Nicotine Content Research Articles

Characteristics and ingredients of disposable 'Elfbar' e-cigarettes sold in the United States and the United Kingdom.

As of 2023, Elfbar remains the most popular brand of disposable e-cigarette available in the United States (US) and United Kingdom (UK), with similar flavor options in both countries. At the time of this study, 5% nicotine Elfbar BC5000 was the only version available in the US, whereas 2% Elfbar 600 was the most popular in the UK. This study measured differences in nicotine content and form, aerosol emissions and flavoring chemicals in the US and UK Elfbar products. A convenience sample of eight Elfbar devices sold in the US and UK, consisting of two Elfbar models with four identical flavor options (Peach Ice, Strawberry Banana, Strawberry Ice and Strawberry Kiwi) purchased between December 2022 and February 2023, were laboratory tested. We measured nicotine concentration, form and total content. We also determined aerosol emissions and estimated the nicotine dose delivery per puff. We identified solvents and flavoring chemicals in these products. Elfbar products within the same country had similar nicotine content, concentration, form and solvents, but they differed in flavoring chemicals. US Elfbar contained, on average, higher volume (mean ± standard deviation = 6.5 ± 0.5 versus 1.8 ± 0.3ml) of nicotine solution with a higher concentration (41.8 ± 2.3 versus 19.7 ± 1.2mg/ml) than the UK Elfbar. An estimated dose of nicotine delivered per puff was four times higher from US Elfbar than UK Elfbar. There were differences in the type and amount of flavoring chemicals used in US and UK Elfbars, including a higher concentration of a synthetic coolant WS-23 in US Elfbar than in UK Elfbar (17.8 ± 1.5 versus 12.9 ± 5.4mg/ml). Because the amount of nicotine found in the US Elfbar e-cigarettes is equivalent to that found in eight UK Elfbar e-cigarettes, people who use Elfbar sold in the US have access to much more nicotine from a single device than those who use Elfbar sold in the United Kingdom.

Prediction of the impact of tobacco waste hydrothermal products on compost microbial growth using hyperspectral imaging combined with machine learning

The insufficient understanding of the impact of hydrothermal products on the growth characteristics of compost microorganisms presents a significant challenge to the broader implementation of hydrothermal coupled composting for tobacco waste. Traditional biochemical detection methods are labor-intensive and time-consuming, highlighting the need for faster and more accurate alternatives. This study investigated the effects of hydrothermal treatment on tobacco straw products and their influence on compost microorganism growth, using hyperspectral imaging (HSI) technology and machine learning algorithms. Sixty-one tobacco straw samples were analyzed with a hyperspectral camera, and image processing was used to extract average spectra from regions of interest (ROI). Hierarchical cluster analysis (HCA) and principal component analysis (PCA) were applied to assess four key variables: nicotine content, total humic acid content, Penicillium chrysogenum H/C ratio, and Bacillus subtilis OD600 ratio. The effects of hydrothermal treatment on compost were classified as promoting, inhibiting, or neutral regarding microbial growth. The Competitive Adaptive Reweighted Sampling (CARS) method identified the most influential wavelengths in the 900-1700 nm spectral range. The Random Forest (RF) model outperformed SVM, KNN, and XGBoost models in predicting microbial growth responses, achieving Rc = 0.957, RMSE = 3.584. Key wavelengths were identified at 1096 nm, 1101 nm, 1163 nm, 1335 nm, and 1421 nm. The results indicate that hyperspectral imaging combined with machine learning can accurately predict changes in the chemical composition of tobacco straws and their effects on microbial activity. This method provides an innovative and effective means of improving the resource usage of tobacco straws in composting, enhancing sustainable waste management procedures.

Experience with reduced-nicotine cigarettes and whether this decreases smoking and substitution for full-nicotine cigarettes.

