Cigarette Nicotine Research Articles

Association of Perceived Neighborhood Disorder with Substance Use Behaviors and Retail Access Among Southern California Adolescents.

Neighborhood disadvantage is associated with a higher concentration of tobacco, cannabis and alcohol retailers and greater risk of certain substance use behaviors among youth. Less is known about the impact of subjective neighborhood disorder, which captures distinct exposures that may be relevant to substance use outcomes, including neighborhood social processes, safety, physical characteristics, and neighborhood drug use. Data are from two waves (Feb-Dec 2022) of a prospective cohort of Southern California high school students (n = 2,139; mean[SD] age = 15.7.[0.6]). We examined associations of perceived neighborhood disorder at baseline with (a) perceived ease of purchase (continuous scale 0-100) for alcohol, cannabis, e-cigarettes, cigarettes, hookah, cigars/cigarillos, and oral nicotine at baseline and follow-up, and (b) repeated measures of past 6-month and past-30-day alcohol, vaped cannabis, smoked cannabis, cannabis edibles, e-cigarette, cigarette, cigarillo, hookah, and oral nicotine use. E-cigarettes were perceived to be the easiest product to purchase. Participants in the highest (vs. lowest) quartile of neighborhood disorder reported greater mean ease of purchasing scores for all products (mean difference range = 5.43 [95%CI: 1.64-9.21] for mint/menthol oral nicotine products to 9.40 [95%CI: 6.16-12.64] for hookah) and greater odds of e-cigarette, smoked cannabis, edibles, vaped THC, and alcohol use (odds ratio range = 1.52 [95%CI: 1.05 to 2.18] for past 6-month alcohol to 5.40 [95% CI: 3.46 to 8.42] for 30-day smoked cannabis). Interventions that shape youth perceptions of their neighborhood and reduce youth retail access in disadvantaged neighborhoods are needed and may help to prevent youth substance use.

Smoking cessation medicines and e-cigarettes in smokers with obesity

Abstract Purpose The interaction between obesity and smoking is complex. Aim of this study is to compare the abstinence rates of smoking cessation pharmacotherapies vs electronic cigarettes in obese smokers. Methods 57 obese smokers (aged 41±8 years, BMI: 33.8 ±2.4 Kg/m2) visiting our unit from January 2016 to November 2022 were randomized into three smoking cessation therapy groups: 1. NRT (nicotine patch), 2. NRT + bupropion (NRT+bupr) and 3. Electronic cigarette (EC). Results There were not significant differences in severity of nicotine dependence and cigarette consumption (pack-years) between the three treatment groups. Furthermore, the three groups had similar age and prevalence of traditional risk factors. At the end of treatment period (3 months), 5/19 (26 %) and 9/19 (47%) of subjects under therapy with NRT alone and NRT + bupropion combination respectively, were abstinent from smoking while 10/19 (53%) of individuals using EC did not smoke combustible cigarettes. Left plot shows the continuous abstinence rates at 6 months. Continuous abstinence rates were similar in the NRT and NRT+bupropion group at 6 months compared to 3 months (end of treatment), while 8/19 (42%) of individuals using EC did not smoke. Interestingly , at 6 months among users of EC 6 continued vaping nicotine alone, 7 continued to smoke tobacco cigarettes while vaping and 4 continued smoking cigarettes alone. Nevertheless only 2 out of 19 participants in that group stayed abstinent from both combustible cigarette smoking and vaping. Blood pressure remained unchanged in all groups while weight decreased in the group treated with the combination of bupropion and NRT compared to NRT alone and EC groups (right plot, P<0.01). Conclusions Our preliminary data indicate that continuous abstinence rates at 6 months were higher in obese smokers receiving NRT+bupropion combination therapy compared to those of individuals who used NRT alone. There is also a low abstinence rate of both cigarette smoking and vaping among individuals using EC as an aid for smoking cessation. The NRT+bupropion combination therapy was associated with a favorable effect on weight change in obese smokers.EC vs pharmacotherapy in obese smokers

