Combustible Tobacco Cigarettes Research Articles

Evaluation of Cytotoxic and Genotoxic Effects in Buccal Mucosal Cells in Non-Smokers and Users of Traditional Combustible Tobacco Products and Non-Combustible Alternatives.

The aim of this cross-sectional observational study was to investigate cytogenetic damage to the buccal mucosa in non-smokers and consumers of traditional combustible tobacco products and non-combustible alternatives. A total of 160 participants were divided into four groups according to the type of product used, including non-smokers, users of conventional combustible tobacco (cigarettes), heated tobacco, and electronic, tobacco-free vapor products (e-cigarettes). Buccal mucosa samples were analyzed using the micronucleus cytome assay to assess cytotoxic and genotoxic damage. E-cigarette users showed significantly higher values for all tested parameters in the micronucleus test compared to non-smokers (p < 0.05). Similarly, users of tobacco heating products showed an increase in all parameters (p < 0.05), with the exception of the number of cells with micronuclei. Conventional cigarette smokers showed a notable increase in the number of binucleated cells and cells with karyorrhexis and karyolysis (p ≤ 0.05). When assessing the differences between users of traditional combustible tobacco products and non-combustible alternatives, these did not appear to be significant, except for e-cigarette users, who had significantly more cells with condensed chromatin (p ≤ 0.001), while users of tobacco heating products had more pyknotic cells (p ≤ 0.001). The results of this study underscore the heightened occurrence of cytotoxic and genotoxic damage in users of both conventional combustible tobacco products and non-combustible alternatives compared to non-smokers, emphasizing the detrimental impact of these products on the oral mucosa.

Evaluation of functional aerobic exercise capacity among chronic e-cigarette users compared to combustible cigarette smokers and non-smokers: a comparative study

BackgroundElectronic cigarettes or e-cigarettes have gained significant popularity as an alternative to traditional combustible tobacco smoking particularly among the youth. Although there is a growing prevalence of e-cigarette usage, the effects on cardiovascular function and physical capacity have not been adequately studied. The toxic products in combustible tobacco cigarettes negatively impact functional exercise capacity. However, the available data regarding the effect of e-cigarette use on functional exercise capacity are scarce. Thus, in the current study, we aimed to evaluate the functional aerobic exercise capacity among chronic e-cigarette users compared to combustible cigarette smokers and non-smokers.ResultsThis comparative, cross-sectional study was conducted on 105 healthy volunteers. Participants were assigned into three study groups each consisting of 35 participants: chronic e-cigarette users, combustible cigarette smokers, and a non-smoker control group. Basal demographic and clinical data were similar in all groups. Mean heart rates and respiratory rates were significantly higher among e-cigarette smokers and combustible cigarette smokers compared to non-smoker controls (p < 0.001). Chronic e-cigarette users and combustible cigarette smokers had shorter 6-MWT distances compared to non-smokers (508.3, 488, and 616.6 m, respectively, p < 0.001). Borg scale scores after performing the six-minute walking test were significantly higher in chronic e-cigarette users and combustible cigarette smokers groups compared to non-smokers, where perceived exertion (4.9, 5.5, 2.1, respectively, p < 0.001), dyspnea (5.7, 6.5, 0.1, respectively, p < 0.001) and leg fatigue (4.2, 5.4, 1.4, respectively, p < 0.001).ConclusionIn this cross-sectional study, significant evidence demonstrates that e-cigarette use is not harmless. This was particularly presented in apparently healthy e-cigarette users in comparison to the healthy non-smoker control group. Chronic e-cigarette use is associated with reduced functional capacity compared to non-smoker controls. This was signified by decreased 6MWT walking distances, higher Borg scale scores, and lower oxygen saturation percentages among the chronic electronic cigarette users as compared to non-smoker controls after performing the six-minute walking test. All the evaluated parameters in the current study were similarly reduced among both the e-cigarette users group and the combustible cigarette smokers group compared to non-smokers with no statistically significant differences between both smoker groups.