Studies suggest that reduced-nicotine cigarettes decrease nicotine intake and dependence. However, questions remain about reduced-nicotine cigarette abuse liability, whether reduced-nicotine cigarette exposure lowers reduced- and full-nicotine cigarette use, and whether reduced-nicotine cigarettes substitute for full-nicotine cigarettes. This randomized, double-blind laboratory study used operant behavioral economics to examine abuse liability of cigarettes with varying nicotine content. Non-treatment-seeking smokers (N = 43) self-administered reduced- (5.2, 2.4, or 1.3 mg/g) and full-nicotine (15.8 mg/g) cigarettes before and after 3 weeks of at-home exposure. Participants were randomized to full-nicotine or one of the reduced-nicotine cigarettes to determine the effect of exposure on abuse liability and substitutability. Abuse liability was assessed in single-commodity sessions, and substitutability was measured in concurrent-commodity sessions. In the self-administration sessions, concurrently available reduced-nicotine cigarettes attenuated full-nicotine cigarette demand and rendered reduced-nicotine cigarettes partial substitutes for full-nicotine cigarettes. Exposure to study cigarettes for 3 weeks marginally reduced demand for reduced- and full-nicotine cigarettes irrespective of nicotine content. Results suggest a limited influence of nicotine content on smoking behavior in established smokers and highlight the role of nonpharmacological factors (e.g., taste/smell) on the maintenance of smoking. These results should be considered in determining whether a nicotine-reduction standard is a feasible path for reducing cigarette demand.

Understanding use of e-cigarettes for smoking cessation among a sample of US adults.

Many adults who smoke cigarettes report trying e-cigarettes to quit smoking. Understanding the use of e-cigarettes for smoking cessation and the type of support that adults desire when trying to quit smoking is important for supporting cessation attempts and maximizing smoking abstinence. In summer 2021, an online survey of 857 adults who reported a history of regular cigarette smoking and endorsed using e-cigarettes in a recent smoking cessation attempt was conducted. Survey items assessed reasons for using e-cigarettes to quit smoking, what was helpful about e-cigarettes, and what information participants desired when using e-cigarettes to quit smoking. Common reasons for using e-cigarettes to quit smoking included beliefs that vaping would be helpful for quitting (53.6%), vaping is safer than smoking (50.5%), and favorable comparisons relative to other nicotine replacement treatment (NRT) like nicotine patches and gum (24.7%). 23.8% selected e-cigarettes because they were cheaper than other smoking cessation aids. 89% of participants reported still smoking cigarettes at the time of survey. The most common information people wanted when quitting was advice on how to gradually reduce nicotine over time to become nicotine-free (46.3%), how different vaping devices work (39.7%), and what nicotine concentration to start with (37.7%). Findings identified common beliefs about e-cigarettes as a smoking cessation aid and how they compare to other treatments including NRT. Understanding factors that support cessation are critical especially due to high relapse rates. Results may help to inform support programs, especially for individuals who are interested in using e-cigarettes to quit smoking. Despite greater reporting, there is a limited understanding of e-cigarette use for quitting among those who smoke cigarettes.Our study highlights the reasons for using e-cigarettes among those who have recently tried e-cigarettes for quitting smoking, and the components of e-cigarette that were helpful.We also examined the desired support in a program designed to use e-cigarettes for quitting smoking. Majority of participants who attempted to quit smoking using an e-cigarette relapsed to smoking, indicating the gap in cessation support that can be filled with greater understanding of the desired support.

International survey of young adults’ opinions on tobacco endgame measures & e-cigarette regulations

Abstract In the last decade, while tobacco consumption has decreased, there has been a significant rise in e-cigarette usage particularly among young people. Tobacco-free generations and other endgame strategies are being considered in several countries, moving from tobacco control towards ending the tobacco epidemic. This online survey of 18-34-year-olds evaluated opinions on potential endgame measures and e-cigarette regulations, to generate evidence to inform policy decisions. The survey was developed with input from the World Federation of Public Health Associations and Tobacco-Free Ireland, asking participants about support (yes/no) for 20 endgame measures in 4 domains and attitudes towards e-cigarettes. Utilising convenience sampling, the survey was distributed through international networks. Of 295 responses in 34 countries, 72% were never smokers and 56% were never e-cigarette users. 31% were aware of tobacco endgame. 68% supported increasing tobacco purchasing age to 21. 70% supported restricting tobacco sales to a limited number of licenced shops. 73% supported reducing nicotine content in cigarettes. 74% supported tobacco companies having to pay for health costs from smoking. 73% would like to see tobacco-free generation legislation in their country, but only 31% expected it would be successful. Regarding e-cigarettes, they were judged as more desirable than cigarettes mostly due to different flavours and visual appearance (both 74%). They were perceived to be an important health risk (82%) and as or more addictive than cigarettes (78%). 65% believed overall harms from e-cigarettes outweigh benefits for society. 86% felt they should be subjected to the same advertising restrictions as cigarettes and 66% supported increasing their cost. There was strong support for various tobacco endgame measures and tobacco-free generation legislation in this 18-34-year-old cohort. The majority recognised health risks of e-cigarettes and favoured stricter regulation of these products. Key messages • An international survey of 295 young adults in 34 countries demonstrated strong support for various tobacco endgame measures including tobacco-free generation legislation. • For e-cigarettes, there was wide acknowledgement of addictiveness and health risk, and support for increased education and warnings, lower nicotine content and reduced advertising and availability.

