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Dabdoub S, Greenlee A, Abboud G, Brengartner L, Zuiker E, Gorr MW, Wold LE, Kumar PS, Cray J. Acute exposure to electronic cigarette components alters mRNA expression of pre-osteoblasts. FASEB J 2024; 38:e70017. [PMID: 39213037 PMCID: PMC11371384 DOI: 10.1096/fj.202302014rrr] [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: 10/03/2023] [Revised: 08/01/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024]
Abstract
The use of traditional nicotine delivery products such as tobacco has long been linked to detrimental health effects. However, little work to date has focused on the emerging market of aerosolized nicotine delivery known as electronic nicotine delivery systems (ENDS) or electronic cigarettes, and their potential for new effects on human health. Challenges studying these devices include heterogeneity in the formulation of the common components of most available ENDS, including nicotine and a carrier (commonly composed of propylene glycol and vegetable glycerin, or PG/VG). In the present study, we report on experiments interrogating the effects of major identified components in e-cigarettes. Specifically, the potential concomitant effects of nicotine and common carrier ingredients in commercial "vape" products are explored in vitro to inform the potential health effects on the craniofacial skeleton through novel vectors as compared to traditional tobacco products. MC3T3-E1 murine pre-osteoblast cells were cultured in vitro with clinically relevant liquid concentrations of nicotine, propylene glycol (PG), vegetable glycerin (VG), Nicotine+PG/VG, and the vape liquid of a commercial product (Juul). Cells were treated acutely for 24 h and RNA-Seq was utilized to determine segregating alteration in mRNA signaling. Influential gene targets identified with sparse partial least squares discriminant analysis (sPLS-DA) implemented in mixOmics were assessed using the PANTHER Classification system for molecular functions, biological processes, cellular components, and pathways of effect. Additional endpoint functional analyses were used to confirm cell cycle changes. The initial excitatory concentration (EC50) studied defined a target concentration of carrier PG/VG liquid that altered the cell cycle of the calvarial cells. Initial sPLS-DA analysis demonstrated the segregation of nicotine and non-nicotine exposures utilized in our in vitro modeling. Pathway analysis suggests a strong influence of nicotine exposures on cellular processes including metabolic processes and response to stimuli including autophagic flux. Further interrogation of the individual treatment conditions demonstrated segregation by treatment modality (Control, Nicotine, Carrier (PG+VG), Nicotine+PG/VG) along three dimensions best characterized by: latent variable 1 (PLSDA-1) showing strong segregation based on nicotine influence on cellular processes associated with cellular adhesion to collagen, osteoblast differentiation, and calcium binding and metabolism; latent variable 2 (PLSDA-2) showing strong segregation of influence based on PG+VG and Control influence on cell migration, survival, and cycle regulation; and latent variable 3 (PLSDA-3) showing strong segregation based on Nicotine and Control exposure influence on cell activity and growth and developmental processes. Further, gene co-expression network analysis implicates targets of the major pathway genes associated with bone growth and development, particularly craniofacial (FGF, Notch, TGFβ, WNT) and analysis of active subnetwork pathways found these additionally overrepresented in the Juul exposure relative to Nicotine+PG/VG. Finally, experimentation confirmed alterations in cell count, and increased evidence of cell stress (markers of autophagy), but no alteration in apoptosis. These data suggest concomitant treatment with Nicotine+PG/VG drives alterations in pre-osteoblast cell cycle signaling, specifically transcriptomic targets related to cell cycle and potentially cell stress. Although we suspected cell stress and well as cytotoxic effects of Nicotine+PG/VG, no great influence on apoptotic factors was observed. Further RNA-Seq analysis allowed for the direct interrogation of molecular targets of major pathways involved in bone and craniofacial development, each demonstrating segregation (altered signaling) due to e-cigarette-type exposure. These data have implications directed toward ENDS formulation as synergistic effects of Nicotine+PG/VG are evidenced here. Thus, future research will continue to interrogate how varied formulation of Nicotine+PG/VG affects overall cell functions in multiple vital systems.
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Affiliation(s)
- Shareef Dabdoub
- Division of Biostatistics and Computational Biology, College of Dentistry, University of Iowa, Iowa City, Iowa 52242, USA
- Department of Periodontics, College of Dentistry, University of Iowa, Iowa City, Iowa 52242, USA
| | - Ashley Greenlee
- Biomedical Sciences Graduate Program, College of Medicine, The Ohio State University, Columbus, Ohio, 43210, USA
| | - George Abboud
- Undergraduate Biomedical Sciences Major, College of Medicine, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Lexie Brengartner
- Undergraduate Biomedical Sciences Major, College of Medicine, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Eryn Zuiker
- Biomedical Sciences Graduate Program, College of Medicine, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Matthew W. Gorr
- Division of Cardiac Surgery, Department of Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Loren E. Wold
- Division of Cardiac Surgery, Department of Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, 43210, USA
| | - Purnima S. Kumar
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan
| | - James Cray
- Department of Biomedical Education and Anatomy, College of Medicine, The Ohio State University, Columbus, Ohio, 43210, USA
- Divisions of Biosciences and Orthodontics, College of Dentistry, The Ohio State University, Columbus, Ohio, 43210, USA
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Gould A, Dargan PI, Wood DM. An Internet Snapshot Survey Assessing the sale of Synthetic Cannabinoid Receptor Agonists for use with Electronic Vaping Devices. J Med Toxicol 2024; 20:271-277. [PMID: 38839732 PMCID: PMC11288222 DOI: 10.1007/s13181-024-01013-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/02/2024] [Accepted: 05/20/2024] [Indexed: 06/07/2024] Open
Abstract
INTRODUCTION Synthetic cannabinoid receptor agonists (SCRAs) are associated with significant toxicity and are increasingly used in electronic vaping devices. We assessed the availability of SCRA vaping products to UK purchasers on the surface web. METHODS An internet snapshot survey was performed between October 2022 and January 2023 on 'google.com' using the search terms "buy c-liquid vape", "buy herbal incense vape liquid", "buy cannabis vape liquid", "buy hashish vape liquid", "buy K2 vape liquid". RESULTS 62 websites selling 128 SCRA vaping brands were identified. Most were purportedly based in the USA (41 websites, 66%) and most sold other controlled substances. Purchase incentives offered included discreet packaging (38, 61%), discounts for bulk purchase (34, 55%) and tracked delivery (30, 48%). Many websites stated SCRA products were: not for human consumption (41, 66%), for research purposes only (15, 24%), or legal (28, 45%). Websites sold a median (IQR) of 16 (7-25) SCRA vaping brands. Almost all were bottles of vaping liquid (1220/1225, 99.6%). The most common bottle size was 5mL (60%), the median (IQR) total volume of SCRA liquid per sale was 50mL (10-200mL). Median (IQR) price was £3.39/mL (£2.01/mL- £5.29/mL). Price decreased with increasing volume purchased (£6.58/mL for ≤ 5mL, £1.60/mL for > 200mL). CONCLUSION SCRA vaping products are easily obtainable online, in both small and bulk quantities. Information provided to purchasers on safety and legality is lacking or misleading. Further studies are needed to confirm the chemistry of these products. Policymakers should consider steps to limit the potential harm caused by the purchase and use of these products.
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Affiliation(s)
- Allon Gould
- Respiratory Medicine, Whipps Cross University Hospital, Barts Health NHS Trust, London, UK.
| | - Paul I Dargan
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Clinical Toxicology, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - David M Wood
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Clinical Toxicology, Faculty of Life Sciences and Medicine, King's College London, London, UK
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Nangia T, Gupta B, Singhania R, Sharma D, Srivastava M, Langpoklakpam C. Choose life, not vapes: empowering teens to make healthier choices - a cross sectional study. Int J Adolesc Med Health 2024; 0:ijamh-2024-0091. [PMID: 39166860 DOI: 10.1515/ijamh-2024-0091] [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: 06/17/2024] [Accepted: 07/30/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVES The tobacco epidemic is more than just a health concern. It is a socioeconomic one with far-reaching effects. Smoking being the most common mode of tobacco use worldwide, has an impact on human life and well-being. Hence, this study aimed to seek the knowledge and awareness of adolescents about e-cigarettes and spread awareness about the harmful effects of vapig so as to reduce the ongoing rise in cigarette consumption among these individuals. METHODS A questionnaire-based cross-sectional survey was conducted among 100 teenage children of urban schools in Delhi NCR of age group 14-17 years which collected information on teenage vaping practices, views about vaping, and their accessibility to vaping items. The data were analyzed using the Statistical Program for Social Sciences - SPSS version 25 through frequency and percent, graphs, Bar chart and Chi-squared test. RESULTS A total 100 participants took part in the survey out of which of 59 were males and 41 were females. A significant proportion of the participants (94 %) possessed knowledge of e-cigarettes, and 14 % had actually used them at some point. Most of the participants were aware of the disposable variety of e-cigarettes and most of them thought that e-cigarettes were less addictive. CONCLUSIONS A significant portion of educated young adults who have never vaped are susceptible to using e-cigarettes in the future. It is also discovered that e-cigarettes are still available and being promoted in spite of the restrictions. In addition to good health education for minors, more stringent enforcement of current rules and monitoring could help prevent larger uptake in the future.
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Affiliation(s)
- Tanu Nangia
- Department of Pediatric and Preventive Dentistry, 77186 Manav Rachna Dental College and Hospital , Faridabad, Haryana, India
| | - Bhuvandeep Gupta
- Department of Public Health Dentistry, ITS Dental College, Ghaziabad, Uttar Pradesh, India
| | - Rashika Singhania
- Department of Pediatric and Preventive Dentistry, 77186 Manav Rachna Dental College and Hospital , Faridabad, Haryana, India
| | - Dipanshi Sharma
- Department of Public Health Dentistry, ITS Dental College, Ghaziabad, Uttar Pradesh, India
| | - Madhulika Srivastava
- Department of Pediatric and Preventive Dentistry, 77186 Manav Rachna Dental College and Hospital , Faridabad, Haryana, India
| | - Carrolene Langpoklakpam
- Department of Pediatric and Preventive Dentistry, 77186 Manav Rachna Dental College and Hospital , Faridabad, Haryana, India
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Jeon J, He X, Shinde A, Meister M, Barnett L, Zhang Q, Black M, Shannahan J, Wright C. The role of puff volume in vaping emissions, inhalation risks, and metabolic perturbations: a pilot study. Sci Rep 2024; 14:18949. [PMID: 39147784 PMCID: PMC11327287 DOI: 10.1038/s41598-024-69985-1] [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: 06/06/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024] Open
Abstract
Secondhand vaping exposure is an emerging public health concern that remains understudied. In this study, saliva and exhaled emissions from ENDS users (secondhand) and non-ENDS users (baseline) were collected, firsthand emissions were generated using an automated ENDS aerosol generation system programmed to simulate puffing topography profiles collected from ENDS users. Particulate concentrations and sizes along with volatile organic compounds were characterized. We revealed puffing topography metrics as potential mediators of firsthand and secondhand particle and chemical exposures, as well as metabolic and respiratory health outcomes. Particle deposition modeling revealed that while secondhand emissions displayed smaller deposited mass, total and pulmonary particle deposition fractions were higher than firsthand deposition levels, possibly due to smaller secondhand emission particle diameters. Lastly, untargeted metabolomic profiling of salivary biomarkers of lung injury due to firsthand ENDS exposures revealed potential early indicators of respiratory distress that may also be relevant in bystanders exposed to secondhand vaping scenarios. By leveraging system toxicology, we identified 10 metabolites, including leukotriene D4, that could potentially serve as biomarkers for ENDS use, exposure estimation, and the prediction of vaping-related disease. This study highlights characterization of vaping behavior is an important exposure component in advancing our understanding of potential health effects in ENDS users and bystanders.
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Affiliation(s)
- Jennifer Jeon
- Chemical Insights Research Institute of UL Research Institutes, Marietta, GA, 30367, USA
| | - Xiaojia He
- Chemical Insights Research Institute of UL Research Institutes, Marietta, GA, 30367, USA
| | - Akshada Shinde
- School of Health Sciences, Purdue University, West Lafayette, IN, 47907, USA
| | - Maureen Meister
- Chemical Insights Research Institute of UL Research Institutes, Marietta, GA, 30367, USA
| | - Lillie Barnett
- Chemical Insights Research Institute of UL Research Institutes, Marietta, GA, 30367, USA
| | - Qian Zhang
- Chemical Insights Research Institute of UL Research Institutes, Marietta, GA, 30367, USA
| | - Marilyn Black
- Chemical Insights Research Institute of UL Research Institutes, Marietta, GA, 30367, USA
| | - Jonathan Shannahan
- School of Health Sciences, Purdue University, West Lafayette, IN, 47907, USA.
| | - Christa Wright
- Chemical Insights Research Institute of UL Research Institutes, Marietta, GA, 30367, USA.