Cigarette smoke extract decreases human bone marrow mesenchymal stromal cell adipogenic differentiation

BackgroundSmoking and nicotine impose detrimental health effects including adipose tissue dysfunction. Despite extensive physiological evidence, the cellular mechanisms remain poorly understood, with few studies examining the effects of cigarette smoke extract (CSE) or nicotine on adipocyte differentiation. MethodsPrimary human bone marrow-derived mesenchymal stromal cells (MSCs) were exposed to CSE or nicotine (50–500 ng/ml) during adipogenic differentiation. Cell viability and metabolic activity were assessed via MTT assay. Lipid droplet accumulation was evaluated using Sudan III staining and quantitative image analysis. Adiponectin, IL6, and IL8 concentrations were measured after 35 days using ELISA. ResultsAt these doses, CSE and nicotine do not immediately affect cell viability but inhibit undifferentiated cell proliferation. Notably, both agents at 50 ng/ml significantly increased lipid accumulation during adipogenesis, while higher CSE doses nearly completely inhibited this process. Additionally, CSE dose-dependently decreased adiponectin secretion and increased IL6 and IL8, indicating a shift towards an inflammatory state. Nicotine alone primarily increased IL6 secretion with less pronounced effects. ConclusionThe study highlights the complex impact of CSE and nicotine on adipocyte function during early differentiation from MSCs. Dose-dependent changes in lipid accumulation, cytokine, and adiponectin secretion induced by CSE and nicotine can partly explain smoking-related adipose tissue dysfunction.

Racial Differences in Nicotine Reduction: Pooled Results from Two Double-Blind Randomized Controlled Trials.

Tobacco regulatory policies are generally intended to apply to all segments of the population and to be equitable. Results from clinical trials on switching from commercial cigarettes to reduced nicotine cigarettes have included black populations but race-specific findings are not widely reported. Data were pooled from two parallel randomized controlled trials of gradually reduced nicotine in cigarettes from 11.6mg per cigarette down to 0.2mg nicotine (very low nicotine content; VLNC) vs. usual nicotine content (UNC) cigarettes (11.6mg) over an 18-week period in smokers with low socioeconomic status (SES) and mental health conditions, respectively. We used linear regression to determine the potential effects of cigarettes and biomarker reductions (blood cotinine and exhaled carbon monoxide) when using VLNC study cigarettes. An intention-to-treat (ITT) analysis included all randomized participants regardless of adherence to the protocol. A secondary compliance analysis compared control subjects (11.6mg cigarettes) only to those switched to low nicotine cigarettes who were biochemically determined to be compliant to exclusively using VLNC cigarettes. Both Black and White VLNC smokers had significantly lower plasma cotinine and exhaled carbon monoxide compared to those randomized to UNC cigarettes. The treatment × race interaction term was not significant for the outcome measures in both the ITT and secondary compliance analyses, except for cotinine in the ITT analysis (Whites: - 190ng/mL vs. Blacks: - 118ng/mL; p = 0.05). A reduced nicotine regulation for cigarettes would result in substantial reduction in exposure to nicotine and toxicants in Black and White smokers.

Changing patterns of cigarette and ENDS transitions in the USA: a multistate transition analysis of youth and adults in the PATH Study in 2015–2017 vs 2017–2019

IntroductionIt is unknown how recent changes in the tobacco product marketplace have impacted transitions in cigarette and electronic nicotine delivery system (ENDS) use.MethodsA multistate transition model was applied to 24...

