase nicotine) were evaluated. From all tested products, eight of them from Germany, Poland, and UK (from 3 to 18 mg/mL), met the ±2% criteria. The ±10% criteria was fulfilled by 50 (58.1%) liquids from all countries. Among 71 liquids which contained nicotine, (one e-liquid labeled as 6 mg/mL had no nicotine level quantified), the amount of freebase nicotine differed from 0 to 97.8%, with a mean value 56.5 ± 35.7. None of the tested liquids had nicotine salt listed in the ingredients. Therefore, a low level of freebase nicotine in some liquids was most likely achieved by added flavorings. All tested liquids presented in this study met the basic requirements of the TPD. There were differences in the scope of information about harmfulness, type of warnings on packaging, attaching leaflets, placing graphic symbols, and discrepancies between the declared and quantified nicotine concentrations.
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Affiliation(s)
- Patryk Krystian Bębenek
- Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jagiellonska 4, 41-200 Sosnowiec, Poland; (P.K.B.); (A.S.)
| | - Vinit Gholap
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA; (V.G.); (M.H.)
| | - Matthew Halquist
- Department of Pharmaceutics, School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA; (V.G.); (M.H.)
| | - Andrzej Sobczak
- Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jagiellonska 4, 41-200 Sosnowiec, Poland; (P.K.B.); (A.S.)
| | - Leon Kośmider
- Department of General and Inorganic Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jagiellonska 4, 41-200 Sosnowiec, Poland; (P.K.B.); (A.S.)
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Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc22-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc22-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Singh A. A commentary on adolescent electronic cigarette use and nicotine addiction. Pediatr Pulmonol 2021; 56:3580-3585. [PMID: 34520125 DOI: 10.1002/ppul.25676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/07/2022]
Abstract
Adolescent electronic cigarette (e-cigarette) use has continued due to the ongoing struggle with nicotine addiction affecting teenagers. By briefly discussing the timeline of the emergence of e-cigarettes and nicotine addiction in adolescents, this author hopes to shed some light on mitigation strategies to curtail this ongoing epidemic of youth e-cigarette use and nicotine addiction through public health education and advocacy.
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Affiliation(s)
- Alvin Singh
- Division of Allergy, Immunology, Pulmonary and Sleep Medicine, Children's Mercy-Kansas City, Kansas City, Missouri, USA
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Wray RJ, Hansen N, Ding D, Masters J. Effects of a campus-wide tobacco-free policy on tobacco attitudes, norms and behaviors among students, staff and faculty. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:860-871. [PMID: 31995456 DOI: 10.1080/07448481.2020.1711763] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/29/2019] [Accepted: 12/22/2019] [Indexed: 06/10/2023]
Abstract
Objective: In 2016 a private Missouri university implemented a campus-wide tobacco-free policy to change social norms and prevent tobacco use among students, staff and faculty. This study assesses impact on tobacco and policy-related perceptions and behaviors. Methods: Before the policy went into effect and again one year later, all university students, staff and faculty were invited to participate in an online survey. Missouri Assessment of College Health Behaviors survey findings supplement results for students. Results: Policy support and norms disapproving tobacco use on campus increased, and self-reported use of any tobacco decreased after the ban was enacted. Conclusions: Our results suggest that the policy led to an increase in the proportion of university community members who agree that smoking on campus is unacceptable, which contributed in turn to a decline in tobacco use on campus, consistent with our theory of effects.
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Affiliation(s)
- Ricardo J Wray
- College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Natasha Hansen
- College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Dong Ding
- G202 MU Student Center, Missouri Partners in Prevention, University of Missouri, Columbia, MO, USA
| | - Joan Masters
- G202 MU Student Center, Missouri Partners in Prevention, University of Missouri, Columbia, MO, USA
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31
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Wills TA, Leventhal AM, Sargent JD, Pagano I. Concurrent Use of E-cigarettes, Combustible Cigarettes, and Marijuana. Pediatrics 2021; 148:e2021050749. [PMID: 34584003 PMCID: PMC8906369 DOI: 10.1542/peds.2021-050749] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/02/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Subgroups of adolescent single and dual e-cigarette and cigarette users have been identified, but usage patterns have changed in recent years, and there has been an increase in marijuana use. Research is needed with current data to identify subgroups of use including marijuana and determine their behavioral correlates. METHODS We cross classified ever and recent use of e-cigarettes, combustible cigarettes, and marijuana among US high school students in the 2019 Youth Risk Behavior Survey (YRBS), providing 8 different groups. Levels of 14 risk and protective factors were compared across groups in general linear models with demographic covariates using omnibus tests, pairwise comparisons, and planned contrasts. Replicability was tested through identical analyses for 2017 YRBS data. RESULTS The nonuser group was 43.9% of the sample. The most frequent user groups were triple users (ever-use proportion: 16.9%), dual (e-cigarette and marijuana) users (15.8%), and exclusive e-cigarette users (13.2%). For risk profiles on levels of psychosocial variables, the triple-user group was typically elevated above all other groups. Exclusive e-cigarette users were above nonusers in risk profile but below dual users (both cigarettes and marijuana). Results were similar for ever use and recent use. The patterning of results in 2019 YRBS data were closely replicated in 2017 YRBS data. CONCLUSIONS Co-occurrence of e-cigarette, cigarette, and marijuana use is currently substantial among adolescents and is associated with an elevated psychosocial risk profile. This has implications for both epidemiology and prevention studies. Further research is needed to study prevalence and identify pathways to triple use.
