Cigarette Smoking and Schizophrenia: Etiology, Clinical, Pharmacological, and Treatment Implications.

High International Electronic Cigarette Use Among Never Smoker Adolescents

Background:Early initiation of tobacco use among adolescents is a significant public health concern. While there is extensive research on overall tobacco use, much of it focuses on initiation in late adolescence, uses cross-sectional designs, and lacks specific exploration of electronic versus conventional cigarette use. This study aims to investigate social determinants influencing the early initiation of electronic and conventional cigarette use among U.S. adolescents.Methods:We utilized data from the Adolescent Brain Cognitive Development (ABCD) study, which follows a cohort of tobacco-naïve children from age nine through age 16. The social determinants examined included household income, parental education, financial difficulties, racial/ethnic minority status, family structure, neighborhood income, and gender minority status. Structural equation models were employed to assess associations between these determinants and early initiation of electronic and conventional cigarette use.Results:Male gender was associated with a higher likelihood of conventional cigarette use, while the risk of early initiation of electronic cigarette use was similar across genders. White adolescents were at a higher risk of conventional cigarette use; however, the risk for electronic cigarette use was comparable across White and non-White groups. Financial difficulties were linked to an increased likelihood of early initiation of conventional cigarette use but not electronic cigarette use. Higher household income was associated with a reduced risk of initiating conventional cigarettes but did not significantly impact electronic cigarette use. Adolescents from married families were less likely to initiate electronic cigarette use. No significant effects were found for parental education or neighborhood income on the initiation of either type of cigarette use. Age did not significantly affect the initiation of either cigarette type, and gender minority status was marginally associated with early initiation of conventional cigarette use.Conclusions:The social patterning of electronic cigarette use differs from that of conventional cigarette use, suggesting that distinct tobacco products do not pose a uniform risk across all adolescents. This study underscores the importance of tailored prevention efforts that address the unique challenges associated with early initiation of electronic and conventional cigarette use among adolescents. The differential risk factors identified suggest targeted prevention strategies for conventional cigarette use, focusing on financial difficulties, household income, and gender-specific interventions. In contrast, prevention efforts for electronic cigarette use may require broader, more inclusive approaches that address all adolescents, regardless of their background. Comprehensive universal screening for electronic cigarette use and targeted screening for conventional cigarette use among adolescents are recommended.

The prevalence rate of smoking among psychiatric patients has been shown to be higher than that among the general population, and this may have several neuropsychiatric implications. This cross-sectional study examines the prevalence, sociodemographic variables and pattern of smoking among psychiatric outpatients in Saudi Arabia. Over a period of 18 months (January 1996 to June 1997), 505 outpatients from five different hospitals were randomly selected to participate in the study. It was observed that 292 patients (57.83%) were current smokers, 199 (39.4%) were nonsmokers and 14 patients (2.77%) were ex-smokers. Besides revealing certain attitudes towards smoking and religious antismoking notions, it was observed that unemployment, low education status, rural background, and drug abuse were significantly associated with smoking. The prevalence rate of smoking revealed in this study is consistent with international data, and probably has implications similar to those reported in other studies. This study also found certain patterns of tobacco use in psychiatric outpatients characterized by certain sociodemographic variables and drug abuse.