The problem of vaping among the young population

Objective: to study the prevalence of vaping and its negative impact on the health of young people.Materials and methods: a sociological study was conducted using a voluntary anonymous survey of 430 1st–6th year students of the Federal State Budgetary Educational Institution of Higher Education “Kaluga State University n. a. K.E. Tsiolkovsky” aged 17 to 54 years.Results: there were 102 smoking respondents (23.7%) and 328 (76.3%) non-smokers. The average age of smoking initiation was 18.2±0.4 years. The distribution by type of smoking was as follows: vaping with nicotine liquids 46%, regular nicotine cigarettes 28.5%, heated tobacco systems (sticks) 9.8%, vaping with nicotine-free liquids 6.9% and other types of smoking 8.8%. The majority of vapers surveyed, 64.8% (35 people), develop complaints (signs of lung injury associated with vaping) during or after vaping. It was found that significantly more often women noted signs of injury associated with vaping (77.2% versus 22.8% in men, p=0.0036).Conclusions: the results of the study showed that vaping is the most popular form of smoking among young people, which poses a serious threat to the health of young people.

Correcting misperceptions about very low nicotine cigarettes for cigarette-only smokers, dual/poly smokers, other tobacco users, and non-tobacco users

BackgroundThe U.S. Food and Drug Administration authorized the sale and marketing of two very low nicotine cigarettes (VLNC) as modified risk tobacco products. The misperception that VLNC are healthier than regular cigarettes is common. This study explores effective message strategies to inform the public about health risks associated with VLNC use, encourage cigarette smokers to try VLNC, and prevent other tobacco users and non-users from product initiation. MethodsFollowing the Reasoned Action approach, a VLNC educational message was developed based on the salient beliefs associated with behavioral intention. The message was tested in an online survey conducted in 2018, where 410 participants were randomly assigned to one of the two message conditions (no-message, VLNC message). Message effects were assessed across four tobacco-use groups (non-tobacco users, cigarette-only smokers, cigarette dual/poly smokers, other tobacco users). ResultsCompared to the no-message control, the VLNC message condition showed lower nicotine risk perception for all participants, lower misbelief in VLNC safety for non-users and cigarette-only smokers, higher belief in VLNC carcinogenicity for other tobacco users, stronger belief in second-hand smoke harm for cigarette dual/poly smokers and other tobacco users, and higher VLNC intention for cigarette-only smokers. ConclusionsDifferent messages are needed for different types of tobacco users. Both cigarette smokers and other tobacco users could benefit from messages that acknowledge the non-addictiveness but emphasize the health risks of VLNC. Regulators could consider making physical harm statements a requirement for VLNC packaging and marketing. New strategies need to be explored to inform cigarette dual/poly smokers.

Do Acculturative Gap Conflicts Impact Parenting Practices and Youth E-Cigarette Use? Tests of Moderated Mediation

Background: Latino/a youth are at increased risk of electronic (e)-cigarette or electronic nicotine delivery systems (ENDS) use; thus, identifying factors impacting initiation is critical. Parenting practices reflecting warmth (e.g., relationship quality) and control (e.g., parental monitoring) and substance use-specific parenting (e.g., reactions to use, parenting self-efficacy) may influence youth substance use. For Latino/a youth, tensions from intergenerational acculturative differences are linked to substance use. We investigated ENDS use-specific parenting as a mediator between general parenting and youth ENDS use, examining whether acculturative gap conflict moderated the association between general and ENDS use-specific parenting. We expected mediation among families experiencing low acculturative gap conflicts. Method: Data were analyzed over two waves from a predominantly White and Latino/a sample of caregiver-child dyads (N = 143) who identified with a culture in addition to or distinct from American. Youth (M age = 14.9 years, SD = 0.67; 62.9% female) reported relationship quality, parental monitoring, caregiver ENDS attitudes and reactions, acculturative gap conflicts, and ENDS use. Caregivers reported on ENDS use-specific parenting self-efficacy. Two moderated multiple mediator regression models (i.e., relationship quality, parental monitoring) were estimated. Results: Among youth reporting low and mean levels of acculturative gap conflict, ENDS use-specific parenting self-efficacy mediated the association between relationship quality and reduced ENDS use. There was no evidence for an interaction in the parental monitoring model. Conclusions: In families experiencing low levels of acculturative gap conflict, relationship quality may impact ENDS use through caregivers’ confidence in their ability to prevent child ENDS use.