The Risk of Oropharyngeal Cancer from E-Cigarette Use: An Urgent Public Health Concern

It is estimated that over 47 million people use tobacco products, mostly in the form of combustible (smokable) tobacco cigarettes. Thirteen to 50% of smokers also use electronic cigarettes (also known as e-cigarettes or vaping). Use of tobacco is the primary preventable cause of death and risk factor for lung, head, neck, and oropharyngeal cancer. Electronic cigarettes are a $10 billion dollar industry and has the potential to surpass the tobacco cigarette market. E-cigarette use is a public health concern because of the health issues of vaping and the limited amount of scientific research to support the safety of e-cigarette use. The authors of this paper want to create awareness that use of e-cigarettes is not a safer alternative to smoking tobacco cigarettes as e-cigarettes contain known carcinogens that may lead to development of oropharyngeal cancer.

The Mood Boost from Tobacco Cigarettes is More Erratic with the Additions of Cannabis and Alcohol.

A large body of literature indicates that nicotine results in an acute mood "boost," including increased positive affect and decreased negative affect. Young adults frequently engage in polysubstance use of cigarettes with cannabis and alcohol-a trend that is likely to accelerate with the expanding legalization of cannabis. However, little is known about whether polysubstance use, defined here as combustible tobacco cigarette use within the same hour as cannabis and alcohol, is associated with changes in the nicotine mood boost. The present study aimed to address this gap. Young adults (N = 202, 52% female, mean age = 21 years at time 1) provided ecological moments assessment (EMA) reports of cigarette use over two 7-day bursts spaced 1 year apart. In each report, participants rated mood levels before and after smoking, and indicated cannabis and alcohol use. Mixed-effects location-scale modeling simultaneously tested changes in mood levels and variability related to smoking events with cannabis and/or alcohol compared with smoking-only events. From before to after smoking, positive affect increased and negative affect decreased, on average. Overall, the additions of cannabis and/or alcohol had nonsignificant associations with these mean changes. However, polysubstance use, as well as cigarette-cannabis co-use, were each associated with significantly greater within-person variability in the positive and negative affect changes related to smoking. The mood benefits associated with smoking were more erratic in the contexts of polysubstance use and cigarette-cannabis co-use. Potential implications for young adults' long-term nicotine use trajectories are discussed. Among young adults who smoke cigarettes, the mood "boost" from smoking may be more erratic-which is to say, more likely to be either amplified or attenuated-with the additions of cannabis and alcohol together, or cannabis alone. On occasions when young adults seek out cannabis and alcohol to enhance their smoking mood boost, but instead experience a dampening effect, they might consume more nicotine, contributing over time to greater dependence. Future investigation is warranted, with particular attention to nicotine-cannabis co-use.

Study protocol: evaluation of the addictive potential of e-cigarettes (EVAPE): neurobiological, sociological, and epidemiological perspectives

BackgroundTobacco use is the largest preventable cause of diseases and deaths; reducing tobacco intake is, therefore, an urgent public health goal. In recent years, e-cigarettes have been marketed as a 'healthier' alternative to tobacco smoking, whilst product features have evolved tremendously in the meantime. A lively scientific debate has developed regarding the potential benefits and risks of e-cigarettes although, surprisingly, there are few studies investigating the addictive potential of nicotine-containing e-cigarettes. The present work comprises three work packages investigating the addictive potential of e-cigarettes from different perspectives: (1) the neurobiological addictive potential of e-cigarettes; (2) the experience and perception of dependence symptoms among users of e-cigarettes in a social context; and (3) the epidemiological perspective regarding factors influencing the potential for dependence.MethodsWork package I: the neurobiological study will investigate the key elements of addiction in e-cigarettes compared to tobacco cigarettes using neurobiological and neuropsychological correlates associated with craving, incentive motivation, cue reactivity and attentional bias. Work package II: the sociological study part examines self-reports on the experience and perception of dependence symptoms in a social context, using focus group interviews and the analysis of posts in online discussion forums on e-cigarettes. Work package III: the epidemiological study part focuses on tolerance development and the role of psychosocial and product factors by analyzing longitudinal data from the International Tobacco Control Policy Evaluation Project (ITC).DiscussionThe present study offers a chosen mix of three methodological approaches, thereby comprehensively examining core symptoms of positive and negative reinforcement in addiction. Whether e-cigarettes are as reinforcing and addictive as combustible tobacco cigarettes is an important public health issue with implications for prevention and treatment programs.Trial registration: Work package I: Registered at clinicaltrials.gov/ct2/show/NCT04772014. Work package II: Registered at OSF Registries: https://osf.io/dxgya (2021, January 14).