Research Article| July 01 2014 Adolescent Electronic and Conventional Cigarette Use AAP Grand Rounds (2014) 32 (1): 4. https://doi.org/10.1542/gr.32-1-4 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Adolescent Electronic and Conventional Cigarette Use. AAP Grand Rounds July 2014; 32 (1): 4. https://doi.org/10.1542/gr.32-1-4 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: cigarette smoking, electronic cigarettes, smoking cessation, cigarettes Source: Dutra LM, Glantz SA. Electronic cigarettes and conventional cigarette use among US adolescents [published online ahead of print March 6, 2014]. JAMA Pediatrics; doi: https://doi.org/10.1001/jamapediatrics.2013.5488 Investigators from the University of California, San Francisco conducted a study to examine the relationship between electronic cigarette (e-cigarette) use and both conventional cigarette use and smoking cessation among US adolescents. The researchers used data from the 2011 and 2012 National Youth Tobacco Survey, a nationally representative, cross-sectional sample of US middle and high school students (grades 6–12) for the study. The self-administered questionnaire included indicators of tobacco use, intention to quit, and smoking cessation. Conventional cigarette users were defined as experimenters (ever tried ≥1 puff), ever smokers (≥100 cigarettes smoked), or current smokers (≥100 cigarettes smoked in last 30 days). Conventional cigarette abstinence was measured at 30 days, 6 months, and 1 year. Participants who responded that they had used “electronic cigarettes or e-cigarettes, such as Ruyan or NJOY” were defined as ever e-cigarette users (ever tried) or current users (used on ≥1 day in the past 30 days). Multivariable logistic regression was used to evaluate the relationship between e-cigarette use and tobacco cigarette use and cessation. The investigators analyzed data from 17,353 respondents in 2011 and 22,539 in 2012. Among cigarette experimenters, ever e-cigarette use was associated with higher odds of being classified as an “ever smoker” (OR = 6.31; 95% CI, 5.39–7.39) and current cigarette smoking (OR = 5.96; 95% CI, 5.67–6.27). Current e-cigarette use was also associated with higher odds of ever having smoked cigarettes (OR = 7.42; 95% CI, 5.63–9.79) and current cigarette smoking (OR = 7.88; 95% CI, 6.01–10.32). For 2011 study participants, current cigarette smokers who had ever used e-cigarettes were more likely to intend to quit smoking within the next year (OR = 1.53; 95% CI, 1.03–2.28). Among cigarette experimenters and ever cigarette smokers, ever e-cigarette use and current e-cigarette use was associated with lower odds of abstinence from cigarettes at 30 days, 6 months, and 1 year. The investigators conclude that e-cigarettes do not discourage use, and may be encouraging use, of conventional cigarettes among US adolescents. They suggest that their results contradict claims that e-cigarettes are effective as smoking cessation aids. Dr Wong has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Adult and youth e-cigarette use has been rapidly rising. In another analysis of the NYTS data, e-cigarette use among youth in grades 6 to 12 doubled, from 3.3% in 2011 to 6.8% in 2012.1 With these increasing rates, the public debate on the impact of e-cigarettes and other electronic nicotine delivery systems on public health has intensified. Other nicotine delivery systems include emerging e-cigarette-like devices marketed under different names, such as “e-hookahs” or “vape pipes,” which may result in considerable underestimates of youth e-cigarette use.2 While e-cigarettes contain fewer toxins and lower levels of these toxins compared to conventional cigarettes, they... You do not currently have access to this content.

Rising rates of adolescent electronic cigarette (ECIG) use is concerning because it can lead to adverse health outcomes and increased risk behavior. There are known predictors of ever versus never ECIG use, but less are known about risk factors for ever versus current use of ECIGs. Problem behavior theory (PBT) was used to evaluate possible risk factors for different ECIG use status. Participants were 573 high school students who completed questionnaires measuring ECIG use, as well as constructs within the Social Environment, Perceived Environment, Personality, and Behavior domains of PBT. Multinomial logistic regression was used to evaluate how predictor variables differentiated between participants who reported (a) never use, (b) ever ECIG use, or (c) current ECIG use. Adolescents were more likely to endorse ever ECIG use than never use if they reported peer ECIG use, perceived more benefits and fewer costs (e.g., health) of ECIG use, higher extraversion, alcohol and cigarette use (never vs. ever vs. past 30 days), or attended a school with a higher percentage of socioeconomically disadvantaged students. Adolescents were more likely to report current ECIG use than ever ECIG use if they perceived fewer costs of ECIG use or used cannabis in their lifetime (yes/no). PBT variables differentiated between ever ECIG use and never ECIG use. However, these variables did not differentiate between ever and current ECIG use. Identifying unique risk factors for current versus ever ECIG use is important to understanding persistent ECIG use and subsequent targeted prevention and intervention programs.

Do population trends in adolescent electronic cigarette use coincide with changes in prevalence of cigarette smoking?

ObjectiveTo examine consistency between cross-sectional studies of conventional and electronic cigarette use among adolescents in terms of the measurement, analysis and reporting of parameters.DesignA systematic analysis of cross-sectional studies of...