Effects of Very Low Nicotine Content Cigarettes and Nicotine Vaping Device Characteristics on Choices to Smoke, Vape, or Abstain in Early Young Adults.

A national nicotine reduction policy could reduce the public health toll of smoking. However, reducing nicotine in cigarettes may lead to changes in the use of other tobacco products such as nicotine vaping devices, particularly among young people. Product use outcomes may depend on characteristics of available nicotine vaping devices. We aimed to determine the impact of cigarette nicotine content, vaping device nicotine concentration, and vaping device flavors on choices to smoke, vape, or abstain. Early young adults (ages 18-20 inclusive, N=80) who reported smoking daily and vaping nicotine at least twice in their lifetime participated in a laboratory study. Participants received either Very Low Nicotine Content (VLNC; 0.4mg nicotine/g of tobacco) or Normal Nicotine Content (NNC; 15.8mg/g) cigarettes. First, participants chose between their assigned cigarette or abstaining. Subsequently, participants chose between 2 cigarette puffs, 2 vape puffs, or abstaining. Vaping device nicotine concentration (3mg vs. 18mg/ml) and flavor (tobacco vs. non-tobacco) were manipulated within-subjects. When only cigarettes were available, there were no differences between the VLNC and NNC groups on cigarette choices. When the nicotine vaping device was concurrently available, the VLNC group made fewer choices to smoke than the NNC group. Non-tobacco flavors and lower vaping device nicotine concentration were associated with fewer choices to smoke. Nicotine vaping device availability reduced choices to smoke VLNC cigarettes, and vaping devices with lower nicotine and non-tobacco flavors led to the fewest choices to smoke. Regulators should consider that the availability and characteristics of alternative tobacco products can moderate the product standard's impact. The U.S. Food and Drug Administration may enact a reduced nicotine product standard that would affect all commercially-available cigarettes. One important population affected by this policy would be early young adults who smoke. We aimed to determine the impact of cigarette nicotine content, vaping device nicotine concentration, and vaping device flavors on choices to smoke, vape, or abstain. Lower nicotine in cigarettes, along with non-tobacco flavors and lower nicotine concentration in the vaping device, were associated with the fewest choices to smoke. Regulators should consider that the availability and characteristics of alternative tobacco products can moderate the product standard's impact.

Associations between compliance with very low nicotine content (VLNC) cigarettes, abstinence self-efficacy, and quit outcomes in a pilot smoking cessation trial

BackgroundSwitching to Very Low Nicotine Content (VLNC) cigarettes reduces toxicant exposure and nicotine dependence, and may improve smoking cessation. However, non-compliance with VLNCs is often high, which may reduce their effectiveness. Here, we conducted secondary analyses of a pilot smoking cessation trial utilizing VLNCs to examine associations between pre-cessation VLNC compliance and changes in smoking rate, dependence, and abstinence self-efficacy, as well as quit outcomes. MethodsPeople who smoke daily (n=35) engaged in a 4-week pre-cessation intervention including VLNCs, transdermal nicotine patch, and behavioral counseling. After quit date, participants received 8 weeks of nicotine replacement therapy and 4 additional behavioral sessions, and were followed for 10 weeks to assess abstinence. Compliance with VLNCs was assessed biweekly during pre-cessation using timeline follow-back. Statistical analyses examined associations between VLNC compliance and a) changes in smoking rate, dependence and abstinence self-efficacy over the course of study cigarette use; and b) time to relapse, controlling for other smoking variables. ResultsGreater compliance during the second half of study cigarette use was associated with subsequent improvement in self-efficacy (p<.05). Increased self-efficacy and VLNC compliance both predicted lower likelihood of relapse. Nicotine dependence and cigarettes per day both decreased following study cigarette use, but were unrelated to compliance or relapse. ConclusionsCompliance with VLNCs prior to quitting increased abstinence self-efficacy and predicted better quit outcomes above and beyond baseline smoking characteristics. Although preliminary, these findings suggest that identifying strategies to promote exclusive use of VLNCs during a brief pre-cessation window may be beneficial.

