E-cigarette Groups Research Articles

Stopping use of E-cigarettes and smoking combustible cigarettes: findings from a large longitudinal digital smoking cessation intervention study in the United States.

Digital interventions have been widely implemented to promote tobacco cessation. However, implementations of these interventions have not yet considered how participants' e-cigarette use may influence their quitting outcomes. We explored the association of e-cigarette use and quitting smoking within the context of a study testing a digital tobacco cessation intervention among individuals in the United States who were 18 years and older, smoked combustible cigarettes, and enrolled in the intervention between August 2017 and March 2019. We identified four e-cigarette user groups (n = 990) based on the participants' baseline and six-month e-cigarette use (non-users, n = 621; recently started users, n = 60; sustained users, n = 187; recently stopped users, n = 122). A multiple logistic regression was used to estimate the adjusted odds ratios (AOR) of six-month quit outcome and the e-cigarette user groups. Compared to e-cigarette non-users, the odds of quitting smoking were significantly higher among recently stopped users (AOR = 1.68, 95% CI [1.06, 2.67], p = 0.03). Participants who were most successful at quitting combustible cigarettes also stopped using e-cigarettes at follow-up, although many sustained using both products. Findings suggest that digital tobacco cessation interventions may carefully consider how to promote e-cigarette use cessation among participants who successfully quit smoking. ClinicalTrials.gov identifier NCT03224520 (July 21, 2017).

Abstract 1142: Effect Of Chronic E-cigarette Nicotine Exposure On A Mouse Model Of Hind-limb Ischemia

Background: The rise of e-cigarette use in the United States has been rapid, yet its impact on peripheral artery disease (PAD) remains largely unexplored. This study investigates the relationship between e-cigarette use and PAD using a mouse ischemic hindlimb model. Method: Mice aged 6-8 weeks were divided into four groups. Three groups inhaled e-cigarette vapor continuously for 14, 20, or 28 days prior, and for 28 days after hindlimb ischemia (HLI) surgery, using an InExpose system (Figure 1). A control group was exposed to room air (RA) before and after HLI. Laser-Doppler perfusion imaging tracked hindlimb blood flow, and functional deficits were assessed using the modified ischemia scale. Figure 1: Methodology Results: Blood perfusion in the ischemic hindlimb of the e-cigarette groups (EC-14, EC-20, EC-28) was significantly lower than the non-vaping group at 21 days post-surgery. In the EC-14 group, perfusion improved after 10 days of vaping cessation (Figure 2). Additionally, there was a reduction in platelet and leukocyte counts in the e-cigarette groups compared to RA, with no difference in red blood cells. Necrosis and claw damage were observed in EC-20 and EC-28 groups but not in non-vaping mice. Figure 2: Representative images of perfusion recovery measured by LDPI. Conclusion: Chronic e-cigarette nicotine exposure impairs blood flow recovery and causes necrosis in mice with hind limb ischemia, potentially due to perturbed angiogenesis and arteriogenesis. This study highlights the detrimental effects of e-cigarette nicotine on vascular health.

The Impact of Three Alternate Nicotine-Delivery Products on Combusted Cigarette Use: A Randomized Controlled Trial.

Smoking cessation is a critical public health goal. This study examined the ability of e-cigarettes and very low nicotine cigarettes (VLNCs) to serve as cigarette substitutes and whether a substitution was supported by steady-state nicotine from a nicotine patch. This mixed design experiment with study product (between-subjects) and patch (within-subjects) factors recruited adults smoking cigarettes daily and not motivated to quit (N = 160). Participants were randomized to 4 weeks of: (1) VLNCs; (2) e-cigarettes; or (3) no product. During two switch weeks, one with an active nicotine patch and one with a placebo patch (in a double-blind and counterbalanced fashion), participants were told to not smoke their usual cigarettes. During the switch weeks, participants in the VLNC (M = 2.88, SD = .65) and e-cigarette (M = 3.20, SD = .63) groups smoked fewer of their own cigarettes per day than did no product group participants who continued to smoke their own cigarettes (M = 5.48, SD = .63); the VLNC and e-cigarette groups did not differ. There was no main effect of patch on mean usual brand cigarettes smoked per day (P = .09), nor was there a product × patch interaction (P = .51). There was a product × age interaction (P = .03); smokers aged 60-74 smoked more of their own cigarettes if they were randomized to no product group. VLNCs and e-cigarettes appear to reduce usual brand cigarettes smoked per day to a similar degree, regardless of patch condition. Behavioral factors, in addition to nicotine dependence, play an important role in sustaining smoking behavior and need to be addressed in smoking cessation treatment. This study found that behavioral substitutes for cigarettes, whether or not they delivered nicotine, reduced the number of usual brand cigarettes smoked. Specifically, both e-cigarettes delivering nicotine and VLNCs equally reduce usual brand cigarettes smoked among adults who smoke daily and do not want to quit.