Beyond smoking: Risk assessment of nicotine in pouches

Orally consumed nicotine pouches that contain no tobacco are marketed as a less harmful alternative to tobacco products. This study aims to assess nicotine in pouches and potential risks for health damage. 31 samples of nicotine pouches were collected and analyzed. The median nicotine uptake from single pouches was calculated to be 65 µg/kg bw. Consumption of more than one pouch per day would lead to a strikingly higher nicotine dose over the day. Health effects after nicotine exposure are, among others, cardiovascular effects. An acute reference dose (ARfD) of 0.8 µg/kg bw was proposed for risk assessment purposes based on an observed increased heart rate in a human study after acute nicotine uptake. The ARfD was exceeded by at least 20-fold, even when considering the consumption of a single pouch with the lowest detected nicotine level. With higher nicotine contents in pouches or with an increasing number of pouches per day, vast ARfD exceedances are possible. Therefore, a clinically relevant elevation of heart rate is very likely to occur in consumers after acute consumption of nicotine pouches.

Social Media Exposure and Other Correlates of Increased e-Cigarette Use Among Adolescents During Remote Schooling: Cross-Sectional Study.

Little is known about the role of exposure to e-cigarette-related digital content, behavioral and mental health factors, and social environment on the change in adolescent e-cigarette use during COVID-19 shelter-in-place orders and remote schooling. The aim of the study was to examine changes in adolescent e-cigarette use during shelter-in-place and remote schooling in association with exposure to e-cigarette-related digital content and other correlates: stronger e-cigarette dependence, feeling lonely, inability to socialize, e-cigarette use to cope with shelter-in-place, and the number of family members aware of participants' e-cigarette use. A cross-sectional survey conducted between August 2020 and March 2021 included 85 California adolescents (mean age 16.7, SD 1.2 years; 39/85, 46% identified as female and 37/85, 44% as Hispanic) who reported e-cigarette use in the past 30 days. Multivariable penalized logistic regressions determined associations adjusted for age, race and ethnicity, and mother's education. The outcome of increased e-cigarette use was defined as more frequent use of e-cigarettes of the same or stronger nicotine or tetrahydrocannabinol concentration. Almost all respondents (83/85, 98%) reported using social media more since shelter-in-place, and 74% (63/85) reported seeing e-cigarette digital content. More than half (46/85, 54%) reported increased e-cigarette use during shelter-in-place. Most individuals who increased use were exposed to e-cigarette digital content (38/46, 83%) compared to those who did not increase e-cigarette use (25/39, 64%), but the association was nonsignificant after adjusting for demographics (adjusted odds ratio [AOR] 2.34, 95% CI 0.71-8.46). Respondents who felt lonely (AOR 3.33, 95% CI 1.27-9.42), used e-cigarettes to cope with shelter-in-place (AOR 4.06, 95% CI 1.39-13.41), or had ≥2 family members aware of participants' e-cigarette use (AOR 6.42, 95% CI 1.29-39.49) were more likely to report increased e-cigarette use. Almost all participants reported using social media more during shelter-in-place, with many respondents reporting increased e-cigarette use, and significant associations with loneliness and use to cope with shelter-in-place. Future interventions should consider leveraging digital platforms for e-cigarette use prevention and cessation and address the mental health consequences of the COVID-19 pandemic.