The prevalence of electronic cigarette use is increasing, particularly among youth. This recent trend is troubling given that electronic cigarette use is associated with future cigarette smoking. Here, we assessed the prevalence of cigarette smoking and use of electronic cigarettes among college students before and after implementation of a university-wide smoking ban on campus. We found that after the smoking ban was implemented, the prevalence of self-reported combustible cigarette smoking decreased (12% versus 7%; unadjusted: OR = 0.55, 95% CI = 0.34, 0.89, p = 0.015), but we did not observe a difference in the prevalence of electronic cigarette use (26.3% versus 27.5%; unadjusted: OR = 1.06, 95% CI = 0.78, 1.43, p = 0.699). Future studies should identify factors that increase the impact of university smoking policies on electronic cigarette use.

Socioeconomic disparities have been established for conventional cigarette use, but not for electronic cigarettes. This study estimates socioeconomic gradients in exclusive use of conventional cigarettes, electronic cigarettes, and dual use (ie, use of both products) among adults in the United States. Analyses consider nationally representative data on 25- to 54-year-old respondents to the 2014-2016 National Health Interview Surveys (N = 50306). Demographically adjusted seemingly unrelated regression models estimate how two socioeconomic status measures-respondent education and household income-relate to current exclusive use of conventional cigarettes, electronic cigarettes, and dual use. Conventional cigarette use exhibits negative education and income gradients, consistent with existing research: -12.9 percentage points (confidence interval [CI]: -14.0, -11.8) if college educated, and -9.5 percentage points (CI: -10.9, -8.1) if household income exceeds 400% of the federal poverty level. These gradients are flatter for dual use (-1.4 [CI: -1.8, -0.9] and -1.9 [CI: -2.5, -1.2]), and statistically insignificant for electronic cigarette use (-0.03 [CI: -0.5, 0.4] and -0.3 [CI: -0.8, -0.2]). Limiting the sample to ever-smokers, higher education is associated with a 0.9 percentage point increase in likelihood of exclusive electronic cigarette use at interview (CI: 0.0, 1.9). Education and income gradients in exclusive electronic cigarette use are small and statistically insignificant, contrasting with strong negative gradients in exclusive conventional cigarette use. Furthermore, more educated smokers are more likely to switch to exclusive e-cigarette use than less educated smokers. Such differential switching may exacerbate socioeconomic disparities in smoking-related morbidity and mortality, but lower the burden of tobacco-related disease. Research has not yet established whether socioeconomic disparities in electronic cigarette (e-cigarette) use resemble those observed for conventional cigarettes. This article uses nationally representative data on US adults aged 25-54 to estimate income and education gradients in exclusive use of conventional cigarettes, e-cigarettes, and dual use. Both gradients are steep and negative for conventional cigarette use, but flat and statistically insignificant for e-cigarette use. Repeating the analysis among ever-smokers indicates that more educated smokers are more likely to transition toward exclusive e-cigarette use than less educated smokers. Such differential substitution may exacerbate disparities in smoking-related morbidity and mortality.

IntroductionSecondhand smoke (SHS) from combustible cigarettes causes numerous diseases. Policies have been developed to prevent SHS exposure from indoor cigarette use to reduce health risks to non-smokers. However, fewer policies...

IntroductionAlthough adolescent cigarette use continues to decline in the United States, electronic cigarette (e‑cigarette) use among adolescents has escalated rapidly. This study assessed trends and patterns of e‑cigarette use and concurrent cigarette smoking and the relationships between e-cigarette use and smoking cessation intentions and behaviors among high school students in North Carolina.MethodsData came from high school students who completed the school-based, cross-sectional North Carolina Youth Tobacco Survey in 2011 (n = 4,791) and 2013 (n = 4,092). This study assessed changes in prevalence of e-cigarette and cigarette use from 2011 through 2013, and cessation-related factors associated with those students’ current and past use of e‑cigarettes in 2013.ResultsThe prevalence of current e-cigarette use (use in the past 30 days) significantly increased from 1.7% (95% CI, 1.3%–2.2%) in 2011 to 7.7% (95% CI, 5.9%–10.0%) in 2013. Among dual users, current e-cigarette use was negatively associated with intention to quit cigarette smoking for good (relative risk ratio [RRR] = 0.51; 95% CI, 0.29–0.87) and with attempts to quit cigarette smoking in the past 12 months (RRR = 0.69; 95% CI, 0.49–0.97). Current e-cigarette smokers were less likely than those who only smoked cigarettes to have ever abstained from cigarette smoking for 6 months (RRR = 0.42; 95% CI, 0.21–0.82) or 1 year (RRR = 0.21; 95% CI, 0.09–0.51) and to have used any kind of aids for smoking cessation (RRR = 0.46; 95% CI, 0.29–0.74).ConclusionPublic health practitioners and cessation clinic service providers should educate adolescents about the risks of using any nicotine-containing products, including e-cigarettes, and provide adequate tobacco cessation resources and counseling to adolescent tobacco users.