Switching from tobacco cigarettes in very early pregnancy: The effects of in utero e-cigarette exposure on mouse offspring neurodevelopment and behaviour

IntroductionElectronic cigarettes (e-cigarettes) are often perceived to be safer than smoking, which has led to some women switching to e-cigarettes during pregnancy. However, the effects of switching from smoking to e-cigarettes on both pregnancy outcomes and the foetus are largely unknown. This study aimed to investigate the effects of switching from tobacco smoking to e-cigarette use in very early pregnancy on birth outcomes, neurodevelopment and behaviour of the offspring. MethodsFemale BALB/c mice were exposed to cigarette smoke for up to two weeks before being mated. Mated dams were then allocated to one of four treatment groups: (i) continued exposure to cigarette smoke (ii) exposure to e-cigarette aerosol with nicotine, (iii) or without nicotine, or (iv) medical air. Pregnant mice were exposed for 2 h per day for the duration of pregnancy. Gestational outcomes including litter size and sex ratio were assessed, in addition to early-life markers of physical- and neuro- development. At 8 weeks of age, motor coordination, anxiety, locomotion, memory and learning of the adult offspring were assessed. ResultsGestational outcomes and early markers of physical- and neuro- development were unaffected by in utero exposure, as well as locomotion, anxiety-like behaviour, and object recognition memory during adulthood. However, both e-cigarette groups displayed increased spatial recognition memory compared to air exposed controls. Maternal exposure to nicotine containing e-cigarette aerosol was found to increase offspring bodyweight and impair motor skill learning. ConclusionsThese results suggest there may be some benefits as well as negative effects of switching to e-cigarettes in early pregnancy.

Specific biomarker comparison in current smokers, e-cigarette users, and non-smokers

IntroductionThis study aims to address the existing gap in the literature, while adding evidence, by comparing tobacco-specific biomarkers (cotinine and nitrosamines: NNK, NNAL, NNN), and other biomarkers of e-cigarette use (humectants: glycerol, 1,2-PD, 1,3-PD) according to five study groups. MethodsA pooling analysis including two different studies was conducted. In both analyses, we took saliva samples from smokers (n = 409) and non-smokers (n = 154), dual tobacco and e-cig users (n = 92), exclusive e-cig user with nicotine (n = 158), and exclusive e-cig users without nicotine (n = 38). We analyzed and compared the geometric means (GM) and geometric standard deviations (GSD) of the concentration of tobacco-specific biomarkers, and e-cigarette biomarkers among groups. We used log-linear models adjusted for sex and age to model the change percentage and their 95% confidence intervals. ResultsCotinine was significantly higher in nicotine consumers and in e-cigarette users without nicotine when compared to non-smokers. TSNAs were generally significantly lower in non-smokers and higher in nicotine consumers. NNN and NNAL were lower in e-cigarette users with nicotine comparted to smokers, and NNN was higher in e-cigarette users without nicotine when compared to non-smokers. No differences were found in humectant biomarkers between e-cigarette groups. ConclusionsAlthough there was a reduction in TSNAs in e-cigarette exclusive users compared to smokers, and a reduction of cotinine concentrations in e-cigarette exclusive users without nicotine compared to smokers, there are still high levels of these biomarkers when compared to non-smokers, which may be a clue towards the harmful effect of e-cigarettes.

Ocular surface assessment and morphological alterations in meibomian glands with non-contact meibography in electronic cigarette smokers.

