Chronic health effects associated with electronic cigarette use: A systematic review

[Safety of use of electronic cigarettes: A systematic review of bronchopulmonary, cardiovascular and cancer risks]

As the effects of electronic cigarettes (ECs) have rapidly become widely known, we propose to take stock of recent findings on the bronchopulmonary and cardiovascular adverse effects (AEs) and the risks of cancer occurrence entailed by EC use. METHOD: We carried out a search from 2018 to October 19, 2023 on PubMed, adopting the PRISMA guidelines (2020) with the following keywords in "Titles and abstracts": electronic cigarette, or e-cigarette, or ENDS, AND safety or toxicology or effect or health effect, using "Systematic Review" as a filter. The inclusion criteria were: systematic review of in vitro or in vivo studies in English or French dealing with the risks of ECs for the bronchopulmonary system, the cardiovascular system, or cancer occurrence. CONCLUSION: Twenty-eight systematic reviews on the adverse effects (AE) of electronic cigarettes (EC) in selected humans show that the toxic substances they generate can cause cancers and increase the risk of cardiac and pulmonary disorders. New studies on the potential dangerousness of EC use are essential and urgent.

Electronic Cigarettes and Peri-Implantitis: An Umbrella Review

Electronic cigarettes (e-cigarettes) are offered to consumers as a healthier option than traditional tobacco. However, the long-term effect of non-heat-burning tobacco and e-cigarettes on periodontal and peri-implantitis is unknown. The present review evaluates the impact of electronic cigarettes on peri-implantitis and compares the results with traditional cigarettes and nonsmokers. Systematic/meta-analysis studies were searched in PubMed, MEDLINE, EMBASE, Cochrane Library, and Google Scholar until December 30, 2022. Five systematic/meta-analysis studies were identified based on the search strategy in the selected databases. The overall quality assessment of the studies showed acceptable evidence with high quality. All systematic review studies showed that compared with traditional tobacco smoke, electronic cigarettes might reduce or not change the clinical inflammatory symptoms of periodontitis and peri-implantitis, such as bleeding on probing, probing depth, peri-implant bone loss, and response to treatments. Electronic cigarettes contain nicotine, which can harm periodontal and implant health. On the other hand, a wide range of oral health consequences may be associated with using e-cigarettes. E-cigarette is a potential risk factor for the healing process and the results of implant treatment.

E -cigarettes and kidney health: current knowledge and future perspectives

BACKGROUND

Chronic conventional cigarette smoking has been closely linked to incident chronic kidney disease (CKD) in the general population. It is associated with the acceleration of pre-existing CKD and failure of kidney allograft function. Cessation of conventional cigarette smoking is effective in reducing the increased risk of smoking induced kidney damage.

METHODS

This narrative review summarizes current knowledge and future study perspectives of the impact of e-cigarettes (e-cigs) use on kidney health.

RESULTS

The past decade has seen a dramatic increase in the use of electronic nicotine delivering systems, also called e-cigs. Compared to conventional cigarette smoking, little is known concerning the effects of e-cigs use on kidney health. A few cross-sectional studies suggest an association between vaping and kidney damage (albuminuria, reduction in estimated glomerular filtration rate) in adolescents and young adults. Furthermore, limited animal experiments indicate that e-cigs constituents/aerosols may lead to structural and functional kidney damage. The renal health effects of e-cigs remain largely uncertain and make it difficult to draw definitive conclusions about e-cigs use and kidney health. The relatively new popularity of e-cigs, the wide variability in device design and e-liquid formulations, and the lack of standardized methods to measure daily or life-long e-cigs exposure make it challenging to conduct comprehensive long-term studies.

CONCLUSIONS

Nephrologists should actively address smoking habits in their patients and urge cessation of conventional cigarette smoking as well as e-cigs use to prevent CKD progression and improve overall health.

Prevalence of self-reported severe periodontitis: Data from the population-based CONSTANCES cohort

AIM

To assess the prevalence of severe periodontitis based on the population-based CONSTANCES cohort using a validated self-reported questionnaire.

MATERIALS AND METHODS

Individuals were selected from the adult population in France using a random sampling scheme. Analyses were restricted to those invited in 2013-2014 who completed the periodontal health questionnaire at the 2017 follow-up. The risk of severe periodontitis was assessed using the periodontal screening score (PESS) and weighting coefficients were applied to provide representative results in the general French population.

RESULTS

The study included 19,859 participants (9204 men, mean age: 52.8 ± 12.6 years). Based on a PESS ≥ 5, 7106 participants were at risk of severe periodontitis, corresponding to a weighted prevalence of 31.6% (95% confidence interval: 30.6%-32.7%). This prevalence was higher among participants aged 55 and over, those with lower socio-economic status as well as current smokers, e-cigarette users and heavy drinkers. Among individuals at risk of severe periodontitis, only 18.8% (17.3%-20.4%) thought they had gum disease, although 50.5% (48.6%-52.5%) reported that their last dental visit was less than 6 months.