Associations between ENDS and cigarette use, and compromised immunity in US adults: Findings from the 2021–2022 NHIS

Background Tobacco use presents increased risks for individuals with weakened immune systems (WIS). We investigated the association between cigarette and electronic nicotine delivery systems (ENDS or e-cigarettes) use and WIS in US adults using data from the 2021–2022 National Health Interview Survey. Methods Data from 57,133 adults were analyzed, focusing on WIS prevalence due to health conditions, prescriptions, or both. Cigarette and ENDS use were categorized as never, former, or current. Weighted multivariable regression models adjusted for demographics and other health conditions to assess associations between tobacco use and WIS. Results Among US adults, 4.3% had prescription-related WIS, 4.6% had health condition-related WIS, and 7% had WIS due to either reason. Adjusted results from multivariable regression models indicated that adults with WIS due to health conditions were more likely to be current (AOR = 1.21, 95%CI: 1.05–1.40) and former (AOR = 1.25, 95%CI: 1.11–1.39) cigarette smokers compared to counterparts without WIS. Adults with WIS due to prescriptions were more likely to be former cigarette smokers (AOR = 1.19, 95%CI: 1.06–1.34). Those with WIS for any reason were more likely to be current (AOR = 1.19, 95%CI: 1.05–1.35) and former (AOR = 1.24, 95%CI: 1.13–1.36) cigarette smokers. Adults with WIS due to health conditions (AOR = 1.23, 95%CI: 1.06–1.41) or any reasons (AOR = 1.19, 95%CI:1.05–1.34) were more likely to be former ENDS users compared to those without WIS. Conclusions In this nationally representative study, we found a notable link between cigarette and ENDS use with WIS, particularly among those with health condition-related or prescription-related WIS, underscoring the importance of addressing tobacco use in this vulnerable population.

Cigarette Smoke Constituents and Nicotine Differentially Affect Cytokine Production by Human Macrophages Stimulated by TLR Ligands In Vitro: Considerations for a Standardised Protocol.

Chronic obstructive pulmonary disease (COPD) is an inflammatory lung condition associated with cigarette (tobacco) smoking. Numerous in vivo animal studies have been conducted to investigate the links between cigarette smoke, nicotine and infection in lung pathology. As an alternative to animal experiments, we used an in vitro system to investigate the effects of cigarette smoke extract (CSE) or nicotine on TNF-α and IL-10 production by monocyte-derived human macrophages. The macrophages were simultaneously stimulated with either poly-IC (as a chemical surrogate for viral infection) or lipopolysaccharide (as a chemical surrogate for Gram-negative bacterial infection). CSE enhanced TNF-α production, whereas nicotine inhibited IL-10 production by the macrophages, particularly when co-stimulated with the microbial chemical surrogates. A system of this type may help to further our understanding of the immunological and inflammatory effects of smoking, without recourse to in vivo studies. Requirements for the optimisation and standardisation of such an in vitro system are also discussed.

Associations of educational and marketing messages with beliefs about nicotine and reduced nicotine cigarettes