Mental health and support for rigorous tobacco control strategies in South Australia

IntroductionTobacco endgame strategy includes policies to end the tobacco epidemic. As tobacco smoking prevalence is higher among people with mental health conditions (MHC), understanding the impact of rigorous tobacco control...

Health Risks Associated with Adopting New-Generation Disposable Products Among Young Adults Who Use E-Cigarettes.

New-generation disposable e-cigarettes have become increasingly popular among young adults in the USA since the FDA's partial flavor ban. This study aims to examine longitudinal changes in health risks among young adults who adopted these novel products, as well as the health effects of device types beyond the effects of other important e-cigarette characteristics. This study recruited e-cigarette users via voluntary response sampling from three college campuses in the USA to respond to four-wave online surveys conducted in four consecutive semesters. Among the participants who adopted disposables during the study, their health risks (dependence symptoms, respiratory symptoms, combustible tobacco use) and e-cigarette consumption characteristics (use frequency, nicotine concentration and flavors) before and after the adoption were compared using paired-sample t- or McNemar's tests. Generalized linear mixed models with a random intercept were conducted on data from the entire sample to investigate the effects of device type (tank, cartridge/pod, disposable) on health risks, controlling for other e-cigarette consumption characteristics. The study sample of 650 e-cigarette users were, on average, 20 years old, with 49% being male, 70% being White, and 13% being Hispanic. Adopting disposables may increase secondary dependence motives (t = 2.42, p < 0.05) and the use of higher levels of nicotine concentration (t = 2.09, p < 0.05) and sweet flavors (x2 = 22.53, p < 0.05) but decrease the number of times of vaping per day (t = -2.18, p < 0.05) and the use of menthol flavors (x2 = 4.57, p < 0.05). Tank use is associated with a higher level of primary dependence motives (b = 0.1998, p < 0.05) and a greater odds of using combustible tobacco (b = 0.4772, p < 0.05). Although disposable use is not associated with the likelihood of using combustible tobacco, it is associated with higher levels of both primary (b = 0.2158, p < 0.05) and secondary (b = 0.2533, p < 0.05) dependence motives. It is not the device type, but rather the frequency of vaping, that affects respiratory symptoms (b = 0.0602, p < 0.05). The findings indicate that when young adults switch to disposables, their e-cigarette dependence and use of sweet-flavored e-liquids increase. Even after controlling for use frequency, nicotine concentration and flavors, using disposables is related to not only instrumental motives that are influenced by psychological and environmental contexts but also heavy, automatic use that can operate without environmental cues. Given the health risks associated with disposable e-cigarettes, more comprehensive tobacco product regulations that consider the impact of device types may be needed.

Conjunctival and Corneal Endothelium Profile in a Sample of Healthy Electronic Cigarette Smokers

Objective: Though e-cigarette is thought of as a healthy alternative way of smoking, the unknown nicotine concentration level and chemical compounds from the aerosol mist and flavourings are potentially harmful and may exert irritation or damage to the ocular surface. Thus, a cross-sectional study was conducted to identify the conjunctival and corneal endothelium profile among healthy e-cigarette smokers, and the relationship between smoking behaviour with the conjunctival and corneal endothelium profile. Material and Methods: Seventeen healthy e-cigarette smokers and 17 non-smokers were recruited for this study where their palpebral redness, bulbar redness, limbal redness, conjunctival roughness, central corneal thickness, endothelial cell density, and coefficient of variation of endothelium cell area were assessed using slit lamp biomicroscope and specular microscope. Results: There was a non-significant, higher mean rank observed in the total palpebral redness, total bulbar redness, total limbal redness, total conjunctival roughness, central corneal thickness, endothelial cell density, and coefficient of variation of the endothelium cell area in e-cigarette smokers compared to non-smokers (p-value&gt;0.05). Only smoking frequency and total palpebral redness showed a statistically significant, positive, and fair correlation (r=0.349, p-value=0.043), while no other smoking behaviour showed a significant correlation (p-value&lt;0.05). Conclusion: The use of e-cigarettes showed no significant impact on the conjunctival and corneal profile among the users, but further research with comprehensive evaluation is required in a larger sample size of more established e-cigarette smoking profiles.