The study aimed to evaluate the ocular surface and meibomian gland morphology in electronic cigarette (e-cigarette) smokers. The upper and lower eyelids of 25 male e-cigarette smokers and 25 healthy male non-smoker patients were evaluated using Sirius meibography. Meibomian glands loss was automatically calculated using Phoenix meibography imaging software module, with the result obtained as percentage loss. Ocular Surface Disease Index (OSDI) questionnaire, tear breakup time test, and Schirmer II test were administered and performed in all cases. The mean e-cigarette smoking duration was 4.9 ± 0.9 (range, 3.4-7) years. While the mean Schirmer II test value was 9.16 ± 2.09 mm in e-cigarette group, it was 11.20 ± 2.14 mm in control group (p=0.003). Mean tear breakup time was 6.96 ± 2.31 seconds in e-cigarette group and 9.84 ± 2.13 seconds in control group (p=0.002). The mean OSDI value was 28.60 ± 6.54 and 15.16 ± 7.23 in e-cigarette and control groups, respectively (p<0.001). In Sirius meibography, the average loss for the upper eyelid was 23.08% ± 6.55% in e-cigarette group and 17.60% ± 4.94% in control group (p=0.002), and the average loss for the lower eyelid was 27.84% ± 5.98% and 18.44% ± 5.91%, respectively (p<0.001). Additionally, a significant positive correlation was identified between the loss rates for both upper and lower eyelid meibography with e-cigarette smoking duration (r=0.348, p<0.013 and r=0.550, p<0.001, respectively). Long-term e-cigarette smoking causes damage to the meibomian glands; therefore, meibomian gland damage should be considered in ocular surface disorders due to e-ci-garette smoking.

How Age and E-cigarette Use Status Interact to Influence E-cigarette Ad Perceptions

Background: The prevalence of e-cigarette use among young people remains high. Young people are susceptible to e-cigarette advertising, although potential heterogeneity in perceptions of e-cigarette ads with respect to age and e-cigarette use history remains unexplored. We aimed to assess differences in perceptions of e-cigarette ads and product use intention, by age and e-cigarette use status. Methods: Participants from an online convenience sample (N = 497, M age=31.9) viewed two randomly selected e-cigarette ads and reported their perceptions of the ads and product use intention. We used mixed effects linear regression models to estimate associations between age group (18–20 years, 21–25 years, 26+ years), e-cigarette use status (never, former, and current use), and their interaction effects, on outcomes related to perceptions of ads and use intention. Models controlled for demographics and other tobacco use. Results: Current e-cigarette users (vs. never users) and participants who were 26+ years old (vs. 18–20 years old) had greater liking of the ads, perceived ad relevance, and perceived ad effectiveness. Among current e-cigarette users, participants who were 26+ years old (vs. 18–20 years old) had lower use intention. Conclusion: The effect of e-cigarette ad exposures on perceptions of the ad and use intention is heterogeneous with respect to age group and e-cigarette use history. While ads appealed more to adults who were 26+ years old across e-cigarette use groups, current e-cigarette users who were 18–20 years old demonstrated high use intention following ad exposure, suggesting a need for marketing interventions to mitigate continued e-cigarette use among young people.

Differences in intention to use flavored oral nicotine products among young adult e-cigarette users and non-users

New oral nicotine products (ONPs; nicotine pouches, gums, lozenges, and gummies), which are regulated as nonmedicinal tobacco products in the U.S., have flavors and other characteristics that previously attracted young adults to e-cigarettes. Whether young adults’ interest in ONPs differs by e-cigarette use status and quit-vaping motivation is unknown but important for understanding the possible health impact of ONPs. It is particularly important to study if nonmedicinal ONPs attract e-cigarette users interested in quitting vaping, given that nicotine replacement (NRT) therapy uptake in young adults is low. In this study, ONP non-users (ages: 20–24) from California viewed digital images of 5 flavored ONPs (4 nonmedicinal and one NRT gum product) and reported intention to use each ONP (0–100 score). Main and interactive effects of Group (past-6-month e-cigarette non-users [n = 1,1388], e-cigarette users unmotivated to quit vaping [n = 168], and e-cigarette users motivated to quit vaping [n = 99]) and ONP type (nonmedicinal gum, nonmedicinal lozenge, gummy, pouch, and NRT gum) on use intention were tested. For each nonmedicinal ONP, use intention was higher in both e-cigarette user groups than non-users (ds = 0.47–0.59; Ps < 0.001), but did not differ between e-cigarette users with and without quit-vaping motivation (Ps ≥ 0.31). A Group × ONP type interaction was found, whereby higher use intention for e-cigarette users with vs without quit motivation was present for only gum NRT (Cohens d = 0.17; P =.01). Among young adults, e-cigarette users might be more inclined than e-cigarette non-users to try nonmedicinal ONPs regardless of quit-vaping motivation.