IntroductionWidespread misperceptions about nicotine may have unintended effects on public health. We examined associations between existing messages about nicotine or tobacco and beliefs about nicotine and reduced nicotine cigarettes (RNC). Methods2962 U.S. 18–45-year-olds were randomized in a May 2022 web-based survey to view one of 26 text-based messages about tobacco or nicotine from three sources: ongoing research (n = 8), messages authorized by FDA for VLN cigarettes (n = 6), and FDA's “From Plant to Product to Puff” campaign (n = 12); six messages from FDA's campaign did not reference nicotine and were treated as the reference source. Analyses examined associations between messages, grouped by source and individually, with beliefs about nicotine and RNC addictiveness and harms. ResultsRelative to FDA messages that did not reference nicotine, all message sources were associated with greater odds of a correct belief about nicotine (Odds Ratios [ORs] = 1.40–1.87, p's < 0.01); VLN messages were associated with greater correct beliefs about RNC addictiveness (b = 0.23, p < .05). No campaign produced greater correct beliefs about RNC harms. At the individual level, only five messages were associated with a correct belief about nicotine (ORs = 2.12–2.56, p-values < .01), and one with correct beliefs about RNC harms (b = 1.09, p < .05), vs. the reference message. ConclusionsFew existing messages improved understanding of the risks of nicotine separately from the risks of combustible products. Communication research is needed to promote greater public understanding of nicotine while minimizing unintended effects on nicotine and tobacco use.

Reactions to a Nicotine Reduction Policy Among Adolescents Who Smoke: A Qualitative Study.

The Biden administration is pursuing a nicotine reduction policy in the U.S. to render cigarettes less addictive. In this study, we qualitatively investigated adolescents' subjective responses to very low nicotine content (VLNC) cigarettes, reasons for incomplete adherence to using them, and their expected responses to a nicotine reduction policy. Adolescents who smoke cigarettes daily (ages 15-19; N=60) were enrolled in a three-week double-blind randomized clinical trial and assigned to smoke either normal nicotine content (NNC) or VLNC research cigarettes. Following the trial, 52 participants completed qualitative interviews about their reactions to the cigarettes and to the idea of a nicotine reduction policy. We utilized a template style approach to thematic analysis involving immersion in the data, codebook development with both inductive and deductive codes, and iterative refinement of themes. Reasons for incomplete adherence to smoking only research cigarettes focused on dislike for cigarette taste and lower satisfaction compared to usual brand cigarettes. Negative evaluations of research cigarettes were common across both groups. Many participants in both groups reported that they would decrease their smoking or quit entirely if the research cigarettes were the only ones legally available for purchase in the U.S. Adolescents may respond to a cigarette nicotine reduction policy by decreasing their cigarette smoking and eventually quitting. These findings suggest a need for public health strategies to reduce smoking initiation and progression in young people and to encourage cessation in the context of a nicotine reduction policy. Participants' negative subjective responses and challenges with research cigarette adherence offer insight into factors that might influence young people's reactions to a real-world nicotine reduction policy. Adolescents who smoke may increase their use of alternative tobacco products, especially e-cigarettes, if this policy were implemented. Specifically, themes identified across participant responses highlight important considerations for how such a policy might be implemented with specific attention to the unique smoking behaviors and needs of this vulnerable population.

Reduced nicotine in cigarettes in a marketplace with alternative nicotine systems: randomized clinical trial

Reducing cigarette addictiveness has the potential to avert millions of yearly tobacco-related deaths worldwide. Substantially reducing nicotine in cigarettes decreases cigarette consumption, but no large clinical trial has determined the effects of reduced-nicotine cigarettes when other nicotine-containing products are available. The aim of this study was to examine the effects of reduced-nicotine cigarettes in the context of the availability of alternative nicotine delivery systems. In a U.S. six-site, open-label, parallel-arm study, smokers were randomized for twelve weeks to an experimental marketplace containing cigarettes with either 0.4mg or 15.8mg nicotine per gram of tobacco; all had access to non-combusted alternative nicotine delivery systems (e.g., e-cigarettes; medicinal nicotine). Group differences in the primary outcomes (cigarettes per day, number of smoke-free days) were examined using linear and negative binomial regression, respectively (Trial Registration: NCT03272685). Among 438 randomized participants (mean [standard deviation (SD), range] age, 44.5 [11.9, 20-73] years, 225 [51.4%] women, 282 [64.4%] White and 339 [77.4%] trial completers), those in the 0.4mg vs. 15.8mg nicotine cigarette condition experienced significantly lower cigarettes per day at the end of intervention (mean [SD], 7.05 [7.88] vs. 12.95 [9.07], adjusted mean difference,-6.21 [95% CI,-7.66 to-4.75], P<0.0001) and greater smoke-free days during intervention (mean [SD], 18.59 [27.97] vs. 5.06 [13.77], adjusted rate ratio, 4.25 [95% CI, 2.58-6.98], P<0.0001). A reduced-nicotine cigarette standard in the context of access to other non-combusted nicotine products has the potential to benefit public health. U.S. NIH/FDA U54DA03165.