The formation of nicotine heterosis is mainly achieved by enhancing the nicotine transport capacity in hybrids

Nicotine exhibits obvious heterosis, which can be used to create Nicotiana tabacum L. (tobacco) varieties with varying nicotine content. However, the reasons for the formation of nicotine heterosis and its relationship to nicotine transport and accumulation remain unknown. This study conducted a comprehensive analysis of six tobacco hybrids with varying heterosis levels and their parent materials from various aspects, such as phenotype, physiology, and transcriptomics. The results showed that the direct path coefficient of transport heterosis to nicotine heterosis was highest in hybrids, at 0.98, and a highly significant positive correlation between the two. The plant height, thick stalk circumference, large flow of tissue fluid in the stalk, and high nicotine concentration of tobacco were the underlying factors that led to the strong nicotine transport capacity of hybrids. The formation of nicotine transport heterosis in hybrids was mainly influenced by non-additive gene effects (accounting for 89.93%), with over-dominant effects playing a dominant role (accounting for 58.79%). Among non-additive expression DEGs, nicotine transporter related multi antimicrobial extrusion protein, drug/metabolite transporter, ABC family transporter, and glutathione S-transferase were significantly upregulated in hybrid strains. The RT-qPCR results indicated that these genes related nicotine transport also exhibited heterosis at the expression level. Our results revealed that the formation of nicotine heterosis is mainly achieved by enhancing the nicotine transport capacity in hybrids. The results are not only beneficial for promoting the theoretical study of nicotine heterosis in tobacco and the breeding and utilization of hybrids, but are also of great significance for guiding nicotine production and promoting its multipurpose utilization.

Biomarkers of Nicotine and Toxicant Exposure by E-liquid Nicotine Concentration Level among U.S. Adult Exclusive E-cigarette Users.

The current e-cigarette market has been rapidly evolving with an increase in the share of high nicotine concentration vaping products. This study examined urinary biomarkers of exposure (BOEs) by nicotine concentration level among exclusive e-cigarette users. Data were drawn from Wave 5 (December 2018-November 2019) of the Population Assessment of Tobacco and Health (PATH) Study. Between-subject differences in BOEs of nicotine, metal, tobacco-specific nitrosamine (TSNA), and volatile organic compounds (VOC) were examined across e-cigarettes containing nicotine or not (yes [n=300] vs. no [n=31] vs. non-tobacco use [n=3021]) and different nicotine concentration levels (0.1-1.7%, 1.8-4.9%, and 5.0%+). Among 3353 participants, exclusive e-cigarette users exhibited higher mean concentrations of nicotine metabolites than non-tobacco users. Nicotine e-cigarette users had higher concentrations of TNE2 (mean [95% CI]=21.8 [15.2-31.2] vs. 0.2 [0.1-0.6] nmol/mg creatinine, p<.0001) and cotinine (1418.2 [998.0-2015.4] vs. 12.2 [0.1-0.6], p<.0001) ng/mg creatinine, p<.0001) than non-nicotine e-cigarette users. Users of e-cigarette products with nicotine levels of 1.8-4.9% had higher TNE2 and cotinine levels than those using 0.1-1.7%, though differences were insignificant after adjusting for covariates. As compared to non-tobacco users, nicotine vapers had higher concentrations of lead (adjusted p=0.01). Nicotine containing e-cigarette users exhibited elevated levels of nicotine metabolites than non-nicotine containing vapers and non-tobacco users. Future research needs to investigate health effects of e-cigarette use across different nicotine levels Impact: Regulating the nicotine content in e-cigarettes could be crucial in managing nicotine exposure and potentially mitigating associated health risks.

Effects of freebase/protonated nicotine concentration, liquid composition and electrical power on throat hit in direct-to-lung vaping: theory and clinical measurements

BackgroundFor decades, the tobacco industry has engineered the sensory characteristics of combustible tobacco products including the degree of harshness experienced at the back of the throat. Commonly referred to as...

Leveraging information from secondary endpoints to enhance dynamic borrowing across subpopulations.