The Tobacco Endgame-Eradicating a Worsening Epidemic: A Joint Opinion From the American Heart Association, World Heart Federation, American College of Cardiology, and the European Society of Cardiology.

The Tobacco Endgame-Eradicating a Worsening Epidemic: A Joint Opinion From the American Heart Association, World Heart Federation, American College of Cardiology, and the European Society of Cardiology.

E-cigarette use and combustible tobacco cigarette smoking uptake among non-smokers, including relapse in former smokers: umbrella review, systematic review and meta-analysis

ObjectiveTo review and summarise the current evidence on the uptake of combustible cigarette smoking following e-cigarette use in non-smokers—including never-smokers, people not currently smoking and past smokers—through an umbrella review,...

Tobacco Smoking and Smokeless Tobacco Use among Domestic and International Medical Students in Hungary

Background: Medical students as future physicians will have an important role in tobacco control; therefore, their tobacco use behavior is of particular interest. Consumption of combustible tobacco (cigarettes, waterpipes, cigars, and pipes) is prevalent throughout Europe, whereas smokeless tobacco use is common mainly in the Nordic countries. Objectives: Aim of our study is to assess tobacco use among medical students from different countries studying in Hungary with special focus on students from Norway where smokeless tobacco is widely used. A self-administered questionnaire survey was carried out to measure current tobacco use. Results: The survey included 1337 students from Hungary, Norway, Germany, and from other countries (Multinational group). The lowest prevalence of cigarette smoking was found among students from Norway (13.0%) when compared with students from Hungary (21.5%), Germany (34.2%), or with students in the Multinational group (29.5%). Conversely, prevalence of smokeless tobacco use was the highest among students from Norway (40.9%) when compared with students from Hungary (1.4%), Germany (2.6%), or with students in the Multinational group (6.2%). Waterpipes, cigars, and pipes were rarely used, mostly only 1–3 times a month in all groups. More than half of Norwegian students used some form of tobacco (smokeless and/or combustible tobacco). Conclusions: Considering the impending role of medical students in tobacco control, faculties of medicine should sensitize their students on the topic of possible health risks associated with combustible and smokeless tobacco products. Culturally tailored tobacco cessation programs need to be offered to medical students coming from different cultural backgrounds.

Oral Hygiene Practices of Hungarian Adult E-Cigarette-Only and Dual Users.

This study aimed to explore self-reported oral hygiene practices (OHPs) among Hungarian adult e-cigarette-only (former smokers who switched completely to e-cigarette use or vaping) and dual users (smokers who use e-cigarettes and combustible tobacco cigarettes concomitantly). A cross-sectional, web-based survey of 930 adult Hungarian e-cigarette users was conducted in 2015. Participants reported 10 OHPs, which were included in analyses as separate binary variables and as a composite variable of the 10 OHP items (inadequate/adequate). Chi-square test was used to explore whether separate OHPs differ by vaping status, and to examine the relationship between inadequate OHPs and past combustible or e-cigarette use characteristics. Associations between separate OHPs and vaping status, and between inadequate OHPs and vaping status were tested by multiple logistic regression analyses. More dual users reported toothbrushing twice a day or more than e-cigarette-only users (73.6% vs 65.3%, respectively, p = 0.041) and using sugar-free chewing gum (57.7% vs 45.8%, respectively, p = 0.006) while adequacy of other OHPs did not differ statistically significantly by vaping status. Inadequate OHPs were more typical in the sample (63.7%) than adequate OHPs, however, inadequate OHPs did not differ statistically significantly among dual users and e-cigarette-only users (62.0% vs 64.0%, respectively, OR = 1.20, p = 0.400), controlling for age, gender, education, past combustible and current e-cigarette use characteristics. In this study, both e-cigarette-only and dual users demonstrated similarly high prevalence of inadequate OHPs. Therefore dentists should educate them about effective OHPs and the role of tobacco and e-cigarette use in the development of oral diseases.