Effect of Exposure to E-Cigarette Vapor and Cigarette Smoke on Seminiferous Tubules Diameter and Spermatozoa Quality of Mice (Mus musculus)

This study aims to compare the quality of spermatozoa (motility and viability) and the diameter ofseminiferous tubules of mice (Mus musculus) by exposing to cigarette smoke and electronic cigarette vapor.This study used 28 male mice divided into 7 groups. Treatment group C was exposed to air, group A1given 1 cigarette/day, group A2 given 2 cigarettes/day, group A3 given 3 cigarettes/day, group B1 given0.7 ml/day, group B2 given 1,3 ml/day, group B3 given 2 ml/day. The treatments were carried out for 36days. The result of this study showed significant difference (p&lt;0.05) in spermatozoa motility percentagebetween C, A1, A2, A3, B3, but in B1 showed no significant difference (p&gt;0,05) with B2. Spermatozoaviability percentage showed significant difference (p&lt;0.05) between control and all treatment groups.Diameter of seminiferous tubules showed significant difference (p&lt;0,05) between C, A1, A2, A3, B1, B3, butin B2 showed no significant difference (p&gt;0.05) with A1 and A2. In conclusion, this study showed that bothcigarette smoke and e-cigarette vapor exposure can decrease the quality of spermatozoa and diameter ofseminiferous tubules. E-cigarette vapor exposure groups showed better quality of spermatozoa and greaterdiameter of seminiferous tubules compared to cigarette smoke exposure groups.

Abstract P171: Effects Of Covid-19 On Cardiometabolic Outcomes (diabetes, Hypertension, And Obesity)

Background: Prior studies have examined cardiometabolic outcomes, but literature on the effects of the COVID-19 pandemic on cardiometabolic outcomes (diabetes, hypertension, and obesity) among the general U.S. population is sparse. Objective: To examine differences in the prevalence of cardiometabolic outcomes by sexual identity, cigarette smoking, e-cigarette use, and anxiety/depression before and during the COVID-19 pandemic. Hypothesis: We assessed the hypothesis that there will be statistically significant differences in cardiometabolic outcomes between sexual minority and heterosexual individuals before and during the COVID-19 pandemic. Methods: Data were drawn from the 2019 (N= 5,359) and 2020 (N= 3,830) Health Information National Trends Surveys on adults. We conducted weighted descriptive and multivariable logistic regression analyses to assess the study objective. Results: During the pandemic, compared to before the pandemic, the prevalence of diabetes (18.10% vs. 17.28%) and obesity (34.68% vs. 34.18%) has increased, while the prevalence has decreased for hypertension (36.38% vs. 36.36%). In general, the prevalence of cardiometabolic outcomes was higher during the pandemic (56.09%) than before the pandemic (54.96%). The prevalence has also increased for sexual minority (53.50% vs. 51.12%) and heterosexual (56.45% vs. 54.96%) individuals, former (67.91% vs. 63.86%) and current (59.39% vs. 55.43%) cigarette smokers, current e-cigarette users (37.24% vs. 28.66%), and individuals with mild (59.62% vs. 55.43%) or moderate (61.98% vs. 57.83%) anxiety/depression symptoms. Contrary to our hypothesis, there were no statistically significant differences in the odds of cardiometabolic outcomes between sexual minority and heterosexual individuals before and during the pandemic. Former smokers, compared to never smokers, had higher odds of cardiometabolic outcomes (AOR= 1.38, 95% CI= 1.01, 1.87 vs. AOR= 1.57, 95% CI= 1.10, 2.25) before and during the pandemic, respectively. The odds were lower for current e-cigarette users (AOR= 0.44, 95% CI= 0.23, 0.85) compared to never e-cigarette users before the pandemic, but no significant differences were found in e-cigarette use groups during the pandemic. People with mild anxiety/depression symptoms (before: AOR= 1.52, 95% CI= 1.06, 2.19 vs. during: AOR= 1.55, 95% CI= 1.01, 2.38) relative to those with no anxiety/depression symptoms had higher odds of cardiometabolic outcomes, whereas the odds were higher for those with severe anxiety/depression symptoms (AOR= 2.44, 95% CI= 1.27, 4.69) before the pandemic but not during the pandemic. Conclusion: Positive associations were noted between tobacco use and mental health and the risks of cardiometabolic outcomes during the COVID-19 pandemic.