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Affiliation(s)
| | | | - James D Sargent
- Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, New Hampshire
| | - Ian Pagano
- University of Hawaii Cancer Center, Honolulu, Hawaii
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Hauser SR, Rodd ZA, Deehan GA, Liang T, Rahman S, Bell RL. Effects of adolescent substance use disorders on central cholinergic function. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 160:175-221. [PMID: 34696873 DOI: 10.1016/bs.irn.2021.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Adolescence is a transitional period between childhood and adulthood, in which the individual undergoes significant cognitive, behavioral, physical, emotional, and social developmental changes. During this period, adolescents engage in experimentation and risky behaviors such as licit and illicit drug use. Adolescents' high vulnerability to abuse drugs and natural reinforcers leads to greater risk for developing substance use disorders (SUDs) during adulthood. Accumulating evidence indicates that the use and abuse of licit and illicit drugs during adolescence and emerging adulthood can disrupt the cholinergic system and its processes. This review will focus on the effects of peri-adolescent nicotine and/or alcohol use, or exposure, on the cholinergic system during adulthood from preclinical and clinical studies. This review further explores potential cholinergic agents and pharmacological manipulations to counteract peri-adolescent nicotine and/or alcohol abuse.
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Affiliation(s)
- S R Hauser
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States; Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States.
| | - Z A Rodd
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States; Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - G A Deehan
- Department of Psychology, East Tennessee State University, Johnson City, TN, United States
| | - T Liang
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Shafiqur Rahman
- Department of Pharmaceutical Sciences, South Dakota State University, Brookings, SD, United States
| | - Richard L Bell
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States; Paul and Carole Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States.
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Abstract
Electronic cigarettes (e-cigarettes) reached the market without either extensive preclinical toxicology testing or long-term safety trials that would be required of conventional therapeutics or medical devices. E-cigarettes are considered a tobacco product and as such have no manufacturing quality or safety standards. A growing body of evidence documents severe harms from e-cigarette use, including injuries from product explosions, nicotine poisoning, and severe lung diseases. Commonly used e-cigarette components have significant inhalation toxicity. Emerging evidence from laboratory studies suggests substantial reason for concern for long-term harms, including risk for cardiovascular disease, chronic obstructive lung disease, and cancer. Rather than helping people stop smoking, e-cigarette use is associated with reduced rates of smoking cessation among current smokers and an increased risk of relapse to smoking among former smokers. The World Health Organization advises, "Unlike the tried and tested nicotine and non-nicotine pharmacotherapies that are known to help people quit tobacco use, WHO does not endorse e-cigarettes as cessation aids." Careful evaluation of all the available research justifies a strong recommendation that healthcare providers should neither prescribe nor recommend e-cigarettes for persons who are tobacco dependent. If a patient is dependent on e-cigarettes, the healthcare provider should provide counseling and treatment (of nicotine dependence) to help the patient to stop their e-cigarette use.
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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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Kaslow JA, Rosas-Salazar C, Moore PE. E-cigarette and vaping product use-associated lung injury in the pediatric population: A critical review of the current literature. Pediatr Pulmonol 2021; 56:1857-1867. [PMID: 33821574 DOI: 10.1002/ppul.25384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 12/12/2022]
Abstract
Use of electronic nicotine delivery systems (ENDS), also known as e-cigarettes, in the adolescent population has significantly increased over the past several years. This rise led to an outbreak of e-cigarette or vaping product use-associated lung injury (EVALI) in the summer of 2019. Since that time, numerous case reports and case series on vaping and EVALI have been published but the majority of literature highlights the adult population with few articles focusing on pediatric patients. Given the addictive nature of these products and the lack of full understanding of the human health effects, there is concern that use of ENDS may have lasting impacts on users, especially adolescents and young adults. The goal of this review is to critically assess published data on ENDS use in children, report our institutional experience, discuss the reasons why the use of ENDS have increased among young individuals, outline the current understanding of EVALI as it pertains to the pediatric population, and discuss future opportunities for health policy implementation.