Aims Electronic cigarettes are often used by smokers to stop smoking and former smokers to prevent relapse. We examined whether electronic cigarette use lead to smoking reduction and cessation among smokers, and relapse among former smokers. Design and Settings The CONSTANCES cohort, France (2012 - ongoing). Measurements Among smokers (N = 5,400, average follow-up of 23.4 months), mixed regression models were used to examine whether electronic cigarette use was linked to a decrease in the number of cigarettes smoked per day and Poisson regression models with sandwich variance estimators were used to test smoking cessation. In parallel, Cox proportional hazards regression models were used to examine the relationship between electronic cigarettes use and smoking relapse among former smokers who stopped smoking since 2010 (N = 2,025, average follow-up of 22.1 months), year in which electronic cigarettes were introduced in France. All statistical analyses were adjusted for socio-demographic characteristics, duration of follow-up, and smoking characteristics. Findings There was a significantly higher decrease in the number of cigarettes smoked/day among smokers who used electronic cigarettes (decrease of 4.4 cigarettes/day) compared to those who did not (decrease of 2.7 cigarettes/day), as well as a higher relative risk of smoking cessation (adjusted RR: 1.67 [95% CI: 1.51-1.84]). At the same time, among former smokers, EC use was associated with an increase in the rate of smoking relapse (adjusted HR = 1.70 [95% CI: 1.25-2.30]). Conclusions After a follow-up of approximately 2 years, electronic cigarettes use among smokers was associated to a decrease in smoking level and an increase in smoking cessation attempts but among former smokers it was associated to a higher risk of smoking relapse. Key messages Among smokers, electronic cigarette use was associated to smoking reduction and smoking cessation. Among former smokers who quit smoking since 2010, electronic cigarette use was associated to a higher likelihood of relapse.

Purpose: Cigarette smoking causes an acute elevation in carboxyhemoglobin levels (HbCO) and has immediate adverse effects on coronary circulation. The goal of this study was to evaluate the effects of electronic cigarette (EC) use on coronary microcirculation. Methods: We recruited 60 healthy participants (age 20-55 years), 30 smokers and 30 ex-smokers who were daily users of EC. Smokers were asked to smoke 2 cigarettes (0.7mg nicotine) and use an EC device with nicotine-containing liquid (9mg/ml) for 15 minutes, in a randomized cross-over design. Coronary flow velocity reserve (CFVR) and coronary vascular resistance index (CVRI) were measured at baseline (after 8 hours abstinence from smoking and caffeine use), 20-30 minutes after smoking two cigarettes and after using the EC device, by intravenous administration of adenosine (140μg/kg/min). HbCO levels were also measured. EC users were evaluated before and after EC use only. Results: Both groups had similar baseline characteristics. Blood pressure and heart rate were similar at baseline and after smoking and EC use. HbCO levels were significantly higher in smokers compared to EC users at baseline (2.93±1.15% vs. 0.81±0.20%, P < 0.001). No elevation in HbCO levels was observed in both groups after using the EC, while smokers had significant elevation in HbCO after smoking (3.50±1.11%, P < 0.001 compared to baseline). Overall, no difference was observed in CFVR (2.94±0.52 vs. 2.99±0.62, P = 0.265) and CVRI (0.346±0.064 vs. 0.345±0.077, P = 0.870) before and after EC use in all 60 participants. Evaluating each group separately, in EC users no difference was found in CFVR (2.99±0.55 vs. 3.05±0.64, P = 0.299) and CVRI (0.341±0.062 vs. 0.337±0.075, P = 0.691) before and after EC use. Similarly, in smokers no difference was observed in CFVR (2.90±0.49 vs. 2.93±0.62, P = 0.593) and CVRI (0.351±0.067 vs. 0.353±0.079, P = 0.891) before and after EC use. However, after smoking 2 cigarettes there was a significant decrease in CFVR (2.45±0.45, P < 0.001 compared to baseline) and an increase in CVRI (0.416±0.077, P < 0.001 compared to baseline). Conclusion: Significant elevations in HbCO and CVRI and decrease in CFVR were observed in smokers after smoking 2 cigarettes. On the contrary, no difference was observed in all parameters after EC use in both smokers and ex-smokers. Research in this field should be intesnified because EC may have the potential to significantly reduce the adverse health effects associated with smoking.