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Carvalho BFDC, Faria NDC, Foiani L, Nepomuceno GLJT, Cavalcanti DR, Alves MGO, Martinho HDS, Pérez‐Sayáns M, Almeida JD. Oral Mucosa and Saliva Alterations Related to Vape. Clin Exp Dent Res 2024; 10:e926. [PMID: 38970232 PMCID: PMC11226547 DOI: 10.1002/cre2.926] [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: 02/16/2024] [Revised: 05/30/2024] [Accepted: 06/15/2024] [Indexed: 07/08/2024] Open
Abstract
OBJECTIVES Electronic nicotine delivery systems (e-cigarette, pod, and vape) are currently among the tobacco consumption of adolescents and young adults. The aim is to show oral mucosa and saliva alterations related to vape. MATERIAL AND METHODS A vape-user patient, presenting a white plaque in the posterior region of the hard palate, underwent clinical examination, sialometry, pH evaluation, and excisional biopsy of the white lesion. Molecular changes in saliva and vape liquid were analyzed by vibrational spectroscopy. RESULTS The histopathological analyses showed hyperparakeratosis without dysplasia. Formaldehyde, ketones, and aromatic hydrocarbon species were identified in e-cig liquid by the FTIR. CONCLUSIONS The use of vape may be related to the development of hyperkeratotic lesions in the oral mucosa as well as significantly modify the patient's salivary patterns as the vape liquid presents carcinogenic and cytotoxic components in its composition.
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Affiliation(s)
- Bruna Fernandes do Carmo Carvalho
- Universidade Estadual Paulista (UNESP)Instituto de Ciência e Tecnologia e of Science and TechnologyCâmpus São José dos CamposSão PauloBrazil
| | - Natália de Carvalho Faria
- Universidade Estadual Paulista (UNESP)Instituto de Ciência e Tecnologia e of Science and TechnologyCâmpus São José dos CamposSão PauloBrazil
| | - Letícia Foiani
- Centro de Ciências Naturais e HumanasUniversidade Federal do ABCSanto AndréSão PauloBrazil
| | | | - Desirée Rosa Cavalcanti
- Oral Specialties Center of SuzanoStomatology Service—SuzanoSao PauloBrazil
- Technology Research Center (NPT)Universidade Mogi das CruzesMogi das CruzesSão PauloBrazil
| | - Mônica Ghislaine Oliveira Alves
- Universidade Estadual Paulista (UNESP)Instituto de Ciência e Tecnologia e of Science and TechnologyCâmpus São José dos CamposSão PauloBrazil
| | | | - Mário Pérez‐Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and DentistryUniversidade de Santiago de CompostelaSantiago de CompostelaSpain
- Instituto de Investigación Sanitaria de Santiago (IDIS), ORALRES GroupSantiago de CompostelaSpain
- Instituto de los materiales de Santiago de Compostela (iMATUS)Santiago de CompostelaSpain
| | - Janete Dias Almeida
- Universidade Estadual Paulista (UNESP)Instituto de Ciência e Tecnologia e of Science and TechnologyCâmpus São José dos CamposSão PauloBrazil
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Kishinchand R, Boyce M, Vyas H, Sewell L, Mohi A, Brengartner L, Miller R, Gorr MW, Wold LE, Cray J. In Utero Exposure to Maternal Electronic Nicotine Delivery System use Demonstrate Alterations to Craniofacial Development. Cleft Palate Craniofac J 2024; 61:1389-1397. [PMID: 36916055 DOI: 10.1177/10556656231163400] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
OBJECTIVE Develop a model for the study of Electronic Nicotine Device (ENDS) exposure on craniofacial development. DESIGN Experimental preclinical design followed as pregnant murine dams were randomized and exposed to filtered air exposure, carrier exposure consisting of 50% volume of propylene glycol and vegetable glycine (ENDS Carrier) respectively, or carrier exposure with 20 mg/ml of nicotine added to the liquid vaporizer (ENDS carrier with nicotine). SETTING Preclinical murine model exposure using the SciReq exposure system. PARTICIPANTS C57BL6 adult 8 week old female pregnant mice and exposed in utero litters. INTERVENTIONS Exposure to control filtered air, ENDS carrier or ENDS carrier with nicotine added throughout gestation at 1 puff/minute, 4 h/day, five days a week. MAIN OUTCOME MEASURES Cephalometric measures of post-natal day 15 pups born as exposed litters. RESULTS Data suggests alterations to several facial morphology parameters in the developing offspring, suggesting electronic nicotine device systems may alter facial growth if used during pregnancy. CONCLUSIONS Future research should concentrate on varied formulations and exposure regimens of ENDS to determine timing windows of exposures and ENDS formulations that may be harmful to craniofacial development.
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Affiliation(s)
- Rajiv Kishinchand
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Mark Boyce
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Heema Vyas
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Leslie Sewell
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Amr Mohi
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Lexie Brengartner
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Roy Miller
- School of Nursing, The Ohio State University, Columbus, OH 43210, USA
| | - Matthew W Gorr
- School of Nursing, The Ohio State University, Columbus, OH 43210, USA
- Department of Physiology and Cell Biology, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Loren E Wold
- School of Nursing, The Ohio State University, Columbus, OH 43210, USA
- Department of Physiology and Cell Biology, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - James Cray
- Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH 43210, USA
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, OH 43210, USA
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Alyaseen HA, Aldhaher ZA. The Effect of New Trend Electronic Cigarettes on Dental Caries in Relation to Glucosyltransferase B and Secretory Immunoglobulin A (A Case-control Study). Cell Biochem Biophys 2024:10.1007/s12013-024-01401-x. [PMID: 39069604 DOI: 10.1007/s12013-024-01401-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2024] [Indexed: 07/30/2024]
Abstract
Electronic cigarettes (vapes) are actively used, and their use is growing globally, especially among young people. Its spread is rapid due to the presence of unproven rumors that it is used to treat smoking addiction as it aids in smoking cessation. However, E.C has a negative impact on dental health by affecting the oral microbiome and salivary components. The goal of this study was to evaluate the impact of electronic cigarettes on dental caries in relation to glucosyltransferase B and secretory immunoglobulin in the saliva of electronic cigarette users. Ninety active males were divided into two groups: 45 electronic-cigarette smokers in addition to 45 non-electronic-cigarette smokers as a control group. An oral examination was performed on the studied groups, and decayed missing filling tooth surfaces (DMFS) were documented. Additionally, unstimulated saliva was collected to evaluate salivary glucosyltransferase B and secretory immunoglobulin A by using a sandwich enzyme-linked immune-sorbent assay (ELISA). The obtained outcomes showed that decayed, missing, and filled Surfaces values(DMFS), salivary glucosyltransferase B, and salivary secretory immunoglobulin A were greater in the study group than in control group. Additionally, a correlation between glucosyltransferase B, secretory immunoglobulin A, and DMFS was positive and significant. It was concluded that e-cigarettes may have an effect on saliva components and dental caries.
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Affiliation(s)
- Haneen A Alyaseen
- Department of Basic Science, College of Dentistry, University of Baghdad, Baghdad, Iraq.
| | - Zainab A Aldhaher
- Department of Basic Science, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Wilson OWA, Bullen C, Duffey M, Bopp M. The association between vaping and health behaviors among undergraduate college students in the United States. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1360-1364. [PMID: 35623030 DOI: 10.1080/07448481.2022.2076097] [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: 04/11/2021] [Revised: 04/13/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
Objective: To examine the association between vaping and health behaviors (physical activity, fruit and vegetable consumption, sleep, cigarette use, alcohol consumption) and mental health among college students. Methods: Socio-demographic characteristics, vaping, health behaviors, perceived stress, and depressive symptoms of undergraduates enrolled at a large university located in the Northeast of the United States were assessed via an online survey. Results: Of all participants (n = 1775), less than a fifth (n = 314, 17.7%) reported any vaping in the past month. More men reported vaping than women (23.2% vs. 14.5%). Those who vaped reported fewer nights of restful sleep and greater alcohol consumption. Those who smoked and binge drank were more likely to report vaping. Perceived stress was greater among women who vaped, and depressive symptoms were greater among those who vaped regardless of gender. Conclusions: Vaping was associated with smoking, alcohol consumption, and poorer mental health among young adults.
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Affiliation(s)
- Oliver W A Wilson
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
- Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Chris Bullen
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Michele Duffey
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Melissa Bopp
- Department of Kinesiology, Pennsylvania State University, University Park, Pennsylvania, USA
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Novak ML, Wang GY. The effect of e-cigarettes on cognitive function: a scoping review. Psychopharmacology (Berl) 2024; 241:1287-1297. [PMID: 38724716 PMCID: PMC11199295 DOI: 10.1007/s00213-024-06607-8] [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: 11/08/2023] [Accepted: 05/02/2024] [Indexed: 06/26/2024]
Abstract
AIM Much research has been conducted on the acute effects of nicotine on human cognitive performance, demonstrating both enhancing and impairing cognitive effects. With the relatively recent introduction of electronic cigarettes ('e-cigarettes') as a smoking cessation device, little is known about the cognitive effects of e-cigarettes specifically, either as a nicotine replacement device or in the absence of nicotine. The purpose of this review was to present an overview of evidence from empirical studies on the effect of e-cigarettes on cognitive function. APPROACH Guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines (PRISMA-ScR), SCOPUS, PubMed, and EBSCOhost were searched from 2006, the year e-cigarettes were introduced, to June 2023 for relevant papers, along with reference lists checked for additional papers. KEY FINDINGS Seven experimental and four cross-sectional survey studies were identified and included. The majority of the studies only include regular and current cigarette smokers and primarily assessed the acute cognitive effect of e-cigarettes relative to nicotine. While the findings primarily suggest either no or positive effect of e-cigarettes on cognition in cigarette smokers, associations between e-cigarettes and cognitive impairments in memory, concentration and decision making were reported in both cigarette smokers and never-smokers. IMPLICATIONS AND CONCLUSIONS The acute cognitive effect of e-cigarettes on regular cigarette smokers appears minimal. However, long-term cognitive effect and their effects on never-smokers are unclear. Given that the increased numbers of e-cigarette users are non-smokers and/or adolescents, research with those naïve to nicotine and a developmentally vulnerable adolescent population on its long-term effect is needed.
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Affiliation(s)
- Marissa L Novak
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Australia
| | - Grace Y Wang
- School of Psychology and Wellbeing, University of Southern Queensland, Ipswich, Australia.
- Centre for Health Research, University of Southern Queensland, Toowoomba, Australia.
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Lund L, Andersen S, Ritz C, Bast LS. Predicting longitudinal changes in patterns of tobacco and nicotine product use among adolescents: A Latent Transition Analysis based on the X:IT study. Soc Sci Med 2024; 352:117029. [PMID: 38843676 DOI: 10.1016/j.socscimed.2024.117029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 07/13/2024]
Abstract
INTRODUCTION Understanding factors influencing the transition from non-use to tobacco and nicotine product initiation among adolescents is crucial for designing and implementing effective preventive strategies. This study explores transition patterns among 13-15-year-old adolescents in lower secondary school, focusing on the transition from non-use to tobacco and nicotine product initiation and the influence of individual, social, risk behavioral, and mental health factors on this transition. METHODS Based on data from a Danish smoking prevention trial between 2017 and 2019, this study employed questionnaire surveys at three time points: baseline (start of seventh grade, n = 1,990, response rate = 86.3%), eight-month follow-up (end of seventh grade, n = 1,666, response rate = 74,8%), and 20-month follow-up (end of eighth grade, n = 1,149, response rate = 70,6%). Tobacco and nicotine use indicators included current and lifetime use of cigarettes and lifetime use of e-cigarettes, smokeless tobacco, and hookah. A latent transition analysis was applied to identify longitudinal transition patterns across waves and to explore predictors of these patterns. RESULTS Three user classes emerged across all waves: none-use, lifetime e-cigarette and cigarette use, and poly-tobacco use. While the most prevalent class was the non-user class (71%-86%), the proportion of the lifetime e-cigarette and cigarette class increased over time (from 12% to 17%). Similarly, the poly-tobacco user class increased from 2% to 12%. The probability of transitioning from non-use to lifetime e-cigarette and cigarette use increased from 0.5% at baseline to 12% by the second follow-up, while the probability of transitioning from lifetime e-cigarette and cigarette use remained stable over time (12%-15%). Across all waves, elevated risk behavior predicted this transition. For instance, binge-drinking (OR = 3.76, 95% CI: 1.51-9.34), susceptibility to smoking (OR = 7.63, 95% CI: 3.68-16.83), and truancy (OR = 7.00, 95% CI: 1.98-24.59) influenced the transition from non-use at baseline to lifetime e-cigarette and cigarette use at first follow-up. Additionally, boys, adolescents with low socioeconomic status, low life satisfaction, and those with smoking friends or parents were more likely to transition from non-use to lifetime e-cigarette and cigarette use. CONCLUSION This study demonstrates that sociodemographic, social risk, behavioral, and mental health factors impact the transition from non-use to lifetime e-cigarette and cigarette use. The findings provide valuable insights for developing targeted preventive strategies focusing on these influencing factors.
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Affiliation(s)
- Lisbeth Lund
- National Institute of Public Health, University of Southern Denmark, Studiestræde, 61455, Copenhagen, Denmark.
| | - Susan Andersen
- National Institute of Public Health, University of Southern Denmark, Studiestræde, 61455, Copenhagen, Denmark.
| | - Christian Ritz
- National Institute of Public Health, University of Southern Denmark, Studiestræde, 61455, Copenhagen, Denmark.
| | - Lotus Sofie Bast
- National Institute of Public Health, University of Southern Denmark, Studiestræde, 61455, Copenhagen, Denmark.