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Affiliation(s)
- Jacob A Kaslow
- Division of Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christian Rosas-Salazar
- Division of Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Paul E Moore
- Division of Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Selya AS, Foxon F. Trends in electronic cigarette use and conventional smoking: quantifying a possible 'diversion' effect among US adolescents. Addiction 2021; 116:1848-1858. [PMID: 33394529 PMCID: PMC8172422 DOI: 10.1111/add.15385] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/12/2020] [Accepted: 12/16/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIMS The impact of electronic cigarettes (ECs) on nicotine use is hotly debated: some fear that ECs are a 'catalyst' to conventional smoking, while others argue that they divert adolescents from the more harmful product. This study used simulation modeling to evaluate the plausibility of catalyst and diversion hypotheses against real-world data. DESIGN A simulation model represented life-time exclusive EC use, exclusive conventional smoking and dual use as separate subpopulations. The 'catalyst' effect was modeled as EC use increasing dual use initiation (i.e. EC users also start smoking). The 'diversion' effect was modeled as EC use decreasing exclusive cigarette initiation. The model was calibrated using data from the US National Youth Tobacco Survey (NYTS). The plausibility of each scenario was evaluated by comparing simulated trends with NYTS data. This is the first study, to our knowledge, to estimate the magnitude of a diversion effect through simulation. SETTING United States. PARTICIPANTS AND MEASUREMENTS Adolescents aged 12-17 years in NYTS, a cross-sectional study from 2000 to 2019 (n = 12 500 to 31 000 per wave). Exclusive cigarette use, exclusive EC use and dual use of both products were defined using cumulative life-time criteria (100+ cigarettes smoked and/or > 100 days vaped). FINDINGS A null model (no catalyst or diversion) over-predicts NYTS smoking by up to 87%. Under the conservative assumption that the catalyst effect accounts for all dual use, an exponential decay constant of 19.6% EC users/year initiating smoking is required; however, this further over-predicts actual smoking by up to 109%. A diversion effect with an exponential decay constant of 55.4%/year or 65.4%/year, with the maximum possible opposing catalyst effect also active, is required optimally to match NYTS smoking trends (root mean square error = 286 632 versus 391 396 in the null model). CONCLUSIONS A simulation model shows that a substantial diversion effect is needed to explain observed nicotine use trends among US adolescents, and it must be larger than any possible opposing catalyst effect, if present.
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Affiliation(s)
- Arielle S. Selya
- Behavioral Sciences Group, Sanford ResearchSioux FallsSDUSA
- Department of PediatricsUniversity of South Dakota Sanford School of MedicineSioux FallsSDUSA
- Master of Public Health Program, Department of Population HealthUniversity of North Dakota School of Medicine and Health SciencesGrand ForksNDUSA
- PinneyAssociatesPittsburghPAUSA
| | - Floe Foxon
- PinneyAssociatesPittsburghPAUSA
- Department of Physics and AstronomyUniversity of NottinghamNottinghamUK
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Renda B, Andrade AK, Stone APS, El Azali R, Sharivker M, Khokhar JY, Antenos M, Murray JE. Adolescent nicotine and footshock exposure augments adult nicotine self-administration and drug-seeking without affecting baseline anxiety-like behaviour or stress responsivity in male rats. Psychopharmacology (Berl) 2021; 238:1687-1701. [PMID: 33649967 PMCID: PMC8141046 DOI: 10.1007/s00213-021-05803-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/15/2021] [Indexed: 12/30/2022]
Abstract
RATIONALE Over the past decade, adolescent cigarette smoking has been declining. However, adolescent nicotine consumption via electronic cigarettes is rapidly gaining popularity. Earlier onset nicotine use is associated with increased risk of dependence. A bidirectional relationship between nicotine and stress exists; perceived stress is a predictor for nicotine use, and stress reduction is a commonly reported reason for using nicotine. OBJECTIVES We assessed the prolonged impact of adolescent high-dose nicotine and/or footshock exposure on adult nicotine self-administration, anxiety-like behaviour, and hormonal responsivity. METHODS During adolescence (postnatal day [P]28-56) male Sprague-Dawley rats were assigned to one of five groups: saline (SALPRE: 1 ml/kg, SC, every day), nicotine (NICPRE: 1 mg/kg, SC, alternating daily with saline; 14 total nicotine injections), footshock (SHOCKPRE: 8 of 0.5 s, 0.8 mA alternating sessions; saline every day), or combination nicotine and footshock (NIC+SHOCK: concurrent and alternating daily with saline, or NIC-SHOCK: alternating with saline on shock sessions). On P70, one cohort underwent spontaneous intravenous nicotine self-administration (0.03 mg/kg/infusion); another cohort was assessed for open-field behaviour (P71), then corticosterone (CORT) response to nicotine or footshock in adulthood (P72-73). RESULTS Intermittent adolescent nicotine or footshock alone (NICPRE and SHOCKPRE) did not potentiate adult spontaneous nicotine intake compared to SALPRE. However, both combination groups (NIC+SHOCK, NIC-SHOCK) showed increased adult nicotine consumption without associated differences in baseline anxiety-like behaviour or CORT response. CONCLUSIONS Adolescent nicotine and footshock stressors have a synergistic effect on adult nicotine consumption, enhancing nicotine intake. Avenues toward reducing stress in adolescent nicotine users may provide opportunities to reduce vulnerability to adult nicotine consumption.
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Affiliation(s)
- Briana Renda
- Department of Psychology, University of Guelph, Guelph, ON, N1G 2W1, Canada
- Collaborative Neuroscience Program, University of Guelph, Guelph, ON, Canada
| | - Allyson K Andrade
- Department of Psychology, University of Guelph, Guelph, ON, N1G 2W1, Canada
- Collaborative Neuroscience Program, University of Guelph, Guelph, ON, Canada
| | - Adiia P S Stone
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Rita El Azali
- Department of Psychology, University of Guelph, Guelph, ON, N1G 2W1, Canada
| | - Michael Sharivker
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada
| | - Jibran Y Khokhar
- Collaborative Neuroscience Program, University of Guelph, Guelph, ON, Canada
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Monica Antenos
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Jennifer E Murray
- Department of Psychology, University of Guelph, Guelph, ON, N1G 2W1, Canada.