Unhealthy Weight Control Behaviors according to the Status of Combustible Cigarette and Noncombustible Nicotine or Tobacco Product Use among Korean Adolescents with Experience Attempting to Reduce or Maintain Their Body Weight: The 15th Korea Youth Risk Behavior Survey, 2019.

Noncombustible nicotine or tobacco product (NNTP) use, and cigarette smoking are associated with a high likelihood of unhealthy weight control behaviors (UWCBs) among adolescents. However, no study has addressed the differences in UWCBs among non-users, single users of combustible cigarettes (CCs) or NNTPs and dual users. This study compared the frequencies of weight control behaviors according to the status of CC and NNTP use among Korean adolescents. This was a cross-sectional study of 25,094 adolescents who had attempted to reduce or maintain their body weight during the past 30 days, using data from the 15th Korea Youth Risk Behavior Survey, 2019. Data on the status of CC and NNTP use, weight status, and weight control behaviors were obtained using self-report questionnaires. Subjects were categorized into four groups: non-users, cigarette-only users, NNTP-only users, and dual users. Among boys and girls, current smokers and NNTP users were 8.9%±0.3% and 5.5%±0.3%, and 4.2%±0.2% and 1.7%±0.1%, respectively. Among boys, NNTP-only users were more likely to engage in extreme weight control behaviors than non-users. Among girls, users of either CCs or NNTPs were more likely to engage in extreme weight control behaviors and less extreme weight control behaviors than non-users. This study shows that users of either CCs or NNTPs are more likely to engage in UWCBs, and NNTP-only users are the most likely to do so.

Comparison of Acute Effects of E-cigarettes With and Without Nicotine and Tobacco Cigarettes on Hemodynamic and Endothelial Parameters: A Systematic Review and Meta-analysis.

Smoke from traditional cigarettes and e-cigarette aerosols have distinct chemical compositions that may impact blood pressure (BP) and heart rate (HR) differently. This study compared the impact of nicotine-containing e-cigarettes (EC+) versus nicotine-free (EC-) on BP, HR and endothelial markers, and assessed if EC+ posed fewer risks than tobacco cigarettes (TC). Electronic databases were searched from inception until November 2023 for studies reporting changes in systolic and diastolic BP (SBP, DBP) and HR and endothelial parameters before and after the use of EC+, EC- and TC. Data were analyzed using weighted mean differences (WMDs) and 95% confidence intervals (CIs). Fifteen studies (n=752) were included in our meta-analysis. We demonstrate that EC+ significantly increased systolic BP (WMD=3.41, 95% CI [0.1,6.73], p=0.04], diastolic BP (WMD=3.42, 95% CI [1.75, 5.09]; p<0.01], and HR (WMD=5.36 BPM, 95% CI [1.87, 8.85]; p<0.01) compared to EC-. However, EC+ was observed to cause less detrimental effect on SBP (WMD=-4.72 mmHg, 95% CI [-6.58, -2.86], p<0.01), and HR (WMD=-3.11 BPM, 95% CI [-4.54, -1.68]; p<0.01) as compared to TC with no difference on DBP (WMD=-1.14mmHg, 95% CI [-2.38, 0.1]; p=0.07). EC+ also led to greater deterioration of endothelial parameters as compared to EC- but to a lesser degree as compared to TC. EC+ shows greater impairment in hemodynamic and endothelial parameters than EC- but less than TC. Additional studies are needed to evaluate prolonged effectsofECuse.