Randomized trials seek efficient treatment effect estimation within target populations, yet scientific interest often also centers on subpopulations. Although there are typically too few subjects within each subpopulation to efficiently estimate these subpopulation treatment effects, one can gain precision by borrowing strength across subpopulations, as is the case in a basket trial. While dynamic borrowing has been proposed as an efficient approach to estimating subpopulation treatment effects on primary endpoints, additional efficiency could be gained by leveraging the information found in secondary endpoints. We propose a multisource exchangeability model (MEM) that incorporates secondary endpoints to more efficiently assess subpopulation exchangeability. Across simulation studies, our proposed model almost uniformly reduces the mean squared error when compared to the standard MEM that only considers data from the primary endpoint by gaining efficiency when subpopulations respond similarly to the treatment and reducing the magnitude of bias when the subpopulations are heterogeneous. We illustrate our model's feasibility using data from a recently completed trial of very low nicotine content cigarettes to estimate the effect on abstinence from smoking within three priority subpopulations. Our proposed model led to increases in the effective sample size two to four times greater than under the standard MEM.

Numerical simulation of particles distribution of environmental tobacco smoke (ETS) and its concentration in a closed environment

Humans are frequently exposed to various chemical hazards, with smoking being a significant source of indoor air pollution. This pollution is particularly pronounced in environments such as smoking rooms, conference halls, cafes, and coffee houses. This study focuses on analyzing the concentration, distribution, and behavior of emitted particles from both mainstream and sidestream smoke in a controlled smoking room environment. A critical aspect of the research is the consideration of the thermal plume generated by the smoker's body, particularly around the breathing zone, which plays a crucial role in the dispersion and inhalation of pollutants. To conduct this analysis, a computational fluid dynamics approach was employed, incorporating a displacement ventilation (DV) system integrated with a detailed surface mesh model of a standing manikin. A Lagrangian approach was utilized to track the particle paths, considering factors such as particle size, density, and initial velocity. This approach was complemented by an Eulerian method to simulate the complex airflow patterns within the smoking room, accounting for turbulent flow and temperature variations. The integration of these methods provides a comprehensive understanding of both the macroscopic and microscopic behaviors of smoke particles. The motion equations governing the particles incorporated several forces, including inertial drag force, viscous drag force, buoyancy force, and gravitational force. Additionally, the study examined the interaction between thermal plumes and smoke particles, particularly how temperature gradients around the body affect particle dispersion and concentration. The study meticulously evaluated the distribution and volume average of respirable suspended particles (RSPs) and nicotine by analyzing a plane opposite to the breathing zone of both heated and unheated manikins. It was observed that the thermal plume generated by the temperature gradient around the body could significantly alter the flow field of both sidestream and mainstream smoke between puff periods. The simulation results demonstrated that the thermal plume increased the concentration of RSPs in the breathing zone, highlighting a critical exposure pathway for smokers and nonsmokers alike. A significant increase of approximately 70% in the nicotine concentration is due to the thermal plume. The concentration of nicotine peaks at approximately 0.003 mg/m3 by the third second in smoker#1's (6 smokers' position) breathing zone. Specific configurations of the DV system showed varying efficiencies in reducing pollutant concentrations, emphasizing the need for targeted ventilation strategies. In a chamber with six smokers, researchers found that the time required for suspended particles to reach a cleaning ratio, considering the dynamics of particle movement due to smoking activity, was approximately 184 s per puff.

Assessment of human abuse potential of an unflavored, sucralose-sweetened electronic cigarette in combustible cigarette smokers.