- Collaborative Neuroscience Program, University of Guelph, Guelph, ON, Canada.
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Legleye S, Aubin HJ, Falissard B, Beck F, Spilka S. Experimenting first with e-cigarettes versus first with cigarettes and transition to daily cigarette use among adolescents: the crucial effect of age at first experiment. Addiction 2021; 116:1521-1531. [PMID: 33201553 DOI: 10.1111/add.15330] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/20/2020] [Accepted: 11/06/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Most studies in English-speaking countries have found a positive association between e-cigarette experimentation and subsequent daily tobacco smoking among adolescents. However, this result may not be valid in other cultural contexts; in addition, few studies have assessed whether this association varies with the subject' age at the time of e-cigarette experimentation. This study aimed to estimate the association between experimenting first with e-cigarette (rather than tobacco) and subsequent daily smoking according to age at the time of experimentation. DESIGN Secondary analysis; risk ratios (RRs) computed using modified Poisson regressions with inverse probability weighting. SETTING A cross-sectional nation-wide representative survey performed in 2017 in France. PARTICIPANTS French adolescents (n = 24 111), aged 17 to 18.5 years, who had previously experimented with either e-cigarettes or tobacco. MEASURES Exposure was defined as the experimentation with e-cigarettes first (whether or not followed by experimentation with tobacco); the outcome as daily tobacco smoking at the time of data collection. Gender, age, literacy, socio-economic status, pre-exposure repeat school years and experimentation with drunkeness, 3 licit and 8 illicit drugs were adjusted for. Uncertainties about the sequence of events defining exposure were handled by the definition of three patterns of exposure, to avoid a misclassification bias. FINDINGS Exposure reduced the risk of transition to daily smoking: RR = 0.58, 95% confidence interval (CI) = 0.54, 0.62. This effect increased in a linear manner with age at exposure (RR = 0.87, 95% CI = 0.78; 0.98 for 1 year, P < 0.001): from RR = 1.30, 95% CI = 1.09; 1.54 at age 9 to RR = 0.38, 95% CI = 0.32; 0.45 at age 17. CONCLUSIONS Experimenting with e-cigarettes first (as opposed to tobacco first) appears to be associated with a reduction in the risk of daily tobacco smoking among French adolescents aged 17-18.5, but this risk varies negatively with age at experimentation, and early e-cigarette experimenters are at higher risk.
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Affiliation(s)
- Stéphane Legleye
- Université Paris-Sud, Université Paris-Saclay, faculté de médecine, faculté de médecine UVSQ, Inserm, Villejuif, 94800, France.,Institut national de la statistique et des études économiques, Montrouge, 92120, France
| | - Henri-Jean Aubin
- Université Paris-Sud, Université Paris-Saclay, faculté de médecine, faculté de médecine UVSQ, Inserm, Villejuif, 94800, France.,AP-HP. Université Paris Saclay, Villejuif, 94800, France
| | - Bruno Falissard
- Université Paris-Sud, Université Paris-Saclay, faculté de médecine, faculté de médecine UVSQ, Inserm, Villejuif, 94800, France
| | - François Beck
- Université Paris-Sud, Université Paris-Saclay, faculté de médecine, faculté de médecine UVSQ, Inserm, Villejuif, 94800, France.,Institut national de la statistique et des études économiques, Montrouge, 92120, France
| | - Stanislas Spilka
- Université Paris-Sud, Université Paris-Saclay, faculté de médecine, faculté de médecine UVSQ, Inserm, Villejuif, 94800, France.,AP-HP. Université Paris Saclay, Villejuif, 94800, France.,Observatoire français des drogues et des toxicomanies (OFDT), Paris, 75007, France
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Escoto A, Watkins SL, Welter T, Beecher S. Developing a targeted e-cigarette health communication campaign for college students. Addict Behav 2021; 117:106841. [PMID: 33588289 DOI: 10.1016/j.addbeh.2021.106841] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 12/16/2020] [Accepted: 01/18/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND E-cigarette use among college students has increased over the last several years, however, there are few published studies on e-cigarette interventions designed to prevent the initiation and escalation of e-cigarette use and to empower cessation for this population. METHODS We developed an e-cigarette health communication campaign for a large Midwestern university through collaboration between academic and student service departments. We conducted focus group discussions (7 groups; 4-25 per group; n = 98) to (a) understand the context of e-cigarette use on campus and (b) solicit feedback on sample messaging. We conducted thematic analysis using focus group notes and used findings to design final campaign messages and materials. RESULTS Six themes emerged: (a) vaping as a popular social activity, (b) progression to and perceptions of addiction, (c) cessation, (d) health effects and uncertainty, (e) intervention points, and (f) individual agency and message tone. Final campaign messages addressed the most salient points from the focus groups and were designed to increase the perceived susceptibility to and severity of risks of e-cigarette use and to increase perceived efficacy for quitting in accord with the Extended Parallel Processing Model (EPPM). Campaign messages and materials were integrated into wellness programming and disseminated across the university and community. CONCLUSIONS Our focus group discussions allowed campaign messages and materials to be tailored to college students. Collaborative approaches between academic and wellness programs can leverage scientific expertise and student services infrastructure to enhance programming on college campuses.