Adolescents and Young Adults Who Vape or Are Susceptible to Vaping: Characteristics, Product Preferences, and Beliefs

Introduction This study examined differences among current vapers, those susceptible to vaping, and those non-susceptible to vaping among adolescents and young adults (AYAs) in the U.S. We sought to understand vaping-related characteristics, preferences, and beliefs across these populations to inform prevention efforts. Methods: Participants were N=543 adolescents and N=557 young adults recruited in mid-2019 in the U.S. In two separate cross-sectional surveys, we assessed vaping preferences, tobacco product use, and both health harm and addiction risk beliefs about vaping. We ran separate multivariate logistic regressions to assess differences in risk beliefs across the three distinct e-cigarette groups among AYAs. Results: A majority of AYAs were either current vapers (adolescents: 32%, young adults: 36%) or susceptible to vaping (adolescents: 34%, young adults: 24%). In both samples, pod-based devices were the most common device type used, and fruit and mint/menthol were the most commonly used flavors. In multivariate analyses, adolescent (p<.05) and young adult (p<.05) current vapers both had lower risk beliefs about the health harms of vaping compared to those susceptible to vaping. Susceptible adolescents also had lower health harm risk beliefs compared to those who were non-susceptible (p<.05). Addiction risk beliefs seldom predicted use or susceptibility in multivariate analyses, with only susceptible young adults having lower addiction beliefs than those non-susceptible (p<.05). Conclusion: Results from this study highlight the role of health harm risk beliefs among AYA vapers and those susceptible to vaping. Prevention efforts should examine the most potent ways to communicate vaping health harms to discourage AYA vaping.

Electronic-Cigarette Use Alters Nasal Mucosal Immune Response to Live-attenuated Influenza Virus. A Clinical Trial.

Inhalation of tobacco smoke has been linked to increased risk of viral infection, such as influenza. Inhalation of electronic-cigarette (e-cigarette) aerosol has also recently been linked to immune suppression within the respiratory tract, specifically the nasal mucosa. We propose that changes in the nasal mucosal immune response modify antiviral host-defense responses in e-cigarette users. Nonsmokers, cigarette smokers, and e-cigarette users were inoculated with live-attenuated influenza virus (LAIV) to safely examine the innate immune response to influenza infection. Before and after LAIV inoculation, we collected nasal epithelial-lining fluid, nasal lavage fluid, nasal-scrape biopsy specimens, urine, and blood. Endpoints examined include cytokines and chemokines, influenza-specific IgA, immune-gene expression, and markers of viral load. Statistical analysis included primary comparisons of cigarette and e-cigarette groups with nonsmokers, as well as secondary analysis of demographic factors as potential modifiers. Markers of viral load did not differ among the three groups. Nasal-lavage-fluid anti-LAIV IgA levels increased in nonsmokers after LAIV inoculation but did not increase in e-cigarette users and cigarette smokers. LAIV-induced gene-expression changes in nasal biopsy specimens differed in cigarette smokers and e-cigarette users as compared with nonsmokers, with a greater number of genes changed in e-cigarette users, mostly resulting in decreased expression. The top downregulated genes in cigarette smokers were SMPD3, NOS2A, and KLRB1, and the top downregulated genes in e-cigarette users were MR1, NT5E, and HRAS. Similarly, LAIV-induced cytokine levels in nasal epithelial-lining fluid differed among the three groups, including decreased antiviral host-defense mediators (IFNγ, IL6, and IL12p40). We also detected that sex interacted with tobacco-product exposure to modify LAIV-induced immune-gene expression. Our results demonstrate that e-cigarette use altered nasal LAIV-induced immune responses, including gene expression, cytokine and chemokine release, and LAIV-specific IgA levels. Together, these data suggest that e-cigarette use induces changes in the nasal mucosa that are consistent with the potential for altered respiratory antiviral host-defense function.Clinical trial registered with www.clinicaltrials.gov (NCT 02019745).