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Kasza KA, Tang Z, Xiao H, Marshall D, Stanton C, Gross A, Jackson K, Kelley D, Schroeder M, Vivar J, Hyland A. National longitudinal tobacco product discontinuation rates among US youth from the PATH Study: 2013-2019 (waves 1-5). Tob Control 2024; 33:511-517. [PMID: 37045605 PMCID: PMC10567990 DOI: 10.1136/tc-2022-057729] [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: 09/01/2022] [Accepted: 02/27/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE Determine longitudinal tobacco product discontinuation rates among youth (ages 12-17 years) in the USA between 2013 and 2019. METHODS The Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort study, was used to determine annual/biennial rates of tobacco product discontinuation behaviours among youth across 2013-2019: (1) discontinuing product use (transition from past 30-day use to no past 30-day use), (2) attempting to quit product use and (3) discontinuing product use among those who attempted to quit. Discontinuing use was evaluated separately for cigarettes, electronic nicotine delivery systems (ENDS), cigars, hookah, smokeless tobacco and any tobacco. Attempting to quit and discontinuing use among those who attempted were each evaluated for cigarettes and ENDS. Generalised estimating equations were used to evaluate linear and non-linear trends in rates across the study period. RESULTS Between 2013 and 2019, biennial rates of discontinuing tobacco product use among youth increased for cigarettes from 29% to 40%, increased for smokeless tobacco from 39% to 60%, and decreased for ENDS from 53% to 27%. By 2018/2019, rates of discontinuing use among attempters were 30% for those who used ENDS and 30% for those who smoked cigarettes. CONCLUSIONS Findings show decreasing rates of discontinuing ENDS use among youth in the USA alongside the changing ENDS marketplace and increasing rates of discontinuing cigarette smoking and smokeless tobacco use. Findings will serve as benchmarks against which future tobacco product discontinuation rates can be compared with evaluating impacts of subsequent tobacco regulatory policies, ENDS product development and public education campaigns.
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Affiliation(s)
- Karin A Kasza
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Zhiqun Tang
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, Maryland, USA
| | - Haijun Xiao
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Daniela Marshall
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland, USA
- Axle Informatics, Rockville, Maryland, USA
| | - Cassandra Stanton
- Behavioral Health and Health Policy Practice, Westat Inc, Rockville, Maryland, USA
| | - Amy Gross
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Kathy Jackson
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Dannielle Kelley
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Megan Schroeder
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Juan Vivar
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
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12
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Travis N, Warner KE, Goniewicz ML, Oh H, Ranganathan R, Meza R, Hartmann-Boyce J, Levy DT. The Potential Impact of Oral Nicotine Pouches on Public Health: A Scoping Review. Nicotine Tob Res 2024:ntae131. [PMID: 38880491 DOI: 10.1093/ntr/ntae131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/30/2024] [Accepted: 05/14/2024] [Indexed: 06/18/2024]
Abstract
INTRODUCTION Oral nicotine pouches (ONPs) are a new class of nicotine products. This scoping review summarizes evidence on ONPs and explores their potential public health impact. AIMS AND METHODS We conducted a structured literature search for empirical studies across three electronic databases through January 10, 2024. Outcomes included ONP product characteristics, use patterns, beliefs and perceptions, toxicity, and marketing and sales. RESULTS Sixty-two studies were included, 17 were industry-funded. Most studies were from the United States. While large variations across studies were observed in ONP youth prevalence estimates, nationally representative U.S. studies find current use at 1.5% and lifetime use below 2.5% through 2023. Between 35% and 42% of U.S. adolescents and young adults have heard of ONPs, and 9-21% of tobacco-naïve youth were susceptible to trying them. U.S. adult-use estimates varied widely (0.8%-3% current; 3%-16% lifetime use) and were limited to populations with a history of tobacco use. The chemical composition of ONPs suggests fewer harmful/potentially harmful compounds at lower levels than cigarettes and smokeless tobacco (SLT), except formaldehyde. Industry-funded studies find substantially less cytotoxicity compared to cigarettes and suggest that higher nicotine-strength ONPs can deliver nicotine at levels comparable to or higher than SLT or cigarettes, although with slower nicotine release than cigarettes. Evidence on the cytotoxicity of ONPs relative to SLT is mixed. CONCLUSIONS ONPs appear to be less toxic than cigarettes and deliver comparable nicotine, presenting an alternative for combustible product users, although key data are mainly available from industry-funded studies. Data from independent research is critically needed. Industry marketing of ONPs may encourage initiation in youth and situational and dual use in adults. IMPLICATIONS The review provides an initial assessment of the potential role of ONPs in harm reduction and aims to determine unintended consequences of their use (youth uptake and dual-use) and identify populations that disproportionately use the product. This information is essential for tobacco regulatory bodies in determining the net public health impact of nicotine pouches.
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Affiliation(s)
- Nargiz Travis
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC, USA
| | - Kenneth E Warner
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Hayoung Oh
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC, USA
| | - Radhika Ranganathan
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC, USA
| | - Rafael Meza
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Jamie Hartmann-Boyce
- Department of Health Promotion and Policy, University of Massachusetts, Amherst, MA, USA
| | - David T Levy
- Lombardi Comprehensive Cancer Center, Georgetown Medical University, Washington, DC, USA
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13
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Sheeran P, Kenny A, Bermudez A, Gray K, Galper EF, Boynton M, Noar SM. Artificial Intelligence Simulation of Adolescents' Responses to Vaping-Prevention Messages. JAMA Pediatr 2024; 178:504-506. [PMID: 38526479 PMCID: PMC10964158 DOI: 10.1001/jamapediatrics.2024.0274] [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] [Received: 11/29/2023] [Accepted: 01/29/2024] [Indexed: 03/26/2024]
Abstract
This quality improvement study investigates if a large language model could simulate adolescents’ responses to vaping-prevention campaigns and identify the most effective messages to address the public health crisis of adolescent vaping.
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Affiliation(s)
- Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill
| | - Alexander Kenny
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill
| | - Andrea Bermudez
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill
| | - Kurt Gray
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill
| | - Emily F. Galper
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill
| | - Marcella Boynton
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill
| | - Seth M. Noar
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill
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14
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Hernández-Torres R, Wang H, Orfin R, Castro-Figueroa EM, Freeman J, Cupertino AP, Ossip DJ, Wilson KM, Cartujano-Barrera F. Exposure to E-Cigarette Marketing and Susceptibility to Future Vaping among Black and Latino Adolescents in the United States. CHILDREN (BASEL, SWITZERLAND) 2024; 11:465. [PMID: 38671682 PMCID: PMC11049197 DOI: 10.3390/children11040465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024]
Abstract
Evidence suggests an association between exposure to electronic cigarette (e-cigarette) marketing and e-cigarette use (vaping) among adolescents. However, there is limited evidence on exposure to e-cigarette marketing and susceptibility to future vaping, especially among Black and Latino adolescents. This study aimed to examine associations between exposure to e-cigarette marketing and susceptibility to future vaping among Black and Latino adolescents in the United States (US). Participants (N = 362; equal representation between Black and Latino adolescents) completed a baseline assessment (available in English and Spanish) including sociodemographic characteristics (e.g., racial/ethnic group, age, gender, sexual orientation, etc.), exposure to e-cigarette marketing, and susceptibility to future vaping. Exposure to e-cigarette marketing was recoded and organized into two categories (high exposure = 2 to 3; low exposure = 0 to 1). Cochran-Mantel-Haenszel tests were used to evaluate the association between exposure to e-cigarette marketing and susceptibility to future vaping, stratified by racial/ethnic group. Multiple logistic regressions assessed the association between exposure to e-cigarette marketing and susceptibility to future vaping, controlling for gender, sexual orientation, grade, and academic performance within each racial/ethnic group. Black adolescents reported significantly higher frequencies of exposure to e-cigarette marketing (p = 0.005). A significant interaction was found between exposure to e-cigarette marketing and racial/ethnic group (X2 (1) = 6.294, p = 0.012). Among Black adolescents, high exposure to e-cigarette marketing (vs. low exposure) was associated with a higher probability of susceptibility to future vaping (OR: 2.399, 95% CI 1.147-5.021, p = 0.020). For Latino adolescents, exposure to e-cigarette marketing was not associated with susceptibility to future vaping (OR: 0.503, 95% CI 0.245-1.03, p = 0.062). Future studies should evaluate how and where adolescents are exposed to e-cigarette marketing. Prevention efforts must include the implementation of effective counter-marketing campaigns and the reduction of exposure to e-cigarette marketing among Black and Latino adolescents.
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Affiliation(s)
- Ruthmarie Hernández-Torres
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USA
| | - Hongyue Wang
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Rafael Orfin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.O.); (D.J.O.); (F.C.-B.)
| | - Eida M. Castro-Figueroa
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce 00716, Puerto Rico;
| | | | - Ana Paula Cupertino
- Department of Surgery, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.O.); (D.J.O.); (F.C.-B.)
- Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Karen M. Wilson
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Francisco Cartujano-Barrera
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA; (R.O.); (D.J.O.); (F.C.-B.)
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15
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Sun Y, Prabhu P, Li D, McIntosh S, Rahman I. Vaping: Public Health, Social Media, and Toxicity. Online J Public Health Inform 2024; 16:e53245. [PMID: 38602734 PMCID: PMC11046396 DOI: 10.2196/53245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/26/2023] [Accepted: 03/08/2024] [Indexed: 04/12/2024] Open
Abstract
This viewpoint aims to provide a comprehensive understanding of vaping from various perspectives that contribute to the invention, development, spread, and consequences of e-cigarette products and vaping. Our analysis showed that the specific characteristics of e-cigarette products as well as marketing strategies, especially social media marketing, fostered the spread of vaping and the subsequent effects on human health and toxicity. We analyzed the components of e-cigarette devices and e-liquids, including the latest variants whose impacts were often overlooked. The different forms of nicotine, including salts and freebase nicotine, tobacco-derived nicotine, tobacco-free nicotine, and cooling agents (WS3 and WS23), have brought more choices for vapers along with more ways for e-cigarette manufacturers to advertise false understandings and present a greater threat to vapers' health. Our work emphasized the products of brands that have gained significant influence recently, which are contributing to severe public health issues. On the other hand, we also discussed in detail the toxicity of e-liquid components and proposed a toxicity mechanism. We also noticed that nicotine and other chemicals in e-liquids promote each other's negative effects through the oxidative stress and inflammatory nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway, a mechanism leading to pulmonary symptoms and addiction. The impact of government regulations on the products themselves, including flavor bans or regulations, has been limited. Therefore, we proposed further interventions or harm reduction strategies from a public health perspective.
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Affiliation(s)
- Yehao Sun
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Prital Prabhu
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Dongmei Li
- Department of Clinical & Translational Research, University of Rochester Medical Center, Rochester, NY, United States
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Irfan Rahman
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States
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16
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Boutouis S, Wymbs F, Franz B. The association between marijuana and e-cigarette use and exercise behavior among adults. Prev Med Rep 2024; 40:102668. [PMID: 38469398 PMCID: PMC10926305 DOI: 10.1016/j.pmedr.2024.102668] [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] [Received: 11/06/2023] [Revised: 01/26/2024] [Accepted: 02/23/2024] [Indexed: 03/13/2024] Open
Abstract
Background As the prevalence of marijuana and e-cigarette use among American adults rises and the perceived risk decreases, more information is needed on the potential costs and benefits of marijuana and e-cigarette use, including patterns of exercise. Prior studies have found mixed results, lacked data on types of exercise, and involved only adolescents and young adults. Thus, the current study explored whether marijuana and e-cigarette use are associated with strength training, walking for exercise, or general physical activity among adults in the United States. Method 2,591 adults from Wave V of the National Longitudinal Study of Adolescent to Adult Health (2016-2018) comprised the sample. Separate one-way analyses of variance (ANOVAs) and post hoc tests examined whether participants' marijuana and e-cigarette use predicted their exercise, while follow-up analyses of covariance (ANCOVAs) probed significant effects. Results Results indicated that participants' marijuana and e-cigarette use predicted their walking for exercise, with marijuana users walking the highest number of times per week, followed by non-users, e-cigarette users, and dual users. However, this effect only approached significance after controlling for covariates. There were no significant differences in strength training or general exercise between groups. Conclusion These findings challenge the stereotype that marijuana and e-cigarette users are less active than non-users, and future research should examine the potential mechanisms of these findings.
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17
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Record RA, Groznik M, Sussman M. Communicative Processes Underlying DIY eJuice Mixing Among Young Adult International ENDS Users. HEALTH COMMUNICATION 2024; 39:666-674. [PMID: 36809903 DOI: 10.1080/10410236.2023.2179718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The use of electronic nicotine delivery systems (ENDS) is increasing around the world, with contemporary trends outpacing scientific understanding of the health implications. Such trends include do-it-yourself eJuice mixing (DIY eJuice), which involves the unregulated homemade mixing of fogging agents, nicotine salts, and flavorants to create personalized liquid for ENDS products. The purpose of this study was to employ a grounded theory approach to gather formative data on the communicative processes surrounding the behavior of DIY eJuice mixing among international, young adult ENDS users. Participants were recruited locally for mini focus group discussions via SONA (n = 4) and internationally for an open-ended survey via Prolific (n = 138). Questions explored experiences with the online DIY eJuice community, motivations for mixing, information seeking strategies, flavor preferences, and perceived benefits of mixing. Thematic analysis and flow sketching revealed the underlying processes of social cognitive theory to explain the communicative processes of DIY eJuice mixing behaviors. Specifically, environmental determinants emerged in the form of online and social influences; personal determinants in the form of curiosity and control; and behavioral determinants following a benefits/barriers analysis, particularly regarding cost. These findings provide theoretical implications for the role of health communication constructs in understanding contemporary trends in ENDS use and practical implications for tobacco prevention messaging and tobacco control regulations.