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Affiliation(s)
- Alejandra Escoto
- Division of Child and Community Health, University of Iowa, Iowa City, IA, United States.
| | - Shannon Lea Watkins
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA, United States.
| | - Trisha Welter
- Student Wellness, University of Iowa, Iowa City, IA, United States.
| | - Steph Beecher
- Student Wellness, University of Iowa, Iowa City, IA, United States.
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Al-Hamdani M, Manly E. Smoking cessation or initiation: The paradox of vaping. Prev Med Rep 2021; 22:101363. [PMID: 33868902 PMCID: PMC8044675 DOI: 10.1016/j.pmedr.2021.101363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/08/2021] [Accepted: 03/15/2021] [Indexed: 10/28/2022] Open
Abstract
In recent years, there has been a rapid expansion of the vaping market which has led many to question whether vaping can assist people in smoking cessation, or if it in fact paves the way for new smokers. While there has not been conclusive evidence regarding vaping as a smoking cessation tool, there is striking evidence that vaping is linked to new smoking addictions, especially in teenagers and young adults. Despite the prevalent belief that tobacco is more harmful to the body, early research on vaping has already shown very detrimental effects, and the comprehensive effects may become much clearer in the years to come. To curtail the rapidly increasing number of teenagers and young adults vaping, strict action must be taken. Legalization with tight control of vaping products would focus the efforts on those attempting to quit, while helping to prevent acquisition by teenagers and young adults that are not of legal age. In the years to come, vaping controls should be carefully considered to ensure that the purported benefits of helping those overcome a smoking addiction are not outweighed by the unintended consequences of creating a teenage demographic addicted to vaping.
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Affiliation(s)
- Mohammed Al-Hamdani
- Saint Mary’s University, Halifax, Nova Scotia, Canada
- The Lung Association of Nova Scotia, Halifax, Nova Scotia, Canada
| | - Eden Manly
- Dalhousie University, Halifax, Nova Scotia, Canada
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Epstein M, Bailey JA, Kosterman R, Rhew IC, Furlong M, Oesterle S, McCabe SE. E-cigarette use is associated with subsequent cigarette use among young adult non-smokers, over and above a range of antecedent risk factors: a propensity score analysis. Addiction 2021; 116:1224-1232. [PMID: 33140475 PMCID: PMC8043961 DOI: 10.1111/add.15317] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/18/2020] [Accepted: 10/23/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS There is a public health concern that the use of e-cigarettes among non-smoking young adults could be associated with transition to combustible cigarette use. The current study is a quasi-experimental test of the relationship between e-cigarette use and subsequent combustible cigarette use among young adult non-smokers, accounting for a wide range of common risk factors. DESIGN Logistic regression was used to predict combustible cigarette use on three or more occasions at age 23 years based on age 21 e-cigarette use. Inverse probability weighting (IPW) was used to account for confounding variables. SETTING Data were drawn from the Community Youth Development Study (CYDS), a cohort study of youth recruited in 2003 in 24 rural communities in seven US. states PARTICIPANTS: Youth in the CYDS study (n = 4407) were surveyed annually from ages 11 to 16, and at ages 18, 19, 21 and 23 years (in 2016). The sample was gender balanced (50% female) and ethnically diverse (20% Hispanic, 64% white, 3% black and 12% other race or ethnicity). The current study was limited to participants who had never used combustible cigarettes by age 21 (n = 1825). MEASUREMENTS Age 21 use of e-cigarettes and age 23 use of combustible cigarettes (three or more occasions) were included in the regression analysis. Age 11-19 measures of 22 common predictors of both e-cigarette and combustible cigarette use (e.g. pro-cigarette attitudes, peer smoking, family monitoring) were used to create IPWs. FINDINGS After applying IPW, e-cigarette use at age 21 was associated with a twofold increase in odds of combustible cigarette use on three or more occasions 2 years later (odds ratio = 2.16, confidence interval 1.23, 3.79). CONCLUSIONS Among previously never-smoking US young adults, e-cigarette use appears to be strongly associated with subsequent combustible cigarette smoking, over and above measured preexisting risk factors.