Electronic cigarette exposure on insulin sensitivity of ApoE gene knockout mice.

INTRODUCTIONThe current study aimed to investigate the effects of electronic cigarettes on insulin sensibility in ApoE gene knockout mice.METHODSIn total, 48 male ApoE gene knockout mice were randomly divided into four exposure groups: 1) electronic cigarette (e-cigarette) containing 12 mg/mL of nicotine, 2) e-cigarette without nicotine (0mg), 3) traditional cigarette (cigarette), and 4) fresh air (control). The first three groups were exposed to the associated smoke for 18 weeks. The body weight was recorded regularly in the four groups. After the last exposure, the concentrations of lipids, hs-CRP and TNF-α in serum were detected and the effect of electronic cigarettes on insulin tolerance was measured.RESULTSThe levels of serum lipid, hs-CRP and TNF-α in the e-cigarette, 0mg and cigarette groups were significantly increased compared with those in the control group (p<0.05). Also, the insulin tolerance in the e-cigarette, 0mg and cigarette groups was significantly decreased compared to that in the control group (p<0.05).CONCLUSIONSElectronic cigarettes showed comparable effects to traditional cigarettes in influencing the metabolic functions in ApoE gene knockout mice.

A Randomized Controlled Trial Evaluating the Efficacy of E-Cigarette Use for Smoking Cessation in the General Population: E3 Trial Design

BackgroundSmoking cessation improves morbidity and mortality among smokers who achieve long-term abstinence. Many smokers are using electronic cigarettes (e-cigarettes) to attempt to quit, despite a lack of data concerning their efficacy and safety for smoking cessation. MethodsThe Evaluating the Efficacy of E-Cigarette use for Smoking Cessation (E3) trial is a multicentre randomized controlled trial (NCT02417467) with a treatment period of 12 weeks and follow-up of 52 weeks. A total of 376 participants motivated to quit smoking were enrolled at 17 Canadian centres (November 2016 to September 2019). Participants were randomized (1:1:1) to 1 of 3 treatment arms: nicotine e-cigarettes, non-nicotine e-cigarettes, or no e-cigarettes. All groups received individual counselling. Treatment allocation was double-blind for the e-cigarette groups. The trial includes follow-ups by telephone at weeks 1, 2, 8, and 18, and clinic visits at weeks 4, 12, 24, and 52. The primary endpoint is to compare nicotine e-cigarettes to counselling alone in terms of biochemically validated point-prevalence smoking abstinence at 12 weeks; the primary endpoint was changed from 52 weeks after early termination (77% of targeted enrollment) due to a prolonged delay in e-cigarette manufacturing. The secondary objectives are to examine the efficacy of nicotine and non-nicotine e-cigarettes in terms of point-prevalence and continuous smoking abstinence, and reduction in daily cigarette consumption at all follow-ups through week 52, and to describe the occurrence of adverse events. ConclusionThe E3 trial will provide regulators, health care professionals, and smokers with important information about the efficacy and safety of e-cigarettes for smoking cessation.

Electronic cigarettes: not an advantageous alternative to conventional smoking in asthma

Background Electronic cigarettes (e-cigarettes) have become increasingly popular as an alternative to cigarette smoking, but little is known about their potential adverse effects on airway inflammatory cells and lung function. Objectives This study aimed to differentiate among nonsmoker asthmatics, asthmatics smokers who use conventional cigarettes, and asthmatics smokers who consume e-cigarettes regarding asthma control test, lung function, blood eosinophils, and airway immunoinflammatory phenotype. Patients and methods A total of 130 asthmatic patients were recruited from the Outpatient Clinic of Chest Department of the October 6 University Hospital. Participating individuals were classified into three main categories: nonsmokers, current conventional cigarette smokers, and e-cigarette smokers. All included participants underwent both spirometry and differential cell count in their induced sputum. A venous blood sample was withdrawn for eosinophil counts, which were obtained from the automated complete blood counts. Results There were significant differences between the nonsmoker group and both conventional and e-cigarette smoker groups regarding spirometry and distribution of sputum cell subtypes. Conclusion This study deduced that asthmatic smoker patients who smoke e-cigarettes develop mixed sputum subtype, with no disparity with conventional smokers regarding the pulmonary function and asthma control. These data challenge the concept that e-cigarettes are a healthier alternative to conventional cigarettes.