Independent and combined effects of very low nicotine cigarette messages and e-cigarette messages: a randomised clinical trial

BackgroundUSA is considering reducing nicotine in cigarettes to non-addictive levels, coupled with promoting alternative nicotine delivery products (eg, e-cigarettes). However, effective communication is needed to reduce misperceptions about very low...

Nicotinic Receptor Alpha-5 Subunit Gene Polymorphism is Associated With Heavy Smoking Under a Range of Nicotine Dosing Conditions.

This study aimed to assess the role of the rs16969968 variant of nicotinic receptor alpha-5 subunit in regulating smoking behavior and nicotine intake in response to nicotine manipulations among dependent smokers in a naturalistic environment. Sixty-nine adults (19 females) smoking 10 or more cigarettes per day (CPD) were asked to complete four 2-week study phases during which they smoked exclusively one of two types of Spectrum nicotine research cigarettes (FTC nicotine yield 0.8 and 1.6 mg, respectively), their usual brand of cigarettes, or their usual brand of cigarettes while wearing a 21-mg nicotine patch. Measurements included rs16969968 genotype, number of CPD, smoking topography, and plasma cotinine. Compared to controls (G/G carriers), A allele carriers reported smoking 4 to 5 more CPD across all conditions (all ps < .05). Mean total smoke volume per day and cotinine were greater in A allele carriers than in controls (ps = .05, .046, respectively). No significant genotype differences were found in smoking compensation indices for the switch from medium to high-nicotine-yield cigarettes. Nicotine patch-induced reductions in cigarettes smoked per day and total smoke volume per day showed significant interactions between genotype and pre-patch levels, with heavier smokers showing greater effects of genotype (p = .052 and p = .006, respectively). Results suggest that the rs16969968 variants regulate the heaviness of smoking primarily by their impact on daily numbers of cigarettes smoked, but no genotype differences were found in smoking compensation after switching from medium to high-nicotine cigarettes. The differences in daily cigarette consumption between rs16969968 risk-allele carriers and controls are shown to be consistent regardless of manipulations of cigarette nicotine content and transdermal nicotine supplementation and markedly greater among dependent smokers than those observed in the general smoker populations. G/G allele carriers, relative to A allele carriers, appeared to be more sensitive to the nicotine patch manipulation, reducing their smoking to a greater extent. These findings support continued efforts in the development of personalized intervention strategies to reduce the rs16969968-conveyed genetic propensity for heavy smoking.

Perceptions of a reduced nicotine policy and predictors of policy support: A nationally representative U.S. survey

BackgroundThe U.S. Food and Drug Administration is considering a policy to reduce nicotine in cigarettes to non-addictive levels. Although current evidence supports the public-health benefits of a reduced-nicotine policy, almost half of people who smoke (∼ 40%) do not support the policy. This study estimates the factors most strongly associated with support or opposition toward the policy, including tobacco use status, perceived effects of a reduced nicotine policy, trust in the FDA, and psychological distress. The study aims to inform messaging campaigns and policy makers. MethodsData were collected in 2021 with nationally representative samples of U.S. adults (n = 1763). After receiving information about the reduced nicotine policy, participants indicated their beliefs and support for or opposition to the policy, along with other individual difference characteristics. Univariate population parameters and multinomial logistic regression coefficients were estimated. ResultsIn adjusted models, people who formerly or never smoked were less likely to oppose the policy compared to those who currently smoke; people with higher psychological distress and those who believe the policy will promote switching to e-cigarettes were more likely to oppose the policy. In addition, people were more likely to support the policy if they believed it would make quitting easier or that the FDA is trustworthy. ConclusionsEducational campaigns about reduced nicotine policy should expect higher impact by targeting prevalent perceptions and those more strongly associated with policy sentiment. In anticipation of the policy rollout, there may be a critical window to shape public opinion.