Sensory experiences and cues among E-cigarette users

Background and aimsWe characterized the extent and quality of respiratory sensations and sensory-related smoking cues associated with e-cigarette use among those who failed to quit combustible tobacco cigarette (CTC) use with traditional FDA approved medications but succeeded in doing so with e-cigarettes. Further, we sought to understand former smokers’ perceptions about the influence of sensory experience with e-cigarette use on CTC cessation outcomes.MethodsA nonrandom purposive sample of 156 participants recruited in the USA through the Consumer Advocates for Smoke Free Alternatives Association Facebook page completed an online cross-sectional survey to assess sensory experiences and smoking cues associated with e-cigarette use. Descriptive statistics were calculated, and the ANOVA/Kruskal–Wallis test with post hoc testing and the two-sample t test/Wilcoxon rank-sum test, as appropriate based on distribution, were used to assess the association between sample characteristics and sensory experiences and cues using investigator constructed questions, the Modified Cigarette Evaluation Questionnaire (mCEQ) and the Smoking Cue Appeal Survey (SCAS).ResultsWith e-cigarette use, participants reported feeling the vapor in their throats, windpipes, noses, lungs, and on their tongues; reductions in nicotine craving; and enjoyment of their e-cigarette, including tasting, smelling, and seeing the vapor and touching the device. Women had greater craving reduction than men (p = 0.023). Those who began smoking at 13 years of age or younger had more satisfaction and had greater sensory enjoyment than those who began smoking at 16–17 years of age (p = 0.015 and p = 0.026, respectively), as well as greater sensory enjoyment than those who began smoking at 14–15 years of age (p = 0.047). There was a significant overall association between the number of years a respondent smoked and e-cigarette sensory enjoyment (p = 0.038). Participants 18–34 years old rated e-cigarettes as being more pleasant compared to 45 + years olds, (p = 0.012). Eighty-four percent of participants reported the sensation of the vapor as important in quitting CTCs, and 91% believed the sensations accompanying e-cigarette use contributed to their smoking cessation success.ConclusionsFor those who failed to quit previously using approved cessation medications to stop smoking cigarettes, sensory experiences associated with e-cigarette use may help smokers quit smoking.

Associations Between Family and Peer E-Cigarette Use With Adolescent Tobacco and Marijuana Usage: A Longitudinal Path Analytic Approach.

Research indicates a link between adolescent e-cigarette use and combustible tobacco cigarette (CTC) initiation, and recent studies suggest their connection with marijuana uptake. Our 3-year longitudinal cohort study investigated the implications of adolescent, peer, and family e-cigarette use with adolescents' expectations and willingness to initiate CTC use, and subsequent CTC and marijuana use. Relationships were examined in a secondary analysis of a 3-year longitudinal cohort subsample involving adolescents enrolled in alternative California high schools (N = 1025). Analyses examined responses over three yearly observations. Family, peer, and respondents' e-cigarette use, respondents' positive cigarette expectancies and willingness to use CTCs were assessed in the study's first year (T1). CTC use in the survey's second year (T2) and marijuana use in the third year (T3) were assessed via path analysis. Respondents reporting at least one family member or peer using e-cigarettes were more likely to use e-cigarettes at T1 than those whose peers/family members did not. They reported more positive expectancies about CTCs and greater willingness to initiate use. These variables predicted CTC use at T2, which directly anticipated marijuana use in the survey's third year (T3), as did adolescents' use of e-cigarettes at T1. All model relations were statistically significant. Analysis demonstrated the strong association of family members' and peers' behaviors with adolescent e-cigarette use, and the temporal precedence of e-cigarette use with subsequent CTC and marijuana uptake. The predictive implications of e-cigarettes for other dangerous substance use should be examined in future prevention campaigns. The presented study expands upon existing literature connecting adolescent e-cigarette use and later CTC and marijuana use. The findings indicate the significant implications of exposure to e-cigarette use by parents and peers and demonstrate in a longitudinal 4-year panel survey the direct and indirect predictive implications of e-cigarette use for CTC and marijuana uptake. The research illustrates the utility of programs and campaigns that target peer and family groups to maximize impacts on adolescent willingness to try CTCs, positive expectancies, and possible onset of CTC and marijuana use.