Electronic Cigarette Harm and Benefit Perceptions and Use Among Youth

The purpose of this study is to examine adolescent perceptions of harms and benefits associated with electronic cigarettes (e-cigarettes) and their associations with use. Data from the 2016 Florida Youth Tobacco Survey were analyzed in 2017. Participants who were in high school aged 14-17 years were included (n=22,884). Logistic regression analyses were used to compare e-cigarette use groups on perceived harms and benefits of e-cigarettes. Less than one half of the sample reported that e-cigarettes are harmful to their health and less than two thirds reported that individuals can get addicted to e-cigarettes. Compared with committed never users, susceptible never users and all e-cigarette use groups were less likely to report that e-cigarettes were harmful to their health, people can get addicted to e-cigarettes, and that smoke from others' e-cigarettes were harmful. Furthermore, susceptible never users and all use groups were more likely to report that it would be easy to quit using e-cigarettes than committed never users. Susceptible never users and all use groups were also more likely to perceive benefits of e-cigarette use including having more friends, looking cool or fitting in, feeling more comfortable in social situations, and stress relief compared with committed never users. Youth who are susceptible to use, currently use, or have used e-cigarettes are less likely to report harms and more likely to perceive benefits associated with e-cigarette use compared with committed never users. Addressing harm and benefit perceptions may be important for interventions designed to reduce e-cigarette use among adolescents.

Maternal E-Cigarette Exposure Results in Cognitive and Epigenetic Alterations in Offspring in a Mouse Model.

Electronic cigarette (e-cigarette) use is on the rise worldwide and is particularly attractive to young people and as a smoking substitute by pregnant woman. There is a perception in pregnant women and women of child-bearing age that the use of e-cigarettes (vaping) is safer than smoking tobacco cigarettes during pregnancy. However, there is little evidence to support this perception. Here, we examined the offspring from mouse dams that had been exposed during and after pregnancy to ambient air (sham) ( n = 8), e-cigarette aerosols with nicotine ( n = 8), or e-cigarette aerosols without nicotine ( n = 8). Offspring underwent cognitive testing at 12 weeks of age and epigenetic testing of brain tissues at 1 day, 20 days, and 13 weeks after birth. The findings showed deficits in short-term memory, reduced anxiety, and hyperactivity in offspring following maternal e-cigarette exposure using the novel object recognition and elevated plus maze tests. In addition, global DNA methylation was increased in the brains of offspring soon after birth. Using a quantitative-PCR array specific to chromatin modification enzymes on genomic DNA and histones,13 key genes were identified to be significantly altered in the offspring brains from the e-cigarette groups compared to the nonexposed groups. The changes to genes Aurka, Aurkb, Aurkc, Kdm5c, Kdm6b, Dnmt3a, Dnmt3b, and Atf2, all associated with modulating neurological activity, were validated using RT-qPCR. In conclusion, in a mouse model, maternal exposure to e-cigarette aerosols resulted in both cognitive and epigenetic changes in offspring. This suggests that the use of e-cigarettes during pregnancy may have hitherto undetected neurological consequences on newborns.

Reductions in biomarkers of exposure, impacts on smoking urge and assessment of product use and tolerability in adult smokers following partial or complete substitution of cigarettes with electronic cigarettes.