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Affiliation(s)
| | | | - Mark Sussman
- Department of Biology, San Diego State University
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18
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Ceasar RC, Braymiller JL, Kechter A, Simpson KA, Schiff SJ, Yamaguchi N, Barrington-Trimis JL. Perceiving E-Cigarettes as Safe and Safer Alternative to Cigarettes Among Young Adults. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:181-190. [PMID: 38281133 DOI: 10.1177/29767342231218533] [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] [Indexed: 01/30/2024]
Abstract
BACKGROUND Young adults are using e-cigarettes at high rates. While the literature on the health risks associated with e-cigarettes is extensive and growing, little is known about young adults' thoughts and perceptions of the safety and harms of e-cigarettes. METHODS We conducted one-on-one interviews with young adults aged 18 to 25 years in Los Angeles, California between June 2018 and June 2019. We interviewed and audio-recorded young adults (N = 62) who consented to the study and self-reported to have used e-cigarettes on a weekly basis or more for at least 5 months prior to study enrollment. Interviews examined participants' thoughts, feelings, and experiences related to e-cigarette use. We audio-recorded, transcribed, and coded the interviews using grounded theory analysis methods. RESULTS Young adults often believed that e-cigarettes were safer than cigarettes and were safe to use, especially following positive vaping experiences. Young adults were skeptical of the available science on e-cigarette use and felt there was not conclusive data on the harms of e-cigarettes. In their selection of e-cigarettes over cigarettes, young adults felt they were making a conscious and healthier choice. Because young adults viewed e-cigarettes to be better for them based on their personal experiences with vaping, they felt e-cigarettes were a superior alternative to combustible tobacco. CONCLUSIONS Young adults in our study believed that the long-term health effects of e-cigarette use are not clearly understood and were generally skeptical of the research on e-cigarette harms. Policy, education, and anti-smoking campaigns need to clarify the negative health-related consequences of e-cigarette use for young people.
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Affiliation(s)
- Rachel Carmen Ceasar
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jessica L Braymiller
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA
| | - Afton Kechter
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kelsey A Simpson
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California, San Diego
| | - Sara J Schiff
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Naosuke Yamaguchi
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Rosalind Franklin University of Medicine and Science
| | - Jessica L Barrington-Trimis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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19
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Ayers JW, Poliak A, Beros NT, Paul M, Dredze M, Hogarth M, Smith DM. A Digital Cohort Approach for Social Media Monitoring: A Cohort Study of People Who Vape E-Cigarettes. Am J Prev Med 2024; 67:S0749-3797(24)00028-X. [PMID: 38904592 DOI: 10.1016/j.amepre.2024.01.016] [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] [Received: 06/26/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION The evidence hierarchy in public health emphasizes longitudinal studies, whereas social media monitoring relies on aggregate analyses. Authors propose integrating longitudinal analyses into social media monitoring by creating a digital cohort of individual account holders, as demonstrated by a case study analysis of people who vape. METHODS All English language X posts mentioning vape or vaping were collected from January 1, 2017 through December 31, 2020. The digital cohort was composed of people who self-reported vaping and posted at least 10 times about vaping during the study period to determine the (1) prevalence, (2) success rate, and (3) timing of cessation behaviors. RESULTS There were 25,112 instances where an account shared at least 10 posts about vaping, with 619 (95% CI=616, 622) mean person-days and 43,810,531 cumulative person-days of observation. Among a random sample of accounts, 39% (95% CI=35, 43) belonged to persons who vaped. Among this digital cohort, 27% (95% CI=21, 33) reported making a quit attempt. For all first quit attempts, 26% (95% CI=19, 33) were successful on the basis of their subsequent vaping posts. Among those with a failed first cessation attempt, 13% (95% CI=6, 19) subsequently made an additional quit attempt, of whom 36% (95% CI=11, 61) were successful. On average, a quit attempt occurred 531 days (95% CI=474, 588) after their first vaping-related post. If their quit attempt failed, any second quit attempt occurred 361 days (95% CI=250, 474) after their first quit attempt. CONCLUSIONS By aligning with standard epidemiologic surveillance practices, this approach can greatly enhance the usefulness of social media monitoring in informing public health decision making, such as yielding insights into the timing of cessation behaviors among people who vape.
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Affiliation(s)
- John W Ayers
- Qualcomm Institute, University of California San Diego, La Jolla, California; Division of Infectious Diseases & Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, California; Altman Clinical Translational Research Institute, University of California San Diego, La Jolla, California.
| | - Adam Poliak
- Department of Computer Science, Bryn Mawr College, Bryn Mawr, Pennsylvania
| | - Nikolas T Beros
- Qualcomm Institute, University of California San Diego, La Jolla, California; Francis Parker High School, San Diego, California
| | - Michael Paul
- Qualcomm Institute, University of California San Diego, La Jolla, California
| | - Mark Dredze
- Department of Computer Science, Whiting School of Engineering, Johns Hopkins University, Baltimore, Maryland
| | - Michael Hogarth
- Altman Clinical Translational Research Institute, University of California San Diego, La Jolla, California; Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Davey M Smith
- Division of Infectious Diseases & Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, California; Altman Clinical Translational Research Institute, University of California San Diego, La Jolla, California
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20
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Renda B, Andrade AK, Wylie IR, Stone AP, Antenos M, Leri F, Murray JE. Adolescent restraint stress enhances adult nicotine reinforcement in male and female rats. Psychoneuroendocrinology 2024; 161:106927. [PMID: 38113767 DOI: 10.1016/j.psyneuen.2023.106927] [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: 07/02/2023] [Revised: 10/16/2023] [Accepted: 12/10/2023] [Indexed: 12/21/2023]
Abstract
Adolescent stress is a risk factor for the initiation of nicotine use, but whether adolescent stress can enhance nicotine reinforcement when it is initiated later in adulthood is unknown, and it is unclear whether males and females are equally impacted. Therefore, this study assessed physiological responses (body weight and blood serum corticosterone - CORT) to restraint stress (RS) during adolescence (P28-55) or during adulthood (P70-96) in male and female Sprague-Dawley rats. When all subjects reached adulthood (P69 or 110; 2 weeks after termination of stress exposure), they were tested on sucrose preference and intravenous single-dose nicotine (0.03 mg/kg/infusion) self-administration. It was found that all rats displayed a significant CORT response to RS. Importantly, stress during adolescence, but not during adulthood, enhanced subsequent acquisition of nicotine intake tested in adulthood. Although this effect was observed in both sexes, only males displayed reduced body weight gain and adult sucrose preference. Moreover, regardless of stress exposure, females were more stimulated by nicotine, consumed more nicotine overall, and displayed enhanced nicotine seeking. These results suggest that adolescence is a period of heightened sensitivity to the enhancing effect of repeated stress on the susceptibility to develop nicotine dependence later in life in both sexes.
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Affiliation(s)
- Briana Renda
- Department of Psychology, University of Guelph, Guelph, ON, Canada; Collaborative Neuroscience Program, University of Guelph, Guelph, ON, Canada
| | - Allyson K Andrade
- Department of Psychology, University of Guelph, Guelph, ON, Canada; Collaborative Neuroscience Program, University of Guelph, Guelph, ON, Canada
| | - Isabella R Wylie
- Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Adiia P Stone
- Department of Psychology, University of Guelph, Guelph, ON, Canada; Collaborative Neuroscience Program, University of Guelph, Guelph, ON, Canada
| | - Monica Antenos
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Francesco Leri
- Department of Psychology, University of Guelph, Guelph, ON, Canada; Collaborative Neuroscience Program, University of Guelph, Guelph, ON, Canada
| | - Jennifer E Murray
- Department of Psychology, University of Guelph, Guelph, ON, Canada; Collaborative Neuroscience Program, University of Guelph, Guelph, ON, Canada.
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21
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Augenstein JA, Smaldone AM, Usseglio J, Bruzzese JM. Electronic Cigarette Use and Academic Performance Among Adolescents and Young Adults: A Scoping Review. Acad Pediatr 2024; 24:228-242. [PMID: 37748535 DOI: 10.1016/j.acap.2023.09.012] [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: 01/22/2023] [Revised: 09/09/2023] [Accepted: 09/20/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND There are documented links between substance use and poor educational outcomes. However, less is known about electronic cigarette (e-cigarette) use in relation to academics. Therefore, this scoping review aimed to synthesize associations between e-cigarette use and academic performance among adolescents and young adults. METHODS Seven electronic databases were searched. Original research articles were included if associations between e-cigarette use and academic performance among adolescents and young adults aged 11 to 25 years were examined. Extracted data included study and participant descriptors, measures of e-cigarette use and academic performance, key findings, and study limitations. Measures of academic performance were grouped as academic achievement, academic behaviors, or cognitive attitudes. RESULTS Thirty-three studies met inclusion criteria. Most were cross-sectional (n = 28). Significant associations to e-cigarette use were identified across all categories: academic achievement (ie, school grades (n = 24)), academic behaviors (ie, school difficulties (n = 1), time spent on homework (n = 1), school suspension (n = 1), and truancy (n = 3)), and cognitive attitudes (ie, school stress (n = 1), school alienation (n = 1), and school engagement (n = 2)). Longitudinal associations were also identified in 5 prospective cohort studies: among adolescents, poor academic grades (n = 4), and truancy (n = 1) predicted future e-cigarette use, and e-cigarette use predicted future lower school grades (n = 1). CONCLUSIONS E-cigarette use during adolescence and young adulthood is associated with poor academic achievement. There is some evidence that academic achievement may predict future e-cigarette use; less evidence supports the opposite direction. Study designs are needed to support a causal connection. Investigators should consider moving from studying associations and instead look for causal evidence.
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Affiliation(s)
- Jacqueline A Augenstein
- Columbia University School of Nursing (JA Augenstein, AM Smaldone, J-M Bruzzese), New York, NY,.
| | - Arlene M Smaldone
- Columbia University School of Nursing (JA Augenstein, AM Smaldone, J-M Bruzzese), New York, NY,; Columbia University College of Dental Medicine (AM Smaldone), New York, NY
| | - John Usseglio
- Augustus C. Long Health Sciences Library (J Usseglio), Columbia University Irving Medical Center, New York, NY
| | - Jean-Marie Bruzzese
- Columbia University School of Nursing (JA Augenstein, AM Smaldone, J-M Bruzzese), New York, NY
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22
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Scholz JR, Malta DC, Fagundes Júnior AADP, Pavanello R, Bredt Júnior GL, Rocha MDS. Brazilian Society of Cardiology Position Statement on the Use of Electronic Nicotine Delivery Systems - 2024. Arq Bras Cardiol 2024; 121:e20240063. [PMID: 38422228 PMCID: PMC11081107 DOI: 10.36660/abc.20240063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Affiliation(s)
- Jaqueline R Scholz
- Instituto do Coração (Incor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), SP - Brasil
| | | | - Antonio Aurélio de Paiva Fagundes Júnior
- Instituto D'Or de Pesquisa e Ensino (IDOR), Brasília, DF - Brasil
- Universidade de Brasília (UNB), Brasília, DF - Brasil
- Hospital DFStar, RedeDO'r, Brasília, DF - Brasil
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23
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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 124] [Impact Index Per Article: 124.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Lee DS, Tackett AP, Naya C, Harlow AF, Mason TB. Trajectories of body mass index and combustible and electronic cigarette use across adolescence: Findings from the PATH study. Addict Behav 2024; 149:107901. [PMID: 37925843 PMCID: PMC10765952 DOI: 10.1016/j.addbeh.2023.107901] [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: 04/25/2023] [Revised: 10/02/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
PURPOSE Associations between empirically-generated body mass index (BMI) trajectories and risk of current use of combustible cigarettes and e-cigarettes across adolescence were examined using longitudinal data from the Population Assessment of Tobacco and Health (PATH) study. METHODS The PATH study is an ongoing annual longitudinal population-based study of adolescents. We utilized Waves 1-4 conducted from 2013 to 2017. Adolescents completed self-reported surveys of their height, weight, and current tobacco use at Waves 1-4 and their tobacco weight control beliefs at Waves 1-2. RESULTS Using latent growth mixture modeling, six trajectories of BMI were identified. The largest group ("normal weight increasing;" n = 4,858; 86.6 %), which was used as the comparator in subsequent analyses, consisted of adolescents ages 12-17 who were normal weight at Wave 1 with a significant increase in BMI across Waves 2--4. The "overweight early increasing," "overweight late increasing," and "obesity stable" classes had greater likelihood of current combustible cigarette use during the study compared to the "normal weight increasing class." The "overweight early increasing," "overweight late increasing," and "overweight increasing then decreasing" classes showed elevated risk for e-cigarette use during the study. Compared to those in the "normal weight increasing" class, those in the "overweight increasing then decreasing" and "obesity stable" classes had greater weight control beliefs at Wave 1 and those in the "obesity stable" class had greater weight control beliefs at Wave 2. CONCLUSIONS Findings highlight the importance of weight trajectories and weight control beliefs by tobacco product use across adolescence and the need for mechanistic and intervention research.