Comparison of the cardiac effects of electronic cigarette aerosol exposure with waterpipe and combustible cigarette smoke exposure in rats

AimsElectronic cigarette (ECIG) has been used as an alternative to tobacco smoking as it lacks the majority of toxicants found in tobacco smoke. However, the effect of ECIG aerosol inhalation on cardiac health are not well studied. The present study aimed to compare the effects of ECIGs with that of combustible tobacco cigarette (T-Cigs) and waterpipe (WP) smoke on cardiac biomarkers of oxidative stress, inflammation, and fibrosis. Main methodsRats were randomized into control (fresh air, n = 12), ECIG aerosol (n = 12), T-Cig smoke (n = 15), or WP (n = 13) smoke conditions in which they were exposed 1 h/daily, 6 day/week for 4 weeks. Cardiac biomarkers of oxidative stress, inflammation, and remodeling were assessed. Key findingsRelative to control, significant increase in heart to body weight ratio was observed in all exposed groups. Cardiac endothelin-1 and myeloperoxidase were increased for ECIG and T-Cig. Cardiac nitrite and TBARS were increased in all exposed groups, but activity of superoxide dismutase was increased for ECIG and T-Cig only while glutathione levels increased for ECIG only. No changes were observed for cardiac C-reactive protein and catalase activity. Cardiac fibrosis was observed in all exposed groups coupled with an increase in the transforming growth factor beta protein that was significant for ECIG only. SignificanceECIG aerosol may promote cardiac alterations in similar manner to tobacco smoke by promoting myocardial oxidative stress and inflammation leading to fibrosis. With regard to cardiac health, exposure to ECIG aerosol and combustible T-Cig smoke may lead to similar adverse outcomes.

E-Cigarettes: A Hazard or a Help?

A global debate has arisen regarding the relative benefits and harm resulting from the use of electronic cigarettes (“e-cigarettes”). In some countries, such as the United Kingdom, the use of e-cigarettes (“vaping”) has been shown to help reduce addiction to combustible tobacco cigarette (“smoking”), which represents the leading preventable health hazard in many countries. In contrast, in other countries, such as the United States, e-cigarettes, which have attracted many adolescents and young adults who would not otherwise have started to smoke, represent an alternative delivery vehicle for nicotine or cannabis (marijuana) by expanding their markets, reducing nicotine cessation rates by means of a more convenient, healthier, and less offensive product. Although considered less harmful health-wise than smoking, the expected net effect of vaping remains controversial, as sufficient experience has not yet been accumulated to confirm the health impacts, especially over the long term. Nevertheless, viewed by themselves, e-cigarettes do represent a health hazard, with growing information regarding their adverse effects. The stakes of this debate are high—for individuals, society and the e-cigarette, tobacco, insurance, and health care industries. After highlighting the current use of e-cigarettes by adults and adolescents, this article summarizes current issues associated with e-cigarettes, highlighting their health effects; nicotine and addiction; initiation; smoking cessation and harm reduction; gateway to smoking; modifications; flavorings; secondhand aerosol; and new product innovations. It discusses the sources of disagreements and reactions from regulators and life insurers. In addition, the modeling, estimates, and uncertainties associated with mortality resulting from vaping are addressed. For life and health insurance, actuaries are assessing whether to treat e-cigarette users in a manner similar to those who smoke combustible tobacco cigarettes.

JUUL and Combusted Cigarettes Comparably Impair Endothelial Function.