Despite the popularity of electronic cigarettes (ECIGs), limited research has examined the role of sweeteners, independent of other flavors, in shaping ECIG human abuse potential (HAP). This study examined the effects of sucralose and nicotine in unflavored ECIG liquid solutions to provide a basic understanding of the effects of sweeteners on ECIG HAP compared to combustible cigarettes. Individuals who smoked cigarettes daily (N = 14) completed five within-subject, Latin-square ordered study sessions that differed by product used: (a) own-brand combustible cigarettes (OB), (b) 0 mg/mL nicotine, unsweetened liquid, (c) 0 mg/mL nicotine, sucralose-sweetened liquid, (d) 15 mg/mL nicotine, unsweetened liquid, and (e) 15 mg/mL nicotine, sucralose-sweetened liquid. Participants completed subjective questionnaires and behavioral tasks following a 10-puff directed use bout during which puff topography was measured, and blood was sampled for later measurement of plasma nicotine concentration. On average, the OB condition had a greater increase in plasma nicotine concentration and produced more pronounced subjective effects compared to the ECIG conditions. The 15 mg/mL nicotine ECIGs delivered significantly more nicotine and produced greater drug effects and reductions in tobacco abstinence symptoms than the 0 mg/mL nicotine ECIGs. Sucralose-containing solutions increased ECIG product appeal, puff duration, and puff volume during the 10-puff directed bout. Findings revealed greater HAP for OB cigarettes relative to all ECIGs tested and suggest that adding sucralose and nicotine elevates ECIG HAP via different mechanisms; sucralose appears to influence HAP through product appeal, while nicotine influences HAP through drug effects and tobacco/nicotine abstinence symptom suppression. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Effect of nicotine mouth spray on urges to vape: A randomized, placebo-controlled, pharmacodynamic clinical trial in exclusive e-cigarette users.

To determine whether nicotine mouth spray provides rapid and prolonged relief of urges to vape and measure the steady-state plasma nicotine levels during vaping and ad libitum mouth spray usage in e-cigarette users. Randomized, parallel group, double-blind trial. Single site at Hammersmith Medicines Research Ltd (HMR), London, UK. 216 (25.9% females, average age 27.6±7.63 [standard deviation, SD]) exclusive vapers who used their e-cigarette within 30 minutes of waking up and had vaped about 2years on average. Two sprays of 1mg nicotine mouth spray (Nicorette QuickMist Freshmint, n = 109), or placebo (identical in appearance and presentation, n = 107). Urge to vape was rated on a 100 mm visual analogue scale before and repeatedly for 2hours after administration. The primary outcome measured average change from baseline in urges to vape ratings during the first hour. Nicotine mouth spray achieved statistically significantly greater reductions in urges to vape than placebo from the first assessment point at 30 seconds to 1hour, when the estimated mean treatment difference was 11.90 mm (95% confidence interval [CI] = 6.86-16.95, P < 0.001). The integrated urge to vape over 11 hours ad libitum usage showed a statistically significant benefit compared with placebo (2.00 [0.88 SD] vs 2.51 [0.84 SD], P< 0.001). Mean steady-state plasma nicotine concentrations were lower after nicotine mouth spray usage compared with vaping (6.22 [4.70 SD] ng/ml vs 9.91 [7.59 SD] ng/ml, respectively). Adverse events were more commonly reported in the nicotine mouth spray group and were mostly mild. Among regular e-cigarette users, nicotine mouth spray provided statistically significant and fast relief of urges to vape one hour after dosing. Nicotine mouth spray showed statistically significant reductions in urges to vape as soon as 30 seconds and up to 2hours after dosing compared with placebo, and nicotine mouth spray was well-tolerated and safe.

Vaping and Orthopedic Surgery: Perioperative Management

The growing use of electronic cigarettes (ECs) as a perceived safer alternative to traditional combustible smoking has significant implications for orthopedic surgery patients. Surgeons need to recognize the harms and risks associated with ECs beyond their nicotine content. EC aerosols contain cytotoxic elements, including harmful chemicals, carcinogens, heavy metals, and flavoring agents. They can induce oxidative stress, resulting from an imbalance between cell antioxidant defense and reactive oxygen species (ROS). These effects can compromise bone repair, particularly with skeletal system disorders. Furthermore, ECs’ impact on wound healing and surgical site infection (SSI) have been well-documented. Smoking can reduce the inflammatory healing response, impair oxidative bacterial killing mechanisms, delay the proliferation healing response, and alter collagen metabolism. Some surgical practices remain unchanged despite physicians’ efforts to inquire about EC use. Most orthopedic surgeons do not delay surgery due to nicotine consumption, and urine tests for nicotine are rarely used. However, preoperative smoking cessation interventions offer a unique opportunity to help patients stop consuming nicotine. Therefore, it is crucial for orthopedic surgeons to understand the harms of ECs and communicate the associated risks to patients.