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Affiliation(s)
- Marina Epstein
- Social Development Research Group, School of Social Work, University of Washington
| | - Jennifer A. Bailey
- Social Development Research Group, School of Social Work, University of Washington
| | - Rick Kosterman
- Social Development Research Group, School of Social Work, University of Washington
| | - Isaac C. Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Madeline Furlong
- Social Development Research Group, School of Social Work, University of Washington
| | - Sabrina Oesterle
- Southwest Interdisciplinary Research Center, School of Social Work, Arizona State University
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, School of Nursing, Institute for Research on Women and Gender, and Center for Human Growth and Development, University of Michigan
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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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Shahab L, Beard E, Brown J. Association of initial e-cigarette and other tobacco product use with subsequent cigarette smoking in adolescents: a cross-sectional, matched control study. Tob Control 2021; 30:212-220. [PMID: 32184339 PMCID: PMC7907552 DOI: 10.1136/tobaccocontrol-2019-055283] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 12/18/2019] [Accepted: 01/13/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION This study assessed whether initiating e-cigarette use increases the uptake of cigarette smoking in US adolescents compared with behavioural and synthetic controls. METHODS Data come from 78 265 adolescents in the National Youth Tobacco Survey (2014-2017) of whom 38 630 provided information about the first tobacco product they had used in 2014/15. Ever, past 30 day and established (30 day use and 100+ lifetime cigarettes) cigarette smoking was compared in adolescents who first used an e-cigarette (exposure group), a non-cigarette combustible (CT) or other non-combustible tobacco (NT) product (behavioural controls), and propensity score matched adolescents without initial e-cigarette use (synthetic controls). RESULTS Relative to behavioural controls, adolescents who tried e-cigarettes first were less likely to have ever smoked cigarettes (26% vs CT (42.4%; OR 0.48, 95% CI 0.40 to 0.57), or NT initiators (52.7%; OR 0.32, 95% CI 0.26 to 0.39)), to be past 30 day (6% vs CT (11.9%; OR 0.48, 95% CI 0.36 to 0.62), or NT initiators (20.0%; OR 0.26, 95% CI 0.19 to 0.35)) or be established cigarette smokers (0.7% vs CT (3.9%; OR 0.17, 95% CI 0.10 to 0.30), or NT initiators (8.4%; OR 0.08, 95% CI 0.04 to 0.13)). E-cigarette initiators were also less likely than synthetic controls (without initial e-cigarette use) to have ever smoked cigarettes (OR 0.76, 95% CI 0.62 to 0.93), be past 30 day (OR 0.71, 95% CI 0.55 to 0.91) or be established cigarette smokers (OR 0.26, 95% CI 0.13 to 0.51). CONCLUSION Less than 1% of US adolescents who use e-cigarettes first were established cigarette smokers. They were less likely to be smokers than adolescents who tried other combustible or non-combustible tobacco products first and propensity score matched adolescents without initial e-cigarette use.
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Affiliation(s)
- Lion Shahab
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK - Shaping Public Health Policies To Reduce Inequalities and Harm, UK
| | - Emma Beard
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK - Shaping Public Health Policies To Reduce Inequalities and Harm, UK
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, UK
- SPECTRUM Consortium, UK - Shaping Public Health Policies To Reduce Inequalities and Harm, UK
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Mattingly DT, Pfeiffer JA, Walker KL, Hart JL. Sex differences in associations between receiving and sharing tobacco-related information and tobacco product use among Appalachian Youth. POPULATION MEDICINE 2021; 2. [PMID: 33629078 PMCID: PMC7899165 DOI: 10.18332/popmed/125911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Given that Appalachian youth tobacco use rates are higher than the US national average, it is important to understand whether sex differences shape associations between receiving and sharing product information and using tobacco. METHODS Middle and high school students in rural Appalachia (n=1038) were surveyed about tobacco-related perceptions and behaviors, including ways youth receive and share conventional tobacco-related and e-cigarette-related information. Youth were characterized as tobacco users (i.e. ever or current users of cigarettes, smokeless tobacco, or e-cigarettes) or never users. Descriptive characteristics were compared by tobacco use and sex. Adjusted logistic regression models evaluated associations between communication channels and tobacco use. Models were stratified by sex to examine effect modification. RESULTS Approximately one-third of Appalachian youth (33.8%) were tobacco users and use varied by sex (males: 54.4%; females: 45.6%). Male (OR=1.75; 95% CI: 1.18-2.60) and female (OR=2.30; 95% CI: 1.53-3.47) youth who received e-cigarette-related information through friends and family (FF) had higher odds of tobacco use. Additionally, females who received e-cigarette-related information through public displays and digital media had nearly two-fold increased odds of tobacco use. Although sharing conventional tobacco-related and e-cigarette-related information through FF was associated with increased odds of tobacco use among both sexes, these relationships were stronger among females. CONCLUSIONS Although specific communication channels were associated with tobacco use, associations involving receiving and sharing e-cigarette information were more pronounced in female tobacco users. Consideration of sex differences in how youth receive and share tobacco-related information may benefit tobacco prevention interventions.
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Affiliation(s)
- Delvon T Mattingly
- Department of Communication, University of Louisville, Louisville, United States
| | - Jack A Pfeiffer
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States
| | - Kandi L Walker
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States
| | - Joy L Hart
- Department of Communication, University of Louisville, Louisville, United States.,Christina Lee Brown Envirome Institute, University of Louisville, Louisville, United States.,American Heart Association Tobacco Center for Regulatory Science, Dallas, United States
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Gallus S, Borroni E, Odone A, van den Brandt PA, Gorini G, Spizzichino L, Pacifici R, Lugo A. The Role of Novel (Tobacco) Products on Tobacco Control in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1895. [PMID: 33669394 PMCID: PMC7920305 DOI: 10.3390/ijerph18041895] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/28/2022]
Abstract
In Italy, electronic cigarettes have spread since 2010 and heated tobacco products (HTP) since 2016. We investigated their public health consequences on conventional cigarette smoking, taking advantage of a series of cross-sectional studies annually conducted between 2001 and 2019 in Italy. Every year, the sample, including around 3000 individuals, was representative of the general Italian population aged ≥15 years. In Italy, smoking prevalence steadily declined from 29.1% in 2001 to 20.6% in 2013, then increased to 22.0% in 2019. In 2017-2019, current electronic cigarette users were 2.1% and in 2019 current HTP users were 1.1%. Among 498 ever electronic cigarette users, 23.2% started or re-started smoking and 15.7% quit smoking after electronic cigarette use; of 49 ever HTP users, 19.1% started or re-started smoking combusted cigarettes and 14.6% quit smoking after HTP use. The availability of novel products in Italy resulted in a halt of the decreasing trend in smoking prevalence. For the first time, we observed an increase of Italians inhaling nicotine, concurrently with the spread of novel (tobacco) products. More importantly, the use of novel products appears to increase-rather than decrease-the likelihood of smoking conventional cigarettes. Considering this evidence, we see no argument to justify the huge fiscal and regulatory benefits these products continue to have, at least in Italy.