JUUL and earlier generation electronic cigarettes (e-cigs) are promoted as being less hazardous than cigarettes. While JUUL Labs, in particular, claims that switching from smoking to vaping has beneficial impacts, the health effects of such products are not well understood. We investigated whether exposure to JUUL and previous generation e-cig aerosol impairs endothelial function comparably to cigarette smoke. We exposed rats to aerosol from Virginia Tobacco flavor JUUL, an e-cig tank system using unflavored freebase nicotine e-liquid, Marlboro Red combustible tobacco cigarettes, or clean air for 10 cycles of 2 second inhalation over 5 minutes. Endothelial function (FMD) was measured pre- and post-exposure. Blood was collected 20 mins post-exposure for serum nicotine analysis. Aerosol/smoke from JUUL, previous generation e-cigs, and cigarettes all impaired FMD. The extent of impairment ranged from 34%-58%, although the differences between groups were insignificant. Nicotine was highest in serum from the JUUL group; for the other e-cig and cigarette groups, nicotine levels were lower and comparable to each other. Aerosol from JUUL and previous generation e-cigs impairs endothelial function in rats, comparable to impairment by cigarette smoke.

Influence of Electronic Cigarette Characteristics on Susceptibility, Perceptions, and Abuse Liability Indices among Combustible Tobacco Cigarette Smokers and Non-Smokers.

This study assessed how electronic cigarette (ECIG) characteristics amenable to regulation—namely nicotine content, flavor, and modified risk messages—impact ECIG use susceptibility, harm/addiction perceptions, and abuse liability indices among combustible tobacco cigarette (CTC) smokers and non-smokers. CTC smokers and non-smokers varying in ECIG use recruited via Amazon Mechanical Turk (MTurk) completed an online survey in 2016 (analytic n = 706). Participants were randomly assigned to one of eight conditions differing in ECIG characteristics: nicotine content (no, low, high), flavor (menthol, tobacco, fruit), or modified risk message (reduced harm, reduced carcinogen exposure). Regressions assessed ECIG susceptibility, harm/addiction perceptions, and abuse liability indices (purchase task measures of breakpoint/intensity) within each regulatory domain (nicotine content, flavor, message) and their interactions with CTC/ECIG status. Differential effects on ECIG susceptibility, harm/addiction perceptions, and abuse liability indices were observed by regulatory domain with many effects moderated by CTC/ECIG status. ECIG nicotine content and flavor conditions were the most influential across outcomes. Greater nicotine content, tobacco-flavored and reduced carcinogen exposure ECIGs were more highly preferred by CTC smokers with some differing preferences for non-users. Findings reinforce consideration of discrete ECIG preferences across tobacco use status to improve regulatory efficacy.

Dual use of electronic cigarettes and tobacco in New Zealand from a nationally representative sample

ObjectiveThere is strong interest in the use of electronic cigarettes (e‐cigarettes) globally. Not much is known about the dual use of e‐cigarettes and combustible tobacco cigarettes, or if there are demographic differences among dual users and e‐cigarette only users. This paper reports on the demographics of dual users and e‐cigarette only users in New Zealand in a nationally representative sample. MethodsThe Health and Lifestyles Survey (HLS) is a biennial face‐to‐face in‐house survey of New Zealand adults aged 15 years or over. The HLS was completed by 3,854 participants in 2016. ResultsThere is clear evidence of significant dual use in the current sample: most current e‐cigarette users (63.9%) were dual users. Respondents 45 years and older were twice as likely to be dual users as those aged 15 to 34 years. ConclusionThe current study found evidence for substantial dual use of e‐cigarettes and combustible tobacco cigarettes among adult e‐cigarette users, particularly among users aged 45 years and over. Implications for public healthPublic health initiatives should provide clear advice that e‐cigarettes should be used as a smoking cessation tool and not as a way to allow the consumption of combustible tobacco to continue.

Perceived health effects of vaping among Hungarian adult e-cigarette-only and dual users: a cross-sectional internet survey