Performance and Evaluation of Hanski 227 Oriental Tobacco in Dak Lak Region, Vietnam from 2022 - 2024

With the results of selecting Oriental tobacco varieties suitable for natural conditions in Vietnam, with potential for raw material quality and raw material production capacity in Vietnam, from 6 oriental tobacco varieties originating from Bulgaria, the Tobacco Institute has been testing in Ninh Thuan province from 2019 to 2021, and Dak Lak from 2021 to 2022. The results of the trial planting show that oriental tobacco varieties are good growth, and are quite suitable for the soil and climate conditions in Ninh Thuan and Dak Lak provinces, and have selected 2 the best oriental tobacco varieties as Basma 16 and Hanski 227. In which, Hanski 227 variety is evaluated to have outstanding prospects due to its good growth ability, high yield, characteristic aroma and good smoking properties. The Hanski 227 variety has less harvested leaves, larger leaf size and mass than Basma 16 variety, so the labor costs for cultivation, harvesting and preliminary processing are lower. To evaluate the ability to expand the oriental area in Vietnam, we continue to trial planting the Hanski 227 oriental variety in Dak Lak in 2023 - 2024, with a fertilizer level and a planting density corresponding to 50N + 30P2O5 + 80K2O (N: NH4NO3, P: (Ca(H2PO4)2 and K: K2SO4) and 110,000 plants/ha. The experimental trial results show the Hanski 227 variety has good growth, high yield, and good quality, with yield fluctuating 1.52 - 1.66 tons/ha, nicotine content: 0.81 - 1.38%, and reducing sugar content: 8.9 - 12.1%, and the oriental material has a characteristic aroma and good smoking properties. Based on the trial results shows that the quality of Hanski 227 grown in Dak Lak are the same the oriental tobacco importing from Bulgaria, Türkiye and Greece. Therefore, the Dak Lak province is the most suitbale region for producing good quality oriental tobacco in Vietnam compared to Ninh Thuan region. Because materials in Ninh Thuan has the high clorua content reducing material quality. In 2025, we continue to grow the Hanski 227 oriental tobacco variety in Dak Lak region on a large area and complete the preliminary processing process, with the goal of producing Oriental tobacco raw materials domestically, with appropriate production costs.

Patterns and perceptions of vaping among adults living in social housing: a representative survey in Great Britain, 2023

BackgroundVaping products are effective for helping people to stop smoking and may therefore offer a potential means to reduce high rates of smoking in socioeconomically disadvantaged groups. This study aimed to examine current patterns and perceptions of vaping among people living in social housing in Great Britain compared with those living in other housing types.MethodsData were from the Smoking Toolkit Study; a nationally-representative survey conducted in 2023 (n = 23,245). Logistic regression tested cross-sectional associations between living in social (vs. other) housing and current vaping among adults; vaping frequency, device type, nicotine concentration, and source of purchase among current vapers; use of vaping products as a smoking cessation aid among past-year smokers who tried to quit; and harm perceptions of vaping products relative to cigarettes among current smokers.ResultsCurrent vaping prevalence was twice as high among adults living in social housing (19.4%) compared with those in other housing types (10.4%; OR = 2.07, 95%CI = 1.84–2.33). This was partly explained by differences in sociodemographic characteristics and smoking status; after adjustment, the odds of being a current vaper were 33% higher (ORadj=1.33, 95%CI = 1.14–1.54). Among vapers, there were no notable differences by housing tenure in vaping frequency, main device type used, usual nicotine concentration, usual source of purchase, or use as a smoking cessation aid. However, current smokers living in social housing were more likely to think vaping is more harmful than cigarettes (31.6% vs. 21.8%; ORadj=1.61, 95%CI = 1.30–1.99).ConclusionsIn Great Britain, adults who live in social housing are more likely to vape than those who live in other housing types, even after accounting for their younger age and higher smoking rates. However, misperceptions about the relative harms of vaping products and tobacco are common among smokers living in social housing. Interventions addressing these misperceptions could help encourage more people living in social housing to switch from smoking to vaping and reduce smoking-related health inequalities.Pre-registrationThe study protocol and analysis plan were pre-registered on Open Science Framework (https://osf.io/n3mvs/).