BackgroundElectronic cigarettes (e-cigarettes) are popular alternatives to conventional cigarettes among adult smokers wishing to reduce their exposure to harmful smoke constituents. However, little information exists on the relative internal exposures resulting from the exclusive or dual use of e-cigarettes.MethodsMeasurements of product use; adverse events; changes in smoking urge; and blood, urine and exhaled breath biomarkers of exposure (BoE) representing toxicants believed to contribute to smoking related diseases were made at baseline and after five days of product use in 105 clinically-confined smokers randomized into groups that partially or completely substituted their usual brand combustible cigarette with commercial e-cigarettes, or discontinued all nicotine and tobacco products.ResultsSubjects switching to e-cigarettes had significantly lower levels (29 %–95 %) of urinary BoEs after 5 days. Nicotine equivalents declined by 25 %–40 %. Dual users who substituted half of their self-reported daily cigarette consumption with e-cigarettes experienced 7 %–38 % reductions, but had increases (1 %–20 %) in nicotine equivalents. Blood nicotine biomarker levels were lower in the cessation (75 %–96 %) and e-cigarette use groups (11 %–83 %); dual users had no significant reductions. All groups experienced significant decreases in exhaled CO (27 %–89 %). Exhaled NO increases (46 %–63 %) were observed in the cessation and e-cigarette use groups; dual users had minimal changes. By Day 5, all groups had greater reductions in smoking urge compared to cessation. However, reductions were larger in the dual use group. No serious adverse events were observed.ConclusionsExposures to harmful smoke toxicants were observed to be lower in smokers who completely or partially replaced their cigarettes with e-cigarettes over five days.

Comparison between electronic cigarette refill liquid and nicotine on metabolic parameters in rats

AimsNicotine is known to promote body weight loss and to disturb glucose homeostasis and lipoprotein metabolism. Electronic cigarettes, as a substitute to nicotine, are becoming increasingly popular, although there is no evidence regarding their safety. Considering the dearth of information about e-cigarette toxicity, the present study was designed to compare nicotine alone to e-liquid with or without nicotine on metabolic parameters in Wistar rats. Main methodsFor this purpose, e-liquid with or without nicotine and nicotine alone (0.5mg/kg of body weight) were administered intra-peritoneally during 28days. Key findingsOur results show a significant decrease in food and energy intake after nicotine or e-liquid with nicotine exposure, when compared to control or e-liquid without nicotine. Analysis of lipid status identified a significant decrease in cholesterol and LDL levels in e-cigarette groups, suggesting an improvement in lipid profile. Interestingly, e-liquid without nicotine induced hyperglycemia which is negatively correlated to hepatic glycogen level, acting like nicotine alone. Furthermore, an increase in liver biomarkers was observed in all treated groups. qRT-PCR analysis showed GSK3β up-regulation in e-liquid with nicotine as well as, surprisingly, in e-liquid without nicotine exposure. In contrast, PEPCK genes were only up-regulated in e-liquid with nicotine. SignificanceWhile some features observed in rats may not be observed in human smokers, most of our data are consistent with, e-liquid per se i.e. without nicotine, not being neutral from a metabolic stand point since disrupting glucose homeostasis in rats.

E-cigarette use among Texas youth: Results from the 2014 Texas Youth Tobacco Survey

IntroductionSeveral characteristics of electronic cigarettes (e-cigarettes), such as candy flavorings, are worrisome for attracting youth. The current cross-sectional study uses data on e-cigarette use from the 2014 Texas Youth Tobacco Survey (TYTS), a representative statewide sample of Texas middle school and high school students. This study's aims are to determine the prevalence of e-cigarette use, including rates of concurrent use with other tobacco products among Texas youth and to describe the demographic and tobacco use differences between e-cigarette users and non-users. MethodsParticipants were 13,602 6th through 12th grade students in Texas. Descriptive statistics were generated to determine the prevalence of current and lifetime e-cigarette use and to determine the prevalence of demographic characteristics across e-cigarette usage groups. Logistic regression analyses were conducted to examine differences in demographic characteristics, cigarette use in the home, and tobacco use behaviors for e-cigarette users versus non-users. ResultsAlmost one quarter of all middle and high school students reported lifetime e-cigarette use and 14.0% were past 30-day users of these products. Current e-cigarette users were more likely to be high school students, white and male than non-current users. Both current and lifetime e-cigarette users were also more likely than their peers to use other tobacco products, although 24.2% of current e-cigarette users had never smoked conventional cigarettes, and 7.3% had never used any other type of tobacco product besides an e-cigarette. ConclusionsFindings highlight the urgency to regulate e-cigarettes as well as to include these products in tobacco prevention programs.