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Affiliation(s)
- Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (E.B.); (A.L.)
| | - Elisa Borroni
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (E.B.); (A.L.)
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
- School of Medicine, University Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Piet A. van den Brandt
- Department of Epidemiology, CAPHRI-School for Public Health and Primary Care, Maastricht University Medical Centre, 6211 LK Maastricht, The Netherlands;
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, 6211 LK Maastricht, The Netherlands
| | - Giuseppe Gorini
- Oncologic Network, Prevention and Research Institute (ISPRO), 50139 Florence, Italy;
| | - Lorenzo Spizzichino
- Italian Ministry of Health, Center for Disease Prevention and Control, 00144 Rome, Italy;
| | - Roberta Pacifici
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy; (E.B.); (A.L.)
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Margolis KA, Thakur SK, Nguyen Zarndt A, Kemp CB, Glover-Kudon R. E-cigarette susceptibility among U.S. middle and high school students: National Youth Tobacco Survey Data Trend Analysis, 2014-2018. Prev Med 2021; 143:106347. [PMID: 33271235 PMCID: PMC10515727 DOI: 10.1016/j.ypmed.2020.106347] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 10/28/2020] [Accepted: 11/24/2020] [Indexed: 11/26/2022]
Abstract
Youth e-cigarette use has rapidly increased in the last few years. Susceptibility is a validated measure associated with future tobacco use. We examined trends in e-cigarette susceptibility across five years (2014-2018) of the National Youth Tobacco Survey among youth e-cigarette never users. We observed increases in overall e-cigarette susceptibility from 2014 to 2016 and decreases from 2016 to 2018. Generally, sociodemographic variables were not associated with trend effects; however, there was an interaction between linear trends with both race/ethnicity and other tobacco product (OTP) use. The percentage of youth who were susceptible to using e-cigarettes ranged from 32.9% in 2014 to 33.2% in 2018 with a high of 36.7% in 2016. We also examined the prevalence of e-cigarette susceptibility by race/ethnicity, sex, school level, OTP use, and e-cigarette harm perception. E-cigarette susceptibility was associated with race, school level, OTP ever use, and e-cigarette harm perceptions. Hispanic youth, those in high school, and OTP ever users were more likely to be susceptible to e-cigarette use compared to their counterparts across all years. E-cigarette susceptibility was most prevalent among those who perceived e-cigarettes to pose "no harm" in 2014 and "little harm" in 2018 when compared to other item response options in 2014 and 2018, respectively. This study is the first to document trends in e-cigarette susceptibility among youth. Understanding antecedents of e-cigarette use and identifying youth subgroups vulnerable to e-cigarette use is valuable to developing effective prevention efforts. Disclaimer: The findings and conclusions in this publication are those of the authors and do not necessarily represent the official position of the Food and Drug Administration or the Centers for Disease Control and Prevention.
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Affiliation(s)
- Katherine A Margolis
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States of America.
| | - Sapna K Thakur
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States of America
| | - Anh Nguyen Zarndt
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States of America
| | - Catherine B Kemp
- US Food and Drug Administration, Center for Tobacco Products, Office of Science, Silver Spring, MD, United States of America
| | - Rebecca Glover-Kudon
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA, United States of America
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Abstract
The American Diabetes Association (ADA) "Standards of Medical Care in Diabetes" includes the ADA's current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee (https://doi.org/10.2337/dc21-SPPC), are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA's clinical practice recommendations, please refer to the Standards of Care Introduction (https://doi.org/10.2337/dc21-SINT). Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.