Electronic cigarette (ECIG) use is growing in popularity, but little is known about the perceived positive outcomes of ECIG use. This study used concept mapping (CM) to examine positive ECIG outcome expectancies. Sixty-three past 30-day ECIG users (38.1% female) between the ages of 18 and 64 (M = 37.8, SD = 13.3) completed a CM module. In an online program, participants provided statements that completed a prompt: "A specific positive, enjoyable, or exciting effect (i.e., physical or psychological) that I have experienced WHILE USING or IMMEDIATELY AFTER USING an electronic cigarette/electronic vaping device is. . . ." Participants (n = 35) sorted 123 statements into "piles" of similar content and rated (n = 43) each statement on a 7-point scale (1 = Definitely NOT a positive effect to 7 = Definitely a positive effect). A cluster map was created using data from the sorting task, and analysis indicated a 7 cluster model of positive ECIG use outcome expectancies: Therapeutic/Affect Regulation, High/Euphoria, Sensation Enjoyment, Perceived Health Effects, Benefits of Decreased Cigarette Use, Convenience, and Social Impacts. The Perceived Health Effects cluster was rated highest, although all mean ratings were greater than 4.69. Mean cluster ratings were compared, and females, younger adults, past 30-day cigarette smokers, users of more "advanced" ECIG devices, and nonlifetime (less than 100 lifetime cigarettes) participants rated certain clusters higher than comparison groups (ps < 0.05). ECIG users associate positive outcomes with ECIG use. ECIG outcome expectancies may affect product appeal and tobacco use behaviors and should be examined further to inform regulatory policies. (PsycINFO Database Record

Electronic cigarette (ECIG) use has grown rapidly in popularity within a short period of time. As ECIG products continue to evolve and more individuals begin using ECIGs, it is important to understand the potential adverse effects that are associated with ECIG use. The purpose of this study was to examine and describe the acute adverse effects associated with ECIG use. This study used an integrated, mixed-method participatory approach called concept mapping (CM). Experienced ECIG users (n = 85) provided statements that answered the focus prompt "A specific negative or unpleasant effect (ie, physical or psychological) that I have experienced either during or immediately after using an electronic cigarette device is…" in an online program. Participants sorted these statements into piles of common themes and rated each statement. Using multidimensional scaling and hierarchical cluster analysis, a concept map of the adverse effects statements was created. Participants generated 79 statements that completed the focus prompt and were retained by researchers. Analysis generated a map containing five clusters that characterized perceived adverse effects of ECIG use: Stigma, Worry/Guilt, Addiction Signs, Physical Effects, and Device/Vapor Problems. ECIG use is associated with adverse effects that should be monitored as ECIGs continue to grow in popularity. If ECIGs are to be regulated, policies should be created that minimize the likelihood of user identified adverse effects. This article provides a list of adverse effects reported by experienced ECIG users. This article organizes these effects into a conceptual model that may be useful for better understanding the adverse outcomes associated with ECIG use. These identified adverse effects may be useful for health professionals and policy makers. Health professionals should be aware of potential negative health effects that may be associated with ECIG use and policy makers could design ECIG regulations that minimize the risk of the adverse effects reported by ECIG users in this study.