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Affiliation(s)
- Derrick S Lee
- Loyola Marymount University, Los Angeles, CA, United States
| | - Alayna P Tackett
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States
| | - Christine Naya
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, United States
| | - Alyssa F Harlow
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, United States
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, United States; Institute for Addiction Science, University of Southern California, Los Angeles, CA, United States.
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Adjei A, Chen B, Mantey DS, Wilkinson AV, Harrell MB. Symptoms of nicotine dependence by e-cigarette and cigarette use behavior and brand: A population-based, nationally representative cross-sectional study. Drug Alcohol Depend 2024; 255:111059. [PMID: 38150895 DOI: 10.1016/j.drugalcdep.2023.111059] [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: 09/22/2023] [Revised: 11/18/2023] [Accepted: 12/05/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Many modern e-cigarette brands contain equivalent or higher nicotine levels than traditional cigarettes. OBJECTIVE To examine differences in four nicotine dependence indicators (i.e., use within 30minutes of waking, cravings, needing to use, and frequent use) among adolescents (aged 12-17 years) with past 30-day (P30D) exclusive use of e-cigarettes, cigarettes, or dual use of both. METHODS Data were from Wave 5 (2018-2019) of the Population Assessment of Tobacco and Health (PATH) study (n=1060; N=2053,659). Multivariable logistic regression was performed to determine differences in indicators by P30D e-cigarette and cigarette use behavior (exclusive vs. dual use) and brand (e-cigarette use: JUUL vs. non-JUUL vs. Unknown). RESULTS The odds of frequent use among adolescents with JUUL (AOR: 2.11; 95% CI=1.02-4.37) and non-JUUL (AOR: 2.12; 95% CI=0.95-4.77) use were similar and paralleled that for dual use (AOR: 3.50; 95% CI=1.46-8.43) but were stronger (JUUL only) than exclusive cigarette use. The odds of using within 30minutes of waking for adolescents with JUUL (AOR: 2.23; 95% CI=0.80-6.25) and non-JUUL (AOR:1.42; 95% CI=0.47-4.32) use were similar and paralleled that for both dual (AOR=3.00; 95% CI=1.01-8.88) and exclusive cigarette use. For adolescents who used unknown brands, the odds of all indicators paralleled exclusive cigarette use but were lower than JUUL, non-JUUL, and dual use. CONCLUSION Compared to exclusive cigarette use, symptoms of nicotine dependence are similar for adolescents with exclusive e-cigarette use, irrespective of brand. Symptoms of nicotine dependence for JUUL and non-JUUL use parallel dual use. Tobacco regulation should consider these findings when assessing the abuse liability of e-cigarettes.
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Affiliation(s)
- Abigail Adjei
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States.
| | - Baojiang Chen
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States
| | - Dale S Mantey
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States
| | - Anna V Wilkinson
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States
| | - Melissa B Harrell
- University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, United States
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26
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Sreeramareddy CT, Acharya K, Manoharan A, Oo PS. Changes in E-cigarette Use, Cigarette Smoking, and Dual-Use Among the Youth (13-15 Years) in 10 Countries (2013-2019)-Analyses of Global Youth Tobacco Surveys. Nicotine Tob Res 2024; 26:142-150. [PMID: 37466212 DOI: 10.1093/ntr/ntad124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/05/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION The increasing use of e-cigarettes among the youth is a public health problem that needs surveillance. We report changes in e-cigarette use, cigarette smoking, and "dual use" among youth in 10 countries. AIMS AND METHODS Global Youth Tobacco Survey (GYTS)s from Georgia, Iraq, Italy, Latvia, Montenegro, Paraguay, Peru, Qatar, Romania, and San Marino were analyzed. Changes in prevalence of "awareness of e-cigarettes," "ever use" (even tried a few puffs) and "current use" (during last 30 days) of e-cigarettes and cigarette smoking, and "dual use" (both e-cigarette and cigarette smoking) between baseline (2013 and 2014) and most recent (2017-2019) surveys were estimated. RESULTS "Awareness of e-cigarettes" and "ever e-cigarette use" significantly increased (p < .001). "Ever e-cigarette use" was highest in Italy, 93% (95% CI 90.9, 94.4). "Current e-cigarette use" significantly (p < .05) increased by > 50% in most countries. During the most recent surveys, "current e-cigarette" use was > 10% in five countries Italy (18.3%) and Latvia (18.5%) being the highest. Cigarette smoking significantly declined in Italy, Latvia, Peru, and San Marino (p < .05) but remains unchanged in other countries. "Dual use" (both electronic and conventional cigarettes) significantly increased in all countries (p < .001). During the most recent surveys "dual use" was highest in Italy (10%, 95% CI 8.1, 12.2) and Latvia (8.6%, 95% CI 7.2, 10.2). Youth aged 14 and ≥15 years the smokers, were more likely to be e-cigarette users. CONCLUSIONS Awareness and use of e-cigarettes and "dual use" among youth have increased. Closer monitoring of tobacco use among youths and comprehensive tobacco control policies inclusive of e-cigarettes are needed. IMPLICATIONS Secondary data analyses of serial GYTSs in 10 countries showed that both awareness of e-cigarette and e-cigarette use has increased among school-going youth aged 13-15 years. A concurrent increase in "dual use" of e-cigarettes and cigarette smoking during the last 30 days in all 10 countries indicates continued cigarette smoking in the absence of e-cigarettes because of the common risk construct of tobacco product use. Results call for continued surveillance of both e-cigarettes and cigarette smoking among school-going youth. Comprehensive tobacco control measures inclusive of e-cigarettes should be implemented to reduce tobacco use among the youth.
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Affiliation(s)
| | | | | | - Phyu Synn Oo
- Department of Pathology, International Medical University, Kuala Lumpur, Malaysia
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Monahan K, Sacco A, Fenn N, Reyes C, Lindsey H, Paiva A, Robbins M. Development of transtheoretical model measures for assessing decisional balance and temptation to vape. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-7. [PMID: 38227915 DOI: 10.1080/07448481.2023.2299412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024]
Abstract
Introduction: Vaping is common among young adults in the United States. The Transtheoretical Model (TTM) has demonstrated success in smoking cessation efforts; however, it has not been comprehensively applied to vaping cessation, and core TTM vaping measures have not been developed. Method: A cross-sectional survey including measures of stage of change (SOC), temptation to vape, and decisional balance (DCBL) was disseminated (n = 459). Items were adapted from TTM smoking scales. The sample was split for exploratory and confirmatory factor analyses (EFA/CFA). Analyses of variance assessed relationships between constructs and SOC. Results: EFA/CFA resulted in one Temptation scale (CFI = .95; α = .87) and two DCBL scales (CFI = .91; Pros α = .72; Cons α = .72). Temptation to vape and Pros of vaping decreased significantly across SOC, while Cons increased significantly. Conclusions: TTM vaping measures for two key TTM constructs were developed utilizing a college sample. Results suggest that the developed measures map well onto the TTM framework.
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Affiliation(s)
- Katie Monahan
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Allegra Sacco
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Natalie Fenn
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Cheyenne Reyes
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Hayley Lindsey
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Andrea Paiva
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Mark Robbins
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
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Hrickova M, Amchova P, Ruda-Kucerova J. The effect of CNQX on self-administration: present in nicotine, absent in methamphetamine model. Front Behav Neurosci 2024; 17:1305412. [PMID: 38249125 PMCID: PMC10796660 DOI: 10.3389/fnbeh.2023.1305412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
Objective Addiction is a chronic disease with limited pharmacological options for intervention. Focusing on reducing glutamate levels in the brain seems to be a promising strategy in addiction treatment research. Our research aimed to evaluate the effects of CNQX, an antagonist that targets AMPA and kainate glutamatergic receptors while also exhibiting affinity for the NMDA receptor, especially by modulating its glycine site. We conducted this assessment on the self-administration of nicotine and methamphetamine via intravenous (IV) administration in rats. Methods An operant IV self-administration model was used in male Wistar rats. When animals maintained a stable intake of nicotine or methamphetamine, we administered a single injection of CNQX (in the dose of 3 or 6 mg/kg IV) to evaluate its effect on drug intake. Subsequently, the rats were forced to abstain by staying in their home cages for 2 weeks. The period of abstinence was followed by a context-induced relapse-like session before which animals were pretreated with the injection of CNQX (3 or 6 mg/kg IV) to evaluate its effect on drug seeking. Results CNQX significantly reduced nicotine intake during the maintenance phase, but no effect was revealed on nicotine seeking after forced abstinence. CNQX did not affect methamphetamine taking or seeking. Conclusion The effect of reducing nicotine taking but not seeking could be explained by different involvement of glutamatergic receptors in various stages of nicotine dependence.
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Affiliation(s)
| | | | - Jana Ruda-Kucerova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Brno, Czechia
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29
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Nabil AK, Barry AE, Kum HC, Ohsfeldt RL. Actual and perceived E-cigarettes behaviors among a national sample of U.S. college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:109-117. [PMID: 35025725 DOI: 10.1080/07448481.2021.2024209] [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: 03/03/2021] [Revised: 10/21/2021] [Accepted: 12/26/2021] [Indexed: 06/14/2023]
Abstract
Objective: Electronic cigarette use represents an important college health concern. This investigation assessed demographic and behavioral correlates associated with actual and perceived e-cigarette use among a national sample of American college students. Methods: Respondents (n = 19,861) comprised college students from over 40 distinct American higher education institutions. Multivariable logistic regression assessed whether (1) alcohol, tobacco or marijuana use were associated with e-cigarette use; (2) perceived peer use of alcohol, tobacco or marijuana were associated with perceived e-cigarette use. Results: Approximately 5% of survey respondents self-reported using e-cigarettes within the past month. More than 7 out of every 10 respondents, however, thought the 'typical student' was an e-cigarette user. As perceptions of typical student substance use increased, respondents were far more likely to contend the typical student used e-cigarettes. Discussion: In addition to adopting smoke-free campus policies, university officials should disseminate accurate information regarding e-cigarette behaviors of students.
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Affiliation(s)
- Anas Khurshid Nabil
- Department of Health & Kinesiology, Texas A&M University, College Station, Texas, USA
- Department of Health Policy and Management, Texas A&M University, College Station, Texas, USA
| | - Adam E Barry
- Department of Health & Kinesiology, Texas A&M University, College Station, Texas, USA
| | - Hye-Chung Kum
- Department of Health Policy and Management, Texas A&M University, College Station, Texas, USA
| | - Robert L Ohsfeldt
- Department of Health Policy and Management, Texas A&M University, College Station, Texas, USA
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Fan J, Mao T, Zhen S, Xu Y, Qu C. Comparative analysis of e-cigarette prevalence and influencing factors among adolescents in Jiangsu Province, China. Front Public Health 2023; 11:1221334. [PMID: 38106882 PMCID: PMC10722425 DOI: 10.3389/fpubh.2023.1221334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/06/2023] [Indexed: 12/19/2023] Open
Abstract
Objective The objectives of this study were to investigate electronic cigarette (e-cigarette) and cigarette use in Jiangsu Province, China, by analyzing the two-year trends of e-cigarette using and to explore the factors influencing the experimentation and use of e-cigarettes. Methods We conducted a cross-sectional study following the standard methodology of the Global Youth Tobacco Survey in 2019 and 2021. A three-stage cluster sampling design was applied. Eighty-two schools in 14 districts (counties) in Jiangsu Province were surveyed. All computations were performed using the SPSS 21.0 complex samples procedure. Multivariate logistic regression was used to explore the factors influencing e-cigarette experimentation and use. Results A total of 12,410 and 12,880 students were surveyed in 2019 and 2021, respectively. E-cigarette experimentation increased from 9.34% in 2019 to 13.07% in 2021 (P < 0.001). E-cigarette use increased from 2.23% in 2019 to 3.74% in 2021 (P < 0.001). The main factors associated with e-cigarette use were cigarette experimentation (OR = 2.700, P < 0.001); male gender (OR = 1.416, P = 0.011); junior high school students (OR = 1.551, P = 0.005) and vocational high school students (OR = 1.644, P = 0.001); more pocket money per week (OR1 = 1.214, P = 0.187; OR2 = 1.686, P = 0.001); exposure to second-hand smoke (SHS) at home (OR = 1.239, P < 0.001); exposure to e-cigarette advertising (OR = 1.855, P < 0.001); believe SHS is harmful (OR = 0.933, P = 0.026); closest friends smoking (OR = 2.501, P < 0.001); believe smoking makes youth look more attractive (OR1 = 1.469, P = 0.040; OR2 = 1.305, P = 0.049); believe tobacco helps youth feel more comfortable in social situations (OR1 = 2.161, P < 0.001; OR2 = 1.635, P = 0.001); will use an e-cigarette product if offered by best friends (OR = 1.322, P < 0.001); intend to use an e-cigarette product in the next 12 months (OR = 1.486, P < 0.001). Conclusion E-cigarette use among adolescents has been on the rise in recent years. E-cigarette use is associated with past cigarette use and a strong desire to smoke. It is crucial to take health education and tobacco control efforts to reduce adolescents' e-cigarette use rate.