CONCLUSIONS

The present survey indicates that (1) self-reported severe periodontitis is highly prevalent with marked disparities between groups in the general French adult population, and (2) periodontitis could frequently be under-diagnosed given the low awareness.

Investigation of the in vitro toxic effects induced by real-time aerosol of electronic cigarette solvents using microfluidic chips

The safety of propylene glycol (PG) and vegetable glycerin (VG) as solvents in electronic cigarette liquid has received increasing attention and discussion. However, the conclusions derived from toxicity assessments conducted through animal experiments and traditional in vitro methodologies have consistently been contentious. This study constructed an original real-time aerosol exposure system, centered around a self-designed microfluidic bionic-lung chip, to assess the biological effects following exposure to aerosols from different solvents (PG, PG/VG mixture alone and PG/VG mixture in combination with nicotine) on BEAS-2B cells. The study aimed to investigate the impact of aerosols from different solvents on gene expression profiles, intracellular biomarkers (i.e., reactive oxygen species content, nitric oxide content, and caspase-3/7 activity), and extracellular biomarkers (i.e., IL-6, IL-8, TNF-α, and malondialdehyde) of BEAS-2B cells on-chip. Transcriptome analyses suggest that ribosomal function could serve as a potential target for the impact of aerosols derived from various solvents on the biological responses of BEAS-2B cells on-chip. And the results showed that aerosols of PG/VG mixtures had significantly less effect on intracellular and extracellular biomarkers in BEAS-2B cells than aerosols of PG, whereas increasing nicotine levels might elevate these effects of aerosol from PG/VG mixture.

Dental Hygienists Knowledge, Beliefs, and Intentions Regarding Asking Adolescents About Electronic Nicotine Delivery Systems Use

PURPOSE

The purpose was to assess clinical dental hygienists' knowledge, beliefs, and intentions regarding asking adolescents about electronic nicotine delivery systems (ENDS) use.

METHODS

Cross-sectional survey research was conducted with a convenience sample of dental hygienists using a validated instrument developed based on the theory of planned behavior (TPB) that contained the following sections: demographics, knowledge, behavioral belief (BB), normative beliefs, control beliefs, and behavioral intention. Outcomes were analyzed using descriptive statistics, correlations, and multivariate regression analysis.

RESULTS

Of the 360 participants who opened the survey, 257 completed it for a completion rate of 71.4%. The knowledge score mean was 72%. BBs suggested that a majority (83%) of participants were likely to ask adolescent patient about ENDS use, however, normative beliefs showed that only about half had the support of their dentist/supervisor, and one-third (33%) felt they had sufficient tobacco/nicotine use and dependency guideline resources. This resulted in only half having the behavioral intention to ask adolescents about ENDS use. Demographic variables were not significantly correlated with the TPB subscales or intention. In the regression model all three TPB subscales predicted intention (F3, 251) = 46.1; p < .001). The coefficient of determination (R2 = 0.35) suggested 35% of the variation in the intention to ask about ENDS use can be explained by the model.

DISCUSSION

Most participants had favorable BBs toward asking about ENDS use among adolescents. However, adequate support from dentists/supervisors and training on guidelines for prevention and cessation of ENDS is needed to encourage dental hygienists to ask adolescents about ENDS use.

Latin America and the Caribbean Code Against Cancer 1st edition: Tobacco and nicotine-related products, secondhand smoke, and alcohol and cancer

Tobacco, secondhand smoke (SHS), and alcohol, all carcinogens, are leading preventable cancer risk factors in Latin America and the Caribbean (LAC). Since 2000, smoking and SHS exposure have significantly decreased in the region. Yet alcohol consumption remains high. The entry of nicotine-related products such as electronic cigarettes (e-cigs) threatens achievements made in tobacco control and chronic diseases prevention, including cancer. E-cigs use is likely associated with smoking initiation among adolescents who had never smoked and dual use with combustible tobacco products. Therefore, the LAC Code Against Cancer recommends to the public actions they can take to reduce their risk of cancer: 1. Don't smoke or use any type of tobacco. If you do, quitting is possible, with professional help if needed. Don't use e-cigarettes either, as they lead to tobacco use. 2. Make your home a smoke-free place. Respect and promote laws that ensure smoke-free spaces to protect our health. and 3. Avoid drinking alcoholic beverages. This helps prevent several types of cancer. The Code recommends to policymakers a package of cost-effective policies based on the MPOWER and SAFER to prevent cancer at the population level. It also recommends that primary care health professionals: 1. Ask all their patients and their families whether they smoke or vape, inform them about the harms of smoking and vaping, and promote tobacco and nicotine related products cessation strategies among users. 2. Inform about the harms of exposure to SHS, especially among children, and promote smoke-free environments, and 3. Prevent alcohol use by their patients and their families, use tools to assess use, intensity, and frequency, and apply brief counseling intervention to support alcohol abstinence in primary care.