BackgroundKnowledge about the health effects of e-cigarette use (or vaping) among past and current combustible cigarette users is limited. Several studies have assessed vaping-related adverse events (AEs) and beneficial health effects, however, most studies focused on AEs in general and examined only a few physiological changes that vapers experience. This study aims to explore self-reported AEs and perceived health changes due to e-cigarette use among Hungarian adult e-cigarette-only users (former smokers who switched completely to e-cigarette use) and dual users (smokers who use e-cigarettes and combustible tobacco cigarettes concomitantly).MethodsA cross-sectional, web-based survey of 1042 adult Hungarian e-cigarette users was conducted in 2015. Participants reported AEs and changes in physiological functions since they switched from smoking to e-cigarette use or while dually using e-cigarettes and combustible cigarettes. Confirmatory factor analysis with covariates was applied to explain perceived health changes due to e-cigarette-only use and dual use.ResultsDual users (17.6%) were significantly more likely to report AEs of vaping than e-cigarette-only users (26.2% vs. 11.8%, p < 0.001). Experiencing health improvements were significantly more likely among e-cigarette-only users than for dual users for all surveyed physiological functions. E-cigarette-only users reported larger effects of vaping on sensory, physical functioning, and mental health factors compared to dual users. Self-reported changes in sensory and physical functioning were significantly higher among individuals using e-cigarettes more than a year and people who were past heavy smokers (smoked ≥20 cigarettes per day). Gender was related to sensory improvement only; males reported greater improvement than females.ConclusionsThe majority of e-cigarette-only users reported more perceived beneficial changes in physiological functions and fewer AEs than dual users. Perceived short-term benefits of e-cigarette use may reinforce users despite the uncertainty of long-term health consequences. Health professionals should provide balanced information regarding the possible short- and long-term positive and negative health effects of e-cigarette use during consultations with patients.

The use of Genomic Allergen Rapid Detection (GARD) assays to predict the respiratory and skin sensitising potential of e-liquids

Electronic cigarettes (e-cigarettes) are an increasingly popular alternative to combustible tobacco cigarettes among smokers worldwide. A growing body of research indicates that flavours play a critical role in attracting and retaining smokers into the e-cigarette category, directly contributing to declining smoking rates and tobacco harm reduction. The responsible selection and inclusion levels of flavourings in e-liquids must be guided by toxicological principles. Some flavour ingredients, whether natural extracts or synthetic, are known allergens. In this study, we used the Genomic Allergen Rapid Detection (GARD) testing strategy to predict and compare the respiratory and skin sensitising potential of three experimental and two commercial e-liquids. These novel, myeloid cell-based assays use changes in the transcriptional profiles of genomic biomarkers that are collectively relevant for respiratory and skin sensitisation. Our initial results indicate that the GARD assays were able to differentiate and broadly classify e-liquids based on their sensitisation potential, which are defined mixtures. Further studies need to be conducted to assess whether and how these assays could be used for the screening and toxicological assessment of e-liquids to support product development and commercialisation.

Experts Call For More Action to Thwart Youth Vaping ‘Epidemic’

Experts Call For More Action to Thwart Youth Vaping ‘Epidemic’

Effects of six weeks of electronic cigarette use on smoking rate, CO, cigarette dependence, and motivation to quit smoking: A pilot study

ObjectivesSwitching from combustible tobacco cigarettes to electronic cigarettes (e-cigs) may or may not help smokers to reduce cigarette consumption and toxicant exposure. This pilot study investigated the effects of asking smokers to switch to e-cigs for 6weeks on smoking, exhaled carbon monoxide (CO) concentration, dependence, and motivation to quit smoking. MethodsNon-treatment seeking daily smokers (n=18) were given free e-cigs and instructed to use them instead of smoking cigarettes for 6weeks. Smokers were assessed at baseline, weekly for 6weeks, and at 8 and 10weeks for cigarettes/day, e-cig use, CO, cigarette dependence, and Contemplation Ladder. ResultsAll participants completed 6weeks; 17 completed 10weeks. At Week 6, cigarettes/day were reduced by two-thirds and CO by 45% from baseline (p's<.001), with reductions maintained at Week 10 (p's<.005). Cigarette dependence scores were a third lower at Weeks 6 (p<.002) and 10 (p<.001) than at baseline. Contemplation Ladder scores were higher at Weeks 6 and 10 (p's<.001) than at baseline. All these statistical effect sizes were large. At Week 6, number of reasons not to use e-cigs increased (p<.011). ConclusionsResults show preliminary evidence for beneficial effects of short-term switching to e-cigs by non-treatment seeking smokers in terms of reduced smoke toxicant exposure and cigarette dependence, and increased motivation to quit, all maintained at least 4weeks after free e-cigs were no longer provided.