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Affiliation(s)
- Jiannan Fan
- Institute of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, China
| | - Tao Mao
- Institute of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Shiqi Zhen
- Institute of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Yan Xu
- Institute of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Chen Qu
- Institute of Health Education, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
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Deery C. What are the health impacts of nicotine and tobacco products on young people? Evid Based Dent 2023; 24:159-160. [PMID: 37857806 PMCID: PMC10724058 DOI: 10.1038/s41432-023-00945-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/21/2023]
Abstract
DESIGN Narrative review. REVIEW QUESTION What are the implications of new nicotine and tobacco products on adolescent health? PRODUCTS E-cigarettes and oral nicotine products such as pouches, lozenges, tablets, gum, and gummies. RESULTS These products can be addictive and can cause respiratory, cardiovascular and oral potential health problems. They also have effects on brain development. Products are attractive to adolescents, with more than 1:10 American adolescents uses them. CONCLUSIONS The use of nicotine and tobacco products by adolescents puts their health at risk and may, in some instances, lead to nicotine addiction. Those providing healthcare for adolescents have an opportunity to provide advice and signpost people to resources to help them stop using such products. There is also a need for legislation to restrict the sale of e-cigarettes and tobacco products.
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Affiliation(s)
- Chris Deery
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
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32
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DiCasmirro J, Tranmer J, Davison C, Woo K, Ross-White A, Hubeny M, Goldie C. Public health interventions to prevent adolescent vaping: a scoping review protocol. JBI Evid Synth 2023; 21:2272-2278. [PMID: 37529974 DOI: 10.11124/jbies-23-00055] [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: 08/03/2023]
Abstract
OBJECTIVE The objective of the review is to systematically examine the emerging literature related to public health interventions aimed at preventing adolescent vaping. INTRODUCTION The prevalence of vaping among adolescents is a rising concern worldwide. A thorough investigation of existing public health interventions to prevent vaping among adolescents is imperative to reduce serious and avoidable vaping-related health risks for this cohort. Many vaping-prevention interventions have been described in the literature, but their key components and outcomes have not been summarized. INCLUSION CRITERIA All English literature related to public health interventions preventing adolescent (aged 10 to 18 years) vaping from all countries will be included. METHODS This review will follow the JBI methodology for scoping reviews. A comprehensive search of academic and gray literature using MEDLINE (Ovid), CINAHL (EBSCOhost), Embase (Ovid), PubMed, PsycINFO (Ovid), ProQuest (Health and Medicine and Sociology Collections), and Web of Science Core Collection will be performed. Articles will be screened for inclusion by 2 independent reviewers. Results will be extracted using customized tools and summarized in a final report using narrative synthesis and presented in table format.
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Affiliation(s)
- Jamie DiCasmirro
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
- School of Nursing, Faculty of Health and Behavioural Sciences, Lakehead University, Thunder Bay, ON, Canada
| | - Joan Tranmer
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
- ICES, Queen's University, Kingston, ON, Canada
| | - Colleen Davison
- Department of Public Health Science, School of Medicine, Queen's University, Kingston, ON, Canada
- Department of Global Development Studies, School of Medicine, Queen's University, Kingston, ON, Canada
| | - Kevin Woo
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
| | - Amanda Ross-White
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
- Bracken Heath Sciences Library, Queen's University, Kingston, ON, Canada
| | - Michael Hubeny
- School of Nursing, Faculty of Health and Behavioural Sciences, Lakehead University, Thunder Bay, ON, Canada
| | - Catherine Goldie
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence, Kingston, ON, Canada
- ICES, Queen's University, Kingston, ON, Canada
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Khorrami A, Khorrami MA, Gheriani H. Vaping-induced acute epiglottitis: a case report. Int J Emerg Med 2023; 16:56. [PMID: 37670242 PMCID: PMC10481551 DOI: 10.1186/s12245-023-00532-x] [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: 11/24/2022] [Accepted: 08/20/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND E-cigarette use, or vaping, is an alternative nicotine delivery system that is becoming increasingly prevalent in adolescents and young adults. There is currently a lack of comprehensive research on the adverse effects of vaping on the upper airway. Acute epiglottitis is a potentially life-threatening condition that can lead to airway obstruction. It is commonly caused by bacterial infections such as streptococci, staphylococcus, and Moraxella. Adult patients with acute epiglottitis mainly present with odynophagia, dysphagia, and respiratory difficulties. The diagnosis of epiglottitis is made by direct laryngoscopy, and the mainstay of treatment is antibiotics. Bozella et al. (2020) reported a case of subacute non-infectious epiglottitis associated with e-cigarette use in a pediatric patient (Pediatrics 145(3), 2020). Here we present a case of acute epiglottitis in a healthy young adult after vaping, with a negative infectious workup. To our knowledge, there has been no such reported case of epiglottitis associated with e-cigarette use in an adult patient. CASE DESCRIPTION A previously healthy 29-year-old male with daily e-cigarette use presented to the emergency department with a severe sore throat, dysphagia, mild hoarseness, and shortness of breath, especially when lying supine. A lateral neck soft tissue radiograph revealed a thickened epiglottis with a thumb sign. Direct bedside laryngoscopy showed a swollen epiglottis, partially obstructing the supraglottic region confirming the diagnosis of acute epiglottitis. Throat and nasal swabs were negative for streptococcus and COVID-19 infection, respectively. The patient's condition improved significantly after receiving intravenous Dexamethasone and antibiotics for 2 days. Repeat laryngoscopy showed the resolution of epiglottis swelling, and subjective symptoms had resolved entirely 2 weeks following the start of the treatment. CONCLUSIONS Although bacterial infections usually cause acute epiglottitis, this case presents the second report of this condition associated with vaping with negative microbiological investigations. Therefore, we recommend that physicians consider non-infectious causes such as vaping in their differential diagnosis for patients with acute and subacute epiglottitis. More research is warranted on the utility of antibiotics in treating vaping-induced epiglottitis.
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Affiliation(s)
- Amir Khorrami
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | | | - Heitham Gheriani
- Department of Surgery Division of Otolaryngology, University of British Columbia, Vancouver, BC, Canada
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Smith MJ, Hilton S. Youth's exposure to and engagement with e-cigarette marketing on social media: a UK focus group study. BMJ Open 2023; 13:e071270. [PMID: 37612101 PMCID: PMC10450076 DOI: 10.1136/bmjopen-2022-071270] [Citation(s) in RCA: 2] [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: 12/20/2022] [Accepted: 06/21/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVE Electronic-cigarettes (e-cigarette) are promoted creatively through social media and considering the potential influence of social media marketing on young people, we explored young people's exposure to and engagement with social media marketing of e-cigarettes. DESIGN Semistructured discussion groups. SUBJECTS Twenty focus groups with 82 young people aged 11-16 living in the Central belt of Scotland. METHODS Youths were asked about smoking and vaping behaviours, social media use, vaping advertisement exposure and were shown illustrative examples of social media content (eg, images and videos) about different messages, presentations and contextual features. Transcripts were imported into NVivo V.12, coded thematically and analysed. RESULTS Youths highlighted a variety of tactics e-cigarette companies use, including influencer or celebrity endorsement, attractive youth flavours, bright colours and emotional appeal to advertise and promote their products directly to young people. Social media influencers who advertise e-cigarettes were described as portraying e-cigarettes as 'cool' and 'fashionable' to entice viewers to try the products. Youths considered that there is a need for more restrictions on social media content to protect youths while also still allowing smokers to purchase them as a cessation device. CONCLUSIONS Our study highlights that the e-cigarette industry is using previously employed tactics similar to the tobacco industry to advertise and promote its products on social media. These findings suggest the growing need for governments to work together to develop and implement policies to restrict the advertising and marketing of e-cigarettes on social media.
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Affiliation(s)
- Marissa J Smith
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Shona Hilton
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Rose JJ, Krishnan-Sarin S, Exil VJ, Hamburg NM, Fetterman JL, Ichinose F, Perez-Pinzon MA, Rezk-Hanna M, Williamson E. Cardiopulmonary Impact of Electronic Cigarettes and Vaping Products: A Scientific Statement From the American Heart Association. Circulation 2023; 148:703-728. [PMID: 37458106 DOI: 10.1161/cir.0000000000001160] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Vaping and electronic cigarette (e-cigarette) use have grown exponentially in the past decade, particularly among youth and young adults. Cigarette smoking is a risk factor for both cardiovascular and pulmonary disease. Because of their more limited ingredients and the absence of combustion, e-cigarettes and vaping products are often touted as safer alternative and potential tobacco-cessation products. The outbreak of e-cigarette or vaping product use-associated lung injury in the United States in 2019, which led to >2800 hospitalizations, highlighted the risks of e-cigarettes and vaping products. Currently, all e-cigarettes are regulated as tobacco products and thus do not undergo the premarket animal and human safety studies required of a drug product or medical device. Because youth prevalence of e-cigarette and vaping product use was as high as 27.5% in high school students in 2019 in the United States, it is critical to assess the short-term and long-term health effects of these products, as well as the development of interventional and public health efforts to reduce youth use. The objectives of this scientific statement are (1) to describe and discuss e-cigarettes and vaping products use patterns among youth and adults; (2) to identify harmful and potentially harmful constituents in vaping aerosols; (3) to critically assess the molecular, animal, and clinical evidence on the acute and chronic cardiovascular and pulmonary risks of e-cigarette and vaping products use; (4) to describe the current evidence of e-cigarettes and vaping products as potential tobacco-cessation products; and (5) to summarize current public health and regulatory efforts of e-cigarettes and vaping products. It is timely, therefore, to review the short-term and especially the long-term implications of e-cigarettes and vaping products on cardiopulmonary health. Early molecular and clinical evidence suggests various acute physiological effects from electronic nicotine delivery systems, particularly those containing nicotine. Additional clinical and animal-exposure model research is critically needed as the use of these products continues to grow.
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Kramer RD, Park-Lee E, Marynak KL, Jones JT, Sawdey MD, Cullen KA. Nicotine Pouch Awareness and Use Among Youth, National Youth Tobacco Survey, 2021. Nicotine Tob Res 2023; 25:1610-1613. [PMID: 37279928 PMCID: PMC10961705 DOI: 10.1093/ntr/ntad080] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 05/09/2023] [Accepted: 05/17/2023] [Indexed: 06/08/2023]
Abstract
INTRODUCTION This manuscript examines prevalence of awareness and use of nicotine pouches among U.S. middle and high school students by sociodemographic characteristics and other tobacco product use and characterizes nicotine pouch and other tobacco product use behaviors among current nicotine pouch users. AIMS AND METHODS Data are from the 2021 National Tobacco Youth Survey, a cross-sectional, school-based survey of middle and high school students (N = 20 413; overall response rate: 44.6%), which included questions on nicotine pouches in 2021 for the first time. Prevalence estimates, 95% confidence intervals, and estimated population counts were assessed for nicotine pouch awareness, ever use, and current (past 30 days) use, and for use behaviors related to nicotine pouches (frequency of use, flavor(s) used) and other tobacco products (ever, current, frequency of use) among current nicotine pouch users. RESULTS Over one-third of students (35.5%) had ever heard of nicotine pouches. An estimated 1.9% (490 000) reported ever using them, while 0.8% (200 000) reported current use. Among current nicotine pouch users, 61.6% reported flavored nicotine pouch use, 64.2% reported current e-cigarette use, and 52.6% used multiple (≥2) tobacco products. Current use of nicotine pouches was common among current smokeless tobacco users (41.3%). CONCLUSIONS Overall, in 2021, while relatively few students had ever tried nicotine pouches or currently used them, more than one-third had heard of them. Current nicotine pouch users tended to use other tobacco products, particularly e-cigarettes and smokeless tobacco. Given previous rapid increases in youth uptake of e-cigarettes, it is important to continue monitoring nicotine pouch use among young people. IMPLICATIONS This study's findings provide an important baseline for future monitoring of nicotine pouch awareness and use among middle and high school students. Emerging tobacco products, particularly those that are flavored, widely available, discreet, and inexpensive have the potential to attract youth. Given the potential of these products to appeal to young people, ongoing monitoring of nicotine pouch use behaviors is important to inform public health and regulatory efforts.
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Affiliation(s)
- Renee D. Kramer
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Eunice Park-Lee
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Kristy L. Marynak
- Office on Smoking and Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jamal T. Jones
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Michael D. Sawdey
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
| | - Karen A. Cullen
- Division of Population Health Science, Office of Science, Center for Tobacco Products, U.S. Food and Drug Administration, Silver Spring, MD, USA
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Heinly A, Walley S. The nicotine and tobacco epidemic among adolescents: new products are addicting our youth. Curr Opin Pediatr 2023; 35:513-521. [PMID: 37335268 DOI: 10.1097/mop.0000000000001271] [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: 06/21/2023]
Abstract
PURPOSE OF REVIEW New nicotine and tobacco products such as electronic cigarettes and oral nicotine products have increased in use and threaten to addict a new generation of youth. This review summarizes current literature on nicotine and tobacco products used by youth, epidemiology, health effects, prevention and treatment of nicotine dependence, and current policies and regulations. RECENT FINDINGS Electronic cigarettes and oral nicotine products are popular among youth, attracting adolescents through exposure to deceptive marketing and fruit, candy and dessert flavors. Electronic cigarettes and oral nicotine product use can lead to nicotine addiction and is associated with respiratory, cardiovascular, and oral health problems, although long-term health effects are not fully known. The Food and Drug Administration (FDA) has authority to regulate nicotine and tobacco products; however, thousands of unregulated and unauthorized products remain on the market. SUMMARY Millions of adolescents continue to use nicotine and tobacco products, which puts them at risk for health problems, including nicotine addiction. Pediatric providers can provide prevention messages, screen youth for tobacco and nicotine use, and offer appropriate treatment options. Regulation of tobacco and nicotine products by the FDA is critical to reverse this public health epidemic of youth nicotine and tobacco use.