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Melka A, Chojenta C, Holliday E, Loxton D. E-cigarette use and cigarette smoking initiation among Australian women who have never smoked. Drug Alcohol Rev 2021; 40:68-77. [PMID: 32750198 DOI: 10.1111/dar.13131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIM Evidence regarding the association between e-cigarette use and subsequent initiation of smoking mostly relates to the US population. In Australia, no studies are available investigating the association between the uses of e-cigarettes and smoking initiation among young adults who have never smoked. This study aimed to determine the association between lifetime e-cigarette use and subsequent initiation of cigarette smoking among tobacco-naïve Australian women aged 20-27. DESIGN AND METHODS The current study used data (n = 5398) from the third (2015) and fourth (2016) surveys collected from a cohort of Australian women born in 1989-1995 who participated in the Australian Longitudinal Study on Women's Health. Multivariable logistic regression was used to identify the association between lifetime e-cigarette use at the baseline survey and initiation of cigarette smoking (smoked 100 cigarettes or more in the last year) at the follow up adjusting for possible confounders. Effects were expressed as odds ratios with 95% confidence interval. RESULTS The mean (± SD) age of the study participants at baseline (third survey) was 22.5 (±1.7). Ever e-cigarette use at baseline was positively associated with smoking initiation at follow up (adjusted odds ratio 3.71; 95% confidence interval 2.33, 5.93). History of depression, binge drinking and higher childhood adversity score were also risk factors for subsequent smoking initiation in the follow up. DISCUSSION AND CONCLUSIONS This study identified a strong association between e-cigarette use and subsequent initiation of smoking. Enforcing the existing restriction of sale and supply of e-liquid containing nicotine is essential to prevent never smokers from nicotine addiction via e-cigarettes.
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Affiliation(s)
- Alemu Melka
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, The University of Newcastle, Newcastle, Australia
| | - Catherine Chojenta
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, The University of Newcastle, Newcastle, Australia
| | - Elizabeth Holliday
- School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Newcastle, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, The University of Newcastle, Newcastle, Australia
- Australian Longitudinal Study on Women's Health, Faculty of Health and Medicine, The University of Newcastle, Newcastle, Australia
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Smith ML, Gotway MB, Crotty Alexander LE, Hariri LP. Vaping-related lung injury. Virchows Arch 2021; 478:81-88. [PMID: 33106908 PMCID: PMC7590536 DOI: 10.1007/s00428-020-02943-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/02/2020] [Accepted: 09/30/2020] [Indexed: 11/24/2022]
Abstract
The use of electronic nicotine delivery systems has increased in popularity dramatically over the past decade. Although lung diseases caused by vaping have been reported since the modern invention of the electronic cigarette, in the summer of 2019, patients began to present to health care centers at epidemic levels with an acute respiratory illness relating to vaping, which the Center for Disease Control termed E-cigarette or vaping product use-associated lung injury (EVALI). This review discusses electronic nicotine delivery systems as well as the etiology, clinical presentation, imaging findings, pathologic features, treatment, and long-term consequences of EVALI. We conclude with the practical impact EVALI has had on the practice of pathology.
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Affiliation(s)
- Maxwell L Smith
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Michael B Gotway
- Department of Radiology, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Laura E Crotty Alexander
- Pulmonary Critical Care Section at the VA San Diego Healthcare System and Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego Health Sciences, San Diego, CA, USA
| | - Lida P Hariri
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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50
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Hair EC, Barton AA, Perks SN, Kreslake J, Xiao H, Pitzer L, Leventhal AM, Vallone DM. Association between e-cigarette use and future combustible cigarette use: Evidence from a prospective cohort of youth and young adults, 2017-2019. Addict Behav 2021; 112:106593. [PMID: 32927247 DOI: 10.1016/j.addbeh.2020.106593] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 07/28/2020] [Accepted: 07/28/2020] [Indexed: 12/31/2022]
Abstract
INTRODUCTION A surge in popularity of e-cigarettes prompts concern given the association between e-cigarettes and future cigarette use. However, much of the evidence for this association comes from early, less efficient, and lower nicotine e-cigarettes than are available and widely used now. The goal of this study was to examine the relationship between e-cigarette use in 2018 and subsequent smoking initiation and continued e-cigarette use. METHODS Participants included members of a national longitudinal panel of youth and young adults aged 15-27 who, in 2017, reported never having used a nicotine containing product (n = 3360). Logistic regression analyses assessed associations between participants' self-reported ever e-cigarette use in 2018 and ever cigarette use, current cigarette use, and current e-cigarette use in 2019, after controlling for demographic and psychosocial variables. RESULTS Compared with those who still had never used an e-cigarette, those who reported ever e-cigarette use in 2018 had significantly higher odds of ever cigarette use (aOR = 7.29, 95% CI [4.10, 12.97]), current cigarette use (aOR = 8.26, 95% CI [3.17, 21.53]), and current e-cigarette use (aOR = 9.70, 95% CI [6.41, 14.69]) one year later in 2019. CONCLUSIONS These findings show that the pod mod style, high nicotine containing e-cigarettes subject young users to the same risks of transitioning to combustible cigarettes as their earlier, less efficient predecessors. Strong regulation of all nicotine products, including e-cigarettes, is needed to prevent the trajectory of e-cigarette to cigarette use among youth and young adults.
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Affiliation(s)
- Elizabeth C Hair
- Schroeder Institute at Truth Initiative, Washington, DC, USA; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; College of Global Public Health, New York University, New York, NY, USA.
| | - Alexis A Barton
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Siobhan N Perks
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Jennifer Kreslake
- Schroeder Institute at Truth Initiative, Washington, DC, USA; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Haijun Xiao
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Lindsay Pitzer
- Schroeder Institute at Truth Initiative, Washington, DC, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California, Keck School of Medicine, Los Angeles CA, USA
| | - Donna M Vallone
- Schroeder Institute at Truth Initiative, Washington, DC, USA; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA; College of Global Public Health, New York University, New York, NY, USA
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