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Affiliation(s)
- Allison Heinly
- Hasbro Children's Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Susan Walley
- Children's National Hospital and George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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Crosbie E, Severini G, Beem A, Tran B, Sebrie EM. New tobacco and nicotine products in Latin America and the Caribbean: assessing the market and regulatory environment. Tob Control 2023; 32:458-466. [PMID: 34916305 DOI: 10.1136/tobaccocontrol-2021-056959] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/04/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To document the regulatory environment of new tobacco and nicotine products (NTNPs), including electronic nicotine delivery systems (ENDS) and heated tobacco products (HTPs), in Latin America and the Caribbean (LAC). METHODS Review of market research reports and databases, regulatory websites, Campaign for Tobacco-Free Kids, relevant published literature and the 2021 WHO Report on the Global Tobacco Epidemic. RESULTS ENDS entered the LAC market in the 2010s and are now available in most LAC countries. A majority of LAC countries (n=18) have either banned the commercialisation of ENDS (n=7) or regulated ENDS as tobacco products (n=7), medicinal products (n=1) or consumer products (n=3). The remaining LAC countries (n=15) do not regulate ENDS. HTPs were first introduced in 2017 and have been officially launched in five countries (Colombia, Guatemala, Dominican Republic, Mexico and Costa Rica). Few countries have banned HTP commercialisation (n=3) or regulated commercialisation and use (n=7), while the majority of countries have existing legislation that applies to HTPs (n=19). A few countries (n=4) have no tobacco control legislation and therefore do not regulate HTPs. CONCLUSION NTNPs are emerging products in the LAC region. Governments should follow WHO guidance and the decisions of the Conference of Parties to the WHO Framework Convention on Tobacco Control and ban or regulate NTNPs as tobacco products; otherwise NTNPs could create a new generation of tobacco and nicotine users.
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Affiliation(s)
- Eric Crosbie
- School of Public Health, University of Nevada, Reno, Reno, NV, USA
| | | | | | - Brian Tran
- School of Public Health, University of Nevada, Reno, Reno, NV, USA
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Han B, Shi Y. Associations of recreational cannabis dispensaries' availability, storefront signage and health benefit signs with cannabis use: findings from a representative adult sample in California, United States. Addiction 2023; 118:1270-1279. [PMID: 36680550 PMCID: PMC10272035 DOI: 10.1111/add.16132] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/02/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIMS There are concerns that availability of recreational cannabis dispensaries (RCDs) and point-of-sale marketing may lead to increased cannabis use in jurisdictions where cannabis retail sale is legal. This paper examined whether the availability RCDs and the presence of storefront signage indicative of cannabis and signs promoting health benefits in RCDs were associated with cannabis use and risk perceptions. DESIGN Cross-sectional, secondary data analysis. SETTING California, USA. PARTICIPANTS A representative sample of 3385 adults in California who participated in the 2020 probability-based Marijuana Use and Environment Survey. MEASUREMENTS Binary outcomes included past-month overall cannabis use, perceiving cannabis smoking as harmful and past-month cannabis use by purpose (medical only, recreational only and dual). The objectively assessed predictors included proximity and density of RCDs and presence of storefront signage indicative of cannabis and signs promoting health benefits in RCDs. FINDINGS In terms of proximity, thepresence of storefront signage in the nearest RCD was associated with smaller odds of perceiving cannabis smoking as harmful [odds ratio (OR) = 0.63, 95% confidence interval (CI) = 0.39, 0.99] if the RCD was located within 2 miles of home. Presence of health benefit signs in the nearest RCD was associated with greater odds of overall cannabis use (OR = 2.45, 95% CI = 1.17, 5.16) and recreational use (OR = 3.50, 95% CI = 1.027, 11.91) if the RCD was located within 2-4 miles of home. In terms of density, count of RCDs, count of RCDs with storefront signage and count of RCDs with health benefit signs within 2 miles of home were each separately associated with greater odds of overall cannabis use and cannabis use for dual purposes. CONCLUSIONS The availability of recreational cannabis dispensaries within 2 miles of one's home and the presence of storefront signage indicating the availability of cannabis and signs promoting health benefits of cannabis appear to be associated with increased cannabis use and reduced risk perceptions among adults in California, USA.
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Affiliation(s)
- Bing Han
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Yuyan Shi
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
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Gribben V, Chang AY, Ling P, Rasmussen J, Tebb K, Fuentes-Afflick E, Marbin J. Impact of a Multidisciplinary Curriculum Training Students and Residents in Tobacco Cessation Strategies for Adult Caregivers of Children. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2023; 19:11313. [PMID: 37228253 PMCID: PMC10203095 DOI: 10.15766/mep_2374-8265.11313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/25/2023] [Indexed: 05/27/2023]
Abstract
Introduction Children's exposure to secondhand smoke is an underaddressed public health threat. The Clinical Effort Against Secondhand Smoke Exposure (CEASE) is a validated framework that trains pediatric providers to screen, counsel, refer to quitlines, and prescribe tobacco cessation medications to adult caregivers of children. Methods A physician champion at a major urban academic center delivered a longitudinal didactic curriculum of CEASE principles to medical and nurse practitioner students and pediatrics and family medicine residents. At the end of each session, participants completed an anonymous survey measuring changes in self-perceived knowledge, comfort, and familiarity with smoking cessation skills and concepts. Using a separate end-of-year questionnaire, we also surveyed a group of pediatric residents to compare the impact of CEASE training on clinical practice. Finally, we tracked the number of referrals to the state's quitline for the duration of the training. Results Fifty-two trainees (55% students, 45% residents) responded to the evaluation survey administered immediately following training. There were statistically significant improvements in median scores after CEASE training for comfort in screening, counseling, motivational interviewing, referring to smokers' helplines, and providing caregivers with nicotine replacement therapy (NRT) prescriptions. Fifty-one percent of pediatric residents (41 of 80) responded to the end-of-year survey, which showed statistically significant differences in the number of patients/caregivers offered a referral to California's quitline and prescription of NRT according to completion of CEASE training. Discussion CEASE training successfully improved the self-efficacy of health professions students and residents in smoking cessation techniques for adult caregivers of children.
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Affiliation(s)
- Valerie Gribben
- Assistant Professor, Department of Pediatrics, University of California, San Francisco, School of Medicine
| | - Andrew Y. Chang
- Clinical Instructor, Department of Medicine, Stanford University Medical Center; Postdoctoral Research Fellow, Stanford Cardiovascular Institute, Stanford University
| | - Pamela Ling
- Director, Center for Tobacco Control Research and Education, University of California, San Francisco; Professor, Department of Medicine, University of California, San Francisco, School of Medicine
| | - Jennifer Rasmussen
- Quality Improvement Analyst, Department of Pediatrics, University of California, San Francisco, School of Medicine
| | - Kathleen Tebb
- Professor, Department of Pediatrics, University of California, San Francisco, School of Medicine
| | - Elena Fuentes-Afflick
- Professor, Department of Pediatrics, University of California, San Francisco, School of Medicine; Vice Dean, University of California, San Francisco, School of Medicine at Zuckerberg San Francisco General Hospital and Trauma Center
| | - Jyothi Marbin
- Professor, Department of Pediatrics, University of California, San Francisco, School of Medicine; Director, UC Berkeley-UCSF Joint Medical Program
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Tweet MS, Wilson M, Rosario JM, Duong M. Acute Pediatric Liquid Nicotine Ingestions. Pediatr Ann 2023; 52:e187-e191. [PMID: 37159065 DOI: 10.3928/19382359-20230307-09] [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: 05/10/2023]
Abstract
Electronic cigarette and vaping device use in the household represents a possible source of unintentional nicotine exposure to pediatric patients. Although most ingestions of nicotine may be mild, there is a potential for significant toxicity. Nicotine toxicity can present similarly to many other types of ingestions, which makes the history an important piece of the encounter. Treatment of nicotine toxicity is primarily supportive care directed at the presenting signs and symptoms. There is no antidotal therapy for nicotine toxicity. This review covers information that can assist clinicians who might treat a pediatric patient presenting with significant nicotine toxicity after the accidental ingestion of liquid nicotine products. [Pediatr Ann. 2023;52(5):e187-e191.].
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Day NJ, Wang J, Johnston CJ, Kim SY, Olson HM, House EL, Attah IK, Clair GC, Qian WJ, McGraw MD. Rat bronchoalveolar lavage proteome changes following e-cigarette aerosol exposures. Am J Physiol Lung Cell Mol Physiol 2023; 324:L571-L583. [PMID: 36881561 PMCID: PMC10085554 DOI: 10.1152/ajplung.00016.2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/21/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
E-cigarette liquids are complex mixtures of chemicals consisting of humectants, such as propylene glycol (PG) and vegetable glycerin (VG), with nicotine or flavorings added. Published literature emphasizes the toxicity of e-cigarette aerosols with flavorings whereas much less attention has been given to the biologic effects of humectants. The purpose of the current study was to provide a comprehensive view of the acute biologic effects of e-cigarette aerosols on rat bronchoalveolar lavage (BAL) using mass spectrometry-based global proteomics. Sprague-Dawley rats were exposed to e-cigarette aerosol for 3 h/day for three consecutive days. Groups included: PG/VG alone, PG/VG + 2.5% nicotine (N), or PG/VG + N + 3.3% vanillin (V). Right lung lobes were lavaged for BAL and supernatants prepared for proteomics. Extracellular BAL S100A9 concentrations and BAL cell staining for citrullinated histone H3 (citH3) were also performed. From global proteomics, ∼2,100 proteins were identified from rat BAL. The greatest change in number of BAL proteins occurred with PG/VG exposures alone compared with controls with biological pathways enriched for acute phase responses, extracellular trap formation, and coagulation. Extracellular BAL S100A9 concentrations and the number of citH3 + BAL cells also increased significantly in PG/VG and PG/VG + 2.5% N. In contrast to PG/VG or PG/VG + N, the addition of vanillin to PG/VG + N increased BAL neutrophilia and downregulated lipid transport proteins. In summary, global proteomics support e-cigarette aerosol exposures to PG/VG alone as having a significant biologic effect on the lung independent of nicotine or flavoring with increased markers of extracellular trap formation.
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Affiliation(s)
- Nicholas J Day
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington, United States
| | - Juan Wang
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington, United States
| | - Carl J Johnston
- Division of Pulmonology, Department of Pediatric Pulmonology, University of Rochester Medical Center, Rochester, New York, United States
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States
| | - So-Young Kim
- Division of Pulmonology, Department of Pediatric Pulmonology, University of Rochester Medical Center, Rochester, New York, United States
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States
| | - Heather M Olson
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington, United States
| | - Emma L House
- Division of Pulmonology, Department of Pediatric Pulmonology, University of Rochester Medical Center, Rochester, New York, United States
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States
| | - Isaac Kwame Attah
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington, United States
| | - Geremy C Clair
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington, United States
| | - Wei-Jun Qian
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, Washington, United States
| | - Matthew D McGraw
- Division of Pulmonology, Department of Pediatric Pulmonology, University of Rochester Medical Center, Rochester, New York, United States
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, New York, United States
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Mamudu HM, Adzrago D, Dada O, Odame EA, Ahuja M, Awasthi M, Weierbach FM, Williams F, Stewart DW, Paul TK. Examining Disparities in Current E-Cigarette Use among U.S. Adults before and after the WHO Declaration of the COVID-19 Pandemic in March 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095649. [PMID: 37174168 PMCID: PMC10177985 DOI: 10.3390/ijerph20095649] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/14/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023]
Abstract
This paper aims to estimate the prevalence of e-cigarette use before and after the COVID-19 pandemic declaration and to delineate disparities in use across subpopulations. Data were derived from the 2020 Health Information National Trends Survey (N = 3865) to conduct weighted multivariable logistic regression and marginal analyses. The overall prevalence of current e-cigarette use increased from 4.79% to 8.63% after the COVID-19 pandemic declaration. Furthermore, non-Hispanic Black people and Hispanic people had lower odds of current e-cigarette use than non-Hispanic White people, but no significant differences were observed between groups before the pandemic. Compared to heterosexual participants, sexual minority (SM) participants had higher odds of current e-cigarette use after the declaration, with insignificant differences before. People who had cardiovascular disease conditions, relative to those without, had higher odds of current e-cigarette use after the declaration, but no group differences were found before the declaration. The marginal analyses showed that before and after the pandemic declaration, SM individuals had a significantly higher probability of using e-cigarettes compared to heterosexual individuals. These findings suggest the importance of adopting a subpopulation approach to understand and develop initiatives to address substance use, such as e-cigarettes, during pandemics and other public health emergencies.
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Affiliation(s)
- Hadii M Mamudu
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - David Adzrago
- Center for Health Promotion and Prevention Research and School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Oluwabunmi Dada
- Department of Occupational Safety and Health, Murray State University, 157 Industry and Technology Center, Murray, KY 42071, USA
| | - Emmanuel A Odame
- Department of Environmental Health Sciences, Ryals Public Health Building (RPHB), University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35233, USA
| | - Manik Ahuja
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Manul Awasthi
- College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
| | - Florence M Weierbach
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- College of Nursing, East Tennessee State University, Johnson City, TN 37614, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD 20892, USA
| | - David W Stewart
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City, TN 37614, USA
| | - Timir K Paul
- Center for Cardiovascular Risk Research, College of Public Health, East Tennessee State University, Johnson City, TN 37614, USA
- Division of Medicine, University of Tennessee at Nashville/Ascension Saint Thomas Hospital, Nashville, TN 37205, USA
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Astudillo C, García-Perdomo HA. Electronic cigarette: is it a risk factor for the development of bladder cancer? Actas Urol Esp 2023:S2173-5786(23)00047-1. [PMID: 37086845 DOI: 10.1016/j.acuroe.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 04/24/2023]
Affiliation(s)
- C Astudillo
- Grupo de Investigación UROGIV, Escuela de Medicina. Universidad del Valle, Cali, Colombia
| | - H A García-Perdomo
- Unidad de Urología/Urooncología, Departamento de Cirugía. Escuela de Medicina, Universidad del Valle, Cali, Colombia.
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Hsiao YC, Matulewicz RS, Sherman SE, Jaspers I, Weitzman ML, Gordon T, Liu CW, Yang Y, Lu K, Bjurlin MA. Untargeted Metabolomics to Characterize the Urinary Chemical Landscape of E-Cigarette Users. Chem Res Toxicol 2023; 36:630-642. [PMID: 36912507 PMCID: PMC10371198 DOI: 10.1021/acs.chemrestox.2c00346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
The health and safety of using e-cigarette products (vaping) have been challenging to assess and further regulate due to their complexity. Inhaled e-cigarette aerosols contain chemicals with under-recognized toxicological profiles, which could influence endogenous processes once inhaled. We urgently need more understanding on the metabolic effects of e-cigarette exposure and how they compare to combustible cigarettes. To date, the metabolic landscape of inhaled e-cigarette aerosols, including chemicals originated from vaping and perturbed endogenous metabolites in vapers, is poorly characterized. To better understand the metabolic landscape and potential health consequences of vaping, we applied liquid chromatography-mass spectrometry (LC-MS) based nontargeted metabolomics to analyze compounds in the urine of vapers, cigarette smokers, and nonusers. Urine from vapers (n = 34), smokers (n = 38), and nonusers (n = 45) was collected for verified LC-HRMS nontargeted chemical analysis. The altered features (839, 396, and 426 when compared smoker and control, vaper and control, and smoker and vaper, respectively) among exposure groups were deciphered for their structural identities, chemical similarities, and biochemical relationships. Chemicals originating from e-cigarettes and altered endogenous metabolites were characterized. There were similar levels of nicotine biomarkers of exposure among vapers and smokers. Vapers had higher urinary levels of diethyl phthalate and flavoring agents (e.g., delta-decalactone). The metabolic profiles featured clusters of acylcarnitines and fatty acid derivatives. More consistent trends of elevated acylcarnitines and acylglycines in vapers were observed, which may suggest higher lipid peroxidation. Our approach in monitoring shifts of the urinary chemical landscape captured distinctive alterations resulting from vaping. Our results suggest similar nicotine metabolites in vapers and cigarette smokers. Acylcarnitines are biomarkers of inflammatory status and fatty acid oxidation, which were dysregulated in vapers. With higher lipid peroxidation, radical-forming flavoring, and higher level of specific nitrosamine, we observed a trend of elevated cancer-related biomarkers in vapers as well. Together, these data present a comprehensive profiling of urinary biochemicals that were dysregulated due to vaping.
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Affiliation(s)
- Yun-Chung Hsiao
- Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC 27599
| | - Richard S. Matulewicz
- Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Scott E. Sherman
- Section on Tobacco, Alcohol and Drug Use, Department of Population Health, NYU School of Medicine, New York, NY 07920
| | - Ilona Jaspers
- Curriculum in Toxicology & Environmental Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC 27599
- Center for Environmental Medicine, Asthma and Lung Biology, School of Medicine, University of North Carolina, Chapel Hill, NC 27599
- Department of Pediatrics, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Michael L. Weitzman
- Department of Pediatrics, New York University School of Medicine, New York, NY 10016
| | - Terry Gordon
- Department of Environmental Medicine, New York University School of Medicine, New York, NY 10016
| | - Chih-Wei Liu
- Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC 27599
| | - Yifei Yang
- Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC 27599
| | - Kun Lu
- Department of Environmental Sciences and Engineering, University of North Carolina, Chapel Hill, NC 27599
| | - Marc A. Bjurlin
- Department of Urology, University of North Carolina, Chapel Hill, NC 27599
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27599
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Golan R, Muthigi A, Ghomeshi A, White J, Saltzman RG, Diaz P, Ramasamy R. Misconceptions of Vaping Among Young Adults. Cureus 2023; 15:e38202. [PMID: 37252604 PMCID: PMC10224737 DOI: 10.7759/cureus.38202] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Background Vaping is growing in popularity worldwide, especially among young adults. To develop effective tobacco prevention interventions, first, there must be an understanding of the attitudes and perceptions of young adults toward the use of vaping. Highlighting perception discrepancies between races may allow physicians to more effectively counsel their patients regarding the risks of vaping. Methodology We conducted an online survey using Amazon Mechanical Turk (MTurk, https://www.mturk.com/) to identify misconceptions about vaping among adults aged 18 to 24 years who currently vape. The survey consisted of 18 questions evaluating reasons for vaping, history of tobacco use, and thoughts on the adverse effects of vaping. The Penn State Electronic Cigarette Dependence Index was implemented to assess dependence. Exclusion criteria comprised respondents who did not vape and were under the age of 18 or over the age of 24. Results A total of 1,009 responses were received with 66% identifying as male (n = 667) and 33% (n = 332) identifying as female. Sixty-nine percent of patients smoked cigarettes or used another form of tobacco previously (n = 692). Of those respondents, 81% indicated that they had since quit using tobacco products (excluding vaping). Switching to vaping was the most common reason for quitting cigarettes or other forms of tobacco, with health concerns and social purposes being the second and third most common reasons provided, respectively. When asked whether vaping had negative health impacts, only 238 (24%) participants strongly agreed with this statement, while a majority (64%) neither agreed nor disagreed or only somewhat agreed. Most participants were white or Caucasian (n = 777). When asked whether smoking or vaping had more severe health implications, 55% of white or Caucasian participants, 41% of Asian participants, and 32% of black or African American participants indicated that vaping was worse than smoking cigarettes. The average Penn State dependence score was 8.7, suggesting medium dependence. Conclusions Our survey sample of 1,006 young adults who vape indicated that the majority did not perceive vaping as significantly harmful. A comprehensive smoking prevention policy, educational interventions, and quit support are needed to enhance awareness among young adults about the health effects associated with vaping. Such interventions should also consider the novel shift toward the replacement of smoking with vaping.
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Affiliation(s)
- Roei Golan
- College of Medicine, Florida State University, Tallahassee, USA
| | - Akhil Muthigi
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, USA
| | - Armin Ghomeshi
- Herbert Wertheim College of Medicine, Florida International University, Miami, USA
| | - Joshua White
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, USA
| | - Russell G Saltzman
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, USA
| | - Parris Diaz
- David Geffen School of Medicine, University of California, Los Angeles, USA
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, USA
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Merz L, Puhan MA, Serra-Burriel M. A discrete choice experiment on price and flavour effects on the appeal of nicotine products: a pilot study among young adults in Switzerland. Swiss Med Wkly 2023; 154:3733. [PMID: 38579318 DOI: 10.57187/s.3733] [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: 04/07/2024] Open
Abstract
AIMS To explore the effects of prices and flavour availability on the appeal of different tobacco and nicotine products, including conventional cigarettes, Electronic Nicotine Delivery Systems (ENDS) and Heated Tobacco Systems (HTS) among an adult population in Switzerland. METHODS We performed a Discrete Choice Experiment among a group of Swiss aged ≥18 years via the online recruiting platform Prolific in a convenience sample. Our sample included both non-smokers and smokers. We used a within-subject, alternative-specific block design in a series of choice sets including different smoking products. We fixed the attributes of nicotine content (high or medium) and harmfulness (in years of life lost) for each product. Attributes of interest included price (ranging from CHF 5 to 25 in increments of 5) and flavour (fruity/menthol vs none/tobacco flavour). We performed a conditional logistic regression on the attributes' influence on the appeal of cigarettes, ENDS and HTS. RESULTS A total of 108 out of 153 participants (n = 25 smokers and n = 83 non-smokers, completion rate = 71%) successfully completed our pilot survey experiment. We found that, in general, increasing the price of combustible cigarettes, ENDS and HTS by one standard deviation (around CHF 7) reduced their appeal by approximately 66% (relative risk [RR]: 0.34; 95% CI: 0.28-0.42). Unflavoured alternative nicotine products were found to be less appealing than flavoured products, especially for non-smokers, with a 86% decrease in appeal (RR: 0.14; 95% CI: 0.13-0.16). For non-smokers, an increase in price by one standard deviation was associated with a decrease in the appeal of any product by approximately 19% (RR: 0.81; 95% CI: 0.72-0.92). For smokers, the effect sizes were smaller, but overall, the appeal of all products decreased with increasing prices and reduced flavours. CONCLUSIONS Our Discrete Choice Experiment suggests that, for the Swiss context, limiting the availability of flavours for alternative smoking products has the potential to reduce their appeal to non-smokers by 86% and that a small but significant increase in prices to CHF 15 for cigarettes, ENDS and HTS could lead to a major (around 66%) decrease in their appeal.
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Affiliation(s)
- Larissa Merz
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Miquel Serra-Burriel
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
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Schneller LM, Felicione NJ, Hammond D, Goniewicz ML, O'Connor RJ. Tobacco-Free Oral Nicotine Product Use Among Youth in the U.S., 2019-2021. AJPM FOCUS 2023; 2:100061. [PMID: 37789938 PMCID: PMC10546555 DOI: 10.1016/j.focus.2022.100061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Novel tobacco-free oral nicotine products are not combusted, easy to conceal, available in flavors, and do not contain tobacco leaf. Since 2016, oral nicotine product sales have increased and may be gaining popularity among youth. This study aims to examine the trends in the prevalence and correlates of oral nicotine product use among U.S. youth. Methods Data from participants aged 16-19 years in the U.S. International Tobacco Control Policy Evaluation Project Youth Tobacco and Vaping Survey were analyzed cross-sectionally from August 2019, February 2020, August 2020, February 2021, and August 2021. Weighted descriptive statistics and logistic regressions were used to describe the use and correlates of oral nicotine products. Results Oral nicotine product use significantly increased from 3.5% in August 2019 to 4.1% in August 2021. Oral nicotine product use was most prevalent among those aged 18 years, male, and non-Hispanic White. Those who used cigarettes (AOR=2.18, 95% CI=19.37, 40.88), nicotine vaping products (AOR=4.27, 95% CI=3.02, 6.04), and smokeless tobacco (AOR=28.14, 95% CI=19.37, 40.88) in the past 30 days were more likely to report recent use of oral nicotine products. Conclusions Although oral nicotine products are less popular among U.S. youth than cigarettes, nicotine vaping products, and smokeless tobacco, their prevalence of use significantly increased. Oral nicotine product users are more likely to use other nicotine products, but the availability of flavors and easy-to-conceal design may be appealing to those who may not use nicotine products. Researchers should continue to observe the behaviors associated with oral nicotine product use to inform the need for future regulatory efforts.
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Affiliation(s)
- Liane M. Schneller
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Nicholas J. Felicione
- Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, New York
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Maciej L. Goniewicz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Richard J. O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1337] [Impact Index Per Article: 1337.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Gribben V, Kosack A, Garell C, Shaikh U, Huang M, Chang AY, Rasmussen J, Tebb K, Marbin J. Impacts of a Multicenter Medical Education Curriculum for Training Pediatric Residents on Tobacco Cessation for Adult Caregivers of Pediatric Patients. Clin Pediatr (Phila) 2023; 62:115-120. [PMID: 35891607 DOI: 10.1177/00099228221113783] [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] [Indexed: 01/11/2023]
Abstract
The Clinical Effort Against Secondhand Smoke Exposure (CEASE) is an evidence-based framework that increases pediatric providers' ability to address secondhand smoke exposure of minors. Physician champions at 4 University of California sites conducted regular 1-hour didactic trainings on CEASE principles to pediatric residents as part of a longitudinal curriculum. At the conclusion of the academic year, 111 of 284 residents (39%) completed an anonymous survey. CEASE-trained residents reported significantly higher rates than untrained residents of counseling on smoking cessation (adjusted odds ratio [OR] = 4.50, P = .009), and referring to the smokers' quitline (adjusted OR 3.6, P = .007) to 50% or more of their patients' caregivers who smoked. In addition, among CEASE-trained residents, there were significant increases in multiple post-training knowledge and self-efficacy items. Our results show that a brief educational curriculum can be helpful in changing pediatric residents' attitudes and behavior toward assisting adult caregivers to pediatric patients in smoking cessation.
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Affiliation(s)
- Valerie Gribben
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Amanda Kosack
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Cambria Garell
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Ulfat Shaikh
- Department of Pediatrics, University of California, Davis, Sacramento, CA, USA
| | - Maria Huang
- Department of Pediatrics, University of California, San Diego, San Diego, CA, USA
| | - Andrew Y Chang
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
| | - Jennifer Rasmussen
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Kathleen Tebb
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Jyothi Marbin
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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